Comparison of coronary CT angiography-based and invasive coronary angiography-based quantitative flow ratio for functional assessment of coronary stenosis: A multicenter retrospective analysis.
J Cardiovasc Comput Tomogr
; 16(6): 509-516, 2022.
Article
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| MEDLINE
| ID: mdl-35811245
ABSTRACT
BACKGROUND:
The aim of this study was to evaluate the diagnostic performance of coronary CT angiography (CTA)-based quantitative flow ratio (QFR), namely CT-QFR, and compare it with invasive coronary angiography (ICA)-based Murray law QFR (µQFR), using fractional flow reserve (FFR) as the reference standard.METHODS:
Patients who underwent coronary CTA, ICA and pressure wire-based FFR assessment within two months were retrospectively analyzed. CT-QFR and µQFR were computed in blinded fashion and compared with FFR, all applying the same cut-off value of ≤0.80 to identify hemodynamically significant stenosis.RESULTS:
Paired comparison between CT-QFR and µQFR was performed in 191 vessels from 167 patients. Average FFR was 0.81 â± â0.10 and 42.4% vessels had an FFR ≤0.80. CT-QFR had a slightly lower correlation with FFR compared with µQFR, although statistically non-significant (r â= â0.87 versus 0.90, p â= â0.110). The vessel-level diagnostic performance of CT-QFR was slightly lower but without statistical significance than µQFR (AUC â= â0.94 versus 0.97, difference -0.03 [95%CI -0.00-0.06], p â= â0.095), and substantially higher than diameter stenosis by CTA (AUC difference 0.17 [95%CI -0.10-0.23], p â< â0.001). The patient-level diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio for CT-QFR to identify FFR value â≤ â0.80 was 88%, 90%, 86%, 86%, 91%, 6.59 and 0.12, respectively. The diagnostic accuracy of CT-QFR was 84% in extensively calcified lesions, while in vessels with no or less calcification, CT-QFR showed a comparable diagnostic accuracy with µQFR (91% versus 92%, p â= â0.595). Intra- and inter-observer variability in CT-QFR analysis was -0.00 â± â0.04 and 0.00 â± â0.04, respectively.CONCLUSIONS:
Performance in diagnosis of hemodynamically significant coronary stenosis by CT-QFR was slightly lower but without statistical significance than µQFR, and substantially higher than CTA-derived diameter stenosis. Extensively calcified lesions reduced the diagnostic accuracy of CT-QFR.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Enfermedad de la Arteria Coronaria
/
Estenosis Coronaria
/
Reserva del Flujo Fraccional Miocárdico
Tipo de estudio:
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
J Cardiovasc Comput Tomogr
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
RADIOLOGIA
Año:
2022
Tipo del documento:
Article
País de afiliación:
China