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Diagnostic Accuracy of Quantitative Flow Ratio for Assessing Myocardial Ischemia in Prior Myocardial Infarction

Hiroki Emori1, Takashi Kubo1, Takeyoshi Kameyama1

  • 1Department of Cardiovascular Medicine, Wakayama Medical University.

Circulation Journal : Official Journal of the Japanese Circulation Society
|January 19, 2018
PubMed

Insights

Quantitative flow ratio (QFR) may be less accurate for assessing coronary stenosis in prior myocardial infarction (MI) areas. This study found reduced diagnostic accuracy of QFR compared to fractional flow reserve (FFR) in these specific coronary arteries.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Quantitative flow ratio (QFR) is a novel index for assessing coronary stenosis functional severity.
  • QFR is derived from 3D quantitative coronary angiography and may not account for viable myocardium in prior myocardial infarction (MI).

Purpose of the Study:

  • To compare the accuracy of QFR (fixed-flow QFR [fQFR] and contrast-flow QFR [cQFR]) against fractional flow reserve (FFR) in coronary arteries with and without prior MI.

Main Methods:

  • Analyzed fQFR, cQFR, and FFR in 75 prior-MI-related and 75 non-prior-MI-related coronary arteries.
  • Correlated QFR measurements with FFR values.
  • Assessed diagnostic accuracy of QFR for predicting FFR ≤0.80.

Main Results:

  • Both fQFR and cQFR showed strong correlations with FFR in all analyzed arteries.
  • fQFR was significantly lower than FFR in prior-MI-related arteries, unlike in non-prior-MI-related arteries.
  • Diagnostic accuracy of fQFR and cQFR for predicting FFR ≤0.80 was numerically lower in prior-MI-related arteries.

Conclusions:

  • The accuracy of QFR in assessing functional coronary stenosis severity may be reduced in arteries with a history of MI when compared to non-MI-related arteries, using FFR as the gold standard.
Abstract

Keywords:
Fractional flow reservePrior myocardial infarctionQuantitative coronary angiographyQuantitative flow ratio

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