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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Structural Interventional Cardiology
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1501576

Differences in severity of diffuse and focal coronary stenosis between visual and quantitative assessment

Provisionally accepted
Wang Xinmao Wang Xinmao *Chao Song Chao Song Heng Liu Heng Liu Lin Zhou Lin Zhou Letian Zhang Letian Zhang
  • Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China

The final, formatted version of the article will be published soon.

    Background: Coronary Artery Disease (CAD) is a leading cause of mortality, with an increasing number of patients affected by coronary artery stenosis each year. Coronary angiography (CAG) is commonly employed as the definitive diagnostic tool for identifying coronary artery stenosis. Physician Visual Assessment (PVA) is often used as the primary method to determine the need for further intervention, but its subjective nature poses challenges. This study sought to evaluate the differences of severity of diffuse and focal coronary stenosis between PVA and Quantitative Coronary Angiography (QCA). Methods: 293 patients with coronary artery disease (334 coronary lesions) underwent CAG and fractional flow reserve (FFR). PVA and QCA was used to quantify diameter stenosis (DS). DS ≥50% was defined as obstructive. FFR ≤0.8 was defined as myocardial ischemia. Results: The mean ± SD age of all patients was 66 ± 9 years. ΔDS between PVA and QCA was higher in diffuse lesions (16.45 ± 7.37%) than in focal lesions (14.39 ± 7.83%) (P = 0.04). DSPVA and DSQCA had linear negative correlation (rPVA=-0.3182, rQCA=-0.4054) with FFR in diffuse, while in focal, DSPVA and DSQCA had an even stronger linear negative correlation (rPVA=-0.4090, rQCA=-0.4861) with FFR. ROC analysis demonstrated that DSQCA had better discrimination capability for myocardial ischemia (FFR ≤ 0.80) than DSPVA in different of length stenosis. Conclusions: PVA was more likely to overestimate diameter stenosis in coronary arteries than QCA, and the severity of diffuse stenosis was more likely to be overestimated than that of focal stenosis.

    Keywords: Diffuse and Focal Stenosis, Quantitative coronary angiography, Physician Visual Assessment, Diameter stenosis, Coronary Artery Disease

    Received: 25 Sep 2024; Accepted: 29 Nov 2024.

    Copyright: © 2024 Xinmao, Song, Liu, Zhou and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Wang Xinmao, Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.