Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0153070
Title: Simplified models of Non-Invasive fractional flow reserve based on CT images
Authors: Zhang J.-M. 
Zhong L. 
Luo T.
Lomarda A.M.
Huo Y.
Yap J.
Lim S.T. 
Tan R.S. 
Wong A.S.L. 
Tan J.W.C. 
Yeo K.K. 
Fam J.M. 
Keng F.Y.J. 
Wan M. 
Su B. 
Zhao X.
Allen J.C. 
Kassab G.S.
Chua T.S.J. 
Tan S.Y. 
Keywords: acetylsalicylic acid
angiotensin receptor antagonist
beta adrenergic receptor blocking agent
calcium channel blocking agent
clopidogrel
creatinine
dipeptidyl carboxypeptidase inhibitor
hemoglobin
hydroxymethylglutaryl coenzyme A reductase inhibitor
nitrate
adolescent
adult
area under the curve
Article
body mass
Chinese
clinical article
computational fluid dynamics
computed tomographic angiography
computer assisted tomography
controlled study
coronary artery circumflex branch
coronary artery obstruction
coronary hemodynamics
diabetes mellitus
diagnostic accuracy
diagnostic test accuracy study
dyspnea
female
fractional flow reserve
heart infarction
heart muscle ischemia
hematocrit
human
hypercholesterolemia
hypertension
image processing
image reconstruction
laboratory test
left anterior descending coronary artery
male
non invasive procedure
percutaneous coronary intervention
pilot study
predictive value
receiver operating characteristic
retrospective study
sensitivity and specificity
smoking
steady state
symptom
thorax pain
aged
middle aged
theoretical model
x-ray computed tomography
Aged
Female
Fractional Flow Reserve, Myocardial
Humans
Male
Middle Aged
Models, Theoretical
Pilot Projects
Tomography, X-Ray Computed
Issue Date: 2016
Publisher: Public Library of Science
Citation: Zhang J.-M., Zhong L., Luo T., Lomarda A.M., Huo Y., Yap J., Lim S.T., Tan R.S., Wong A.S.L., Tan J.W.C., Yeo K.K., Fam J.M., Keng F.Y.J., Wan M., Su B., Zhao X., Allen J.C., Kassab G.S., Chua T.S.J., Tan S.Y. (2016). Simplified models of Non-Invasive fractional flow reserve based on CT images. PLoS ONE 11 (5) : e0153070. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0153070
Abstract: Invasive fractional flow reserve (FFR) is the gold standard to assess the functional coronary stenosis. The non-invasive assessment of diameter stenosis (DS) using coronary computed tomography angiography (CTA) has high false positive rate in contrast to FFR. Combining CTA with computational fluid dynamics (CFD), recent studies have shown promising predictions of FFRCT for superior assessment of lesion severity over CTA alone. The CFD models tend to be computationally expensive, however, and require several hours for completing analysis. Here, we introduce simplified models to predict noninvasive FFR at substantially less computational time. In this retrospective pilot study, 21 patients received coronary CTA. Subsequently a total of 32 vessels underwent invasive FFR measurement. For each vessel, FFR based on steady-state and analytical models (FFRSS and FFRAM , respectively) were calculated non-invasively based on CTA and compared with FFR. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 90.6% (87.5%), 80.0% (80.0%), 95.5% (90.9%), 88.9% (80.0%) and 91.3% (90.9%) respectively for FFRSS (and FFRAM ) on a per-vessel basis, and were 75.0%, 50.0%, 86.4%, 62.5% and 79.2% respectively for DS. The area under the receiver operating characteristic curve (AUC) was 0.963, 0.954 and 0.741 for FFRSS, FFRAM and DS respectively, on a perpatient level. The results suggest that the CTA-derived FFRSS performed well in contrast to invasive FFR and they had better diagnostic performance than DS from CTA in the identification of functionally significant lesions. In contrast to FFRCT , FFRSS requires much less computational time. © 2016 Zhang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
URI: https://scholarbank.nus.edu.sg/handle/10635/165748
ISSN: 19326203
DOI: 10.1371/journal.pone.0153070
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