Kolli Kranthi K, van de Hoef Tim P, Effat Mohamed A, Banerjee Rupak K, Peelukhana Srikara V, Succop Paul, Leesar Massoud A, Imran Arif, Piek Jan J, Helmy Tarek A
Department of Mechanical and Materials Engineering, University of Cincinnati, Cincinnati, Ohio.
Veteran Affairs Medical Center, Cincinnati, Ohio.
Catheter Cardiovasc Interv. 2016 Feb 1;87(2):273-82. doi: 10.1002/ccd.26063. Epub 2015 Oct 1.
Functional assessment of intermediate coronary stenosis during cardiac catheterization is conducted using diagnostic parameters like fractional flow reserve (FFR), coronary flow reserve (CFR), hyperemic stenosis resistance index (HSR), and hyperemic microvascular resistance (HMR). CDP (ratio of pressure drop across a stenosis to distal dynamic pressure), a nondimensional index derived from fundamental fluid dynamic principles, based on a combination of intracoronary pressure, and flow measurements may improve the functional assessment of coronary lesion severity.
Patient-level data pertaining to 350 intracoronary pressure and flow measurements across coronary stenoses was assessed to evaluate CFR, FFR, HSR, HMR, and CDP. CDP was calculated as (ΔP)/(0.5 × ρ × APV(2)). The density of blood (ρ) was assumed to be 1.05 g/cm(3). The correlation of current diagnostic parameters (CFR, FFR, HSR, and HMR) with CDP was evaluated. The receiver operating characteristic (ROC) curve was used to identify the optimal cut-off point of CDP, corresponding to the clinically used cut-off values (FFR = 0.80 and CFR = 2.0).
CDP correlated significantly with FFR (r = 0.81, P < 0.05) and had significant diagnostic efficiency (ROC-area under curve of 86%), specificity (72%) and sensitivity (85%) at FFR < 0.8. The corresponding cut-off value for CDP to detect FFR < 0.8 was at CDP>25.4. CDP also correlated significantly (r = 0.98, P < 0.05) with epicardial-specific parameter, HSR.
CDP, a functional parameter based on both intracoronary pressure and flow measurements, has close agreement (area under ROC curve = 86%) with FFR, the frequently used method of evaluating stenosis severity.
在心脏导管插入术中，使用诸如血流储备分数（FFR）、冠状动脉血流储备（CFR）、充血性狭窄阻力指数（HSR）和充血性微血管阻力（HMR）等诊断参数对中度冠状动脉狭窄进行功能评估。CDP（狭窄两端压力降与远端动态压力之比）是一个基于基本流体动力学原理得出的无量纲指数，结合冠状动脉内压力和血流测量，可能会改善对冠状动脉病变严重程度的功能评估。
评估了350例跨冠状动脉狭窄的冠状动脉内压力和血流测量的患者水平数据，以评估CFR、FFR、HSR、HMR和CDP。CDP计算为(ΔP)/(0.5×ρ×APV(2))。假定血液密度（ρ）为1.05 g/cm³。评估了当前诊断参数（CFR、FFR、HSR和HMR）与CDP的相关性。使用受试者操作特征（ROC）曲线来确定CDP的最佳截断点，对应于临床使用的截断值（FFR = 0.80和CFR = 2.0）。
CDP与FFR显著相关（r = 0.81，P < 0.05），并且在FFR < 0.8时具有显著的诊断效率（ROC曲线下面积为86%）、特异性（72%）和敏感性（85%）。检测FFR < 0.8时CDP的相应截断值为CDP > 25.4。CDP也与心外膜特异性参数HSR显著相关（r = 0.98，P < 0.05）。
CDP是一个基于冠状动脉内压力和血流测量的功能参数，与评估狭窄严重程度的常用方法FFR具有高度一致性（ROC曲线下面积 = 86%）。
