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The ability of contemporary cardiologists to judge the ischemic impact of a coronary lesion visually
Foley, Michael; Rajkumar, Christopher A; Ahmed-Jushuf, Fiyyaz; Nour, Daniel; Fung, Chi Ho; Seligman, Henry; Pathimagaraj, Rachel H; Petraco, Ricardo; Sen, Sayan; Nijjer, Sukhjinder; Howard, James P; Ahmad, Yousif; Allahwala, Usaid; Bhindi, Ravinay; Chamie, Daniel; Doi, Shunich; Kuwata, Shingo; Kaihara, Toshiki; Koga, Masashi; Ishibashi, Yuki; Higuma, Takumi; Tanabe, Yasuhiro; Nakayama, Masafumi; Kawase, Yoshiaki; Watanabe, Akifumi; Funayama, Naohiro; Horinaka, Ryo; Hijikata, Nobuhiro; Takahashi, Takamichi; Matsuo, Hitoshi; Hansen, Peter S; Manica, Andre; Weaver, James; Alzuhairi, Karam; Yong, Thon-Hon; Warisawa, Takayuki; Francis, Darrel P; Shun-Shin, Matthew J; Al-Lamee, Rasha K.
Afiliação
  • Foley, Michael; National Heart and Lung Institute. London. GB
  • Rajkumar, Christopher A; National Heart and Lung Institute. London. GB
  • Ahmed-Jushuf, Fiyyaz; National Heart and Lung Institute. London. GB
  • Nour, Daniel; James Cook University. Queensland. AU
  • Fung, Chi Ho; Imperial College Healthcare NHS Trust. London. GB
  • Seligman, Henry; National Heart and Lung Institute. London. GB
  • Pathimagaraj, Rachel H; National Heart and Lung Institute. London. GB
  • Petraco, Ricardo; National Heart and Lung Institute. London. GB
  • Sen, Sayan; National Heart and Lung Institute. London. GB
  • Nijjer, Sukhjinder; National Heart and Lung Institute. London. GB
  • Howard, James P; National Heart and Lung Institute. London. GB
  • Ahmad, Yousif; Yale University. New Haven. US
  • Allahwala, Usaid; Royal North Shore Hospital. Sydney. AU
  • Bhindi, Ravinay; Royal North Shore Hospital. Sydney. AU
  • Chamie, Daniel; Instituto Dante Pazzanese de Cardiologia. São Paulo. BR
  • Doi, Shunich; St Marianna University School of Medicine. Kawasaki. JP
  • Kuwata, Shingo; St Marianna University School of Medicine. Kawasaki. JP
  • Kaihara, Toshiki; St Marianna University School of Medicine. Kawasaki. JP
  • Koga, Masashi; St Marianna University School of Medicine. Kawasaki. JP
  • Ishibashi, Yuki; St Marianna University School of Medicine. Kawasaki. JP
  • Higuma, Takumi; St Marianna University School of Medicine. Kawasaki. JP
  • Tanabe, Yasuhiro; St Marianna University School of Medicine. Kawasaki. JP
  • Nakayama, Masafumi; Gifu Heart Center. Gifu. JP
  • Kawase, Yoshiaki; Gifu Heart Center. Gifu. JP
  • Watanabe, Akifumi; Toda Chuo General Hospital. Toda. JP
  • Funayama, Naohiro; Hokkaido Cardiovascular Hospital. Sapporo. JP
  • Horinaka, Ryo; Toda Chuo General Hospital. Toda. JP
  • Hijikata, Nobuhiro; Toda Chuo General Hospital. Toda. JP
  • Takahashi, Takamichi; Toda Chuo General Hospital. Toda. JP
  • Matsuo, Hitoshi; Gifu Heart Center. Gifu. JP
  • Hansen, Peter S; Royal North Shore Hospital. Sydney. AU
  • Manica, Andre; Fundação Universitária de Cardiologia. Porto Alegre. BR
  • Weaver, James; Royal Prince Alfred Hospital. Camperdown. AU
  • Alzuhairi, Karam; Great Western Hospital. Swindon. GB
  • Yong, Thon-Hon; Imperial College Healthcare NHS Trust. London. GB
  • Warisawa, Takayuki; National Heart and Lung Institute. London. GB
  • Francis, Darrel P; National Heart and Lung Institute. London. GB
  • Shun-Shin, Matthew J; National Heart and Lung Institute. London. GB
  • Al-Lamee, Rasha K; National Heart and Lung Institute. London. GB
Cardiovasc. revasc. med ; Cardiovasc. revasc. med;59: 60-66, fev.2024. ilus, tab
Article em En | CONASS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1527062
Biblioteca responsável: BR79.1
ABSTRACT

BACKGROUND:

Landmark trials showed that invasive pressure measurement (Fractional Flow Reserve, FFR) was a better guide to coronary stenting than visual assessment. However, present-day interventionists have benefited from extensive research and personal experience of mapping anatomy to hemodynamics.

AIMS:

To determine if visual assessment of the angiogram performs as well as invasive measurement of coronary physiology.

METHODS:

25 interventional cardiologists independently visually assessed the single vessel coronary disease of 200 randomized participants in The Objective Randomized Blinded Investigation with optimal medical Therapy of Angioplasty in stable angina trial (ORBITA). They gave a visual prediction of the FFR and Instantaneous Wave-free Ratio (iFR), denoted vFFR and viFR respectively. Each judged each lesion on 2 occasions, so that every lesion had 50 vFFR, and 50 viFR assessments. The group consensus visual estimates (vFFR-group and viFR-group) and individual cardiologists' visual estimates (vFFR-individual and viFR-individual) were tested alongside invasively measured FFR and iFR for their ability to predict the placebo-controlled reduction in stress echo ischemia with stenting.

RESULTS:

Placebo-controlled ischemia improvement with stenting was predicted by vFFR-group (p < 0.0001) and viFR-group (p < 0.0001), vFFR-individual (p < 0.0001) and viFR-individual (p < 0.0001). There were no significant differences between the predictive performance of the group visual estimates and their invasive counterparts p = 0.53 for vFFR vs FFR and p = 0.56 for viFR vs iFR.

CONCLUSION:

Visual assessment of the angiogram by contemporary experts, provides significant additional information on the amount of ischaemia which can be relieved by placebo-controlled stenting in single vessel coronary artery disease.
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Coleções: 06-national / BR Base de dados: CONASS / SES-SP / SESSP-IDPCPROD Assunto principal: Doença da Artéria Coronariana / Reserva Fracionada de Fluxo Miocárdico Tipo de estudo: Clinical_trials Idioma: En Revista: Cardiovasc. revasc. med Ano de publicação: 2024 Tipo de documento: Article
Buscar no Google
Adicionar na Minha BVS
Imprimir
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Coleções: 06-national / BR Base de dados: CONASS / SES-SP / SESSP-IDPCPROD Assunto principal: Doença da Artéria Coronariana / Reserva Fracionada de Fluxo Miocárdico Tipo de estudo: Clinical_trials Idioma: En Revista: Cardiovasc. revasc. med Ano de publicação: 2024 Tipo de documento: Article