Xin Liu1,2, Yabin Wang3, Heye Zhang4, Youbing Yin5, Kunlin Cao5, Zhifan Gao6, Huafeng Liu7, William Kongto Hau8, Lei Gao3, Yundai Chen3, Feng Cao9, Wenhua Huang10. 1. Shenzhen Institutes of Advanced Technology & National Clinical Research Center of Geriatric Disease, Chinese PLA General Hospital, Beijing, China. 2. Guangdong Academy Research on VR Industry, Foshan University, Foshan, Guangdong, China. 3. Department of Cardiology & National Clinical Research Center of Geriatric Disease, Chinese PLA General Hospital, Beijing, China. 4. Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China. 5. Shenzhen Keya Medical Technology, Shenzhen, Guangdong, China. 6. The School of Schulich Medicine and Dentistry, Western University, London, Ontario, N6A 3K7, Canada. 7. State Key Laboratory of Modern Optical Instrumentation, Zhejiang University, Hangzhou, Zhejiang, China. 8. Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. 9. Department of Cardiology & National Clinical Research Center of Geriatric Disease, Chinese PLA General Hospital, Beijing, China. wind8828@gmail.com. 10. School of Basic Medical Science, Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Medical Biomechanics, Southern Medical University, Guangzhou, Guangdong, China. haungwenhua2009@139.com.
Abstract
BACKGROUND: We aimed to compare the performance of FFRCT and FFRQCA in assessing the functional significance of coronary artery stenosis in patients suffering from coronary artery disease with stable angina. METHOD: A total of 101 stable coronary heart disease (CAD) patients with 181 lesions were recruited. FFRCT and FFRQCA were compared using invasive fractional flow reserve (FFR) as a reference standard. Comparisons between FFRCT and FFRQCA were conducted based on strategies of the geometric reconstruction, boundary conditions, and geometric characteristics. The performance of FFRCT and FFRQCA in detecting hemodynamic significance was also investigated. RESULTS: The performance of FFRCT and FFRQCA in discriminating hemodynamically significant lesions was compared. Good correlation and agreement with invasive FFR was found using FFRCT and FFRQCA (r = 0.809, p < 0.001 and r = 0.755, p < 0.001). A significant difference was observed in the complex coronary artery tree, in which relatively better prediction was observed using FFRCT than FFRQCA when analyzing the stenosis distributed in the middle segment of a stenotic branch (p = 0.036). Moreover, FFRCT was found to be better at predicting hemodynamically insignificant stenosis than FFRQCA (p = 0.007), while the performance of the two parameters was similar in discriminating functional significant lesions using an FFR threshold of ≤ 0.8 as a reference standard. CONCLUSION: FFRCT and FFRQCA could both accurately rule out functional insignificant lesions in stable CAD patients. FFRCT was found to be better for the noninvasive screening of CAD patients with stable angina than FFRQCA. KEY POINTS: • FFR CT and FFR QCA were both in good correlation and agreement with invasive FFR measurements. • FFR CT is superior in accuracy and consistency compared to FFR QCA in patients with stenoses distributed in left coronary artery. • The noninvasive nature of FFR CT could provide potential benefit for stable CAD patients on disease management.
BACKGROUND: We aimed to compare the performance of FFRCT and FFRQCA in assessing the functional significance of coronary artery stenosis in patients suffering from coronary artery disease with stable angina. METHOD: A total of 101 stable coronary heart disease (CAD) patients with 181 lesions were recruited. FFRCT and FFRQCA were compared using invasive fractional flow reserve (FFR) as a reference standard. Comparisons between FFRCT and FFRQCA were conducted based on strategies of the geometric reconstruction, boundary conditions, and geometric characteristics. The performance of FFRCT and FFRQCA in detecting hemodynamic significance was also investigated. RESULTS: The performance of FFRCT and FFRQCA in discriminating hemodynamically significant lesions was compared. Good correlation and agreement with invasive FFR was found using FFRCT and FFRQCA (r = 0.809, p < 0.001 and r = 0.755, p < 0.001). A significant difference was observed in the complex coronary artery tree, in which relatively better prediction was observed using FFRCT than FFRQCA when analyzing the stenosis distributed in the middle segment of a stenotic branch (p = 0.036). Moreover, FFRCT was found to be better at predicting hemodynamically insignificant stenosis than FFRQCA (p = 0.007), while the performance of the two parameters was similar in discriminating functional significant lesions using an FFR threshold of ≤ 0.8 as a reference standard. CONCLUSION: FFRCT and FFRQCA could both accurately rule out functional insignificant lesions in stable CAD patients. FFRCT was found to be better for the noninvasive screening of CAD patients with stable angina than FFRQCA. KEY POINTS: • FFR CT and FFR QCA were both in good correlation and agreement with invasive FFR measurements. • FFR CT is superior in accuracy and consistency compared to FFR QCA in patients with stenoses distributed in left coronary artery. • The noninvasive nature of FFR CT could provide potential benefit for stable CAD patients on disease management.
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