Evidence mapPaperPMID 38726901Full record

SynthesisJournal of the American Heart Association2024

Agreement of Fractional Flow Reserve Estimated by Computed Tomography With Invasively Measured Fractional Flow Reserve: A Systematic Review and Meta-Analysis.

Thomas I Faulder, Kurundeniya Prematunga, Soniah B Moloi, Lauren E Faulder, Rhondda Jones, Joseph V Moxon

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Journal of the American Heart Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Applications of coronary computed tomography angiography: a clinical cardiologist's point of view.European heart journal supplements : journal of the European Society of Cardiology · 2026
    Article
  5. Cardiac CT for the Assessment of Ischemic Cardiomyopathy.Journal of the Korean Society of Radiology · 2026
    Review
  6. Review
  7. Review
  8. Article
  9. Article
  10. Article
  11. Review
  12. Article
  13. Non-invasive physiological assessment of coronary artery obstruction on coronary computed tomography angiography.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Thomas I FaulderCollege of Medicine and Dentistry James Cook University Townsville QLD Australia.ORCID 0009-0000-8721-3700
Kurundeniya PrematungaDepartment of Medical Imaging Townsville University Hospital Townsville QLD Australia.ORCID 0009-0006-4876-5303
Soniah B MoloiDepartment of Cardiology Townsville University Hospital Townsville QLD Australia.
Lauren E FaulderCollege of Medicine and Dentistry University of Adelaide Adelaide SA Australia.
Rhondda JonesGraduate Research School James Cook University Townsville QLD Australia.ORCID 0000-0002-1031-2863
Joseph V MoxonCollege of Medicine and Dentistry James Cook University Townsville QLD Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFractional flow reserve (FFR) is the ratio of blood pressure measured distal to a stenosis and pressure proximal to a stenosis. FFR can be estimated noninvasively using computed tomography (CT) although the usefulness of this technique remains controversial. This meta-analysis evaluated the agreement of FFR estimated by CT (FFR-CT) with invasively measured FFR. The study also evaluated the diagnostic accuracy of FFR-CT, defined as the ability of FFR-CT to classify lesions as hemodynamically significant (invasive FFR ≤0.8) or insignificant (invasive FFR >0.8). METHODS AND

resultsForty-three studies reporting on 7291 blood vessels from 5236 patients were included. A moderate positive linear relationship between FFR-CT and invasively measured FFR was observed (Spearman correlation coefficient: 0.67). Agreement between the 2 measures increased as invasively measured FFR values approached 1. The overall diagnostic accuracy, sensitivity and specificity of FFR-CT were 82.2%, 80.9%, and 83.1%, respectively. Diagnostic accuracy of 90% could be demonstrated for FFR-CT values >0.90 and <0.49. The diagnostic accuracy of off-site tools was 79.4% and the diagnostic accuracy of on-site tools was 84.1%.

conclusionsThe agreement between FFR-CT and invasive FFR is moderate although agreement is highest in vessels with FFR-CT >0.9. Diagnostic accuracy varies widely with FFR-CT value but is above 90% for FFR-CT values >0.90 and <0.49. Furthermore, on-site and off-site tools have similar performance. Ultimately, FFR-CT may be a useful adjunct to CT coronary angiography as a gatekeeper for invasive coronary angiogram.

Indexed as

Computed Tomography AngiographyCoronary AngiographyCoronary StenosisFractional Flow Reserve, MyocardialCardiac CatheterizationCoronary Artery DiseaseCoronary VesselsHumansPredictive Value of TestsReproducibility of ResultsSeverity of Illness IndexTomography, X-Ray ComputedCTdiagnostic accuracyfractional flow reservefractional flow reserve‐CT coronary angiography

Identifiers

PMID38726901
PMCPMC11179792

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.