title: Assessing Computational Fractional Flow Reserve From Optical Coherence Tomography in Patients With Intermediate Coronary Stenosis in the Left Anterior Descending Artery.
abstract: Intravascular optical coherence tomography (OCT) imaging provides limited information on the functional assessment of coronary stenosis. We evaluated a new approach to OCT image-based computation modeling, which can be used to estimate the fractional flow reserve (FFR) in patients with intermediate coronary stenosis.
  
  
  
  Ninety-two patients with intermediate diameter stenosis in the left anterior descending artery underwent both FFR measurement with pressure wires and OCT examination. Using the OCT data, a computational fluid dynamics algorithm was used to calculate the computational FFR (FFROCT). The diagnostic performance of the FFROCT was assessed based on the pressure wire-based FFR. The median FFR and FFROCT values were 0.86 (0.79-0.89) and 0.89 (0.82-0.94), respectively. The average diameter stenosis in quantitative coronary angiography and area stenosis in OCT were 58.1±13.4% and 67.5±13.5%, respectively. The FFROCT was better correlated to the FFR than were the anatomic variables (r=0.72; P<0.001 versus r=0.46; P<0.001 for minimal luminal diameter on quantitative coronary angiography or r=0.57; P<0.001 for minimal lumen area on OCT). When functionally significant stenosis was defined as an FFR cutoff value of ≤0.8, FFROCT resulted in 88.0% accuracy, 68.7% sensitivity, and 95.6% specificity. The positive and negative predictive values were 84.2% and 89.0%, respectively.
  
  
  
  The computation of FFROCT enables assessment not only of anatomic information, but also of the functional significance of intermediate stenosis. This measurement may be a useful approach for the simultaneous evaluation of the functional and anatomic severity of coronary stenosis.
authors: From the Department of Electrical Engineering, Sejong University, Seoul, Korea (J.H., J.L., G.K., S.L.); Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.); Cardiovascular Research Institute (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.) and Severance Biomedical Science Institute (Y.J., M.-K.H.), Yonsei University College of Medicine, Seoul, Korea; and Department of Mechanical Engineering, Yonsei University, Seoul, Korea (J.S.L.).
authors: Jinyong
authors: J
authors: Ha
authors: From the Department of Electrical Engineering, Sejong University, Seoul, Korea (J.H., J.L., G.K., S.L.); Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.); Cardiovascular Research Institute (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.) and Severance Biomedical Science Institute (Y.J., M.-K.H.), Yonsei University College of Medicine, Seoul, Korea; and Department of Mechanical Engineering, Yonsei University, Seoul, Korea (J.S.L.).
authors: Jung-Sun
authors: JS
authors: Kim
authors: From the Department of Electrical Engineering, Sejong University, Seoul, Korea (J.H., J.L., G.K., S.L.); Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.); Cardiovascular Research Institute (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.) and Severance Biomedical Science Institute (Y.J., M.-K.H.), Yonsei University College of Medicine, Seoul, Korea; and Department of Mechanical Engineering, Yonsei University, Seoul, Korea (J.S.L.).
authors: Jaeyeong
authors: J
authors: Lim
authors: From the Department of Electrical Engineering, Sejong University, Seoul, Korea (J.H., J.L., G.K., S.L.); Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.); Cardiovascular Research Institute (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.) and Severance Biomedical Science Institute (Y.J., M.-K.H.), Yonsei University College of Medicine, Seoul, Korea; and Department of Mechanical Engineering, Yonsei University, Seoul, Korea (J.S.L.).
authors: Gihoon
authors: G
authors: Kim
authors: From the Department of Electrical Engineering, Sejong University, Seoul, Korea (J.H., J.L., G.K., S.L.); Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.); Cardiovascular Research Institute (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.) and Severance Biomedical Science Institute (Y.J., M.-K.H.), Yonsei University College of Medicine, Seoul, Korea; and Department of Mechanical Engineering, Yonsei University, Seoul, Korea (J.S.L.).
authors: Seungwan
authors: S
authors: Lee
authors: From the Department of Electrical Engineering, Sejong University, Seoul, Korea (J.H., J.L., G.K., S.L.); Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.); Cardiovascular Research Institute (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.) and Severance Biomedical Science Institute (Y.J., M.-K.H.), Yonsei University College of Medicine, Seoul, Korea; and Department of Mechanical Engineering, Yonsei University, Seoul, Korea (J.S.L.).
authors: Joon Sang
authors: JS
authors: Lee
authors: From the Department of Electrical Engineering, Sejong University, Seoul, Korea (J.H., J.L., G.K., S.L.); Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.); Cardiovascular Research Institute (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.) and Severance Biomedical Science Institute (Y.J., M.-K.H.), Yonsei University College of Medicine, Seoul, Korea; and Department of Mechanical Engineering, Yonsei University, Seoul, Korea (J.S.L.).
authors: Dong-Ho
authors: DH
authors: Shin
authors: From the Department of Electrical Engineering, Sejong University, Seoul, Korea (J.H., J.L., G.K., S.L.); Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.); Cardiovascular Research Institute (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.) and Severance Biomedical Science Institute (Y.J., M.-K.H.), Yonsei University College of Medicine, Seoul, Korea; and Department of Mechanical Engineering, Yonsei University, Seoul, Korea (J.S.L.).
authors: Byeong-Keuk
authors: BK
authors: Kim
authors: From the Department of Electrical Engineering, Sejong University, Seoul, Korea (J.H., J.L., G.K., S.L.); Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.); Cardiovascular Research Institute (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.) and Severance Biomedical Science Institute (Y.J., M.-K.H.), Yonsei University College of Medicine, Seoul, Korea; and Department of Mechanical Engineering, Yonsei University, Seoul, Korea (J.S.L.).
authors: Young-Guk
authors: YG
authors: Ko
authors: From the Department of Electrical Engineering, Sejong University, Seoul, Korea (J.H., J.L., G.K., S.L.); Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.); Cardiovascular Research Institute (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.) and Severance Biomedical Science Institute (Y.J., M.-K.H.), Yonsei University College of Medicine, Seoul, Korea; and Department of Mechanical Engineering, Yonsei University, Seoul, Korea (J.S.L.).
authors: Donghoon
authors: D
authors: Choi
authors: From the Department of Electrical Engineering, Sejong University, Seoul, Korea (J.H., J.L., G.K., S.L.); Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.); Cardiovascular Research Institute (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.) and Severance Biomedical Science Institute (Y.J., M.-K.H.), Yonsei University College of Medicine, Seoul, Korea; and Department of Mechanical Engineering, Yonsei University, Seoul, Korea (J.S.L.).
authors: Yangsoo
authors: Y
authors: Jang
authors: From the Department of Electrical Engineering, Sejong University, Seoul, Korea (J.H., J.L., G.K., S.L.); Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.); Cardiovascular Research Institute (J.-S.K., D.-H.S., B.-K.K., Y.-G.K., D.C., Y.J., M.-K.H.) and Severance Biomedical Science Institute (Y.J., M.-K.H.), Yonsei University College of Medicine, Seoul, Korea; and Department of Mechanical Engineering, Yonsei University, Seoul, Korea (J.S.L.). mkhong61@yuhs.ac.
authors: Myeong-Ki
authors: MK
authors: Hong
mesh_terms: D000368:Aged; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D008875:Middle Aged; D041623:Tomography, Optical Coherence / Q000379:methods*
keywords: coronary artery disease; coronary stenosis; coronary vessels; fractional flow reserve, myocardial; tomography, optical coherence