Comparison of 3-dimensional and 2-dimensional quantitative coronary angiography and intravascular ultrasound for functional assessment of coronary lesions

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• 作者：Takeshi Nishi ; MD ; ^{takeshi24@hotmail.co.jp} ; Hideki Kitahara ; MD ; Yoshihide Fujimoto ; MD ; Takashi Nakayama ; MD ; Kazumasa Sugimoto ; MD ; Masayuki Takahara ; MD ; Yoshio Kobayashi ; MD ; FJCC
• 关键词：Three-dimensional quantitative angiography ; Fractional flow reserve ; Intravascular ultrasound
• 刊名：Journal of Cardiology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：69
• 期：1
• 页码：280-286
• 全文大小：1066 K
• 卷排序：69

文摘

Three-dimensional quantitative coronary angiography (3D-QCA) reportedly allows more accurate delineation of true vessel geometry when compared with standard two-dimensional (2D) QCA and has been validated by intravascular ultrasound (IVUS). This study sought to compare diagnostic efficiency of 2D- and 3D-QCA, and IVUS in identifying hemodynamically significant coronary stenoses as determined by fractional flow reserve (FFR).MethodsForty-two lesions in 40 patients were assessed by FFR, IVUS, and 2D- and 3D-QCA. Correlations between FFR values and anatomical parameters obtained by 2D- and 3D-QCA and IVUS were analyzed. The receiver operating characteristic (ROC) curves were used to compare the diagnostic accuracy of the parameters for predicting FFR ≤ 0.80.ResultsMean FFR value was 0.75 ± 0.13. FFR ≤ 0.80 was observed in 28 lesions (67%). Of IVUS measurements, minimum lumen area (MLA) well correlated with FFR values (r = 0.71, p < 0.001). Of 3D- and 2D-QCA measurements, minimum lumen diameter (MLD) correlated best with FFR values (r = 0.79, p < 0.01; r = 0.68, p < 0.01, respectively), followed by MLA (r = 0.76, p < 0.01; r = 0.67, p < 0.01, respectively). The area under the ROC curve for 3D-QCA MLD was greater than those for 2D-QCA MLD (p = 0.03) and 2D-QCA MLA (p = 0.03). On the other hand, the AUC for 3D-QCA MLD, 3D-QCA MLA, and IVUS MLA were not significantly different.Conclusions3D-QCA is more useful than 2D-QCA and possibly comparable to IVUS in the assessment of functional stenosis severity. When FFR is not available, 3D-QCA MLA and MLD may assist in the assessment of functional severity of intermediate lesions.