Key result
μQFR achieves ~94% diagnostic accuracy versus FFR regardless of abnormal cardiac structure or function.
Why the study?
The diagnostic accuracy of μQFR in patients with abnormal cardiac structure, left ventricular diastolic dysfunction, and valvular regurgitation was not clear.
Does Murray law-based quantitative flow ratio (μQFR) accurately diagnose hemodynamically significant coronary stenosis compared to FFR in patients with suspected coronary heart disease, including those with abnormal cardiac structure, valvular regurgitation, and left ventricular diastolic dysfunction?
Observational (n=261)
No
Does Murray law-based quantitative flow ratio (μQFR) accurately diagnose hemodynamically significant coronary stenosis compared to FFR in patients with suspected coronary heart disease, including those with abnormal cardiac structure, valvular regurgitation, and left ventricular diastolic dysfunction?
μQFR demonstrates excellent diagnostic agreement with FFR for assessing coronary stenosis, and its accuracy is not affected by abnormal cardiac structure, valvular regurgitation, or left ventricular diastolic dysfunction.
Objective: The study aimed to investigate the diagnostic accuracy of Murray law-based quantitative flow ratio (μQFR) from a single angiographic view in patients with abnormal cardiac structure, left ventricular diastolic dysfunction, and valvular regurgitation. Background: μQFR is a novel fluid dynamics method for deriving fractional flow reserve (FFR). In addition, current studies of μQFR mainly analyzed patients with normal cardiac structure and function. The accuracy of μQFR when patients had abnormal cardiac structure, left ventricular diastolic dysfunction, and valvular regurgitation has not been clear. Methods: This study retrospectively analyzed 261 patients with 286 vessels that underwent both FFR and μQFR prior to intervention. The cardiac structure and function were measured using echocardiography. Pressure wire-derived FFR ≤0.80 was defined as hemodynamically significant coronary stenosis. Results: = 0.192). With FFR as the standard, the diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of μQFR were 94.06% (90.65-96.50), 82.56% (72.87-89.90), 99.00% (96.44-99.88), 97.26 (89.91-99.30), and 92.96% (89.29-95.44), respectively. The concordance of μQFR/FFR was not associated with abnormal cardiac structure, valvular regurgitation (aortic valve, mitral valve, and tricuspid valve), and left ventricular diastolic function. Coronary hemodynamics showed no difference between normality and abnormality of cardiac structure and left ventricular diastolic function. Coronary hemodynamics demonstrated no difference among valvular regurgitation (none, mild, moderate, or severe). Conclusion: μQFR showed an excellent agreement with FFR. The effect of abnormal cardiac structure, valvular regurgitation, and left ventricular diastolic function did not correlate with the diagnostic accuracy of μQFR. Coronary hemodynamics showed no difference in patients with abnormal cardiac structure, valvular regurgitation, and left ventricular diastolic function.
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Yang et al. (2023) conducted an observational in Suspected coronary heart disease (n=261). Murray law-based quantitative flow ratio (μQFR) vs. Fractional flow reserve (FFR) was evaluated on Diagnostic accuracy of μQFR (95% CI 90.65-96.50). Murray law-based quantitative flow ratio (μQFR) demonstrated a diagnostic accuracy of 94.06% compared to fractional flow reserve, and its performance was not affected by abnormal cardiac structure or function.
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