Conference proceeding
Sex-Specific Interpretation of Coronary Flow Reserve and Fractional Flow Reserve Metrics, Including Their Companions
2019 41ST ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY (EMBC), v 2019, pp 7006-7009
01 Jan 2019
PMID: 31947451
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND: Impairment of coronary flow is usually evaluated by considering the ratio of two measurements. Fractional flow reserve (FFR) estimates impact on an epicardial artery by taking mean post-stenotic pressure divided by mean aortic pressure, both obtained during adenosine induced hyperemia. Coronary flow reserve (CFR) compares hyperemic flow or velocity with the baseline situation, also as a ratio. As severity of underlying pathology may differ for men and women, we investigate the impact of these differences on relevant metrics.
METHODS: As sex associated differences may cancel out in a ratio, this weakness of a ratio can he compensated by analyzing the intrinsic companion (C) and consider polar coordinates. Thus, besides the familiar ratio based metrics, we also analyze FFRC and CFRC. Outcomes of in silico studies are employed to extrapolate actual patient data and predict consequences. For FFR 129 patients (38 women) were invasively studied using pressure wires. CFR was measured noninvasively for the left anterior descending coronary artery by recording ultrasound based Doppler velocity in 114 individuals (28 women).
RESULTS: The FFR can be identified as an indicator of the pressure gradient over the stenosis (R=-(J.90), while FFRC differs for men compared to women (P=0.04) and correlates (R=0.93) with post-stenotic driving pressure. CFR shows a difference for men versus women (P=0.04) and is best associated with hyperemic flow (R=0.64), whereas CFRC relates to hyperemia recruited velocity (R=0.97). Simulation studies show that FFR may differ for both sexes when considering elderly.
CONCLUSIONS: Analysis of ratios require inclusion of the companion, and sex-specific differences deserve attention.
Metrics
Details
- Title
- Sex-Specific Interpretation of Coronary Flow Reserve and Fractional Flow Reserve Metrics, Including Their Companions
- Creators
- Peter L. M. Kerkhof - Amsterdam UMC Location VUmcElena Osto - Amsterdam UMC Location VUmcFrancesco Tona - Amsterdam UMC Location VUmcGuy R. Heyndrickx - Amsterdam UMC Location VUmcNeal Handly - Amsterdam UMC Location Vrije Universiteit AmsterdamIEEE
- Publication Details
- 2019 41ST ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY (EMBC), v 2019, pp 7006-7009
- Series
- IEEE Engineering in Medicine and Biology Society Conference Proceedings
- Publisher
- IEEE
- Number of pages
- 4
- Resource Type
- Conference proceeding
- Language
- English
- Academic Unit
- Emergency Medicine
- Web of Science ID
- WOS:000557295307103
- Scopus ID
- 2-s2.0-85077892711
- Other Identifier
- 991019168013904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Engineering, Biomedical
- Engineering, Electrical & Electronic