Plaque volume derived from three-dimensional reconstruction of coronary angiography predicts the fractional flow reserve

ObjectivesTo compare the data calculated from the three dimensional (3D) reconstruction of a coronary stenosis with the fractional flow reserve (FFR) values measured on the same coronary segment.MethodsMultiple projections of 22 patients (7 female, 15 male, age: 61 ± 9.73 years) were evaluated by the IC30 software of the Axiom Artis X-ray machine. 3D reconstruction was successfully carried out on 23 coronary arteries (14 LAD, 4 CX and 5 RCA).ResultsRegression analysis demonstrated significant relationship between the cross-sectional area percentage stenosis (AS) calculated based on the 3D measurement and the FFR (r: − 0.566, p: 0.008), as well as between the 3D derived plaque volume (PV) and the FFR (r: − 0.501, p: 0.018). On the other hand, the diameter stenosis (DS) and the minimal lumen diameter (MLD) did not correlate with the FFR values. According to the Receiver Operating Characteristic (ROC) analysis the rank of the areas under the ROC curves (AUC) was the following: 1. PV (0.76), 2. AS (0.74), 3. DS (0.62), 4. MLA (0.55), and 5. MLD (0.51). The difference between the AUC of the PV and MLA was found to be significant (p = 0.02). The best agreement with the FFR was found when the PV was > 44% (sensitivity 66.67%, specificity 82.35%) and the 3D AS was > 60% (sensitivity 100%, specificity 47%).ConclusionBesides the 3D AS the calculated PV characterizing the entire lesion is also an important predictor of the flow consequence of the stenosis.