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Emori H, Kubo T, Tanigaki T, Kawase Y, Shiono Y, Shimamura K, Sobue Y, Matsuo Y, Hirata T, Kitabata H, Ota H, Ino Y, Okubo M, Matsuo H, Akasaka T. P1252Diagnostic performance of quantitative flow ratio from coronary angiography versus fractional flow reserve from computed tomography. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
QFR and FFRCT are recently developed, less-invasive techniques for functional assessment of coronary artery disease.
Objectives
We compared the diagnostic performance between fractional flow reserve derived from computed tomography (FFRCT) and quantitative flow ratio (QFR) derived from coronary angiography, using FFR as the standard reference.
Methods
We measured FFRCT, QFR and FFR in 152 patients (233 vessels) with stable coronary artery disease.
Results
QFR was highly correlated with FFR (r=0.78, p<0.001), while FFRCT was moderately correlated with FFR (r=0.63, p<0.001). Both QFR and FFRCT showed good agreements with FFR, presenting small values of mean difference and root-mean-squared deviation (FFR -QFR: 0.02±0.09 and FFR -FFRCT: 0.03±0.11). The AUC of QFR was significantly greater than that of 3D-QCA-derived %DS (0.93 vs. 0.78; difference: 0.15; 95% CI: 0.09 to 0.20; p<0.001). The AUC of FFRCTwas significantly greater than that of CCTA-derived %DS (0.82 vs. 0.70; difference: 0.12; 95% CI: 0.05 to 0.19; p<0.001). The AUC of QFR was significantly greater than that of FFRCT (0.93 vs. 0.82; difference: 0.11; 95% CI: 0.05 to 0.16; p<0.001). The sensitivity, specificity, positive predictive value, and negative predictive valueof QFR ≤0.80 for predicting FFR ≤0.80 were 90%, 82%, 81%, and 90%, respectively. Those of FFRCT ≤0.80 for predicting FFR ≤0.80 were 82%, 70%, 70%, and 82%, respectively. The diagnostic accuracy of QFR ≤0.80 for predicting FFR ≤0.80 was 85% [95% confidence interval: 81% to 89%], while that of FFRCT≤0.80 for predicting FFR ≤0.80was 76% [95% confidence interval: 70% to 80%].
Figure 1. Comparison of FFR ≤0.80 predictors
Conclusions
Both QFR and FFRCTpossessed the ability to accurately evaluate the functional severity of coronary stenosis.
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Affiliation(s)
- H Emori
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
| | - T Kubo
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
| | | | | | - Y Shiono
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
| | - K Shimamura
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
| | - Y Sobue
- Gifu Heart Center, Gifu, Japan
| | - Y Matsuo
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
| | | | - H Kitabata
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
| | - H Ota
- Gifu Heart Center, Gifu, Japan
| | - Y Ino
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
| | - M Okubo
- Gifu Heart Center, Gifu, Japan
| | | | - T Akasaka
- Wakayama Medical University, Division of cardiovascular medicine, Wakayama, Japan
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Ota H, Omori H, Tanigaki T, Okamoto S, Hirata T, Kikuchi J, Sobue Y, Miyake T, Kawamura I, Kawase Y, Okubo M, Kamiya H, Tsuchiya K, Matsuo H. 6108Efficacy of the PCSK9 inhibitor for lipid-rich coronary plaque reduction: a near-infrared spectroscopy analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Recently, some studies have highlighted proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors produce incremental low-density lipoprotein cholesterol (LDL-C) lowering effect. However, it is unknown whether the lipid composition of plaque changes is associated with serum LDL-C reduction due to PCSK9 inhibitors administration.
Purpose
The purpose of this study was to determine the effects of PCSK9 inhibitor (PCSK9i) on coronary plaque component in patients with a history of coronary artery disease (CAD) assessed by near-infrared spectroscopy intravascular ultrasound (NIRS-IVUS).
Methods
A total of 67 non-culprit coronary segments were identified in 34 patients. These lesions were analyzed utilizing NIRS-IVUS at baseline and follow-up coronary angiography (CAG). The subjects were divided into two groups according to lipid-lowering treatment; administration of PCSK9i group (PCSK9i: 19 segments, 9 patients) and traditional statin treatment group (Control: 48 segments, 25 patients). The change of lipid-rich plaque distribution between baseline and follow-up NIRS-IVUS was defined as the change of maximal lipid core burden index (LCBI) score for each of the 4-mm longitudinal segments (maxLCBI4mm).
