Advanced computed tomographic anatomical and morphometric plaque analysis for prediction of fractional flow reserve in intermediate coronary lesions
Opolski MP, Kepka C, Achenbach S, Pregowski J, Kruk M, Staruch AD, Kadziela J, Ruzyllo W, Witkowski A (2014)
Publication Type: Journal article
Publication year: 2014
Journal
Publisher: Elsevier
Book Volume: 83
Pages Range: 135-41
Journal Issue: 1
DOI: 10.1016/j.ejrad.2013.10.005
Abstract
To determine the application of advanced coronary computed tomography angiography (CCTA) plaque analysis for predicting invasive fractional flow reserve (FFR) in intermediate coronary lesions.Sixty-one patients with 71 single intermediate coronary lesions (>= 50-80% stenosis) on CCTA prospectively underwent coronary angiography and FFR. Advanced anatomical and morphometric plaque analysis was performed based on CCTA data set to determine optimal criteria for significant flow impairment. A significant stenosis was defined as FFR <= 0.80.FFR averaged 0.85 ± 0.09, and 19 lesions (27%) were functionally significant. FFR correlated with minimum lumen area (MLA) (r=0.456, p<0.001), minimum lumen diameter (MLD) (r=0.326, p=0.006), reference lumen diameter (RLD) (r=0.245, p=0.039), plaque burden (r=-0.313, p=0.008), lumen area stenosis (r=-0.305, p=0.01), lesion length (r=-0.692, p<0.001), and plaque volume (r=-0.668, p<0.001). There was no relationship between FFR and CCTA morphometric plaque parameters. By multivariate analysis the independent predictors of FFR were lesion length (beta=-0.581, p<0.001), MLA (beta=0.360, p=0.041), and RLD (beta=-0.255, p=0.036). The optimal cutoffs for lesion length, MLA, MLD, RLD, and lumen area stenosis were >18.5mm, <= 3.0mm(2), <= 2.1mm, <= 3.2mm, and >69%, respectively (max. sensitivity: 100% for MLA, max. specificity: 79% for lumen area stenosis).CCTA predictors for FFR support the mathematical relationship between stenosis pressure drop and coronary flow. CCTA could prove to be a useful rule-out test for significant hemodynamic effects of intermediate coronary stenoses.
Authors with CRIS profile
Involved external institutions
The Cardinal Stefan Wyszyński Institute of Cardiology / Instytut Kardiologii im. Prymasa Tysiąclecia Kardynała Stefana Wyszyńskiego
Poland (PL)
Wrocław Medical University / Uniwersytet Medyczny we Wrocławiu
Poland (PL)
Poland (PL)
Wrocław Medical University / Uniwersytet Medyczny we Wrocławiu
Poland (PL)
How to cite
APA:
Opolski, M.P., Kepka, C., Achenbach, S., Pregowski, J., Kruk, M., Staruch, A.D.,... Witkowski, A. (2014). Advanced computed tomographic anatomical and morphometric plaque analysis for prediction of fractional flow reserve in intermediate coronary lesions. European Journal of Radiology, 83(1), 135-41. https://doi.org/10.1016/j.ejrad.2013.10.005
MLA:
Opolski, Maksymilian P., et al. "Advanced computed tomographic anatomical and morphometric plaque analysis for prediction of fractional flow reserve in intermediate coronary lesions." European Journal of Radiology 83.1 (2014): 135-41.
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