著者

Shintaro Nakano Shun Kohsaka Taishiro Chikamori Kenji Fukushima Yoshio Kobayashi Ken Kozuma Susumu Manabe Hitoshi Matsuo Masato Nakamura Takayuki Ohno Mitsuaki Sawano Koichi Toda Yasunori Ueda Hiroyoshi Yokoi Yodo Gatate Tokuo Kasai Yoshiaki Kawase Naoya Matsumoto Hitoshi Mori Ryo Nakazato Nozomi Niimi Yuichi Saito Ayumi Shintani Ippei Watanabe Yusuke Watanabe Yuji Ikari Masahiro Jinzaki Masami Kosuge Kenichi Nakajima Takeshi Kimura on behalf of the JCS Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-1041, (Released:2022-03-11)

参考文献数

245

被引用文献数

40

著者

Hiroyuki Omori Yoshiaki Kawase Takuya Mizukami Toru Tanigaki Tetsuo Hirata Munenori Okubo Hiroki Kamiya Akihiro Hirakawa Masanori Kawasaki Takeshi Kondo Takahiko Suzuki Hitoshi Matsuo

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0771, (Released:2023-03-28)

参考文献数

22

被引用文献数

2

---

Background: Angiographic fractional flow reserve (angioFFR) is a novel artificial intelligence (AI)-based angiography-derived fractional flow reserve (FFR) application. We investigated the diagnostic accuracy of angioFFR to detect hemodynamically relevant coronary artery disease.Methods and Results: Consecutive patients with 30–90% angiographic stenoses and invasive FFR measurements were included in this prospective, single-center study conducted between November 2018 and February 2020. Diagnostic accuracy was assessed using invasive FFR as the reference standard. In patients undergoing percutaneous coronary intervention, gradients of invasive FFR and angioFFR in the pre-senting segments were compared. We assessed 253 vessels (200 patients). The accuracy of angioFFR was 87.7% (95% confidence interval [CI] 83.1–91.5%), with a sensitivity of 76.8% (95% CI 67.1–84.9%), specificity of 94.3% (95% CI 89.5–97.4%), and area under the curve of 0.90 (95% CI 0.86–0.93%). AngioFFR was well correlated with invasive FFR (r=0.76; 95% CI 0.71–0.81; P<0.001). The agreement was 0.003 (limits of agreement: −0.13, 0.14). The FFR gradients of angioFFR and invasive FFR were comparable (n=51; mean [±SD] 0.22±0.10 vs. 0.22±0.11, respectively; P=0.87).Conclusions: AI-based angioFFR showed good diagnostic accuracy for detecting hemodynamically relevant stenosis using invasive FFR as the reference standard. The gradients of invasive FFR and angioFFR in the pre-stenting segments were comparable.

著者

Hiroyuki Omori Hideaki Ota Takuya Mizukami Yoshiaki Kawase Toru Tanigaki Tetsuo Hirata Munenori Okubo Masanori Kawasaki Hitoshi Matsuo

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.85, no.8, pp.1404, 2021-07-21 (Released:2021-07-21)

参考文献数

2

被引用文献数

3

著者

Masakazu Yamagishi Nagara Tamaki Takashi Akasaka Takanori Ikeda Kenji Ueshima Shiro Uemura Yutaka Otsuji Yasuki Kihara Kazuo Kimura Takeshi Kimura Yoshiki Kusama Shinichiro Kumita Hajime Sakuma Masahiro Jinzaki Hiroyuki Daida Yasuchika Takeishi Hiroshi Tada Taishiro Chikamori Kenichi Tsujita Kunihiko Teraoka Kenichi Nakajima Tomoaki Nakata Satoshi Nakatani Akihiko Nogami Koichi Node Atsushi Nohara Atsushi Hirayama Nobusada Funabashi Masaru Miura Teruhito Mochizuki Hiroyoshi Yokoi Kunihiro Yoshioka Masafumi Watanabe Toshihiko Asanuma Yuichi Ishikawa Takahiro Ohara Koichi Kaikita Tokuo Kasai Eri Kato Hiroshi Kamiyama Masaaki Kawashiri Keisuke Kiso Kakuya Kitagawa Teruhito Kido Toshio Kinoshita Tomonari Kiriyama Teruyoshi Kume Akira Kurata Satoshi Kurisu Masami Kosuge Eitaro Kodani Akira Sato Yasutsugu Shiono Hiroki Shiomi Junichi Taki Masaaki Takeuchi Atsushi Tanaka Nobuhiro Tanaka Ryoichi Tanaka Takuya Nakahashi Takehiro Nakahara Akihiro Nomura Akiyoshi Hashimoto Kenshi Hayashi Masahiro Higashi Takafumi Hiro Daisuke Fukamachi Hitoshi Matsuo Naoya Matsumoto Katsumi Miyauchi Masao Miyagawa Yoshitake Yamada Keiichiro Yoshinaga Hideki Wada Tetsu Watanabe Yukio Ozaki Shun Kohsaka Wataru Shimizu Satoshi Yasuda Hideaki Yoshino on behalf of the Japanese Circulation Society Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-1131, (Released:2021-02-16)

