Cardiac CT perfusion and FFR CTA : pathophysiological features in ischemic heart disease.

Autor: Seitun S; Department of Radiology, IRCCS Policlinico San Martino Hospital, Genoa, Italy., Clemente A; Department of Radiology, CNR (National Council of Research)/Tuscany Region 'Gabriele Monasterio' Foundation (FTGM), Massa, Italy., De Lorenzi C; Department of Radiology, IRCCS Policlinico San Martino Hospital, Genoa, Italy., Benenati S; Clinic of Cardiovascular Diseases, IRCCS Policlinico San Martino Hospital, University of Genoa, Genoa, Italy., Chiappino D; Department of Radiology, CNR (National Council of Research)/Tuscany Region 'Gabriele Monasterio' Foundation (FTGM), Massa, Italy., Mantini C; Department of Neuroscience, Imaging and Clinical Science, Institute of Radiology, 'G. d'Annunzio' University, Chieti, Italy., Sakellarios AI; Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece., Cademartiri F; SDN IRCCS, Naples, Italy., Bezante GP; Clinic of Cardiovascular Diseases, IRCCS Policlinico San Martino Hospital, University of Genoa, Genoa, Italy., Porto I; Clinic of Cardiovascular Diseases, IRCCS Policlinico San Martino Hospital, University of Genoa, Genoa, Italy.
Jazyk: angličtina
Zdroj: Cardiovascular diagnosis and therapy [Cardiovasc Diagn Ther] 2020 Dec; Vol. 10 (6), pp. 1954-1978.
DOI: 10.21037/cdt-20-414
Abstrakt: Cardiac computed tomography (CCT) has rapidly evolved, becoming a powerful integrated tool for the evaluation of coronary artery disease (CAD), and being superior to other noninvasive methods due to its high accuracy and ability to simultaneously assess both lumen stenosis and atherosclerotic plaque burden. Furthermore, CCT is regarded as an effective gatekeeper for coronary angiography, and carries independent important prognostic information. In the last decade, the introduction of new functional CCT applications, namely CCT perfusion (CCTP) imaging and CT-derived fractional flow reserve (FFR CTA ), has opened the door for accurate assessment of the haemodynamic significance of stenoses. These new CCT technologies, thus, share the unique advantage of assessing both myocardial ischemia and patient-specific coronary artery anatomy, providing an integrated anatomical/functional analysis. In the present review, starting from the pathophysiology of myocardial ischemia, we evaluate the existing evidence for functional CCT imaging and its value in relation to alternative, well-established, non-invasive imaging modalities and invasive indices of ischemia (currently the gold-standard). The knowledge of clinical applications, benefits, and limitations of these new CCT technologies will allow efficient and optimal use in clinical practice in the near future.
Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/cdt-20-414). The series “Clinical Impact of Cardiac CT in Clinical Practice” was commissioned by the editorial office without any funding or sponsorship. AIS reports grants from FORTH during the conduct of the study. FC serves as an unpaid editorial board member of Cardiovascular Diagnosis and Therapy from Jul 2019 to Jun 2021. FC served as the unpaid Guest Editors of the series. The other authors have no other conflicts of interest to declare.
(2020 Cardiovascular Diagnosis and Therapy. All rights reserved.)
Databáze: MEDLINE
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