Diagnosis of Ischemia-Causing Coronary Stenoses by Noninvasive Fractional Flow Reserve Computed From Coronary Computed Tomographic Angiograms Results From the Prospective Multicenter DISCOVER-FLOW (Diagnosis of Ischemia-Causing Stenoses Obtained Via Noninvasive Fractional Flow Reserve) Study
Diagnosis of Ischemia-Causing Coronary Stenoses by Noninvasive Fractional Flow Reserve Computed From Coronary Computed Tomographic Angiograms Results From the Prospective Multicenter DISCOVER-FLOW (Diagnosis of Ischemia-Causing Stenoses Obtained Via Noninvasive Fractional Flow Reserve) Study
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DOI：
10.1016/j.jacc.2011.06.066
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发表时间：
2011-11-01
影响因子：
24
通讯作者：
Min, James K.
中科院分区：
文献类型：
--
作者：
Koo, Bon-Kwon;Erglis, Andrejs;Min, James K.
目的本研究的目的是确定一种新方法的诊断性能，该方法通过计算流体动力学（CFD）定量血流储备分数（FFR），应用于疑似或已知冠状动脉疾病（CAD）患者的冠状动脉计算机断层扫描血管造影（CCTA）数据。背景在侵入性冠状动脉造影术期间测量FFR是用于识别引起缺血的冠状动脉病变的金标准，改善了血运重建的临床决策。从CCTA数据（FFRCT）计算血流储备分数提供了一种非侵入性的方法，用于识别缺血引起的狭窄，但是，这种新方法的诊断性能是unknown.MethodsComputation从CCTA数据的血流储备分数进行了159支血管在103例接受CCTA，侵入性冠状动脉造影，和血流储备分数。独立核心实验室通过CCTA确定FFRCT和CAD狭窄严重程度。缺血由FFRCT和FFR = 50%定义。以有创血流储备分数作为参考标准评估了FFRCT和CCTA狭窄的诊断性能。
ObjectivesThe aim of this study was to determine the diagnostic performance of a new method for quantifying fractional flow reserve (FFR) with computational fluid dynamics (CFD) applied to coronary computed tomography angiography (CCTA) data in patients with suspected or known coronary artery disease (CAD).BackgroundMeasurement of FFR during invasive coronary angiography is the gold standard for identifying coronary artery lesions that cause ischemia and improves clinical decision-making for revascularization. Computation of FFR from CCTA data (FFRCT) provides a noninvasive method for identifying ischemia-causing stenosis; however, the diagnostic performance of this new method is unknown.MethodsComputation of FFR from CCTA data was performed on 159 vessels in 103 patients undergoing CCTA, invasive coronary angiography, and FFR. Independent core laboratories determined FFRCT and CAD stenosis severity by CCTA. Ischemia was defined by an FFRCT and FFR = 50%. Diagnostic performance of FFRCT and CCTA stenosis was assessed with invasive FFR as the reference standard.ResultsFifty-six percent of patients had >= 1 vessel with FFR