Huang Yuming, Lin Zehuo, Wu Quanmin, Chen Liansheng, Yang Junqing, Deng Huiliang, Liu Yuanhui, Xie Nianjin
Department of Catheterization Lab, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
Shantou University Medical College, Shantou 515041, China.
J Clin Med. 2022 Sep 2;11(17):5198. doi: 10.3390/jcm11175198.
Objectives: The study aimed to evaluate the diagnostic performance of optical coherence tomography (OCT) in identifying functionally significant coronary stenosis in a vessel with single stenosis. Background: The OCT-based morphofunctional computational method for deriving the optical flow ratio (OFR) has diagnostic value, as it can identify the functional severity of coronary stenosis, but the ability of the OFR to aid the OCT in determining coronary stenosis hemodynamics in single-stenosis lesion remains unclear. Methods: 74 vessels with single stenosis were studied in 69 patients; all cases were performed through OCT and quantitative flow ratio (QFR), and OCT images were used to perform OFR. Results: Among vessels with single stenosis, OFR showed a good correlation with QFR (r = 0.86; p < 0.001). Taking QFR as the standard, the vessel-level diagnosis accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of OFR were 90% (95% CI: 81 to 96), 94% (95% CI: 77 to 99), 88% (95% CI: 74 to 96), 85% (95% CI: 68 to 94) and 95% (95% CI: 82 to 99), respectively. Among vessels with OFR/QFR concordance, both the minimum lumen area (MLA) and minimum lumen diameter (MLD) showed excellent diagnostic efficiency (MLA: area under the curve (AUC) = 0.92, 95% CI: 0.85 to 0.98, p < 0.001; MLD: AUC = 0.93, 95% CI: 0.86 to 0.98, p < 0.001) in determining the functional significance of coronary stenosis in a single stenosis lesion, and the best cutoff values were 1.55 mm2 and 1.40 mm. Conclusions: OFR has a good correlation with QFR. OCT-measured MLA and MLD have excellent diagnostic efficiency in identifying the hemodynamic significance of coronary stenosis in a vessel with single stenosis.
本研究旨在评估光学相干断层扫描（OCT）在识别单处狭窄血管中具有功能意义的冠状动脉狭窄方面的诊断性能。背景：基于OCT的形态功能计算方法用于推导光学血流比（OFR）具有诊断价值，因为它可以识别冠状动脉狭窄的功能严重程度，但OFR在辅助OCT确定单处狭窄病变中冠状动脉狭窄血流动力学方面的能力仍不明确。方法：对69例患者的74处单处狭窄血管进行了研究；所有病例均通过OCT和定量血流比（QFR）进行，并且使用OCT图像来计算OFR。结果：在单处狭窄血管中，OFR与QFR显示出良好的相关性（r = 0.86；p < 0.001）。以QFR为标准，OFR的血管水平诊断准确性、敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为90%（95%CI：81至96）、94%（95%CI：77至99）、88%（95%CI：74至96）、85%（95%CI：68至94）和95%（95%CI：82至99）。在OFR/QFR一致的血管中，最小管腔面积（MLA）和最小管腔直径（MLD）在确定单处狭窄病变中冠状动脉狭窄的功能意义方面均显示出优异的诊断效率（MLA：曲线下面积（AUC） = 0.92，95%CI：0.85至0.98，p < 0.001；MLD：AUC = 0.93，95%CI：0.86至0.98，p < 0.001），最佳截断值分别为1.55 mm²和1.40 mm。结论：OFR与QFR具有良好的相关性。OCT测量的MLA和MLD在识别单处狭窄血管中冠状动脉狭窄的血流动力学意义方面具有优异的诊断效率。
