Fractional Flow Reserve and Coronary Bifurcation Anatomy: A Novel Quantitative Model to Assess and Report the Stenosis Severity of Bifurcation Lesions

摘要: Objectives The aim of this study was to develop a new model for assessment stenosis severity in bifurcation lesion including its core. The diagnostic performance model, powered by 3-dimensional quantitative coronary angiography predict the functional significance obstructive stenoses, evaluated using fractional flow reserve (FFR) as reference standard. Background Development advanced models might help establish relationship between anatomy and FFR. Methods Patients who had undergone interventions 5 European cardiology centers were randomly selected analyzed. Different fractal laws, Murray, Finet, HK implemented resulting different degrees severity. Results A total 78 lesions 73 patients In 51 (65%) bifurcations, FFR measured main vessel. A 34 (43.6%) interrogated vessels an ≤0.80. Correlation diameter poor conventional straight analysis (ρ = −0.23, p < 0.001) but significantly improved analyses: highest law −0.50, 0.001), followed Finet −0.49, Murray −0.41, 0.001). area under receiver-operating characteristics curve predicting ≤0.80 higher compared with analysis: 0.72 (95% confidence interval: 0.61 0.82) versus 0.60 0.49 0.71; Applying threshold ≥50% stenosis, assessed resulted 23 true positives, 27 negatives, 17 false 11 negatives. Conclusions The provides comprehensive anatomy. Compared analysis, identification preserved values stenoses improved. Nevertheless, accuracy limited solely anatomical parameters