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Abstract：
BACKGROUND: The existing diagnostic methods for coronary artery disease (CAD), such as coronary angiography and fractional flow reserve (FFR), have limitations regarding their invasiveness, cost, and discomfort. We explored a novel diagnostic approach, coronary contrast intensity analysis (CCIA), and conducted a comparative analysis between it and FFR.
METHODS: We used an in vitro coronary-circulation-mimicking system with nine stenosis models representing various stenosis lengths (6, 18, and 30 mm) and degrees (30%, 50%, and 70%). The angiographic brightness values were analyzed for CCIA. The in vivo experiments included 15 patients with a normal sinus rhythm. Coronary angiography was performed, and arterial movement was tracked, enabling CCIA derivation. The CCIA values were compared with the FFR (n = 15) and instantaneous wave-free ratio (iFR; n = 11) measurements.
RESULTS: In vitro FFR showed a consistent trend related to the length and severity of stenosis. The CCIA was related to stenosis but had a weaker correlation with length, except for with 70% stenosis (6 mm: 0.82 ± 0.007, 0.68 ± 0.007, 0.61 ± 0.004; 18 mm: 0.78 ± 0.052, 0.69 ± 0.025, 0.44 ± 0.016; 30 mm: 0.80 ± 0.018, 0.64 ± 0.006, 0.40 ± 0.026 at 30%, 50%, and 70%, respectively). In vitro CCIA and FFR were significantly correlated (R = 0.9442, p < 0.01). The in vivo analysis revealed significant correlations between CCIA and FFR (R = 0.5775, p < 0.05) and the iFR (n = 11, R = 0.7578, p < 0.01).
CONCLUSIONS: CCIA is a promising alternative for diagnosing stenosis in patients with CAD. The initial in vitro validation and in vivo confirmation in patients demonstrate the feasibility of applying CCIA during coronary angiography. Further clinical studies are warranted to fully evaluate the diagnostic accuracy and potential impact of CCIA on CAD management.
METHODS: We used an in vitro coronary-circulation-mimicking system with nine stenosis models representing various stenosis lengths (6, 18, and 30 mm) and degrees (30%, 50%, and 70%). The angiographic brightness values were analyzed for CCIA. The in vivo experiments included 15 patients with a normal sinus rhythm. Coronary angiography was performed, and arterial movement was tracked, enabling CCIA derivation. The CCIA values were compared with the FFR (n = 15) and instantaneous wave-free ratio (iFR; n = 11) measurements.
RESULTS: In vitro FFR showed a consistent trend related to the length and severity of stenosis. The CCIA was related to stenosis but had a weaker correlation with length, except for with 70% stenosis (6 mm: 0.82 ± 0.007, 0.68 ± 0.007, 0.61 ± 0.004; 18 mm: 0.78 ± 0.052, 0.69 ± 0.025, 0.44 ± 0.016; 30 mm: 0.80 ± 0.018, 0.64 ± 0.006, 0.40 ± 0.026 at 30%, 50%, and 70%, respectively). In vitro CCIA and FFR were significantly correlated (R = 0.9442, p < 0.01). The in vivo analysis revealed significant correlations between CCIA and FFR (R = 0.5775, p < 0.05) and the iFR (n = 11, R = 0.7578, p < 0.01).
CONCLUSIONS: CCIA is a promising alternative for diagnosing stenosis in patients with CAD. The initial in vitro validation and in vivo confirmation in patients demonstrate the feasibility of applying CCIA during coronary angiography. Further clinical studies are warranted to fully evaluate the diagnostic accuracy and potential impact of CCIA on CAD management.
摘要：
背景：现有的冠状动脉疾病（CAD）诊断方法，如冠状动脉造影和血流储备分数（FFR），对它们的侵入性有限制，成本,和不适。我们探索了一种新的诊断方法，冠状动脉造影强度分析(CCIA),并将其与FFR进行了比较分析。
方法：我们使用了一种体外冠状动脉循环模拟系统，该系统具有9种狭窄模型，分别代表各种狭窄长度（6、18和30mm）和程度（30％，50%,和70%）。分析了CCIA的血管造影亮度值。体内实验包括15例正常窦性心律的患者。进行了冠状动脉造影,动脉运动被追踪，启用CCIA推导。将CCIA值与FFR(n=15)和瞬时无波比(iFR;n=11)测量值进行比较。
结果：体外FFR显示出与狭窄的长度和严重程度相关的一致趋势。CCIA与狭窄有关，但与长度的相关性较弱，除70%狭窄外(6mm:0.82±0.007,0.68±0.007,0.61±0.004;18mm:0.78±0.052,0.69±0.025,0.44±0.016;30mm:0.80±0.018,0.64±0.006,0.40±0.026,30%50%,70%,分别)。体外CCIA与FFR显著相关(R=0.9442,p<0.01)。体内分析显示，CCIA和FFR（R=0.5775，p<0.05）与iFR（n=11，R=0.7578，p<0.01）之间存在显着相关性。
结论：CCIA是诊断CAD患者狭窄的有希望的替代方法。患者的初步体外验证和体内确认证明了在冠状动脉造影期间应用CCIA的可行性。需要进一步的临床研究来全面评估CCIA对CAD管理的诊断准确性和潜在影响。
方法：我们使用了一种体外冠状动脉循环模拟系统，该系统具有9种狭窄模型，分别代表各种狭窄长度（6、18和30mm）和程度（30％，50%,和70%）。分析了CCIA的血管造影亮度值。体内实验包括15例正常窦性心律的患者。进行了冠状动脉造影,动脉运动被追踪，启用CCIA推导。将CCIA值与FFR(n=15)和瞬时无波比(iFR;n=11)测量值进行比较。
结果：体外FFR显示出与狭窄的长度和严重程度相关的一致趋势。CCIA与狭窄有关，但与长度的相关性较弱，除70%狭窄外(6mm:0.82±0.007,0.68±0.007,0.61±0.004;18mm:0.78±0.052,0.69±0.025,0.44±0.016;30mm:0.80±0.018,0.64±0.006,0.40±0.026,30%50%,70%,分别)。体外CCIA与FFR显著相关(R=0.9442,p<0.01)。体内分析显示，CCIA和FFR（R=0.5775，p<0.05）与iFR（n=11，R=0.7578，p<0.01）之间存在显着相关性。
结论：CCIA是诊断CAD患者狭窄的有希望的替代方法。患者的初步体外验证和体内确认证明了在冠状动脉造影期间应用CCIA的可行性。需要进一步的临床研究来全面评估CCIA对CAD管理的诊断准确性和潜在影响。
