Skip to main content
Top
Published in: Current Cardiovascular Imaging Reports 1/2016

Open Access 01-01-2016 | Cardiac Computed Tomography (T.C. Villines, Section Editor)

Coronary Computed Tomography Angiography Derived Fractional Flow Reserve and Plaque Stress

Authors: Bjarne Linde Nørgaard, Jonathon Leipsic, Bon-Kwon Koo, Christopher K. Zarins, Jesper Møller Jensen, Niels Peter Sand, Charles A. Taylor

Published in: Current Cardiovascular Imaging Reports | Issue 1/2016

Login to get access

Abstract

Fractional flow reserve (FFR) measured during invasive coronary angiography is an independent prognosticator in patients with coronary artery disease and the gold standard for decision making in coronary revascularization. The integration of computational fluid dynamics and quantitative anatomic and physiologic modeling now enables simulation of patient-specific hemodynamic parameters including blood velocity, pressure, pressure gradients, and FFR from standard acquired coronary computed tomography (CT) datasets. In this review article, we describe the potential impact on clinical practice and the science behind noninvasive coronary computed tomography (CT) angiography derived fractional flow reserve (FFRCT) as well as future applications of this technology in treatment planning and quantifying forces on atherosclerotic plaques.
Literature
1.
go back to reference Abdulla J, Abildstrom SZ, Gotzsche O, Christensen E, Kober L, Torp-Pedersen C. 64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis. Eur Heart J. 2007;28:3042–50.CrossRefPubMed Abdulla J, Abildstrom SZ, Gotzsche O, Christensen E, Kober L, Torp-Pedersen C. 64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis. Eur Heart J. 2007;28:3042–50.CrossRefPubMed
2.
go back to reference Budoff MJ, Dowe D, Jollis JG, Gitter M, Sutherland J, Halamert E, 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;52:1724–32.CrossRefPubMed Budoff MJ, Dowe D, Jollis JG, Gitter M, Sutherland J, Halamert E, 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;52:1724–32.CrossRefPubMed
3.
go back to reference Heydari B, Leipsic J, Mancini GB, Min JK, Labounty T, Taylor C, et al. Diagnostic performance of high-definition coronary computed tomography angiography performed with multiple radiation dose reduction strategies. Can J Cardiol. 2011;27:606–12.CrossRefPubMed Heydari B, Leipsic J, Mancini GB, Min JK, Labounty T, Taylor C, et al. Diagnostic performance of high-definition coronary computed tomography angiography performed with multiple radiation dose reduction strategies. Can J Cardiol. 2011;27:606–12.CrossRefPubMed
4.
go back to reference Rochitte CE, George RT, Chen MY, Arbab-Zadeh A, Dewey M, Miller JM, et al. Computed tomography angiography and perfusion to assess coronary artery stenosis causing perfusion defects by single photon emission computed tomography: the CORE320 study. Eur Heart J. 2014;35:1120–30.CrossRefPubMed Rochitte CE, George RT, Chen MY, Arbab-Zadeh A, Dewey M, Miller JM, et al. Computed tomography angiography and perfusion to assess coronary artery stenosis causing perfusion defects by single photon emission computed tomography: the CORE320 study. Eur Heart J. 2014;35:1120–30.CrossRefPubMed
5.
go back to reference Ropers U, Ropers D, Pflederer T, Anders K, Kuettner A, Stilianakis NI, et al. Influence of heart rate on the diagnostic accuracy of dual-source computed tomography coronary angiography. J Am Coll Cardiol. 2007;50:2393–8.CrossRefPubMed Ropers U, Ropers D, Pflederer T, Anders K, Kuettner A, Stilianakis NI, et al. Influence of heart rate on the diagnostic accuracy of dual-source computed tomography coronary angiography. J Am Coll Cardiol. 2007;50:2393–8.CrossRefPubMed
6.
go back to reference Achenbach S, Marwan M, Ropers D, Schepis T, Pflederer T, Anders K, et al. Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition. Eur Heart J. 2010;31:340–6.CrossRefPubMed Achenbach S, Marwan M, Ropers D, Schepis T, Pflederer T, Anders K, et al. Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition. Eur Heart J. 2010;31:340–6.CrossRefPubMed
7.
go back to reference LaBounty TM, Leipsic J, Poulter R, Wood D, Johnson M, Srichai MB, et al. Coronary CT angiography of patients with a normal body mass index using 80 kVp versus 100 kVp: a prospective, multicenter, multivendor randomized trial. AJR Am J Roentgenol. 2011;197:W860–7.CrossRefPubMed LaBounty TM, Leipsic J, Poulter R, Wood D, Johnson M, Srichai MB, et al. Coronary CT angiography of patients with a normal body mass index using 80 kVp versus 100 kVp: a prospective, multicenter, multivendor randomized trial. AJR Am J Roentgenol. 2011;197:W860–7.CrossRefPubMed
8.
go back to reference Leipsic J, Nguyen G, Brown J, Sin D, Mayo JR. A prospective evaluation of dose reduction and image quality in chest CT using adaptive statistical iterative reconstruction. AJR Am J Roentgenol. 2010;195:1095–9.CrossRefPubMed Leipsic J, Nguyen G, Brown J, Sin D, Mayo JR. A prospective evaluation of dose reduction and image quality in chest CT using adaptive statistical iterative reconstruction. AJR Am J Roentgenol. 2010;195:1095–9.CrossRefPubMed
9.
go back to reference Meijboom WB, Van Mieghem CA, van Pelt N, Weustink A, Pugliese F, Mollet NR, 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;52:636–43.CrossRefPubMed Meijboom WB, Van Mieghem CA, van Pelt N, Weustink A, Pugliese F, Mollet NR, 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;52:636–43.CrossRefPubMed
10.
go back to reference Tonino PA, Fearon WF, De Bruyne B, Oldroyd KG, Leesar MA, Ver Lee PN, 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;55:2816–21.CrossRefPubMed Tonino PA, Fearon WF, De Bruyne B, Oldroyd KG, Leesar MA, Ver Lee PN, 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;55:2816–21.CrossRefPubMed
11.••
go back to reference Douglas PS, Hoffmann U, Patel MR, Mark DB, Al-Khalidi HR, Cavanaugh B, et al. Outcomes of anatomical versus functional testing for coronary artery disease. New Engl J Med. 2015;372:1291–300. The first large-scale randomized trial comparing clinical outcomes following coronary CTA vs conventional ischemia testing in stable coronary artery disease. PubMedCentralCrossRefPubMed Douglas PS, Hoffmann U, Patel MR, Mark DB, Al-Khalidi HR, Cavanaugh B, et al. Outcomes of anatomical versus functional testing for coronary artery disease. New Engl J Med. 2015;372:1291–300. The first large-scale randomized trial comparing clinical outcomes following coronary CTA vs conventional ischemia testing in stable coronary artery disease. PubMedCentralCrossRefPubMed
12.
go back to reference Patel MR. Detecting obstructive coronary disease with CT angiography and noninvasive fractional flow reserve. JAMA. 2012;308:1269–70.CrossRefPubMed Patel MR. Detecting obstructive coronary disease with CT angiography and noninvasive fractional flow reserve. JAMA. 2012;308:1269–70.CrossRefPubMed
13.
go back to reference Ko BS, Cameron JD, Meredith IT, Leung M, Antonis PR, Nasis A, et al. Computed tomography stress myocardial perfusion imaging in patients considered for revascularization: a comparison with fractional flow reserve. Eur Heart J. 2012;33:67–77.CrossRefPubMed Ko BS, Cameron JD, Meredith IT, Leung M, Antonis PR, Nasis A, et al. Computed tomography stress myocardial perfusion imaging in patients considered for revascularization: a comparison with fractional flow reserve. Eur Heart J. 2012;33:67–77.CrossRefPubMed
14.••
go back to reference Johnson NP, Toth GG, Lai D, Zhu H, Agostoni P, Appelman Y, et al. Prognostic value of fractional flow reserve: linking physiologic severity to clinical outcomes. J Am Coll Cardiol. 2014;64:1641–54. Comprehensive metaanalysis linking the value of fractional flow reserve to prognosis. CrossRefPubMed Johnson NP, Toth GG, Lai D, Zhu H, Agostoni P, Appelman Y, et al. Prognostic value of fractional flow reserve: linking physiologic severity to clinical outcomes. J Am Coll Cardiol. 2014;64:1641–54. Comprehensive metaanalysis linking the value of fractional flow reserve to prognosis. CrossRefPubMed
15.
go back to reference Tonino PA, De Bruyne B, Pijls NH, Siebert U, Ikeno F, van’ t Veer M, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med. 2009;360:213–24. Tonino PA, De Bruyne B, Pijls NH, Siebert U, Ikeno F, van’ t Veer M, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med. 2009;360:213–24.
16.
go back to reference Fearon WF, Shilane D, Pijls NH, Boothroyd DB, Tonino PA, Barbato E, et al. Cost-effectiveness of percutaneous coronary intervention in patients with stable coronary artery disease and abnormal fractional flow reserve. Circulation. 2013;128:1335–40.CrossRefPubMed Fearon WF, Shilane D, Pijls NH, Boothroyd DB, Tonino PA, Barbato E, et al. Cost-effectiveness of percutaneous coronary intervention in patients with stable coronary artery disease and abnormal fractional flow reserve. Circulation. 2013;128:1335–40.CrossRefPubMed
17.
go back to reference De Bruyne B, Fearon WF, Pijls NH, Barbato E, Tonino P, Piroth Z, et al. Fractional flow reserve-guided PCI for stable coronary artery disease. N Engl J Med. 2014;371:1208–17.CrossRefPubMed De Bruyne B, Fearon WF, Pijls NH, Barbato E, Tonino P, Piroth Z, et al. Fractional flow reserve-guided PCI for stable coronary artery disease. N Engl J Med. 2014;371:1208–17.CrossRefPubMed
18.
go back to reference Morris PD, Ryan D, Morton AC, Lycett R, Lawford PV, Hose DR, et al. Virtual fractional flow reserve from coronary angiography: modeling the significance of coronary lesions: results from the VIRTU-1 (VIRTUal Fractional Flow Reserve From Coronary Angiography) study. JACC Cardiovasc Interv. 2013;6:149–57.CrossRefPubMed Morris PD, Ryan D, Morton AC, Lycett R, Lawford PV, Hose DR, et al. Virtual fractional flow reserve from coronary angiography: modeling the significance of coronary lesions: results from the VIRTU-1 (VIRTUal Fractional Flow Reserve From Coronary Angiography) study. JACC Cardiovasc Interv. 2013;6:149–57.CrossRefPubMed
19.
go back to reference Park SJ, Ahn JM, Park GM, Cho YR, Lee JY, Kim WJ, et al. Trends in the outcomes of percutaneous coronary intervention with the routine incorporation of fractional flow reserve in real practice. Eur Heart J. 2013;34:3353–61.CrossRefPubMed Park SJ, Ahn JM, Park GM, Cho YR, Lee JY, Kim WJ, et al. Trends in the outcomes of percutaneous coronary intervention with the routine incorporation of fractional flow reserve in real practice. Eur Heart J. 2013;34:3353–61.CrossRefPubMed
20.••
go back to reference Taylor CA, Fonte TA, Min JK. Computational fluid dynamics applied to cardiac computed tomography for noninvasive quantification of fractional flow reserve: scientific basis. J Am Coll Cardiol. 2013;61:2233–41. Provides a comprehensive description of the FFR CT technology. Taylor CA, Fonte TA, Min JK. Computational fluid dynamics applied to cardiac computed tomography for noninvasive quantification of fractional flow reserve: scientific basis. J Am Coll Cardiol. 2013;61:2233–41. Provides a comprehensive description of the FFR CT technology.
