Diagnostic Performances of Computed TomographIc Coronary Angiography and Intravascular Ultrasound

Diagnostic Performances of the Computed Tomographic Coronary Angiography and IntraVascular UltraSound to Evaluate Ischemia Causing Coronary Artery Stenosis

Diagnostic purposes of the coronary angiography is to detect stenosis (anatomy) and to detect ischemia related stenosis (function). Coronary angiography (CAG) is a gold standard invasive techniques, but has several limitations. Intravascular ultrasound (IVUS) provides tomographic intra-luminal images. Coronary computed tomographic angiography (CCTA) is helpful to assess precise anatomical information. Optimal functional criteria and their accuracy of IVUS and CCTA by fraction flow reserve (FFR) have not been compared yet.

Correlation between CCTA, IVUS and FFR will be evaluated. The presence of myocardial ischemia will be assessed by fractional flow reserve (FFR).

Diagnostic performance (sensitivity, specificity, positive predictive/negative predictive values and diagnostic accuracy) of each modality will be assessed and compared.

Inclusion Criteria:

• patients presenting chest pain suspected stable angina or unstable angina
• patients permit informed consents
• patients performed all the procedures including CCTA, IVUS and FFR and present coronary artery stenosis

Exclusion Criteria:

• acute myocardial infarction
• ejection fraction less than 40%
• infarct related artery
• chronic renal insufficiency
• left main stenosis, in-stent restenosis and grafted vessels
• allergy in contrast agent and adenosine
• unable to get a informed consents