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Diagnostic performance of quantitative flow ratio from coronary angiography versus fractional flow reserve from computed tomography

Session Assessment of residual risk after percutaneous coronary intervention

Speaker Hiroki Emori

Congress : ESC Congress 2019

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease: Angiography, Invasive Imaging, FFR
  • Session type : Moderated Posters
  • FP Number : P1252

Authors : H Emori (Wakayama,JP), T Kubo (Wakayama,JP), T Tanigaki (Gifu,JP), Y Kawase (Gifu,JP), Y Shiono (Wakayama,JP), K Shimamura (Wakayama,JP), Y Sobue (Gifu,JP), Y Matsuo (Wakayama,JP), T Hirata (Gifu,JP), H Kitabata (Wakayama,JP), H Ota (Gifu,JP), Y Ino (Wakayama,JP), M Okubo (Gifu,JP), H Matsuo (Gifu,JP), T Akasaka (Wakayama,JP)

Authors:
H Emori1 , T Kubo1 , T Tanigaki2 , Y Kawase2 , Y Shiono1 , K Shimamura1 , Y Sobue2 , Y Matsuo1 , T Hirata2 , H Kitabata1 , H Ota2 , Y Ino1 , M Okubo2 , H Matsuo2 , T Akasaka1 , 1Wakayama Medical University, Division of cardiovascular medicine - Wakayama - Japan , 2Gifu Heart Center - Gifu - Japan ,

Citation:

Background:QFR and FFRCTare recently developed, less-invasive techniques for functional assessment of coronary artery disease.  

Objectives:We compared the diagnostic performance between fractional flow reserve derived from computed tomography(FFRCT) and quantitative flow ratio(QFR) derived from coronary angiography, using FFR as the standard reference.


Methods:We measuredFFRCT, QFR and FFR in 152 patients (233 vessels) with stable coronary artery disease.


Results:QFR was highly correlated with FFR (r = 0.78, p < 0.001), while FFRCTwas moderately correlated with FFR (r = 0.63, p < 0.001). Both QFR and FFRCTshowed good agreements with FFR, presenting small values of mean difference and root-mean-squared deviation (FFR -QFR: 0.02 ± 0.09 and FFR -FFRCT: 0.03 ± 0.11). The AUC of QFR was significantly greater than that of 3D-QCA-derived %DS(0.93 vs. 0.78; difference: 0.15; 95% CI: 0.09 to 0.20; p < 0.001). The AUC of FFRCTwas significantly greater than that of CCTA-derived %DS (0.82 vs. 0.70; difference: 0.12; 95% CI: 0.05 to 0.19; p < 0.001). The AUC of QFR was significantly greater than that of FFRCT(0.93 vs. 0.82; difference: 0.11; 95% CI: 0.05 to 0.16; p < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive valueof QFR =0.80 for predicting FFR =0.80 were 90%, 82%, 81%, and 90%, respectively. Those of FFRCT=0.80 for predicting FFR =0.80 were 82%, 70%, 70%, and 82%, respectively. The diagnostic accuracy of QFR =0.80 for predicting FFR =0.80 was 85% [95% confidence interval: 81% to 89%], while that of FFRCT=0.80 for predicting FFR =0.80was 76% [95% confidence interval: 70% to 80%]. 

Conclusions:Both QFR and FFRCTpossessed the ability to accurately evaluate the functional severity of coronary stenosis.

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