Results
Mean duration from baseline to follow-up CAG was 239.4±52.4 days in the PCSK9i group and 341.0±84.1 days in the Control group (p<0.001). Despite the higher total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in the PCSK9i group at baseline (206.6±40.9 mg/dl vs. 168.5±37.1 mg/dl, 131.5±35.4 mg/dl vs. 100.0±29.5 mg/dl; respectively, p<0.001 for both), the PCSK9i group was significantly lower TC and LDL-C at the follow-up (111.5±23.5 mg/dl vs. 157.4±27.8 mg/dl, 40.8±15.7 mg/dl vs. 86.2±19.6 mg/dl; respectively, p<0.001 for both). Furthermore, the PCSK9i group induced greater regression of maxLCBI4mm than that of Control group (99.6±156.6 vs. 27.9±118.0, p=0.046) (Figure).
Figure 1
Conclusion
Compared with traditional statin therapy, PCSK9i treatment resulted in a greater decrease in lipid component in non-culprit coronary plaques. Therefore, PCSK9i may be useful option in preventing from adverse coronary events for the patients with CAD.
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Affiliation(s)
- H Ota
- Gifu Heart Center, Department of Cardiology, Gifu, Japan
| | - H Omori
- Gifu Heart Center, Department of Cardiology, Gifu, Japan
| | - T Tanigaki
- Gifu Heart Center, Department of Cardiology, Gifu, Japan
| | - S Okamoto
- Gifu Heart Center, Department of Cardiology, Gifu, Japan
| | - T Hirata
- Gifu Heart Center, Department of Cardiology, Gifu, Japan
| | - J Kikuchi
- Gifu Heart Center, Department of Cardiology, Gifu, Japan
| | - Y Sobue
- Gifu Heart Center, Department of Cardiology, Gifu, Japan
| | - T Miyake
- Gifu Heart Center, Department of Cardiology, Gifu, Japan
| | - I Kawamura
- Gifu Heart Center, Department of Cardiology, Gifu, Japan
| | - Y Kawase
- Gifu Heart Center, Department of Cardiology, Gifu, Japan
| | - M Okubo
- Gifu Heart Center, Department of Cardiology, Gifu, Japan
| | - H Kamiya
- Gifu Heart Center, Department of Cardiology, Gifu, Japan
| | - K Tsuchiya
- Gifu Heart Center, Department of Cardiology, Gifu, Japan
| | - H Matsuo
- Gifu Heart Center, Department of Cardiology, Gifu, Japan
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Hirata T, Tanigaki T, Kawase Y, Hirakawa A, Omori H, Okamoto S, Ota H, Sobue Y, Kikuchi J, Okubo M, Kamiya H, Kawasaki M, Suzuki T, Pijls NHJ, Matsuo H. Post-occlusional hyperemia for fractional flow reserve assessment and pull-back curve analysis. Cardiovasc Interv Ther 2019; 35:142-149. [PMID: 30788697 DOI: 10.1007/s12928-019-00579-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/12/2019] [Indexed: 11/25/2022]
Abstract
Balloon occlusion is a potential method for inducing hyperemia to measure post-percutaneous coronary intervention (PCI) fractional flow reserve (FFR). The objective of this study was to determine the clinical usefulness of post-occlusional hyperemia. FFRs measured using post-occlusional hyperemia caused by 30 (FFRoccl30) and 60 s (FFRoccl60) of balloon occlusion after PCI were compared in 60 lesions from 60 patients. The duration of hyperemia was also measured. There was a strong correlation between FFRoccl30 and FFRoccl60 (r = 0.969, p < 0.01). The duration of hyperemia was significantly longer with FFRoccl60 than with FFRoccl30 (68 ± 23 vs. 37 ± 15 s, p < 0.01). The time required for pullback curve analysis was around 45 s. However, in 7 (12%) cases, the duration of hyperemia with FFRoccl60 was < 45 s, which was not enough for pull-back curve analysis. To predict the duration of hyperemia with FFRoccl60 ≥ 45 s, the receiver operating characteristic curve analysis revealed a cut-off value of 25 s of hyperemia with FFRoccl30. FFRoccl30 is sufficient for diagnostic purposes. FFRoccl60 is suitable for pull-back curve analysis in select cases based on predictions made using the duration of hyperemia with FFRoccl30.
