Τίτλος:
Characterization of functionally significant coronary artery disease by a coronary computed tomography angiography-based index: A comparison with positron emission tomography
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
To test the hypothesis that virtual functional assessment index (vFAI) is related with regional flow parameters derived by quantitative positron emission tomography (PET) and can be used to assess abnormal vasodilating capability in coronary vessels with stenotic lesions at coronary computed tomography angiography (CCTA). Methods and results: vFAI, stress myocardial blood flow (MBF), and myocardial flow reserve (MFR) were assessed in 78 patients (mean age 62.2 ± 7.7 years) with intermediate pre-test likelihood of coronary artery disease (CAD). Coronary stenoses ≥50% were considered angiographically significant. PET was considered positive for significant CAD, when more than one contiguous segments showed stress MBF ≤2.3 mL/g/min for O-water or <1.79 mL/g/min for N-ammonia. MFR thresholds were ≤2.5 and ≤2.0, respectively. vFAI was lower in vessels with abnormal stress MBF (0.76 ± 0.10 vs. 0.89 ± 0.07, P < 0.001) or MFR (0.80 ± 0.10 vs. 0.89 ± 0.07, P < 0.001). vFAI had an accuracy of 78.6% and 75% in unmasking abnormal stress MBF and MFR in O-water and 82.7% and 71.2% in N-ammonia studies, respectively. Addition of vFAI to anatomical CCTA data increased the ability for predicting abnormal stress MBF and MFR in O-water studies [AUCccta + vfai = 0.866, 95% confidence interval (CI) 0.783-0.949; P = 0.013 and AUCccta + vfai = 0.737, 95% CI 0.648-0.825; P = 0.007, respectively]. An incremental value was also demonstrated for prediction of stress MBF (AUCccta + vfai = 0.887, 95% CI 0.799-0.974; P = 0.001) in N-ammonia studies. A similar trend was recorded for MFR (AUCccta + vfai = 0.780, 95% CI 0.632-0.929; P = 0.13). Conclusion: vFAI identifies accurately the presence of impaired vasodilating capability. In combination with anatomical data, vFAI enhances the diagnostic performance of CCTA. © 2019 Published on behalf of the European Society of Cardiology. All rights reserved.
Συγγραφείς:
Anagnostopoulos, C.D.
Siogkas, P.K.
Liga, R.
Benetos, G.
Maaniitty, T.
Sakellarios, A.I.
Koutagiar, I.
Karakitsios, I.
Papafaklis, M.I.
Berti, V.
Sciagrà, R.
Scholte, A.J.H.A.
Michalis, L.K.
Gaemperli, O.
Kaufmann, P.A.
Pelosi, G.
Parodi, O.
Knuuti, J.
Fotiadis, D.I.
Neglia, D.
Περιοδικό:
European Heart Journal - Cardiovascular Imaging
Εκδότης:
Oxford University Press
Λέξεις-κλειδιά:
ammonia n 13, adult; area under the curve; Article; computed tomographic angiography; coronary angiography; coronary artery; coronary artery blood flow; coronary artery disease; coronary artery obstruction; coronary blood vessel; female; functional assessment; heart muscle blood flow; human; hybrid; hypothesis; image quality; intermethod comparison; major clinical study; male; middle aged; parameters; positron emission tomography; prediction; priority journal; sensitivity and specificity; stress; blood flow velocity; comparative study; computer assisted diagnosis; coronary angiography; coronary artery disease; diagnostic imaging; fractional flow reserve; pathophysiology; three-dimensional imaging; vasodilatation, Blood Flow Velocity; Computed Tomography Angiography; Coronary Angiography; Coronary Artery Disease; Coronary Circulation; Female; Fractional Flow Reserve, Myocardial; Humans; Imaging, Three-Dimensional; Male; Middle Aged; Positron-Emission Tomography; Radiographic Image Interpretation, Computer-Assisted; Vasodilation
DOI:
10.1093/ehjci/jey199
