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The computed instantaneous wave-free ratio (CT-iFR) is a noninvasive method to estimate iFR using computer simulations. Here, we developed a vessel-length-based CT-iFR method in patient-specific models of coronary arteries. This method was implemented by coupling a three-dimensional computational fluid dynamics model with a lumped parameter model (LPM) of coronary circulation in a non-hyperemic resting state. A time-varying resistance in the LPM was used for the iFR simulation. In total, 50 coronary vessels of 32 patients were computed, and their CT-iFR values were compared with clinically measured iFRs to evaluate the diagnostic performance of the present CT-iFR method. The area under the receiver operating characteristics curve of CT-iFR validation was 0.93. In diagnostic performances of CT-iFR, accuracy, sensitivity, and specificity were 86%, 83.3%, and 86.8%, respectively. These results indicate that this CT-iFR method can be used as a pre-operative aid to establish a percutaneous coronary intervention strategy as a noninvasive alternative to iFR.<\/jats:p>","DOI":"10.1038\/s41598-020-57424-w","type":"journal-article","created":{"date-parts":[[2020,1,24]],"date-time":"2020-01-24T11:03:17Z","timestamp":1579863797000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Diagnostic performance of a vessel-length-based method to compute the instantaneous wave-free ratio in coronary arteries"],"prefix":"10.1038","volume":"10","author":[{"given":"Kyung Eun","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gook Tae","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eui Cheol","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9169-6968","authenticated-orcid":false,"given":"Eun Seok","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Bo","family":"Shim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,1,24]]},"reference":[{"key":"57424_CR1","doi-asserted-by":"publisher","first-page":"3183","DOI":"10.1161\/01.CIR.92.11.3183","volume":"92","author":"NH Pijls","year":"1995","unstructured":"Pijls, N. 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Development and validation of a new adenosine-independent index of stenosis severity from coronary wave-intensity analysis: results of the ADVISE (ADenosine Vasodilator Independent Stenosis Evaluation) study. J. Am Coll Cardiol. 59, 1392\u20131402 (2012).","journal-title":"J. Am Coll Cardiol."},{"key":"57424_CR5","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1016\/j.jcin.2015.01.029","volume":"8","author":"J Escande","year":"2015","unstructured":"Escande, J. et al. Prospective assessment of the diagnostic accuracy of instantaneous wave-free ratio to assess coronary stenosis relevance: Results of ADVISE II International, Multicenter Study (ADenosine Vasodilator Independent Stenosis Evaluation II). JACC Cardiovasc Interv. 8, 824\u2013833 (2015).","journal-title":"JACC Cardiovasc Interv."},{"key":"57424_CR6","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1016\/j.jacc.2012.09.065","volume":"61","author":"C Berry","year":"2013","unstructured":"Berry, C. et al. VERIFY (VERification of Instantaneous Wave-Free Ratio and Fractional Flow Reserve for the Assessment of Coronary Artery Stenosis Severity in EverydaY Practice): a multicenter study in consecutive patients. J. Am Coll Cardiol. 61, 1421\u20131427 (2013).","journal-title":"J. Am Coll Cardiol."},{"key":"57424_CR7","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1016\/j.jacc.2013.09.060","volume":"63","author":"A Jeremias","year":"2014","unstructured":"Jeremias, A. et al. Multicenter core laboratory comparison of the instantaneous wave-free ratio and resting Pd\/Pa with fractional flow reserve: the RESOLVE study. J. Am Coll Cardiol. 63, 1253\u20131261 (2014).","journal-title":"J. Am Coll Cardiol."},{"key":"57424_CR8","doi-asserted-by":"publisher","first-page":"4070","DOI":"10.1016\/j.ijcard.2013.07.030","volume":"168","author":"JJ Park","year":"2013","unstructured":"Park, J. J. et al. 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