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Current Cardiovascular Imaging Reports
Published in: Current Cardiovascular Imaging Reports 5/2012

01-10-2012 | Cardiac Computed Tomography (TC Villines and S Achenbach, Section Editors)

Integrating Physiologic and Anatomic Assessment of Coronary Artery Disease by Coronary Computed Tomographic Angiography

Authors: Reza Arsanjani, Hyung B. Park, Daniel S. Berman, James K. Min

Published in: Current Cardiovascular Imaging Reports | Issue 5/2012

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Abstract

Coronary computed tomographic angiography (CCTA) has emerged as a novel noninvasive method for the evaluation of coronary artery stenosis, arterial wall, and plaque features. Recent developments in CCTA technology, CT perfusion imaging, and fractional flow reserve CT (FFRCT) have emerged which combine anatomy and physiology by identifying obstructive lesions that are ischemia-causing. These techniques are currently at an early stage, and future studies are needed to further establish their clinical utility. The aim of this review is to compare these modalities.
Literature
1.
Yusuf S, Reddy S, Ounpuu S, et al. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104(22):2746–53.PubMedCrossRef
2.
Yusuf S, Reddy S, Ounpuu S, et al. Global burden of cardiovascular diseases: Part II: variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation. 2001;104(23):2855–64.PubMedCrossRef
3.
Lerner DJ, Kannel WB. Patterns of coronary heart disease morbidity and mortality in the sexes: a 26-year follow-up of the Framingham population. Am Heart J. 1986;111(2):383–90.PubMedCrossRef
4.
Gould KL, Lipscomb K, Hamilton GW. Physiologic basis for assessing critical coronary stenosis. Instantaneous flow response and regional distribution during coronary hyperemia as measures of coronary flow reserve. Am J Cardiol. 1974;33(1):87–94.PubMedCrossRef
5.
Tonino PAL, Fearon WF, De Bruyne B, et al. Angiographic versus functional severity of coronary artery stenoses in the FAME study fractional flow reserve versus angiography in multivessel evaluation. J Am Coll Cardiol. 2010;55(25):2816–21.PubMedCrossRef
6.
7.
Berman DS, Abidov A, Kang X, et al. Prognostic validation of a 17-segment score derived from a 20-segment score for myocardial perfusion SPECT interpretation. J Nucl Cardiol. 2004;11(4):414–23.PubMedCrossRef
8.
Hachamovitch R, Hayes SW, Friedman JD, et al. Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography. Circulation. 2003;107(23):2900–7.PubMedCrossRef
9.
Shaw LJ, Berman DS, Maron DJ, 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. Circulation. 2008;117(10):1283–91.PubMedCrossRef
10.
Pijls NHJ, Fearon WF, Tonino PAL, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease: 2-year follow-up of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) study. J Am Coll Cardiol. 2010;56(3):177–84.PubMedCrossRef
11.
Tonino PAL, De Bruyne B, Pijls NHJ, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med. 2009;360(3):213–24.PubMedCrossRef
12.
Min JK, Shaw LJ, Berman DS. The present state of coronary computed tomography angiography a process in evolution. J Am Coll Cardiol. 2010;55(10):957–65.PubMedCrossRef
13.
Budoff MJ, Dowe D, Jollis JG, et al. Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J Am Coll Cardiol. 2008;52(21):1724–32.PubMedCrossRef
14.
Gottlieb I, Miller JM, Arbab-Zadeh A, et al. The absence of coronary calcification does not exclude obstructive coronary artery disease or the need for revascularization in patients referred for conventional coronary angiography. J Am Coll Cardiol. 2010;55(7):627–34.PubMedCrossRef
15.
Meijboom WB, Meijs MFL, Schuijf JD, et al. Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study. J Am Coll Cardiol. 2008;52(25):2135–44.PubMedCrossRef
16.
Hulten EA, Carbonaro S, Petrillo SP, et al. Prognostic value of cardiac computed tomography angiography: a systematic review and meta-analysis. J Am Coll Cardiol. 2011;57(10):1237–47.PubMedCrossRef
17.
Schmermund A, Elsässer A, Behl M, et al. Comparison of prognostic usefulness (three years) of computed tomographic angiography versus 64-slice computed tomographic calcium scanner in subjects without significant coronary artery disease. Am J Cardiol. 2010;106(11):1574–9.PubMedCrossRef
18.
