Sara Gaur1, Hiram G Bezerra2, Jens F Lassen3, Evald H Christiansen3, Kentaro Tanaka2, Jesper M Jensen3, Keith G Oldroyd4, Jonathon Leipsic5, Stephan Achenbach6, Anne K Kaltoft3, Hans Erik Bøtker3, Bjarne L Nørgaard3. 1. Department of Cardiology, Aarhus University Hospital, Brendstrupgaardsvej 100, Skejby, 8200 Aarhus N, Denmark. Electronic address: sargau@rm.dk. 2. Harrington Heart and Vascular Institute, Case Medical Center, Cleveland, OH, USA. 3. Department of Cardiology, Aarhus University Hospital, Brendstrupgaardsvej 100, Skejby, 8200 Aarhus N, Denmark. 4. Department of Cardiology, Golden Jubilee National Hospital, Glasgow, Scotland. 5. Department of Radiology, St. Paul's Hospital, Vancouver, BC, Canada. 6. Department of Cardiology, University of Erlangen, Erlangen, Germany.
Abstract
BACKGROUND: Fractional flow reserve (FFR) is the standard of reference for assessing the hemodynamic significance of coronary stenoses in patients with stable coronary artery disease. Noninvasive FFR derived from coronary CT angiography (FFRCT) is a promising new noninvasive method for assessing the physiologic significance of epicardial stenoses. The reproducibility of FFRCT has not yet been established. OBJECTIVE: The aim of this study was to evaluate the variation of repeated analyses of FFRCT per se and in the context of the reproducibility of repeated FFR measurements. METHODS: Coronary CT angiography and invasive coronary angiography with repeated FFR measurements were performed in 28 patients (58 vessels) with suspected stable coronary artery disease. Based on the coronary CT angiography data set, FFRCT analyses were performed twice by 2 independent blinded analysts. RESULTS: In 12 of 58 (21%) vessels FFR was ≤ 0.80. The standard deviation for the difference between first and second FFRCT analyses was 0.034 vs 0.033 for FFR repeated measurements (P = .722). Limits of agreement were -0.06 to 0.08 for FFRCT and -0.07 to 0.06 for FFR. The coefficient of variation of FFRCT (CVFFRct) was 3.4% (95% confidence interval [CI], 1.4%-4.6%) vs 2.7% (95% CI, 1.8%-3.3%) for FFR. In vessels with mean FFR ranging between 0.70 and 0.90 (n = 25), the difference between the first and second FFRCT analyses was 0.035 and FFR repeated measurements was 0.043 (P = .357), whereas CVFFRct was 3.3% (95% CI, 1.5%-4.3%) and coefficient of variation for FFR was 3.6% (95% CI, 2.3%-4.6%). CONCLUSIONS: The reproducibility of both repeated FFRCT analyses and repeated FFR measurements is high.
BACKGROUND: Fractional flow reserve (FFR) is the standard of reference for assessing the hemodynamic significance of coronary stenoses in patients with stable coronary artery disease. Noninvasive FFR derived from coronary CT angiography (FFRCT) is a promising new noninvasive method for assessing the physiologic significance of epicardial stenoses. The reproducibility of FFRCT has not yet been established. OBJECTIVE: The aim of this study was to evaluate the variation of repeated analyses of FFRCT per se and in the context of the reproducibility of repeated FFR measurements. METHODS: Coronary CT angiography and invasive coronary angiography with repeated FFR measurements were performed in 28 patients (58 vessels) with suspected stable coronary artery disease. Based on the coronary CT angiography data set, FFRCT analyses were performed twice by 2 independent blinded analysts. RESULTS: In 12 of 58 (21%) vessels FFR was ≤ 0.80. The standard deviation for the difference between first and second FFRCT analyses was 0.034 vs 0.033 for FFR repeated measurements (P = .722). Limits of agreement were -0.06 to 0.08 for FFRCT and -0.07 to 0.06 for FFR. The coefficient of variation of FFRCT (CVFFRct) was 3.4% (95% confidence interval [CI], 1.4%-4.6%) vs 2.7% (95% CI, 1.8%-3.3%) for FFR. In vessels with mean FFR ranging between 0.70 and 0.90 (n = 25), the difference between the first and second FFRCT analyses was 0.035 and FFR repeated measurements was 0.043 (P = .357), whereas CVFFRct was 3.3% (95% CI, 1.5%-4.3%) and coefficient of variation for FFR was 3.6% (95% CI, 2.3%-4.6%). CONCLUSIONS: The reproducibility of both repeated FFRCT analyses and repeated FFR measurements is high.
Authors: Francesco Secchi; Marco Alì; Elena Faggiano; Paola Maria Cannaò; Marco Fedele; Silvia Tresoldi; Giovanni Di Leo; Ferdinando Auricchio; Francesco Sardanelli Journal: Eur Heart J Suppl Date: 2016-04-29 Impact factor: 1.803