Early Feasibility of Automated Artificial Intelligence Angiography Based Fractional Flow Reserve Estimation

Am J Cardiol. 2021 Jan 15:139:8-14. doi: 10.1016/j.amjcard.2020.10.022. Epub 2020 Oct 13.

Abstract

Despite the evidence of improved patients' outcome, fractional flow reserve (FFR) is underused in current everyday practice. We aimed to evaluate the feasibility of a novel automated artificial intelligence angiography-based FFR software (AutocathFFR) as a decision supporting tool for interventional cardiologists. AutocathFFR was performed on angiographic images of patients who underwent coronary angiography with a pressure wire FFR measurement. Sensitivity and specificity for detection of FFR cut-off of 0.8 were calculated. Thirty-one patients were included in the present study, with a mean age of 64 ± 10 years, 80% were males, 32% patients had diabetes, 39% had previous percutaneous coronary intervention. The left anterior descending artery was the target vessel in 80% of patients. Automatic lesion detection was successful in all of the lesions with FFR value of ≤0.8. The sensitivity of AutocathFFR for predicting a wire based FFR ≤0.8 was 88% and the specificity for FFR >0.8 was 93%, with a positive predictive value of 94% and negative predictive value of 87%, indicating an accuracy level of 90% and area under the curve of 0.91. AutocathFFR has excellent accuracy in prediction of wire based FFR and is a promising technology that may facilitate appropriate decision and treatment choices for coronary artery disease patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Artificial Intelligence*
  • Coronary Angiography / methods*
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / physiopathology
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / physiopathology
  • Feasibility Studies
  • Female
  • Fractional Flow Reserve, Myocardial / physiology*
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • ROC Curve
  • Time Factors