Toshimitsu Tsugu, Kaoru Tanaka, Dries Belsack, Mayuko Tsugu, Nico Buls, Jean-François Argacha, Bernard Cosyns, Yuji Nagatomo, Johan De Mey
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Enrolled vessels were classified into four groups according to lesion length (focal, <40 mm; diffuse, ≥40 mm) and DS (moderate, 50%–69%; severe, 70%–99%). FFR<sub>CT</sub> was measured at the distal end of the vessel (vessel-distal FFR<sub>CT</sub>), distal to the stenotic lesion (lesion-specific FFR<sub>CT</sub>), and trans-lesion FFR<sub>CT</sub> (ΔFFR<sub>CT</sub>) and compared with DS. Vessel morphology and left ventricular mass were assessed.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In focal lesions, the predictive ability for revascularization of ΔFFR<sub>CT</sub> (AUC = 0.71) was comparable to that of DS (AUC = 0.76, <i>p</i> = 0.166) and higher than that of lesion-specific FFR<sub>CT</sub> (AUC = 0.67, <i>p</i> < 0.001) and vessel-distal FFR<sub>CT</sub> (AUC = 0.63, <i>p</i> < 0.001). Multivariable analysis showed that lesion length was the strongest predictor of ΔFFR<sub>CT</sub> (<i>β</i>-coefficient = 0.42, <i>p</i> = 0.006). In diffuse lesions, the predictive ability for revascularization of ΔFFR<sub>CT</sub> (AUC = 0.73) was comparable to that of DS (AUC = 0.77, <i>p</i> = 0.667), lesion-specific FFR<sub>CT</sub> (AUC = 0.72, <i>p</i> = 0.653), and vessel-distal FFR<sub>CT</sub> (AUC = 0.69, <i>p</i> = 0.242). Multivariable analysis showed that lesion length was the strongest predictor of ΔFFR<sub>CT</sub> (<i>β</i>-coefficient = 0.99, <i>p</i> < 0.001).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The predictive performance of ΔFFR<sub>CT</sub> for revascularization was similar to DS in focal and diffuse lesions. ΔFFR<sub>CT</sub> was influenced by lesion length.</p>\n </section>\n </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of Diagnostic Accuracy of CT Derived Fractional Flow Reserve for Predicting Revascularization\",\"authors\":\"Toshimitsu Tsugu, Kaoru Tanaka, Dries Belsack, Mayuko Tsugu, Nico Buls, Jean-François Argacha, Bernard Cosyns, Yuji Nagatomo, Johan De Mey\",\"doi\":\"10.1111/echo.70137\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>CT-derived fractional-flow-reserve (FFR<sub>CT</sub>) is recommended for determining the indication of revascularization. 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引用次数: 0
摘要
目的ct衍生的分数血流储备（FFRCT）被推荐用于确定血运重建的适应症。关于部分流量储备（FFR）的最佳测量方法和损伤缺乏共识。探讨FFRCT测量方法预测血运重建的诊断准确性及影响FFRCT测量方法的因素。方法对340例（382条血管）行CT血管造影，有创冠状动脉造影显示冠脉狭窄≥50%的患者进行评价。根据病变长度将入组血管分为四组(局灶性，40 mm；弥漫性，≥40 mm)和DS(中度，50%-69%；严重,70% - -99%)。测量血管远端FFRCT（血管远端FFRCT）、狭窄病变远端FFRCT（病变特异性FFRCT）和跨病变FFRCT （ΔFFRCT），并与DS进行比较。评估血管形态和左心室质量。结果在局灶性病变中，ΔFFRCT的预测能力（AUC = 0.71）与DS （AUC = 0.76, p = 0.166）相当，高于病变特异性FFRCT (AUC = 0.67, p <；0.001)和血管远端FFRCT (AUC = 0.63, p <；0.001)。多变量分析显示，病变长度是ΔFFRCT的最强预测因子（β-系数= 0.42,p = 0.006）。在弥漫性病变中，ΔFFRCT （AUC = 0.73）对血流重建的预测能力与DS （AUC = 0.77, p = 0.667）、病变特异性FFRCT （AUC = 0.72, p = 0.653）和血管远端FFRCT （AUC = 0.69, p = 0.242）相当。多变量分析显示，病变长度是ΔFFRCT的最强预测因子(β-系数= 0.99,p <；0.001)。结论ΔFFRCT对局灶性和弥漫性病变血运重建的预测效果与DS相似。ΔFFRCT受病变长度的影响。
Comparison of Diagnostic Accuracy of CT Derived Fractional Flow Reserve for Predicting Revascularization
Purpose
CT-derived fractional-flow-reserve (FFRCT) is recommended for determining the indication of revascularization. Consensus on optimal fractional-flow-reserve (FFR) measurement methods and lesions is lacking. To investigate the diagnostic accuracy of FFRCT measurement methods for predicting revascularization and factors affecting FFRCT measurement methods.
Methods
A total of 340 patients (382 vessels) who underwent CT angiography and showed ≥50% diameter stenosis (DS) on invasive coronary angiography were evaluated. Enrolled vessels were classified into four groups according to lesion length (focal, <40 mm; diffuse, ≥40 mm) and DS (moderate, 50%–69%; severe, 70%–99%). FFRCT was measured at the distal end of the vessel (vessel-distal FFRCT), distal to the stenotic lesion (lesion-specific FFRCT), and trans-lesion FFRCT (ΔFFRCT) and compared with DS. Vessel morphology and left ventricular mass were assessed.
Results
In focal lesions, the predictive ability for revascularization of ΔFFRCT (AUC = 0.71) was comparable to that of DS (AUC = 0.76, p = 0.166) and higher than that of lesion-specific FFRCT (AUC = 0.67, p < 0.001) and vessel-distal FFRCT (AUC = 0.63, p < 0.001). Multivariable analysis showed that lesion length was the strongest predictor of ΔFFRCT (β-coefficient = 0.42, p = 0.006). In diffuse lesions, the predictive ability for revascularization of ΔFFRCT (AUC = 0.73) was comparable to that of DS (AUC = 0.77, p = 0.667), lesion-specific FFRCT (AUC = 0.72, p = 0.653), and vessel-distal FFRCT (AUC = 0.69, p = 0.242). Multivariable analysis showed that lesion length was the strongest predictor of ΔFFRCT (β-coefficient = 0.99, p < 0.001).
Conclusion
The predictive performance of ΔFFRCT for revascularization was similar to DS in focal and diffuse lesions. ΔFFRCT was influenced by lesion length.
期刊介绍：
Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.
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