21.
go back to reference Taylor CA, Steinman DA. Image-based modeling of blood flow and vessel wall dynamics: applications, methods and future directions. Ann Biomed Eng. 2010;38:1188–203.CrossRefPubMed Taylor CA, Steinman DA. Image-based modeling of blood flow and vessel wall dynamics: applications, methods and future directions. Ann Biomed Eng. 2010;38:1188–203.CrossRefPubMed
22.
go back to reference Wang KC, Dutton RW, Taylor CA. Improving geometric model construction for blood flow modeling. IEEE Eng Med Biol. 1999;18:33–9.CrossRef Wang KC, Dutton RW, Taylor CA. Improving geometric model construction for blood flow modeling. IEEE Eng Med Biol. 1999;18:33–9.CrossRef
23.
go back to reference Taylor CA, Draney MT, Ku JP, Parker D, Steele BN, Wang K, et al. Predictive medicine: computational techniques in therapeutic decision-making. Comput Aided Surg. 1999;4:231–47.CrossRefPubMed Taylor CA, Draney MT, Ku JP, Parker D, Steele BN, Wang K, et al. Predictive medicine: computational techniques in therapeutic decision-making. Comput Aided Surg. 1999;4:231–47.CrossRefPubMed
24.
go back to reference Koo BK, Erglis A, Doh JH, Daniels DV, Jegere S, Kim HS, 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;58:1989–97.CrossRefPubMed Koo BK, Erglis A, Doh JH, Daniels DV, Jegere S, Kim HS, 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;58:1989–97.CrossRefPubMed
25.••
go back to reference Min JK, Leipsic J, Pencina MJ, Berman DS, Koo BK, van Mieghem C, et al. Diagnostic accuracy of fractional flow reserve from anatomic CT angiography. JAMA. 2012;308:1237–45. Large scale multicenter study testing the diagnostic performance of FFR CT using measured fractional flow reserve as the reference standard. Min JK, Leipsic J, Pencina MJ, Berman DS, Koo BK, van Mieghem C, et al. Diagnostic accuracy of fractional flow reserve from anatomic CT angiography. JAMA. 2012;308:1237–45. Large scale multicenter study testing the diagnostic performance of FFR CT using measured fractional flow reserve as the reference standard.
26.••
go back to reference Nørgaard BL, Leipsic J, Gaur S, Seneviratne S, Ko BS, Ito H, et al. Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in suspected coronary artery disease: the NXT trial (analysis of coronary blood flow using CT Angiography: next steps). J Am Coll Cardiol. 2014;63:1145–55. Large scale multicenter study testing the diagnostic performance of FFR CT using the most updated analysis software with measured fractional flow reserve as the reference standard. Nørgaard BL, Leipsic J, Gaur S, Seneviratne S, Ko BS, Ito H, et al. Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in suspected coronary artery disease: the NXT trial (analysis of coronary blood flow using CT Angiography: next steps). J Am Coll Cardiol. 2014;63:1145–55. Large scale multicenter study testing the diagnostic performance of FFR CT using the most updated analysis software with measured fractional flow reserve as the reference standard.
27.•
go back to reference Leipsic J, Yang TH, Thompson A, Koo BK, Mancini GB, Taylor C, et al. CT angiography (CTA) and diagnostic performance of noninvasive fractional flow reserve: results from the Determination of Fractional Flow Reserve by Anatomic CTA (DeFACTO) study. AJR Am J Roentgenol. 2014;202:989–94. Document the importance of sufficient heart rate control and use of nitroglycerin for coronary CTA and FFR CT assessment. Leipsic J, Yang TH, Thompson A, Koo BK, Mancini GB, Taylor C, et al. CT angiography (CTA) and diagnostic performance of noninvasive fractional flow reserve: results from the Determination of Fractional Flow Reserve by Anatomic CTA (DeFACTO) study. AJR Am J Roentgenol. 2014;202:989–94. Document the importance of sufficient heart rate control and use of nitroglycerin for coronary CTA and FFR CT assessment.
28.
go back to reference Achenbach S, Manolopoulos M, Schuhback A, Ropers D, Rixe J, Schneider C, et al. Influence of heart rate and phase of the cardiac cycle on the occurrence of motion artifact in dual-source CT angiography of the coronary arteries. J Cardiovasc Comput Tomogr. 2012;6:91–8.CrossRefPubMed Achenbach S, Manolopoulos M, Schuhback A, Ropers D, Rixe J, Schneider C, et al. Influence of heart rate and phase of the cardiac cycle on the occurrence of motion artifact in dual-source CT angiography of the coronary arteries. J Cardiovasc Comput Tomogr. 2012;6:91–8.CrossRefPubMed
29.
go back to reference Gaur S, Achenbach S, Leipsic J, Mauri L, Bezerra HG, Jensen JM, et al. Rationale and design of the HeartFlowNXT (HeartFlow analysis of coronary blood flow using CT angiography: Next sTeps) study. J Cardiovasc Comput Tomogr. 2013;7:279–88.CrossRefPubMed Gaur S, Achenbach S, Leipsic J, Mauri L, Bezerra HG, Jensen JM, et al. Rationale and design of the HeartFlowNXT (HeartFlow analysis of coronary blood flow using CT angiography: Next sTeps) study. J Cardiovasc Comput Tomogr. 2013;7:279–88.CrossRefPubMed
30.
go back to reference Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the task force on the management of stable coronary artery disease of the european society of cardiology. Eur Heart J. 2013;34:2949–3003.CrossRefPubMed Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the task force on the management of stable coronary artery disease of the european society of cardiology. Eur Heart J. 2013;34:2949–3003.CrossRefPubMed
31.
go back to reference Nørgaard BL, Leipsic J, Achenbach S, Gaur S, Bezerra H, Jensen JM. Improved specificity of non-invasive fractional flow reserve from coronary CT angiography employing latest generation techniques and standardized image metrics. J Cardiovasc Comput Tomogr (Suppl). 2014;171 (abstract). Nørgaard BL, Leipsic J, Achenbach S, Gaur S, Bezerra H, Jensen JM. Improved specificity of non-invasive fractional flow reserve from coronary CT angiography employing latest generation techniques and standardized image metrics. J Cardiovasc Comput Tomogr (Suppl). 2014;171 (abstract).
