Universität zu Köln

Wienemann, Hendrik, Langenbach, Marcel C., Mauri, Victor, Banazadeh, Maryam ORCID: 0000-0002-9112-2753, Klein, Konstantin, Hohmann, Christopher, Lee, Samuel ORCID: 0000-0001-6768-7079, Breidert, Isabel, Hof, Alexander ORCID: 0000-0001-6554-8892, Eghbalzadeh, Kaveh, Kuhn, Elmar, Halbach, Marcel, Maintz, David, Baldus, Stephan, Bunck, Alexander and Adam, Matti ORCID: 0000-0002-6990-8135 (2022). Feasibility and Comparison of Resting Full-Cycle Ratio and Computed Tomography Fractional Flow Reserve in Patients with Severe Aortic Valve Stenosis. J. Cardiovasc. Dev. Dis., 9 (4). BASEL: MDPI. ISSN 2308-3425

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Abstract

Background: Computed tomography derived Fractional Flow Reserve (CT-FFR) has been shown to decrease the referral rate for invasive coronary angiography (ICA). The purpose of the study was to evaluate the diagnostic performance of CT-FFR compared to hyperemia-free index Resting Full-cycle Ratio (RFR) in patients with relevant aortic stenosis (AS) and intermediate coronary stenosis. Methods: 41 patients with 46 coronary lesions underwent ICA with quantitative coronary angiography (QCA), pressure wire assessment and routine pre-transcatheter aortic valve replacement (TAVR) computed tomography (CT). CT-FFR analysis was performed using prototype on-site software. Results: RFR showed a significant correlation with CT-FFR (Pearson's correlation, r = 0.632, p < 0.001). On a per-lesion basis, diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CT-FFR were 82.6% (95% CI 68.6-92.2), 69.6% (95% CI 47.1-86.8), 95.7% (95% CI 78.1-99.9), 94.1% (95% CI 69.8-99.1), and 75.9% (95% CI 62.7-85.4), respectively. The optimal cutoff value of the CT-FFR for RFR <= 0.89 prediction was 0.815. The area under the receiver curve showed a larger area under the curve for CT-FFR (0.87; 95% CI 0.75-0.98) compared with CTA stenosis of >= 50% (0.54, 95% CI 0.38-0.71), CTA >= 70% (0.72, 95% CI 0.57-0.87) and QCA >= 50% (0.67, 95% CI 0.52-0.83). Conclusions: CT-FFR assessed by routine pre-TAVR CT is safe and feasible and shows a significant correlation with RFR in patients with AS. CT-FFR is superior to QCA >= 50%, CT >= 50% and CT >= 70% in assessing the hemodynamic relevance of intermediate coronary lesions. Thus, CT-FFR has the potential to guide revascularization in patients with AS.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wienemann, Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Langenbach, Marcel C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mauri, Victor UNSPECIFIED UNSPECIFIED UNSPECIFIED Banazadeh, Maryam UNSPECIFIED orcid.org/0000-0002-9112-2753 UNSPECIFIED Klein, Konstantin UNSPECIFIED UNSPECIFIED UNSPECIFIED Hohmann, Christopher UNSPECIFIED UNSPECIFIED UNSPECIFIED Lee, Samuel UNSPECIFIED orcid.org/0000-0001-6768-7079 UNSPECIFIED Breidert, Isabel UNSPECIFIED UNSPECIFIED UNSPECIFIED Hof, Alexander UNSPECIFIED orcid.org/0000-0001-6554-8892 UNSPECIFIED Eghbalzadeh, Kaveh UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Elmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Halbach, Marcel UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Bunck, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Adam, Matti UNSPECIFIED orcid.org/0000-0002-6990-8135 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-657279
DOI:	10.3390/jcdd9040116
Journal or Publication Title:	J. Cardiovasc. Dev. Dis.
Volume:	9
Number:	4
Date:	2022
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	2308-3425
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CORONARY-ARTERY-DISEASE; DIAGNOSTIC-ACCURACY; CT ANGIOGRAPHY; INTERMEDIATE; PCI Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/65727