Imperial College London
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Dr Ricardo Petraco

Faculty of Medicine, National Heart & Lung Institute

Honorary Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 7594 3386r.petraco

 
 
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Location

 

Block B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{de:2018:eurheartj/ehy632,
author = {de, Waard GA and Danad, I and Petraco, R and Driessen, RS and Raijmakers, PG and Teunissen, PF and van, de Ven PM and van, Leeuwen MAH and Nap, A and Harms, HJ and Lammertsma, AA and Davies, JE and Knaapen, P and van, Royen N},
doi = {eurheartj/ehy632},
journal = {European Heart Journal},
pages = {4072--4081},
title = {Fractional flow reserve, instantaneous wave-free ratio, and resting P-d/P-a compared with [O-15]H2O positron emission tomography myocardial perfusion imaging: a PACIFIC trial sub-study},
url = {http://dx.doi.org/10.1093/eurheartj/ehy632},
volume = {39},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - AimsGuidelines recommend the use of fractional flow reserve (FFR) to guide percutaneous coronary intervention. For this purpose, physiological lesion assessment without adenosine may have a similar diagnostic accuracy as FFR. We aimed to investigate the performances of FFR, resting instantaneous wave-free ratio (iFR), and resting Pd/Pa compared with [15O]H2O positron emission tomography (PET) perfusion imaging.Methods and results[15O]H2O PET and intracoronary pressure measurements were evaluated in 320 coronary arteries (of which 136 coronary stenoses) in 129 stable patients. The primary analysis consisting of the area-under-the-receiver-operating-characteristic curve for impaired PET hyperaemic myocardial blood flow (MBF) <2.3 mL⋅min−1⋅g−1 in coronary stenoses was 0.78 [95% confidence interval (CI): 0.70–0.85] for FFR, 0.74 (95% CI: 0.66–0.81) for iFR, and 0.75 (95% CI: 0.67–0.82) for Pd/Pa. No significant differences between area-under-the-receiver-operating-characteristic curve were observed for any two indices compared. In a secondary analysis, the diagnostic accuracy compared with impaired PET hyperaemic MBF in coronary stenoses was 72% (95% CI: 64–79%, κ: 0.44) for FFR ≤0.80, 72% (95% CI: 64–80%, κ: 0.44) for iFR ≤0.89, and 70% (95% CI: 62–78%, κ: 0.40) for Pd/Pa ≤0.92. Other secondary analyses included a comparison of physiological indices with PET hyperaemic MBF in all vessels and all of the aforementioned analyses using PET myocardial perfusion reserve as comparator. Statistical testing for the secondary analyses showed results that were consistent with the results of the primary analysis.ConclusionFractional flow reserve, iFR, and Pd/Pa showed a similar performance when compared with PET imaging. Our results support the validity of invasive physiological lesion assessment under resting conditions by iFR or Pd/Pa.Trial registrationSub-study of the PACIFIC trial wi
AU  - de,Waard GA
AU  - Danad,I
AU  - Petraco,R
AU  - Driessen,RS
AU  - Raijmakers,PG
AU  - Teunissen,PF
AU  - van,de Ven PM
AU  - van,Leeuwen MAH
AU  - Nap,A
AU  - Harms,HJ
AU  - Lammertsma,AA
AU  - Davies,JE
AU  - Knaapen,P
AU  - van,Royen N
DO  - eurheartj/ehy632
EP  - 4081
PY  - 2018///
SN  - 0195-668X
SP  - 4072
TI  - Fractional flow reserve, instantaneous wave-free ratio, and resting P-d/P-a compared with [O-15]H2O positron emission tomography myocardial perfusion imaging: a PACIFIC trial sub-study
T2  - European Heart Journal
UR  - http://dx.doi.org/10.1093/eurheartj/ehy632
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000456853800009&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://academic.oup.com/eurheartj/article/39/46/4072/5173693
VL  - 39
ER  -
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