32.
go back to reference Gaur S, Bezerra HG, Lassen JF, Christiansen EH, Tanaka K, Jensen JM, et al. Fractional flow reserve derived from coronary CT angiography: variation of repeated analyses. J Cardiovasc Comput Tomogr. 2014;8:307–14.CrossRefPubMed Gaur S, Bezerra HG, Lassen JF, Christiansen EH, Tanaka K, Jensen JM, et al. Fractional flow reserve derived from coronary CT angiography: variation of repeated analyses. J Cardiovasc Comput Tomogr. 2014;8:307–14.CrossRefPubMed
33.
go back to reference Nørgaard BL, Gaur S, Leipsic J, Ito H, Miyoshi T, Park SJ, et al. Influence of coronary calcification on the diagnostic performance of CT angiography derived FFR in coronary artery disease: a substudy of the NXT trial. JACC Cardiovasc Imaging. 2015;8:1209–22. Nørgaard BL, Gaur S, Leipsic J, Ito H, Miyoshi T, Park SJ, et al. Influence of coronary calcification on the diagnostic performance of CT angiography derived FFR in coronary artery disease: a substudy of the NXT trial. JACC Cardiovasc Imaging. 2015;8:1209–22.
34.
go back to reference Tanaka K, Bezerra HG, Gaur S, Attizzani GF, Bøtker HE, Costa MA, et al. Comparison between noninvasive (coronary computed tomography angiography derived) and invasive-fractional flow reserve in patients with serial stenoses within one coronary artery: a NXT Trial substudy. Ann Biomed Eng. 2015;in press. Tanaka K, Bezerra HG, Gaur S, Attizzani GF, Bøtker HE, Costa MA, et al. Comparison between noninvasive (coronary computed tomography angiography derived) and invasive-fractional flow reserve in patients with serial stenoses within one coronary artery: a NXT Trial substudy. Ann Biomed Eng. 2015;in press.
35.
go back to reference Nørgaard BL, Jensen JM, Leipsic J. Fractional flow reserve derived from coronary CT angiography in stable coronary disease: a new standard in non-invasive testing? Eur Radiol. 2015;25:2282–90.CrossRefPubMed Nørgaard BL, Jensen JM, Leipsic J. Fractional flow reserve derived from coronary CT angiography in stable coronary disease: a new standard in non-invasive testing? Eur Radiol. 2015;25:2282–90.CrossRefPubMed
36.
go back to reference Curzen N, Rana O, Nicholas Z, Golledge P, Zaman A, Oldroyd K, et al. Does routine pressure wire assessment influence management strategy at co-ronary angiography for diagnosis of chest pain?: the RIPCORD study. Circ Cardiovasc Interv. 2014;7:248–55.CrossRefPubMed Curzen N, Rana O, Nicholas Z, Golledge P, Zaman A, Oldroyd K, et al. Does routine pressure wire assessment influence management strategy at co-ronary angiography for diagnosis of chest pain?: the RIPCORD study. Circ Cardiovasc Interv. 2014;7:248–55.CrossRefPubMed
37.
go back to reference Park SJ, Kang SJ, Ahn JM, Shim EB, Kim YT, Yun SC, et al. Visual-functional mismatch between coronary angiography and fractional flow reserve. JACC Cardiovasc Interv. 2012;5:1029–36.CrossRefPubMed Park SJ, Kang SJ, Ahn JM, Shim EB, Kim YT, Yun SC, et al. Visual-functional mismatch between coronary angiography and fractional flow reserve. JACC Cardiovasc Interv. 2012;5:1029–36.CrossRefPubMed
38.
go back to reference Toth G, Hamilos M, Pyxaras S, Mangiacapra F, Nelis O, Vroey D, et al. Evolving concepts of angiogram: fractional flow reserve discordances in 4000 coronary stenoses. Eur Heart J. 2014;35:2831–8.CrossRefPubMed Toth G, Hamilos M, Pyxaras S, Mangiacapra F, Nelis O, Vroey D, et al. Evolving concepts of angiogram: fractional flow reserve discordances in 4000 coronary stenoses. Eur Heart J. 2014;35:2831–8.CrossRefPubMed
39.
go back to reference De Bruyne B, Hersbach F, Pijls NH, Bartunek J, Bech JW, Heyndrickx GR, et al. Abnormal epicardial coronary resistance in patients with diffuse atherosclerosis but “Normal” coronary angiography. Circulation. 2001;104:2401–6.CrossRefPubMed De Bruyne B, Hersbach F, Pijls NH, Bartunek J, Bech JW, Heyndrickx GR, et al. Abnormal epicardial coronary resistance in patients with diffuse atherosclerosis but “Normal” coronary angiography. Circulation. 2001;104:2401–6.CrossRefPubMed
40.
go back to reference Patel MR, Peterson ED, Dai D, Brennan JM, Redberg RF, Anderson HV, et al. Low diagnostic yield of elective coronary angiography. N Engl J Med. 2010;362:886–95.PubMedCentralCrossRefPubMed Patel MR, Peterson ED, Dai D, Brennan JM, Redberg RF, Anderson HV, et al. Low diagnostic yield of elective coronary angiography. N Engl J Med. 2010;362:886–95.PubMedCentralCrossRefPubMed
41.
go back to reference Lin GA, Dudley RA, Lucas FL, Malenka DJ, Vittinghoff E, Redberg RF. Frequency of stress testing to document ischemia prior to elective percutaneous coronary intervention. JAMA. 2008;300: 1765–73. Lin GA, Dudley RA, Lucas FL, Malenka DJ, Vittinghoff E, Redberg RF. Frequency of stress testing to document ischemia prior to elective percutaneous coronary intervention. JAMA. 2008;300: 1765–73.
