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Diagnostic Performance of CT FFR With a New Parameter Optimized Computational Fluid Dynamics Algorithm From the CT-FFR-CHINA Trial: Characteristic Analysis of Gray Zone Lesions and Misdiagnosed Lesions

To assess the diagnostic performance of fractional flow reserve (FFR) derived from coronary computed tomography angiography (CTA) (CT-FFR) obtained by a new computational fluid dynamics (CFD) algorithm to detect ischemia, using FFR as a reference, and analyze the characteristics of “gray zone” and m...

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Autores principales: Gao, Yang, Zhao, Na, Song, Lei, Hu, Hongjie, Jiang, Tao, Chen, Wenqiang, Zhang, Feng, Dou, Kefei, Mu, Chaowei, Yang, Weixian, Fu, Guosheng, Xu, Li, Li, Dumin, Fan, Lijuan, An, Yunqiang, Wang, Yang, Li, Wei, Xu, Bo, Lu, Bin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980684/
https://www.ncbi.nlm.nih.gov/pubmed/35391840
http://dx.doi.org/10.3389/fcvm.2022.819460
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author Gao, Yang
Zhao, Na
Song, Lei
Hu, Hongjie
Jiang, Tao
Chen, Wenqiang
Zhang, Feng
Dou, Kefei
Mu, Chaowei
Yang, Weixian
Fu, Guosheng
Xu, Li
Li, Dumin
Fan, Lijuan
An, Yunqiang
Wang, Yang
Li, Wei
Xu, Bo
Lu, Bin
author_facet Gao, Yang
Zhao, Na
Song, Lei
Hu, Hongjie
Jiang, Tao
Chen, Wenqiang
Zhang, Feng
Dou, Kefei
Mu, Chaowei
Yang, Weixian
Fu, Guosheng
Xu, Li
Li, Dumin
Fan, Lijuan
An, Yunqiang
Wang, Yang
Li, Wei
Xu, Bo
Lu, Bin
author_sort Gao, Yang
collection PubMed
description To assess the diagnostic performance of fractional flow reserve (FFR) derived from coronary computed tomography angiography (CTA) (CT-FFR) obtained by a new computational fluid dynamics (CFD) algorithm to detect ischemia, using FFR as a reference, and analyze the characteristics of “gray zone” and misdiagnosed lesions. This prospective multicenter clinical trial (NCT03692936, https://clinicaltrials.gov/) analyzed 317 patients with coronary stenosis between 30 and 90% in 366 vessels from five centers undergoing CTA and FFR between November 2018 and March 2020. CT-FFR were obtained from a CFD algorithm (Heartcentury Co., Ltd., Beijing, China). Diagnostic performance of CT-FFR and CTA in detecting ischemia was assessed. Coronary atherosclerosis characteristics of gray zone and misdiagnosed lesions were analyzed. Per-vessel sensitivity, specificity and accuracy for CT-FFR and CTA were 89.9, 87.8, 88.8% and 89.3, 35.5, 60.4%, respectively. Accuracy of CT-FFR was 80.0% in gray zone lesions. In gray zone lesions, lumen area and diameter were significantly larger than lesions with FFR < 0.76 (both p < 0.001), lesion length, non-calcified and calcified plaque volume were all significantly higher than non-ischemic lesions (all p < 0.05). In gray zone lesions, Agatston score (OR = 1.009, p = 0.044) was the risk factor of false negative results of CT-FFR. In non-ischemia lesions, coronary stenosis >50% (OR = 2.684, p = 0.03) was the risk factor of false positive results. Lumen area (OR = 0.567, p = 0.02) and diameter (OR = 0.296, p = 0.03) had a significant negative effect on the risk of false positive results of CT-FFR. In conclusion, CT-FFR based on the new parameter-optimized CFD model provides better diagnostic performance for lesion-specific ischemia than CTA. For gray zone lesions, stenosis degree was less than those with FFR < 0.76, and plaque load was heavier than non-ischemic lesions.
