オオツキ ヒサオ   OOTSUKI Hisao
  大槻 尚男
   所属   医学部 医学科(東京女子医科大学病院)
   職種   特任助教
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Relationship between instantaneous wave-free ratio and fractional flow reserve in patients receiving hemodialysis.
掲載誌名 正式名:Cardiovascular intervention and therapeutics
略  称:Cardiovasc Interv Ther
ISSNコード:1868-4300/1868-4297
掲載区分国内
出版社 Japanese Association of Cardiovascular Intervention and Therapeutics
巻・号・頁 33(3),256-263頁
著者・共著者 MORIOKA Yuta†, ARASHI Hiroyuki*, OOTSUKI Hisao, YAMAGUCHI Junichi, HAGIWARA Nobuhisa
発行年月 2018/07
概要 Abstract
Instantaneous wave-free ratio (iFR) is a vasodilator-free index and is reported to have a good correlation with fractional flow reserve (FFR). Hemodialysis patients exhibit left ventricular hypertrophy, reduced arterial compliance, and impaired microcirculation. Such a coronary flow condition in these patients may influence the relationship between iFR and FFR. This study assessed the impact of hemodialysis on the relationship between iFR and FFR. The study enrolled 196 patients with 265 stenoses who underwent assessment via iFR, FFR assessment, and right heart catheterization. A good correlation between iFR and FFR was observed in hemodialysis patients. iFR in the hemodialysis group was significantly lower than in the non-hemodialysis group (0.81 ± 0.13 vs. 0.86 ± 0.13, p = 0.005), although no significant difference was found in FFR and percentage diameter stenosis. An iFR value of 0.84 was found to be equivalent to an FFR value of 0.8 in hemodialysis patients, which was lower than the standard predictive iFR range for ischemia. Vasodilator-free assessment by iFR could be beneficial in evaluating intermediate coronary stenosis in patients receiving hemodialysis. However, the threshold for iFR abnormality needs adjustment in hemodialysis patients, and larger clinical trials are required to confirm the results in this specific subset.
DOI 10.1007/s12928-017-0479-4
PMID 28643215