scholarly journals Hemodynamic impact of coronary stenosis using computed tomography: comparison between noninvasive fractional flow reserve and 3D fusion of coronary angiography with stress myocardial perfusion

2019 ◽  
Vol 35 (9) ◽  
pp. 1733-1743 ◽  
Author(s):  
Amit R. Patel ◽  
Francesco Maffessanti ◽  
Mita B. Patel ◽  
Kalie Kebed ◽  
Akhil Narang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Angiography ◽  
Myocardial Perfusion ◽  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Fractional Flow ◽  
Stress Myocardial Perfusion ◽  
Flow Reserve

scholarly journals Computed Tomography Myocardial Perfusion Imaging With Transesophageal Atrial Pacing Stress Test in Patients With Borderline Stenoses in the Coronary Arteries: a Comparison With Fractional Flow Reserve

Kardiologiia ◽  
2021 ◽  
Vol 61 (1) ◽  
pp. 4-11
Author(s):  
Yu. A. Omarov ◽  
T. N. Veselova ◽  
R. M. Shakhnovich ◽  
T. S. Sukhinina ◽  
N. S. Zhukova ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Myocardial Perfusion ◽  
Coronary Arteries ◽  
Fractional Flow Reserve ◽  
Predictive Value ◽  
Coronary Stenosis ◽  
Stress Test ◽  
Atrial Pacing ◽  
Fractional Flow ◽  
Flow Reserve

Aim      To evaluate the diagnostic accuracy of cardiac perfusion computed tomography (PCT) with transesophageal electrocardiostimulation (TE ECS) for detection of ischemia in patients with borderline coronary stenosis (50–75 %) compared to measurements of fractional flow reserve (FFR).Material and methods  The study included 25 patients with borderline (50–75 %) coronary stenosis as per data of computed tomography angiography (CTA) or coronary angiography (CAG). Later the patients underwent invasive measurement of FFR and cardiac PCT on a 320-row detector tomograph in combination with the TE ECS stress test.  FFR values <0.8 indicated the hemodynamic significance of stenosis. Myocardial perfusion was evaluated visually based on consensus of two experts.Results All patients completed the study protocol. Cardiac pacing duration was 6 min for all patients. Four patients required intravenous administration of atropine sulphate. PCT with TE ECS detected significant for FFR stenoses with sensitivity, specificity, and predictive value of a positive result and predictive value for a negative result of 47, 90, 87, and 53 %, respectively.Conclusion      PCT with TE ECS in combination with CTA can be considered as an informative method for simultaneous evaluation of the condition of coronary arteries and detection of myocardial ischemia. This method is particularly relevant for assessing the hemodynamic significance of borderline coronary stenoses.

Fractional flow reserve derived from coronary computed tomography: where are we now and where are we heading?

2020 ◽  
Author(s):  
Lavinia Gabara ◽  
Jonathan Hinton ◽  
Thomas Russell Gilpin ◽  
Nick Curzen
Keyword(s):  
Computed Tomography ◽  
Coronary Angiography ◽  
Fractional Flow Reserve ◽  
Computed Tomography Coronary Angiography ◽  
Future Research ◽  
Fractional Flow ◽  
Clinical Events ◽  
Flow Reserve ◽  
Invasive Angiography ◽  
Physiological Assessment

Computed tomography coronary angiography is emerging as the preferred diagnostic tool for patients with chest pain. Additional knowledge of the extent and distribution of myocardial ischemia enables tailored patient management. Computed tomography-derived fractional flow reserve (FFRCT) employs computed tomography coronary angiography raw data processed via complex computational fluid dynamics and produces a surrogate of the invasive fractional flow reserve (FFR) thus delivering anatomical and physiological assessment in a single test. FFRCT has been extensively validated against invasive FFR and observational clinical studies have consistently demonstrated its utility as gatekeeper to invasive angiography while also reducing downstream clinical events and costs. Novel workstation-based models of estimating FFR are now being tested. Ongoing and future research results will define their role in clinical practice.

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