Departments of Interventional Cardiology and Angiology.
Medical University of Warsaw, Warsaw, Poland.
J Thorac Imaging. 2021 May 1;36(3):189-196. doi: 10.1097/RTI.0000000000000570.
The quantitative RESOLVE (Risk prEdiction of Side branch OccLusion in coronary bifurcation interVEntion) score derived from coronary computed tomography angiography (coronary CTA) was developed as a noninvasive and accurate prediction tool for side branch (SB) occlusion in coronary bifurcation intervention. We aimed to determine the ability of a visually estimated CTA-derived RESOLVE score (V-RESOLVE score) to predict SB occlusion in coronary bifurcation intervention.
The present study included 363 patients with 400 bifurcation lesions. CTA-derived V-RESOLVE score was derived and compared with the quantitative CTA-derived RESOLVE score. The scoring systems were divided into quartiles, and classified as the high-risk and non-high-risk groups. SB occlusion was defined as any decrease in thrombolysis in myocardial infarction flow grade after main vessel stenting.
In total, 28 SB occlusions (7%) occurred. The concordance between visual and quantitative CTA analysis showed poor to excellent agreement (weighted κ range: 0.099 to 0.867). The area under the receiver operating curve for the prediction of SB occlusion was significantly higher for the CTA-derived V-RESOLVE score than for quantitative CTA-derived RESOLVE score (0.792 vs. 0.709, P=0.049). The total net reclassification index was 42.7% (P=0.006), and CTA-derived V-RESOLVE score showed similar capability to discriminate between high-risk group (18.6% vs. 13.8%, P=0.384) and non-high-risk group (3.8% vs. 4.9%, P=0.510) as compared with quantitative CTA-derived RESOLVE score.
Visually estimated CTA-derived V-RESOLVE score is an accurate and easy-to-use prediction tool for the stratification of SB occlusion in coronary bifurcation intervention.
基于冠状动脉计算机断层扫描血管造影（coronary CTA）的定量 RESOLVE（冠状动脉分叉介入术侧支闭塞风险预测）评分是一种用于预测冠状动脉分叉介入术侧支（SB）闭塞的非侵入性和准确的预测工具。我们旨在确定基于视觉评估的 CTA 衍生 RESOLVE 评分（V-RESOLVE 评分）预测冠状动脉分叉介入术 SB 闭塞的能力。
本研究纳入了 363 例 400 处分叉病变患者。推导了 CTA 衍生的 V-RESOLVE 评分，并与定量 CTA 衍生的 RESOLVE 评分进行了比较。评分系统分为四分之一，分为高危和非高危组。SB 闭塞定义为主血管支架置入后心肌梗死溶栓血流分级任何下降。
共有 28 处 SB 闭塞（7%）。视觉和定量 CTA 分析之间的一致性显示出较差到较好的一致性（加权κ范围：0.099 至 0.867）。预测 SB 闭塞的受试者工作特征曲线下面积 V-RESOLVE 评分明显高于定量 CTA 衍生的 RESOLVE 评分（0.792 与 0.709，P=0.049）。总净重新分类指数为 42.7%（P=0.006），V-RESOLVE 评分在区分高危组（18.6%与 13.8%，P=0.384）和非高危组（3.8%与 4.9%，P=0.510）方面与定量 CTA 衍生的 RESOLVE 评分具有相似的能力。
视觉评估的 CTA 衍生的 V-RESOLVE 评分是一种准确且易于使用的预测工具，可用于分层冠状动脉分叉介入术 SB 闭塞。
