Functional evaluation of intermediate coronary lesions with integrated computed tomography angiography and invasive angiography in patients with stable coronary artery disease

Journal of Translational Internal Medicine

article

Jingyi Xue¹  Jianqiang Li¹  Danghui Sun¹  Li Sheng¹  Yongtai Gong¹  Dingyu Wang¹  Song Zhang¹  Yilun Zou¹  Jing Shi¹  Wei Xu¹  Mengnan An¹  Chenguang Dai¹  Weimin Li¹  Linqun Zheng³  Asiia Vinograd¹  Guangzhong Liu¹  Yihui Kong¹  Yue Li¹ 

[1] Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin 150001, Heilongjiang Province;Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510000, Guangdong Province;Molecular and Translational Cardiology, Hannover Medical University

关键词: artificial intelligence;    CT angiography-derived fractional flow reserve;    fractional flow reserve;    quantitative flow ratio;    stable coronary artery disease;   

DOI  :  10.2478/jtim-2022-0018

来源: Walter de Gruyter GmbH

【 摘 要 】

Background and objectives The hemodynamic evaluation of coronary stenoses undergoes a transition from wire-based invasive measurements to image-based computational assessments. However, fractional flow reserve (FFR) values derived from coronary CT angiography (CCTA) and angiography-based quantitative flow ratio have certain limitations in accuracy and efficiency, preventing their widespread use in routine practice. Hence, we aimed to investigate the diagnostic performance of FFR derived from the integration of CCTA and invasive angiography (FFRCT-angio) with artificial intelligence assistance in patients with stable coronary artery disease (CAD). Methods Forty stable CAD patients with 67 target vessels (50%–90% diameter stenosis) were included in this single-center retrospective study. All patients underwent CCTA followed by coronary angiography with FFR measurement within 30 days. Both CCTA and angiographic images were combined to generate a three-dimensional reconstruction of the coronary arteries using artificial intelligence. Subsequently, functional assessment was performed through a deep learning algorithm. FFR was used as the reference. Results FFRCT-angio values were significantly correlated with FFR values (r = 0.81, P < 0.001, Spearman analysis). Per-vessel diagnostic accuracy of FFRCT-angio was 92.54%. Sensitivity and specificity in identifying ischemic lesions were 100% and 88.10%, respectively. Positive predictive value and negative predictive value were 83.33% and 100%, respectively. Moreover, the diagnostic performance of FFRCT-angio was satisfactory in different target vessels and different segment lesions. Conclusions FFRCT-angio exhibits excellent diagnostic performance of identifying ischemic lesions in patients with stable CAD. Combining CCTA and angiographic imaging, FFRCT-angio may represent an effective and practical alternative to invasive FFR in selected patients.

【 授权许可】

Unknown