Applicability of 3-Dimensional Quantitative Coronary Angiography-Derived Computed Fractional Flow Reserve for Intermediate Coronary Stenosis

Kyoichiro Yazaki; Masato Otsuka; Shohei Kataoka; Mitsuru Kahata; Asako Kumagai; Koji Inoue; Hiroshi Koganei; Kenji Enta; Yasuhiro Ishii

doi:10.1253/circj.CJ-16-1261

Cardiovascular Intervention

Applicability of 3-Dimensional Quantitative Coronary Angiography-Derived Computed Fractional Flow Reserve for Intermediate Coronary Stenosis

Kyoichiro Yazaki, Masato Otsuka, Shohei Kataoka, Mitsuru Kahata, Asako Kumagai, Koji Inoue, Hiroshi Koganei, Kenji Enta, Yasuhiro Ishii

Author information

Kyoichiro Yazaki
Department of Cardiology, Cardiovascular Center, Ogikubo Hospital
Masato Otsuka
Department of Cardiology, Cardiovascular Center, Ogikubo Hospital
Shohei Kataoka
Department of Cardiology, Cardiovascular Center, Ogikubo Hospital
Mitsuru Kahata
Department of Cardiology, Cardiovascular Center, Ogikubo Hospital
Asako Kumagai
Department of Cardiology, Cardiovascular Center, Ogikubo Hospital
Koji Inoue
Department of Cardiology, Cardiovascular Center, Ogikubo Hospital
Hiroshi Koganei
Department of Cardiology, Cardiovascular Center, Ogikubo Hospital
Kenji Enta
Department of Cardiology, Cardiovascular Center, Ogikubo Hospital
Yasuhiro Ishii
Department of Cardiology, Cardiovascular Center, Ogikubo Hospital

Keywords: 3-dimensional quantitative coronary angiography, Fractional flow reserve, Myocardial ischemia, Quantitative flow ratio

JOURNAL FREE ACCESS FULL-TEXT HTML

2017 Volume 81 Issue 7 Pages 988-992

DOI https://doi.org/10.1253/circj.CJ-16-1261

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Abstract

Background:Quantitative flow ratio (QFR) is a newly developed image-based index for estimating fractional flow reserve (FFR).

Methods and Results:We analyzed 151 coronary arteries with intermediate stenosis in 142 patients undergoing wire-based FFR measurement using dedicated software. Predefined contrast flow QFR, which was derived from 3-dimensional quantitative coronary angiography (3-D QCA) withThrombolysis in Myocardial Infarction (TIMI) frame counts, was compared with FFR as a reference. QFR had good correlation (r=0.80, P<0.0001) and agreement (mean difference: 0.01±0.05) with FFR. After applying the FFR cut-off ≤0.8, the overall accuracy rate of QFR ≤0.8 was 88.0%. On receiver operating characteristics analysis, the area under the curve was 0.93 for QFR. In contrast, 3-D QCA-derived anatomical indices had insufficient correlation with FFR and diagnostic performance compared with QFR.

Conclusions:QFR had good correlation and agreement with FFR and high diagnostic performance in the evaluation of intermediate coronary stenosis, suggesting that QFR may be an alternative tool for estimating myocardial ischemia.

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