Diagnostic Accuracy of Two-Dimensional Coronary Angiographic-Derived Fractional Flow Reserve—Preliminary Results Publisher Pubmed



Babakhani H^{1, 2} ; Sadeghipour P¹ ; Tashakori Beheshti A¹ ; Ghasemi M³ ; Moosavi J¹ ; Sadeghian M³ ; Salesi M¹ ; Zahedmehr A¹ ; Shafe O¹ ; Shakerian F¹ ; Mohebbi B¹ ; Alemzadehansari MJ¹ ; Firouzi A¹ ; Geraiely B³ Show All Authors Show Affiliations
Source: Catheterization and Cardiovascular Interventions Published:2021

Abstract

Aim: Noninvasive fractional flow reserve (NiFFR) is an emerging method for evaluating the functional significance of a coronary lesion during diagnostic coronary angiography (CAG). The method relies on the computational flow dynamics and the three-dimensional (3D) reconstruction of the vessel extracted from CAG. In the present study, we sought to evaluate the diagnostic performance and applicability of 2D-based NiFFR. Methods: In this prospective observational study, we evaluated 2D-based NiFFR in 279 candidates for invasive CAG and invasive fractional flow reserve (FFR). NiFFR was calculated via two methods: variable NiFFR, in which the contrast transport time was extracted from the angiographic view, and fixed NiFFR, in which a prespecified frame count was applied. Results: The final analysis was performed on 245 patients (250 lesions). Variable NiFFR had an area under the receiver operating characteristic curve of 81.5%, an accuracy of 80.0%, a sensitivity of 82.2%, a specificity of 82.2%, a negative predictive value of 91.4%, and a positive predictive value of 63.6%. The mean difference between FFR and NiFFR was −0.0244 ±.0616 (p ≤.0001). A pressure wire-free hybrid strategy was possible in 68.8% of our population with variable NiFFR. Conclusions: Our 2D-based NiFFR yielded results comparable to those derived from 3D-based software. Our findings should; however, be confirmed in larger trials. © 2020 Wiley Periodicals LLC.