Noninvasive Fractional Flow Reserve Derived From Coronary CT Angiography: Clinical Data and Scientific Principles

James K Min; Charles A Taylor; Stephan Achenbach; Bon Kwon Koo; Jonathon Leipsic; Bjarne L Nørgaard; Nico J Pijls; Bernard De Bruyne

doi:10.1016/j.jcmg.2015.08.006

Noninvasive Fractional Flow Reserve Derived From Coronary CT Angiography: Clinical Data and Scientific Principles

JACC Cardiovasc Imaging. 2015 Oct;8(10):1209-1222. doi: 10.1016/j.jcmg.2015.08.006.

Authors

James K Min¹, Charles A Taylor², Stephan Achenbach³, Bon Kwon Koo⁴, Jonathon Leipsic⁵, Bjarne L Nørgaard⁶, Nico J Pijls⁷, Bernard De Bruyne⁸

Affiliations

¹ Departments of Radiology and Medicine, Weill Cornell Medical College, New York, New York; Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital, New York, New York. Electronic address: jkm2001@med.cornell.edu.
² HeartFlow, Inc., Redwood City, California; Department of Bioengineering, Stanford University, Stanford, California.
³ Department of Cardiology, Erlangen University Hospital, Erlangen, Germany.
⁴ Department of Medicine, Seoul National University Hospital, Seoul, South Korea.
⁵ Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
⁶ Department of Medicine, Weill Cornell Medical Center, New York, New York; Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark.
⁷ Catharina Hospital, Eindhoven, the Netherlands.
⁸ Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium.

PMID: 26481846
DOI: 10.1016/j.jcmg.2015.08.006

Abstract

Fractional flow reserve derived from coronary computed tomography angiography enables noninvasive assessment of the hemodynamic significance of coronary artery lesions and coupling of the anatomic severity of a coronary stenosis with its physiological effects. Since its initial demonstration of feasibility of use in humans in 2011, a significant body of clinical evidence has developed to evaluate the diagnostic performance of coronary computed tomography angiography-derived fractional flow reserve compared with an invasive fractional flow reserve reference standard. The purpose of this paper was to describe the scientific principles and to review the clinical data of this technology recently approved by the U.S. Food and Drug Administration.

Keywords: FFR(CT); coronary CTA; coronary artery disease; fractional flow reserve; ischemia.

Publication types

Review

MeSH terms

Coronary Angiography / methods*
Coronary Artery Disease / diagnostic imaging*
Coronary Artery Disease / physiopathology
Coronary Vessels / diagnostic imaging*
Coronary Vessels / physiopathology
Fractional Flow Reserve, Myocardial*
Hemodynamics
Humans
Predictive Value of Tests
Prognosis
Reproducibility of Results
Tomography, X-Ray Computed*