The diagnostic performance of quantitative flow ratio and perfusion imaging in patients with prior coronary artery disease

医学 冠状动脉疾病 部分流量储备 心脏病学 内科学 心肌梗塞 经皮冠状动脉介入治疗 灌注 接收机工作特性 单光子发射计算机断层摄影术 心肌灌注成像 正电子发射断层摄影术 血流 磁共振成像 核医学 放射科 冠状动脉造影
作者
Pepijn A. van Diemen,Ruben W. de Winter,Stefan Schumacher,Henk Everaars,Michiel J. Bom,Ruurt Jukema,Yvemarie Somsen,Pieter G. Raijmakers,Rolf Kooistra,Janny Timmer,Teemu Maaniitty,Lourens Robbers,Bob von Bartheld,Ahmet Demirkıran,Albert C. van Rossum,Johan H. C. Reiber,Juhani Knuuti,S. Richard Underwood,Eike Nagel,Paul Knaapen,Roel S. Driessen,Ibrahim Danad
出处
期刊:European Journal of Echocardiography [Oxford University Press]
卷期号:25 (1): 116-126 被引量:6
标识
DOI:10.1093/ehjci/jead197
摘要

In chronic coronary syndrome (CCS) patients with documented coronary artery disease (CAD), ischaemia detection by myocardial perfusion imaging (MPI) and an invasive approach are viable diagnostic strategies. We compared the diagnostic performance of quantitative flow ratio (QFR) with single-photon emission computed tomography (SPECT), positron emission tomography (PET), and cardiac magnetic resonance imaging (CMR) in patients with prior CAD [previous percutaneous coronary intervention (PCI) and/or myocardial infarction (MI)].This PACIFIC-2 sub-study evaluated 189 CCS patients with prior CAD for inclusion. Patients underwent SPECT, PET, and CMR followed by invasive coronary angiography with fractional flow reserve (FFR) measurements of all major coronary arteries (N = 567), except for vessels with a sub-total or chronic total occlusion. Quantitative flow ratio computation was attempted in 488 (86%) vessels with measured FFR available (FFR ≤0.80 defined haemodynamically significant CAD). Quantitative flow ratio analysis was successful in 334 (68%) vessels among 166 patients and demonstrated a higher accuracy (84%) and sensitivity (72%) compared with SPECT (66%, P < 0.001 and 46%, P = 0.001), PET (65%, P < 0.001 and 58%, P = 0.032), and CMR (72%, P < 0.001 and 33%, P < 0.001). The specificity of QFR (87%) was similar to that of CMR (83%, P = 0.123) but higher than that of SPECT (71%, P < 0.001) and PET (67%, P < 0.001). Lastly, QFR exhibited a higher area under the receiver operating characteristic curve (0.89) than SPECT (0.57, P < 0.001), PET (0.66, P < 0.001), and CMR (0.60, P < 0.001).QFR correlated better with FFR in patients with prior CAD than MPI, as reflected in the higher diagnostic performance measures for detecting FFR-defined, vessel-specific, significant CAD.
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