Identification of Flow-Limiting Coronary Stenosis With PCS: A New Cost-Effective Index Derived From the Product of Corrected TIMI Frame Count and Percent Diameter Stenosis

Background: Identifying functional coronary stenosis with simple and cost-effective methods during invasive coronary angiography is still challenging. Corrected TIMI frame count (CTFC) is considered to be the frame count velocity of coronary blood flow. We aimed to propose a simple and cost-effectiv...

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Autores principales:	Xinhao Li, Lijuan Lyu, Wei Yang, Jichen Pan, Mei Dong, Mei Zhang, Pengfei Zhang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	coronary artery disease fractional flow reserve percutaneous coronary intervention corrected TIMI frame count flow-limiting coronary stenosis Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/83bedd899e74488dbdbc09795849d554
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spelling	oai:doaj.org-article:83bedd899e74488dbdbc09795849d5542021-11-04T07:21:41ZIdentification of Flow-Limiting Coronary Stenosis With PCS: A New Cost-Effective Index Derived From the Product of Corrected TIMI Frame Count and Percent Diameter Stenosis2297-055X10.3389/fcvm.2021.718935https://doaj.org/article/83bedd899e74488dbdbc09795849d5542021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.718935/fullhttps://doaj.org/toc/2297-055XBackground: Identifying functional coronary stenosis with simple and cost-effective methods during invasive coronary angiography is still challenging. Corrected TIMI frame count (CTFC) is considered to be the frame count velocity of coronary blood flow. We aimed to propose a simple and cost-effective index based on CTFC and percent diameter stenosis (DS) to identify flow-limiting coronary stenosis. For this, a new index was put forward as the product of CTFC and DS (PCS). PCS can be regarded as the loss of coronary blood flow due to diameter stenosis.Methods: DS, CTFC, PCS, and Fractional flow reserve (FFR) of 111 vessels in 84 patients with suspected coronary heart disease were measured. FFR ≤0.80 was defined as flow-limiting. Models involving CTFC, DS, and PCS were developed. Logistic regression was performed to evaluate the values on diagnosing flow-limiting stenosis.Results: Vessels with flow-limiting coronary stenosis exhibited higher CTFC values than those without (28.56 vs. 21.64). The performance including the AUC (0.887), sensitivity (87.8%), and Youden index (0.678) for detecting flow-limiting stenosis was improved by adding the CTFC to the DS, while PCS had the largest positive predictive value (PPV) and diagnostic accuracy (DA) being 72.0 and 82.9%, respectively. For vessels with ≥50% lesions, PCS still had the best DA (80.9%), specificity (85.9%), and PPV (72.9%). At the same stenosis severity level, the AUC, Youden index and, DA of PCS were higher than those of CTFC.Conclusions: PCS is simple and accurate to identify flow-limiting coronary stenosis, especially at vessels with moderate to severe stenosis.Xinhao LiLijuan LyuWei YangJichen PanMei DongMei ZhangPengfei ZhangFrontiers Media S.A.articlecoronary artery diseasefractional flow reservepercutaneous coronary interventioncorrected TIMI frame countflow-limiting coronary stenosisDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	coronary artery disease fractional flow reserve percutaneous coronary intervention corrected TIMI frame count flow-limiting coronary stenosis Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	coronary artery disease fractional flow reserve percutaneous coronary intervention corrected TIMI frame count flow-limiting coronary stenosis Diseases of the circulatory (Cardiovascular) system RC666-701 Xinhao Li Lijuan Lyu Wei Yang Jichen Pan Mei Dong Mei Zhang Pengfei Zhang Identification of Flow-Limiting Coronary Stenosis With PCS: A New Cost-Effective Index Derived From the Product of Corrected TIMI Frame Count and Percent Diameter Stenosis
description	Background: Identifying functional coronary stenosis with simple and cost-effective methods during invasive coronary angiography is still challenging. Corrected TIMI frame count (CTFC) is considered to be the frame count velocity of coronary blood flow. We aimed to propose a simple and cost-effective index based on CTFC and percent diameter stenosis (DS) to identify flow-limiting coronary stenosis. For this, a new index was put forward as the product of CTFC and DS (PCS). PCS can be regarded as the loss of coronary blood flow due to diameter stenosis.Methods: DS, CTFC, PCS, and Fractional flow reserve (FFR) of 111 vessels in 84 patients with suspected coronary heart disease were measured. FFR ≤0.80 was defined as flow-limiting. Models involving CTFC, DS, and PCS were developed. Logistic regression was performed to evaluate the values on diagnosing flow-limiting stenosis.Results: Vessels with flow-limiting coronary stenosis exhibited higher CTFC values than those without (28.56 vs. 21.64). The performance including the AUC (0.887), sensitivity (87.8%), and Youden index (0.678) for detecting flow-limiting stenosis was improved by adding the CTFC to the DS, while PCS had the largest positive predictive value (PPV) and diagnostic accuracy (DA) being 72.0 and 82.9%, respectively. For vessels with ≥50% lesions, PCS still had the best DA (80.9%), specificity (85.9%), and PPV (72.9%). At the same stenosis severity level, the AUC, Youden index and, DA of PCS were higher than those of CTFC.Conclusions: PCS is simple and accurate to identify flow-limiting coronary stenosis, especially at vessels with moderate to severe stenosis.
format	article
author	Xinhao Li Lijuan Lyu Wei Yang Jichen Pan Mei Dong Mei Zhang Pengfei Zhang
author_facet	Xinhao Li Lijuan Lyu Wei Yang Jichen Pan Mei Dong Mei Zhang Pengfei Zhang
author_sort	Xinhao Li
title	Identification of Flow-Limiting Coronary Stenosis With PCS: A New Cost-Effective Index Derived From the Product of Corrected TIMI Frame Count and Percent Diameter Stenosis
title_short	Identification of Flow-Limiting Coronary Stenosis With PCS: A New Cost-Effective Index Derived From the Product of Corrected TIMI Frame Count and Percent Diameter Stenosis
title_full	Identification of Flow-Limiting Coronary Stenosis With PCS: A New Cost-Effective Index Derived From the Product of Corrected TIMI Frame Count and Percent Diameter Stenosis
title_fullStr	Identification of Flow-Limiting Coronary Stenosis With PCS: A New Cost-Effective Index Derived From the Product of Corrected TIMI Frame Count and Percent Diameter Stenosis
title_full_unstemmed	Identification of Flow-Limiting Coronary Stenosis With PCS: A New Cost-Effective Index Derived From the Product of Corrected TIMI Frame Count and Percent Diameter Stenosis
title_sort	identification of flow-limiting coronary stenosis with pcs: a new cost-effective index derived from the product of corrected timi frame count and percent diameter stenosis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/83bedd899e74488dbdbc09795849d554
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Identification of Flow-Limiting Coronary Stenosis With PCS: A New Cost-Effective Index Derived From the Product of Corrected TIMI Frame Count and Percent Diameter Stenosis

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