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Coronary Angiography-Derived Diastolic Pressure Ratio
Yanjun Gong1, Yundi Feng2, Tieci Yi1
1Department of Cardiology, Peking University First Hospital, Beijing, China.
Frontiers in Bioengineering and Biotechnology
|November 16, 2020
Summary
A new computational fluid dynamic (CFD) method, coronary angiography-derived diastolic pressure ratio (caDPR), shows high diagnostic accuracy for assessing coronary artery disease without invasive pressure wires. This non-invasive technique could improve hemodynamic assessment in clinical practice.
Area of Science:
- Cardiovascular Medicine
- Medical Imaging
- Computational Fluid Dynamics
Background:
- Invasive pressure wire measurements are standard for assessing coronary artery stenosis severity.
- Non-invasive methods are needed to improve diagnostic efficiency and patient comfort.
Purpose of the Study:
- To evaluate the diagnostic performance of a novel computational fluid dynamic (CFD) derived coronary angiography-derived diastolic pressure ratio (caDPR).
- To assess caDPR's accuracy compared to invasive wire-derived fractional flow reserve (FFR) in a multicenter setting.
Main Methods:
- A CFD method was developed to calculate caDPR from aortic pressure waveforms.
- Offline caDPR was compared to wire-derived FFR in 328 vessels from 330 patients with stable or unstable angina.
- Diagnostic performance metrics including accuracy, sensitivity, specificity, and AUC were calculated.
Main Results:
- The caDPR demonstrated high diagnostic accuracy (87.7%), sensitivity (89.5%), and specificity (86.8%) with an AUC of 0.940.
- A caDPR cutoff of 0.89 closely correlated with a wire-derived FFR cutoff of 0.80.
- The method was validated against invasive FFR in a multicenter cohort.
Conclusions:
- The novel CFD-designed caDPR exhibits good diagnostic performance for hemodynamic assessment of coronary lesions.
- caDPR offers a promising non-invasive alternative to traditional pressure wire measurements.
- This technique has the potential to enhance the assessment of coronary artery disease in the catheterization laboratory.
