Fractional flow reserve derived from coronary CT angiography: Variation of repeated analyses |
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| Institution: | 1. Department of Cardiology, Aarhus University Hospital, Brendstrupgaardsvej 100, Skejby, 8200 Aarhus N, Denmark;2. Harrington Heart and Vascular Institute, Case Medical Center, Cleveland, OH, USA;3. Department of Cardiology, Golden Jubilee National Hospital, Glasgow, Scotland;4. Department of Radiology, St. Paul''s Hospital, Vancouver, BC, Canada;5. Department of Cardiology, University of Erlangen, Erlangen, Germany;1. Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark;2. Department of Radiology, St. Paul''s Hospital, University of British Columbia, Vancouver, British Columbia, Canada;3. MonashHeart, Monash Medical Center and Monash University, Victoria, Australia;4. Department of Cardiology, Okayama University Hospital, Okayama, Japan;6. Division of Cardiovascular Medicine, Brigham and Women''s Hospital, Boston, Massachusetts;5. Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium;7. Department of Cardiology, Erlangen University Hospital, Erlangen, Germany;11. Department of Cardiology and Angiology, Elisabeth-Krankenhaus Essen, Essen, Germany;12. Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, Riga, Latvia;8. Heart Institute, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea;1. Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive Charleston, SC 29425-2260, USA;2. Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China;3. Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, 61231 Bad Nauheim, Germany;4. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany;5. Departments of Radiological Sciences, Oncology, and Pathology, University of Rome “Sapienza”-Polo Pontino, Latina, Viale Regina Elena, 324-00161 Roma, Italy;6. First Department of Medicine, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany;1. Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark;2. Department of Radiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada;3. Department of Cardiology, Okayama University Hospital, Okayama, Japan;4. Heart Institute, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea;6. Diagnostic Institute of Radiology, Paul Stradins Clinical University Hospital, Riga, Latvia;5. Department of Radiology, Golden Jubilee Hospital, Glasgow, Scotland;7. Department of Cardiology, Harrington Heart and Vascular Institute, University Hospitals, Cleveland, Ohio;11. Department of Cardiology, Erlangen University Hospital, Erlangen, Germany;1. Heart & Vascular Center, Medical University of South Carolina, Charleston, South Carolina;2. Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany;3. Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China;4. Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany;5. First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany |
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| Abstract: | BackgroundFractional flow reserve (FFR) is the standard of reference for assessing the hemodynamic significance of coronary stenoses in patients with stable coronary artery disease. Noninvasive FFR derived from coronary CT angiography (FFRCT) is a promising new noninvasive method for assessing the physiologic significance of epicardial stenoses. The reproducibility of FFRCT has not yet been established.ObjectiveThe aim of this study was to evaluate the variation of repeated analyses of FFRCT per se and in the context of the reproducibility of repeated FFR measurements.MethodsCoronary CT angiography and invasive coronary angiography with repeated FFR measurements were performed in 28 patients (58 vessels) with suspected stable coronary artery disease. Based on the coronary CT angiography data set, FFRCT analyses were performed twice by 2 independent blinded analysts.ResultsIn 12 of 58 (21%) vessels FFR was ≤0.80. The standard deviation for the difference between first and second FFRCT analyses was 0.034 vs 0.033 for FFR repeated measurements (P = .722). Limits of agreement were −0.06 to 0.08 for FFRCT and −0.07 to 0.06 for FFR. The coefficient of variation of FFRCT (CVFFRct) was 3.4% (95% confidence interval CI], 1.4%–4.6%) vs 2.7% (95% CI, 1.8%–3.3%) for FFR. In vessels with mean FFR ranging between 0.70 and 0.90 (n = 25), the difference between the first and second FFRCT analyses was 0.035 and FFR repeated measurements was 0.043 (P = .357), whereas CVFFRct was 3.3% (95% CI, 1.5%–4.3%) and coefficient of variation for FFR was 3.6% (95% CI, 2.3%–4.6%).ConclusionsThe reproducibility of both repeated FFRCT analyses and repeated FFR measurements is high. |
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| Keywords: | Computational fluid dynamics Computed tomography angiography Coronary angiography Fractional flow reserve Invasive coronary angiography Reproducibility |
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