Diagnostic Performance of Intracoronary Optical Coherence Tomography-Modulated Quantitative Flow Ratio for Assessing Coronary Stenosis

Overview

Journal J Soc Cardiovasc Angiogr Interv

Specialty Cardiology & Vascular Diseases

Date 2024 Aug 12

PMID 39132390

Authors

Tianxiao Xu

Wei Yu

Daixin Ding

Chunming Li

Jiayue Huang

Takashi Kubo

William Wijns

Shengxian Tu

Affiliations

Soon will be listed here.

Abstract

Background: A novel method for fast computation of Murray law-based quantitative flow ratio (μQFR) from coregistered angiography and optical coherence tomography (OCT) was recently developed. This study aimed to evaluate the diagnostic performance of this OCT-modulated μQFR (OCT-μFR).

Methods: Patients who underwent coronary angiography, OCT, and fractional flow reserve (FFR) were retrospectively enrolled. μQFR was computed from a single angiographic projection. Subsequently, OCT image pullback was coregistered with the angiogram, and OCT-μFR was calculated based on the coregistered data. The same cut-off value of 0.80 was used for OCT-μFR, μQFR, and FFR to define ischemia.

Results: A paired comparison of OCT-μFR and μQFR was performed in 269 vessels from 218 patients. The mean FFR was 0.81 ± 0.11, and 45.0% of vessels had an FFR ≤0.80. OCT-μFR showed a better correlation with FFR than μQFR (r = 0.83 vs 0.76, = .018) and numerically higher diagnostic performance (area under the curve [AUC] = 0.95 vs 0.92, = .057). Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio for OCT-μFR to identify ischemia-causing stenosis were 89.3%, 93.2%, 91.5%, 91.4%, 13.2, and 0.1, respectively. In addition, OCT-μFR showed significantly higher diagnostic performance compared with μQFR in vessels with suboptimal angiographic image quality (AUC = 0.93 vs 0.87, = .028) and tandem lesions (AUC = 0.94 vs 0.87, = .017).

Conclusions: Computation of OCT-μFR was feasible and accurately identified physiologically significant coronary stenosis with simultaneous morphological assessment. In vessels with suboptimal angiographic image quality or tandem lesions, OCT-μFR had a higher diagnostic performance than angiography-based μQFR.

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