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Abstract：
Purpose This special report outlines a retrospective observational study of CT fractional flow reserve (CT-FFR) analysis using dual-source coronary CT angiography (CTA) scans performed without heart rate control and its impact on clinical outcomes. Materials and Methods All patients who underwent clinically indicated coronary CTA between August 2020 and August 2021 were included in this retrospective observational study. Scans were performed in the late systolic to early diastolic period without heart rate control and analyzed at the interpreting physician\'s discretion. Demographics, coronary CTA features, and rates of invasive coronary angiography (ICA), percutaneous coronary intervention (PCI), myocardial infarction, and all-cause death at 3 months were assessed by chart review. Results During the study period, 3098 patients underwent coronary CTA, of whom 113 with coronary bypass grafting were excluded. Of the remaining 2985 patients, 292 (9.7%) were referred for CT-FFR analysis. Two studies (0.7%) were rejected from CT-FFR analysis, and six (2.1%) analyses did not evaluate the lesion of concern. A total of 160 patients (56.3%) had CT-FFR greater than 0.80. Among patients with significant stenosis at coronary CTA, patients who underwent CT-FFR analysis presented with lower rates of ICA (74.5% vs 25.5%, P = .04) and PCI (78.9% vs 21.1%, P = .05). Conclusion CT-FFR was implemented in patients not requiring heart rate control by using dual-source coronary CTA acquisition and showed the potential to decrease rates of ICA and PCI without compromising safety in patients with significant stenosis and an average heart rate of 65 beats per minute. Keywords: Angiography, CT, CT-Angiography, Fractional Flow Reserve, Cardiac, Heart, Arteriosclerosis Supplemental material is available for this article. © RSNA, 2024.
摘要：
目的本特别报告概述了在不控制心率的情况下使用双源冠状动脉CT血管造影（CTA）扫描进行的CT血流储备分数（CT-FFR）分析的回顾性观察性研究及其对临床结果的影响。材料与方法所有在2020年8月至2021年8月期间接受临床诊断为冠状动脉CTA的患者均纳入本回顾性观察性研究。在没有心率控制的情况下，在收缩后期至舒张早期进行扫描，并在解释医师的判断下进行分析。人口统计,冠状动脉CTA特征，和侵入性冠状动脉造影（ICA）的比率，经皮冠状动脉介入治疗(PCI),心肌梗塞,和3个月时的全因死亡通过图表审查进行评估.结果在研究期间，3098例患者行冠状动脉CTA,其中113例冠状动脉旁路移植术被排除在外.在剩下的2985名患者中，292例（9.7%）转诊进行CT-FFR分析。两项研究（0.7%）被CT-FFR分析拒绝，6项(2.1%)分析未评估关注的病变.共有160例患者（56.3%）的CT-FFR大于0.80。在冠状动脉CTA明显狭窄的患者中，接受CT-FFR分析的患者ICA发生率较低(74.5%vs25.5%,P=.04）和PCI（78.9%vs21.1%，P=0.05）。结论CT-FFR是通过双源冠状动脉CTA采集在不需要心率控制的患者中实施的，并且显示出降低ICA和PCI速率的潜力，而不影响严重狭窄患者的安全性和平均心率为65次/分钟。关键词:血管造影术,CT,CT-血管造影,血流储备分数,心脏,心,动脉粥样硬化补充材料可用于本文。©RSNA,2024.
