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Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
Published on: June 28, 2019
Three dimensional quantitative coronary angiography can detect reliably ischemic coronary lesions based on fractional
Woo-Young Chung1, Byoung-Joo Choi2, Seong-Hoon Lim3
1Devision of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University, College of Medicine, Seoul, Korea.
Insights
Three dimensional quantitative coronary angiography (3D-QCA) can accurately predict coronary artery disease causing ischemia. This advanced imaging technique may guide treatment decisions for patients with reduced myocardial fractional flow reserve (FFR).
Area of Science:
- Cardiovascular Imaging
- Interventional Cardiology
- Medical Technology
Background:
- Conventional coronary angiography (CAG) has limitations in assessing ischemic coronary lesions.
- Myocardial fractional flow reserve (FFR) is a gold standard for ischemia assessment but is invasive.
Purpose of the Study:
- To evaluate the reliability of three dimensional quantitative coronary angiography (3D-QCA) in predicting ischemia (FFR < 0.80).
Main Methods:
- 3D-QCA images were reconstructed from CAG data.
- Key parameters including minimal luminal diameter (MLD), percent diameter stenosis (%DS), minimal luminal area (MLA), and percent area stenosis (%AS) were measured.
- 3D-QCA measurements were compared with FFR values in 266 patients.
Main Results:
- MLD, %DS, MLA, and %AS were all significantly correlated with FFR (P < 0.001).
- Lesions with MLA < 4.0 mm² and %AS > 65.5% showed 80% sensitivity and 83% specificity for predicting FFR < 0.80 (AUC = 0.878).
Conclusions:
- 3D-QCA reliably predicts coronary lesions causing ischemia.
- 3D-QCA shows potential as a non-invasive tool to guide therapeutic strategies in coronary artery disease.
Abstract:
Conventional coronary angiography (CAG) has limitations in evaluating lesions producing ischemia. Three dimensional quantitative coronary angiography (3D-QCA) shows reconstructed images of CAG using computer based algorithm, the Cardio-op B system (Paieon Medical, Rosh Ha'ayin, Israel). The aim of this study was to evaluate whether 3D-QCA can reliably predict ischemia assessed by myocardial fractional flow reserve (FFR) < 0.80. 3D-QCA images were reconstructed from CAG which also were evaluated with FFR to assess ischemia. Minimal luminal diameter (MLD), percent diameter stenosis (%DS), minimal luminal area (MLA), and percent area stenosis (%AS) were obtained. The results of 3D-QCA and FFR were compared. A total of 266 patients was enrolled for the present study. FFR for all lesions ranged from 0.57 to 1.00 (0.85 ± 0.09). Measurement of MLD, %DS, MLA, and %AS all were significantly correlated with FFR (r = 0.569, 0609, 0.569, 0.670, respectively, all P < 0.001). In lesions with MLA < 4.0 mm(2), %AS of more than 65.5% had a 80% sensitivity and a 83% specificity to predict FFR < 0.80 (area under curve, AUC was 0.878). 3D-QCA can reliably predict coronary lesions producing ischemia and may be used to guide therapeutic approach for coronary artery disease.
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