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[Diagnosis of stable coronary artery disease with non-invasive FFR: myth or reality?]

M Tapponnier1, J-F lglesias, E Eeckhout

  • 1Unité de cardiologie interventionnelle, Service de cardiologie, CHUV, 1011 Lausanne. maxime.tapponnier@chuv.ch

Revue Medicale Suisse
|June 25, 2013
PubMed

Insights

Fractional flow reserve computed from CT scans (FFRcT) shows promise for detecting myocardial ischemia in patients with coronary artery disease. This non-invasive method may improve diagnostic accuracy compared to standard CT scans, though further development is needed.

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Medical Diagnostics

Background:

  • Revascularization decisions in stable coronary artery disease (CAD) hinge on detecting myocardial ischemia.
  • Assessing intermediate coronary stenosis severity and its functional impact often necessitates invasive methods like fractional flow reserve (FFR).

Purpose of the Study:

  • To evaluate the diagnostic performance of a novel computer-based method for measuring FFR using standard coronary CT scan data (FFRcT).
  • To compare the accuracy of FFRcT against standard coronary CT angiography for detecting significant myocardial ischemia.

Main Methods:

  • A computer-based algorithm was developed to calculate FFR (FFRcT) from data acquired during coronary CT scans.
  • The diagnostic performance of FFRcT was assessed in recent clinical studies, including DeFACTO and DISCOVER-FLOW.

Main Results:

  • FFRcT demonstrated improved diagnostic accuracy in detecting myocardial ischemia compared to standard coronary CT angiography.
  • Clinical studies indicate FFRcT's potential to aid in revascularization decisions for intermediate coronary stenosis.

Conclusions:

  • FFRcT represents a promising non-invasive approach for assessing the functional significance of coronary stenosis.
  • While FFRcT shows enhanced diagnostic capabilities, further research and development are required for widespread clinical adoption.

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