title: The effect of blood pressure on non-invasive fractional flow reserve derived from coronary computed tomography angiography.
abstract: OBJECTIVE
  The aim of this study is to assess the effect of blood pressure (BP) on coronary computed tomography angiography (CTA) derived computational fractional flow reserve (CTA-FFR).
  
  
  METHODS
  Twenty-one patients who underwent coronary CTA and invasive FFR were retrospectively identified. Ischemia was defined as invasive FFR ≤0.80. Using a work-in-progress computational fluid dynamics algorithm, CTA-FFR was computed with BP measured before CTA, and simulated BPs of 60/50, 90/60, 110/70, 130/80, 150/90, and 180/100 mmHg respectively. Correlation between CTA-FFR and invasive FFR was assessed using Pearson test. The repeated measuring test was used for multiple comparisons of CTA-FFR values by simulated BP inputs.
  
  
  RESULTS
  Twenty-nine vessels (14 with invasive FFR ≤0.80) were assessed. The average CTA-FFR for measured BP (134 ± 20/73 ± 12 mmHg) was 0.77 ± 0.12. Correlation between CTA-FFR by measured BP and invasive FFR was good (r = 0.735, P < 0.001). For simulated BPs of 60/50, 90/60, 110/70, 130/80, 150/90, and 180/100 mmHg, the CTA-FFR increased: 0.69 ± 0.13, 0.73 ± 0.12, 0.75 ± 0.12, 0.77 ± 0.11, 0.79 ± 0.11, and 0.81 ± 0.10 respectively (P < 0.05).
  
  
  CONCLUSIONS
  Measurement of the BP just before CTA is preferred for accurate CTA-FFR simulation. BP variations in the common range slightly affect CTA-FFR. However, inaccurate BP assumptions differing from the patient-specific BP could cause misinterpretation of borderline significant lesions.
  
  
  CONCLUSIONS
  • The blood pressure (BP) affects the CTA-FFR computation. • Measured BP before CT examination is preferable for accurate CTA-FFR simulation. • Inaccurate BP assumptions can cause misinterpretation of borderline significant lesions.
authors.affiliation: Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan. akuratasan2000@gmail.com.|Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands. akuratasan2000@gmail.com.
authors.forename: Akira
authors.initials: A
authors.lastname: Kurata
authors.affiliation: Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands.|Departmenet of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Adriaan
authors.initials: A
authors.lastname: Coenen
authors.affiliation: Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands.|Departmenet of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Marisa M
authors.initials: MM
authors.lastname: Lubbers
authors.affiliation: Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands.|Departmenet of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Koen
authors.initials: K
authors.lastname: Nieman
authors.affiliation: Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors.forename: Teruhito
authors.initials: T
authors.lastname: Kido
authors.affiliation: Department of Radiology, Matsuyama Saiseikai Hospital, Matsuyama, Ehime, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kido
authors.affiliation: Division of Clinical Biostatistics, Section of Cancer Prevention and Epidemiology, Clinical Research Center, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan.
authors.forename: Natsumi
authors.initials: N
authors.lastname: Yamashita
authors.affiliation: Department of Cardiology, Matsuyama Saiseikai Hospital, Matsuyama, Ehime, Japan.
authors.forename: Kouki
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Gabriel P
authors.initials: GP
authors.lastname: Krestin
authors.affiliation: Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors.forename: Teruhito
authors.initials: T
authors.lastname: Mochizuki
mesh_terms: D000368:Aged; D000465:Algorithms; D001794:Blood Pressure / Q000502:physiology*; D000072226:Computed Tomography Angiography / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Blood pressure; Computed tomography; Coronary artery disease; Fractional flow reserve; Myocardial ischemia