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...
Autores principales: | , , , , , , , , , |
---|---|
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 |