Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Imaging

Can FFRCT replace old indices of coronary stenosis severity?

The NXT trial supports the value of computational fluid dynamics applied to the digitally reconstructed coronary tree as a noninvasive method of identifying ischaemia-generating stenoses. The results of the study also suggest that old indices of angiographic severity used in clinical practice, such as percent diameter stenosis, might become obsolete.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Assessment of coronary stenosis relevance performed with different angiographic modalities.

References

  1. van de Hoef, T. P. et al. Fractional flow reserve as a surrogate for inducible myocardial ischaemia. Nat. Rev. Cardiol. 10, 439–452 (2013).

    Article  Google Scholar 

  2. Nørgaard, B. L. et al. Diagnostic performance of non-invasive fractional flow reserve derived from coronary CT angiography in suspected coronary artery disease: the NXT trial. J. Am. Coll. Cardiol. http://dx.doi.org/10.1016/j.jacc.2013.11.043.

  3. Gonzalo, N. et al. Morphometric assessment of coronary stenosis relevance with optical coherence tomography: a comparison with fractional flow reserve and intravascular ultrasound. J. Am. Coll. Cardiol. 59, 1080–1089 (2012).

    Article  Google Scholar 

  4. Kirkeeide, R. L., Gould, K. L. & Parsel, L. Assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilation. VII. Validation of coronary flow reserve as a single integrated functional measure of stenosis severity reflecting all its geometric dimensions. J. Am. Coll. Cardiol. 7, 103–113 (1986).

    Article  CAS  Google Scholar 

  5. Schuleri, K. H., George, R. T. & Lardo, A. C. Applications of cardiac multidetector CT beyond coronary angiography. Nat. Rev. Cardiol. 6, 699–710 (2009).

    Article  Google Scholar 

  6. Koo, B. K. et al. Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms. Results from the prospective multicenter DISCOVER-FLOW (Diagnosis of Ischemia-Causing Stenoses Obtained Via Noninvasive Fractional Flow Reserve) study. J. Am. Coll. Cardiol. 58, 1989–1997 (2011).

    Article  Google Scholar 

  7. Min, J. K. et al. Diagnostic accuracy of fractional flow reserve from anatomic CT angiography. JAMA 308, 1237–1245 (2012).

    Article  CAS  Google Scholar 

  8. Blankstein, R. & Di Carli, M. F. Integration of coronary anatomy and myocardial perfusion imaging. Nat. Rev. Cardiol. 7, 226–236 (2010).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Javier Escaned.

Ethics declarations

Competing interests

The author declares no competing financial interests.

PowerPoint slides

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Escaned, J. Can FFRCT replace old indices of coronary stenosis severity?. Nat Rev Cardiol 11, 252–254 (2014). https://doi.org/10.1038/nrcardio.2014.41

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrcardio.2014.41

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing