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Fractional Flow Reserve Versus Instantaneous Wave-Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study

T. Kovarnik, M. Hitoshi, A. Kral, S. Jerabek, D. Zemanek, Y. Kawase, H. Omori, T. Tanigaki, J. Pudil, A. Vodzinska, M. Branny, R. Stipal, P. Kala, J. Mrozek, M. Porzer, T. Grezl, K. Novobilsky, O. Mendiz, K. Kopriva, M. Mates, M. Chval, Z. Chen,...

. 2022 ; 11 (9) : e021490. [pub] 20220503

Language English Country Great Britain

Document type Journal Article, Multicenter Study

Persistent link   https://www.medvik.cz/link/bmc22018484

Background The FiGARO FFR versus iFR in Assessment of Hemodynamic Lesion Significance and an Explanation of Their Discrepancies trial is a prospective registry searching for predictors of fractional flow reserve instantaneous wave free ratio FFR iFR discrepancy Methods and Results FFR iFR were analyzed using a Verrata wire and coronary flow reserve was analyzed using a Combomap machine b

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$a Kovarnik, Tomas $u 2nd Department of Medicine Department of Cardiovascular Medicine First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech Republic $1 https://orcid.org/0000000183084657 $7 xx0080785
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$a Fractional Flow Reserve Versus Instantaneous Wave-Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study / $c T. Kovarnik, M. Hitoshi, A. Kral, S. Jerabek, D. Zemanek, Y. Kawase, H. Omori, T. Tanigaki, J. Pudil, A. Vodzinska, M. Branny, R. Stipal, P. Kala, J. Mrozek, M. Porzer, T. Grezl, K. Novobilsky, O. Mendiz, K. Kopriva, M. Mates, M. Chval, Z. Chen, P. Martasek, A. Linhart, FiGARO trial investigators
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$a Background The FiGARO (FFR versus iFR in Assessment of Hemodynamic Lesion Significance, and an Explanation of Their Discrepancies) trial is a prospective registry searching for predictors of fractional flow reserve/instantaneous wave-free ratio (FFR/iFR) discrepancy. Methods and Results FFR/iFR were analyzed using a Verrata wire, and coronary flow reserve was analyzed using a Combomap ma $a Background The FiGARO (FFR versus iFR in Assessment of Hemodynamic Lesion Significance, and an Explanation of Their Discrepancies) trial is a prospective registry searching for predictors of fractional flow reserve/instantaneous wave-free ratio (FFR/iFR) discrepancy. Methods and Results FFR/iFR were analyzed using a Verrata wire, and coronary flow reserve was analyzed using a Combomap machine (both Philips-Volcano). The risk polymorphisms for endothelial nitric oxide synthase and for heme oxygenase-1 were analyzed. In total, 1884 FFR/iFR measurements from 1564 patients were included. The FFR/iFR discrepancy occurred in 393 measurements (20.9%): FFRp (positive)/iFRn (negative) type (264 lesions, 14.0%) and FFRn/iFRp (129 lesions, 6.8%) type. Coronary flow reserve was measured in 343 lesions, correlating better with iFR (R=0.56, P<0.0001) than FFR (R=0.36, P<0.0001). The coronary flow reserve value in FFRp/iFRn lesions (2.24±0.7) was significantly higher compared with both FFRp/iFRp (1.39±0.36), and FFRn/iFRn lesions (1.8±0.64, P<0.0001). Multivariable logistic regression analysis confirmed (1) sex, age, and lesion location in the right coronary artery as predictors for FFRp/iFRn discrepancy; and (2) hemoglobin level, smoking, and renal insufficiency as predictors for FFRn/iFRp discrepancy. The FFRn/iFRp type of discrepancy was significantly more frequent in patients with both risk types of polymorphisms (endothelial nitric oxide synthaser+heme oxygenase-1r): 8 patients (24.2%) compared with FFRp/iFRn type of discrepancy: 2 patients (5.9%), P=0.03. Conclusions Predictors for FFRp/iFRn discrepancy were sex, age, and location in the right coronary artery. Predictors for FFRn/iFRp were hemoglobin level, smoking, and renal insufficiency. The risk type of polymorphism in endothelial nitric oxide synthase and heme oxygenase-1 genes was more frequently found in patients with FFRn/iFRp type of discrepancy. Registration URL: https://clinicaltrials.gov; Unique identifier: NCT03033810. $a Background The FiGARO FFR versus iFR in Assessment of Hemodynamic Lesion Significance and an Explanation of Their Discrepancies trial is a prospective registry searching for predictors of fractional flow reserve instantaneous wave free ratio FFR iFR discrepancy Methods and Results FFR iFR were analyzed using a Verrata wire and coronary flow reserve was analyzed using a Combomap machine b
