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Noninvasive FFR derived from coronary CT angiography in the management of coronary artery disease: technology and clinical update

Authors Nakanishi R, Budoff M

Received 18 September 2015

Accepted for publication 29 February 2016

Published 22 June 2016 Volume 2016:12 Pages 269—278

DOI https://doi.org/10.2147/VHRM.S79632

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Jaya Mallela

Peer reviewer comments 4

Editor who approved publication: Dr Daniel Duprez


Rine Nakanishi, Mathew J Budoff

Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA

Abstract: After a decade of clinical use of coronary computed tomographic angiography (CCTA) to evaluate the anatomic severity of coronary artery disease, new methods of deriving functional information from CCTA have been developed. These methods utilize the anatomic information provided by CCTA in conjunction with computational fluid dynamics to calculate fractional flow reserve (FFR) values from CCTA image data sets. Computed tomography-derived FFR (CT-FFR) enables the identification of lesion-specific drop noninvasively. A three-dimensional CT-FFR modeling technique, which provides FFR values throughout the coronary tree (HeartFlow FFRCT analysis), has been validated against measured FFR and is now approved by the US Food and Drug Administration for clinical use. This technique requires off-site supercomputer analysis. More recently, a one-dimensional computational analysis technique (Siemens cFFR), which can be performed on on-site workstations, has been developed and is currently under investigation. This article reviews CT-FFR technology and clinical evidence for its use in stable patients with suspected coronary artery disease.

Keywords: fractional flow reserve, coronary computed tomographic angiography, FFRCT, cFFR

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