Computed Fractional Flow Reserve (FFTCT) Derived From Coronary CT Angiography

J Cardiovasc Transl Res. 2013 Oct;6(5):708-14. doi: 10.1007/s12265-013-9498-4. Epub 2013 Aug 10.

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.

Publication types

  • Review

MeSH terms

  • Blood Pressure
  • Coronary Angiography / methods*
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / physiopathology
  • Coronary Stenosis / diagnostic imaging*
  • Coronary Stenosis / physiopathology
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / physiopathology
  • Fractional Flow Reserve, Myocardial*
  • Humans
  • Predictive Value of Tests
  • Prognosis
  • Radiographic Image Interpretation, Computer-Assisted
  • Severity of Illness Index
  • Tomography, X-Ray Computed*