Coronary Physiology-Based Approaches for Plaque Vulnerability: Implications for Risk Prediction and Treatment Strategies

Abstract

Author's summary While coronary physiology and plaque vulnerability have been considered distinct attributes of coronary artery disease, evaluated from different diagnostic modalities, clinical data and underlying pathophysiology have demonstrated that there is a strong connection between hemodynamic properties and vulnerable plaque. This link suggests that using invasive physiological indexes to identify functional significance may also be somewhat useful in detecting plaque vulnerability. Furthermore, emerging data have suggested the independent and synergistic prognostic value between a physiology-based approach and a plaque-based approach, and understanding the prognostic relevance between the two can optimize risk prediction and treatment decision-making.

Diagnostic Performance of On-Site Automatic Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve

“… 3) 6) With the advancement of technology, FFR can be noninvasively computed from CCTA and numerous studies have demonstrated a good correlation between invasive FFR and CCTA-derived FFR (CT-FFR) and its incremental information on practical decision-making. 7) 8) 9) 10) 11) 12) 13) 14) However, previous methods need the transfer of CCTA data to external facilities, supercomputing, and waiting times for processing. Several algorithms have been developed to mitigate these limitations and enable these processes on-site.…”