Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Internal Medicine, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
Tex Heart Inst J. 2023 Jan 1;50(1). doi: 10.14503/THIJ-20-7410.
Measurement of fractional flow reserve (FFR) is the gold standard for determining the physiologic significance of coronary artery stenosis, but newer software programs can calculate the FFR from 2-dimensional angiography images.
A retrospective analysis was conducted using the records of patients with intermediate coronary stenoses who had undergone adenosine FFR (aFFR). To calculate the computed FFR, a software program used simulated coronary blood flow using computational geometry constructed using at least 2 patient-specific angiographic images. Two cardiologists reviewed the angiograms and determined the computational FFR independently. Intraobserver variability was measured using κ analysis and the intraclass correlation coefficient. The correlation coefficient and Bland-Altman plots were used to assess the agreement between the calculated FFR and the aFFR.
A total of 146 patients were included, with 95 men and 51 women, with a mean (SD) age of 61.1 (9.5) y. The mean (SD) aFFR was 0.847 (0.072), and 41 patients (27.0%) had an aFFR of 0.80 or less. There was a strong intraobserver correlation between the computational FFRs (r = 0.808; P < .001; κ = 0.806; P < .001). There was also a strong correlation between aFFR and computational FFR (r = 0.820; P < .001) and good agreement on the Bland-Altman plot. The computational FFR had a high sensitivity (95.1%) and specificity (90.1%) for detecting an aFFR of 0.80 or less.
A novel software program provides a feasible method of calculating FFR from coronary angiography images without resorting to pharmacologically induced hyperemia.
分数血流储备（FFR）的测量是确定冠状动脉狭窄生理意义的金标准，但较新的软件程序可以从二维血管造影图像计算 FFR。
回顾性分析了接受腺苷 FFR（aFFR）检查的中度冠状动脉狭窄患者的记录。为了计算计算 FFR，使用一种软件程序，使用基于至少 2 个患者特定血管造影图像构建的计算几何来模拟冠状动脉血流。两位心脏病专家独立审查血管造影并确定计算 FFR。使用 κ 分析和组内相关系数测量观察者内变异性。使用相关系数和 Bland-Altman 图评估计算 FFR 与 aFFR 的一致性。
共纳入 146 例患者，其中男性 95 例，女性 51 例，平均（SD）年龄 61.1（9.5）岁。平均（SD）aFFR 为 0.847（0.072），41 例（27.0%）患者的 aFFR 为 0.80 或更低。计算 FFR 之间观察者内相关性较强（r = 0.808；P <.001；κ = 0.806；P <.001）。aFFR 和计算 FFR 之间也存在较强的相关性（r = 0.820；P <.001），Bland-Altman 图上的一致性较好。计算 FFR 检测 aFFR 为 0.80 或更低的灵敏度（95.1%）和特异性（90.1%）较高。
一种新的软件程序提供了一种从冠状动脉造影图像计算 FFR 的可行方法，而无需进行药物诱导的充血。
