Coronary Stenosis
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2021 ◽  
Vol 98 (5) ◽  
pp. 863-863
Omar Wani ◽  
Samuel M. Butman

2021 ◽  
Vol 42 (Supplement_1) ◽  
S Smolka ◽  
A Fava ◽  
M Moshage ◽  
M Marwan ◽  
S Achenbach ◽  

Abstract Background Functional assessment of coronary stenosis using computational fluid dynamics is increasingly used, however other factors besides coronary stenosis may affect the results. We assessed several predictors for CT-derived fractional flow reserve (CT-FFR) in patients with suspected coronary artery disease (CAD) undergoing coronary computed tomographic angiography (CCTA). Methods 2505 consecutive patients with suspected CAD undergoing CCTA from 2008 to 2016 were screened, 1549 were excluded due to incomplete data (934), image quality (345), software error (147) or other reasons (123). Minimal CT-FFR was measured using an on-site prototype (cFFR Version 3.0, Siemens Healthineers, Forchheim, Germany) in coronaries ≥2mm. Several clinical as well as technical criteria were assessed for predicting the minimal CT-FFR per patient. Results 956 patients (51±12 years, 51.2% men) were included in this analysis. Mean EF was 59.4±7.4%, heart rate 63±9 bpm, systolic (126.5±20mmHg) and diastolic (70±11 mmHg) blood pressure (BP). Regression analysis and ANOVA showed low but significant impact on minimal CT-FFR (mean 0.85±0.10) by EF, aortic valvular dysfunction, heart rate and systolic blood pressure as well as image quality (esp. blooming and image noise). See Tables 1 and 2. Conclusion Coronary stenosis may not be the only relevant predictor for CT-FFR. Several clinical criteria (EF, heart rate, BP, aortic valve dysfunction) as well as image criteria (image quality, artifacts) can affect CT-FFR results. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Cleveland Clinic Foundation Table 1. ANOVA analysis Table 2. Regression analysis

2021 ◽  
Vol 17 (9) ◽  
pp. 757-764
Daniel Candeias Faria ◽  
Joo Myung Lee ◽  
Tim van der Hoef ◽  
Hernán Mejía-Rentería ◽  
Mauro Echavarría-Pinto ◽  

2021 ◽  
Vol 42 (Supplement_1) ◽  
F Barbieri ◽  
S Bleckwenn ◽  
L Stoessl ◽  
F Plank ◽  
C Beyer ◽  

Abstract Background Bicuspid aortic valve (BAV) is associated with genetic defects (NOTCH 1, GATA 5 mutations) and aortopathy. Differences in flow pattern and a genetic predisposition could also affect coronary arteries. Purpose To assess the coronary artery calcium score (CACS) and coronary artery disease (CAD) burden by coronary computed tomography angiography (CTA) in patients with BAV stenosis, as compared to those with tricuspid aortic valve (TAV) stenosis. Methods 47 patients with congenital BAV (68.9 years±12.9, 38.3% females) who underwent cardiovascular CTA for TAVR planning were matched with 47 TAV patients for age, gender, smoking, arterial hypertension, dyslipidemia, diabetes, body-mass-index and chronic kidney disease. The coronary artery calcium score (CACS) (Agatston Units=AU) and coronary stenosis severity by CTA (CADRAD:<25% minimal,<50%milde,50–70%moderate,>70/%severe) were quantified. Results The coronary artery calcium score (CACS) was lower in BAV (237.4 vs. 1013.3AU; p<0.001), and coronary stenosis severity was less (CAD-RAD:p<0.001) as compared to patients with TAV. More patients with BAV had CACS zero (27.7% vs. 0%, p<0.001). The majority (68.1%) of patients with BAV had no or non-obstructive CAD but only 25.5% of tricuspid (p<0.001). Obstructive CAD (>50% stenosis) by CTA was more frequently observed in TAV patients (68.1%; p<0.001). There were no differences in statin use and NOAC, and other co-morbidities such as AF and COPD. Conclusion Patients with BAV have markedly less coronary artery calcium load and yielded less severe coronary stenosis. CTA succeeds to rule out obstructive CAD in the majority of patients with BAV, with adherent implications for TAVR planning. FUNDunding Acknowledgement Type of funding sources: None. 72 YOM with BAV, zero CACS and no CAD CACS was lower in BAV

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