42.
go back to reference Patel MR, Dai D, Hernandez AF, Douglas PS, Messenger J, Garratt KN, et al. Prevalence and predictors of nonobstructive coronary artery disease identified with coronary angiography in contemporary clinical practice. Am Heart J. 2014;167:846–52.CrossRefPubMed Patel MR, Dai D, Hernandez AF, Douglas PS, Messenger J, Garratt KN, et al. Prevalence and predictors of nonobstructive coronary artery disease identified with coronary angiography in contemporary clinical practice. Am Heart J. 2014;167:846–52.CrossRefPubMed
43.••
go back to reference Douglas PS, Pontone G, Hlatky MA, Patel MR, Norgaard BL, Byrne RA, et al. Clinical outcomes of fractional flow reserve by computed tomographic angiography-guided diagnostic strategies vs usual care in patients with suspected coronary artery disease: the prospective longitudinal trial of FFRct: outcome and resource impacts (PLATFORM) study. Eur Heart J. 2015;36:3359–67. The first large-scale trial invastigating clinical outcomes and downstream resource utilization following FFR CT vs conventional ischemia testing. Douglas PS, Pontone G, Hlatky MA, Patel MR, Norgaard BL, Byrne RA, et al. Clinical outcomes of fractional flow reserve by computed tomographic angiography-guided diagnostic strategies vs usual care in patients with suspected coronary artery disease: the prospective longitudinal trial of FFRct: outcome and resource impacts (PLATFORM) study. Eur Heart J. 2015;36:3359–67. The first large-scale trial invastigating clinical outcomes and downstream resource utilization following FFR CT vs conventional ischemia testing.
44.•
go back to reference Nørgaard BL, Hjort J, Gaur S, Hansson N, Bøtker HE, Leipsic J, et al. Clinical use of coronary computed tomography angiography derived fractional flow reserve (FFRCT) for decision making in stable coronary artery disease. JACC Cardiovasc Imaging. 2015;in press. The first real-world report on the diagnostic performance of FFR CT in CAD. Nørgaard BL, Hjort J, Gaur S, Hansson N, Bøtker HE, Leipsic J, et al. Clinical use of coronary computed tomography angiography derived fractional flow reserve (FFRCT) for decision making in stable coronary artery disease. JACC Cardiovasc Imaging. 2015;in press. The first real-world report on the diagnostic performance of FFR CT in CAD.
45.
go back to reference Hlatky MA, Saxena A, Koo BK, Erglis A, Zarins CK, Min JK. Projected costs and consequences of computed tomography-determined fractional flow reserve. Clin Cardiol. 2013;36:743–8.CrossRefPubMed Hlatky MA, Saxena A, Koo BK, Erglis A, Zarins CK, Min JK. Projected costs and consequences of computed tomography-determined fractional flow reserve. Clin Cardiol. 2013;36:743–8.CrossRefPubMed
46.
go back to reference Kimura T, Shiomi H, Kuribayashi S, Isshiko T, Kanazawa S, Ito H, et al. Cost analysis of non-invasive fractional flow reserve derived from coronary computed tomographic angiography in Japan. Cardiovasc Interv Ther. 2015;30:38–44.PubMedCentralCrossRefPubMed Kimura T, Shiomi H, Kuribayashi S, Isshiko T, Kanazawa S, Ito H, et al. Cost analysis of non-invasive fractional flow reserve derived from coronary computed tomographic angiography in Japan. Cardiovasc Interv Ther. 2015;30:38–44.PubMedCentralCrossRefPubMed
47.••
go back to reference Hlatky MA, De Bruyne B, Pontone G, Patel MR, Norgaard BL, Byrne RA, et al. Quality of life and economic outcomes of assessing fractional flow reserve with computed tomography Angiography: the PLATFORM study. J Am Coll Cardiol. 2015;66:2315–23. The first large-scale trial invastigating quality of life and economic aspects following FFR CT vs conventional ischemia testing. A substudy of the PLATFORM trial. Hlatky MA, De Bruyne B, Pontone G, Patel MR, Norgaard BL, Byrne RA, et al. Quality of life and economic outcomes of assessing fractional flow reserve with computed tomography Angiography: the PLATFORM study. J Am Coll Cardiol. 2015;66:2315–23. The first large-scale trial invastigating quality of life and economic aspects following FFR CT vs conventional ischemia testing. A substudy of the PLATFORM trial.
