Noninvasive Fractional Flow Reserve Derived From Coronary CT Angiography: Clinical Data and Scientific Principles.

Fractional flow reserve derived from coronary computed tomography angiography enables noninvasive assessment of the hemodynamic significance of coronary artery lesions and coupling of the anatomic severity of a coronary stenosis with its physiological effects. Since its initial demonstration of feasibility of use in humans in 2011, a significant body of clinical evidence has developed to evaluate the diagnostic performance of coronary computed tomography angiography-derived fractional flow reserve compared with an invasive fractional flow reserve reference standard. The purpose of this paper was to describe the scientific principles and to review the clinical data of this technology recently approved by the U.S. Food and Drug Administration.

[1]  Nikola Jagic,et al.  Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease. , 2012, The New England journal of medicine.

[2]  B. Gersh,et al.  Angiographic Versus Functional Severity of Coronary Artery Stenoses in the FAME Study: Fractional Flow Reserve Versus Angiography in Multivessel Evaluation , 2011 .

[3]  A. Dunning,et al.  Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms. Results from the prospective multicenter DISCOVER-FLOW (Diagnosis of Ischemia-Causing Stenoses Obtained Via Noninvasive Fractional Flow Reserve) study. , 2011, Journal of the American College of Cardiology.

[4]  A. Ellims,et al.  T1 Mapping Techniques in Assessment of Ventricular Stiffness , 2015, Current Cardiovascular Imaging Reports.

[5]  Helmut Baumgartner,et al.  2014 ESC/EACTS Guidelines on myocardial revascularization: the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Developed with the special contribution of the European Association of Percutaneous , 2014, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[6]  V. Fowler,et al.  Echocardiographic Findings Predict In-Hospital and 1-Year Mortality in Left-Sided Native Valve Staphylococcus aureus EndocarditisCLINICAL PERSPECTIVE , 2015 .

[7]  K. Lipscomb,et al.  Effects of coronary stenoses on coronary flow reserve and resistance. , 1974, The American journal of cardiology.

[8]  P. Kaufmann,et al.  Coronary artery dimensions in primary and secondary left ventricular hypertrophy. , 1996, Journal of the American College of Cardiology.

[9]  Michael J Pencina,et al.  Diagnostic accuracy of fractional flow reserve from anatomic CT angiography. , 2012, JAMA.

[10]  Matthias Gutberlet,et al.  Clinical outcomes of fractional flow reserve by computed tomographic angiography-guided diagnostic strategies vs. usual care in patients with suspected coronary artery disease: the prospective longitudinal trial of FFRCT: outcome and resource impacts study , 2015, European heart journal.

[11]  B. De Bruyne,et al.  Coronary pressure measurement and fractional flow reserve , 1998, Heart.

[12]  Mark A Hlatky,et al.  Projected Costs and Consequences of Computed Tomography‐Determined Fractional Flow Reserve , 2013, Clinical cardiology.

[13]  Thomas J. R. Hughes,et al.  On the one-dimensional theory of blood flow in the larger vessels , 1973 .

[14]  Charles A. Taylor,et al.  Computational fluid dynamics applied to cardiac computed tomography for noninvasive quantification of fractional flow reserve: scientific basis. , 2013, Journal of the American College of Cardiology.

[15]  K. Gould,et al.  Abnormal Epicardial Coronary Resistance in Patients With Diffuse Atherosclerosis but “Normal” Coronary Angiography , 2001, Circulation.

[16]  T Togawa,et al.  Adaptive regulation of wall shear stress to flow change in the canine carotid artery. , 1980, The American journal of physiology.

[17]  O. Frank,et al.  Die grundform des arteriellen pulses , 1899 .

[18]  Volkmar Falk,et al.  2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Ca , 2014, European heart journal.

[19]  Nikola Jagic,et al.  Fractional flow reserve-guided PCI for stable coronary artery disease. , 2014, The New England journal of medicine.

[20]  Juhani Knuuti,et al.  Anatomic versus physiologic assessment of coronary artery disease. Role of coronary flow reserve, fractional flow reserve, and positron emission tomography imaging in revascularization decision-making. , 2013, Journal of the American College of Cardiology.

[21]  K. Chinnaiyan,et al.  Coronary CT angiography after stress testing: An efficient use of resources? Implications of the Advanced Cardiovascular Imaging Consortium (ACIC) results , 2012, Journal of Nuclear Cardiology.

