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Rationale and design of the HeartFlowNXT (HeartFlow analysis of coronary blood flow using CT angiography: NeXt sTeps)

Sara Gaur1, Stephan Achenbach, Jonathon Leipsic

  • 1Department of Cardiology, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus N, Skejby, Denmark.

Journal of Cardiovascular Computed Tomography
|November 26, 2013
PubMed

Insights

Computed fractional flow reserve (FFRCT) from coronary CT angiography shows promise for identifying significant coronary artery disease. This study evaluates FFRCT

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Coronary CT angiography (CTA) visualizes coronary artery disease but lacks physiological information to identify ischemia-causing lesions.
  • Computed fractional flow reserve (FFRCT) from CTA images offers a noninvasive method to assess lesion-specific ischemia.
  • The diagnostic performance of FFRCT compared to invasive fractional flow reserve (FFR) requires further establishment.

Purpose of the Study:

  • To evaluate the diagnostic performance of FFRCT for detecting and excluding flow-limiting coronary stenoses.
  • To compare the diagnostic accuracy of FFRCT against coronary CTA alone in identifying hemodynamically significant coronary lesions.
  • To establish FFRCT as a reliable noninvasive tool for assessing coronary artery disease.

Main Methods:

  • Prospective, international, multicenter study (HeartFlowNXT) involving 270 subjects.
  • Coronary CTA and invasive coronary angiography with FFR performed on all participants.
  • Blinded core laboratory interpretation for FFRCT, invasive angiography, and FFR measurements.

Main Results:

  • The study aims to determine the diagnostic performance of FFRCT versus coronary CTA alone.
  • Secondary endpoints include assessment of diagnostic accuracy, sensitivity, specificity, PPV, and NPV of FFRCT.
  • FFR values ≤ 0.80 will define ischemia-causing lesions.

Conclusions:

  • FFRCT holds potential for noninvasively assessing hemodynamically significant coronary lesions.
  • This research will clarify the role of FFRCT in the diagnosis of coronary artery disease.
  • Establishing FFRCT's diagnostic performance is crucial for its clinical integration.
Abstract

Keywords:
Computational fluid dynamicsComputed tomographyCoronary CT angiographyCoronary artery diseaseFractional flow reserve

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