Energy loss is related to CT fractional flow reserve progression in type 2 diabetes mellitus patients.

Autor: Tomizawa N; Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan., Fujimoto S; Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan., Takahashi D; Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan., Nozaki Y; Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan., Fan R; Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan., Kudo A; Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan., Kawaguchi Y; Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan., Takamura K; Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan., Hiki M; Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan., Kadowaki S; Department of Diabetes, Endocrinology, and Metabolism, Juntendo University Graduate School of Medicine, Tokyo, Japan., Ikeda F; Department of Diabetes, Endocrinology, and Metabolism, Juntendo University Graduate School of Medicine, Tokyo, Japan., Kumamaru KK; Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan., Watada H; Department of Diabetes, Endocrinology, and Metabolism, Juntendo University Graduate School of Medicine, Tokyo, Japan., Minamino T; Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan., Aoki S; Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Jazyk: angličtina
Zdroj: American heart journal plus : cardiology research and practice [Am Heart J Plus] 2023 Sep 28; Vol. 35, pp. 100328. Date of Electronic Publication: 2023 Sep 28 (Print Publication: 2023).
DOI: 10.1016/j.ahjo.2023.100328
Abstrakt: Background: We aimed to investigate the diagnostic value of energy loss (EL) and baseline CT fractional flow reserve (CT-FFR) computed using computational fluid dynamics to predict functional progression of coronary stenosis in patients with type 2 diabetes mellitus.
Methods: This single-center prospective study included 61 patients with type 2 diabetes mellitus (mean age, 61 years ±9 [SD]; 43 men) showing 20-70 % stenosis who underwent serial coronary CT performed at 2-year interval between October 2015 and March 2020. A mesh-free simulation was performed to calculate the CT-FFR and EL. Functional progression was defined as ≥ 0.05 decrease in CT-FFR on the second coronary CT. Models using baseline CT-FFR and EL were compared by analyzing the receiver operating characteristic (ROC) curve.
Results: Of the 94 vessels evaluated, 25 vessels (27 %) showed functional progression. EL at distal stenosis (EL dis ) of vessels with functional progression was higher than that of vessels without functional progression (27.6 W/m 3 [interquartile range (IQR): 15.0, 53.0] vs. 5.7 W/m 3 [IQR: 2.3, 10.1], p  < 0.001). Multivariable analysis showed that EL dis (per unit Ln(EL); odds ratio, 11.8; 95 % CI: 4.0-34.9; p < 0.001) remained as a predictor of functional progression after adjustment for diameter stenosis and baseline CT-FFR. The area under the ROC curve using EL dis (0.89; 95 % CI: 0.82-0.96) was higher than that using baseline CT-FFR (0.71; 95 % CI: 0.59-0.83; p  < 0.001).
Conclusion: When EL dis and baseline CT-FFR were considered, EL dis was a better predictor of functional progression of coronary stenosis.
(© 2023 The Authors.)
Databáze: MEDLINE
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