Enhanced diagnosis of ischemic coronary artery stenosis using CT-derived fractional flow reserve based on computational fluid dynamics.

IF 1.4 4区医学 Q2 Medicine

Revista De Investigacion Clinica-Clinical and Translational Investigation Pub Date : 2025-10-07 DOI:10.1016/j.ric.2025.100021

Gang Yang, Qiucang Xue, Jiani Yin, Jing Liang, Wenping Chen, Bing Zhang, Dan Mu

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引用次数: 0

Abstract

Background: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. Conventional CCTA has limited ability to evaluate functional significance of stenosis, highlighting the need for non-invasive physiological assessment methods.

Objective: This study aimed to assess the diagnostic performance of a CT-FFR algorithm based on CFD in identifying ischemic coronary artery stenosis.

Methods: A total of 184 vessels from 171 patients undergoing both CCTA and ICA were retrospectively analyzed. CT-FFR and QFR were computed, with QFR ≤0.8 serving as the reference standard for ischemia. The diagnostic capabilities of CT-FFR were compared with anatomical evaluation via CCTA.

Results: CT-FFR demonstrated superior diagnostic performance over CCTA, with per-vessel sensitivity of 95.5%, specificity of 74.2%, and accuracy of 91.8% (AUC: 0.839 vs. 0.637, P<0.001). In lesions with intermediate QFR values (0.75-0.85), CT-FFR maintained high diagnostic accuracy (79.4%) and AUC (0.785), outperforming CCTA. Furthermore, CT-FFR remained reliable across various calcification levels, with diagnostic efficacy unaffected by Agatston scores.

Conclusion: CT-FFR based on CFD offers a robust, non-invasive solution for the functional assessment of coronary stenosis. Its diagnostic superiority over CCTA and consistent performance in calcified vessels highlight its clinical utility in precision cardiovascular care.

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基于计算流体动力学的ct衍生分数血流储备增强缺血性冠状动脉狭窄诊断。

背景：冠状动脉疾病（CAD）仍然是世界范围内发病率和死亡率的主要原因。传统的CCTA评估狭窄的功能意义的能力有限，突出了对非侵入性生理评估方法的需求。目的：本研究旨在评估基于CFD的CT-FFR算法对缺血性冠状动脉狭窄的诊断性能。方法：回顾性分析171例同时行CCTA和ICA的患者的184条血管。计算CT-FFR和QFR，以QFR≤0.8作为缺血的参考标准。将CT-FFR的诊断能力与CCTA的解剖评价进行比较。结果：CT-FFR的诊断性能优于CCTA，单支血管敏感性为95.5%，特异性为74.2%，准确率为91.8% （AUC: 0.839 vs. 0.637）。结论：基于CFD的CT-FFR为冠状动脉狭窄的功能评估提供了一种可靠的、无创的解决方案。它比CCTA的诊断优势和在钙化血管中的一致表现突出了它在精确心血管护理中的临床应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista De Investigacion Clinica-Clinical and Translational Investigation 医学-医学：内科

CiteScore

3.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： The Revista de Investigación Clínica – Clinical and Translational Investigation (RIC-C&TI), publishes original clinical and biomedical research of interest to physicians in internal medicine, surgery, and any of their specialties. The Revista de Investigación Clínica – Clinical and Translational Investigation is the official journal of the National Institutes of Health of Mexico, which comprises a group of Institutes and High Specialty Hospitals belonging to the Ministery of Health. The journal is published both on-line and in printed version, appears bimonthly and publishes peer-reviewed original research articles as well as brief and in-depth reviews. All articles published are open access and can be immediately and permanently free for everyone to read and download. The journal accepts clinical and molecular research articles, short reports and reviews. Types of manuscripts: – Brief Communications – Research Letters – Original Articles – Brief Reviews – In-depth Reviews – Perspectives – Letters to the Editor