Impact of sublingual nitroglycerin dosage on FFRCT assessment and coronary luminal volume–to–myocardial mass ratio

Holmes, Kate; Fonte, Tim A.; Weir‐McCall, Jonathan R.; Anastasius, Malcolm; Blanke, Philipp; Payne, Geoffrey W.; Ellis, Jen; Murphy, Darra; Taylor, Charles A.; Leipsic, Jonathon; Sellers, Stephanie

doi:10.1007/s00330-019-06293-7

Cited by 16 publications

(12 citation statements)

References 25 publications

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“…Improvements in CTCA image quality with routine nitroglycerin and heart-rate control, in addition to advances in post-imaging data analysis have been important in optimizing the calculation of coronary luminal volume. 68 However, the spatial resolution of CTCA remains an intrinsic limitation and prohibits the complete visualization of the coronary vasculature. 19 Recently, algorithms have been developed that allow for the generation of synthetic patient-specific coronary vascular networks from the segmented epicardial vessels down to the microvascular arterioles.…”

Section: Future Directionsmentioning

confidence: 99%

Cardiac computed tomography-derived coronary artery volume to myocardial mass

Ihdayhid

Fairbairn

Gulsin

et al. 2022

Journal of Cardiovascular Computed Tomography

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Section: Future Directionsmentioning

confidence: 99%

Cardiac computed tomography-derived coronary artery volume to myocardial mass

Ihdayhid

Fairbairn

Gulsin

et al. 2022

Journal of Cardiovascular Computed Tomography

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“…However, no optimal nitroglycerin dose was recommended. One study has shown that there was no statistical difference in the influence of sublingual nitroglycerin at 0.8 mg and 0.4 mg in conventional clinical CCTA on CT-FFR values 36. In addition, diastolic image acquisition was recommended for CT-FFR measurement in patients with a lower heart rate.…”

Section: Ct-ffr Application Interpretationsmentioning

confidence: 99%

Coronary Computed Tomography Angiography–derived Fractional Flow Reserve

Zhang

Tang

et al. 2022

Journal of Thoracic Imaging

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Invasive fractional flow reserve (FFR) measured by a pressure wire is a reference standard for evaluating functional stenosis in coronary artery disease. Coronary computed tomography angiography-derived fractional flow reserve (CT-FFR) uses advanced computational analysis methods to noninvasively obtain FFR results from a single conventional coronary computed tomography angiography data to evaluate the hemodynamic significance of coronary artery disease. More and more evidence has found good correlation between the results of noninvasive CT-FFR and invasive FFR. CT-FFR has proven its potential in optimizing patient management, improving risk stratification and prognosis, and reducing total health care costs. However, there is still a lack of standardized interpretation of CT-FFR technology in real-world clinical settings. This expert consensus introduces the principle, workflow, and interpretation of CT-FFR; summarizes the stateof-the-art application of CT-FFR; and provides suggestions and recommendations for the application of CT-FFR with the aim of promoting the standardized application of CT-FFR in clinical practice.

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“…NTG and adenosine take effects on different positions of the coronary artery. NTG is also known to affect the diameter of the perfused artery on CCTA 57 . There are some studies about the physiological effects of NTG and adenosine on coronary arteries.…”

Section: Limitationsmentioning

confidence: 99%

Coronary CT angiography-based estimation of myocardial perfusion territories for coronary artery FFR and wall shear stress simulation

Hsieh

Lee

Wang

et al. 2021

Sci Rep

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This study aims to apply a CCTA-derived territory-based patient-specific estimation of boundary conditions for coronary artery fractional flow reserve (FFR) and wall shear stress (WSS) simulation. The non-invasive simulation can help diagnose the significance of coronary stenosis and the likelihood of myocardial ischemia. FFR is often regarded as the gold standard to evaluate the functional significance of stenosis in coronary arteries. In another aspect, proximal wall shear stress ($$\mathrm{{WSS}_{prox}}$$ WSS prox ) can also be an indicator of plaque vulnerability. During the simulation process, the mass flow rate of the blood in coronary arteries is one of the most important boundary conditions. This study utilized the myocardium territory to estimate and allocate the mass flow rate. 20 patients are included in this study. From the knowledge of anatomical information of coronary arteries and the myocardium, the territory-based FFR and the $$\mathrm{{WSS}_{prox}}$$ WSS prox can both be derived from fluid dynamics simulations. Applying the threshold of distinguishing between significant and non-significant stenosis, the territory-based method can reach the accuracy, sensitivity, and specificity of 0.88, 0.90, and 0.80, respectively. For significantly stenotic cases ($$\mathrm{FFR}_{m}$$ FFR m $$\le$$ ≤ 0.80), the vessels usually have higher wall shear stress in the proximal region of the lesion.

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Impact of sublingual nitroglycerin dosage on FFRCT assessment and coronary luminal volume–to–myocardial mass ratio

Cited by 16 publications

References 25 publications

Cardiac computed tomography-derived coronary artery volume to myocardial mass

Cardiac computed tomography-derived coronary artery volume to myocardial mass

Coronary Computed Tomography Angiography–derived Fractional Flow Reserve

Coronary CT angiography-based estimation of myocardial perfusion territories for coronary artery FFR and wall shear stress simulation

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