Letter to the Editor
A novel noninvasive method for measuring fractional flow reserve through three-dimensional modeling
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Submission date: 2012-09-04
Final revision date: 2012-09-11
Acceptance date: 2012-09-16
Online publication date: 2013-05-07
Publication date: 2013-06-01
Arch Med Sci 2013;9(3):581–583
Introduction: Fractional flow reserve (FFR) is a well-evaluated functional index to assess the ischemic severity of coronary stenoses and the necessity for performing revascularization. However, the invasiveness and high-cost greatly restrict its clinical application. This study aims to develop a novel noninvasive FFR (FFRni) assessment. Material and Methods: FFRni is calculated by three dimensional coronary modeling reconstructed from coronary computed tomography angiography (CCTA), finite element analysis and computational fluid dynamics. After the presentation of methodology, clinical data of a patient with coronary artery stenoses are calculated as a pilot study to test the feasibility and accuracy of FFRni with diagnosis of invasive coronary angiography (ICA) and CCTA as reference standards. Results: The novel FFRni is applied successfully in the pilot study. Diagnostic performance of FFRni for lesion ischemia is consistent with the results of ICA and CCTA. FFRni determine the exact lesion in proximal right coronary artery (RCA), left anterior descending coronary (LAD) and diffuse left circumflex artery (LCX), with values 0.73, 0.76, 0.64, respectively, which suggest the severity of functional ischemia of distal myocardium. Moreover, the velocity migration and acceleration at the right site of stenoses can be clearly observed via rate distribution, which may lead to the rupture of unstable atherosclerotic plaques. Conclusions: In conclusion, FFRni, as a novel noninvasive, cost-effective, simple and efficient method, has been made up, to a certain extent, deficiencies in the field of evaluating functional myocardial ischemia and hemodynamic of coronary artery.