Highlights
- •Fractional flow reserve (FFR) can be computed based on coronary angiography, intravascular ultrasound, and OCT.
- •Computational FFR derived from those modalities has excellent diagnostic performance.
- •Invasive imaging-derived FFR may facilitate coronary functional assessment.
Abstract
Background
Little is known about the overall diagnostic performance of computational fractional
flow reserve (FFR) derived from angiography (Angio-FFR), intravascular ultrasound
(IVUS-FFR), and optical coherence tomography (OCT-FFR) to detect hemodynamically significant
coronary artery disease. The present study aimed to evaluate the diagnostic performance
of those novel physiologic indices using conventional FFR as the gold standard.
Methods
PubMed and Embase were searched in September 2021 for a systematic review and meta-analysis
of studies assessing the diagnostic performance of invasive imaging-derived FFR. The
primary outcomes were the summary sensitivity, specificity, correlation coefficients
of each index.
Results
A total of 6572 records were initially identified and 49 studies were included in
the final analysis (7010 lesions from 36 studies for Angio-FFR, 305 lesions from 5
studies for IVUS-FFR, and 667 lesions from 8 studies for OCT-FFR). Invasive imaging-derived
FFR had a high diagnostic performance to detect functionally significant coronary
lesions using conventional FFR as the gold standard [Angio-FFR, sensitivity 0.87 (95%
CI 0.84–0.89), specificity 0.93 (95% CI 0.910.95); IVUS-FFR, sensitivity 0.90 (95%
CI 0.84–0.94), specificity 0.95 (95% CI 0.90–0.98); OCT-FFR, sensitivity 0.85 (95%
CI 0.78–0.91), specificity 0.93 (95% CI 0.89–0.95)]. The summary correlation coefficients
of Angio-, IVUS-, and OCT-FFRs with wire-based FFR were 0.83 (95% CI 0.80–0.85), 0.85
(95% CI 0.79–0.91), and 0.80 (95% CI 0.74–0.86), respectively.
Conclusions
This meta-analysis demonstrated that computational FFR derived from invasive coronary
imaging has clinically acceptable diagnostic performances irrespective of modalities,
supporting their applicability to clinical practice.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: March 10, 2022
Accepted:
February 17,
2022
Received in revised form:
February 6,
2022
Received:
December 27,
2021
Identification
Copyright
© 2022 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. All rights reserved.
