Distal-vessel fractional flow reserve by computed tomography to monitor epicardial coronary artery disease.
| Autor: | Chen, Michael, Almeida, Shone O, Sayre, James W, Karlsberg, Ronald P, Packard, René R Sevag |
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| Předmět: |
CORONARY arterial radiography
STATISTICS CORONARY artery stenosis BLOOD vessels PREDICTIVE tests CONFIDENCE intervals STENOSIS MULTIPLE regression analysis PATHOLOGICAL anatomy RETROSPECTIVE studies ARTIFICIAL intelligence CORONARY circulation CORONARY angiography PEARSON correlation (Statistics) CORONARY artery disease DESCRIPTIVE statistics RESEARCH funding COMPUTED tomography RECEIVER operating characteristic curves DATA analysis DATA analysis software |
| Zdroj: | European Heart Journal - Cardiovascular Imaging; Feb2024, Vol. 25 Issue 2, p163-172, 10p |
| Abstrakt: | Aims Coronary computed tomography angiography (CTA) and fractional flow reserve by computed tomography (FFR-CT) are increasingly utilized to characterize coronary artery disease (CAD). We evaluated the feasibility of distal-vessel FFR-CT as an integrated measure of epicardial CAD that can be followed serially, assessed the CTA parameters that correlate with distal-vessel FFR-CT, and determined the combination of clinical and CTA parameters that best predict distal-vessel FFR-CT and distal-vessel FFR-CT changes. Methods and results Patients (n = 71) who underwent serial CTA scans at ≥2 years interval (median = 5.2 years) over a 14-year period were included in this retrospective study. Coronary arteries were analysed blindly using artificial intelligence-enabled quantitative coronary CTA. Two investigators jointly determined the anatomic location and corresponding distal-vessel FFR-CT values at CT1 and CT2. A total of 45.3% had no significant change, 27.8% an improvement, and 26.9% a worsening in distal-vessel FFR-CT at CT2. Stepwise multiple logistic regression analysis identified a four-parameter model consisting of stenosis diameter ratio, lumen volume, low density plaque volume, and age, that best predicted distal-vessel FFR-CT ≤ 0.80 with an area under the curve (AUC) = 0.820 at CT1 and AUC = 0.799 at CT2. Improvement of distal-vessel FFR-CT was captured by a decrease in high-risk plaque and increases in lumen volume and remodelling index (AUC = 0.865), whereas increases in stenosis diameter ratio, medium density calcified plaque volume, and total cholesterol presaged worsening of distal-vessel FFR-CT (AUC = 0.707). Conclusion Distal-vessel FFR-CT permits the integrative assessment of epicardial atherosclerotic plaque burden in a vessel-specific manner and can be followed serially to determine changes in global CAD. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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