Author + information
- Received February 4, 2019
- Revision received June 24, 2019
- Accepted June 25, 2019
- Published online October 21, 2019.
- Toru Tanigaki, MDa,∗,
- Hiroki Emori, MDb,∗,
- Yoshiaki Kawase, MDa,
- Takashi Kubo, MD, PhDb,∗ (, )
- Hiroyuki Omori, MDa,
- Yasutsugu Shiono, MD, PhDb,
- Yoshihiro Sobue, MD, PhDa,
- Kunihiro Shimamura, MD, PhDb,
- Tetsuo Hirata, MDa,
- Yoshiki Matsuo, MD, PhDb,
- Hideaki Ota, MDa,
- Hironori Kitabata, MD, PhDb,
- Munenori Okubo, MD, PhDa,
- Yasushi Ino, MD, PhDb,
- Hitoshi Matsuo, MD, PhDa,† and
- Takashi Akasaka, MD, PhDb,†
- aDepartment of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
- bDepartment of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
- ↵∗Address for correspondence:
Dr. Takashi Kubo, Wakayama Medical University, Department of Cardiovascular Medicine, 811-1 Kimiidera, Wakayama 641-8509, Japan.
Objectives The aim of this study was to compare diagnostic performance between quantitative flow ratio (QFR) derived from coronary angiography and fractional flow reserve derived from computed tomography (FFRCT) using fractional flow reserve (FFR) as the reference standard.
Background QFR and FFRCT are recently developed, less invasive techniques for functional assessment of coronary artery disease.
Methods QFR, FFRCT, and FFR were measured in 152 patients (233 vessels) with stable coronary artery disease.
Results QFR was highly correlated with FFR (r = 0.78; p < 0.001), whereas FFRCT was moderately correlated with FFR (r = 0.63; p < 0.001). Both QFR and FFRCT showed moderately good agreement with FFR, presenting small values of mean difference but large values of root mean squared deviation (FFR-QFR, 0.02 ± 0.09; FFR-FFRCT, 0.03 ± 0.11). The sensitivity, specificity, positive predictive value, and negative predictive value of 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 [CI]: 81% to 89%), whereas that of FFRCT ≤0.80 for predicting FFR ≤0.80 was 76% (95% CI: 70% to 80%).
Conclusions QFR and FFRCT showed significant correlation with FFR. Mismatches between QFR and FFR and between FFRCT and FFR were frequent.
- computed tomography angiography
- fractional flow reserve
- quantitative coronary angiography
- quantitative flow ratio
↵∗ Drs. Tanigaki and Emori contributed equally to this work.
↵† Drs. H. Matsuo and Akasaka contributed equally to this work.
The international FFRCT registry (ADVANCE [Assessing Diagnostic Value of Non-Invasive FFRCT in Coronary Care]) was supported by HeartFlow. Dr. Akasaka has served on the advisory boards of Abbott Vascular and HeartFlow; and has received lecture fees and research grants from Abbott Vascular and HeartFlow. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received February 4, 2019.
- Revision received June 24, 2019.
- Accepted June 25, 2019.
- 2019 American College of Cardiology Foundation
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