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Affiliation(s)
- T Hirata
- Department of Cardiovascular Medicine, Gifu Heart Center, 4-14-4 Yabutaminami, Gifu city, 5008384, Gifu, Japan
| | - T Tanigaki
- Department of Cardiovascular Medicine, Gifu Heart Center, 4-14-4 Yabutaminami, Gifu city, 5008384, Gifu, Japan
| | - Y Kawase
- Department of Cardiovascular Medicine, Gifu Heart Center, 4-14-4 Yabutaminami, Gifu city, 5008384, Gifu, Japan.
| | - A Hirakawa
- Department of Biostatistics and Bioinformatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - H Omori
- Department of Cardiovascular Medicine, Gifu Heart Center, 4-14-4 Yabutaminami, Gifu city, 5008384, Gifu, Japan
| | - S Okamoto
- Department of Cardiovascular Medicine, Gifu Heart Center, 4-14-4 Yabutaminami, Gifu city, 5008384, Gifu, Japan
| | - H Ota
- Department of Cardiovascular Medicine, Gifu Heart Center, 4-14-4 Yabutaminami, Gifu city, 5008384, Gifu, Japan
| | - Y Sobue
- Department of Cardiovascular Medicine, Gifu Heart Center, 4-14-4 Yabutaminami, Gifu city, 5008384, Gifu, Japan
| | - J Kikuchi
- Department of Cardiovascular Medicine, Gifu Heart Center, 4-14-4 Yabutaminami, Gifu city, 5008384, Gifu, Japan
| | - M Okubo
- Department of Cardiovascular Medicine, Gifu Heart Center, 4-14-4 Yabutaminami, Gifu city, 5008384, Gifu, Japan
| | - H Kamiya
- Department of Cardiovascular Medicine, Gifu Heart Center, 4-14-4 Yabutaminami, Gifu city, 5008384, Gifu, Japan
| | - M Kawasaki
- Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - T Suzuki
- Department of Cardiovascular Medicine, Gifu Heart Center, 4-14-4 Yabutaminami, Gifu city, 5008384, Gifu, Japan
| | - N H J Pijls
- Department of Cardiology, Catharina Hospital, Eindhoven, Netherlands
| | - H Matsuo
- Department of Cardiovascular Medicine, Gifu Heart Center, 4-14-4 Yabutaminami, Gifu city, 5008384, Gifu, Japan
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Omori H, Witberg G, Kawase Y, Tanigaki T, Okamoto S, Hirata T, Sobue Y, Ota H, Kamiya H, Okubo M, Valzer O, Kornowski R, Matsuo H. Angiogram based fractional flow reserve in patients with dual/triple vessel coronary artery disease. Int J Cardiol 2019; 283:17-22. [PMID: 30819589 DOI: 10.1016/j.ijcard.2019.01.072] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/06/2018] [Accepted: 01/21/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To assess the performance of angiography derived Fractional Flow Reserve (FFRangio) in multivessel disease (MVD) patients undergoing angiography. BACKGROUND FFR is the reference standard for physiologic assessment of coronary stenosis and guidance of revascularization, especially in patients with MVD, yet it remains grossly underutilized. The non-wire based FFRangio performs well in non-MVD patients, but its accuracy in MVD is unknown. METHODS A prospective clinical study was conducted at Gifu Heart Centre, Japan. Patients underwent physiologic assessment of all relevant coronary lesions using wire-based FFR (wbFFR) and FFRangio. Primary outcome was diagnostic performance (sensitivity, specificity, accuracy) for FFRangio with wbFFR as reference. Other outcomes were the correlation between wbFFR/FFRangio, time required for wbFFR/FFRangio measurements, and the effect of wbFFR/FFRangio on the reclassification of coronary disease severity. RESULTS Fifty patients (118 lesions in total) were included. Mean age was 72 ± 9 years, 72% were male, 36% had triple vessel disease and the average SYNTAX score was 13. The mean measurement of wbFFR and FFRangio were 0.83 ± 0.12 and 0.81 ± 0.11, respectively. Accuracy, sensitivity and specificity for FFRangio were 92.3% (95% CI 79.1-98.4%), 92.4% (95% CI 84.3-97.2%) and 92.4% (95% CI 87.4-97.3%), respectively. Pearson's r between wbFFR and FFRangio was 0.83. FFRangio measurement was faster than wbFFR (9.6 ± 3.4 vs. 15.0 ± 8.9 min, p < 0.001). CONCLUSIONS In patients with MVD, FFRangio shows good correlation and excellent diagnostic performance compared to wbFFR, and measuring FFRangio is faster than wbFFR. These results highlight the potential clinical benefits of utilizing FFRangio among patients with MVD.
