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Related Concept Videos

Exercise Stress Test01:26

Exercise Stress Test

178
Introduction
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
178

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Related Experiment Video

Updated: Jun 13, 2025

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Selective FFRCT testing in suspected stable angina in clinical practice - initial experiences.

Shifan Thangavel1,2, Kristian Taekker Madsen3, Niels Peter Rønnow Sand3,4

  • 1Department of Cardiology, University Hospital of Southern Denmark, Vejle and Kolding, Denmark. Mohathan@rm.dk.

The International Journal of Cardiovascular Imaging
|September 11, 2024
PubMed
Summary

Coronary CT angiography (CTA) with fractional flow reserve (FFRCT) is feasible for guiding invasive coronary angiography decisions at referral hospitals. This approach reduced invasive procedures and increased revascularization rates in patients with suspected coronary artery disease.

Keywords:
Angina pectorisComputed tomographyCoronary angiographyMyocardial fractional flow reserveMyocardial revascularizationXray

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Area of Science:

  • Cardiology
  • Medical Imaging
  • Interventional Cardiology

Background:

  • Coronary CT angiography (CTA) derived fractional flow reserve (FFRCT) is recommended for assessing intermediate coronary stenosis.
  • Guiding referral to invasive coronary angiography (ICA) is crucial for optimal patient management.

Purpose of the Study:

  • To evaluate the real-world feasibility of implementing a CTA/FFRCT algorithm as a gatekeeper to ICA at referral hospitals.
  • To assess the impact of FFRCT on invasive procedure rates and revascularization outcomes.

Main Methods:

  • Retrospective study of 3974 patients with suspected coronary stenosis (30-89%) by CTA.
  • FFRCT analysis was performed by skilled CT-cardiologists.
  • Decisions for downstream testing (ICA or non-invasive imaging) were based on CTA and FFRCT results.

Main Results:

  • FFRCT was feasible in 98% of cases, with analysis rejected in only 2% due to image quality.
  • 71% of patients were deferred from ICA after FFRCT, while 27% were referred.
  • Revascularization rates were significantly higher in FFRCT-guided referrals compared to CTA-guided referrals for both 30-69% and 70-89% stenosis.

Conclusions:

  • Implementation of FFRCT at referral hospitals is feasible and effective.
  • The CTA/FFRCT algorithm successfully reduced invasive procedures.
  • FFRCT-guided referral increased appropriate revascularization rates in patients with obstructive coronary artery disease.