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Relative atherosclerotic plaque volume by CT coronary angiography trumps conventional stenosis assessment for identifying flow-limiting lesions.
Int J Cardiovasc Imaging. 2017 Nov; 33(11):1847-1855.IJ

Abstract

The new methods for diagnosing the ischemia with coronary computed tomographic angiography (CTA) as a noninvasive test have been investigated. To compare the relative plaque volume to quantitative CTA and quantitative coronary angiography (QCA) for detecting flow-limiting coronary artery stenoses. We studied 49 patients with 55 intermediate lesions (30-69% diameter stenosis) who underwent CTA, coronary angiography (CAG), and FFR. CTA and QCA measures included lesion length, percent diameter stenosis (%DS), minimal lumen diameter (MLD), target main vessel percent plaque volume (%PV), lesion %PV, target main vessel percent lumen volume (%LV), and lesion %LV. FFR ≤0.80 was considered diagnostic of a flow-limiting lesion. The area under the receiver-operating characteristic curve (AUC) was used to determine the accuracy of detecting flow-limiting lesions. We also investigated the AUC of discrimination of flow-limiting lesion according to calcium score. Eighteen of 55 lesions (32.7%) had an FFR ≤0.80. Only vessel %PV differentiated between lesions with and without flow obstruction (67.6 vs. 62.7%, p = 0.018). The AUC for vessel %PV was greatest (0.76; 95% CI 0.61-0.87). The AUC for the discrimination of the flow-limiting lesions according to low calcium score (≤400) improved to 0.82 (95% CI 0.57-0.94). In intermediate coronary artery stenoses, vessel %PV is more accurate than conventional stenosis assessment for detecting flow-limiting lesions. In low calcium score, vessel %PV is more useful for diagnosis of ischemic heart disease compared with conventional quantitative measures.

Authors+Show Affiliations

Division of Cardiology, Mitsui Memorial Hospital, 1 Kandaizumi-cho, Chiyoda-ku, Tokyo, Japan.Division of Diabetes Mitsui Memorial Hospital, 1 Kandaizumi-cho Chiyoda-ku, Tokyo, Japan. m980287@gmail.com.Division of Cardiology, Johns Hopkins Hospital and School of Medicine, Blalock 524, 600N Wolfe Street, Baltimore, MD, 21287, USA.The Ottawa Hospital Research Institute and Department of Radiology, The University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.Division of Cardiology, Mitsui Memorial Hospital, 1 Kandaizumi-cho, Chiyoda-ku, Tokyo, Japan.Division of Cardiology, Mitsui Memorial Hospital, 1 Kandaizumi-cho, Chiyoda-ku, Tokyo, Japan.Division of Cardiology, Mitsui Memorial Hospital, 1 Kandaizumi-cho, Chiyoda-ku, Tokyo, Japan.Division of Cardiology, Mitsui Memorial Hospital, 1 Kandaizumi-cho, Chiyoda-ku, Tokyo, Japan.Division of Cardiology, Mitsui Memorial Hospital, 1 Kandaizumi-cho, Chiyoda-ku, Tokyo, Japan.Division of Cardiology, Mitsui Memorial Hospital, 1 Kandaizumi-cho, Chiyoda-ku, Tokyo, Japan.Division of Diagnostic Radiology Mitsui Memorial Hospital, 1 Kandaizumi-cho Chiyoda-ku, Tokyo, Japan.Division of Cardiology, Johns Hopkins Hospital and School of Medicine, Blalock 524, 600N Wolfe Street, Baltimore, MD, 21287, USA.Division of Cardiology, Mitsui Memorial Hospital, 1 Kandaizumi-cho, Chiyoda-ku, Tokyo, Japan.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28597124

