Are baseline conditions of coronary arteries sufficient for calculating angio-based index of microcirculatory resistance and fractional flow reserve?

作者：Chenguang Li, Yumeng Hu, Jingpu Wang, Congcong Pan, Hao Lü, Yizhe Wu, Zhangwei Chen, Zhiqiang Pei, Li Shen, Jingsong He, Xiaochang Leng, Jianping Xiang, Junbo Ge · 发表于：Quantitative Imaging in Medicine and Surgery · 年份：2023 · DOI：10.21037/qims-23-72 · 被引用次数：12 · 研究领域：Coronary Interventions and Diagnostics、Acute Myocardial Infarction Research、Cardiac Imaging and Diagnostics

Background: Angio-based index of microcirculatory resistance (IMR) and fractional flow reserve (FFR) have been developed, however, the differences between baseline and hyperemic data and their effects on their computation have not yet been discussed. This study aimed to compare the diagnostic performance of a novel method for calculating IMR and FFR from coronary angiography under baseline and hyperemic conditions. Methods: We performed a retrospective study to investigate the diagnostic performance of angiography-derived IMR (AccuIMR) and FFR (AccuFFRangio) computed from the hyperemic condition (AccuIMRhyp, AccuFFRangiohyp) and baseline condition (AccuIMRbase, AccuFFRangiobase) in 101 consecutive patients with chronic coronary syndrome (CCS) who underwent measurements of IMR and FFR at a single center, using wire-based IMR and FFR as the reference standard. Results: AccuIMRhyp showed much better correlation with IMR than AccuIMRbase (r=0.77 vs. 0.47, P<0.001). The diagnostic accuracy and area under the curve (AUC) for identifying significant microvascular dysfunction was higher for AccuIMRhyp than AccuIMRbase [92.1% (95% CI: 85.0–96.5%) vs. 83.2% (95% CI: 74.4–89.9%), P=0.012; 0.942 (95% CI: 0.877–0.979) vs. 0.815 (95% CI: 0.726–0.886), P=0.003]. The computed AccuFFRangio showed good correlations with FFR and good diagnostic performance under both hyperemic and baseline conditions [r=0.68 vs. 0.68, P>0.99; diagnostic accuracy =95.9% (95% CI: 89.8–98.9%) vs. 94.9% (95% CI: 88...