Validation of Coronary Angiography-Derived Vessel Fractional Flow Reserve in Heart Transplant Patients with Suspected Graft Vasculopathy

被引：1

作者：

Mileva, Niya ^{[1
,2
]}

Nagumo, Sakura ^{[1
,3
]}

Gallinoro, Emanuele ^{[1
,4
]}

Sonck, Jeroen ^{[1
,5
]}

Verstreken, Sofie ^{[1
]}

Dierkcx, Riet ^{[1
]}

Heggermont, Ward ^{[1
]}

Bartunek, Jozef ^{[1
]}

Goethals, Marc ^{[1
]}

Heyse, Alex ^{[1
]}

Barbato, Emanuele ^{[1
,4
]}

De Bruyne, Bernard ^{[1
,6
]}

Collet, Carlos ^{[1
]}

Vanderheyden, Marc ^{[1
]}

机构：

[1] Cardiovasc Ctr Aalst, OLV Clin, B-9300 Aalst, Belgium

[2] Alexandrovska Univ Hosp, Cardiol Clin, Sofia 1430, Bulgaria

[3] Showa Univ, Fujigaoka Hosp, Dept Cardiol, Tokyo 8501, Japan

[4] Univ Campania Luigi Vanvitelli, Dept Translat Med Sci, I-81100 Naples, Italy

[5] Univ Federico II, Dept Adv Biomed Sci, I-80131 Naples, Italy

[6] Lausanne Univ Hosp, Dept Cardiol, CH-1100 Lausanne, Switzerland

来源：

DIAGNOSTICS | 2021年 / 11卷 / 10期

关键词：

cardiac transplant related arteriopathy; fractional flow reserve; functional assessment; INTERNATIONAL SOCIETY; PHYSIOLOGY; MORTALITY; REGISTRY;

D O I：

10.3390/diagnostics11101750

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Cardiac transplant-related vasculopathy remains a leading cause of morbidity and mortality in heart transplant (HTx) recipients. Recently, coronary angiography-derived vessel fractional flow reserve (vFFR) has emerged as a new diagnostic computational tool to functionally evaluate the severity of coronary artery disease. Although vFFR estimates have been shown to perform well against invasive FFR in atherosclerotic coronary artery disease, data on the use of vFFR in heart transplant recipients suffering from cardiac transplant-related arteriopathy are lacking. The aim of the presented study was to validate coronary angiography-derived vessel fractional flow reserve to calculate fractional flow reserve in HTx patients with and without cardiac transplant-related vasculopathy. A prospective, single center study of HTx patients referred for annual check-up, undergoing surveillance coronarography was conducted. Invasive FFR was measured using a motorized device at the speed of 1.0 mm/s in all three major coronary arteries. Angiography-derived pullback FFR was derived from the angiogram and compared with invasive FFR pullback curve. Overall, 18,059 FFR values were extracted from the FFR pullback curves from 23 HTx patients. The mean age was 59.3 +/- 9.7 years, the mean time after transplantation was 5.24 years [IQR 1.20, 11.25]. A total of 39 vessels from 23 patients (24 LAD, 11 LCX, 4 RCA) were analyzed. Mean distal vFFR was 0.87 +/- 0.14 whereas invasive distal FFR was 0.88 +/- 0.17. An excellent correlation was found between invasive distal FFR and vFFR (r = 0.92; p < 0.001). The correlation of the pullback tracing was high, with a correlation coefficient between vFFR and invasive FFR pullback values of 0.72 (95% CI 0.71 to 0.73, p < 0.001). The mean difference between vFFR and invasive FFR pullback values was -0.01 with 0.06 of SD (limits of agreements -0.12 to 0.13). In HTx patients, coronary angiography-derived FFR correlates excellently with invasively measured wire-derived FFR. Therefore, angiography derived FFR could be used as a novel diagnostic tool to quantify the functional severity of graft vasculopathy.

引用

页数：9