Relationship between Left Ventricle Myocardium Volume in Coronary Territories’ Analysis and Fractional Flow Reserve

Abstract

This study aimed to investigate the feasibility of estimating functional ischemia information from coronary artery computed tomography (CACT) data (i.e., morphological information). Fifty-five suspected ischemic heart disease patients were included in this study. To calculate the ischemic myocardium percentage (LV myocardial territories volume of distal portion the stenotic lesion/total LV myocardial volume) from CACT data with “coronary territories analysis, Ziostation2”, and compared with the ischemic LV myocardium percentage and the functional flow reserve (FFR). The results showed that ischemic LV myocardium percentage was correlated with the FFR (r=−0.57). The median ischemic LV myocardium percentage of the FFR-positive group (n=33) was 37.1% (interquartile range [IQR] 33, 41.4%) and that of the FFR-negative group (n=22) was 24.8% (IQR 19.6, 30.6%). The ischemic LV myocardium percentage was significantly higher in the FFR-positive group (p<0.01) than in the FFR-negative group. The receiver operating characteristic (ROC) curve showed that the cutoff value for the ischemic LV myocardium percentage was 30%, with the sensitivity of 90.9% and the specificity of 77.3%. In conclusion, myocardial ischemia to diagnosis of FFR may occur when ischemic LV myocardium percentage is over than 30% and is unlikely to occur when it is less than 30%. This study suggests that the analysis of CACT data may contribute to the diagnosis of functional ischemia.