Coronary CT angiography derived morphological and functional quantitative plaque markers correlated with invasive fractional flow reserve for detecting hemodynamically significant stenosis

被引：59

作者：

Tesche, Christian ^{[1
,2
]}

De Cecco, Carlo N. ^{[1
,3
]}

Caruso, Damiano ^{[1
,3
]}

Baumann, Stefan ^{[1
,4
]}

Renker, Matthias ^{[1
,5
]}

Mangold, Stefanie ^{[1
,6
]}

Dyer, Kevin T. ^{[1
]}

Varga-Szemes, Akos ^{[1
]}

Baquet, Moritz ^{[7
]}

Jochheim, David ^{[7
]}

Ebersberger, Ullrich ^{[1
,2
]}

Bayer, Richard R., II ^{[8
]}

Hoffmann, Ellen ^{[2
]}

Steinberg, Daniel H. ^{[8
]}

Schoepf, U. Joseph ^{[1
,8
]}

机构：

[1] Med Univ S Carolina, Dept Radiol & Radiol Sci, Div Cardiovasc Imaging, Charleston, SC 29425 USA

[2] Heart Ctr Munich Bogenhausen, Dept Cardiol & Intens Care Med, Munich, Germany

[3] Univ Roma La Sapienza, Dept Radiol Sci Oncol & Pathol, Piazzale Aldo Moro 5, I-00185 Rome, Italy

[4] Heidelberg Univ, Univ Med Ctr Mannheim UMM, Fac Med Mannheim, Dept Med 1, Mannheim, Germany

[5] Univ Giessen, Dept Internal Med 1, Cardiol Angiol, D-35390 Giessen, Germany

[6] Univ Tubingen, Dept Diagnost & Intervent Radiol, Tubingen, Germany

[7] Univ Munich, Dept Cardiol, Hosp, Munich, Germany

[8] Med Univ S Carolina, Dept Med, Div Cardiol, Charleston, SC 29425 USA

来源：

JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY | 2016年 / 10卷 / 03期

关键词：

Coronary artery disease; Invasive catheter angiography; Fractional flow reserve; Coronary computed tomography angiography; Transluminal attenuation gradient; Corrected coronary opacification; TRANSLUMINAL ATTENUATION GRADIENT; COMPUTED-TOMOGRAPHY ANGIOGRAPHY; DIAGNOSTIC PERFORMANCE; DISCOVER-FLOW; GUIDELINES; SOCIETY; BURDEN;

D O I：

10.1016/j.jcct.2016.03.002

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: Compare morphological and functional coronary plaque markers derived from coronary CT angiography (CCTA) for their ability to detect lesion-specific ischemia. Materials and methods: Data of patients who had undergone both dual-source CCTA and invasive fractional flow reserve (FFR) measurement within 3 months were retrospectively analyzed. Various quantitative stenosis markers were derived from CCTA: Corrected coronary opacification (CCO), transluminal attenuation gradient (TAG), remodeling index (RI), computational FFR (cFFR), lesion length (LL), vessel volume (VV), total plaque volume (TPV), and calcified and non-calcified plaque volume (CPV and NCPV). Discriminatory power of these markers for flow-limiting versus non-significant coronary stenosis was assessed against invasive FFR as the reference standard. Results: The cohort included 37 patients (61 +/- 12 years, 68% male). Among 37 lesions, 11 were hemodynamically significant by FFR. On a per-lesion level, sensitivity and specificity of TPV, CPV, and NCPV for hemodynamically significant stenosis detection were 88% and 74%, 67% and 53%, and 92% and 81%, respectively. For CCO, TAG, RI, and cFFR these were 64% and 86%, 35% and 56%, 82% and 54%, and 100% and 90%, respectively. At ROC analysis, only TPV (0.78, p = 0.013), NCPV (0.79, p = 0.009), cFFR (0.85, p = 0.003), and CCO (0.82, p = 0.0003) showed discriminatory power for detecting hemodynamically significant stenosis. Conclusion: TPV, NCPV, CCO, and cFFR derived from CCTA can aid detecting hemodynamically significant coronary lesions with cFFR showing the greatest discriminatory ability. (C) 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

引用

页码：199 / 206

页数：8

共 26 条

[1] Coronary CT angiography-derived fractional flow reserve correlated with invasive fractional flow reserve measurements - initial experience with a novel physician-driven algorithm [J].