Min JK, Feignoux J, Treutenaere J, et al. The prognostic value of multidetector coronary CT angiography for the prediction of major adverse cardiovascular events: a multicenter observational cohort study. Int J Cardiovasc Imaging. 2010;26(6):721–8.PubMedCrossRef
19.
Russo V, Zavalloni A, Bacchi Reggiani ML, et al. Incremental prognostic value of coronary CT angiography in patients with suspected coronary artery disease. Circ Cardiovasc Imaging. 2010;3(4):351–9.PubMedCrossRef
20.
Sozzi FB, Civaia F, Rossi P, et al. Long-term follow-up of patients with first-time chest pain having 64-slice computed tomography. Am J Cardiol. 2011;107(4):516–21.PubMedCrossRef
21.
Min JK, Shaw LJ, Devereux RB, et al. Prognostic value of multidetector coronary computed tomographic angiography for prediction of all-cause mortality. J Am Coll Cardiol. 2007;50(12):1161–70.PubMedCrossRef
22.
Min JK, Dunning A, Lin FY, et al. Age- and sex-related differences in all-cause mortality risk based on coronary computed tomography angiography findings results from the International Multicenter CONFIRM (Coronary CT angiography evaluation for clinical outcomes: an International Multicenter Registry) of 23,854 patients without known coronary artery disease. J Am Coll Cardiol. 2011;58(8):849–60.PubMedCrossRef
23.
Min JK, Lin FY, Dunning AM, et al. Incremental prognostic significance of left ventricular dysfunction to coronary artery disease detection by 64-detector row coronary computed tomographic angiography for the prediction of all-cause mortality: results from a two-centre study of 5330 patients. Eur Heart J. 2010;31(10):1212–9.PubMedCrossRef
24.
de Graaf FR, van Werkhoven JM, van Velzen JE, et al. Incremental prognostic value of left ventricular function analysis over non-invasive coronary angiography with multidetector computed tomography. J Nucl Cardiol. 2010;17(6):1034–40.PubMedCrossRef
25.
Hacker M, Jakobs T, Matthiesen F, et al. Comparison of spiral multidetector CT angiography and myocardial perfusion imaging in the noninvasive detection of functionally relevant coronary artery lesions: first clinical experiences. J Nucl Med. 2005;46(8):1294–300.PubMed
26.
Di Carli MF, Dorbala S, Curillova Z, et al. Relationship between CT coronary angiography and stress perfusion imaging in patients with suspected ischemic heart disease assessed by integrated PET-CT imaging. J Nucl Cardiol. 2007;14(6):799–809.PubMedCrossRef
27.
Meijboom WB, Van Mieghem CAG, van Pelt N, 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. J Am Coll Cardiol. 2008;52(8):636–43.PubMedCrossRef
28.
Blankstein R, Shturman LD, Rogers IS, et al. Adenosine-induced stress myocardial perfusion imaging using dual-source cardiac computed tomography. J Am Coll Cardiol. 2009;54(12):1072–84.PubMedCrossRef
29.
30.
Shuman WP, Branch KR, May JM, et al. Prospective versus retrospective ECG gating for 64-detector CT of the coronary arteries: comparison of image quality and patient radiation dose. Radiology. 2008;248(2):431–7.PubMedCrossRef
31.
Cury RC, Nieman K, Shapiro MD, et al. Comprehensive assessment of myocardial perfusion defects, regional wall motion, and left ventricular function by using 64-section multidetector CT. Radiology. 2008;248(2):466–75.PubMedCrossRef
32.
George RT, Jerosch-Herold M, Silva C, et al. Quantification of myocardial perfusion using dynamic 64-detector computed tomography. Invest Radiol. 2007;42(12):815–22.PubMedCrossRef
33.
Christian TF, Frankish ML, Sisemoore JH, et al. Myocardial perfusion imaging with first-pass computed tomographic imaging: Measurement of coronary flow reserve in an animal model of regional hyperemia. J Nucl Cardiol. 2010;17(4):625–30.PubMedCrossRef
34.
Kurata A, Mochizuki T, Koyama Y, et al. Myocardial perfusion imaging using adenosine triphosphate stress multi-slice spiral computed tomography: alternative to stress myocardial perfusion scintigraphy. Circ J. 2005;69(5):550–7.PubMedCrossRef
35.
George RT, Arbab-Zadeh A, Miller JM, et al. Adenosine stress 64- and 256-row detector computed tomography angiography and perfusion imaging: a pilot study evaluating the transmural extent of perfusion abnormalities to predict atherosclerosis causing myocardial ischemia. Circ Cardiovasc Imaging. 2009;2(3):174–82.PubMedCrossRef
36.
