Diagnostic performance of angiography-derived fractional flow reserve: a systematic review and Bayesian meta-analysis.
Carlos Collet,Yoshinobu Onuma,Jeroen Sonck,Taku Asano,Bert Vandeloo,Ran Kornowski,Shengxian Tu,Jelmer Westra,Niels Ramsing Holm,Bo Xu,Robbert J. de Winter,Jan G.P. Tijssen,Yosuke Miyazaki,Yuki Katagiri,Erhan Tenekecioglu,Rodrigo Modolo,Ply Chichareon,Bernard Cosyns,Daniel Schoors,Bram Roosens,Stijn Lochy,J. F. Argacha,Alexandre van Rosendael,Jeroen J. Bax,Johan H. C. Reiber,Javier Escaned,Bernard De Bruyne,William Wijns,Patrick W. Serruys +28 more
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The accuracy of angiography-derived FFR was good to detect haemodynamically significant lesions with pressure-wire measured FFR as a reference, and a diagnostic strategy trial with angiographer's derived FFR evaluating clinical endpoints is warranted.Abstract:
Aims Pressure-wire assessment of coronary stenosis is considered the invasive reference standard for detection of ischaemia-generating lesions. Recently, methods to estimate the fractional flow reserve (FFR) from conventional angiography without the use of a pressure wire have been developed, and were shown to have an excellent diagnostic accuracy. The present systematic review and meta-analysis aimed at determining the diagnostic performance of angiography-derived FFR for the diagnosis of haemodynamically significant coronary artery disease. Methods and results A systematic review and meta-analysis of studies assessing the diagnostic performance of angiography-derived FFR systems were performed. The primary outcome of interest was pooled sensitivity and specificity. Thirteen studies comprising 1842 vessels were included in the final analysis. A Bayesian bivariate meta-analysis yielded a pooled sensitivity of 89% (95% credible interval 83-94%), specificity of 90% (95% credible interval 88-92%), positive likelihood ratio (+LR) of 9.3 (95% credible interval 7.3-11.7) and negative likelihood ratio (-LR) of 0.13 (95% credible interval 0.07-0.2). The summary area under the receiver-operating curve was 0.84 (95% credible interval 0.66-0.94). Meta-regression analysis did not find differences between the methods for pressure-drop calculation (computational fluid dynamics vs. mathematical formula), type of analysis (on-line vs. off-line) or software packages. Conclusion The accuracy of angiography-derived FFR was good to detect haemodynamically significant lesions with pressure-wire measured FFR as a reference. Computational approaches and software packages did not influence the diagnostic accuracy of angiography-derived FFR. A diagnostic strategy trial with angiography-derived FFR evaluating clinical endpoints is warranted.read more
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Expert recommendations on the assessment of wall shear stress in human coronary arteries: existing methodologies, technical considerations, and clinical applications
Frank J. H. Gijsen,Yuki Katagiri,Peter Barlis,Peter Barlis,Christos V. Bourantas,Christos V. Bourantas,Carlos Collet,Umit Coskun,Joost Daemen,Jouke Dijkstra,Elazer R. Edelman,Elazer R. Edelman,Paul C. Evans,Kim Van der Heiden,Rod Hose,Rod Hose,Bon Kwon Koo,Bon Kwon Koo,Rob Krams,Alison L. Marsden,Francesco Migliavacca,Yoshinobu Onuma,Andrew Ooi,Eric K. W. Poon,Habib Samady,Peter Stone,Kuniaki Takahashi,Dalin Tang,Vikas Thondapu,Vikas Thondapu,Erhan Tenekecioglu,Lucas H. Timmins,Lucas H. Timmins,Ryo Torii,Jolanda J. Wentzel,Patrick W. Serruys,Patrick W. Serruys,Patrick W. Serruys +37 more
TL;DR: In this paper, the authors proposed a method to solve the problem of the problem: this paper ] of "uniformity" of the distribution of data points in the data set.
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Measurement of Hyperemic Pullback Pressure Gradients to Characterize Patterns of Coronary Atherosclerosis.
Carlos Collet,Jeroen Sonck,Bert Vandeloo,Takuya Mizukami,Bram Roosens,Stijn Lochy,J. F. Argacha,Danny Schoors,Iginio Colaiori,Giuseppe Di Gioia,M Kodeboina,Hiroshi Suzuki,Marcel van 't Veer,Jozef Bartunek,Emanuele Barbato,Bernard Cosyns,Bernard De Bruyne +16 more
TL;DR: Pathophysiological patterns of CAD can be characterized by motorized hyperemic PPGs, a novel metric that quantifies the distribution of epicardial resistance and discriminates focal from diffuse CAD.
Journal ArticleDOI
Diagnostic performance of quantitative flow ratio in prospectively enrolled patients: An individual patient-data meta-analysis.
Jelmer Westra,Shengxian Tu,Gianluca Campo,Shubin Qiao,Hitoshi Matsuo,Xinkai Qu,Lukasz Koltowski,Yunxiao Chang,Tommy Liu,Junqing Yang,Birgitte Krogsgaard Andersen,Ashkan Eftekhari,Evald Høj Christiansen,Javier Escaned,William Wijns,Bo Xu,Niels Ramsing Holm +16 more
TL;DR: This work aimed to provide robust performance estimates for quantitative flow ratio (QFR) in assessment of intermediary coronary lesions with high confidence in terms of accuracy and consistency.
Journal ArticleDOI
Fractional flow reserve in clinical practice: from wire-based invasive measurement to image-based computation
Shengxian Tu,Jelmer Westra,Julien Adjedj,Daixin Ding,Fuyou Liang,Bo Xu,Niels Ramsing Holm,Johan H. C. Reiber,William Wijns +8 more
TL;DR: Computational FFR has the potential to expand and facilitate the use of physiology for diagnosis, procedural guidance, and evaluation of therapies, with anticipated impact on resource utilization and patient outcomes.
Journal ArticleDOI
Accuracy of computational pressure-fluid dynamics applied to coronary angiography to derive fractional flow reserve: FLASH FFR
Jianping Li,Yanjun Gong,Weimin Wang,Qing Yang,Bin Liu,Yuan Lu,Yawei Xu,Yunlong Huo,Yi Tieci,Jian Liu,Yongle Li,Shaopeng Xu,Lei Zhao,Ziad A. Ali,Ziad A. Ali,Yong Huo +15 more
TL;DR: Using wire-based FFR as the reference, caFFR has high accuracy, sensitivity and specificity and could eliminate the need of a pressure wire, technical error and potentially increase adoption of physiological assessment of coronary artery stenosis severity.
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