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<p>Coronary flow reserve (CFR) is a key parameter for risk stratification in coronary artery disease but is limited by high cost, prolonged procedure time, and suboptimal reproducibility. We proposed a novel angiography-based method (Angio-CFR) to overcome these challenges and assessed its diagnostic performance. 107 consecutive patients underwent invasive coronary angiography with thermodilution-derived CFR (CFR<sub>thermo</sub>) were prospectively enrolled. Flow velocity at hyperemia and rest was estimated from angiographic images, and Angio-CFR was calculated as their ratio. Angio-CFR correlated well with CFR<sub>thermo</sub> (r = 0.72, <i>p</i> &lt; 0.001), and showed good discrimination of CFR<sub>thermo</sub> &lt; 2.5 (AUC = 0.879, <i>p</i> &lt; 0.001) with an optimal cut-off of 2.5. The accuracy, sensitivity, and specificity of Angio-CFR were 81.71%, 83.33%, and 81.25%, respectively. Angio-CFR provides a pressure-wire-free method for coronary function assessment, demonstrating promising diagnostic accuracy and offering a more accessible approach for CFR measurement in clinical practice.</p> Graphical Abstract <p></p>

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A Novel Angiography-Derived Computational Coronary Flow Reserve to Evaluate Non-Obstructive Coronary Artery Disease

  • 期刊论文

  • 发表日期：

    2025年5月19日

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  • Jingpu Wang,
  • Yumeng Hu,
  • Xinyi Yang,
  • Rende Xu,
  • Zhangwei Chen,
  • Zhe Wang,
  • Leilei Ma,
  • Feng Zhang,
  • Xiaochang Leng,
  • Junbo Ge,
  • Jianping Xiang,
  • Chenguang Li

摘要

Coronary flow reserve (CFR) is a key parameter for risk stratification in coronary artery disease but is limited by high cost, prolonged procedure time, and suboptimal reproducibility. We proposed a novel angiography-based method (Angio-CFR) to overcome these challenges and assessed its diagnostic performance. 107 consecutive patients underwent invasive coronary angiography with thermodilution-derived CFR (CFRthermo) were prospectively enrolled. Flow velocity at hyperemia and rest was estimated from angiographic images, and Angio-CFR was calculated as their ratio. Angio-CFR correlated well with CFRthermo (r = 0.72, p < 0.001), and showed good discrimination of CFRthermo < 2.5 (AUC = 0.879, p < 0.001) with an optimal cut-off of 2.5. The accuracy, sensitivity, and specificity of Angio-CFR were 81.71%, 83.33%, and 81.25%, respectively. Angio-CFR provides a pressure-wire-free method for coronary function assessment, demonstrating promising diagnostic accuracy and offering a more accessible approach for CFR measurement in clinical practice.

Graphical Abstract