Correlation between coronary computed tomographic angiography and fractional flow reserve

Kristensen, Thomas Bjerring; Engstrøm, Thomas; Kelbæk, Henning; Recke, Peter von der; Nielsen, Michael Bachmann; Kofoed, Klaus F.

doi:10.1016/j.ijcard.2009.04.024

Cited by 48 publications

(34 citation statements)

References 40 publications

(45 reference statements)

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“…This is within the range reported in previous studies assessing specifically intermediate-grade CAS on CCA [27,28] and on CCTA [13]. However, our reported prevalence was substantially higher than the rate of 18 % (10/56) reported by Kristensen et al [26] but lower than the rate of 45 % reported by Rossi et al [12]. This difference in prevalence is mainly due to differences in FFR cut-off, patient selection and the mode of stenosis assessment (visual or quantitative) on CCTA.…”

Section: Discussionsupporting

confidence: 82%

“…For example, in our study, 2.3 mm 2 MLA was the best predictor of FFR B 0.8, with a sensitivity and specificity of 88 and 60 % respectively. Our cut-off value, though similar to the 2.2 mm 2 reported by Doh et al [13], is slightly higher to the 1.8 mm 2 reported by Kristensen et al [26], and lower than the 3.0 mm 2 reported by Opolski et al [14].…”

Section: Discussionsupporting

confidence: 72%

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Diagnostic performance of quantitative coronary computed tomography angiography and quantitative coronary angiography to predict hemodynamic significance of intermediate-grade stenoses

Ghekiere

Dewilde

Bellekens

et al. 2015

Int J Cardiovasc Imaging

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 72%

Diagnostic performance of quantitative coronary computed tomography angiography and quantitative coronary angiography to predict hemodynamic significance of intermediate-grade stenoses

Ghekiere

Dewilde

Bellekens

et al. 2015

Int J Cardiovasc Imaging

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“…14 In our study, similar to Kristensen et al, 20 a curvilinear significant relationship was found between quantitative CTCA-derived parameters and FFR for a wide range of coronary lesion severity.…”

Section: Relationship Between Quantitative Ctca-derived Parameters Ansupporting

confidence: 88%

Quantitative Computed Tomographic Coronary Angiography

Rossi

Papadopoulou

Pugliese

et al. 2014

Circ: Cardiovascular Imaging

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Background-Coronary lesions with a diameter narrowing ≥50% on visual computed tomographic coronary angiography (CTCA) are generally considered for referral to invasive coronary angiography. However, similar to invasive coronary angiography, visual CTCA is often inaccurate in detecting functionally significant coronary lesions. We sought to compare the diagnostic performance of quantitative CTCA with visual CTCA for the detection of functionally significant coronary lesions using fractional flow reserve (FFR) as the reference standard. Methods and Results-CTCA and FFR measurements were obtained in 99 symptomatic patients. In total, 144 coronary lesions detected on CTCA were visually graded for stenosis severity. Quantitative CTCA measurements included lesion length, minimal area diameter, % area stenosis, minimal lumen diameter, % diameter stenosis, and plaque burden [(vessel area−lumen area)/vessel area×100]. Optimal cutoff values of CTCA-derived parameters were determined, and their diagnostic accuracy for the detection of flow-limiting coronary lesions (FFR ≤0.80) was compared with visual CTCA. FFR was ≤0.80 in 54 of 144 (38%) coronary lesions. Optimal cutoff values to predict flow-limiting coronary lesion were 10 mm for lesion length, 1.8 mm 2 for minimal area diameter, 73% for % area stenosis, 1.5 mm for minimal lumen diameter, 48% for % diameter stenosis, and 76% for plaque burden. No significant difference in sensitivity was found between visual CTCA and quantitative CTCA parameters (P>0.05). The specificity of visual CTCA (42%; 95% confidence interval [CI], 31%-54%) was lower than that of minimal area diameter (68%; 95% CI, 57%-77%; P=0.001), % area stenosis (76%; 95% CI, 65%-84%; P<0.001), minimal lumen diameter (67%; 95% CI, 55%-76%; P=0.001), % diameter stenosis (72%; 95% CI, 62%-80%; P<0.001), and plaque burden (63%; 95% CI, 52%-73%; P=0.004). The specificity of lesion length was comparable with that of visual CTCA. Conclusions-Quantitative CTCA improves the prediction of functionally significant coronary lesions compared with visual CTCA assessment but remains insufficient. Functional assessment is still required in lesions of moderate stenosis to accurately detect impaired FFR. (Circ Cardiovasc Imaging. 2014;7:43-51.)

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“…Coronary computed tomography angiography (CCTA) has emerged as a non-invasive technique to evaluate the presence of coronary artery disease and noninvasive FFR derived from it, shows high diagnostic performance for the detection of ischemic stenosis 30,31 . From a clinical study by Kristensen et al 28 , %AS obtained from CCTA was found to be clinically useful and significantly correlated with FFR. Notably, the percentage difference between FFR of 0 and 120 curvature models was 7.5 in 80% AS (considered intermediate stenosis).…”

Section: Discussionmentioning

confidence: 97%

“…Kristensen et al 28 have reported a two-dimensional plot of % AS versus FFR for individual hemodynamic clinical data, from which the FFR data around 70% AS were digitized and compared with those of the present study (Table 2). It is found that the numerical data in this study are in close agreement with the clinical data.…”

Section: Discussionmentioning

confidence: 99%

A Parametric Study of the Effect of Arterial Wall Curvature on Non-Invasive Assessment of Stenosis Severity:Computational Fluid Dynamics Study

et al. 2016

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Correlation between coronary computed tomographic angiography and fractional flow reserve

Cited by 48 publications

References 40 publications

Diagnostic performance of quantitative coronary computed tomography angiography and quantitative coronary angiography to predict hemodynamic significance of intermediate-grade stenoses

Diagnostic performance of quantitative coronary computed tomography angiography and quantitative coronary angiography to predict hemodynamic significance of intermediate-grade stenoses

Quantitative Computed Tomographic Coronary Angiography

A Parametric Study of the Effect of Arterial Wall Curvature on Non-Invasive Assessment of Stenosis Severity:Computational Fluid Dynamics Study

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