Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025
VERMONT: Vessel Fractional Flow Reserve (vFFR) Assessment of Stenosis Severity: A Prospective Study.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Akrawi Daniel, Kadappu Krishna, Xu James, Badie Tamer Yousef Naguib, Gibbs Oliver, Kachwalla Hashim, Nguyen Phong T D, Kurup Rahul, Premawardhana Upul, Lo Sidney, Huang Justyn, Tran Hao, Soosapilla Kavie, O'Loughlin Aiden, Hennessy Annemarie, Femia Giuseppe
Аннотация
BACKGROUND: Vessel fractional flow reserve (vFFR) is an angiogram-based technique validated in early studies; however, data on its real-time diagnostic performance and integration into routine workflow remain limited.
AIMS: The VERMONT study evaluated the diagnostic accuracy and time efficiency of real-time vFFR versus conventional wire-based FFR in detecting functionally significant coronary lesions.
METHODS: We conducted a prospective, single-center, blinded study in which vFFR was measured during coronary angiography and compared with simultaneous wire-based FFR. A wire-based FFR of ≤ 0.80 defined a physiologically significant lesion.
RESULTS: In 209 patients with 225 intermediate lesions, only 20 (8.9%) of lesions were excluded from vFFR analysis. vFFR demonstrated an AUC of 0.92 (95% CI, 0.89-0.96) for detecting lesions with FFR ≤ 0.80, achieving 90% sensitivity, 79% specificity, a negative predictive value of 93%, and a positive predictive value of 74%. Interobserver agreement was excellent (r = 0.97, p < 0.001). Real-time vFFR computation was on average 13.9 min faster than wire-based FFR (p < 0.001).
CONCLUSION: Real-time vFFR demonstrated excellent diagnostic performance with high sensitivity and NPV for identifying functionally significant intermediate lesions, supporting its use as a reliable screening tool. Importantly, this was achieved with a low exclusion rate, rapid computation time, and minimal interobserver variability, underscoring its practicality in routine clinical practice.
AIMS: The VERMONT study evaluated the diagnostic accuracy and time efficiency of real-time vFFR versus conventional wire-based FFR in detecting functionally significant coronary lesions.
METHODS: We conducted a prospective, single-center, blinded study in which vFFR was measured during coronary angiography and compared with simultaneous wire-based FFR. A wire-based FFR of ≤ 0.80 defined a physiologically significant lesion.
RESULTS: In 209 patients with 225 intermediate lesions, only 20 (8.9%) of lesions were excluded from vFFR analysis. vFFR demonstrated an AUC of 0.92 (95% CI, 0.89-0.96) for detecting lesions with FFR ≤ 0.80, achieving 90% sensitivity, 79% specificity, a negative predictive value of 93%, and a positive predictive value of 74%. Interobserver agreement was excellent (r = 0.97, p < 0.001). Real-time vFFR computation was on average 13.9 min faster than wire-based FFR (p < 0.001).
CONCLUSION: Real-time vFFR demonstrated excellent diagnostic performance with high sensitivity and NPV for identifying functionally significant intermediate lesions, supporting its use as a reliable screening tool. Importantly, this was achieved with a low exclusion rate, rapid computation time, and minimal interobserver variability, underscoring its practicality in routine clinical practice.
Предметные рубрики MeSH
HumansFractional Flow Reserve, MyocardialProspective StudiesMaleFemaleCoronary AngiographyMiddle AgedPredictive Value of TestsSeverity of Illness IndexCoronary StenosisAgedReproducibility of ResultsCardiac CatheterizationCoronary VesselsVermontObserver VariationTime FactorsSingle-Blind MethodCardiac Catheters