Highlights
- •Fractional flow reserve (FFR) is the gold standard for revascularization in patients with stable coronary artery disease.
- •Application of computational fluid dynamics to computed tomography (CT) enables non-invasive calculation of FFR (FFRCT).
- •Numerous factors impact on FFRCT calculation as well as invasive FFR.
- •There is a gap in interpretation of FFRCT results between diagnostic studies and clinical studies.
Summary
Fractional flow reserve (FFR) is currently considered as the gold standard for revascularization
decision-making in patients with stable coronary artery disease (CAD). The application
of computational fluid dynamics to coronary computed tomography (CT) angiography (CCTA)
enables calculation of FFR without additional testing, radiation exposure, contrast
medium injection, and hyperemia (FFRCT). Although multiple diagnostic and clinical studies have enriched the scientific
evidence, it is still challenging to integrate FFRCT into clinical practice. Both meticulous scientific backgrounds and precise anatomical
data derived from CCTA are fundamental for FFRCT computation, and there are numerous factors impacting on FFRCT calculation and interpretation: coronary artery stenosis, calcium, atherosclerosis,
luminal volume, and left ventricular myocardial mass. Further, there is a gap that
clinicians using FFRCT need to recognize in interpretation of FFRCT results between diagnostic studies and clinical studies. In this review, we summarize
multiple evidence related to FFRCT computation and interpretation to refine the FFRCT strategy in patients with stable CAD.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: February 23, 2023
Accepted:
January 24,
2023
Received:
January 12,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
