|
1
|
Wu J, Yang D, Zhang Y, Xian H, Weng Z, Ji L, Yang F. Non-invasive imaging innovation: FFR-CT combined with plaque characterization, safeguarding your cardiac health. J Cardiovasc Comput Tomogr 2024:S1934-5925(24)00433-7. [PMID: 39299900 DOI: 10.1016/j.jcct.2024.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 08/27/2024] [Accepted: 08/29/2024] [Indexed: 09/22/2024]
Abstract
Studies have shown that high-risk plaque features (including thin fibrous caps, lipid-rich cores, large plaque volumes, and intraplaque microcalcifications) are closely associated with the occurrence of acute coronary events. CT-derived fractional flow reserve (CT-FFR) is a non-invasive imaging post-processing technique that utilizes artificial intelligence to analyze data obtained from conventional coronary CT angiography (CCTA). FFR-CT technology offers the hemodynamic assessment of coronary lesions, aiding in the prediction of potential cardiovascular risks. This review summarizes the latest research progress on the complex relationship between FFR-CT, plaque characteristics, and hemodynamics, closely linking plaque volume, composition, and distribution with the clinical significance of coronary artery stenosis. It is hoped that these research findings will provide valuable guidance for clinicians, promoting the application of CT in the non-invasive detection of vulnerable plaques, thereby more effectively preventing and managing coronary artery disease. In the future, further optimization of FFR-CT technology and expansion of its clinical application are expected to significantly reduce the incidence and mortality of coronary artery disease, offering new hope for the prevention and treatment of cardiovascular diseases.
Collapse
Affiliation(s)
- Jianjun Wu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China; Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China
| | - Dawei Yang
- Department of Orthopedics, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Youqi Zhang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China; Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China
| | - Huimin Xian
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Ziqian Weng
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Liu Ji
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China; Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China
| | - Fan Yang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China; Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China.
| |
Collapse
|
|
2
|
Teira Calderón A, Sorrolla Romero J, Echavarria-Pinto M, Hussain B, Diez Gil JL, Martinez Dolz L, Sanz Sánchez J, Garcia-Garcia HM. Does fractional flow reserve impact on clinical outcomes by reducing number of stents and contrast media? Findings from a systematic review (N = 56,185) and meta-analysis. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2024; 62:135-136. [PMID: 38171984 DOI: 10.1016/j.carrev.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/09/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Affiliation(s)
| | | | | | - Bilal Hussain
- Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY, United States of America
| | - José Luis Diez Gil
- Hospital Universitari i Politecnic La Fe, Valencia, Spain; Centro de Investigación Biomedica en Red (CIBERCV), Madrid, Spain
| | - Luis Martinez Dolz
- Hospital Universitari i Politecnic La Fe, Valencia, Spain; Centro de Investigación Biomedica en Red (CIBERCV), Madrid, Spain
| | - Jorge Sanz Sánchez
- Hospital Universitari i Politecnic La Fe, Valencia, Spain; Centro de Investigación Biomedica en Red (CIBERCV), Madrid, Spain.
| | | |
Collapse
|
|
3
|
Improta R, Di Pietro G, Giansanti M, Bruno F, De Filippo O, Tocci M, Colantonio R, Sardella G, D’Ascenzo F, Mancone M. Comparison between Imaging and Physiology in Guiding Coronary Revascularization: A Meta-Analysis. J Clin Med 2024; 13:2504. [PMID: 38731033 PMCID: PMC11084876 DOI: 10.3390/jcm13092504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Percutaneous coronary intervention (PCI) is a widely used revascularization strategy for coronary artery disease. The choice between imaging-guided and physiology-guided PCI has been a subject of debate. This meta-analysis aims to systematically compare outcomes between imaging and physiology-guided PCI and management of intermediate coronary lesions (ICLs). Methods: A comprehensive literature search was conducted across major databases for studies published up to December 2023 following PRISMA guidelines. Seven eligible studies comparing imaging-guided and physiology-guided PCI were selected for the final analysis. Relevant outcome measures included major adverse cardiovascular events (MACE), target vessel revascularization (TVR), target vessel failure (TVF), and target lesion revascularization (TLR). Subgroup analysis was performed for ICLs. Results: A total of 5701 patients were included in the meta-analysis. After a mean follow-up of 2.1 years, imaging-guided PCI was associated with lower rates of TVR compared to physiology-guided PCI (OR 0.70, 95% CI 0.52-0.95, p = 0.02); concerning MACE, TVF, and TLR, no differences were found. When the analysis was restricted to studies considering ICLs management, there were no differences between the two techniques. Meta regression analysis did not show any impact of acute coronary syndromes (ACS) presentation on MACE and TVR. Conclusions: The findings suggest that imaging-guided PCI may reduce the need for future revascularization of the target vessel compared to the functional-guided approach, and this result was not influenced by ACS presentation. These results may have important implications for clinical practice, guiding interventional cardiologists in selecting the most appropriate guidance strategy.
Collapse
Affiliation(s)
- Riccardo Improta
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155 (Emodinamica A, Ottavo Padiglione, II Piano), 00161 Rome, Italy; (R.I.); (G.D.P.); (M.T.); (R.C.); (G.S.)
| | - Gianluca Di Pietro
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155 (Emodinamica A, Ottavo Padiglione, II Piano), 00161 Rome, Italy; (R.I.); (G.D.P.); (M.T.); (R.C.); (G.S.)
| | - Michele Giansanti
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155 (Emodinamica A, Ottavo Padiglione, II Piano), 00161 Rome, Italy; (R.I.); (G.D.P.); (M.T.); (R.C.); (G.S.)
| | - Francesco Bruno
- Department of Medical Science, Division of Cardiology, Molinette Hospital, Turin University, 10124 Turin, Italy; (F.B.); (O.D.F.); (F.D.)
| | - Ovidio De Filippo
- Department of Medical Science, Division of Cardiology, Molinette Hospital, Turin University, 10124 Turin, Italy; (F.B.); (O.D.F.); (F.D.)
| | - Marco Tocci
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155 (Emodinamica A, Ottavo Padiglione, II Piano), 00161 Rome, Italy; (R.I.); (G.D.P.); (M.T.); (R.C.); (G.S.)
| | - Riccardo Colantonio
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155 (Emodinamica A, Ottavo Padiglione, II Piano), 00161 Rome, Italy; (R.I.); (G.D.P.); (M.T.); (R.C.); (G.S.)
| | - Gennaro Sardella
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155 (Emodinamica A, Ottavo Padiglione, II Piano), 00161 Rome, Italy; (R.I.); (G.D.P.); (M.T.); (R.C.); (G.S.)
| | - Fabrizio D’Ascenzo
- Department of Medical Science, Division of Cardiology, Molinette Hospital, Turin University, 10124 Turin, Italy; (F.B.); (O.D.F.); (F.D.)
| | - Massimo Mancone
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155 (Emodinamica A, Ottavo Padiglione, II Piano), 00161 Rome, Italy; (R.I.); (G.D.P.); (M.T.); (R.C.); (G.S.)
| |
Collapse
|