[22]  B. Dimitrov,et al.  Does Routine Pressure Wire Assessment Influence Management Strategy at Coronary Angiography for Diagnosis of Chest Pain?: The RIPCORD Study , 2014, Circulation. Cardiovascular interventions.

[23]  Charles A. Taylor,et al.  Fast Computation of Hemodynamic Sensitivity to Lumen Segmentation Uncertainty , 2015, IEEE Transactions on Medical Imaging.

[24]  Patrick W Serruys,et al.  Comprehensive assessment of coronary artery stenoses: computed tomography coronary angiography versus conventional coronary angiography and correlation with fractional flow reserve in patients with stable angina. , 2008, Journal of the American College of Cardiology.

[25]  R. Wilson,et al.  Effects of adenosine on human coronary arterial circulation. , 1990, Circulation.

[26]  E. Nagel,et al.  Diagnostic Accuracy of Stress Myocardial Perfusion Imaging Compared to Invasive Coronary Angiography With Fractional Flow Reserve Meta-Analysis , 2015, Circulation. Cardiovascular imaging.

[27]  D. Berman,et al.  Comparative definitions for moderate-severe ischemia in stress nuclear, echocardiography, and magnetic resonance imaging. , 2014, JACC. Cardiovascular imaging.

[28]  Hiroshi Ito,et al.  Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in suspected coronary artery disease: the NXT trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps). , 2014, Journal of the American College of Cardiology.

[29]  Dennis G. Fryback,et al.  The Efficacy of Diagnostic Imaging , 1991, Medical decision making : an international journal of the Society for Medical Decision Making.

[30]  Hyung-Bok Park,et al.  Noninvasive Fractional Flow Reserve Derived From Computed Tomography Angiography for Coronary Lesions of Intermediate Stenosis Severity: Results From the DeFACTO Study , 2013, Circulation. Cardiovascular imaging.

[31]  Ghassan S Kassab,et al.  Scaling of myocardial mass to flow and morphometry of coronary arteries. , 2008, Journal of applied physiology.

[32]  J. Min,et al.  Finding the Gatekeeper to the Cardiac Catheterization Laboratory: Coronary CT Angiography or Stress Testing? , 2015, Journal of the American College of Cardiology.

[33]  D. Berman,et al.  The present state of coronary computed tomography angiography a process in evolution. , 2010, Journal of the American College of Cardiology.

[34]  Colin Berry,et al.  Role of multidetector computed tomography in the diagnosis and management of patients attending the rapid access chest pain clinic, The Scottish computed tomography of the heart (SCOT-HEART) trial: study protocol for randomized controlled trial , 2012, Trials.

[35]  D. Berman,et al.  Clinical benefits of noninvasive testing: coronary computed tomography angiography as a test case. , 2010, JACC. Cardiovascular imaging.

[36]  Marleen de Bruijne,et al.  Robust Shape Regression for Supervised Vessel Segmentation and its Application to Coronary Segmentation in CTA , 2011, IEEE Transactions on Medical Imaging.

[37]  E. Yow,et al.  A selection of recent, original research papers , 2015, Journal of Nuclear Cardiology.

[38]  Charles A. Taylor,et al.  Patient-Specific Modeling of Blood Flow and Pressure in Human Coronary Arteries , 2010, Annals of Biomedical Engineering.

[39]  Guido Germano,et al.  Optimal Medical Therapy With or Without Percutaneous Coronary Intervention to Reduce Ischemic Burden: Results From the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) Trial Nuclear Substudy , 2008, Circulation.

[40]  William Wijns,et al.  Percutaneous coronary intervention of functionally nonsignificant stenosis: 5-year follow-up of the DEFER Study. , 2007, Journal of the American College of Cardiology.

[41]  B. J. Gersh.  Optimal Medical Therapy With or Without Percutaneous Coronary Intervention to Reduce Ischemic Burden: Results from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) Trial Nuclear Substudy , 2009 .

[42]  Manesh R. Patel,et al.  Prevalence and predictors of nonobstructive coronary artery disease identified with coronary angiography in contemporary clinical practice. , 2014, American heart journal.

[43]  S Glagov,et al.  Shear stress regulation of artery lumen diameter in experimental atherogenesis. , 1987, Journal of vascular surgery.

[44]  H. Bøtker,et al.  Fractional flow reserve derived from coronary CT angiography: variation of repeated analyses. , 2014, Journal of cardiovascular computed tomography.