A Preliminary Study On The Diagnostic Efficacy Of Non-invasive Fraction Flow Reserve Based On Coronary CT Angiography For Myocardial Ischemia

ObjectiveWith a standard of invasive fraction flow reserve(FFR),the clinical diagnostic efficacy of domestic non-invasive blood fraction flow reserve based on coronary CT angiography(FFRCT)for functional myocardial ischemia was preliminarily investigated.MethodsPatients with chest pain who were admitted to the Third Medical Center of PLA General Hospital from May 2019 to August 2020 were included.The enrolled patients received coronary CT angiography,and the invasive coronary angiography and FFR examination were completed within 1 week.FFRCT value was performed in an independent central laboratory(Beijing Guanshengyun Medical Technology Co.,Ltd.,China).With the standard of invasive FFR value,the accuracy,sensitivity,specificity,positive predictive value and negative predictive value of FFRCT in the diagnosis of myocardial functional ischemia were calculated in the per-vessel level.The receiver operating characteristic curve(ROC)of FFRCT was plotted to obtain the area under the curve(AUC).Pearson correlation analysis was used to test the correlation between FFRCT value and FFR value,and Bland-Altman plot was drawn to test the consistency between FFRCT value and FFR value.ResultsA total of 36 patients with 43 coronary vessels were included.The mean age of the patients was 59.50±9.42 years,including 25 males and 11 females.In the per-vessel level,the accuracy,sensitivity,specificity,positive predictive value and negative predictive value of FFRCT in the diagnosis of myocardial functional ischemia were 90.70%,100%,85.7%,78.9% and 100%,respectively;The area under the ROC of FFRCT for the diagnosis of myocardial ischemia was 0.948(95%CI: 0.833-0.992,P<0.0001),and the optimal threshold was 0.797,the sensitivity was 100% and specificity was 85.71%;Pearson correlation analysis showed that FFRCT value was positively correlated with FFR value and they had a high correlation(r=0.6822,95%CI:0.4803-0.8155,P<0.0001).The Bland-Altman plot showed that there was good agreement between FFRCT value and FFR value.ConclusionsWith the standard of invasive FFR value,the domestic FFRCT software used in this study has a good diagnostic efficacy for functional myocardial ischemia and has an exciting prospect of clinical application.