48.
go back to reference Nakazato R, Park HB, Berman DS, Gransar H, Koo BK, Erglis A, et al. Noninvasive fractional flow reserve derived from computed tomography angiography for coronary lesions of intermediate severity: results from the DeFACTo study. Circ Cardiovasc Imaging. 2013;6:881–9.CrossRefPubMed Nakazato R, Park HB, Berman DS, Gransar H, Koo BK, Erglis A, et al. Noninvasive fractional flow reserve derived from computed tomography angiography for coronary lesions of intermediate severity: results from the DeFACTo study. Circ Cardiovasc Imaging. 2013;6:881–9.CrossRefPubMed
49.
go back to reference De Bruyne B, Sarma J. Fractional flow reserve: a review: invasive imaging. Heart. 2008;94:949–59.48.CrossRefPubMed De Bruyne B, Sarma J. Fractional flow reserve: a review: invasive imaging. Heart. 2008;94:949–59.48.CrossRefPubMed
50.
go back to reference Abbara S, Arbab-Zadeh A, Callister TQ, Desai MY, Mamuya W, Thomson L, et al. SCCT guidelines for performance of coronary computed tomographic angiography: a report of the society of cardiovascular computed tomography guidelines committee. J Cardiovasc Comput Tomogr. 2009;3:190–204.CrossRefPubMed Abbara S, Arbab-Zadeh A, Callister TQ, Desai MY, Mamuya W, Thomson L, et al. SCCT guidelines for performance of coronary computed tomographic angiography: a report of the society of cardiovascular computed tomography guidelines committee. J Cardiovasc Comput Tomogr. 2009;3:190–204.CrossRefPubMed
51.
go back to reference Min JK, Koo BK, Erglis A, Doh JH, Daniels DV, Jegere S, et al. Effect of image quality on diagnostic accuracy of noninvasive fractional flow reserve: results from the prospective multicenter international DISCOVER-FLOW study. J Cardiovasc Comput Tomogr. 2012;6:191–9.CrossRefPubMed Min JK, Koo BK, Erglis A, Doh JH, Daniels DV, Jegere S, et al. Effect of image quality on diagnostic accuracy of noninvasive fractional flow reserve: results from the prospective multicenter international DISCOVER-FLOW study. J Cardiovasc Comput Tomogr. 2012;6:191–9.CrossRefPubMed
52.
go back to reference Renker M, Schoepf UJ, Wang R, Meinel FG, Rier JD, Bayer II RR, et al. Comparison of diagnostic value of a novel noninvasive coronary computed tomography angiography method vs standard coronary angiography for assessing fractional flow reserve. Am J Cardiol. 2014;114:1303–8.CrossRefPubMed Renker M, Schoepf UJ, Wang R, Meinel FG, Rier JD, Bayer II RR, et al. Comparison of diagnostic value of a novel noninvasive coronary computed tomography angiography method vs standard coronary angiography for assessing fractional flow reserve. Am J Cardiol. 2014;114:1303–8.CrossRefPubMed
53.
go back to reference Coenen A, Lubbers MM, Kurata A, Kono A, Dedic A, Chelu RG, et al. Fractional flow reserve computed from noninvasive CT angiography data: diagnostic performance of an on-site clinician-operated computationa fluid dynamics algorithm. Radiology. 2015;274:674–83.CrossRefPubMed Coenen A, Lubbers MM, Kurata A, Kono A, Dedic A, Chelu RG, et al. Fractional flow reserve computed from noninvasive CT angiography data: diagnostic performance of an on-site clinician-operated computationa fluid dynamics algorithm. Radiology. 2015;274:674–83.CrossRefPubMed
54.
go back to reference Nørgaard BL, Leipsic J. From Newton to the coronaries. Computational fluid dynamics has entered the clinical scene. JACC Cardiovasc Imaging. 2015;in press. Nørgaard BL, Leipsic J. From Newton to the coronaries. Computational fluid dynamics has entered the clinical scene. JACC Cardiovasc Imaging. 2015;in press.
55.
go back to reference Kim KH, Doh JH, Koo BK, et al. A novel noninvasive technology for treatment planning using virtual coronary stenting and computed tomography-derived computed fractional flow reserve. JACC Cardiovasc Interv. 2014;7:72–8.CrossRefPubMed Kim KH, Doh JH, Koo BK, et al. A novel noninvasive technology for treatment planning using virtual coronary stenting and computed tomography-derived computed fractional flow reserve. JACC Cardiovasc Interv. 2014;7:72–8.CrossRefPubMed
56.
go back to reference Liu SQ, Fung YC. Relationship between hypertension, hypertrophy, and opening angle of zero-stress state of arteries following aortic constriction. J Biomech Eng. 1989;111:325–35.CrossRefPubMed Liu SQ, Fung YC. Relationship between hypertension, hypertrophy, and opening angle of zero-stress state of arteries following aortic constriction. J Biomech Eng. 1989;111:325–35.CrossRefPubMed
57.•
go back to reference Choi G, Lee JM, Kim HJ, Park JB, Sankaran S, Otake H, et al. Coronary artery axial plaque stress and its relationship with lesion geometry: application of computational fluid dynamics to coronary CT angiography. JACC Cardiovasc Imaging. 2015;8:1156–66. Introduction of coronary artery axial plaques forces for assessment of coronary artery disease. CrossRefPubMed Choi G, Lee JM, Kim HJ, Park JB, Sankaran S, Otake H, et al. Coronary artery axial plaque stress and its relationship with lesion geometry: application of computational fluid dynamics to coronary CT angiography. JACC Cardiovasc Imaging. 2015;8:1156–66. Introduction of coronary artery axial plaques forces for assessment of coronary artery disease. CrossRefPubMed
58.
go back to reference Tang BT, Cheng CP, Draney MT, Wilson NM, Tsao PS, Herfkens RL, et al. Abdominal aortic hemodynamics in young healthy adults at rest and during lower limb exercise: quantification using image-based computer modeling. Am J Physiol Heart Circ Physiol. 2006;291:H668–76.CrossRefPubMed Tang BT, Cheng CP, Draney MT, Wilson NM, Tsao PS, Herfkens RL, et al. Abdominal aortic hemodynamics in young healthy adults at rest and during lower limb exercise: quantification using image-based computer modeling. Am J Physiol Heart Circ Physiol. 2006;291:H668–76.CrossRefPubMed
59.
