title: Measuring pressure-derived fractional flow reserve through four French diagnostic catheters.
abstract: Measurement of fractional flow reserve (FFR) with a pressure wire is used to discriminate between patients with and without functionally significant lesions. FFR can be assessed through a conventional 4Fr diagnostic catheter, which is a more convenient method of assessment. The aim of this study was to assess the feasibility, safety, repeatability, and reliability of routine FFR measurements through 4Fr diagnostic catheters. From a single-center prospective registry, results of FFR assessment through a 4Fr catheter were used to determine: (1) feasibility and safety, by the procedural success rate and immediate and 30-day clinical outcome; (2) repeatability, by the intraclass correlation coefficient and comparison of the difference (means +/- 2 SDs); and (3) reliability, by comparison of results obtained using 4Fr versus 7Fr guiding catheters. During the study period, FFR was measured in 190 patients, in 122 using a diagnostic 4Fr catheter (study population) and in 68 using a 7Fr guiding catheter. Measurement of FFR wa successful in 115 of 122 patients (94%). No complications related to the use of the 4Fr catheter occurred. Repeatability was determined from 108 repeated measurements: the intraclass correlation coefficient was 0.942 and the mean difference between repeated FFR measurements was -0.001 +/- 0.038. Reliability was determined from 15 unselected patients; there was no systematic error and only 1 value was out of the range of 2 SDs of the mean difference. Using a threshold value of 0.75, the Kappa coefficient for the qualitative agreement was 0.84. Thus, pressure-derived FFR assessment can safely be performed through 4Fr diagnostic catheters, with similar repeatability and reliability as 7Fr guiding catheters, resulting in a simplification of the measurement procedure.
authors.affiliation: University Hospital Jean-Minjoz, Besançon, France
authors.forename: Pierre
authors.initials: P
authors.lastname: Legalery
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Seronde
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meneveau
authors.forename: François
authors.initials: F
authors.lastname: Schiele
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bassand
mesh_terms: D006328:Cardiac Catheterization / Q000295:instrumentation*; D017023:Coronary Angiography; D003326:Coronary Circulation; D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D015203:Reproducibility of Results