The Functional Severity Assessment of Coronary Stenosis Using Coronary Computed Tomography Angiography-Based Myocardial Mass at Risk and Minimal Lumen Diameter

Autor: Kiyoshi Hironaga, Kohei Muramatsu, Yoshihiro Fukumoto, Kazuhiro Nagaoka, Kenji Sadamatsu, Kotaro Kagiyama, Takafumi Ueno, Hideki Tashiro, Yasuaki Koga
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Computed Tomography Angiography
medicine.medical_treatment
Fractional flow reserve
Coronary Artery Disease
030204 cardiovascular system & hematology
Coronary Angiography
Severity of Illness Index
0302 clinical medicine
Japan
Risk Factors
Pharmacology (medical)
030212 general & internal medicine
Computed tomography angiography
medicine.diagnostic_test
General Medicine
Prognosis
Coronary Vessels
Fractional Flow Reserve
Myocardial
Predictive value of tests
Cardiology
Female
Cardiology and Cardiovascular Medicine
Research Article
medicine.medical_specialty
Article Subject
RM1-950
Revascularization
complex mixtures
03 medical and health sciences
Left coronary artery
Predictive Value of Tests
Internal medicine
medicine.artery
Severity of illness
Multidetector Computed Tomography
medicine
Diseases of the circulatory (Cardiovascular) system
Humans
Aged
Retrospective Studies
Pharmacology
Receiver operating characteristic
business.industry
Coronary Stenosis
Reproducibility of Results
Lumen Diameter
RC666-701
Therapeutics. Pharmacology
business
Zdroj: Cardiovascular Therapeutics
Cardiovascular Therapeutics, Vol 2020 (2020)
ISSN: 1755-5922
1755-5914
Popis: Background. We investigated whether or not the addition of myocardial mass at risk (MMAR) to quantitative coronary angiography was useful for diagnosing functionally significant coronary stenosis in the daily practice. Methods. We retrospectively enrolled 111 consecutive patients with 149 lesions who underwent clinically indicated coronary computed tomography angiography and subsequent elective coronary angiography with fractional flow reserve (FFR) measurement. MMAR was calculated using a workstation-based software program with ordinary thin slice images acquired for the computed tomography, and the minimal lumen diameter (MLD) and the diameter stenosis were measured with quantitative coronary angiography. Results. The MLD and MMAR were significantly correlated with the FFR, and the MMAR-to-MLD ratio (MMAR/MLD) showed a good correlation. The area under the receiver operating characteristic curve (AUC) of MMAR/MLD for FFR ≤ 0.8 was 0.746, and the sensitivity, specificity, positive predictive value, and negative predictive value were 60%, 83%, 68%, and 77%, respectively, at a cut-off value of 29.5 ml/mm. The addition of MMAR/MLD to diameter stenosis thus made it possible to further discriminate lesions with FFR ≤ 0.8 (AUC = 0.750). For the proximal left coronary artery lesions, in particular, MMAR/MLD showed a better correlation with the FFR, and the AUC of MMAR/MLD for FFR ≤ 0.8 was 0.919 at a cut-off value of 31.7 ml/mm. Conclusions. The index of MMAR/MLD correlated well with the physiological severity of coronary stenosis and showed good accuracy for detecting functional significance. The MMAR/MLD might be a useful parameter to consider when deciding the indication for revascularization.
Databáze: OpenAIRE
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