Morphometric assessment for functional evaluation of coronary stenosis with intravascular ultrasound and ultrasonic flow ratio in vessel with single stenosis

Abstract

Background: The ultrasonic flow ratio(UFR) derived from morpho-functional computational method by IVUS image. UFR can identify the functional severity of coronary stenosis, but it is unclear whether UFR would improve diagnostic accuracy of IVUS in determining coronary stenosis hemodynamics in single-stenosis lesion. Aim: The study investigatedthe diagnostic performance of intravascular ultrasound-derived parameters (IVUS) in identifying functionally significant coronary stenosis in a vessel with single stenosis. Methods: 68 patients with 70vessels were enrolled in this single stenosis study, all vessels were performed with IVUSand Murray law based quantitative flow ratio (μQFR), and IVUSimages were used to perform UFR. Results: UFR showed a good correlation with μQFR(r =0.87; p <0.001). With μQFRas the reference, the diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of UFR was98.57%, 95%, 100%, 100.00% and 98%, respectively. With UFR/μQFRconcordance, lesion length, minimal lumen diameter (MLD), diameter stenosis (DS), and area stenosis (AS) in quantitative coronary angiography (QCA), minimal lumen area (MLA), plaque burden, and plaque volume in IVUS showed excellent diagnostic efficiency in determining the functional significance of coronary stenosis in a vessel with single stenosis. Multiple logistic regression models, including the lesion length and DS in QCA, and MLA in IVUS provided superior predictive efficacy for physiologically significant ischemia. Conclusions: UFR has a good correlation with μQFR. IVUS derived parameters have excellent diagnostic efficiency in identifying the hemodynamic significance of coronary stenosis in a vessel with single stenosis.