Retrospective study on the diagnostic performance of noninvasive fractional flow reserve derived from coronary CT angiography for myocardial ischemia

Objective?To evaluate the diagnostic performance of noninvasive fractional flow reserve (FFR) derived from coronary computed tomographic angiography (CTA) (FFRCT) for functional myocardial ischemia. Methods?Thirty-nine patients undergone coronary CTA and FFR examination from Aug. 2012 to Jul. 2015 in PLA General Hospital were retrospectively included in present study. Measurements of invasive FFR value was used as reference standard, and FFRCT based on coronary CTA image was performed in either per-patient or per-vessel level to assess the accuracy, specificity, sensitivity, the positive predictive value and negative predictive value for functional myocardial ischemia. Results?In per-patient level, the accuracy of FFRCT was 82.05%, sensitivity was 83.33%, specificity was 80.95%, positive predictive value was 78.95% and negative predictive value was 85.00%. In per-vessel level, the accuracy of FFRCT was 76.79%, sensitivity was 69.57%, specificity was 81.82%, positive predictive value was 72.73% and negative predictive value was 79.41%. The area under ROC was 0.826 in per-patient level, and 0.786 in per-vessel level. For per-vessel, FFRCT was positively correlated with FFR value significantly (r=0.644; 95%CI: 0.458-0.775). Conclusion?With FFR as reference standard, domestic noninvasive FFRCT can be used for the diagnosis of functional myocardial ischemia with high diagnostic performance and clinical application prospect. DOI: 10.11855/j.issn.0577-7402.2018.01.07