Non-invasive physiological assessment of coronary artery obstruction on coronary computed tomography angiography.

Autor: Becker LM; Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands. l.becker@antoniusziekenhuis.nl.; Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands. l.becker@antoniusziekenhuis.nl., Peper J; Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands., van Nes SH; Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands., van Es HW; Department of Radiology, St. Antonius Hospital, Nieuwegein, The Netherlands., Sjauw KD; Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands., van de Hoef TP; Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands., Leiner T; Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands.; Department of Radiology, Mayo Clinics, Rochester, MN, USA., Swaans MJ; Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
Jazyk: angličtina
Zdroj: Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation [Neth Heart J] 2024 Nov; Vol. 32 (11), pp. 397-404. Date of Electronic Publication: 2024 Oct 07.
DOI: 10.1007/s12471-024-01902-7
Abstrakt: Computed tomography-derived fractional flow reserve (CT-FFR) enhances the specificity of coronary computed tomography angiography (CCTA) to that of the most specific non-invasive imaging techniques, while maintaining high sensitivity in stable coronary artery disease (CAD). As gatekeeper for invasive coronary angiography (ICA), use of CT-FFR results in a significant reduction of negative ICA procedures and associated costs and complications, without increasing cardiovascular events. It is expected that CT-FFR algorithms will continue to improve, regarding accuracy and generalisability, and that introduction of new features will allow further treatment guidance and reduced invasive diagnostic testing. Advancements in CCTA quality and artificial intelligence (AI) are starting to unfold the incremental diagnostic and prognostic capabilities of CCTA's attenuation-based images in CAD, with future perspectives promising additional CCTA parameters which will enable non-invasive assessment of myocardial ischaemia as well as CAD activity and future cardiovascular risk. This review discusses practical application, interpretation and impact of CT-FFR on patient care, and how this ties into the CCTA 'one stop shop' for coronary assessment and patient prognosis. In this light, selective adoption of the most promising, objective and reproducible techniques and algorithms will yield maximal diagnostic value of CCTA without overcomplicating patient management and guideline recommendations.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: