title: Three dimensional quantitative coronary angiography can detect reliably ischemic coronary lesions based on fractional flow reserve.
abstract: Conventional coronary angiography (CAG) has limitations in evaluating lesions producing ischemia. Three dimensional quantitative coronary angiography (3D-QCA) shows reconstructed images of CAG using computer based algorithm, the Cardio-op B system (Paieon Medical, Rosh Ha'ayin, Israel). The aim of this study was to evaluate whether 3D-QCA can reliably predict ischemia assessed by myocardial fractional flow reserve (FFR) < 0.80. 3D-QCA images were reconstructed from CAG which also were evaluated with FFR to assess ischemia. Minimal luminal diameter (MLD), percent diameter stenosis (%DS), minimal luminal area (MLA), and percent area stenosis (%AS) were obtained. The results of 3D-QCA and FFR were compared. A total of 266 patients was enrolled for the present study. FFR for all lesions ranged from 0.57 to 1.00 (0.85 ± 0.09). Measurement of MLD, %DS, MLA, and %AS all were significantly correlated with FFR (r = 0.569, 0609, 0.569, 0.670, respectively, all P < 0.001). In lesions with MLA < 4.0 mm(2), %AS of more than 65.5% had a 80% sensitivity and a 83% specificity to predict FFR < 0.80 (area under curve, AUC was 0.878). 3D-QCA can reliably predict coronary lesions producing ischemia and may be used to guide therapeutic approach for coronary artery disease.
authors.affiliation: Devision of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University, College of Medicine, Seoul, Korea.
authors.forename: Woo-Young
authors.identifier: 0000-0002-9106-9331
authors.initials: WY
authors.lastname: Chung
authors.affiliation: Department of Cardiology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Byoung-Joo
authors.identifier: 0000-0002-3045-5343
authors.initials: BJ
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Internal Medicine, School of Medicine, Dankook University, Cheonan, Korea.
authors.forename: Seong-Hoon
authors.identifier: 0000-0002-2941-2784
authors.initials: SH
authors.lastname: Lim
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Matsuo
authors.affiliation: Division of Cardiovascular Disease, Mayo Clinic, Rochester, MN, USA.
authors.forename: Ryan J
authors.identifier: 0000-0002-8366-8422
authors.initials: RJ
authors.lastname: Lennon
authors.affiliation: Division of Cardiovascular Disease, Mayo Clinic, Rochester, MN, USA.
authors.forename: Rajiv
authors.identifier: 0000-0002-2713-0433
authors.initials: R
authors.lastname: Gulati
authors.affiliation: Division of Cardiovascular Disease, Mayo Clinic, Rochester, MN, USA.
authors.forename: Gurpreet S
authors.identifier: 0000-0002-4456-6183
authors.initials: GS
authors.lastname: Sandhu
authors.affiliation: Division of Cardiovascular Disease, Mayo Clinic, Rochester, MN, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Holmes
authors.affiliation: Division of Cardiovascular Disease, Mayo Clinic, Rochester, MN, USA.
authors.forename: Charanjit S
authors.initials: CS
authors.lastname: Rihal
authors.affiliation: Division of Cardiovascular Disease, Mayo Clinic, Rochester, MN, USA.
authors.forename: Amir
authors.identifier: 0000-0002-9446-5313
authors.initials: A
authors.lastname: Lerman
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Coronary Angiography; Coronary Artery Disease; Myocardial Ischemia