Rocha-Filho JA, Blankstein R, Shturman LD, et al. Incremental value of adenosine-induced stress myocardial perfusion imaging with dual-source CT at cardiac CT angiography. Radiology. 2010;254(2):410–9.PubMedCrossRef
37.
Bastarrika G, Ramos-Duran L, Rosenblum MA, et al. Adenosine-stress dynamic myocardial CT perfusion imaging: initial clinical experience. Invest Radiol. 2010;45(6):306–13.PubMed
38.
Ho K-T, Chua K-C, Klotz E, et al. Stress and rest dynamic myocardial perfusion imaging by evaluation of complete time-attenuation curves with dual-source CT. JACC Cardiovasc Imaging. 2010;3(8):811–20.PubMedCrossRef
39.
Bamberg F, Becker A, Schwarz F, et al. Detection of hemodynamically significant coronary artery stenosis: incremental diagnostic value of dynamic CT-based myocardial perfusion imaging. Radiology. 2011;260(3):689–98.PubMedCrossRef
40.
Ko BS, Cameron JD, Meredith IT, et al. Computed tomography stress myocardial perfusion imaging in patients considered for revascularization: a comparison with fractional flow reserve. Eur Heart J. 2012;33(1):67–77.PubMedCrossRef
41.
Karçaaltıncaba M, Aktaş A. Dual-energy CT revisited with multidetector CT: review of principles and clinical applications. Diagn Interv Radiol. 2011;17(3):181–94.PubMed
42.
Ko SM, Choi JW, Song MG, et al. Myocardial perfusion imaging using adenosine-induced stress dual-energy computed tomography of the heart: comparison with cardiac magnetic resonance imaging and conventional coronary angiography. Eur Radiol. 2011;21(1):26–35.PubMedCrossRef
43.
Weininger M, Schoepf UJ, Ramachandra A, et al. Adenosine-stress dynamic real-time myocardial perfusion CT and adenosine-stress first-pass dual-energy myocardial perfusion CT for the assessment of acute chest pain: initial results. Eur J Radiol [Internet]. 2010 Dec 29 [cited 2012 May 10];Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​21194865
44.
Meyer M, Nance JW Jr, Schoepf UJ, et al. Cost-effectiveness of substituting dual-energy CT for SPECT in the assessment of myocardial perfusion for the workup of coronary artery disease. Eur J Radiol [Internet]. 2011 Jan 27 [cited 2012 May 10];Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​21277132
45.
Feuchtner G, Goetti R, Plass A, et al. Adenosine stress high-pitch 128-slice dual-source myocardial computed tomography perfusion for imaging of reversible myocardial ischemia: comparison with magnetic resonance imaging. Circ Cardiovasc Imaging. 2011;4(5):540–9.PubMedCrossRef
46.
Pijls NH, Van Gelder B, Van der Voort P, et al. Fractional flow reserve. A useful index to evaluate the influence of an epicardial coronary stenosis on myocardial blood flow. Circulation. 1995;92(11):3183–93.PubMedCrossRef
47.
De Bruyne B, Pijls NH, Bartunek J, et al. Fractional flow reserve in patients with prior myocardial infarction. Circulation. 2001;104(2):157–62.PubMedCrossRef
48.
Kim HJ, Jansen KE, Taylor CA. Incorporating autoregulatory mechanisms of the cardiovascular system in three-dimensional finite element models of arterial blood flow. Ann Biomed Eng. 2010;38(7):2314–30.PubMedCrossRef
49.
Kim HJ, Vignon-Clementel IE, Coogan JS, et al. Patient-specific modeling of blood flow and pressure in human coronary arteries. Ann Biomed Eng. 2010;38(10):3195–209.PubMedCrossRef
50.
Kim HJ, Vignon-Clementel IE, Figueroa CA, et al. On coupling a lumped parameter heart model and a three-dimensional finite element aorta model. Ann Biomed Eng. 2009;37(11):2153–69.PubMedCrossRef
51.
Koo B-K, Erglis A, Doh J-H, 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. J Am Coll Cardiol. 2011;58(19):1989–97.PubMedCrossRef
52.
Min JK, Berman DS, Budoff MJ, et al. Rationale and design of the DeFACTO (Determination of Fractional Flow Reserve by Anatomic Computed Tomographic AngiOgraphy) study. J Cardiovasc Comput Tomogr. 2011;5(5):301–9.PubMedCrossRef
Metadata
Title
Integrating Physiologic and Anatomic Assessment of Coronary Artery Disease by Coronary Computed Tomographic Angiography
Authors
Reza Arsanjani
Hyung B. Park
Daniel S. Berman
James K. Min
Publication date
01-10-2012
Publisher
Current Science Inc.
Published in
Current Cardiovascular Imaging Reports / Issue 5/2012
Print ISSN: 1941-9066
Electronic ISSN: 1941-9074
DOI
https://doi.org/10.1007/s12410-012-9159-z

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