Computational Fractional Flow Reserve From Coronary Computed Tomography Angiography—Optical Coherence Tomography Fusion Images in Assessing Functionally Significant Coronary Stenosis

BACKGROUND: Coronary computed tomography angiography (CTA) and optical coherence tomography (OCT) provide additional functional information beyond the anatomy by applying computational fluid dynamics (CFD). This study sought to evaluate a novel approach for estimating computational fractional flow r...

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Detalles Bibliográficos
Autores principales: Lee, Yong-Joon, Kim, Young Woo, Ha, Jinyong, Kim, Minug, Guagliumi, Giulio, Granada, Juan F., Lee, Seul-Gee, Lee, Jung-Jae, Cho, Yun-Kyeong, Yoon, Hyuck Jun, Lee, Jung Hee, Kim, Ung, Jang, Ji-Yong, Oh, Seung-Jin, Lee, Seung-Jun, Hong, Sung-Jin, Ahn, Chul-Min, Kim, Byeong-Keuk, Chang, Hyuk-Jae, Ko, Young-Guk, Choi, Donghoon, Hong, Myeong-Ki, Jang, Yangsoo, Lee, Joon Sang, Kim, Jung-Sun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Cardiovascular Medicine
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9234158/
https://www.ncbi.nlm.nih.gov/pubmed/35770218
http://dx.doi.org/10.3389/fcvm.2022.925414
Descripción
Sumario:BACKGROUND: Coronary computed tomography angiography (CTA) and optical coherence tomography (OCT) provide additional functional information beyond the anatomy by applying computational fluid dynamics (CFD). This study sought to evaluate a novel approach for estimating computational fractional flow reserve (FFR) from coronary CTA-OCT fusion images. METHODS: Among patients who underwent coronary CTA, 148 patients who underwent both pressure wire-based FFR measurement and OCT during angiography to evaluate intermediate stenosis in the left anterior descending artery were included from the prospective registry. Coronary CTA-OCT fusion images were created, and CFD was applied to estimate computational FFR. Based on pressure wire-based FFR as a reference, the diagnostic performance of Fusion-FFR was compared with that of CT-FFR and OCT-FFR. RESULTS: Fusion-FFR was strongly correlated with FFR (r = 0.836, P < 0.001). Correlation between FFR and Fusion-FFR was stronger than that between FFR and CT-FFR (r = 0.682, P < 0.001; z statistic, 5.42, P < 0.001) and between FFR and OCT-FFR (r = 0.705, P < 0.001; z statistic, 4.38, P < 0.001). Area under the receiver operating characteristics curve to assess functionally significant stenosis was higher for Fusion-FFR than for CT-FFR (0.90 vs. 0.83, P = 0.024) and OCT-FFR (0.90 vs. 0.83, P = 0.043). Fusion-FFR exhibited 84.5% accuracy, 84.6% sensitivity, 84.3% specificity, 80.9% positive predictive value, and 87.5% negative predictive value. Especially accuracy, specificity, and positive predictive value were superior for Fusion-FFR than for CT-FFR (73.0%, P = 0.007; 61.4%, P < 0.001; 64.0%, P < 0.001) and OCT-FFR (75.7%, P = 0.021; 73.5%, P = 0.020; 69.9%, P = 0.012). CONCLUSION: CFD-based computational FFR from coronary CTA-OCT fusion images provided more accurate functional information than coronary CTA or OCT alone. CLINICAL TRIAL REGISTRATION: [www.ClinicalTrials.gov], identifier [NCT03298282].

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