Key result
A 1D computational hemodynamic framework predicted computed fractional flow reserve with 75.76% diagnostic accuracy compared to invasive measurements and identified an iFR diagnostic threshold of 0.8910.
Why the study?
The study was conducted to estimate the diagnostic threshold of the instantaneous wave-free ratio (iFR) using a one-dimensional haemodynamic framework.
Does a 1D computational hemodynamic framework accurately predict FFR and estimate the diagnostic threshold for iFR in patients with coronary stenoses?
Observational (n=52)
Does a 1D computational hemodynamic framework accurately predict FFR and estimate the diagnostic threshold for iFR in patients with coronary stenoses?
A 1D computational hemodynamic model based on CCTA can predict FFR with 75.76% accuracy and estimates the optimal iFR diagnostic threshold to be 0.8910, consistent with clinical studies.
May support noninvasive FFR estimation in stenoses; supports iFR threshold consensus but leaves open need for prospective validation.
In this work, we estimate the diagnostic threshold of the instantaneous wave-free ratio (iFR) through the use of a one-dimensional haemodynamic framework. To this end, we first compared the computed fractional flow reserve (cFFR) predicted from a 1D computational framework with invasive clinical measurements. The framework shows excellent promise and utilises minimal patient data from a cohort of 52 patients with a total of 66 stenoses. The diagnostic accuracy of the cFFR model was 75.76%, with a sensitivity of 71.43%, a specificity of 77.78%, a positive predictive value of 60%, and a negative predictive value of 85.37%. The validated model was then used to estimate the diagnostic threshold of iFR. The model determined a quadratic relationship between cFFR and the ciFR. The iFR diagnostic threshold was determined to be 0.8910 from a receiver operating characteristic curve that is in the range of 0.89 to 0.9 that is normally reported in clinical studies.
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Carson et al. (2019) conducted an observational in Coronary artery stenoses (n=52). 1D computational hemodynamic framework (cFFR and ciFR) vs. Invasive fractional flow reserve (FFR) was evaluated on Diagnostic accuracy of computed fractional flow reserve (cFFR) compared to invasive FFR. A 1D computational hemodynamic framework predicted computed fractional flow reserve with 75.76% diagnostic accuracy compared to invasive measurements and identified an iFR diagnostic threshold of 0.8910.
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