Research on the Method of Predicting Fractional Flow Reserve Based on Multiple Independent Risk Factors

Abstract

The use of diameter stenosis (DS), as revealed by coronary angiography, for predicting fractional flow reserve (FFR) usually results in a high error rate of detection. In this study, we investigated a method for predicting FFR in patients with coronary stenosis based on multiple independent risk factors. The aim of the study was to improve the accuracy of detection. First, we searched the existing literature to identify multiple independent risk factors and then calculated the corresponding odds ratios. The improved analytic hierarchy process (IAHP) was then used to determine the weighted value of each independent risk factor, based on the corresponding odds ratio. Next, we developed a novel method, based on the top seven independent risk factors with the highest weighted values, to predict FFR. This model was then used to predict the FFR of 253 patients with coronary stenosis, and the results were then compared with previous methods (DS alone and a simplified scoring system). In addition to DS, we identified a range of other independent risk factors, with the highest weighted values, for predicting FFR, including gender, body mass index, location of stenosis, type of coronary artery distribution, left ventricular ejection fraction, and left myocardial mass. The area under the receiver-operating characteristic curve (AUC) for the newly developed method was 84.3% (95% CI: 79.2–89.4%), which was larger than 65.3% (95% CI: 61.5–69.1%) of DS alone and 74.8% (95% CI: 68.4–81.2%) of the existing simplified scoring system. The newly developed method, based on multiple independent risk factors, effectively improves the prediction accuracy for FFR.

Uric Acid to High-Density Lipoprotein Cholesterol Ratio is a Novel Marker to Predict Functionally Significant Coronary Artery Stenosis

“…ese emerging indicators have the advantages of simplicity, time savings, and no need to use adenosine. On the other hand, based on diameter stenosis determined by CAG, several clinical risk factors were also taken into account and significantly improved predictive accuracy [23]. Erdogan M et al suggested a systemic immune-inflammation index, calculated by neutrophil * platelets/lymphocytes, can predict the FFR ≤0.8, with 78.4% sensitivity and 64.0% specificity [7].…”

A novel method for noninvasive quantification of fractional flow reserve based on the custom function

“…The measurement of invasive FFR relied on three steps: 1) Adenosine (140 μg/kg/min) was administrated through intravenous infusion to induce maximum hyperemia of the coronary artery; 2) We obtained pressure waveforms of aortic pressure and distal arterial pressure using pressure wire measurement; 3) We further calculated the invasive FFR for the ratio of the mean pressure at a cross- Section 3 cm downstream of the stenosis (P d ) to the aortic pressure (P a ) at least three cardiac cycles ( Taylor et al, 2013 ; Zhang et al, 2021a ). Patient informed consent was waived due to the retrospective nature of the study.…”

“…The blood flow state was steady, and the properties of the arterial walls were set to non-slip rigid ( Zhang et al, 2014 ). The density and viscosity of blood flow were set at 1,050 kg/m 3 and 0.0035 Pa s, respectively ( Zhang et al, 2021a ). The mesh of the coronary geometry model discretized the computational domain into tetrahedral elements.…”

“…Coronary heart disease, including coronary stenosis, has become the disease with the highest mortality rate worldwide ( Bruyne et al, 2014 ; Zhang et al, 2021a ; Li X. J. et al, 2021 ). Currently, pressure field-based fractional flow reserve (FFR) is the gold standard for clinical diagnosis of myocardial ischemia severity caused by coronary stenosis ( Cesaro et al, 2018 ; Zhang et al, 2021b ).…”