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$a hemoxygenasa-1 $x genetika $7 D051547
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$a hemodynamika $7 D006439
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$a Hitoshi, Matsuo $u Gifu Heart Center Gifu Japan $1 https://orcid.org/0000000215716533
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$a Kral, Ales $u 2nd Department of Medicine Department of Cardiovascular Medicine First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech Republic
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$a Jerabek, Stepan $u 2nd Department of Medicine Department of Cardiovascular Medicine First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech Republic
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$a Zemanek, David $u 2nd Department of Medicine Department of Cardiovascular Medicine First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech Republic
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$a Kawase, Yoshiaki $u Gifu Heart Center Gifu Japan
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$a Omori, Hiroyuki $u Gifu Heart Center Gifu Japan
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$a Tanigaki, Toru $u Gifu Heart Center Gifu Japan
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$a Pudil, Jan $u 2nd Department of Medicine Department of Cardiovascular Medicine First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech Republic
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$a Vodzinska, Alexandra $u Cardiology Department of Trinec Podlesi Hospital Trinec Czech Republic
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$a Branny, Marian $u Cardiovascular Department University Hospital Ostrava Ostrava Czech Republic
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$a Stipal, Roman $u Department of Internal Medicine and Cardiology University HospitalFaculty of MedicineMasaryk University Brno Brno Czech Republic
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$a Kala, Petr $u Department of Internal Medicine and Cardiology University HospitalFaculty of MedicineMasaryk University Brno Brno Czech Republic
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$a Mrozek, Jan $u Cardiovascular Department University Hospital Ostrava Ostrava Czech Republic
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$a Porzer, Martin $u Cardiovascular Department University Hospital Ostrava Ostrava Czech Republic
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$a Grézl, Tomáš, $u Cardiovascular Department University Hospital Ostrava Ostrava Czech Republic $d 1989- $7 xx0283382
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$a Novobilsky, Kamil $u Cardiology Department Municipal Hospital Ostrava Ostrava Czech Republic
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$a Mendiz, Oscar $u Fundacion Favaloro Buenos Aires Argentina $1 https://orcid.org/0000000252680429
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$a Kopriva, Karel $u Cardiology Department Homolka Hospital Prague Czech Republic
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$a Mates, Martin $u Cardiology Department Homolka Hospital Prague Czech Republic $1 https://orcid.org/0000000233243469
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$a Chval, Martin $u Institute for Research and Development of Education Faculty of Education Charles University Prague Czech Republic
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$a Chen, Zhi $u Department of Electrical & Computer Engineering Iowa Institute for Biomedical ImagingThe University of Iowa IA
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$a Martasek, Pavel $u Department of Paediatrics and Inherited Metabolic Disorders First Faculty of Medicine Charles UniversityGeneral University Hospital Prague Czech Republic
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$a Linhart, Ales $u 2nd Department of Medicine Department of Cardiovascular Medicine First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech Republic
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$a FiGARO trial investigators
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$w MED00188127 $t Journal of the American Heart Association $x 2047-9980 $g Roč. 11, č. 9 (2022), s. e021490
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$u https://pubmed.ncbi.nlm.nih.gov/35502771 $y Pubmed
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