Coronary Computed Tomographic Angiography for Complete Assessment of Coronary Artery Disease: JACC State-of-the-Art Review

被引:108
|
作者
Serruys, Patrick W. [1 ,2 ]
Hara, Hironori [1 ,3 ]
Garg, Scot [4 ]
Kawashima, Hideyuki [1 ,3 ]
Norgaard, Bjarne L. [5 ]
Dweck, Marc R. [6 ]
Bax, Jeroen J. [7 ]
Knuuti, Juhani [8 ,9 ]
Nieman, Koen [10 ,11 ]
Leipsic, Jonathon A. [12 ]
Mushtaq, Saima [13 ]
Andreini, Daniele [13 ,14 ]
Onuma, Yoshinobu [1 ]
机构
[1] Natl Univ Ireland, Galway NUIG, Dept Cardiol, Galway, Ireland
[2] Imperial Coll London, NHLI, London, England
[3] Univ Amsterdam, Dept Cardiol, Acad Med Ctr, Amsterdam, Netherlands
[4] Royal Blackburn Hosp, Dept Cardiol, Blackburn, Lancs, England
[5] Aarhus Univ Hosp, Dept Cardiol, Aarhus, Denmark
[6] Univ Edinburgh, Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland
[7] Leiden Univ, Med Ctr, Dept Cardiol, Leiden, Netherlands
[8] Turku Univ Hosp, Heart Ctr, Turku PET Ctr, Turku, Finland
[9] Univ Turku, Turku, Finland
[10] Stanford Univ, Sch Med, Dept Radiol, Stanford, CA USA
[11] Stanford Univ, Sch Med, Div Cardiovasc Med, Stanford, CA USA
[12] Univ British Columbia, Dept Med & Radiol, Vancouver, BC, Canada
[13] IRCCS, Ctr Cardiol Monzino, Milan, Italy
[14] Univ Milan, Cardiovasc Sect, Dept Clin Sci & Community Hlth, Milan, Italy
关键词
coronary plaque; coronary computed tomography angiography; coronary physiology; FRACTIONAL FLOW RESERVE; STABLE CHEST-PAIN; CT ANGIOGRAPHY; MYOCARDIAL-PERFUSION; DIAGNOSTIC-ACCURACY; PLAQUE CHARACTERISTICS; PRETEST PROBABILITY; RISK STRATIFICATION; SECONDARY ANALYSIS; CLINICAL-OUTCOMES;
D O I
10.1016/j.jacc.2021.06.019
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Coronary computed tomography angiography (CTA) has shown great technological improvements over the last 2 decades. High accuracy of CTA in detecting significant coronary stenosis has promoted CTA as a substitute for conven-tional invasive coronary angiography in patients with suspected coronary artery disease. In patients with coronary stenosis, CTA-derived physiological assessment is surrogate for intracoronary pressure and velocity wires, and renders possible decision-making about revascularization solely based on computed tomography. Computed tomography coro-nary anatomy with functionality assessment could potentially become a first line in diagnosis. Noninvasive imaging assessment of plaque burden and morphology is becoming a valuable substitute for intravascular imaging. Recently, wall shear stress and perivascular inflammation have been introduced. These assessments could support risk management for both primary and secondary cardiovascular prevention. Anatomy, functionality, and plaque composition by CTA tend to replace invasive assessment. Complete CTA assessment could provide a 1-stop-shop for diagnosis, risk management, and decision-making on treatment. (J Am Coll Cardiol 2021;78:713-736) (c) 2021 by the American College of Cardiology Foundation.
引用
收藏
页码:713 / 736
页数:24
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