Relationship of the Duke jeopardy score combined with minimal lumen diameter as assessed by computed tomography angiography to the hemodynamic relevance of coronary artery stenosis |
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Institution: | 1. Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People''s Hospital, #600, Yishan Rd, Shanghai, China;2. Department of Thoracic Surgery, Shanghai Jiao Tong University Affiliated Sixth People''s Hospital, #600, Yishan Rd, Shanghai, China;3. Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People''s Hospital, #600, Yishan Rd, Shanghai, China;4. Department of Biostatistics, Beth Israel Deaconess Medical Center, General Medicine and Primary Care Research, Boston, United States;1. Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, United States;2. Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States;1. Department of Cardiology, Friedrich-Alexander-Universität, Germany;2. Department of Cardiac Surgery, Friedrich-Alexander-Universität, Germany |
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Abstract: | ObjectivesTo study the diagnostic performance of the ratio between the Duke jeopardy score (DJS) and the minimal lumen diameter (MLD) (DJS/MLDCT ratio) as assessed by coronary computed tomographic angiography (CTA) for differentiating functionally significant from non-significant coronary artery stenoses, with reference to invasive fractional flow reserve (FFR).MethodsPatients who underwent both coronary CTA and FFR measurement during invasive coronary angiography (ICA) within 2 weeks were retrospectively included in the study. Invasive FFR measurement was performed in patients with intermediate to severe coronary stenoseis. DJS/MLDCT ratio and anatomical parameters were recorded. Lesions with FFR ≤0.80 were considered to be functionally significant.ResultsOne hundred and sixty-one patients with 175 lesions were included into the analysis. Diameter stenosis in CT, area stenosis, plaque burden, lesion length (LL), ICA-based stenosis degree, DJS, LL/MLD4 ratio, DJS/MLA ratio as well as DJS/MLD ratio were all significantly different between hemodynamically significant and non-significant lesions (p<0.05 for all). ROC curve analysis determined the optimal cut-off value for DJS/MLDCT ratio to be 1.96 (area under curve = 0.863, 95 % confidence interval = 0.803–0.910), yielding a high diagnostic accuracy (86.9%, 152/175).ConclusionsIn coronary artery stenoses detected by coronary CTA, the DJS/MLD ratio is able to predict hemodynamic relevance. |
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Keywords: | Duke jeopardy score Minimal lumen diameter Computed tomography angiography Hemodynamic relevance Coronary artery disease Fractional flow reserve CTA"} {"#name":"keyword" "$":{"id":"kwrd0045"} "$$":[{"#name":"text" "_":"computed tomography angiography DJS"} {"#name":"keyword" "$":{"id":"kwrd0055"} "$$":[{"#name":"text" "_":"Duke Jeopardy Score FFR"} {"#name":"keyword" "$":{"id":"kwrd0065"} "$$":[{"#name":"text" "_":"fractional flow reserve MLD"} {"#name":"keyword" "$":{"id":"kwrd0075"} "$$":[{"#name":"text" "_":"minimal lumen diameter PCI"} {"#name":"keyword" "$":{"id":"kwrd0085"} "$$":[{"#name":"text" "_":"percutaneous coronary intervention |
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