Advanced analyses of computed tomography coronary angiography can help discriminate ischemic lesions.
Int J Cardiol
; 267: 208-214, 2018 Sep 15.
Article
em En
| MEDLINE
| ID: mdl-29685695
ABSTRACT
BACKGROUND:
Computed tomography coronary angiography (CTCA) image analysis enables plaque characterization and non-invasive fractional flow reserve (FFR) calculation. We analyzed various parameters derived from CTCA images and evaluated their associations with ischemia.METHODS:
49 (61 lesions) patients underwent CTCA and invasive FFR. Lesions with diameter stenosis (DS)â¯≥â¯50% were considered obstructive. CTCA image processing incorporating analytical and numerical methods were used to quantify anatomical parameters of lesion length (LL) and minimum lumen area (MLA); plaque characteristic parameters of plaque volume, low attenuation plaque (LAP) volume, dense calcium volume (DCV), normalized plaque volume (NP Vol), plaque burden, eccentricity index and napkin-ring (NR) sign; and hemodynamic parameters of resistance index, stenosis flow reserve (SFR) and FFRB. Ischemia was defined as FFRâ¯≤â¯0.8.RESULTS:
Plaque burden and plaque volume were inversely related to FFR. Multivariable logistic regression analysis identified the best anatomical, plaque and hemodynamic predictors, respectively, as DS (≥50% vs <50%; OR 8.0; 95% CI 1.6-39.4), normalized plaque volume (NP Vol) (≥4.3 vs <4.3; OR 3.9; 95% CI 1.1-14.0) and NR Sign (0 vs 1; OR 13.6; 95% CI 1.3-146.1), and FFRB (≤0.8 vs >0.8; OR 44.4; 95% CI 8.8-224.8). AUC increased from 0.70 with DS as the sole predictor to 0.81 after adding NP Vol and NR Sign; further addition of FFRB increased AUC to 0.93.CONCLUSION:
Normalized plaque volume, napkin-ring derived from plaque analysis, and FFRB from numerical simulations on CTCA images substantially improved discrimination of ischemic lesions, compared to assessment by DS alone.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
/
Vasos Coronários
/
Placa Aterosclerótica
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Int J Cardiol
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Singapura