Diagnostic accuracy of quantitative flow ratio (QFR) and vessel fractional flow reserve (vFFR) estimated retrospectively by conventional radiation saving X-ray angiography
| Autor: | Hannah Safi, Guosheng Fu, Vincenzo Tufaro, Andreas Baumbach, Anthony Mathur, Chongying Jin, Yakup Kilic, Retesh Bajaj, Anantharaman Ramasamy, Christos V. Bourantas |
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| Rok vydání: | 2021 |
| Předmět: |
Diagnostic accuracy
Fractional flow reserve Coronary Angiography Single Center Severity of Illness Index QFR Cohort Studies X-ray Angiography Predictive Value of Tests Humans Medicine Radiology Nuclear Medicine and imaging Cardiac imaging Retrospective Studies Original Paper medicine.diagnostic_test business.industry X-Rays Angiography Coronary Stenosis Gold standard (test) vFFR Coronary Vessels Fractional Flow Reserve Myocardial Flow ratio Cardiology and Cardiovascular Medicine business Nuclear medicine |
| Zdroj: | The International Journal of Cardiovascular Imaging |
| ISSN: | 1573-0743 1569-5794 |
| Popis: | Background Angiography derived FFR reveals good performance in assessing intermediate coronary stenosis. However, its performance under contemporary low X-ray frame and pulse rate settings is unknown. We aim to validate the feasibility and performance of quantitative flow ratio (QFR) and vessel fractional flow reserve (vFFR) under such angiograms. Methods This was an observational, retrospective, single center cohort study. 134 vessels in 102 patients, with angiograms acquired under 7.5fps and 7pps mode, were enrolled. QFR (fQFR and cQFR) and vFFR were validated with FFR as the gold standard. A conventional manual and a newly developed algorithmic exclusion method (M and A group) were both evaluated for identification of poor-quality angiograms. Results Good agreement between QFR/vFFR and FFR were observed in both M and A group, except for vFFR in the M group. The correlation coefficients between fQFR/cQFR/vFFR and FFR were 0.6242, 0.5888, 0.4089 in the M group, with rvFFR significantly lower than rfQFR (p = 0.0303), and 0.7055, 0.6793, 0.5664 in the A group, respectively. AUCs of detecting lesions with FFR ≤ 0.80 were 0.852 (95% CI 0.722–0.913), 0.858 (95% CI 0.778–0.917), 0.682 (95% CI 0.586–0.768), for fQFR/cQFR/vFFR in the M group, while vFFR performed poorer than fQFR (p = 0.0063) and cQFR (p = 0.0054). AUCs were 0.898 (95% CI 0.811–0.945), 0.892 (95% CI 0.803–0.949), 0.843 (95% CI 0.746–0.914) for fQFR/cQFR/vFFR in the A group. AUCvFFR was significantly higher in the A group than that in the M group (p = 0.0399). Conclusions QFR/vFFR assessment is feasible under 7.5fps and 7pps angiography, where cQFR showed no advantage compared to fQFR. Our newly developed algorithmic exclusion method could be a better method of selecting angiograms with adequate quality for angiography derived FFR assessment. |
| Databáze: | OpenAIRE |
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