go back to reference Les AS, Shadden SC, Figueroa CA, Park JM, Tedesco MM, Herfkens RJ, et al. Quantification of hemodynamics in abdominal aortic aneurysms during rest and exercise using magnetic resonance imaging and computational fluid dynamics. Ann Biomed Eng. 2010;38:1288–313.CrossRefPubMed Les AS, Shadden SC, Figueroa CA, Park JM, Tedesco MM, Herfkens RJ, et al. Quantification of hemodynamics in abdominal aortic aneurysms during rest and exercise using magnetic resonance imaging and computational fluid dynamics. Ann Biomed Eng. 2010;38:1288–313.CrossRefPubMed
60.
go back to reference Acevedo-Bolton G, Jou LD, Dispensa BP, Lawton MT, Higashida RT, Martin AJ, et al. Estimating the hemodynamic impact of interventional treatments of aneurysms: numerical simulation with experimental validation: technical case report. Neurosurgery. 2006;59:E429–30.CrossRefPubMed Acevedo-Bolton G, Jou LD, Dispensa BP, Lawton MT, Higashida RT, Martin AJ, et al. Estimating the hemodynamic impact of interventional treatments of aneurysms: numerical simulation with experimental validation: technical case report. Neurosurgery. 2006;59:E429–30.CrossRefPubMed
61.
go back to reference Cebral JR, Castro MA, Burgess JE, Pergolizzi RS, Sheridan MJ, Putman CM. Characterization of cerebral aneurysms for assessing risk of rupture by using patient-specific computational hemodynamics models. AJNR Am J Neuroradiol. 2005;26:2550–9.PubMed Cebral JR, Castro MA, Burgess JE, Pergolizzi RS, Sheridan MJ, Putman CM. Characterization of cerebral aneurysms for assessing risk of rupture by using patient-specific computational hemodynamics models. AJNR Am J Neuroradiol. 2005;26:2550–9.PubMed
62.
go back to reference Cebral JR, Yim PJ, Lohner R, Soto O, Choyke PL. Blood flow modeling in carotid arteries with computational fluid dynamics and MR imaging. Acad Radiol. 2002;9:1286–99.CrossRefPubMed Cebral JR, Yim PJ, Lohner R, Soto O, Choyke PL. Blood flow modeling in carotid arteries with computational fluid dynamics and MR imaging. Acad Radiol. 2002;9:1286–99.CrossRefPubMed
63.
go back to reference Milner JS, Moore JA, Rutt BK, Steinman DA. Hemodynamics of human carotid artery bifurcations: computational studies with models reconstructed from magnetic resonance imaging of normal subjects. J Vasc Surg. 1998;28:143–56.CrossRefPubMed Milner JS, Moore JA, Rutt BK, Steinman DA. Hemodynamics of human carotid artery bifurcations: computational studies with models reconstructed from magnetic resonance imaging of normal subjects. J Vasc Surg. 1998;28:143–56.CrossRefPubMed
64.
go back to reference Tang BT, Fonte TA, Chan FP, Tsao PS, Feinstein JA, Taylor CA. Three-dimensional hemodynamics in the human pulmonary arteries under resting and exercise conditions. Ann Biomed Eng. 2011;39:347–58.CrossRefPubMed Tang BT, Fonte TA, Chan FP, Tsao PS, Feinstein JA, Taylor CA. Three-dimensional hemodynamics in the human pulmonary arteries under resting and exercise conditions. Ann Biomed Eng. 2011;39:347–58.CrossRefPubMed
65.
go back to reference Tang BT, Pickard SS, Chan FP, Tsao PS, Taylor CA, Feinstein JA. Wall shear stress is decreased in the pulmonary arteries of patients with pulmonary arterial hypertension: an image-based, computational fluid dynamics study. Pulm Circ. 2012;2:470–6.PubMedCentralCrossRefPubMed Tang BT, Pickard SS, Chan FP, Tsao PS, Taylor CA, Feinstein JA. Wall shear stress is decreased in the pulmonary arteries of patients with pulmonary arterial hypertension: an image-based, computational fluid dynamics study. Pulm Circ. 2012;2:470–6.PubMedCentralCrossRefPubMed
66.
go back to reference Glagov S, Weisenberg E, Zarins CK, Stankunavicius R, Kolettis GJ. Compensatory enlargement of human atherosclerotic coronary arteries. N Engl J Med. 1987;316:1371–5.CrossRefPubMed Glagov S, Weisenberg E, Zarins CK, Stankunavicius R, Kolettis GJ. Compensatory enlargement of human atherosclerotic coronary arteries. N Engl J Med. 1987;316:1371–5.CrossRefPubMed
67.
go back to reference Slager CJ, Wentzel JJ, Gijsen FJ, Thury A, van der Wal AC, Schaar JA, et al. The role of shear stress in the generation of rupture-prone vulnerable plaques. Nat Clin Pract Cardiovasc Med. 2005;2:401–7.CrossRefPubMed Slager CJ, Wentzel JJ, Gijsen FJ, Thury A, van der Wal AC, Schaar JA, et al. The role of shear stress in the generation of rupture-prone vulnerable plaques. Nat Clin Pract Cardiovasc Med. 2005;2:401–7.CrossRefPubMed
68.
go back to reference Zarins C, Giddens D, Bharadvaj B, Sottiurai V, Mabon R, Glagov S. Carotid bifurcation atherosclerosis: quantitative correlation of plaque localization with flow velocity profiles and wall shear stress. Circ Res. 1983;53:502–14.CrossRefPubMed Zarins C, Giddens D, Bharadvaj B, Sottiurai V, Mabon R, Glagov S. Carotid bifurcation atherosclerosis: quantitative correlation of plaque localization with flow velocity profiles and wall shear stress. Circ Res. 1983;53:502–14.CrossRefPubMed
69.
go back to reference Zarins CK, Zatina MA, Giddens DP, Ku DN, Glagov S. Shear stress regulation of artery lumen diameter in experimental atherogenesis. J Vasc Surg. 1987;5:413–20.CrossRefPubMed Zarins CK, Zatina MA, Giddens DP, Ku DN, Glagov S. Shear stress regulation of artery lumen diameter in experimental atherogenesis. J Vasc Surg. 1987;5:413–20.CrossRefPubMed
70.
go back to reference Gijsen FJ, Wentzel JJ, Thury A, Mastik F, Schaar JA, Schuurbies JC, et al. A new imaging technique to study 3-D plaque and shear stress distribution in human coronary artery bifurcations in vivo. J Biomech. 2007;40:2349–57.CrossRefPubMed Gijsen FJ, Wentzel JJ, Thury A, Mastik F, Schaar JA, Schuurbies JC, et al. A new imaging technique to study 3-D plaque and shear stress distribution in human coronary artery bifurcations in vivo. J Biomech. 2007;40:2349–57.CrossRefPubMed
71.
go back to reference Samady H, Eshtehardi P, McDaniel MC, Suo J, Dhawan SS, Maynard C, et al. Coronary artery wall shear stress is associated with progression and transformation of atherosclerotic plaque and arterial remodeling in patients with coronary artery disease. Circulation. 2011;124:779–88.CrossRefPubMed Samady H, Eshtehardi P, McDaniel MC, Suo J, Dhawan SS, Maynard C, et al. Coronary artery wall shear stress is associated with progression and transformation of atherosclerotic plaque and arterial remodeling in patients with coronary artery disease. Circulation. 2011;124:779–88.CrossRefPubMed
72.
go back to reference Chatzizisis YS, Jonas M, Coskun AU, Beigel R, Stone BV, Maynard C, et al. Prediction of the localization of high-risk coronary atherosclerotic plaques on the basis of low endothelial shear stress: an intravascular ultrasound and histopathology natural history study. Circulation. 2008;117:993–1002.CrossRefPubMed Chatzizisis YS, Jonas M, Coskun AU, Beigel R, Stone BV, Maynard C, et al. Prediction of the localization of high-risk coronary atherosclerotic plaques on the basis of low endothelial shear stress: an intravascular ultrasound and histopathology natural history study. Circulation. 2008;117:993–1002.CrossRefPubMed
73.
go back to reference Papafaklis MI, Takahashi S, Antoniadis AP, Coskun AU, Tsuda M, Mizuno S, et al. Effect of the local hemodynamic environment on the de novo development and progression of eccentric coronary atherosclerosis in humans: insights from PREDICTION. Atherosclerosis. 2015;240:205–11.CrossRefPubMed Papafaklis MI, Takahashi S, Antoniadis AP, Coskun AU, Tsuda M, Mizuno S, et al. Effect of the local hemodynamic environment on the de novo development and progression of eccentric coronary atherosclerosis in humans: insights from PREDICTION. Atherosclerosis. 2015;240:205–11.CrossRefPubMed
74.
go back to reference Stone PH, Saito S, Takahashi S, Makita Y, Nakamura S, Kawasaki T, et al. Prediction of progression of coronary artery disease and clinical outcomes using vascular profiling of endothelial shear stress and arterial plaque characteristics: the PREDICTION Study. Circulation. 2012;126:172–81.CrossRefPubMed Stone PH, Saito S, Takahashi S, Makita Y, Nakamura S, Kawasaki T, et al. Prediction of progression of coronary artery disease and clinical outcomes using vascular profiling of endothelial shear stress and arterial plaque characteristics: the PREDICTION Study. Circulation. 2012;126:172–81.CrossRefPubMed
75.
go back to reference Kim HJ, Vignon-Clementel IE, Coogan JS, Figueroa CA, Jansen KE, Taylor CA. Patient-specific modeling of blood flow and pressure in human coronary arteries. Ann Biomed Eng. 2010;38:3195–209.CrossRefPubMed Kim HJ, Vignon-Clementel IE, Coogan JS, Figueroa CA, Jansen KE, Taylor CA. Patient-specific modeling of blood flow and pressure in human coronary arteries. Ann Biomed Eng. 2010;38:3195–209.CrossRefPubMed
76.
go back to reference van der Giessen AG, Wentzel JJ, Meijboom WB, Mollet NR, van der Steen AF, et al. Plaque and shear stress distribution in human coronary bifurcations: a multislice computed tomography study. EuroIntervention. 2009;4:654–61.CrossRefPubMed van der Giessen AG, Wentzel JJ, Meijboom WB, Mollet NR, van der Steen AF, et al. Plaque and shear stress distribution in human coronary bifurcations: a multislice computed tomography study. EuroIntervention. 2009;4:654–61.CrossRefPubMed
77.
go back to reference Jensen JM, Gormsen LC, Mølgaard H, Nørgaard BL. Noninvasive fractional flow reserve for the diagnosis of lesion specific ischemia: a case example. J Clin Imaging Sci. 2015;5:3.PubMedCentralCrossRefPubMed Jensen JM, Gormsen LC, Mølgaard H, Nørgaard BL. Noninvasive fractional flow reserve for the diagnosis of lesion specific ischemia: a case example. J Clin Imaging Sci. 2015;5:3.PubMedCentralCrossRefPubMed
Metadata
Title
Coronary Computed Tomography Angiography Derived Fractional Flow Reserve and Plaque Stress
Authors
Bjarne Linde Nørgaard
Jonathon Leipsic
Bon-Kwon Koo
Christopher K. Zarins
Jesper Møller Jensen
Niels Peter Sand
Charles A. Taylor
Publication date
01-01-2016
Publisher
Springer US
Published in
Current Cardiovascular Imaging Reports / Issue 1/2016
Print ISSN: 1941-9066
Electronic ISSN: 1941-9074
DOI
https://doi.org/10.1007/s12410-015-9366-5