Computed Tomography-Derived Fractional Flow Reserve: Developing A Gold Standard for Coronary Artery Disease Diagnostics

Rev Cardiovasc Med. 2024 Oct 22;25(10):372. doi: 10.31083/j.rcm2510372. eCollection 2024 Oct.

Abstract

In recent years, a new technique called computed tomography-derived fractional flow reserve (CT-FFR) has been developed. CT-FFR overcomes many limitations in the current gold-standard fractional flow reserve (FFR) techniques while maintaining a better concordance with FFR. This technique integrates static coronary CT angiography data with hydrodynamic models, employing algorithms rather than guidewire interventions to compute the FFR. In addition to diagnosing coronary heart disease, CT-FFR has been applied in the preoperative risk assessment of major adverse cardiovascular events (MACEs) in organ transplantation and transcatheter aortic valve replacement (TAVR). Continuous advancements in CT-FFR techniques and algorithms are expanding their applicability to other methodologies. Subsequently, with robust clinical trial validation, CT-FFR can potentially supersede FFR as the primary "gatekeeper" for interventions.

Keywords: coronary CT angiography; coronary artery disease; coronary computed tomography angiography; fractional flow reserve.

Publication types

  • Review

Grants and funding

The grants for this study were supported stage-wise by the National Natural Science Foundation of China (grant no. 82260069), the China Postdoctoral Science Foundation (Grant No. 2021MD703817).