Fractional Flow Reserve Calculation From 3-Dimensional Quantitative Coronary Angiography and TIMI Frame Count
Fractional Flow Reserve Calculation From 3-Dimensional Quantitative Coronary Angiography and TIMI Frame Count
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DOI：
10.1016/j.jcin.2014.03.004
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发表时间：
2014-07-01
影响因子：
11.3
通讯作者：
Reiber, Johan H. C.
中科院分区：
文献类型：
--
作者：
Tu, Shengxian;Barbato, Emanuele;Reiber, Johan H. C.
目的建立一种快速计算心肌血流储备分数（FFR）的计算机模型，并对其在中度冠状动脉狭窄患者中的应用进行评价。背景FFR是识别单个冠状动脉狭窄引起的局部缺血不可缺少的工具。从x线血管造影数据计算FFR可以提高FFR评估的实用性。方法对连续行压力丝法FFR测量的中度冠状动脉狭窄患者进行核心实验室分析。行三维定量冠状动脉造影（QCA），利用TIMI （Thrombolysis In Myocardial Infarction）帧数结合三维定量QCA计算充血时的平均体积血流率。应用计算流体力学方法，提出了一种计算FFR的新方法。以线基FFR作为参考标准，评估计算FFR （FFRQCA）的诊断性能。结果对68例患者的77条血管进行FFRQCA计算。平均直径狭窄46.6%±7.3%。FFRQCA与FFR相关良好（r = 0.81, p < 0.001），平均差值为0.00 +/- 0.06 （p = 0.541）。的FFR截止值
Objectives This study sought to present a novel computer model for fast computation of myocardial fractional flow reserve (FFR) and to evaluate it in patients with intermediate coronary stenoses.Background FFR is an indispensable tool to identify individual coronary stenoses causing ischemia. Calculation of FFR from x-ray angiographic data may increase the utility of FFR assessment.Methods Consecutive patients with intermediate coronary stenoses undergoing pressure wire-based FFR measurements were analyzed by a core laboratory. Three-dimensional quantitative coronary angiography (QCA) was performed and the mean volumetric flow rate at hyperemia was calculated using TIMI (Thrombolysis In Myocardial Infarction) frame count combined with 3-dimensional QCA. Computational fluid dynamics was applied subsequently with a novel strategy for the computation of FFR. Diagnostic performance of the computed FFR (FFRQCA) was assessed using wire-based FFR as reference standard.Results Computation of FFRQCA was performed on 77 vessels in 68 patients. Average diameter stenosis was 46.6 +/- 7.3%. FFRQCA correlated well with FFR (r = 0.81, p < 0.001), with a mean difference of 0.00 +/- 0.06 (p = 0.541). Applying the FFR cutoff value of