Cargando…

Noninvasive fractional flow reserve derived from coronary computed tomography angiography for identification of ischemic lesions: a systematic review and meta-analysis

Detection of coronary ischemic lesions by fractional flow reserve (FFR) has been established as the gold standard. In recent years, novel computer based methods have emerged and they can provide simulation of FFR using coronary artery images acquired from coronary computed tomography angiography (FF...

Descripción completa

Detalles Bibliográficos
Autores principales: Wu, Wen, Pan, Dao-Rong, Foin, Nicolas, Pang, Si, Ye, Peng, Holm, Niels, Ren, Xiao-Min, Luo, Jie, Nanjundappa, Aravinda, Chen, Shao-Liang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4932511/
https://www.ncbi.nlm.nih.gov/pubmed/27377422
http://dx.doi.org/10.1038/srep29409
_version_ 1782441069317718016
author Wu, Wen
Pan, Dao-Rong
Foin, Nicolas
Pang, Si
Ye, Peng
Holm, Niels
Ren, Xiao-Min
Luo, Jie
Nanjundappa, Aravinda
Chen, Shao-Liang
author_facet Wu, Wen
Pan, Dao-Rong
Foin, Nicolas
Pang, Si
Ye, Peng
Holm, Niels
Ren, Xiao-Min
Luo, Jie
Nanjundappa, Aravinda
Chen, Shao-Liang
author_sort Wu, Wen
collection PubMed
description Detection of coronary ischemic lesions by fractional flow reserve (FFR) has been established as the gold standard. In recent years, novel computer based methods have emerged and they can provide simulation of FFR using coronary artery images acquired from coronary computed tomography angiography (FFR(CT)). This meta-analysis aimed to evaluate diagnostic performance of FFR(CT) using FFR as the reference standard. Databases of PubMed, Cochrane Library, EMBASE, Medion and Web of Science were searched. Seven studies met the inclusion criteria, including 833 stable patients (1377 vessels or lesions) with suspected or known coronary artery disease (CAD). The patient-based analysis showed pooled estimates of sensitivity, specificity and diagnostic odds ratio (DOR) for detection of ischemic lesions were 0.89 [95%confidence interval (CI), 0.85–0.93], 0.76 (95%CI, 0.64–0.84) and 26.21 (95%CI, 13.14–52.28). At a per-vessel or per-lesion level, the pooled estimates were as follows: sensitivity 0.84 (95%CI, 0.80–0.87), specificity 0.76 (95%CI, 0.67–0.83) and DOR 16.87 (95%CI, 9.41–30.25). Area under summary receiver operating curves was 0.90 (95%CI, 0.87–0.92) and 0.86 (95%CI, 0.83–0.89) at the two analysis levels, respectively. In conclusion, FFR(CT) technology achieves a moderate diagnostic performance for noninvasive identification of ischemic lesions in stable patients with suspected or known CAD in comparison to invasive FFR measurement.
format Online
Article
Text
id pubmed-4932511
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Nature Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-49325112016-07-06 Noninvasive fractional flow reserve derived from coronary computed tomography angiography for identification of ischemic lesions: a systematic review and meta-analysis Wu, Wen Pan, Dao-Rong Foin, Nicolas Pang, Si Ye, Peng Holm, Niels Ren, Xiao-Min Luo, Jie Nanjundappa, Aravinda Chen, Shao-Liang Sci Rep Article Detection of coronary ischemic lesions by fractional flow reserve (FFR) has been established as the gold standard. In recent years, novel computer based methods have emerged and they can provide simulation of FFR using coronary artery images acquired from coronary computed tomography angiography (FFR(CT)). This meta-analysis aimed to evaluate diagnostic performance of FFR(CT) using FFR as the reference standard. Databases of PubMed, Cochrane Library, EMBASE, Medion and Web of Science were searched. Seven studies met the inclusion criteria, including 833 stable patients (1377 vessels or lesions) with suspected or known coronary artery disease (CAD). The patient-based analysis showed pooled estimates of sensitivity, specificity and diagnostic odds ratio (DOR) for detection of ischemic lesions were 0.89 [95%confidence interval (CI), 0.85–0.93], 0.76 (95%CI, 0.64–0.84) and 26.21 (95%CI, 13.14–52.28). At a per-vessel or per-lesion level, the pooled estimates were as follows: sensitivity 0.84 (95%CI, 0.80–0.87), specificity 0.76 (95%CI, 0.67–0.83) and DOR 16.87 (95%CI, 9.41–30.25). Area under summary receiver operating curves was 0.90 (95%CI, 0.87–0.92) and 0.86 (95%CI, 0.83–0.89) at the two analysis levels, respectively. In conclusion, FFR(CT) technology achieves a moderate diagnostic performance for noninvasive identification of ischemic lesions in stable patients with suspected or known CAD in comparison to invasive FFR measurement. Nature Publishing Group 2016-07-05 /pmc/articles/PMC4932511/ /pubmed/27377422 http://dx.doi.org/10.1038/srep29409 Text en Copyright © 2016, Macmillan Publishers Limited http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
spellingShingle Article
Wu, Wen
Pan, Dao-Rong
Foin, Nicolas
Pang, Si
Ye, Peng
Holm, Niels
Ren, Xiao-Min
Luo, Jie
Nanjundappa, Aravinda
Chen, Shao-Liang
Noninvasive fractional flow reserve derived from coronary computed tomography angiography for identification of ischemic lesions: a systematic review and meta-analysis
title Noninvasive fractional flow reserve derived from coronary computed tomography angiography for identification of ischemic lesions: a systematic review and meta-analysis
title_full Noninvasive fractional flow reserve derived from coronary computed tomography angiography for identification of ischemic lesions: a systematic review and meta-analysis
title_fullStr Noninvasive fractional flow reserve derived from coronary computed tomography angiography for identification of ischemic lesions: a systematic review and meta-analysis
title_full_unstemmed Noninvasive fractional flow reserve derived from coronary computed tomography angiography for identification of ischemic lesions: a systematic review and meta-analysis
title_short Noninvasive fractional flow reserve derived from coronary computed tomography angiography for identification of ischemic lesions: a systematic review and meta-analysis
title_sort noninvasive fractional flow reserve derived from coronary computed tomography angiography for identification of ischemic lesions: a systematic review and meta-analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4932511/
https://www.ncbi.nlm.nih.gov/pubmed/27377422
http://dx.doi.org/10.1038/srep29409
work_keys_str_mv AT wuwen noninvasivefractionalflowreservederivedfromcoronarycomputedtomographyangiographyforidentificationofischemiclesionsasystematicreviewandmetaanalysis
AT pandaorong noninvasivefractionalflowreservederivedfromcoronarycomputedtomographyangiographyforidentificationofischemiclesionsasystematicreviewandmetaanalysis
AT foinnicolas noninvasivefractionalflowreservederivedfromcoronarycomputedtomographyangiographyforidentificationofischemiclesionsasystematicreviewandmetaanalysis
AT pangsi noninvasivefractionalflowreservederivedfromcoronarycomputedtomographyangiographyforidentificationofischemiclesionsasystematicreviewandmetaanalysis
AT yepeng noninvasivefractionalflowreservederivedfromcoronarycomputedtomographyangiographyforidentificationofischemiclesionsasystematicreviewandmetaanalysis
AT holmniels noninvasivefractionalflowreservederivedfromcoronarycomputedtomographyangiographyforidentificationofischemiclesionsasystematicreviewandmetaanalysis
AT renxiaomin noninvasivefractionalflowreservederivedfromcoronarycomputedtomographyangiographyforidentificationofischemiclesionsasystematicreviewandmetaanalysis
AT luojie noninvasivefractionalflowreservederivedfromcoronarycomputedtomographyangiographyforidentificationofischemiclesionsasystematicreviewandmetaanalysis
AT nanjundappaaravinda noninvasivefractionalflowreservederivedfromcoronarycomputedtomographyangiographyforidentificationofischemiclesionsasystematicreviewandmetaanalysis
AT chenshaoliang noninvasivefractionalflowreservederivedfromcoronarycomputedtomographyangiographyforidentificationofischemiclesionsasystematicreviewandmetaanalysis