Diagnostic Performance of Angiography-Based Fractional Flow Reserve for Functional Evaluation of Coronary Artery Stenosis
Background: A new method for calculating fraction flow reserve (FFR) without pressure-wire (angiography-derived FFR) based on invasive coronary angiography (ICA) images can be used to evaluate the functional problems of coronary stenosis.Objective: The aim of this study was to assess the diagnostic...
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| Format: | Article |
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Frontiers Media S.A.
2021-10-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.714077/full |
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| author | Changling Li Xiaochang Leng Jingsong He Yongqing Xia Wenbing Jiang Yibin Pan Liang Dong Yong Sun Xinyang Hu Jian'an Wang Jianping Xiang Jun Jiang |
| author_facet | Changling Li Xiaochang Leng Jingsong He Yongqing Xia Wenbing Jiang Yibin Pan Liang Dong Yong Sun Xinyang Hu Jian'an Wang Jianping Xiang Jun Jiang |
| author_sort | Changling Li |
| collection | DOAJ |
| description | Background: A new method for calculating fraction flow reserve (FFR) without pressure-wire (angiography-derived FFR) based on invasive coronary angiography (ICA) images can be used to evaluate the functional problems of coronary stenosis.Objective: The aim of this study was to assess the diagnostic performance of a novel method of calculating the FFR compared to wire-based FFR using retrospectively collected data from patients with stable angina.Methods: Three hundred patients with stable angina pectoris who underwent ICA and FFR measurement were included in this study. Two ICA images with projections >25° apart at the end-diastolic frame were selected for 3D reconstruction. Then, the contrast frame count was performed in an angiographic run to calculate the flow velocity. Based on the segmented vessel, calculated velocity, and aortic pressure, AccuFFRangio distribution was calculated through the pressure drop equation.Results: Using FFR ≤ 0.8 as a reference, we evaluated AccuFFRangio performance for 300 patients with its accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Comparison of AccuFFRangio with wire-measured FFR resulted in an area under the curve (AUC) of 0.954 (per-vessel, p < 0.0001). Accuracy for AccuFFRangio was 93.7% for Pa set from measurement and 87% for Pa = 100 mmHg in this clinical study. Overall sensitivity, specificity, PPV, and NPV for per-vessel were 90, 95, 86.7, 96.3, and 57.5, 97.7, 90.2, 86.3%, respectively. Overall accuracy, sensitivity, specificity, PPV, and NPV for 2-dimensional (2D) quantitative coronary angiography (QCA) were 63.3, 42.5, 70.9, 34.7, and 77.2%, respectively. The average processing time of AccuFFRangio was 4.30 ± 1.87 min.Conclusions: AccuFFRangio computed from coronary ICA images can be an accurate and time-efficient computational tool for detecting lesion-specific ischemia of coronary artery stenosis. |
| first_indexed | 2024-12-22T08:31:33Z |
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| id | doaj.art-faba44a667ec4829877ea8addf6df1ce |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-22T08:31:33Z |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-faba44a667ec4829877ea8addf6df1ce2022-12-21T18:32:30ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-10-01810.3389/fcvm.2021.714077714077Diagnostic Performance of Angiography-Based Fractional Flow Reserve for Functional Evaluation of Coronary Artery StenosisChangling Li0Xiaochang Leng1Jingsong He2Yongqing Xia3Wenbing Jiang4Yibin Pan5Liang Dong6Yong Sun7Xinyang Hu8Jian'an Wang9Jianping Xiang10Jun Jiang11Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaArteryFlow Technology Co., Ltd., Hangzhou, ChinaArteryFlow Technology Co., Ltd., Hangzhou, ChinaArteryFlow Technology Co., Ltd., Hangzhou, ChinaDepartment of Cardiology, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, ChinaDepartment of Cardiology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaArteryFlow Technology Co., Ltd., Hangzhou, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaBackground: A new method for calculating fraction flow reserve (FFR) without pressure-wire (angiography-derived FFR) based on invasive coronary angiography (ICA) images can be used to evaluate the functional problems of coronary stenosis.Objective: The aim of this study was to assess the diagnostic performance of a novel method of calculating the FFR compared to wire-based FFR using retrospectively collected data from patients with stable angina.Methods: Three hundred patients with stable angina pectoris who underwent ICA and FFR measurement were included in this study. Two ICA images with projections >25° apart at the end-diastolic frame were selected for 3D reconstruction. Then, the contrast frame count was performed in an angiographic run to calculate the flow velocity. Based on the segmented vessel, calculated velocity, and aortic pressure, AccuFFRangio distribution was calculated through the pressure drop equation.Results: Using FFR ≤ 0.8 as a reference, we evaluated AccuFFRangio performance for 300 patients with its accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Comparison of AccuFFRangio with wire-measured FFR resulted in an area under the curve (AUC) of 0.954 (per-vessel, p < 0.0001). Accuracy for AccuFFRangio was 93.7% for Pa set from measurement and 87% for Pa = 100 mmHg in this clinical study. Overall sensitivity, specificity, PPV, and NPV for per-vessel were 90, 95, 86.7, 96.3, and 57.5, 97.7, 90.2, 86.3%, respectively. Overall accuracy, sensitivity, specificity, PPV, and NPV for 2-dimensional (2D) quantitative coronary angiography (QCA) were 63.3, 42.5, 70.9, 34.7, and 77.2%, respectively. The average processing time of AccuFFRangio was 4.30 ± 1.87 min.Conclusions: AccuFFRangio computed from coronary ICA images can be an accurate and time-efficient computational tool for detecting lesion-specific ischemia of coronary artery stenosis.https://www.frontiersin.org/articles/10.3389/fcvm.2021.714077/fullfractional flow reserveinvasive coronary angiographycoronary arteryischemiastenosis |
| spellingShingle | Changling Li Xiaochang Leng Jingsong He Yongqing Xia Wenbing Jiang Yibin Pan Liang Dong Yong Sun Xinyang Hu Jian'an Wang Jianping Xiang Jun Jiang Diagnostic Performance of Angiography-Based Fractional Flow Reserve for Functional Evaluation of Coronary Artery Stenosis Frontiers in Cardiovascular Medicine fractional flow reserve invasive coronary angiography coronary artery ischemia stenosis |
| title | Diagnostic Performance of Angiography-Based Fractional Flow Reserve for Functional Evaluation of Coronary Artery Stenosis |
| title_full | Diagnostic Performance of Angiography-Based Fractional Flow Reserve for Functional Evaluation of Coronary Artery Stenosis |
| title_fullStr | Diagnostic Performance of Angiography-Based Fractional Flow Reserve for Functional Evaluation of Coronary Artery Stenosis |
| title_full_unstemmed | Diagnostic Performance of Angiography-Based Fractional Flow Reserve for Functional Evaluation of Coronary Artery Stenosis |
| title_short | Diagnostic Performance of Angiography-Based Fractional Flow Reserve for Functional Evaluation of Coronary Artery Stenosis |
| title_sort | diagnostic performance of angiography based fractional flow reserve for functional evaluation of coronary artery stenosis |
| topic | fractional flow reserve invasive coronary angiography coronary artery ischemia stenosis |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.714077/full |
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