What question did this study set out to answer?

To evaluate the diagnostic utility of CT-μFR for assessing coronary artery stenosis in patients undergoing TAVI.

April 1, 2026

Accuracy of on-site CT-uFR analyses for evaluation of intermediate coronary stenoses in patients undergoing TAVI

Resultado clave

CT-μFR demonstrated 92% diagnostic agreement, 82% sensitivity, and 95% specificity compared to invasive FFR for evaluating coronary stenoses in patients undergoing TAVI.

Puntos clave

To evaluate the diagnostic utility of CT-μFR for assessing coronary artery stenosis in patients undergoing TAVI.
Conducted a multicenter, cross-sectional study
Included patients undergoing CCTA and FFR assessments prior to TAVI
Utilized dedicated software for CT-μFR analysis blinded to initial FFR results
Evaluated accuracy of CT-μFR using two FFR thresholds: ≤ 0.80 and ≤ 0.83
Included 50 vessels from 42 patients with a mean age of 78.9 years
Median FFR was 0.87 and median CT-μFR was 0.89
CT-μFR showed 92% diagnostic agreement at both FFR thresholds
Sensitivity was 82% and specificity 95% using FFR ≤ 0.80
Sensitivity improved to 87% and specificity was 94% using FFR ≤ 0.83

PICO estructurado

Does on-site CT-μFR accurately identify physiologically significant coronary stenoses compared to invasive FFR in patients undergoing TAVI?

Población

42 patients (50 vessels) undergoing TAVI who underwent CCTA and FFR assessment prior to TAVI, mean age 78.9±8.0.

Intervención

On-site computed tomography-derived Murray law-based quantitative flow ratio (CT-μFR) analysis using dedicated software (CtaPlus)

Comparador

Invasive fractional flow reserve (FFR)

Resultado

Accuracies of CT-μFR in identifying physiologically significant coronary artery stenosis, defined as FFR values ≤ 0.80 and ≤ 0.83surrogate

On-site CT-μFR demonstrates strong diagnostic agreement with invasive FFR for evaluating coronary stenoses in patients undergoing TAVI, offering a potential non-invasive alternative.

Resultado numérico

Tasa de eventos absoluta: 0% vs 0%

Resumen

Abstract Background Recent studies showed the clinical benefit of functional evaluation of coronary stenoses among patients undergoing transcatheter valve implantation (TAVI). Novel solutions enabled the non-invasive assessment directly from coronary computed tomography angiography (CCTA); however, current approaches are limited. A recently developed software enables on-site evaluation of computed tomography-derived Murray law-based quantitative flow ratio (CT-μFR), yet its diagnostic accuracy has not been validated in patients undergoing TAVI. This study aimed to assess the diagnostic utility of CT-μFR in patients undergoing TAVI. Methods This multicenter, cross-sectional study included patients who underwent CCTA and fractional flow reserve (FFR) assessment prior to TAVI. CT-μFR and plaque characteristics were evaluated using dedicated software (CtaPlus, Pulse Medical Technology) by an analyst blinded to the initial FFR results. The two coprimary endpoints were the accuracies of CT-μFR in identifying physiologically significant coronary artery stenosis, defined as FFR values ≤ 0.80 and ≤ 0.83, respectively. Results This study included 50 vessels from 42 patients (mean age of 78.9±8.0). Median FFR was 0.87 (IQR: 0.82–0.90) and median CT-μFR was 0.89 (IQR: 0.82–0.92)(p = 0.45); a strong correlation was observed between the two modalities (r=0.832, p0.001). At the lesion level, using an FFR threshold of 0.80, CT-μFR demonstrated 92% diagnostic agreement, with 82% sensitivity and 95% specificity. Using an FFR threshold of 0.83, the agreement remained 92%, with sensitivity of 87% and specificity of 94%. Conclusion CT-μFR demonstrated strong agreement with invasive FFR among patients undergoing TAVI. These results underscore the need for prospective studies to validate the clinical applicability.Figure 1For image description, please refer to the figure legend and surrounding text.

Me gusta

Guardar