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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/20590

Title: Diagnostic performance of quantitative coronary computed tomography angiography and quantitative coronary angiography to predict hemodynamic significance of intermediate-grade stenoses
Authors: Ghekiere, Olivier
Dewilde, Willem
Bellekens, Michel
Hoa, Denis
Couvreur, Thierry
Djekic, Julien
Coolen, Tim
Mancini, Isabelle
Vanhoenacker, Piet K.
Dendale, Paul
Nchimi, Alain
Issue Date: 2015
Publisher: SPRINGER
Abstract: Fractional flow reserve (FFR) during invasive coronary angiography has become an established tool for guiding treatment. However, only one-third of intermediate-grade coronary artery stenosis (ICAS) are hemodynamically significant and require coronary revascularization. Additionally, the severity of stenosis visually established by coronary computed tomography angiography (CCTA) does not reliably correlate with the functional severity. Therefore, additional angiographic morphologic descriptors affecting hemodynamic significance are required. To evaluate quantitative stenosis analysis and plaque descriptors by CCTA in predicting the hemodynamic significance of ICAS and to compare it with quantitative catheter coronary angiography (QCA). QCA was performed in 65 patients (mean age 63 +/- A 9 years; 47 men) with 76 ICAS (40-70 %) on CCTA. Plaque descriptors were determined including circumferential extent of calcification, plaque composition, minimal lumen diameter (MLD) and area, diameter stenosis percentage (Ds %), area stenosis percentage and stenosis length on CCTA. MLD and Ds % were also analyzed on QCA. FFR was measured on 52 ICAS lesions on CCTA and QCA. The diagnostic values of the best CCTA and QCA descriptors were calculated for ICAS with FFR a parts per thousand currency sign 0.80. Of the 76 ICAS on CCTA, 52 (68 %) had a Ds % between 40 and 70 % on QCA. Significant intertechnique correlations were found between CCTA and QCA for MLD and Ds % (p < 0.001). In 17 (33 %) of the 52 ICAS lesions on QCA, FFR values were a parts per thousand currency sign0.80. Calcification circumference extent (p = 0.50) and plaque composition assessment (p = 0.59) did not correlate with the hemodynamic significance. Best predictors for FFR a parts per thousand currency sign 0.80 stenosis were a parts per thousand currency sign1.35 mm MLD (82 % sensitivity, 66 % specificity), and a parts per thousand currency sign2.3 mmA(2) minimal lumen area (88 % sensitivity, 60 % specificity) on CCTA, and a parts per thousand currency sign1.1 mm MLD (59 % sensitivity, 77 % specificity) on QCA. Quantitative CCTA and QCA poorly predict hemodynamic significance of ICAS, though CCTA seems to have a better sensitivity than QCA. In this range of stenoses, additional functional evaluation is required.
Notes: [Ghekiere, Olivier; Couvreur, Thierry; Djekic, Julien; Mancini, Isabelle] Ctr Hosp Chretien, Dept Radiol, B-4000 Liege, Belgium. [Ghekiere, Olivier] Jessa Ziekenhuis, Dept Radiol, B-3500 Hasselt, Belgium. [Ghekiere, Olivier; Dendale, Paul] Hasselt Univ, Fac Med & Life Sci, B-3500 Hasselt, Belgium. [Dewilde, Willem] Amphia Ziekenhuis, Dept Cardiol, NL-4818 CK Breda, Netherlands. [Bellekens, Michel] Ctr Hosp Chretien, Dept Cardiol, B-4000 Liege, Belgium. [Hoa, Denis] Clin Parc, Dept Radiol, F-34170 Castelnau Le Lez, France. [Coolen, Tim] Univ Libre Bruxelles, Dept Radiol, B-1070 Brussels, Belgium. [Vanhoenacker, Piet K.] OLV Ziekenhuis Aalst, Dept Radiol, B-9300 Aalst, Belgium. [Dendale, Paul] Jessa Ziekenhuis, Dept Cardiol, B-3500 Hasselt, Belgium. [Nchimi, Alain] Univ Hosp Sart Tilman Liege ULg, GIGA Cardiovasc Dis, Dept Radiol, B-4000 Liege, Belgium.
URI: http://hdl.handle.net/1942/20590
DOI: 10.1007/s10554-015-0748-1
ISI #: 000365293900022
ISSN: 1569-5794
Category: A1
Type: Journal Contribution
Validation: ecoom, 2016
Appears in Collections: Research publications

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