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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Intravascular Imaging-Derived Physiology-Basic Principles and Clinical Application.

Annemieke C Ziedses des Plantes1, Alessandra Scoccia1, Frank Gijsen2

  • 1Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.

Cardiology Clinics
|November 10, 2023
PubMed
Summary

Intravascular imaging now offers simultaneous anatomic and functional assessment of lesions. This review covers new optical coherence tomography and intravascular ultrasound-based fractional flow reserve (FFR) indices, evaluating their performance and use.

Keywords:
Functional lesion assessmentIVUS-based FFROCT-based FFROFRPercutaneous coronary interventionVirtual FFR

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Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Physiology

Background:

  • Intravascular imaging provides anatomical detail of coronary lesions.
  • Functional assessment of lesions is crucial for guiding revascularization decisions.
  • Current methods for functional assessment can be invasive and time-consuming.

Purpose of the Study:

  • To review emerging intravascular imaging-derived physiological indices.
  • To summarize the diagnostic performance of these novel indices.
  • To discuss the clinical applications of intravascular imaging-based physiology.

Main Methods:

  • Literature review of studies on intravascular imaging-based physiological indices.
  • Analysis of computational fluid dynamics, fluid dynamics equations, and machine-learning methods for FFR calculation.
  • Evaluation of diagnostic accuracy and clinical utility.

Main Results:

  • Several optical coherence tomography (OCT) and intravascular ultrasound (IVUS) based fractional flow reserve (FFR) indices have been developed.
  • These indices utilize advanced modeling techniques for FFR computation.
  • Performance data on diagnostic accuracy is emerging for these novel tools.

Conclusions:

  • Intravascular imaging-derived physiology is a rapidly advancing field.
  • These tools promise simultaneous anatomic and functional assessment, potentially improving lesion management.
  • Further validation and clinical integration are expected.