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spelling pubmed-89806842022-04-06 Diagnostic Performance of CT FFR With a New Parameter Optimized Computational Fluid Dynamics Algorithm From the CT-FFR-CHINA Trial: Characteristic Analysis of Gray Zone Lesions and Misdiagnosed Lesions Gao, Yang Zhao, Na Song, Lei Hu, Hongjie Jiang, Tao Chen, Wenqiang Zhang, Feng Dou, Kefei Mu, Chaowei Yang, Weixian Fu, Guosheng Xu, Li Li, Dumin Fan, Lijuan An, Yunqiang Wang, Yang Li, Wei Xu, Bo Lu, Bin Front Cardiovasc Med Cardiovascular Medicine To assess the diagnostic performance of fractional flow reserve (FFR) derived from coronary computed tomography angiography (CTA) (CT-FFR) obtained by a new computational fluid dynamics (CFD) algorithm to detect ischemia, using FFR as a reference, and analyze the characteristics of “gray zone” and misdiagnosed lesions. This prospective multicenter clinical trial (NCT03692936, https://clinicaltrials.gov/) analyzed 317 patients with coronary stenosis between 30 and 90% in 366 vessels from five centers undergoing CTA and FFR between November 2018 and March 2020. CT-FFR were obtained from a CFD algorithm (Heartcentury Co., Ltd., Beijing, China). Diagnostic performance of CT-FFR and CTA in detecting ischemia was assessed. Coronary atherosclerosis characteristics of gray zone and misdiagnosed lesions were analyzed. Per-vessel sensitivity, specificity and accuracy for CT-FFR and CTA were 89.9, 87.8, 88.8% and 89.3, 35.5, 60.4%, respectively. Accuracy of CT-FFR was 80.0% in gray zone lesions. In gray zone lesions, lumen area and diameter were significantly larger than lesions with FFR < 0.76 (both p < 0.001), lesion length, non-calcified and calcified plaque volume were all significantly higher than non-ischemic lesions (all p < 0.05). In gray zone lesions, Agatston score (OR = 1.009, p = 0.044) was the risk factor of false negative results of CT-FFR. In non-ischemia lesions, coronary stenosis >50% (OR = 2.684, p = 0.03) was the risk factor of false positive results. Lumen area (OR = 0.567, p = 0.02) and diameter (OR = 0.296, p = 0.03) had a significant negative effect on the risk of false positive results of CT-FFR. In conclusion, CT-FFR based on the new parameter-optimized CFD model provides better diagnostic performance for lesion-specific ischemia than CTA. For gray zone lesions, stenosis degree was less than those with FFR < 0.76, and plaque load was heavier than non-ischemic lesions. Frontiers Media S.A. 2022-03-22 /pmc/articles/PMC8980684/ /pubmed/35391840 http://dx.doi.org/10.3389/fcvm.2022.819460 Text en Copyright © 2022 Gao, Zhao, Song, Hu, Jiang, Chen, Zhang, Dou, Mu, Yang, Fu, Xu, Li, Fan, An, Wang, Li, Xu and Lu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Gao, Yang
Zhao, Na
Song, Lei
Hu, Hongjie
Jiang, Tao
Chen, Wenqiang
Zhang, Feng
Dou, Kefei
Mu, Chaowei
Yang, Weixian
Fu, Guosheng
Xu, Li
Li, Dumin
Fan, Lijuan
An, Yunqiang
Wang, Yang
Li, Wei
Xu, Bo
Lu, Bin
Diagnostic Performance of CT FFR With a New Parameter Optimized Computational Fluid Dynamics Algorithm From the CT-FFR-CHINA Trial: Characteristic Analysis of Gray Zone Lesions and Misdiagnosed Lesions
title Diagnostic Performance of CT FFR With a New Parameter Optimized Computational Fluid Dynamics Algorithm From the CT-FFR-CHINA Trial: Characteristic Analysis of Gray Zone Lesions and Misdiagnosed Lesions
title_full Diagnostic Performance of CT FFR With a New Parameter Optimized Computational Fluid Dynamics Algorithm From the CT-FFR-CHINA Trial: Characteristic Analysis of Gray Zone Lesions and Misdiagnosed Lesions
title_fullStr Diagnostic Performance of CT FFR With a New Parameter Optimized Computational Fluid Dynamics Algorithm From the CT-FFR-CHINA Trial: Characteristic Analysis of Gray Zone Lesions and Misdiagnosed Lesions
title_full_unstemmed Diagnostic Performance of CT FFR With a New Parameter Optimized Computational Fluid Dynamics Algorithm From the CT-FFR-CHINA Trial: Characteristic Analysis of Gray Zone Lesions and Misdiagnosed Lesions
title_short Diagnostic Performance of CT FFR With a New Parameter Optimized Computational Fluid Dynamics Algorithm From the CT-FFR-CHINA Trial: Characteristic Analysis of Gray Zone Lesions and Misdiagnosed Lesions
title_sort diagnostic performance of ct ffr with a new parameter optimized computational fluid dynamics algorithm from the ct-ffr-china trial: characteristic analysis of gray zone lesions and misdiagnosed lesions
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980684/
https://www.ncbi.nlm.nih.gov/pubmed/35391840
http://dx.doi.org/10.3389/fcvm.2022.819460
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