参考文献数

1401

被引用文献数

50

著者

Shintaro Nakano Shun Kohsaka Taishiro Chikamori Kenji Fukushima Yoshio Kobayashi Ken Kozuma Susumu Manabe Hitoshi Matsuo Masato Nakamura Takayuki Ohno Mitsuaki Sawano Koichi Toda Yasunori Ueda Hiroyoshi Yokoi Yodo Gatate Tokuo Kasai Yoshiaki Kawase Naoya Matsumoto Hitoshi Mori Ryo Nakazato Nozomi Niimi Yuichi Saito Ayumi Shintani Ippei Watanabe Yusuke Watanabe Yuji Ikari Masahiro Jinzaki Masami Kosuge Kenichi Nakajima Takeshi Kimura on behalf of the JCS Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.86, no.5, pp.882-915, 2022-04-25 (Released:2022-04-25)

参考文献数

245

被引用文献数

40

著者

Yasushi Ueki Shoichi Kuramitsu Tatsuya Saigusa Keisuke Senda Hitoshi Matsuo Kazunori Horie Hiroaki Takashima Hidenobu Terai Yuetsu Kikuta Takayuki Ishihara Tomohiro Sakamoto Nobuhiro Suematsu Yasutsugu Shiono Taku Asano Kenichi Tsujita Katsuhiko Masamura Tatsuki Doijiri Yohei Sasaki Manabu Ogita Tairo Kurita Akiko Matsuo Ken Harada Kenji Yaginuma Noriyoshi Kanemura Shinjo Sonoda Hiroyoshi Yokoi Nobuhiro Tanaka on behalf of the J-CONFIRM Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-1024, (Released:2022-03-12)

参考文献数

19

被引用文献数

1

---

Background:Little evidence is available regarding the long-term outcome in elderly patients after deferral of revascularization based on fractional flow reserve (FFR).Methods and Results:From the J-CONFIRM registry (long-term outcomes of Japanese patients with deferral of coronary intervention based on fractional flow reserve in multicenter registry), 1,262 patients were divided into 2 groups according to age: elderly and younger patients (aged ≥75 or <75 years, respectively). The primary endpoint was the cumulative 5-year incidence of target vessel failure (TVF), defined as a composite of cardiac death, target vessel-related myocardial infarction (TVMI), and clinically driven target vessel revascularization (CDTVR). Cumulative 5-year incidence of TVF was not significantly different between elderly and younger patients (14.3% vs. 10.8%, P=0.12). Cardiac death occurred more frequently in elderly patients than younger patients (4.4% vs. 0.8%, P<0.001), whereas TVMI and CDTVR did not differ between groups (1.3% vs. 0.9%, P=0.80; 10.7% vs. 10.1%, P=0.80, respectively). FFR values in lesions with diameter stenosis <50% were significantly higher in elderly patients than in younger patients (0.88±0.07 vs. 0.85±0.07, P=0.01), whereas this relationship was not observed in those with diameter stenosis ≥50%.Conclusions:Elderly patients had no excess risk of ischemic events related to the deferred coronary lesions by FFR, although FFR values in mild coronary artery stenosis were modestly different between elderly and younger patients.

著者

Masafumi Nakayama Takashi Uchiyama Nobuhiro Tanaka Takaaki Ohkawauchi Shunsuke Miwa Nobuhiro Hijikata Yuichi Kobori Hitoshi Matsuo Kiyotaka Iwasaki

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.2, no.11, pp.665-673, 2020-11-10 (Released:2020-11-10)

