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Diagnostic agreement of quantitative flow ratio with fractional flow reserve in a Latin-American population

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Abstract

Quantitative flow ratio (QFR) is a recently proposed angiographic index that allows to assess the pressure loss in coronary arteries in a similar fashion as the fractional flow reserve (FFR). The purpose of this study was to evaluate the diagnostic performance of QFR as compared to FFR, in a Latin-American population of patients with suspected ischaemic heart disease. QFR was retrospectively derived from coronary angiograms. The association, diagnostic performance, and continuous agreement of fixed-flow QFR (fQFR) and contrast-flow QFR (cQFR) with FFR was assessed by continuous and dichotomous methods. 90 vessels form 66 patients were finally included. The study comprised coronary stenoses of intermediate severity, both angiographically (diameter stenosis: 46.6 ± 12.8%) and physiologically [median FFR = 0.83 (quartile 1–3, 0.76–0.89)]. The correlation of FFR with both fQFR [ρ = 0.841, (95% CI 0.767 to 0.893), p < 0.001] and cQFR [ρ = 0.833, (95% CI 0.755 to 0.887), p < 0.001] was strong. The diagnostic performance of cQFR was good [area under the ROC curve of 0.92 (95% CI 0.86 to 0.97, p < 0.001)], with 0.80 as the optimal cQFR cut-off against FFR ≤ 0.80. This 0.80 cQFR cut-off classified correctly 83.3% of total stenoses, with a sensitivity of 85.2% and specificity of 80.6%. QFR was strongly associated with FFR and exhibited a high diagnostic performance in this Latin-American population.

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Acknowledgements

MEP acknowledges the staff and Directive Team of Hospital General ISSSTE Querétaro for their support for the development of this project.

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The authors have not disclosed any funding.

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Authors and Affiliations

  1. Hospital General ISSSTE, Santiago de Querétaro, México

    Mauro Echavarría-Pinto, Nancy Pacheco-Beltran, Jesus Eduardo Reyes-Carrera, Eduardo Rangel-Alvarado, Elizabeth Ledezma-Ledezma, Laura Alicia Aguilar-Castillo, Andrea Itzel Tovar-Becerra, Juan Ernesto Muñoz Arellano, María Neftalí Maqueda Ramírez, Miriam Muruaga, Ana Maria Ibarra-Rangel, Carlos Alberto Montes-Collantes, Jorge Luis Castrejon-Mora, Irma Hualtal Chong-Benitez & Luis Homero Vargas-Torrrescano

  2. Autonomous University of Querétaro, Santiago de Querétaro, México

    Mauro Echavarría-Pinto, Luis Homero Vargas-Torrrescano & Hector M. García-García

  3. Amsterdam UMC, Amsterdam, The Netherlands

    Tim P. Van de Hoef

  4. Georgetown University, Washington, USA

    Hector M. García-García

  5. Section of Interventional Cardiology, MedStar Washington Hospital Center, 110 Irving Street NW, Suite 4B-1, Washington, DC, 20010, USA

    Hector M. García-García

Authors
  1. Mauro Echavarría-Pinto
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  2. Tim P. Van de Hoef
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  3. Nancy Pacheco-Beltran
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  6. Elizabeth Ledezma-Ledezma
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  7. Laura Alicia Aguilar-Castillo
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  8. Andrea Itzel Tovar-Becerra
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  9. Juan Ernesto Muñoz Arellano
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  10. María Neftalí Maqueda Ramírez
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  11. Miriam Muruaga
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  12. Ana Maria Ibarra-Rangel
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  13. Carlos Alberto Montes-Collantes
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  14. Jorge Luis Castrejon-Mora
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  15. Irma Hualtal Chong-Benitez
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  16. Luis Homero Vargas-Torrrescano
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  17. Hector M. García-García
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Corresponding author

Correspondence to Mauro Echavarría-Pinto.

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Conflict of interest

MEP, TPH, HGG have served as speakers in educational events organized Boston Scientific and Abbot, developers of pressure wires.

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Echavarría-Pinto, M., Van de Hoef, T.P., Pacheco-Beltran, N. et al. Diagnostic agreement of quantitative flow ratio with fractional flow reserve in a Latin-American population. Int J Cardiovasc Imaging 38, 1423–1430 (2022). https://doi.org/10.1007/s10554-022-02547-6

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