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Non-invasive fractional flow reserve derived from coronary computed tomography angiography in patients with acute chest pain: Subgroup analysis of the ROMICAT II trial.
Ferencik, Maros; Lu, Michael T; Mayrhofer, Thomas; Puchner, Stefan B; Liu, Ting; Maurovich-Horvat, Pal; Ghemigian, Khristine; Ivanov, Alexander; Adami, Elizabeth; Nagurney, John T; Woodard, Pamela K; Truong, Quynh A; Udelson, James E; Hoffmann, Udo.
Afiliación
  • Ferencik M; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. Elec
  • Lu MT; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Mayrhofer T; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; School of Business Studies, Stralsund University of Applied Sciences, Stralsund, Germany.
  • Puchner SB; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna,
  • Liu T; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, China.
  • Maurovich-Horvat P; MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Centre, Semmelweis University, Budapest, Hungary.
  • Ghemigian K; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Ivanov A; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Adami E; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Nagurney JT; Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Woodard PK; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
  • Truong QA; Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA.
  • Udelson JE; Division of Cardiology and the Cardio-Vascular Center, Tufts Medical Center, Boston, MA, USA.
  • Hoffmann U; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
J Cardiovasc Comput Tomogr ; 13(4): 196-202, 2019.
Article en En | MEDLINE | ID: mdl-31113728
BACKGROUND: Non-invasive fractional flow reserve (FFRCT) derived from coronary computed tomography angiography (CTA) permits hemodynamic evaluation of coronary stenosis and may improve efficiency of assessment in stable chest pain patients. We determined feasibility of FFRCT in the population of acute chest pain patients and assessed the relationship of FFRCT with outcomes of acute coronary syndrome (ACS) and revascularization and with plaque characteristics. METHODS: We included 68 patients (mean age 55.8 ±â€¯8.4 years, 71% men) from the ROMICAT II trial who had ≥50% stenosis on coronary CTA or underwent additional non-invasive stress test. We evaluated coronary stenosis and high-risk plaque on coronary CTA. FFRCT was measured in a core laboratory. RESULTS: We found correlation between anatomic severity of stenosis and FFRCT ≤0.80 vs. FFRCT >0.80 (severe stenosis 84.8% vs. 15.2%; moderate stenosis 33.3% vs. 66.7%; mild stenosis 33.3% vs. 66.7% patients). Patients with severe stenosis had lower FFRCT values (median 0.64, 25th-75th percentile 0.50-0.75) as compared to patients with moderate (median 0.84, 25th-75th percentile, p < 0.001) or mild stenosis (median 0.86, 25th-75th percentile 0.78-0.88, p < 0.001). The relative risk of ACS and revascularization in patients with positive FFRCT ≤0.80 was 4.03 (95% CI 1.56-10.36) and 3.50 (95% CI 1.12-10.96), respectively. FFRCT ≤0.80 was associated with the presence of high-risk plaque (odds ratio 3.91, 95% CI 1.55-9.85, p = 0.004) after adjustment for stenosis severity. CONCLUSION: Abnormal FFRCT was associated with the presence of ACS, coronary revascularization, and high-risk plaque. FFRCT measurements correlated with anatomic severity of stenosis on coronary CTA and were feasible in population of patients with acute chest pain.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Angiografía Coronaria / Estenosis Coronaria / Reserva del Flujo Fraccional Miocárdico / Síndrome Coronario Agudo / Angiografía por Tomografía Computarizada / Angina de Pecho Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: J Cardiovasc Comput Tomogr Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / RADIOLOGIA Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Angiografía Coronaria / Estenosis Coronaria / Reserva del Flujo Fraccional Miocárdico / Síndrome Coronario Agudo / Angiografía por Tomografía Computarizada / Angina de Pecho Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: J Cardiovasc Comput Tomogr Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / RADIOLOGIA Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos