Frontiers in Cardiovascular Medicine (Oct 2021)
Diagnostic Performance of Fractional Flow Reserve From CT Coronary Angiography With Analytical Method
- Jun-Mei Zhang,
- Jun-Mei Zhang,
- Huan Han,
- Ru-San Tan,
- Ru-San Tan,
- Ping Chai,
- Ping Chai,
- Jiang Ming Fam,
- Lynette Teo,
- Lynette Teo,
- Chee Yang Chin,
- Ching Ching Ong,
- Ching Ching Ong,
- Ris Low,
- Gaurav Chandola,
- Shuang Leng,
- Shuang Leng,
- Weimin Huang,
- John C. Allen,
- Lohendran Baskaran,
- Lohendran Baskaran,
- Ghassan S. Kassab,
- Adrian Fatt Hoe Low,
- Mark Yan-Yee Chan,
- Mark Yan-Yee Chan,
- Koo Hui Chan,
- Koo Hui Chan,
- Poay Huan Loh,
- Poay Huan Loh,
- Aaron Sung Lung Wong,
- Aaron Sung Lung Wong,
- Swee Yaw Tan,
- Swee Yaw Tan,
- Terrance Chua,
- Terrance Chua,
- Soo Teik Lim,
- Soo Teik Lim,
- Liang Zhong,
- Liang Zhong
Affiliations
- Jun-Mei Zhang
- National Heart Centre Singapore, Singapore, Singapore
- Jun-Mei Zhang
- Duke-NUS Medical School, Singapore, Singapore
- Huan Han
- National Heart Centre Singapore, Singapore, Singapore
- Ru-San Tan
- National Heart Centre Singapore, Singapore, Singapore
- Ru-San Tan
- Duke-NUS Medical School, Singapore, Singapore
- Ping Chai
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
- Ping Chai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Jiang Ming Fam
- National Heart Centre Singapore, Singapore, Singapore
- Lynette Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Lynette Teo
- Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore
- Chee Yang Chin
- National Heart Centre Singapore, Singapore, Singapore
- Ching Ching Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Ching Ching Ong
- Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore
- Ris Low
- National Heart Centre Singapore, Singapore, Singapore
- Gaurav Chandola
- National Heart Centre Singapore, Singapore, Singapore
- Shuang Leng
- National Heart Centre Singapore, Singapore, Singapore
- Shuang Leng
- Duke-NUS Medical School, Singapore, Singapore
- Weimin Huang
- Institute for Infocomm Research, Agency for Science, Technology and Research, Singapore, Singapore
- John C. Allen
- Duke-NUS Medical School, Singapore, Singapore
- Lohendran Baskaran
- National Heart Centre Singapore, Singapore, Singapore
- Lohendran Baskaran
- Duke-NUS Medical School, Singapore, Singapore
- Ghassan S. Kassab
- California Medical Innovations Institute, San Diego, CA, United States
- Adrian Fatt Hoe Low
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
- Mark Yan-Yee Chan
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
- Mark Yan-Yee Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Koo Hui Chan
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
- Koo Hui Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Poay Huan Loh
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
- Poay Huan Loh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Aaron Sung Lung Wong
- National Heart Centre Singapore, Singapore, Singapore
- Aaron Sung Lung Wong
- Duke-NUS Medical School, Singapore, Singapore
- Swee Yaw Tan
- National Heart Centre Singapore, Singapore, Singapore
- Swee Yaw Tan
- Duke-NUS Medical School, Singapore, Singapore
- Terrance Chua
- National Heart Centre Singapore, Singapore, Singapore
- Terrance Chua
- Duke-NUS Medical School, Singapore, Singapore
- Soo Teik Lim
- National Heart Centre Singapore, Singapore, Singapore
- Soo Teik Lim
- Duke-NUS Medical School, Singapore, Singapore
- Liang Zhong
- National Heart Centre Singapore, Singapore, Singapore
- Liang Zhong
- Duke-NUS Medical School, Singapore, Singapore
- DOI
- https://doi.org/10.3389/fcvm.2021.739633
- Journal volume & issue
-
Vol. 8
Abstract
The aim of this study was to evaluate a new analytical method for calculating non-invasive fractional flow reserve (FFRAM) to diagnose ischemic coronary lesions. Patients with suspected or known coronary artery disease (CAD) who underwent computed tomography coronary angiography (CTCA) and invasive coronary angiography (ICA) with FFR measurements from two sites were prospectively recruited. Obstructive CAD was defined as diameter stenosis (DS) ≥50% on CTCA or ICA. FFRAM was derived from CTCA images and anatomical features using analytical method and was compared with computational fluid dynamics (CFD)-based FFR (FFRB) and invasive ICA-based FFR. FFRAM, FFRB, and invasive FFR ≤ 0.80 defined ischemia. A total of 108 participants (mean age 60, range: 30–83 years, 75% men) with 169 stenosed coronary arteries were analyzed. The per-vessel accuracy, sensitivity, specificity, and positive predictive and negative predictive values were, respectively, 81, 75, 86, 81, and 82% for FFRAM and 87, 88, 86, 83, and 90% for FFRB. The area under the receiver operating characteristics curve for FFRAM (0.89 and 0.87) and FFRB (0.90 and 0.86) were higher than both CTCA- and ICA-derived DS (all p < 0.0001) on per-vessel and per-patient bases for discriminating ischemic lesions. The computational time for FFRAM was much shorter than FFRB (2.2 ± 0.9 min vs. 48 ± 36 min, excluding image acquisition and segmentation). FFRAM calculated from a novel and expeditious non-CFD approach possesses a comparable diagnostic performance to CFD-derived FFRB, with a significantly shorter computational time.
Keywords
- coronary artery disease
- fractional flow reserve
- computed tomography coronary angiography
- analytical method
- non-invasive