The application of computational fluid dynamics to coronary computed tomography angiography allows Fractional Flow Reserve (FFR) to be calculated non-invasively (FFRCT), enabling computation of FFR from coronary computed tomography angiography acquired at rest both for individual lesions as well as along the entire course of a coronary artery. FFRCT, validated in a number of accuracy studies and a large clinical utility trial, is beginning to penetrate clinical practice. Importantly, while accuracy trials compared FFRCT to invasively measured FFR at a single point in the coronary tree, clinical reports of FFRCT provide information regarding a patient's entire coronary vasculature. Specifically, in distal coronary segments, calculated FFRCT values may be low and below 0.80 even in the absence of localized stenoses within the course of the artery. As a result, the reporting physician needs to understand how to interpret the findings in a clinically useful and thoughtful fashion. This review provides a brief overview of the background of both invasively measured and computationally derived FFR, explains changes in FFR along the course of normal coronary arteries and those affected by coronary atherosclerosis, and outlines the relevance of measurement location when interpreting and reporting FFR and FFRCT results. Published by Elsevier Inc. on behalf of Society of Cardiovascular Computed Tomography.

Interpreting results of coronary computed tomography angiography-derived fractional flow reserve in clinical practice / M.G. Rabbat, D.S. Berman, M. Kern, G. Raff, K. Chinnaiyan, L. Koweek, L.J. Shaw, P. Blanke, M. Scherer, J.M. Jensen, J. Lesser, B.L. Nørgaard, G. Pontone, B. De Bruyne, J.J. Bax, J. Leipsic. - In: JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY. - ISSN 1876-861X. - 11:5(2017), pp. 383-388. [10.1016/j.jcct.2017.06.002]

Interpreting results of coronary computed tomography angiography-derived fractional flow reserve in clinical practice

G. Pontone;
2017

Abstract

The application of computational fluid dynamics to coronary computed tomography angiography allows Fractional Flow Reserve (FFR) to be calculated non-invasively (FFRCT), enabling computation of FFR from coronary computed tomography angiography acquired at rest both for individual lesions as well as along the entire course of a coronary artery. FFRCT, validated in a number of accuracy studies and a large clinical utility trial, is beginning to penetrate clinical practice. Importantly, while accuracy trials compared FFRCT to invasively measured FFR at a single point in the coronary tree, clinical reports of FFRCT provide information regarding a patient's entire coronary vasculature. Specifically, in distal coronary segments, calculated FFRCT values may be low and below 0.80 even in the absence of localized stenoses within the course of the artery. As a result, the reporting physician needs to understand how to interpret the findings in a clinically useful and thoughtful fashion. This review provides a brief overview of the background of both invasively measured and computationally derived FFR, explains changes in FFR along the course of normal coronary arteries and those affected by coronary atherosclerosis, and outlines the relevance of measurement location when interpreting and reporting FFR and FFRCT results. Published by Elsevier Inc. on behalf of Society of Cardiovascular Computed Tomography.
Computational fluid dynamics; Coronary artery disease; Coronary computed tomography angiography; Fractional flow reserve
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
2017
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/956575
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