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Combining CT Coronary Angiography and Myocardial Flow Reserve: Is It the Future?

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Molecular and Multimodality Imaging in Cardiovascular Disease

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Abstract

Coronary artery disease (CAD) is the leading cause of death in the Western world. An accurate and early diagnosis is therefore warranted to determine the presence and extent of disease to guide clinical management. Invasive coronary angiography (ICA), in conjunction with intracoronary pressure measurements for intermediate coronary lesions, is considered the reference standard for this purpose. With supreme temporal and spatial resolution, ICA provides reliable and accurate information on coronary luminal abnormalities. Furthermore, simultaneous assessment of fractional flow reserve (FFR) identifies patients who are eligible for revascularization, and FFR-driven percutaneous coronary intervention (PCI) improves outcome. The invasive nature and high costs, however, warrant noninvasive screening to act as gatekeeper for conventional angiography and select those patients in whom obstructive CAD is most likely.

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  1. Department of Cardiology, VU University Medical Center of Amsterdam, Amsterdam, The Netherlands

    Paul Knaapen MD

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  1. Johns Hopkins University, Radiology School of Medicine, Cardiovascular Nuclear Medicine, Baltimore, Maryland, USA

    Thomas H. Schindler

  2. Johns Hopkins University, School of Medicine, Cardiology, Baltimore, Maryland, USA

    Richard T. George

  3. Radiology and Epidemiology, Johns Hopkins University, School of Medicine, Cardiology, Baltimore, Maryland, USA

    Joao A.C. Lima

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Knaapen, P. (2015). Combining CT Coronary Angiography and Myocardial Flow Reserve: Is It the Future?. In: Schindler, T., George, R., Lima, J. (eds) Molecular and Multimodality Imaging in Cardiovascular Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-19611-4_11

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