English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background Machine-Learning Computed Tomography-Based Fractional Flow Reserve (CT-FFR ML ) is a novel tool for the assessment of hemodynamic relevance of coronary artery stenoses. We examined the diagnostic performance of CT-FFR ML  compared to stress perfusion cardiovascular magnetic resonance (CMR) and tested if there is an additional value of CT-FFR ML  over coronary computed tomography angiography (cCTA). Methods Our retrospective analysis included 269 vessels in 141 patients (mean age 67 ± 9 years, 78% males) who underwent clinically indicated cCTA and subsequent stress perfusion CMR within a period of 2 months. CT-FFR ML  values were calculated from standard cCTA. Results CT-FFR ML  revealed no hemodynamic significance in 79% of the patients having ≥ 50% stenosis in cCTA. Chi 2  values for the statistical relationship between CT-FFR ML  and stress perfusion CMR was significant ( p  &lt; 0.0001). CT-FFR ML  and cCTA (≥ 70% stenosis) provided a per patient sensitivity of 88% (95%CI 64–99%) and 59% (95%CI 33–82%); specificity of 90% (95%CI 84–95%) and 85% (95%CI 78–91%); positive predictive value of 56% (95%CI 42–69%) and 36% (95%CI 24–50%); negative predictive value of 98% (95%CI 94–100%) and 94% (95%CI 90–96%); accuracy of 90% (95%CI 84–94%) and 82% (95%CI 75–88%) when compared to stress perfusion CMR. The accuracy of cCTA (≥ 50% stenosis) was 19% (95%CI 13–27%). The AUCs were 0.89 for CT-FFR ML  and 0.74 for cCTA (≥ 70% stenosis) and therefore significantly different ( p  &lt; 0.05). Conclusion CT-FFR ML  compared to stress perfusion CMR as the reference standard shows high diagnostic power in the identification of patients with hemodynamically significant coronary artery stenosis. This could support the role of cCTA as gatekeeper for further downstream testing and may reduce the number of patients undergoing unnecessary invasive workup.

bmc cardiovascular disorders

Stable patients with suspected myocardial ischemia: comparison of machine-learning computed tomography-based fractional flow reserve and stress perfusion cardiovascular magnetic resonance imaging to detect myocardial ischemia