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Article Abstract
Background: Coronary computed tomography angiography (CTA) and optical coherence tomography (OCT) provide additional functional information beyond the anatomy by applying computational fluid dynamics (CFD). This study sought to evaluate a novel approach for estimating computational fractional flow reserve (FFR) from coronary CTA-OCT fusion images.
Methods: Among patients who underwent coronary CTA, 148 patients who underwent both pressure wire-based FFR measurement and OCT during angiography to evaluate intermediate stenosis in the left anterior descending artery were included from the prospective registry. Coronary CTA-OCT fusion images were created, and CFD was applied to estimate computational FFR. Based on pressure wire-based FFR as a reference, the diagnostic performance of Fusion-FFR was compared with that of CT-FFR and OCT-FFR.
Results: Fusion-FFR was strongly correlated with FFR ( = 0.836, < 0.001). Correlation between FFR and Fusion-FFR was stronger than that between FFR and CT-FFR ( = 0.682, < 0.001; z statistic, 5.42, < 0.001) and between FFR and OCT-FFR ( = 0.705, < 0.001; z statistic, 4.38, < 0.001). Area under the receiver operating characteristics curve to assess functionally significant stenosis was higher for Fusion-FFR than for CT-FFR (0.90 vs. 0.83, = 0.024) and OCT-FFR (0.90 vs. 0.83, = 0.043). Fusion-FFR exhibited 84.5% accuracy, 84.6% sensitivity, 84.3% specificity, 80.9% positive predictive value, and 87.5% negative predictive value. Especially accuracy, specificity, and positive predictive value were superior for Fusion-FFR than for CT-FFR (73.0%, = 0.007; 61.4%, < 0.001; 64.0%, < 0.001) and OCT-FFR (75.7%, = 0.021; 73.5%, = 0.020; 69.9%, = 0.012).
Conclusion: CFD-based computational FFR from coronary CTA-OCT fusion images provided more accurate functional information than coronary CTA or OCT alone.
Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT03298282].
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9234158 | PMC |
| http://dx.doi.org/10.3389/fcvm.2022.925414 | DOI Listing |
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