Measurement of Instantaneous Wave-free Ratio through a Diagnostic Catheter: Comparison of the Results between 4Fr and 5Fr

Authors

Shinichiro Masuda^{1, 3, *,} , Ryota Uemura^{1, 4}, Yoshiyuki Saiki^{1, 5}, Tatsuo Haraki¹, Takeshi Lee²

¹Department of Cardiology, Saitama Eastern Cardiovascular Hospital, Saitama, Japan

²Department of Cardiovascular Surgery, Saitama Eastern Cardiovascular Hospital, Saitama, Japan

³Department of Cardiology, Ageo Central General Hospital, Saitama, Japan

⁴Department of Cardiology, Haibara General Hospital, Shizuoka, Japan

⁵Department of Cardiology, Nippon Medical School Hospital, Tokyo, Japan

^*Corresponding author. Email: giga627@yahoo.co.jp

DOI

10.2991/artres.k.200620.001How to use a DOI?

Keywords

Instantaneous wave-free ratio; pressure study; reliability; diagnostic catheter

Abstract

Background: Clinical evidence of coronary pressure assessment through a diagnostic catheter is limited. The aim of this study was to assess the difference, safety, and rate of successful measurement of Instantaneous Wave-free Ratio (iFR) through 4Fr and 5Fr diagnostic catheters.

Methods: This single-centre prospective study included 32 lesions among 24 patients exhibiting intermediate coronary stenosis on coronary angiography. iFR measurements were performed through 4Fr and 5Fr diagnostic catheters for each lesion. The primary outcome was the reliability, as assessed by a Bland–Altman plot, for comparison of the mean differences [mean ± 2 Standard Deviations (SDs)], and the agreement on the Kappa coefficient, using a threshold iFR value of 0.89. The secondary outcome was the rate of successful iFR measurement. Safety was assessed by procedural complications and in-hospital Major Adverse Cardiac Events (MACE).

Results: The mean difference was −0.0003 ± 0.058, according to the Bland–Altman plot. One lesion was out of the range of 2 SDs. There was good agreement (Kappa coefficient = 0.85), and the correlation coefficient between the 4Fr and 5Fr catheters was 0.948 (p < 0.001). The success rate was not significantly different between the 4Fr and 5Fr catheters (90.6% vs. 96.9%, p = 0.09), although the 4Fr catheter had a lower success rate. No procedural complications or in-hospital MACE occurred.

Conclusion: Our findings suggest that iFR measurements could be safely performed, with similar reliability and success rate, through either the 4Fr or 5Fr diagnostic catheter.

HIGHLIGHTS

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  Instantaneous Wave-free Ratio (iFR) measurements through 4Fr and 5Fr diagnostic catheters.

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  Correlation and agreement of iFR between 4Fr and 5Fr.

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  To compare the successful measurement of iFR values.

Copyright

© 2020 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.

Open Access

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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TY  - JOUR
AU  - Shinichiro Masuda
AU  - Ryota Uemura
AU  - Yoshiyuki Saiki
AU  - Tatsuo Haraki
AU  - Takeshi Lee
PY  - 2020
DA  - 2020/06/26
TI  - Measurement of Instantaneous Wave-free Ratio through a Diagnostic Catheter: Comparison of the Results between 4Fr and 5Fr
JO  - Artery Research
SP  - 143
EP  - 147
VL  - 26
IS  - 3
SN  - 1876-4401
UR  - https://doi.org/10.2991/artres.k.200620.001
DO  - 10.2991/artres.k.200620.001
ID  - Masuda2020
ER  -