Validation of a Prediction Model From Quantitative Coronary Angiography to Detect Ischaemic Lesions as Evaluated by Invasive Fractional Flow Reserve

Validation of a Prediction Model From Quantitative Coronary Angiography to Detect Ischaemic Lesions as Evaluated by Invasive Fractional Flow Reserve

Heart, Lung and Circulation

10.1016/j.hlc.2024.09.004

https://doi.org/10.1016/j.hlc.2024.09.004

Shuai Yang, Shuang Leng, Jiang Ming Fam, Adrian Fatt Hoe Low, Ru-San Tan, Ping Chai, Lynette Teo, Chee Yang Chin, John C. Allen, Mark Yan-Yee Chan, Khung Keong Yeo, Aaron Sung Lung Wong, Qinghua Wu, Soo Teik Lim, Liang Zhong

Coronary artery disease, Fractional flow reserve, Quantitative coronary angiography, Stenotic flow reserve, Ischaemic lesions

12 December 2024

Yang, S., Leng, S., Fam, J. M., Low, A. F. H., Tan, R.-S., Chai, P., Teo, L., Chin, C. Y., Allen, J. C., Chan, M. Y.-Y., Yeo, K. K., Wong, A. S. L., Wu, Q., Lim, S. T., & Zhong, L. (2025). Validation of a Prediction Model From Quantitative Coronary Angiography to Detect Ischaemic Lesions as Evaluated by Invasive Fractional Flow Reserve. Heart, Lung and Circulation, 34(2), 125–134. https://doi.org/10.1016/j.hlc.2024.09.004

Aim Physician visual assessment (PVA) in invasive coronary angiography (ICA) is clinically used to determine stenosis severity and guide coronary intervention. However, PVA provides limited information regarding the haemodynamic significance of stenosis. This prospective study aimed to develop a model combining visual diameter stenosis (DSPVA) and quantitative coronary angiography (QCA)-derived parameters to diagnose ischaemic lesions using invasive fractional flow reserve (FFR) with pharmacologically induced maximal hyperaemia as the gold standard. Methods A total of 103 patients (148 lesions) who underwent ICA and FFR measurement were included in the study. Quantitative coronary angiography was used to evaluate various parameters, including anatomical parameters such as lesion length (LL), minimal lumen diameter (MLD), and minimal lumen area, along with haemodynamic parameters like LL/MLD4 and stenotic flow reserve (SFR). Plaque area, a characteristic parameter of plaque, was also assessed. Lesion-specific ischaemia was defined as invasive FFR ≤0.8. Results The LL/MLD4 (r= −0.66, p<0.001) and SFR (r=0.66, p

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This research / project is supported by the A*STAR, National Research Foundation and EDB - Industry Alignment Fund Pre Positioning
Grant Reference no. : H20c6a0035

This research / project is supported by the National Medical Research Council Singapore - NMRC Bedside and Bench Grant (BnB)
Grant Reference no. : NMRC/BnB/0017/2015

This research / project is supported by the National Medical Research Council Singapore - NMRC Health Services Research Grant (HSRG)
Grant Reference no. : MOH-000358

https://oar.a-star.edu.sg/communities-collections/articles/21623

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Institute for Infocomm Research