Online Angiography Image-Based FFR Assessment During Coronary Catheterization: A Single-Center Study

Area of Science:

• Cardiovascular diagnostics
• Interventional cardiology
• Medical imaging analysis

Background:

• Fractional flow reserve (FFR) is the gold standard for assessing coronary stenosis severity but is underutilized.
• Current FFR methods require invasive pressure measurements and hyperemia, increasing procedural time and risks.
• Angiography-derived FFR (FFRangio) offers a non-invasive alternative with potential advantages.

Purpose of the Study:

• To evaluate the diagnostic performance of online FFRangio during routine coronary angiography.
• To compare FFRangio measurements with invasive FFR in patients with stable coronary artery disease.

Main Methods:

• FFRangio technology was applied online in the catheterization laboratory.
• Hemodynamic data and routine angiograms were used to generate FFR values.
• Fifty-three patients and 60 coronary lesions were analyzed and compared to invasive FFR.

Main Results:

• FFRangio values closely correlated with invasive FFR (r=0.91, P<.001).
• Bland-Altman analysis showed narrow limits of agreement (-0.065 to 0.07).
• FFRangio demonstrated high diagnostic accuracy (95%), sensitivity (86%), and specificity (100%) for an FFR cut-off of 0.80.

Conclusions:

• This study reports the first online application of the FFRangio system.
• FFRangio showed excellent correlation with invasive FFR in a single-center experience.
• FFRangio is a promising tool for online assessment of coronary stenosis severity.