1-Year Impact on Medical Practice and Clinical Outcomes of FFRCT

Patel, Manesh R.; Nørgaard, Bjarne Linde; Fairbairn, Timothy A.; Nieman, Koen; Akasaka, Takashi; Berman, Daniel S.; Raff, Gilbert; Koweek, Lynne M. Hurwitz; Pontone, Gianluca; Kawasaki, Terukazu; Sand, Niels Peter Rønnow; Jensen, Jesper Møller; Amano, Tetsuya; Poon, Michael; Øvrehus, Kristian Altern; Sonck, Jeroen; Rabbat, Mark; Mullen, Sarah; Bruyne, Bernard De; Rogers, Campbell; Matsuo, Hitoshi; Bax, Jeroen J.; Leipsic, Jonathon

doi:10.1016/j.jcmg.2019.03.003

Cited by 233 publications

(192 citation statements)

References 13 publications

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“…There was no MACE at 1 year in patients in whom ICA was deferred as a consequence of a negative CT-FFR, indicating that this is a safe and feasible test [113,125]. The 1-year outcomes in the ADVANCE FFR CT registry study also indicated a low event rate, fewer MACE, and less revascularization in those with negative CT-FFR [129].…”

Section: Current Evidence Of Ct-ffrmentioning

confidence: 82%

Computed tomographic evaluation of myocardial ischemia

et al. 2020

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Myocardial ischemia is caused by a mismatch between myocardial oxygen consumption and oxygen delivery in coronary artery disease (CAD). Stratification and decision-making based on ischemia improves the prognosis in patients with CAD. Non-invasive tests used to evaluate myocardial ischemia include stress electrocardiography, echocardiography, single-photon emission computed tomography, and magnetic resonance imaging. Invasive fractional flow reserve is considered the reference standard for assessment of the hemodynamic significance of CAD. Computed tomography (CT) angiography has emerged as a first-line imaging modality for evaluation of CAD, particularly in the population at low to intermediate risk, because of its high negative predictive value; however, CT angiography does not provide information on the hemodynamic significance of stenosis, which lowers its specificity. Emerging techniques, e.g., CT perfusion and CT-fractional flow reserve, help to address this limitation of CT, by determining the hemodynamic significance of coronary artery stenosis. CT perfusion involves acquisition during the first pass of contrast medium through the myocardium following pharmacological stress. CTfractional flow reserve uses computational fluid dynamics to model coronary flow, pressure, and resistance. In this article, we review these two functional CT techniques in the evaluation of myocardial ischemia, including their principles, technology, advantages, limitations, pitfalls, and the current evidence.

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Section: Current Evidence Of Ct-ffrmentioning

confidence: 82%

Computed tomographic evaluation of myocardial ischemia

et al. 2020

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“…Second, among patients with FFR CT values less than or equal to 0.80, there is a graded correlation between FFR CT and invasive FFR, with the highest FFR CT uncertainty in the range between 0.76 and 0.80 and the highest agreement when FFR CT is less than or equal to 0.75 (12,18). Third, FFR CT , similar to FFR, exhibits a continuous relationship between its numerical value and clinical outcomes, with the worst outcome at lower FFR CT values (14,22,23). Finally, symptomatic patients with moderate CAD determined at CT angiography and FFR CT values greater than 0.80 and in whom invasive angiography is deferred have a favorable prognosis (12,14,22,23).…”

Section: Ffr Versus Ffr Ctmentioning

confidence: 97%

“…Accordingly, in vessels that have been assessed using both techniques, if the measurement locations of invasive FFR and FFR CT are not matched, their values can be different and may not closely correlate. significant and that the patient can be safely treated with optimal medical treatment without further downstream testing (1,(12)(13)(14)(15)(16)(17)(18)22,23). A poststenotic FFR CT value less than or equal to 0.80 indicates the possibility of hemodynamic significance (1,(15)(16)(17)(18).…”

Section: Ffr Versus Ffr Ctmentioning

confidence: 99%

“…Third, FFR CT , similar to FFR, exhibits a continuous relationship between its numerical value and clinical outcomes, with the worst outcome at lower FFR CT values (14,22,23). Finally, symptomatic patients with moderate CAD determined at CT angiography and FFR CT values greater than 0.80 and in whom invasive angiography is deferred have a favorable prognosis (12,14,22,23).…”

Section: Ffr Versus Ffr Ctmentioning

confidence: 99%

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Coronary CT Angiography-derived Fractional Flow Reserve Testing in Patients with Stable Coronary Artery Disease: Recommendations on Interpretation and Reporting

Nørgaard¹,

Fairbairn²,

Safian³

et al. 2019

Radiology: Cardiothoracic Imaging

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Noninvasive fractional flow reserve derived from coronary CT angiography (FFR CT ) is increasingly used in patients with coronary artery disease as a gatekeeper to the catheterization laboratory. While there is emerging evidence of the clinical benefit of FFR CT in patients with moderate coronary disease as determined with coronary CT angiography, there has been less focus on interpretation, reporting, and integration of FFR CT results into routine clinical practice. Because FFR CT analysis provides a plethora of information regarding pressure and flow across the entire coronary tree, standardized criteria on interpretation and reporting of the FFR CT analysis result are of crucial importance both in context of the clinical adoption and in future research. This report represents expert opinion and recommendation on a standardized FFR CT interpretation and reporting approach.Published under a CC BY 4.0 license.

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“…Patient-specific modeling of blood flow has emerged as a tool with increasing importance in the diagnosis and treatment of patients with coronary artery disease [1] [2] [3] [4] [5] [6]. A unique strength of simulation methodologies lie in the predictive modeling of hemodynamics in response to unplanned events (such as progression or regression of lesions), or the outcome of planned procedures (such as surgical intervention) [7].…”

Section: Introductionmentioning

confidence: 99%