Performance of a Novel CT-Derived Fractional Flow Reserve Measurement to Detect Hemodynamically Significant Coronary Stenosis
- 주제(키워드) Computed Tomography , Coronary CT Angiography , Fractional Flow Reserve , Coronary Artery Disease
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Kang, Si-Hyuck; Kim, Soo-Hyun; Kim, Sun-Hwa; Yoon, Chang-Hwan; Youn, Tae-Jin; Chae, In-Ho] Seoul Natl Univ, Coll Med, Dept Internal Med, Div Cardiol, 166 Gumi Ro, Seongnam 13620, South Korea; [Kang, Si-Hyuck; Kim, Soo-Hyun; Kim, Sun-Hwa; Yoon, Chang-Hwan; Youn, Tae-Jin; Chae, In-Ho] Seoul Natl Univ, Cardiovasc Ctr, Bundang Hosp, 166 Gumi Ro, Seongnam 13620, South Korea; [Chun, Eun Ju] Seoul Natl Univ, Dept Radiol, Bundang Hosp, Seongnam, South Korea; [Chung, Woo-Young] Boramae Med Ctr, Dept Internal Med, Seoul, South Korea; [Park, Sang-Don] Inha Univ Hosp, Dept Internal Med, Div Cardiol, Incheon, South Korea; [Nam, Chang-Wook] Keimyung Univ, Dept Internal Med, Dongsan Hosp, Daegu, South Korea; [Nam, Chang-Wook] Keimyung Univ, Cardiovasc Res Inst, Dongsan Hosp, Daegu, South Korea; [Kwon, Ki-Hwan] Ewha Womans Univ, Dept Internal Med, Div Cardiol, Sch Med, Seoul, South Korea; [Doh, Joon-Hyung] Inje Univ, Dept Internal Med, Ilsan Paik Hosp, Goyang, South Korea; [Byun, Young-Sup] Inje Univ, Sanggye Paik Hosp, Dept Internal Med, Div Cardiol,Coll Med, Seoul, South Korea; [Bae, Jang-Whan] Chungbuk Natl Univ, Coll Med, Dept Internal Med, Cheongju, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- OA유형 gold, Green Published
- 발행기관 KOREAN ACAD MEDICAL SCIENCES
- 발행년도 2023
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000211494
- 본문언어 영어
- Published As https://doi.org/10.3346/jkms.2023.38.e254
- PubMed 37582501
초록/요약
Background: Fractional flow reserve (FFR) based on computed tomography (CT) has been shown to better identify ischemia-causing coronary stenosis. However, this current technology requires high computational power, which inhibits its widespread implementation in clinical practice. This prospective, multicenter study aimed at validating the diagnostic performance of a novel simple CT based fractional flow reserve (CT-FFR) calculation method in patients with coronary artery disease. Methods: Patients who underwent coronary CT angiography (CCTA) within 90 days and invasive coronary angiography (ICA) were prospectively enrolled. A hemodynamically significant lesion was defined as an FFR & LE; 0.80, and the area under the receiver operating characteristic curve (AUC) was the primary measure. After the planned analysis for the initial algorithm A, we performed another set of exploratory analyses for an improved algorithm B. Results: Of 184 patients who agreed to participate in the study, 151 were finally analyzed. Hemodynamically significant lesions were observed in 79 patients (52.3%). The AUC was 0.71 (95% confidence interval [CI], 0.63-0.80) for CCTA, 0.65 (95% CI, 0.56-0.74) for CT-FFR algorithm A (P = 0.866), and 0.78 (95% CI, 0.70-0.86) for algorithm B (P = 0.112). Diagnostic accuracy was 0.63 (0.55-0.71) for CCTA alone, 0.66 (0.58-0.74) for algorithm A, and 0.76 (0.68-0.82) for algorithm B. Conclusion: This study suggests the feasibility of automated CT-FFR, which can be performed on-site within several hours. However, the diagnostic performance of the current algorithm does not meet the a priori criteria for superiority. Future research is required to improve the accuracy.
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