Discordance between Invasive and Non-Invasive Coronary Angiography: An In-Depth Functional and Anatomical Analysis

Shigetaka Kageyama; Kaoru Tanaka; Shinichiro Masuda; Momoko Kageyama; Scot Garg; Adam Updegrove; Johan De Mey; Mark La Meir; Yoshinobu Onuma; Patrick W. Serruys

doi:10.3390/biomedicines11030913

Discordance between Invasive and Non-Invasive Coronary Angiography: An In-Depth Functional and Anatomical Analysis

Shigetaka Kageyama
, Kaoru Tanaka
, Shinichiro Masuda
, Momoko Kageyama
, Scot Garg
, Adam Updegrove
, Johan De Mey
, Mark La Meir
, Yoshinobu Onuma
, Patrick W. Serruys

Medicine

University of Galway
Universitair Ziekenhuis Brussel
Royal Blackburn Hospital
HeartFlow, Inc.
Imperial College London

Research output: Contribution to a Journal (Peer & Non Peer) › Article › peer-review

1 Citation (Scopus)

Abstract

A 79-year-old male with chronic coronary syndrome with complex coronary artery disease was included in the first-in-man trial of surgical revascularization guided solely by coronary computed tomography angiography (CCTA) and fractional flow reserve derived from CCTA (FFR_CT). In CCTA analysis, the patient had calcified three-vessel disease, with a global anatomical SYNTAX score of 27. In contrast, in the initial FFR_CT, only the ramus intermediate stenosis was physiologically significant, with no other vessels having an FFR_CT ≤ 0.80 (functional SYNTAX score of 2). Discordance between the results of the CCTA and FFR_CT necessitated an in-depth analysis by using both invasive and non-invasive coronary angiography. Angiography-derived fractional flow reserve (FFR) confirmed that the stenosis in the proximal left anterior descending artery (LAD) was physiologically significant, while it remained functionally negative in the second assessment of FFR_CT. Extensive calcification is the most plausible explanation for the underestimation of the stenosis of proximal LAD in CCTA-derived FFR technology.

Original language	English
Article number	913
Journal	Biomedicines
Volume	11
Issue number	3
DOIs	https://doi.org/10.3390/biomedicines11030913
Publication status	Published - Mar 2023

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

CABG
coronary computed tomography angiography (CCTA)
fractional flow reserve derived from CCTA (FFR)
invasive coronary angiography
non-invasive coronary angiography

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10.3390/biomedicines11030913

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@article{12767e67f54c4fba84d51adb3a68cf12,

title = "Discordance between Invasive and Non-Invasive Coronary Angiography: An In-Depth Functional and Anatomical Analysis",

abstract = "A 79-year-old male with chronic coronary syndrome with complex coronary artery disease was included in the first-in-man trial of surgical revascularization guided solely by coronary computed tomography angiography (CCTA) and fractional flow reserve derived from CCTA (FFRCT). In CCTA analysis, the patient had calcified three-vessel disease, with a global anatomical SYNTAX score of 27. In contrast, in the initial FFRCT, only the ramus intermediate stenosis was physiologically significant, with no other vessels having an FFRCT ≤ 0.80 (functional SYNTAX score of 2). Discordance between the results of the CCTA and FFRCT necessitated an in-depth analysis by using both invasive and non-invasive coronary angiography. Angiography-derived fractional flow reserve (FFR) confirmed that the stenosis in the proximal left anterior descending artery (LAD) was physiologically significant, while it remained functionally negative in the second assessment of FFRCT. Extensive calcification is the most plausible explanation for the underestimation of the stenosis of proximal LAD in CCTA-derived FFR technology.",

keywords = "CABG, coronary computed tomography angiography (CCTA), fractional flow reserve derived from CCTA (FFR), invasive coronary angiography, non-invasive coronary angiography",

author = "Shigetaka Kageyama and Kaoru Tanaka and Shinichiro Masuda and Momoko Kageyama and Scot Garg and Adam Updegrove and \{De Mey\}, Johan and \{La Meir\}, Mark and Yoshinobu Onuma and Serruys, \{Patrick W.\}",

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year = "2023",

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doi = "10.3390/biomedicines11030913",

language = "English",

volume = "11",

journal = "Biomedicines",

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T1 - Discordance between Invasive and Non-Invasive Coronary Angiography

T2 - An In-Depth Functional and Anatomical Analysis

AU - Kageyama, Shigetaka

AU - Tanaka, Kaoru

AU - Masuda, Shinichiro

AU - Kageyama, Momoko

AU - Garg, Scot

AU - Updegrove, Adam

AU - De Mey, Johan

AU - La Meir, Mark

AU - Onuma, Yoshinobu

AU - Serruys, Patrick W.

PY - 2023/3

Y1 - 2023/3

N2 - A 79-year-old male with chronic coronary syndrome with complex coronary artery disease was included in the first-in-man trial of surgical revascularization guided solely by coronary computed tomography angiography (CCTA) and fractional flow reserve derived from CCTA (FFRCT). In CCTA analysis, the patient had calcified three-vessel disease, with a global anatomical SYNTAX score of 27. In contrast, in the initial FFRCT, only the ramus intermediate stenosis was physiologically significant, with no other vessels having an FFRCT ≤ 0.80 (functional SYNTAX score of 2). Discordance between the results of the CCTA and FFRCT necessitated an in-depth analysis by using both invasive and non-invasive coronary angiography. Angiography-derived fractional flow reserve (FFR) confirmed that the stenosis in the proximal left anterior descending artery (LAD) was physiologically significant, while it remained functionally negative in the second assessment of FFRCT. Extensive calcification is the most plausible explanation for the underestimation of the stenosis of proximal LAD in CCTA-derived FFR technology.

AB - A 79-year-old male with chronic coronary syndrome with complex coronary artery disease was included in the first-in-man trial of surgical revascularization guided solely by coronary computed tomography angiography (CCTA) and fractional flow reserve derived from CCTA (FFRCT). In CCTA analysis, the patient had calcified three-vessel disease, with a global anatomical SYNTAX score of 27. In contrast, in the initial FFRCT, only the ramus intermediate stenosis was physiologically significant, with no other vessels having an FFRCT ≤ 0.80 (functional SYNTAX score of 2). Discordance between the results of the CCTA and FFRCT necessitated an in-depth analysis by using both invasive and non-invasive coronary angiography. Angiography-derived fractional flow reserve (FFR) confirmed that the stenosis in the proximal left anterior descending artery (LAD) was physiologically significant, while it remained functionally negative in the second assessment of FFRCT. Extensive calcification is the most plausible explanation for the underestimation of the stenosis of proximal LAD in CCTA-derived FFR technology.

KW - CABG

KW - coronary computed tomography angiography (CCTA)

KW - fractional flow reserve derived from CCTA (FFR)

KW - invasive coronary angiography

KW - non-invasive coronary angiography

UR - https://www.scopus.com/pages/publications/85152009609

U2 - 10.3390/biomedicines11030913

DO - 10.3390/biomedicines11030913

M3 - Article

AN - SCOPUS:85152009609

SN - 2227-9059

VL - 11

JO - Biomedicines

JF - Biomedicines

IS - 3

M1 - 913

ER -

Discordance between Invasive and Non-Invasive Coronary Angiography: An In-Depth Functional and Anatomical Analysis

Abstract

UN SDGs

Keywords

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