Citation

Kato, Nahoko, et al. "Relative Atherosclerotic Plaque Volume By CT Coronary Angiography Trumps Conventional Stenosis Assessment for Identifying Flow-limiting Lesions." The International Journal of Cardiovascular Imaging, vol. 33, no. 11, 2017, pp. 1847-1855.
Kato N, Kishi S, Arbab-Zadeh A, et al. Relative atherosclerotic plaque volume by CT coronary angiography trumps conventional stenosis assessment for identifying flow-limiting lesions. Int J Cardiovasc Imaging. 2017;33(11):1847-1855.
Kato, N., Kishi, S., Arbab-Zadeh, A., Rybicki, F. J., Tanimoto, S., Aoki, J., Watanabe, M., Horiuchi, Y., Furui, K., Hara, K., Ibukuro, K., Lima, J. A. C., & Tanabe, K. (2017). Relative atherosclerotic plaque volume by CT coronary angiography trumps conventional stenosis assessment for identifying flow-limiting lesions. The International Journal of Cardiovascular Imaging, 33(11), 1847-1855. https://doi.org/10.1007/s10554-017-1186-z
Kato N, et al. Relative Atherosclerotic Plaque Volume By CT Coronary Angiography Trumps Conventional Stenosis Assessment for Identifying Flow-limiting Lesions. Int J Cardiovasc Imaging. 2017;33(11):1847-1855. PubMed PMID: 28597124.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relative atherosclerotic plaque volume by CT coronary angiography trumps conventional stenosis assessment for identifying flow-limiting lesions. AU - Kato,Nahoko, AU - Kishi,Satoru, AU - Arbab-Zadeh,Armin, AU - Rybicki,Frank J, AU - Tanimoto,Shuzou, AU - Aoki,Jiro, AU - Watanabe,Mika, AU - Horiuchi,Yu, AU - Furui,Koichi, AU - Hara,Kazuhiro, AU - Ibukuro,Kenji, AU - Lima,Joao A C, AU - Tanabe,Kengo, Y1 - 2017/06/08/ PY - 2017/02/25/received PY - 2017/05/30/accepted PY - 2017/6/10/pubmed PY - 2018/1/6/medline PY - 2017/6/10/entrez KW - CT coronary angiography KW - Coronary artery disease KW - Fractional flow reserve KW - Plaque volume SP - 1847 EP - 1855 JF - The international journal of cardiovascular imaging JO - Int J Cardiovasc Imaging VL - 33 IS - 11 N2 - The new methods for diagnosing the ischemia with coronary computed tomographic angiography (CTA) as a noninvasive test have been investigated. To compare the relative plaque volume to quantitative CTA and quantitative coronary angiography (QCA) for detecting flow-limiting coronary artery stenoses. We studied 49 patients with 55 intermediate lesions (30-69% diameter stenosis) who underwent CTA, coronary angiography (CAG), and FFR. CTA and QCA measures included lesion length, percent diameter stenosis (%DS), minimal lumen diameter (MLD), target main vessel percent plaque volume (%PV), lesion %PV, target main vessel percent lumen volume (%LV), and lesion %LV. FFR ≤0.80 was considered diagnostic of a flow-limiting lesion. The area under the receiver-operating characteristic curve (AUC) was used to determine the accuracy of detecting flow-limiting lesions. We also investigated the AUC of discrimination of flow-limiting lesion according to calcium score. Eighteen of 55 lesions (32.7%) had an FFR ≤0.80. Only vessel %PV differentiated between lesions with and without flow obstruction (67.6 vs. 62.7%, p = 0.018). The AUC for vessel %PV was greatest (0.76; 95% CI 0.61-0.87). The AUC for the discrimination of the flow-limiting lesions according to low calcium score (≤400) improved to 0.82 (95% CI 0.57-0.94). In intermediate coronary artery stenoses, vessel %PV is more accurate than conventional stenosis assessment for detecting flow-limiting lesions. In low calcium score, vessel %PV is more useful for diagnosis of ischemic heart disease compared with conventional quantitative measures. SN - 1875-8312 UR - https://www.unboundmedicine.com/medline/citation/28597124/Relative_atherosclerotic_plaque_volume_by_CT_coronary_angiography_trumps_conventional_stenosis_assessment_for_identifying_flow_limiting_lesions_ L2 - https://doi.org/10.1007/s10554-017-1186-z DB - PRIME DP - Unbound Medicine ER -