Evaluation of Accuracy of CFD-based RuiXin-FFR by Comparing With Pressure-wire-based FFR

NCT ID: NCT04731285

Last Updated: 2021-09-05

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 316 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2019-03-13
• Study Completion Date: 2020-08-31

Brief Summary

Coronary Artery Disease (CAD) is the top killer nowadays. Pressure-wire-based Fractional Flow Reserve (FFR) is the gold standard for measuring ischemia in coronary arteries. CFD-based RuiXin-FFR, which is noninvasive, is developed recently. But its accuracy is not verified. This is a multi-center and prospective study to evaluate the sensitivity, specificity, and accuracy of CFD-based RuiXin-FFR compared with wire-based FFR.

Detailed Description

The participants are entered with suspended CAD and angiography ischemia between 30%-90% from 6 hospitals in China. Pressure-wire-based FFR is conducted in the standard protocol by each hospital. FFR>0.8 is chosen as the threshold to indicate non-ischemia. CFD-based RuiXin-FFR is performed by Raysight Medical (Shenzhen, China). CT images are acquired in a standard protocol by each hospital. Images with poor quality are excluded in this trial. Based on these images, RuiXin-FFR reconstructs the 3D model of coronary trees and obtains RuiXin-FFR values by conducting CFD simulations in a blinded fashion. RuiXin-FFR>0.8 is chosen as the threshold to indicate non-ischemia as well. By comparing the clinical diagnosis outcome of pressure-wire-based FFR and CFD-based RuiXin-FFR, the sensitivity and specificity of the RuiXin-FFR are obtained, which is the primary end point of this trial. The secondary end point includes the measurement of accuracy, NPV, PPV and ROC of the RuiXin-FFR.

Conditions

Coronary Artery Disease; Myocardial Ischemia; Myocardial Fractional Flow Reserve

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Pressure wire based FFR

Pressure wire based FFR was reference group

Pressure wire fractional flow reserve

Intervention Type: DIAGNOSTIC_TEST

Pressure wire is inserted into coronary arteries. The ratio of the average distal pressure and average aorta pressure is FFR.

CT-FFR

CFD-based RuiXin-FFR was test group

CFD-based RuiXin-FFR

Intervention Type: DIAGNOSTIC_TEST

CT-FFR was evaluated in a blinded fashion with a "Coarse-to-Fine Subpixel" algorithm for lumen contour

Interventions

Pressure wire fractional flow reserve

Pressure wire is inserted into coronary arteries. The ratio of the average distal pressure and average aorta pressure is FFR.

Intervention Type: DIAGNOSTIC_TEST

CFD-based RuiXin-FFR

CT-FFR was evaluated in a blinded fashion with a "Coarse-to-Fine Subpixel" algorithm for lumen contour

Intervention Type: DIAGNOSTIC_TEST

Eligibility Criteria

Inclusion Criteria

• able to understand the purpose of the study and sign the informed consent
• with diagnosed or confirmed coronary artery disease according to the comprehensive clinical assessment
• with CTA image indicating that the diameter of the reference vessel in the stenosis segment was ≥2mm
• with CTA image indicating that the stenosis degree of coronary artery lumen diameter ≥30% and ≤90%

Exclusion Criteria

• prior coronary artery bypass bypass (CABG) surgery, coronary interventional therapy (PCI), artificial heart valve implantation, cardiac pacemaker or implantable defibrillator implantation
• persistent or active symptoms of clinical instability, including acute chest pain (sudden onset), cardiogenic shock, unstable blood pressure status (systolic pressure less than 90 mmHg), severe congestive heart failure (NYHA grade III or IV), or acute pulmonary edema
• acute myocardial infarction occurred within 7 days before inclusion
• complex congenital heart disease, sick sinus syndrome, long QT syndrome, severe arrhythmia, tachycardia, severe asthma, severe or very severe chronic obstructive pulmonary disease (COPD) and chronic renal damage (serum creatinine value > 1.5 mg/dl or creatinine clearance < 45 ml/Kg*1.73 m2)
• there are contraindications for the use of adenosine disodium triphosphate
• allergic to iodized contrast media
• pregnancy or pregnancy status unknown
• life expectancy less than 2 months
• there are any factors that other researchers consider not suitable for inclusion or completion of this study
• obvious mismatch of coronary artery CTA images
• CTA image showing calcification occupies the cross-sectional area of the lumen > 80%
• CT value standard deviation of aortic root image >30HU
• coronary artery occlusion.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Beijing Anzhen Hospital

OTHER

Sponsor Role: lead

Responsible Party

Shao-Ping Nie

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Zhanquan Li, MD

Role: PRINCIPAL_INVESTIGATOR

Liaoning Provincial People's Hospital

Locations

Shaoping Nie

Beijing, , China

Countries

China

References

Zeng Y, Wang X, Tang Z, Li T, Jiang X, Ji F, Zhou Y, Ge J, Li Z, Zhao Y, Ma C, Mintz GS, Nie S. Diagnostic accuracy of CT-FFR with a new coarse-to-fine subpixel algorithm in detecting lesion-specific ischemia: a prospective multicenter study. Rev Esp Cardiol (Engl Ed). 2024 Feb;77(2):129-137. doi: 10.1016/j.rec.2023.05.008. Epub 2023 Jul 13. English, Spanish.

Reference Type: DERIVED

PMID: 37453536 (View on PubMed)

Other Identifiers

201901RX

Identifier Type: -

Identifier Source: org_study_id