ARASHI Hiroyuki
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Relationship between instantaneous wave-free ratio and fractional flow reserve in patients receiving hemodialysis.
Journal Formal name:Cardiovascular intervention and therapeutics
Abbreviation:Cardiovasc Interv Ther
ISSN code:1868-4300/1868-4297
Domestic / ForeginDomestic
Publisher Japanese Association of Cardiovascular Intervention and Therapeutics
Volume, Issue, Page 33(3),256-263頁
Author and coauthor MORIOKA Yuta†, ARASHI Hiroyuki*, OOTSUKI Hisao, YAMAGUCHI Junichi, HAGIWARA Nobuhisa
Publication date 2018/07
Summary 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