Diagnostic Performance of Noninvasive Fractional Flow Reserve Derived From Coronary Computed Tomography Angiography in Suspected Coronary Artery Disease The NXT Trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps)
Diagnostic Performance of Noninvasive Fractional Flow Reserve Derived From Coronary Computed Tomography Angiography in Suspected Coronary Artery Disease The NXT Trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps)
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DOI：
10.1016/j.jacc.2013.11.043
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发表时间：
2014-04-01
影响因子：
24
通讯作者：
Achenbach, Stephan
中科院分区：
文献类型：
--
作者：
Norgaard, Bjarne L.;Leipsic, Jonathon;Achenbach, Stephan
本研究的目的是确定来自标准获得性冠状动脉计算机断层造影（CTA）数据集（FFRCT）的无创分数血流储备（FFR）对疑似稳定型冠状动脉疾病（CAD）患者心肌缺血的诊断价值。背景：有创冠状动脉造影（ICA）期间测量的FFR是稳定型CAD患者病变特异性冠状动脉重建术决策的金标准。FFRCT在疑似CAD患者中无创识别缺血的潜力尚未得到充分的研究。方法本前瞻性多中心试验纳入254例疑似CAD患者，计划行临床适应症ICA。术前行冠状动脉CTA检查。冠状动脉CTA的狭窄评估（bbb50 %管腔缩小）由当地调查员进行，ICA由独立的核心实验室进行。FFRCT由一个独立的核心实验室以盲法计算和解释。将结果与有创测量的FFR进行比较，将缺血定义为FFRCT或FFR
Objectives The goal of this study was to determine the diagnostic performance of noninvasive fractional flow reserve (FFR) derived from standard acquired coronary computed tomography angiography (CTA) datasets (FFRCT) for the diagnosis of myocardial ischemia in patients with suspected stable coronary artery disease (CAD).Background FFR measured during invasive coronary angiography (ICA) is the gold standard for lesion-specific coronary revascularization decisions in patients with stable CAD. The potential for FFRCT to noninvasively identify ischemia in patients with suspected CAD has not been sufficiently investigated.Methods This prospective multicenter trial included 254 patients scheduled to undergo clinically indicated ICA for suspected CAD. Coronary CTA was performed before ICA. Evaluation of stenosis (>50% lumen reduction) in coronary CTA was performed by local investigators and in ICA by an independent core laboratory. FFRCT was calculated and interpreted in a blinded fashion by an independent core laboratory. Results were compared with invasively measured FFR, with ischemia defined as FFRCT or FFR