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Performance of a Novel CT-Derived Fractional Flow Reserve Measurement to Detect Hemodynamically Significant Coronary Stenosis.
Kang, Si-Hyuck; Kim, Soo-Hyun; Kim, Sun-Hwa; Chun, Eun Ju; Chung, Woo-Young; Yoon, Chang-Hwan; Park, Sang-Don; Nam, Chang-Wook; Kwon, Ki-Hwan; Doh, Joon-Hyung; Byun, Young-Sup; Bae, Jang-Whan; Youn, Tae-Jin; Chae, In-Ho.
Afiliación
  • Kang SH; Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National University and Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
  • Kim SH; Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National University and Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
  • Kim SH; Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National University and Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
  • Chun EJ; Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
  • Chung WY; Department of Internal Medicine, Boramae Medical Center, Seoul, Korea.
  • Yoon CH; Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National University and Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
  • Park SD; Division of Cardiology, Department of Internal Medicine, Inha University Hospital, Incheon, Korea.
  • Nam CW; Department of Internal Medicine and Cardiovascular Research Institute, Keimyung University Dongsan Hospital, Daegu, Korea.
  • Kwon KH; Division of Cardiology, Department of Internal Medicine, Ewha Woman's University School of Medicine, Seoul, Korea.
  • Doh JH; Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
  • Byun YS; Division of Cardiology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
  • Bae JW; Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea.
  • Youn TJ; Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National University and Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea. ytjmd@snubh.org.
  • Chae IH; Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National University and Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
J Korean Med Sci ; 38(32): e254, 2023 08 14.
Article en En | MEDLINE | ID: mdl-37582501
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 ≤ 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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Estenosis Coronaria / Reserva del Flujo Fraccional Miocárdico Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Korean Med Sci Asunto de la revista: MEDICINA Año: 2023 Tipo del documento: Article Pais de publicación: Corea del Sur
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Estenosis Coronaria / Reserva del Flujo Fraccional Miocárdico Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Korean Med Sci Asunto de la revista: MEDICINA Año: 2023 Tipo del documento: Article Pais de publicación: Corea del Sur