title: Quantification of fractional flow reserve based on angiographic image data.
abstract: Coronary angiography provides excellent visualization of coronary arteries, but has limitations in assessing the clinical significance of a coronary stenosis. Fractional flow reserve (FFR) has been shown to be reliable in discerning stenoses responsible for inducible ischemia. The purpose of this study is to validate a technique for FFR quantification using angiographic image data. The study was carried out on 10 anesthetized, closed-chest swine using angioplasty balloon catheters to produce partial occlusion. Angiography based FFR was calculated from an angiographically measured ratio of coronary blood flow to arterial lumen volume. Pressure-based FFR was measured from a ratio of distal coronary pressure to aortic pressure. Pressure-wire measurements of FFR (FFR( P )) correlated linearly with angiographic volume-derived measurements of FFR (FFR( V )) according to the equation: FFR( P ) = 0.41 FFR( V ) + 0.52 (P-value < 0.001). The correlation coefficient and standard error of estimate were 0.85 and 0.07, respectively. This is the first study to provide an angiographic method to quantify FFR in swine. Angiographic FFR can potentially provide an assessment of the physiological severity of a coronary stenosis during routine diagnostic cardiac catheterization without a need to cross a stenosis with a pressure-wire.
authors.affiliation: Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, CA 92697, USA.
authors.forename: Jerry T
authors.initials: JT
authors.lastname: Wong
authors.forename: Huy
authors.initials: H
authors.lastname: Le
authors.forename: William M
authors.initials: WM
authors.lastname: Suh
authors.forename: David A
authors.initials: DA
authors.lastname: Chalyan
authors.forename: Toufan
authors.initials: T
authors.lastname: Mehraien
authors.forename: Morton J
authors.initials: MJ
authors.lastname: Kern
authors.forename: Ghassan S
authors.initials: GS
authors.lastname: Kassab
authors.forename: Sabee
authors.initials: S
authors.lastname: Molloi
mesh_terms: D000818:Animals; D001783:Blood Flow Velocity; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D004195:Disease Models, Animal; D053805:Fractional Flow Reserve, Myocardial; D007472:Iohexol; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D013552:Swine
chemical_list: D003287:Contrast Media; D007472:Iohexol