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Multicenter Study
. 2022;29(3):388-395.
doi: 10.5603/CJ.a2022.0030. Epub 2022 May 17.

Agreement between Murray law-based quantitative flow ratio (μQFR) and three-dimensional quantitative flow ratio (3D-QFR) in non-selected angiographic stenosis: A multicenter study

Carlos Cortés  1 , Lili Liu  2 , Scarlet Luisa Berdin  3   4 , Pablo M Fernández-Corredoira  1 , Ruiyan Zhang  2 , Ulrich Schäfer  5 , María López  6 , José A Diarte  1 , Shengxian Tu  7 , Juan Luis Gutiérrez-Chico  8   9
Affiliations
Multicenter Study

Agreement between Murray law-based quantitative flow ratio (μQFR) and three-dimensional quantitative flow ratio (3D-QFR) in non-selected angiographic stenosis: A multicenter study

Carlos Cortés et al. Cardiol J. 2022.

Abstract

Background: The agreement between single-projection Murray-based quantitative flow ratio (mQFR) and conventional three-dimensional quantitative flow ratio (3D-QFR) has not been reported hitherto.

Methods: Patients from a multinational database were randomly selected for the study of agreement, according to sample size calculation. Both conventional 3D-QFR and mQFR were analyzed for all available arteries at a central corelab by independent analysts, blinded to each other's results.

Results: Ninety-eight coronary arteries from 35 patients were finally analyzed. Median 3D-QFR was 0.82 (interquartile range 0.78-0.87). The intraclass correlation coefficient for the absolute agreement between 3D-QFR and mQFR was 0.996 (95% confidence interval [CI]: 0.993-0.997); Lin's coefficient 0.996 (95% CI: 0.993-0.997), without constant or proportional bias (intercept = 0 and slope = 1 in orthogonal regression). As dichotomous variable, there was absolute agreement between mQFR and 3D-QFR, resulting in no single false positive or negative. Kappa index was 1 and the diagnostic accuracy 100%.

Conclusions: mQFR using a single angiographic projection showed almost perfect agreement with standard 3D-QFR. These results encourage the interchangeable use of mQFR and 3D-QFR, which can be interesting to improve QFR feasibility in retrospective studies, wherein appropriate double angiographic projections might be challenging to obtain.

Keywords: Murray law; computational physiology; coronary heart disease; coronary physiology; quantitative flow ratio; resting index; μQFR.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1
Figure 1
Paradigmatic example of both quantitative flow ratio (QFR) modalities: μQFR (A) and three-dimensional quantitative flow ratio (3D-QFR) (B).
Figure 2
Figure 2
Flow chart; CABG — coronary artery bypass grafting; CTO — chronic total occlusion.
Figure 3
Figure 3
Agreement between three-dimensional quantitative flow ratio (3D-QFR) and single angiographic view quantitative flow ratio (μQFR) estimated by orthogonal regression line in panel A (Passing-Bablok method) and Bland-Altman graphics in panel B.
See this image and copyright information in PMC

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