{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T14:41:54Z","timestamp":1747147314784,"version":"3.40.5"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T00:00:00Z","timestamp":1636675200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>We evaluated the occurrence and physiology of respiration\u2010related beat\u2010to\u2010beat variations in resting Pd\/Pa and FFR during intravenous adenosine administration, and its impact on clinical decision\u2010making.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Coronary pressure tracings in rest and at plateau hyperemia were analyzed in a total of 39 stenosis from 37 patients, and respiratory rate was calculated with ECG\u2010derived respiration (EDR) in 26 stenoses from 26 patients. Beat\u2010to\u2010beat variations in FFR occurred in a cyclical fashion and were strongly correlated with respiratory rate (R<jats:sup>2<\/jats:sup>\u00a0=\u00a00.757, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). There was no correlation between respiratory rate and variations in resting Pd\/Pa. When single\u2010beat averages were used to calculate FFR, mean \u0394FFR was 0.04\u2009\u00b1\u20090.02. With averaging of FFR over three or five cardiac cycles, mean \u0394FFR decreased to 0.02\u2009\u00b1\u20090.02, and 0.01\u2009\u00b1\u20090.01, respectively. Using a FFR \u2264 0.80 threshold, stenosis classification changed in 20.5% (8\/39), 12.8% (5\/39) and 5.1% (2\/39) for single\u2010beat, three\u2010beat and five\u2010beat averaged FFR. The impact of respiration was more pronounced in patients with pulmonary disease (\u0394FFR 0.05\u2009\u00b1\u20090.02 vs 0.03\u2009\u00b1\u20090.02, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.021).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Beat\u2010to\u2010beat variations in FFR during plateau hyperemia related to respiration are common, of clinically relevant magnitude, and frequently lead FFR to cross treatment thresholds. A five\u2010beat averaged FFR, overcomes clinically relevant impact of FFR variation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30012","type":"journal-article","created":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T10:25:39Z","timestamp":1636712739000},"page":"844-852","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Respiration\u2010related variations in Pd\/Pa ratio and fractional flow reserve in resting conditions and during intravenous adenosine administration"],"prefix":"10.1002","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7094-6457","authenticated-orcid":false,"given":"Rutger G. T.","family":"Feenstra","sequence":"first","affiliation":[{"name":"Amsterdam UMC, Heart Center Department of Cardiology, Amsterdam Cardiovascular Sciences  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martijn A.","family":"van Lavieren","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Heart Center Department of Cardiology, Amsterdam Cardiovascular Sciences  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Echavarria\u2010Pinto","sequence":"additional","affiliation":[{"name":"Hospital General ISSSTE \u2010 Facultad de Medicina Universidad Aut\u00f3noma De Quer\u00e9taro  Quer\u00e9taro Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4086-8029","authenticated-orcid":false,"given":"Gilbert W.","family":"Wijntjens","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Heart Center Department of Cardiology, Amsterdam Cardiovascular Sciences  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie E.","family":"Stegehuis","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Heart Center Department of Cardiology, Amsterdam Cardiovascular Sciences  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martijn","family":"Meuwissen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Amphia Hospital  Breda The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robbert J.","family":"de Winter","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Heart Center Department of Cardiology, Amsterdam Cardiovascular Sciences  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7984-3021","authenticated-orcid":false,"given":"Marcel A.M.","family":"Beijk","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Heart Center Department of Cardiology, Amsterdam Cardiovascular Sciences  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir","family":"Lerman","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, and Department of Internal Medicine Mayo Clinic and Mayo Foundation  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Escaned","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital Cl\u00ednico San Carlos, IDISSC and Universidad Complutense de Madrid  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8666-7129","authenticated-orcid":false,"given":"Jan J.","family":"Piek","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Heart Center Department of Cardiology, Amsterdam Cardiovascular Sciences  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0682-0619","authenticated-orcid":false,"given":"Tim P.","family":"van de Hoef","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Heart Center Department of Cardiology, Amsterdam Cardiovascular Sciences  Amsterdam The 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