Coronary CT Angiography Derived Fractional Flow Reserve: The Game Changer in Noninvasive Testing

• Published in: Current cardiology reports Vol. 19; no. 11; p. 112
• Main Authors: Nørgaard, Bjarne Linde, Jensen, Jesper Møller, Blanke, Philipp, Sand, Niels Peter, Rabbat, Mark, Leipsic, Jonathon
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.11.2017
• Subjects: Cardiac PET; Cardiology; Computed Tomography Angiography - economics; Computed Tomography Angiography - utilization; Coronary Angiography - economics; Coronary Angiography - methods; Coronary Angiography - utilization; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - therapy; Fractional Flow Reserve, Myocardial; Humans; Medicine; Medicine & Public Health; MRI; MRI (F Pugliese and SE Petersen; Multicenter Studies as Topic; Prospective Studies; Section Editors; Topical Collection on Cardiac PET; coronary computed tomography angiography; Coronary artery disease; fractional flow reserve
• ISSN: 1523-3782; 1534-3170
• DOI: 10.1007/s11886-017-0923-1

Purpose of Review To summarize the scientific basis of CT derived fractional flow reserve (FFR CT ) and present an updated review on the evidence from clinical trials and real-world observational data Recent Findings In prospective multicenter studies of patients with stable coronary artery disease (CAD), FFR CT showed high diagnostic performance. More recently, FFR CT has advanced to the realm of clinical utility and real-world clinical practice with emerging data showing that FFR CT when compared to standard care is efficient in safely reducing downstream utilization of invasive coronary angiography (ICA), and costs, as well as improving the diagnostic yield of ICA. Moreover, FFR CT may broaden applicability of frontline coronary CTA testing to patients with high pre-test risk of CAD. Summary Introducing FFR CT into clinical practice has the potential to significantly improve the management of patients with stable CAD. The optimal FFR CT testing interpretation strategy, as well as the relative cost-efficiency of FFR CT against standard noninvasive functional testing, need further investigation.