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Affiliation(s)
- H Omori
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | - G Witberg
- Department of Cardiology, Rabin Medical Center, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Y Kawase
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | - T Tanigaki
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | - S Okamoto
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | - T Hirata
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | - Y Sobue
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | - H Ota
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | - H Kamiya
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | - M Okubo
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | - O Valzer
- Department of Cardiology, Rabin Medical Center, Petah-Tikva, Israel; CathWorks, Kfar-Saba, Israel
| | - R Kornowski
- Department of Cardiology, Rabin Medical Center, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - H Matsuo
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
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Sobue Y, Matsuo H, Kawase Y, Kondo T, Tanigaki T, Okamoto S, Omori H, Hirata T, Kikuchi J, Ota H, Miyake T, Kawamura I, Kamiya H, Tsuchiya K, Suzuki T. 3284Impact of noninvasive fractional flow reserve derived from coronary computed tomography angiography for prognosis in patients with suspected stable coronary artery disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y Sobue
- Gifu Heart Center, Gifu, Japan
| | | | | | - T Kondo
- Gifu Heart Center, Gifu, Japan
| | | | | | - H Omori
- Gifu Heart Center, Gifu, Japan
| | | | | | - H Ota
- Gifu Heart Center, Gifu, Japan
| | | | | | | | | | - T Suzuki
- Toyohashi Heart Center, Toyohashi, Japan
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Sobue Y, Matsuo H, Kawase Y, Kondo T, Tanigaki T, Okamoto S, Omori H, Hirata T, Kikuchi J, Ota H, Kawamura I, Okubo M, Kamiya H, Suzuki T. P1784Risk stratification with combined FFR-CT and Agatston score in patient with suspected coronary artery disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y Sobue
- Gifu Heart Center, Gifu, Japan
| | | | | | - T Kondo
- Gifu Heart Center, Gifu, Japan
| | | | | | - H Omori
- Gifu Heart Center, Gifu, Japan
| | | | | | - H Ota
- Gifu Heart Center, Gifu, Japan
| | | | - M Okubo
- Gifu Heart Center, Gifu, Japan
| | | | - T Suzuki
- Toyohashi Heart Center, Toyohashi, Japan
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Kawai H, Watanabe E, Yamamoto M, Ichikawa T, Harigaya H, Okuda K, Sobue Y, Motoyama S, Sarai M, Ozaki Y. What is the optimal antithrombotic therapy of atrial fibrillation patients after coronary artery stent deployment? Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sobue Y, Watanabe E, Yamamoto M, Sano K, Harigaya H, Okuda K, Ozaki Y. Beat-to-beat variability of T-wave amplitude for the risk assessment of ventricular tachyarrhythmia in patients without structural heart disease. Europace 2011; 13:1612-8. [DOI: 10.1093/europace/eur177] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Watanabe E, Sobue Y, Osaka M, Ozaki Y, Kodama I, Tanabe T, Aizawa Y, Lousinha A, Oliveira M, Silva Cunha P, Nogueira Silva M, Lopes J, Silva S, Carlos I, Cruz Ferreira R, Chiladakis I, Kalogeropoulos A, Koutsogiannis N, Zagkli F, Arvanitis P, Alexopoulos D, Sepsi M, Kadlecova V, Zeman M, Sindler M, Gaillyova R, Vasku A, Kozak M, Krivan L, Talib A, Sato N, Talib A, Nakagawa N, Sakamoto N, Takeuchi T, Kawamura Y, Hasebe N. Non invasive of risk stratification sudden cardiac death. Europace 2011. [DOI: 10.1093/europace/eur216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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