Diagnostic performance of CT-derived resting distal to aortic pressure ratio (resting Pd/Pa) vs. CT-derived fractional flow reserve (CT-FFR) in coronary lesion severity assessmentShow others and affiliations
2021 (English)In: Annals of Translational Medicine, ISSN 2305-5839, E-ISSN 2305-5847, Vol. 9, no 17, article id 1390Article in journal (Refereed) Published
Abstract [en]
Background: Computed tomography-derived fractional flow reserve (CT-FFR) has emerged as a promising non-invasive substitute for fractional flow reserve (FFR) measurement. Normally, CT-FFR providing functional significance of coronary artery disease (CAD) by using a simplified total coronary resistance index (TCRI) model. Yet the error or discrepancy caused by this simplified model remains unclear. Methods: A total of 20 consecutive patients with suspected CAD who underwent CTA and invasive FFR measurement were retrospectively analyzed. CT-FFR and CT-(Pd/Pa)rest values derived from the coronary CTA images. The diagnostic performance of CT-FFR and CT-(Pd/Pa)rest were evaluated on a per-vessel level using C statistics with invasive FFR<0.80 as the reference standard. Results: Of the 25 vessels eventually analyzed, the prevalence of functionally significant CAD were 64%. The Youden index of the ROC curve indicated that the best cutoff value of invasive resting Pd/Pa was 0.945 for identifying functionally significant lesions. Sensitivity, specificity, negative predictive value, positive predictive value and accuracy were 85%, 91%, 92%, 83% and 88% for CT-(Pd/Pa)rest and 85%, 58% 69%, 78% and 72% for CT-FFR. Area under the receiver-operating characteristic curve (AUC) to detect functionally significant stenoses of CT-(Pd/Pa)rest and CT-FFR were 0.87 and 0.90. Conclusions: In this study, the results suggest CT-derived resting Pd/Pa has a potential advantage over CT-FFR in triaging patients for revascularization.
Place, publisher, year, edition, pages
AME Publishing Company , 2021. Vol. 9, no 17, article id 1390
Keywords [en]
Fractional flow reserve (FFR), computational fluid dynamics, coronary CT angiography, pressure ratio
National Category
Cardiology and Cardiovascular Disease Cell and Molecular Biology Physiology and Anatomy
Identifiers
URN: urn:nbn:se:kth:diva-318992DOI: 10.21037/atm-21-4325ISI: 000701244200002PubMedID: 34733942OAI: oai:DiVA.org:kth-318992DiVA, id: diva2:1699104
Note
QC 20220927
2022-09-272022-09-272025-02-10Bibliographically approved