Ultrasonic flow ratio versus Murray law-based quantitative flow ratio for predicting target vessel failure after...

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Imaging

Background:

• Residual ischemia post-percutaneous coronary intervention (PCI) is linked to poor clinical outcomes.
• Quantitative flow ratio (μQFR) from coronary angiography shows prognostic value.
• Intravascular ultrasound (IVUS) derived ultrasonic flow ratio (UFR) combines imaging with physiology, but its prognostic role versus μQFR after IVUS-guided PCI needs clarification.

Purpose of the Study:

• To compare the prognostic performance of ultrasonic flow ratio (UFR) and quantitative flow ratio (μQFR) in patients undergoing IVUS-guided PCI.
• To assess the independent association of UFR with target vessel failure (TVF) post-PCI.

Main Methods:

• Retrospective single-center study of 127 patients who underwent IVUS-guided PCI.
• Measurement of UFR and μQFR at the distal stent edge.
• Primary endpoint: target vessel failure (TVF).
• Statistical analysis included ROC curve analysis and Cox regression.

Main Results:

• The TVF group (19 patients) had lower minimum/mean stent expansion and post-PCI UFR compared to the non-TVF group (108 patients).
• UFR demonstrated superior discriminatory ability for TVF compared to μQFR.
• Post-PCI UFR was the sole independent predictor of TVF in multivariable analysis.

Conclusions:

• IVUS-derived anatomical-functional assessment using UFR provides significant value for post-PCI risk stratification.
• UFR outperforms μQFR in predicting TVF after IVUS-guided PCI.
• UFR may enhance clinical decision-making in interventional cardiology.