title: Determining the haemodynamic significance of arterial stenosis: the relationship between CT angiography, computational fluid dynamics, and non-invasive fractional flow reserve.
abstract: Coronary artery disease causes significant morbidity and mortality worldwide. Invasive coronary angiography (ICA) is currently the reference standard investigation. Fractional flow reserve (FFR) complements traditional ICA by providing extra information on blood flow, which has convincingly led to better patient management and improved cost-effectiveness. Computed tomography coronary angiography (CTCA) is suitable for the investigation of chest pain, especially in the low- and intermediate-risk groups. FFR generated using CT data (producing FFRCT) may improve the positive predictive value of CTCA. The basic science of FFRCT is like a "black box" to most imaging professionals. A fundamental principle is that good quality CTCA is likely to make any post-processing easier and more reliable. Both diagnostic and observational studies have suggested that the accuracy and the short-term outcome of using FFRCT are both comparable with FFR in ICA. More multidisciplinary research with further refined diagnostic and longer-term observational studies will hopefully pinpoint the role of FFRCT in existing clinical pathways.
authors.affiliation: Plymouth NHS Hospital Trust, Plymouth, UK; Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth University, UK. Electronic address: c.pang@doctors.org.uk.
authors.forename: C L
authors.initials: CL
authors.lastname: Pang
authors.affiliation: Plymouth NHS Hospital Trust, Plymouth, UK.
authors.forename: R
authors.initials: R
authors.lastname: Alcock
authors.affiliation: Plymouth NHS Hospital Trust, Plymouth, UK.
authors.forename: N
authors.initials: N
authors.lastname: Pilkington
authors.affiliation: School of Computing, Electronics and Mathematics, Plymouth University, UK.
authors.forename: T
authors.initials: T
authors.lastname: Reis
authors.affiliation: Plymouth NHS Hospital Trust, Plymouth, UK; Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth University, UK.
authors.forename: C
authors.initials: C
authors.lastname: Roobottom
mesh_terms: D000072226:Computed Tomography Angiography / Q000379:methods*; D003198:Computer Simulation; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D053805:Fractional Flow Reserve, Myocardial; D018056:Hemorheology; D006801:Humans; D057446:Hydrodynamics; D008955:Models, Cardiovascular; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods