Diagnostic Accuracy of Diastolic Fractional Flow Reserve for Functional Evaluation of Coronary Stenosis: DIASTOLE Study.

Background

In the resting conditions, narrowing the window of coronary pressure measurements from the whole cardiac cycle to diastole improves diagnostic performance of coronary pressure-derived physiological index. However, whether this also applies to the hyperemic conditions has not yet been thoroughly evaluated.

Objectives

The purpose of this study was to assess whether diastolic fractional flow reserve (diastolic FFR) has better diagnostic performance in identifying ischemia-causing coronary lesions than conventional FFR in a prospective, multicenter, and independent core laboratory-based environment.

Methods

In this prospective multicenter registry at 29 Japanese centers, we compared the diagnostic performance of FFR, diastolic FFR, resting distal to aortic coronary pressure (Pd/Pa), and diastolic pressure ratio (dPR) using myocardial perfusion scintigraphy (MPS) as the reference standard in 378 patients with single-vessel coronary disease.

Results

Inducible myocardial ischemia was found on MPS in the relevant myocardial territory of the target vessel in 85 patients (22%). In the receiver-operating curve analyses, diastolic FFR had comparable area under the curve (AUC) compared with FFR (AUC

Conclusions

Diastolic FFR showed a similar diagnostic performance to FFR as compared with MPS. This result reaffirms the use of FFR as the most accurate invasive physiological lesion assessment. (Diagnostic accuracy of diastolic fractional flow reserve (d-FFR) for functional evaluation of coronary stenosis; UMIN000015906).

Informations de copyright

© 2021 The Authors.

Déclaration de conflit d'intérêts

This study was supported by a grant from NPO Association for Thinking about the Future of the Heart Angioplasty and JSPS KAKENHI Grant Number JP15K09093; however, these entities were not involved in the design and execution of this study. Drs Akasaka and Kubo have received lecture fees and research grants from Abbott Vascular. Dr Tanaka has received lecture fees and research grants from Abbott Vascular, Philips, and Boston Scientific Japan. Dr Matsuo has received lecture fees from Phillips, Abbott Vascular, and Boston Scientific Japan, and consultant fees from Zeon Medical. Drs Yokoi and Shiono have received lecture fees from Abbott Vascular and Philips. All other authors have no relationships relevant to the contents of this paper to disclose.