Guan Xueqiang, Song Dan, Li Changling, Hu Yumeng, Leng Xiaochang, Sheng Xiaosheng, Bao Lifang, Pan Yibin, Dong Liang, Jiang Jun, Xiang Jianping, Jiang Wenbing
Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan, China.
J Cardiovasc Transl Res. 2023 Aug;16(4):905-915. doi: 10.1007/s12265-023-10361-1. Epub 2023 Mar 13.
This study was designed to compare the diagnostic performance of angio-FFR and CT-FFR for detecting hemodynamically significant coronary stenosis. Angio-FFR and CT-FFR were measured in 110 patients (139 vessels) with stable coronary disease using invasive FFR as the reference standard. On per-patient basis, angio-FFR was highly correlated with FFR (r =0.78, p <0.001), while the correlation was moderate between CT-FFR and FFR (r =0.68, p <0.001). Diagnostic accuracy, sensitivity, and specificity for angio-FFR were 94.6%, 91.4%, and 96.0%, respectively; and those of CT-FFR were 91.8%, 91.4%, and 92%, respectively. Bland-Altman analysis showed that angio-FFR had a larger average difference and a smaller root mean squared deviation than CT-FFR compared with FFR (-0.014±0.056 vs. 0.0003±0.072). Angio-FFR had a slightly higher AUC than that of CT-FFR (0.946 vs. 0.935, p =0.750). Angio-FFR and CT-FFR computed from coronary images could be accurate and efficient computational tools for detecting lesion-specific ischemia of coronary artery stenosis. Angio-FFR and CT-FFR calculated based on the two types of images can both accurately diagnose functional ischemia of coronary stenosis. CT-FFR can act as a gatekeeper to the catheter room, assisting doctors in determining whether patients need to be screened by coronary angiography. Angio-FFR can be used in the catheter room to determine the functional significant stenosis for helping decision-making in revascularization.
本研究旨在比较血管造影血流储备分数（angio-FFR）和CT血流储备分数（CT-FFR）检测血流动力学显著冠状动脉狭窄的诊断性能。以有创血流储备分数（FFR）作为参考标准，对110例（139支血管）稳定型冠心病患者进行了血管造影血流储备分数和CT血流储备分数测量。在个体患者层面，血管造影血流储备分数与FFR高度相关（r =0.78，p <0.001），而CT血流储备分数与FFR的相关性为中等（r =0.68，p <0.001）。血管造影血流储备分数的诊断准确性、敏感性和特异性分别为94.6%、91.4%和96.0%；CT血流储备分数的诊断准确性、敏感性和特异性分别为91.8%、91.4%和92%。Bland-Altman分析显示，与FFR相比，血管造影血流储备分数的平均差异更大，均方根偏差更小（-0.014±0.056 vs. 0.0003±0.072）。血管造影血流储备分数的曲线下面积（AUC）略高于CT血流储备分数（0.946 vs. 0.935，p =0.750）。从冠状动脉图像计算得到的血管造影血流储备分数和CT血流储备分数可能是检测冠状动脉狭窄病变特异性缺血的准确且高效的计算工具。基于两种类型图像计算得到的血管造影血流储备分数和CT血流储备分数均能准确诊断冠状动脉狭窄的功能性缺血。CT血流储备分数可作为导管室检查的守门人，协助医生确定患者是否需要进行冠状动脉造影筛查。血管造影血流储备分数可用于导管室，以确定功能性显著狭窄，辅助血管重建决策。
