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Evaluation of epicardial coronary resistance using computed tomography angiography: A Proof Concept.

Abstract：

AIMS:Fractional flow reserve (FFR) pullback allows to assess the distribution of pressure loss along the coronary vessels. FFR derived from CT (FFRCT) provides a virtual pullback curve that may also aid in the assessment of the distribution of epicardial coronary resistance in the non-invasive setting. The present study aims to determine the accuracy of the virtual FFRCT pullback curve using a motorized invasive FFR pullback as reference in patients with stable coronary artery disease. METHODS AND RESULTS:FFR values were extracted from coronary vessels at approximately 1 mm to generate pullback curves. Invasive motorized FFR pullbacks were acquired using a dedicated device at a speed of 1 mm/s. A total of 3172 matched FFRCT and FFR values were obtained in 24 vessels. The correlation coefficient between FFRCT and FFR was 0.76 (95%CI 0.75 to 0.78; p < 0.001). The area under the pullback curve was similar between FFRCT and invasive FFR (79.0 ± 16.1 vs. 85.3 ± 16.4, p = 0.097). The mean difference in lesion gradient between FFRCT and FFR was -0.07 (LOA -0.26 to 0.13) whereas in non-obstructive segments was -0.01 (LOA -0.06 to 0.05). CONCLUSION:The evaluation of epicardial coronary resistance using coronary CT angiography with FFRCT was feasible. FFRCT virtual pullback appears to be accurate for the evaluation of pressure gradients. FFRCT has the potential to identify the pathophysiological pattern of coronary artery disease in the non-invasive setting.

journal_name

J Cardiovasc Comput Tomogr

journal_title

Journal of cardiovascular computed tomography

authors

Mizukami T,Tanaka K,Sonck J,Vandeloo B,Roosens B,Lochy S,Argacha JF,Schoors D,Suzuki H,Belsack D,Andreini D,Barbato E,De Mey J,De Bruyne B,Cosyns B,Collet C

doi

10.1016/j.jcct.2019.09.004

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

177-184

issue

2

eissn

1934-5925

issn

1876-861X

pii

S1934-5925(19)30165-0

journal_volume

14

pub_type

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