PMID- 35268488
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230308
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 11
IP  - 5
DP  - 2022 Mar 3
TI  - Diagnostic Accuracy of Coronary Angiography-Based Vessel Fractional Flow Reserve 
      (vFFR) Virtual Stenting.
LID - 10.3390/jcm11051397 [doi]
LID - 1397
AB  - 3D coronary angiography-based vessel fractional flow reserve (vFFR) proved to be 
      an accurate diagnostic alternative to invasively measured pressure wire based 
      fractional flow reserve (FFR). The ability to compute post-PCI vFFR using pre-PCI 
      vFFR virtual stent analysis is unknown. We aimed to assess the feasibility and 
      diagnostic accuracy of pre-PCI vFFR virtual stenting analysis (residual vFFR) 
      with post-PCI FFR as a reference. This is an observational, single-center 
      retrospective cohort study including consecutive patients from the FFR-SEARCH 
      registry. We blindly calculated residual vFFR from pre-PCI angiograms and 
      compared them to invasive pressure-wire based post-PCI FFR. Inclusion criteria 
      involved presentation with either stable or unstable angina or non-ST elevation 
      myocardial infarction (NSTEMI), >/=1 significant stenosis in one of the epicardial 
      coronary arteries (percentage diameter stenosis of >70% by QCA or hemodynamically 
      relevant stenosis with FFR </=0.80) and pre procedural angiograms eligible for vFFR 
      analysis. Exclusion criteria comprised patients with ST elevation myocardial 
      infarction (STEMI), coronary bypass grafts, cardiogenic shock or severe 
      hemodynamic instability. Eighty-one pre-PCI residual vFFR measurements were 
      compared to post-PCI FFR and post-PCI vFFR measurements. Mean residual vFFR was 
      0.91 +/- 0.06, mean post-PCI FFR 0.91 +/- 0.06 and mean post-PCI vFFR was 0.92 +/- 
      0.05. Residual vFFR showed a high linear correlation (r = 0.84) and good 
      agreement (mean difference (95% confidence interval): 0.005 (-0.002-0.012)) with 
      post-PCI FFR, as well as with post-PCI-vFFR (r = 0.77, mean difference -0.007 
      (-0.015-0.0003)). Residual vFFR showed good accuracy in the identification of 
      lesions with post-PCI FFR < 0.90 (sensitivity 94%, specificity 71%, area under 
      the curve (AUC) 0.93 (95% CI: 0.86-0.99), p < 0.001). Virtual stenting using vFFR 
      provided an accurate estimation of post-PCI FFR and post-PCI vFFR. Further 
      studies are needed to prospectively validate a vFFR-guided PCI strategy.
FAU - Tomaniak, Mariusz
AU  - Tomaniak M
AD  - Department of Cardiology, Erasmus University Medical Center, ThoraxCenter, 3000 
      CA Rotterdam, The Netherlands.
AD  - First Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, 
      Poland.
FAU - Neleman, Tara
AU  - Neleman T
AD  - Department of Cardiology, Erasmus University Medical Center, ThoraxCenter, 3000 
      CA Rotterdam, The Netherlands.
FAU - Ziedses des Plantes, Anniek
AU  - Ziedses des Plantes A
AD  - Department of Cardiology, Erasmus University Medical Center, ThoraxCenter, 3000 
      CA Rotterdam, The Netherlands.
FAU - Masdjedi, Kaneshka
AU  - Masdjedi K
AD  - Department of Cardiology, Erasmus University Medical Center, ThoraxCenter, 3000 
      CA Rotterdam, The Netherlands.
FAU - van Zandvoort, Laurens J C
AU  - van Zandvoort LJC
AD  - Department of Cardiology, Erasmus University Medical Center, ThoraxCenter, 3000 
      CA Rotterdam, The Netherlands.
FAU - Kochman, Janusz
AU  - Kochman J
AD  - First Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, 
      Poland.
FAU - den Dekker, Wijnand K
AU  - den Dekker WK
AD  - Department of Cardiology, Erasmus University Medical Center, ThoraxCenter, 3000 
      CA Rotterdam, The Netherlands.
FAU - Wilschut, Jeroen M
AU  - Wilschut JM
AD  - Department of Cardiology, Erasmus University Medical Center, ThoraxCenter, 3000 
      CA Rotterdam, The Netherlands.
FAU - Diletti, Roberto
AU  - Diletti R
AD  - Department of Cardiology, Erasmus University Medical Center, ThoraxCenter, 3000 
      CA Rotterdam, The Netherlands.
FAU - Kardys, Isabella
AU  - Kardys I
AD  - Department of Cardiology, Erasmus University Medical Center, ThoraxCenter, 3000 
      CA Rotterdam, The Netherlands.
FAU - Zijlstra, Felix
AU  - Zijlstra F
AD  - Department of Cardiology, Erasmus University Medical Center, ThoraxCenter, 3000 
      CA Rotterdam, The Netherlands.
FAU - Van Mieghem, Nicolas M
AU  - Van Mieghem NM
AD  - Department of Cardiology, Erasmus University Medical Center, ThoraxCenter, 3000 
      CA Rotterdam, The Netherlands.
FAU - Daemen, Joost
AU  - Daemen J
AD  - Department of Cardiology, Erasmus University Medical Center, ThoraxCenter, 3000 
      CA Rotterdam, The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20220303
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC8910880
OTO - NOTNLM
OT  - angiography-based FFR
OT  - computational fluid dynamics
OT  - coronary artery disease
OT  - fractional flow reserve
OT  - novel interventional coronary diagnostics
OT  - percutaneous coronary intervention
OT  - residual ischemia
OT  - vFFR
OT  - virtual PCI
COIS- M. Tomaniak acknowledges funding as the laureate of the European Society of 
      Cardiology Research and Training Program in the form of the ESC 2018 Grant. K. 
      Masdjedi received an institutional grant from Acist Medical. L. J. C. van 
      Zandvoort received an institutional research grant from Acist Medical. N. Van 
      Mieghem received a research grant from Edwards, Medtronic, Abbott, Boston 
      Scientific, Pulse Cath, Acist Medical and Essential Medical. J. Daemen received 
      institutional grant/research support from Abbott Vascular, Boston Scientific, 
      Acist Medical, Medtronic and PulseCath, and consultancy and speaker fees from 
      Acist Medical, Boston Scientific, ReCor Medical, Medtronic and Pulse Cath. The 
      remaining authors have nothing to disclose. The manufacturer of CAAS workstation 
      (the software used in this study) had no role in the design of the study; in the 
      collection, analyses, or interpretation of data; in the writing of the 
      manuscript, or in the decision to publish the results.
EDAT- 2022/03/11 06:00
MHDA- 2022/03/11 06:01
PMCR- 2022/03/03
CRDT- 2022/03/10 15:29
PHST- 2022/01/31 00:00 [received]
PHST- 2022/02/20 00:00 [revised]
PHST- 2022/02/22 00:00 [accepted]
PHST- 2022/03/10 15:29 [entrez]
PHST- 2022/03/11 06:00 [pubmed]
PHST- 2022/03/11 06:01 [medline]
PHST- 2022/03/03 00:00 [pmc-release]
AID - jcm11051397 [pii]
AID - jcm-11-01397 [pii]
AID - 10.3390/jcm11051397 [doi]
PST - epublish
SO  - J Clin Med. 2022 Mar 3;11(5):1397. doi: 10.3390/jcm11051397.