Edward Hulten1, Ron Blankstein, Marcelo F Di Carli. 1. aCardiovascular Imaging Program, Departments of Radiology and Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts bCardiology Service, Division of Medicine, Walter Reed National Military Medical Center and Uniformed Services University of Health Sciences, Bethesda, Maryland, United States.
Abstract
PURPOSE OF REVIEW: Contemporary diagnosis and management of stable chest pain symptoms possibly due to coronary ischemia is a frequent clinical challenge that involves a variety of test options, based upon either coronary angiographic (anatomic) or functional imaging. This review will discuss the evolution of coronary computed tomography derived fractional flow reserve (FFRCT) from basic science to a currently clinically approved diagnostic test. RECENT FINDINGS: In recent years, FFR measured invasively in the coronary catheterization lab has demonstrated clinical outcome benefit for coronary revascularization decisions. Both coronary angiographic (anatomic) and functional myocardial imaging have been limited by an inability to reliably estimate physiologic significance determined by FFR. However, advances in computational fluid dynamics have led to interest in FFR estimated by coronary angiograms obtained noninvasively through coronary CT angiography. SUMMARY: The current use of FFRCT has been mostly limited to research applications due to lack of availability and cost, as well as limited outcomes and cost-effectiveness data. Nevertheless, interest remains in the potential role of FFRCT for coronary revascularization treatment decisions, and thus, ongoing and future studies will continue to investigate this technology.
PURPOSE OF REVIEW: Contemporary diagnosis and management of stable chest pain symptoms possibly due to coronary ischemia is a frequent clinical challenge that involves a variety of test options, based upon either coronary angiographic (anatomic) or functional imaging. This review will discuss the evolution of coronary computed tomography derived fractional flow reserve (FFRCT) from basic science to a currently clinically approved diagnostic test. RECENT FINDINGS: In recent years, FFR measured invasively in the coronary catheterization lab has demonstrated clinical outcome benefit for coronary revascularization decisions. Both coronary angiographic (anatomic) and functional myocardial imaging have been limited by an inability to reliably estimate physiologic significance determined by FFR. However, advances in computational fluid dynamics have led to interest in FFR estimated by coronary angiograms obtained noninvasively through coronary CT angiography. SUMMARY: The current use of FFRCT has been mostly limited to research applications due to lack of availability and cost, as well as limited outcomes and cost-effectiveness data. Nevertheless, interest remains in the potential role of FFRCT for coronary revascularization treatment decisions, and thus, ongoing and future studies will continue to investigate this technology.
Authors: Edward A Hulten; Salvatore Carbonaro; Sara P Petrillo; Joshua D Mitchell; Todd C Villines Journal: J Am Coll Cardiol Date: 2010-12-08 Impact factor: 24.094
Authors: Tim P van de Hoef; Martijn A van Lavieren; Peter Damman; Ronak Delewi; Martijn A Piek; Steven A J Chamuleau; Michiel Voskuil; José P S Henriques; Karel T Koch; Robbert J de Winter; Jos A E Spaan; Maria Siebes; Jan G P Tijssen; Martijn Meuwissen; Jan J Piek Journal: Circ Cardiovasc Interv Date: 2014-04-29 Impact factor: 6.546
Authors: Viviany R Taqueti; Rory Hachamovitch; Venkatesh L Murthy; Masanao Naya; Courtney R Foster; Jon Hainer; Sharmila Dorbala; Ron Blankstein; Marcelo F Di Carli Journal: Circulation Date: 2014-11-16 Impact factor: 29.690
Authors: Bon-Kwon Koo; Andrejs Erglis; Joon-Hyung Doh; David V Daniels; Sanda Jegere; Hyo-Soo Kim; Allison Dunning; Tony DeFrance; Alexandra Lansky; Jonathan Leipsic; James K Min Journal: J Am Coll Cardiol Date: 2011-11-01 Impact factor: 24.094
Authors: Hyung-Bok Park; Ran Heo; Bríain Ó Hartaigh; Iksung Cho; Heidi Gransar; Ryo Nakazato; Jonathon Leipsic; G B John Mancini; Bon-Kwon Koo; Hiromasa Otake; Matthew J Budoff; Daniel S Berman; Andrejs Erglis; Hyuk-Jae Chang; James K Min Journal: JACC Cardiovasc Imaging Date: 2015-01
Authors: James K Min; Jonathon Leipsic; Michael J Pencina; Daniel S Berman; Bon-Kwon Koo; Carlos van Mieghem; Andrejs Erglis; Fay Y Lin; Allison M Dunning; Patricia Apruzzese; Matthew J Budoff; Jason H Cole; Farouc A Jaffer; Martin B Leon; Jennifer Malpeso; G B John Mancini; Seung-Jung Park; Robert S Schwartz; Leslee J Shaw; Laura Mauri Journal: JAMA Date: 2012-09-26 Impact factor: 56.272
Authors: Ibrahim Danad; Jackie Szymonifka; Jos W R Twisk; Bjarne L Norgaard; Christopher K Zarins; Paul Knaapen; James K Min Journal: Eur Heart J Date: 2017-04-01 Impact factor: 35.855