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European Radiology
Published in: European Radiology 4/2017

01-04-2017 | Cardiac

The effect of blood pressure on non-invasive fractional flow reserve derived from coronary computed tomography angiography

Authors: Akira Kurata, Adriaan Coenen, Marisa M. Lubbers, Koen Nieman, Teruhito Kido, Tomoyuki Kido, Natsumi Yamashita, Kouki Watanabe, Gabriel P. Krestin, Teruhito Mochizuki

Published in: European Radiology | Issue 4/2017

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Abstract

Objectives

The aim of this study is to assess the effect of blood pressure (BP) on coronary computed tomography angiography (CTA) derived computational fractional flow reserve (CTA-FFR).

Materials and methods

Twenty-one patients who underwent coronary CTA and invasive FFR were retrospectively identified. Ischemia was defined as invasive FFR ≤0.80. Using a work-in-progress computational fluid dynamics algorithm, CTA-FFR was computed with BP measured before CTA, and simulated BPs of 60/50, 90/60, 110/70, 130/80, 150/90, and 180/100 mmHg respectively. Correlation between CTA-FFR and invasive FFR was assessed using Pearson test. The repeated measuring test was used for multiple comparisons of CTA-FFR values by simulated BP inputs.

Results

Twenty-nine vessels (14 with invasive FFR ≤0.80) were assessed. The average CTA-FFR for measured BP (134 ± 20/73 ± 12 mmHg) was 0.77 ± 0.12. Correlation between CTA-FFR by measured BP and invasive FFR was good (r = 0.735, P < 0.001). For simulated BPs of 60/50, 90/60, 110/70, 130/80, 150/90, and 180/100 mmHg, the CTA-FFR increased: 0.69 ± 0.13, 0.73 ± 0.12, 0.75 ± 0.12, 0.77 ± 0.11, 0.79 ± 0.11, and 0.81 ± 0.10 respectively (P < 0.05).

Conclusion

Measurement of the BP just before CTA is preferred for accurate CTA-FFR simulation. BP variations in the common range slightly affect CTA-FFR. However, inaccurate BP assumptions differing from the patient-specific BP could cause misinterpretation of borderline significant lesions.

Key Points

• The blood pressure (BP) affects the CTA-FFR computation.
• Measured BP before CT examination is preferable for accurate CTA-FFR simulation.
• Inaccurate BP assumptions can cause misinterpretation of borderline significant lesions.
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Metadata
Title
The effect of blood pressure on non-invasive fractional flow reserve derived from coronary computed tomography angiography
Authors
Akira Kurata
Adriaan Coenen
Marisa M. Lubbers
Koen Nieman
Teruhito Kido
Tomoyuki Kido
Natsumi Yamashita
Kouki Watanabe
Gabriel P. Krestin
Teruhito Mochizuki
Publication date
01-04-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 4/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4541-x

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