Novel application of quantitative flow ratio for predicting microvascular dysfunction after ST‐segment‐elevation myocardial infarction. (8th January 2020)

• Record Type: Journal Article
• Authors: Sheng, Xincheng; Qiao, Zhiqing; Ge, Heng; Sun, Jiateng; He, Jie; Li, Zheng; Ding, Song; Pu, Jun
• Other Names: Gao Runlin guestEditor.; Xu Bo guestEditor.
• Is Part Of: Catheterization and cardiovascular interventions. Volume 95(2020)Supplement 1
• Page Start: 624
• Page End: 632
• Publication Date: 2020-01-08
• Subjects: cardiac magnetic resonance -- microvascular dysfunction -- quantitative flow ratio -- ST‐segment elevation myocardial infarction; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.28718
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Objectives: This study evaluated quantitative flow ratio (QFR) to predict microvascular dysfunction (MVD) in patients with ST‐segment elevation myocardial infarction (STEMI). Background: QFR is a novel approach for the rapid computation of fractional flow reserve based on three‐dimensional quantitative coronary angiography. We hypothesized that QFR computation could be used to predict MVD after STEMI. Methods: Indexes such as contrast‐flow QFR (cQFR), fixed‐flow QFR (fQFR), and hyperemic flow velocity (HFV) were calculated in 130 STEMI patients with culprit lesion with ≥50% diameter stenosis and TIMI flow grade 2/3 in the spontaneously recanalized culprit artery on initial angiography. MVD was defined as microvascular obstruction determined by contrast‐enhanced cardiac magnetic resonance at a median of 5 days after percutaneous coronary intervention. Results: Patients were divided into the MVD group (76/130, 58.5%) and non‐MVD group (54/130, 41.5%). Patients with MVD had higher cQFR‐fQFR value (0.080 ± 0.058 vs. 0.038 ± 0.039, p < .001) and lower modeled HFV (0.096 ± 0.044 vs. 0.144 ± 0.041 m/s, p < .001). Receiver operator characteristic curve analysis revealed that both the cQFR‐fQFR value (area under the curve, AUC = 0.716, p < .001) and modeled HFV (AUC = 0.805, p < .001) had high specificity and positive predictive value to predict MVD. In multivariable logistic analysis, cQFR‐fQFR was identified as an independent predictor of MVD (odds ratio = 9.800, p < .001). Conclusions: This proof‐of‐concept study suggested that QFR computation may be a useful tool to predict MVD after STEMI (Trial Registration:NCT03780335).