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Atlas of Cardiovascular Computed Tomography pp 165–175Cite as

Functional Significance of Coronary Stenoses Identified by CT

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Abstract

Coronary CT angiography provides increasingly excellent anatomic detail of coronary stenosis, with a high sensitivity and negative predictive value for coronary artery disease (CAD). From the advent of this technology, however, concerns were raised regarding the limited specificity of the technology for determining which coronary stenoses cause myocardial ischemia [1]. This determination is important, as detection of ischemia is the cornerstone of “functional” testing for CAD, whether noninvasively through myocardial perfusion imaging (MPI) and stress echocardiography or invasively through fractional flow reserve (FFR) [2]. There was also hesitation that the highly sensitive anatomic detection of CAD by CT could lead to increased invasive downstream testing and revascularization, which was observed in CT trials [3, 4]. Functional imaging providing information about specific lesions or the subtended myocardium could potentially improve the value of a CT scan and its role as a gatekeeper to the catheterization laboratory [5]. As such, a major focus of CT research has been the devising of techniques to garner functional information from CT images. Early success augurs future progress in this area.

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References

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Acknowledgement

We appreciate the provision of images from Dr. Christopher K. Zarins, HeartFlow, Inc.

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Authors and Affiliations

  1. Department of Cardiology, Albany Medical Center, 47 New Scotland Avenue, Albany, NY, 12208, USA

    Joshua Schulman-Marcus

  2. Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA

    James K. Min

Authors
  1. Joshua Schulman-Marcus
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  2. James K. Min
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Correspondence to James K. Min .

Editor information

Editors and Affiliations

  1. Los Angeles Biomedical Research Institute, UCLA, Torrance, California, USA

    Matthew J. Budoff

  2. Department of Cardiology, Universitätsklinikum Erlangen, Erlangen, Germany

    Stephan S. Achenbach

  3. Mount Sinai Hospital, New York City, New York, USA

    Harvey S. Hecht

  4. Department of Cardiology , Mount Sinai Hospital, New York, New York, USA

    Jagat Narula

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Schulman-Marcus, J., Min, J.K. (2018). Functional Significance of Coronary Stenoses Identified by CT. In: Budoff, M., Achenbach, S., Hecht, H., Narula, J. (eds) Atlas of Cardiovascular Computed Tomography. Springer, London. https://doi.org/10.1007/978-1-4471-7357-1_9

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  • DOI: https://doi.org/10.1007/978-1-4471-7357-1_9

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  • Publisher Name: Springer, London

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  • Online ISBN: 978-1-4471-7357-1

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