参考文献数

38

被引用文献数

2

---

Background:We hypothesized that the intracoronary-electrocardiogram (IC-ECG)-based pressure index would be more stable and precise than the instantaneous flow reserve (iFR). We investigated the usefulness of the IC-ECG-based pressure index for diagnosing myocardial ischemia.Methods and Results:Thirty-seven consecutive patients with coronary stenosis requiring physiological assessment were enrolled in the study. iFR was measured at rest and under hyperemia in 51 and 40 lesions, respectively. The IC-ECG-triggered distal pressure (Pd)/aortic pressure (Pa) ratio (ICE-T) was defined as the mean Pd/Pa ratio in the period corresponding to the isoelectric line. The ICE-T was significantly lower than the iFR both at rest and during hyperemia (P<0.00001 for both). Fluctuations in the ICE-T pressure parameters (Pd/Pa, Pa, and Pd) were significantly smaller than those of iFR both at rest and during hyperemia. The diagnostic accuracy of predicting a fractional flow reserve (FFR) ≤0.80 of the ICE-T at rest was significantly higher than that of iFR (P=0.008). Receiver operating characteristic curve analyses showed that the ICE-T predicts FFR ≤0.80 more accurately than the iFR (area under curve 0.897 vs. 0.810 for ICE-T and iFR, respectively).Conclusions:We identified the period in the IC-ECG in which resting Pd/Pa was low and constant. The IC-ECG-based algorithm may improve the accuracy of diagnosing myocardial ischemia, without increasing invasiveness, compared with pressure-dependent indices.

著者

Hitoshi Matsuo Tomohiro Kawasaki Tetsuya Amano Yoshiaki Kawase Yoshihiro Sobue Takeshi Kondo Yoshihiro Morino Shunichi Yoda Tomohiro Sakamoto Hiroshi Ito Junya Shite Hiromasa Otake Nobuhiro Tanaka Mitsuyasu Terashima Kazushige Kadota Manesh R. Patel Koen Nieman Campbell Rogers Bjarne L. Norgaard Jeroen J. Bax Kavitha M. Chinnaiyan Daniel S. Berman Timothy A. Fairbairn Lynne M. Hurwitz Koweek Jonathon Leipsic Takashi Akasaka

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.2, no.7, pp.364-371, 2020-07-10 (Released:2020-07-10)

参考文献数

9

被引用文献数

1

---

Background:Coronary computed tomography angiography (CCTA)-derived fractional flow reserve (FFRCT) is an established tool for identifying lesion-specific ischemia that is now approved for use by the Japanese insurance system. However, current clinical reimbursement is strictly limited to institutions with designated appropriate use criteria (AUC). This study assessed differences in physicians’ behavior (e.g., use and interpretation of FFRCT, final management) according to Japanese AUC and non-AUC site designation.Methods and Results:Of 5,083 patients in the ADVANCE Registry, 1,829 from Japan were enrolled in this study. Physicians’ behavior after interrogating CCTA and FFRCTwas analyzed separately according to AUC and non-AUC site designation. Compared with AUC sites, patients referred for FFRCTfrom non-AUC sites had a higher rate of negative FFRCT, less severe anatomic stenosis, and a slightly lower rate of management plan reclassification (51.2% vs. 61.3%), with near-identical utility in both groups. Actual care corresponded equally well to post-FFRCTplans in both groups. The likelihood of revascularization for positive or negative FFRCTwas similar between the 2 groups. Importantly, AUC and non-AUC sites were equally unlikely to revascularize patients with negative FFRCTand stenosis >50% or patients with positive FFRCTand stenosis <50%.Conclusions:Compared with AUC sites, non-AUC sites had lower disease burden and reclassification of management plans, but nearly identical clinical integration. Actual care corresponded equally well to post-FFRCTrecommendations at both sites.

著者

Hiromasa Otake Charles A. Taylor Hitoshi Matsuo Nobuhiro Tanaka Takashi Akasaka

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-16-0503, (Released:2017-04-11)

参考文献数

36

被引用文献数

5

---

Despite the clinical importance of ischemia evaluation, obtaining fractional flow reserve (FFR) value has, heretofore, only been available during invasive cardiac catheterization. Although there is a clear linkage between morphology and physiology, a significant gap still exists. FFR derived from coronary computed tomography angiography (FFRCT) is a novel method of quantifying the hemodynamic significance of coronary artery stenoses by translating morphological information into hemodynamic data. Improved diagnostic performance of FFRCThas been repeatedly demonstrated in comparison with coronary computed tomography angiography alone with an invasive FFR reference standard. More recently, the potential benefit of this technology to safely defer non-indicated catheterizations and reduce healthcare costs has been established and indicates this technology may improve the management of patients with coronary artery disease. In this review, we summarize the scientific basis of FFRCTand evidence from clinical trials, provide illustrative examples of clinical applications, discuss potential limitations, and outline avenues for future research.