論文

2020年10月

On-site assessment of computed tomography-derived fractional flow reserve in comparison with myocardial perfusion imaging and invasive fractional flow reserve.

Heart and vessels
  • Keiichi Miyajima
  • ,
  • Sadako Motoyama
  • ,
  • Masayoshi Sarai
  • ,
  • Hideki Kawai
  • ,
  • Yasuomi Nagahara
  • ,
  • Ryota Matsumoto
  • ,
  • Wakaya Fujiwara
  • ,
  • Takashi Muramatsu
  • ,
  • Hiroshi Takahashi
  • ,
  • Hiroyuki Naruse
  • ,
  • Junnichi Ishii
  • ,
  • Takeshi Kondo
  • ,
  • Jagat Narula
  • ,
  • Hideo Izawa
  • ,
  • Yukio Ozaki

35
10
開始ページ
1331
終了ページ
1340
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s00380-020-01606-z

Myocardial perfusion imaging (MPI) using Single Photon Emission Computed Tomography has been established as a standard noninvasive tool for risk stratification of coronary artery disease (CAD). We evaluated the diagnostic performance of on-site workstation-based computed tomography-derived fractional flow reserve (CT-FFR) in comparison with MPI using invasive fractional flow reserve (invasive FFR) as a gold standard. We enrolled 97 patients with suspected CAD. Diagnostic performance of CT angiography (CTA), and CT-FFR was compared in 105 lesions of 97 patients. Invasive FFR ≤ 0.8 was detected in 38 (36%) lesions. Diagnostic performance of CT-FFR was improved compared with CTA (AUC 0.83 vs. 0.60, p < 0.0001). The lesions with both CTA and MPI findings (n = 47), invasive FFR ≤ 0.8 was detected in 19 (40.4) lesions. CT-FFR (AUC 0.81, 95% CI 0.72-0.94) significantly improved diagnostic performance compared with CTA-50% (AUC 0.59, p = 0.00019) and MPI (AUC 0.64, p = 0.0082). In lesions with ≥ 50% on CTA (n = 42), diagnostic accuracy of CT-FFR (AUC 0.81) was significantly superior to MPI (AUC 0.64, p = 0.0239). In conclusions, CT-FFR improved diagnostic accuracy to detect invasive FFR ≤ 0.8 compared with luminal stenosis on CTA and ischemia on MPI. Patients with ≥ 50% stenosis on CTA would be the candidates for CT-FFR.

リンク情報
DOI
https://doi.org/10.1007/s00380-020-01606-z
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32350637
ID情報
  • DOI : 10.1007/s00380-020-01606-z
  • PubMed ID : 32350637

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