CT-derived fractional flow reserve (FFRct) for functional coronary artery evaluation in the follow-up of patients after heart transplantation
| Autor: | Alexander Hirsch, Koen Nieman, Olivier C. Manintveld, Jonathon Leipsic, Fay M. A. Nous, Jasper J. Brugts, Alina A. Constantinescu, Stefan Roest, Lynne M. Hurwitz Koweek, Ricardo P.J. Budde |
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| Přispěvatelé: | Radiology & Nuclear Medicine, Cardiology |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Heart transplantation
medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment Ultrasound Interventional radiology General Medicine Fractional flow reserve medicine.disease Stenosis medicine.anatomical_structure medicine Radiology Nuclear Medicine and imaging Radiology business Computed tomography angiography Neuroradiology Artery |
| Zdroj: | European Radiology, 32(3), 1843-1852. Springer-Verlag |
| ISSN: | 0938-7994 |
| Popis: | Objectives Invasively measured fractional flow reserve (FFR) is associated with outcome in heart transplant (HTx) patients. Coronary computed tomography angiography (CCTA)–derived FFR (FFRct) provides additional functional information from anatomical CT images. We describe the first use of FFRct in HTx patients. Methods HTx patients underwent CCTA with FFRct to screen for cardiac allograft vasculopathy. FFRct was measured distal to each coronary stenosis > 30% and FFRct ≤ 0.8 indicated hemodynamically significant stenosis. FFRct was also measured at the most distal location of each vessel. Overall distal FFRct was calculated as the mean of the distal values in the left, right, and circumflex coronary artery in each patient. Results Seventy-three patients (age 56 (42–65) years, 63% males) at 11 (8–16) years after HTx were included. Eighteen (25%) patients had a focal hemodynamically significant stenosis (stenosis > 30% with FFRct ≤ 0.8). In the 55 patients without a hemodynamically significant focal FFRct stenosis (FFRct > 0.80), the distal left anterior descending artery FFRct was p = 0.93). Conclusions FFRct performed on CCTA scans of HTx patients demonstrated that 25% of patients had a focal coronary stenosis with FFRct ≤ 0.8. Even without a focal stenosis, FFRct values are often abnormal in HTx patients. Key Points • This is the first report describing the use of FFRct in in heart transplant patients. • FFRct identifies patients after heart transplantation with hemodynamically significant coronary stenosis. • Even without a focal stenosis, FFRct values are often abnormal in heart transplant patients. |
| Databáze: | OpenAIRE |
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