While CCTA's performance as a diagnostic for identifying and excluding obstructive coronary stenoses is favorable, its predictive value for identifying lesions that cause ischemia has been less reliable. FFR, on the other hand, has been shown to be a useful tool for interventional cardiologists for assessing ischemia-specific lesions and for deciding to proceed to revascularization.
In an effort to achieve the benefits of both approaches, Bon-Kwon Koo, MD, PhD, of the department of medicine at Seoul National University Hospital in Seoul, South Korea, and colleagues applied computational fluid dynamics (CFD) to CCTA images to predict blood flow and pressure in coronary arteries to calculate lesion-specific FFR. The technique, which they call FFRCT, requires no additional scans, medications, or changes to protocols.
They used the international prospective DISCOVER-FLOW (Diagnosis of Ischemia-Causing Stenoses Obtained Via Noninvasive Fractional Flow Reserve) study, which enrolled patients with suspected or known coronary artery disease (CAD) at four sites. From that study group they identified 103 stable patients (159 vessels total) who were 18 years old or older, had undergone CCTA, invasive coronary angiography (ICA) and FFR between Oct. 13, 2009, and Jan. 14, 2011. Based on the CCTA, each had stenosis of 50 percent or greater in a major coronary artery and a diameter greater or equal to 2 mm.
Read the full article at Cardiovascular Business.