Accuracy of coronary computed tomography angiography-derived quantitative flow ratio for onsite assessment of coronary lesions

作者：Tingwen Weng, Daixin Ding, Guanyu Li, Shaofeng Guan, Wenzheng Han, Qian Gan, Ming Li, Qi Lin, Cheng Li, Yang Chen, Liang Zhang, Tianqi Li, Xifeng Chang, Yankai Chen, William Wijns, Xinkai Qu, Shengxian Tu · 发表于：EuroIntervention · 年份：2024 · DOI：10.4244/eij-d-24-00336 · 被引用次数：5 · 研究领域：Coronary Interventions and Diagnostics、Cardiac Imaging and Diagnostics、Cerebrovascular and Carotid Artery Diseases

BACKGROUND: Coronary computed tomography angiography (CCTA)-derived Murray law-based quantitative flow ratio (CT-μFR) is a novel non-invasive method for fast computation of fractional flow reserve (FFR) from CCTA images, yet its diagnostic performance remains to be prospectively validated. AIMS: We aimed to evaluate the diagnostic performance of onsite CT-μFR in patients with coronary artery disease. METHODS: This prospective, single-centre trial enrolled patients with ≥1 lesion with 30-90% diameter stenosis on CCTA and planned invasive coronary angiography (ICA) within 30 days. CT-μFR, ICA-derived μFR and FFR were evaluated separately in a blinded fashion. The primary endpoint was the diagnostic accuracy of CT-μFR in identifying patients with haemodynamically significant coronary stenosis defined by the invasive standard: FFR ≤0.80, or μFR ≤0.80 when FFR was not available. RESULTS: Between December 2020 and August 2023, 260 patients were consecutively enrolled. Paired comparison between CT-μFR and the invasive standard was obtained in 706 vessels from 260 patients. The patient-level accuracy of CT-μFR was 89.6% (95% confidence interval [CI]: 85.9-93.4%), which was significantly higher than the prespecified target of 72.0% (p<0.001). Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios for CT-μFR were 93.1%, 86.1%, 87.1%, 92.5%, 6.7, and 0.1, respectively. Out of the 231 vessels investigated by FFR, the accuracy of CT-...