TY - JOUR
T1 - Influence of heart rate on FFR measurements
T2 - An experimental and clinical validation study
AU - Kwasiborski, Przemysław J.
AU - Czerwiński, Wojciech
AU - Kowalczyk, Paweł
AU - Buksińska-Lisik, Małgorzata
AU - Horszczaruk, Grzegorz
AU - Aboodi, Michael S.
AU - Derbisz, Kamil
AU - Hochul, Mariusz
AU - Janas, Adam
AU - Cwetsch, Andrzej
AU - Wąsek, Wojciech
AU - Buszman, Piotr P.
AU - Bartunek, Jozef
AU - Buszman, Paweł E.
AU - Serruys, Patrick W.
AU - Milewski, Krzysztof
N1 - Publisher Copyright:
© 2020 The Authors
PY - 2020/10/15
Y1 - 2020/10/15
N2 - Background: Functional lesion assessment in stable coronary disease is considered the gold standard. The result of fractional flow reserve (FFR) in stable coronary disease is often a decision-maker for patient qualification. Taking into account the paramount position of FFR, it is crucial to acknowledge and reduce all potential bias. Aims: In the present study, we quantified the influence of elevated HR on FFR results using a preclinical model and then validated the results in a clinical setting. Methods and results: The relationship between FFR and HR was first explored experimentally in a porcine model. A clinical validation study was conducted in patients with isolated moderate lesions in the left anterior descending artery (LAD) or right coronary artery (RCA). In both the experimental and clinical arms, FFR was measured at resting HR and with pacing at 100, 130, 160, and 180 (for pigs) beats per minute. In the porcine model and in the clinical settings, a significant correlation between FFR and HR was confirmed in the LAD (r = 0.89, p <.0001; r = 0.53, p =.00002), but not in the RCA (r = −0.19, p =.5; r = 0.14, p =.3). Post hoc analyses revealed that the FFR values in the LAD at 130/min and above tended to be significantly different from the baseline HR. Conclusions: The results of this study indicate that in an experimental setting, tachycardia might be responsible for an overestimation of FFR results in LAD lesions.
AB - Background: Functional lesion assessment in stable coronary disease is considered the gold standard. The result of fractional flow reserve (FFR) in stable coronary disease is often a decision-maker for patient qualification. Taking into account the paramount position of FFR, it is crucial to acknowledge and reduce all potential bias. Aims: In the present study, we quantified the influence of elevated HR on FFR results using a preclinical model and then validated the results in a clinical setting. Methods and results: The relationship between FFR and HR was first explored experimentally in a porcine model. A clinical validation study was conducted in patients with isolated moderate lesions in the left anterior descending artery (LAD) or right coronary artery (RCA). In both the experimental and clinical arms, FFR was measured at resting HR and with pacing at 100, 130, 160, and 180 (for pigs) beats per minute. In the porcine model and in the clinical settings, a significant correlation between FFR and HR was confirmed in the LAD (r = 0.89, p <.0001; r = 0.53, p =.00002), but not in the RCA (r = −0.19, p =.5; r = 0.14, p =.3). Post hoc analyses revealed that the FFR values in the LAD at 130/min and above tended to be significantly different from the baseline HR. Conclusions: The results of this study indicate that in an experimental setting, tachycardia might be responsible for an overestimation of FFR results in LAD lesions.
KW - Coronary artery disease
KW - Fractional flow reserve
KW - Heart rate
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U2 - 10.1016/j.ijcard.2020.05.089
DO - 10.1016/j.ijcard.2020.05.089
M3 - Article
C2 - 32504716
AN - SCOPUS:85086832049
SN - 0167-5273
VL - 317
SP - 13
EP - 17
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -