Less invasive fractional flow reserve measurement from 3-dimensional quantitative coronary angiography and classic fluid dynamic equations

EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
B TarZsolt Kőszegi

Abstract

The aim of this study was to develop a simplified model of FFR calculation (FFRsim) derived from three-dimensional (3D) coronary angiographic data and classic fluid dynamic equations without using finite element analysis. Intracoronary pressure measurements were performed by pressure wire sensors. The lumens of the interrogated vessel segments were reconstructed in 3D. The coronary artery volumetric flow was calculated based on the velocity of the contrast material. Pressure gradients were computed by classic fluid dynamic equations. The diagnostic power of the simplified computation of the FFR (FFRsim) was assessed by comparing the results with standard invasive FFR measurements (FFRmeas) in 68 vessels with a single stenosis. We found a strong correlation between the FFRsim and the FFRmeas (r=0.86, p<0.0001). The sensitivity and specificity for predicting the abnormal FFR of ≤0.80 (indicating haemodynamically significant stenosis) were 90% and 100%, respectively. The area under the curve (AUC) was 0.96. To achieve 100% negative and positive predictive values we defined the FFRsim >0.88 and the FFRsim ≤0.8 ranges. In our patient population, these ranges were found in 69% of the cases. According to our simplified model, the inva...Continue Reading

References

Jul 1, 1973·Journal of Biomechanics·D F Young, F Y Tsai
Jun 11, 2003·Circulation·Martin G StoelCees A Visser
Feb 20, 2004·European Heart Journal·Emanuele BarbatoUNKNOWN Week 25 study group
Feb 10, 2010·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Mohammed SaadGert Richardt
Jun 6, 2013·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Bruno R NascimentoMarco A Costa
Jul 6, 2014·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Michail I PapafaklisPatrick W Serruys
Apr 29, 2015·International Journal of Cardiology·Anastasios KopanidisDemosthenes Katritsis
Aug 28, 2017·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Carlos ColletPatrick W Serruys

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Citations

Dec 28, 2018·Circulation·William F FearonUNKNOWN FAST-FFR Study Investigators
Feb 6, 2020·Cardiovascular Research·Christopher C Y Wong, Andy S C Yong
May 13, 2020·Journal of Interventional Cardiology·Anantharaman RamasamyAndreas Baumbach
Jul 31, 2021·Trends in Cardiovascular Medicine·Dimitrios Terentes-PrintziosCharalambos Vlachopoulos

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