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Clinical feasibility of resting full-cycle ratio as a unique non-hyperemic index of invasive functional lesion assessment

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Abstract

The resting full-cycle ratio (RFR) is a new physiologic index to assess myocardial ischemia. RFR and fractional flow reserve (FFR), the conventionally used index, have not been directly compared in evaluating the entire cardiac cycle. Accordingly, we aimed to compare the diagnostic performance of RFR directly with FFR and clarify the clinical feasibility of RFR as a unique non-hyperemic index in evaluating the cardiac cycle. The diagnostic performance of RFR was compared with FFR using an automated online calculation software. A total of 156 consecutive patients with 220 intermediate lesions were enrolled. RFR showed significant correlation with FFR (r = 0.774, p < 0.001). RFR systole and RFR diastole did also with FFR (r = 0.918, p < 0.001, and r = 0.733, p < 0.001, respectively). With FFR < 0.80 as a reference standard, RFR showed good diagnostic accuracy (DA: 80.5%), similar DA between RFR systole and RFR diastole (79.6% and 87.5%, p = 0.58, respectively), and good DA in any lesion locations, especially in non-left anterior descending coronary artery (LAD) lesions (73.7% and 87.6% for LAD vs. non-LAD, p < 0.05, respectively). RFR is a feasible and reliable non-hyperemic index regardless of the difference in cardiac cycle in evaluating physiological lesion severity in daily practice.

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Acknowledgements

The authors would like to thank all staff and patients who are contributed to this study.

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Authors and Affiliations

  1. Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan

    Hirofumi Ohashi, Hiroaki Takashima, Hirohiko Ando, Akihiro Suzuki, Shinichiro Sakurai, Yusuke Nakano, Hiroaki Sawada, Masanobu Fujimoto, Wataru Suzuki, Masahiro Shimoda, Atomu Tajima, Katsuhisa Waseda & Tetsuya Amano

  2. Medical Education Center, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, Japan

    Katsuhisa Waseda

  3. Division of Biostatistics, Clinical Research Center, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, Japan

    Wataru Ohashi

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  1. Hirofumi Ohashi
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  2. Hiroaki Takashima
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  3. Hirohiko Ando
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Correspondence to Hiroaki Takashima.

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Ohashi, H., Takashima, H., Ando, H. et al. Clinical feasibility of resting full-cycle ratio as a unique non-hyperemic index of invasive functional lesion assessment. Heart Vessels 35, 1518–1526 (2020). https://doi.org/10.1007/s00380-020-01638-5

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