{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T20:39:37Z","timestamp":1793911177393,"version":"4.8.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T00:00:00Z","timestamp":1711929600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Intravascular imaging and intracoronary physiology may both be used to guide and optimize percutaneous coronary intervention; however, they are rarely used together. The virtual flow reserve (VFR) is an optical coherence tomography (OCT)\u2013based model of fractional flow reserve (FFR) facilitating the assessment of the physiological significance of coronary lesions. We aimed to validate the VFR assessment of intermediate coronary artery stenoses.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>FUSION (Validation of OCT-Based Functional Diagnosis of Coronary Stenosis) was a multicenter, prospective, observational study comparing OCT-derived VFR to invasive FFR. VFR was mathematically derived from a lumped parameter flow model based on 3-dimensional lumen morphology. Patients undergoing coronary angiography with intermediate angiographic stenosis (40%\u201390%) requiring physiological assessment were enrolled. Investigational sites were blinded to the VFR analysis, and all OCT and FFR data were reviewed by an independent core laboratory. The coprimary end points were the sensitivity and specificity of VFR against FFR as the reference standard, each of which was tested against prespecified performance goals.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              After core laboratory review, 266 vessels in 224 patients from 25 US centers were included in the analysis. The mean angiographic diameter stenosis was 65.5%\u00b114.9%, and the mean FFR was 0.83\u00b10.11. Overall accuracy, sensitivity, and specificity of VFR versus FFR using a binary cutoff point of 0.80 were 82.0%, 80.4%, and 82.9%, respectively. The 97.5% lower confidence bound met the prespecified performance goal for sensitivity (71.6% versus 70%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.01) and specificity (76.6% versus 75%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.01). The area under the curve was 0.88 (95% CI, 0.84\u20130.92;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.0001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>OCT-derived VFR demonstrates high sensitivity and specificity for predicting invasive FFR. Integrating high-resolution intravascular imaging with imaging-derived physiology may provide synergistic benefits as an adjunct to percutaneous coronary intervention.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\">https:\/\/clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT04356027.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.123.013702","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T09:00:28Z","timestamp":1711357228000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Optical Coherence Tomography\u2013Based Functional Stenosis Assessment: FUSION\u2014A Prospective Multicenter Trial"],"prefix":"10.1161","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct04356027","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2328-4686","authenticated-orcid":true,"given":"Allen","family":"Jeremias","sequence":"first","affiliation":[{"name":"St. Francis Hospital &amp; Heart Center, Roslyn, NY (A.J., R.A.S., Z.A.A.)."},{"name":"Cardiovascular Research Foundation, New York, NY (A.J., A.M., M.M., Z.A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1910-8447","authenticated-orcid":true,"given":"Akiko","family":"Maehara","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation, New York, NY (A.J., A.M., M.M., Z.A.A.)."},{"name":"Columbia University Medical Center, New York, NY (A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2082-0247","authenticated-orcid":true,"given":"Mitsuaki","family":"Matsumura","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation, New York, NY (A.J., A.M., M.M., Z.A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Shlofmitz","sequence":"additional","affiliation":[{"name":"St. Francis Hospital &amp; Heart Center, Roslyn, NY (A.J., R.A.S., Z.A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aziz","family":"Maksoud","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute of Kansas, Wichita (A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3020-9369","authenticated-orcid":true,"given":"Takashi","family":"Akasaka","sequence":"additional","affiliation":[{"name":"Wakayama Medical University, Japan (T.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8973-2440","authenticated-orcid":true,"given":"Hiram G.","family":"Bezerra","sequence":"additional","affiliation":[{"name":"Tampa General Hospital, University of South Florida, Tampa (H.G.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1799-1368","authenticated-orcid":true,"given":"William F.","family":"Fearon","sequence":"additional","affiliation":[{"name":"Stanford University Medical Center, CA (W.F.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5722-7252","authenticated-orcid":true,"given":"Habib","family":"Samady","sequence":"additional","affiliation":[{"name":"Northeast Georgia Medical Center, Gainesville (H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Samuels","sequence":"additional","affiliation":[{"name":"Cedars-Sinai Medical Center, Los Angeles, CA (B.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Rapkin","sequence":"additional","affiliation":[{"name":"Abbott Vascular, Santa Clara, CA (J.R., A.G., N.T.T., J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Gopinath","sequence":"additional","affiliation":[{"name":"Abbott Vascular, Santa Clara, CA (J.R., A.G., N.T.T., J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6390-6537","authenticated-orcid":true,"given":"Nutte Tarn","family":"Teraphongphom","sequence":"additional","affiliation":[{"name":"Abbott Vascular, Santa Clara, CA (J.R., A.G., N.T.T., J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Buccola","sequence":"additional","affiliation":[{"name":"Abbott Vascular, Santa Clara, CA (J.R., A.G., N.T.T., J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2482-3197","authenticated-orcid":true,"given":"Ziad A.","family":"Ali","sequence":"additional","affiliation":[{"name":"St. Francis Hospital &amp; 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