Key result
In patients with severe aortic stenosis, iFR showed 100% agreement with FFR for assessing the physiological significance of borderline coronary lesions, while QFR showed 69% agreement.
Why the study?
In patients with coronary heart disease and severe aortic stenosis, obtaining coronary artery physiological data for intermediate lesions can facilitate clinical decision-making regarding revascularization.
Do iFR and QFR agree with FFR for assessing coronary stenosis severity in patients with severe aortic stenosis?
Observational (n=12)
Single-blind
No
Do iFR and QFR agree with FFR for assessing coronary stenosis severity in patients with severe aortic stenosis?
In patients with severe aortic stenosis, iFR showed 100% agreement with FFR for assessing borderline coronary lesions, suggesting iFR may be a safe and comparable alternative that avoids the need for hyperemia.
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iFR may support lesion assessment in severe aortic stenosis; leaves open validation in larger prospective studies before practice change.
Introduction: Some patients with coronary heart disease are diagnosed with severe aortic stenosis. For further treatment, coronary angiography is performed in these patients. For intermediate lesions, obtaining coronary artery physiological data can facilitate clinical decision-making regarding revascularization. Aim: The study compared the physiological significance of coronary artery stenosis using the fractional flow reserve (FFR) method with instantaneous wave-free pressure ratio (iFR) and quantitative flow ratio (QFR) in patients qualified for aortic valve replacement. Material and methods: Department of Cardiology, University Hospital in Krakow. The left anterior descending artery was assessed in 12 from 13 cases (92%). In comparison to FFR, all iFR measurements were concordant with FFR. The total agreement between QFR and FFR/iFR assessment was 69%. Conclusions: Despite the controversy and uncertainty of some operators regarding the interpretation of the FFR test in patients with severe aortic stenosis, we obtained complete agreement of FFR with iFR assessment. This fact suggests that in patients with severe aortic stenosis the choice of an invasive method to assess the physiological significance of the stenosis in the coronary artery is not crucial - both iFR and FFR allow comparable results.
Zasada et al. (2022) conducted an observational in Severe aortic stenosis and coronary heart disease (n=12). iFR and QFR assessment vs. FFR assessment was evaluated on Total agreement between FFR and iFR/QFR for assessing physiological significance of coronary artery stenosis. In patients with severe aortic stenosis, iFR showed 100% agreement with FFR for assessing the physiological significance of borderline coronary lesions, while QFR showed 69% agreement.