August 9, 2013Journal of Cardiovascular Translational Research125 citationsOpen Access
Computed Fractional Flow Reserve (FFTCT) Derived from Coronary CT Angiography
Key Points
- The study aims to evaluate the effectiveness of computed fractional flow reserve derived from coronary CT angiography (FFRCT) in diagnosing coronary artery disease (CAD).
- Prospective multicenter trials compared FFRCT to invasive fractional flow reserve as the reference standard.
- The method integrates anatomical and physiological assessments through noninvasive imaging.
- Computed FFRCT improves diagnostic accuracy compared to CT stenosis alone.
- The technology enhances discrimination for diagnosing hemodynamically significant CAD.
Abstract
Recent advances in image-based modeling and computational fluid dynamics permit the calculation of coronary artery pressure and flow from typically acquired coronary computed tomography (CT) scans. Computed fractional flow reserve is the ratio of mean coronary artery pressure divided by mean aortic pressure under conditions of simulated maximal coronary hyperemia, thus providing a noninvasive estimate of fractional flow reserve (FFRCT) at every point in the coronary tree. Prospective multicenter clinical trials have shown that computed FFRCT improves diagnostic accuracy and discrimination compared to CT stenosis alone for the diagnosis of hemodynamically significant coronary artery disease (CAD), when compared to invasive FFR as the reference gold standard. This promising new technology provides a combined anatomic and physiologic assessment of CAD in a single noninvasive test that can help select patients for invasive angiography and revascularization or best medical therapy. Further evaluation of the clinical effectiveness and economic implications of noninvasive FFRCT are now being explored.