Inge J van den Hoogen, Alexander R van Rosendael, Fay Y Lin, Jeroen J Bax, Leslee J Shaw, James K Min
{"title":"冠状动脉ct血管造影作为冠状动脉血运重建的看门人:强调狭窄以外的动脉粥样硬化发现。","authors":"Inge J van den Hoogen, Alexander R van Rosendael, Fay Y Lin, Jeroen J Bax, Leslee J Shaw, James K Min","doi":"10.1007/s12410-019-9497-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>Coronary computed tomography angiography (CCTA) is the optimal non-invasive test to rule out coronary artery disease (CAD). Decisions to perform coronary revascularization have traditionally been based upon ischemia testing. This review summarizes the latest observations and trials evaluating the suitability of CCTA to select patients for invasive coronary angiography (ICA) and subsequent revascularization.</p><p><strong>Recent findings: </strong>Recent data shows that beyond stenosis, whole-heart quantification and characterization of coronary atherosclerotic plaque improves the estimation of myocardial ischemia. This comprehensive evaluation of the coronary artery tree has greater diagnostic accuracy for invasive fractional flow reserve (FFR) than conventional stress tests. Further, clinical trials have demonstrated that the performance of CCTA in patients with a clinical indication for ICA results in more effective patient care and significantly lower costs.</p><p><strong>Summary: </strong>Besides the excellent ability to rule out CAD, recent data shows that quantification and characterization of the coronary artery tree results in high accuracy for ischemia and that CCTA-guided care to select patients for ICA and revascularization is effective. Trials evaluating revascularization based on CCTA findings may be needed.</p>","PeriodicalId":51842,"journal":{"name":"Current Cardiovascular Imaging Reports","volume":null,"pages":null},"PeriodicalIF":0.6000,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s12410-019-9497-1","citationCount":"3","resultStr":"{\"title\":\"Coronary Computed Tomography Angiography as a Gatekeeper to Coronary Revascularization: Emphasizing Atherosclerosis Findings Beyond Stenosis.\",\"authors\":\"Inge J van den Hoogen, Alexander R van Rosendael, Fay Y Lin, Jeroen J Bax, Leslee J Shaw, James K Min\",\"doi\":\"10.1007/s12410-019-9497-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose of review: </strong>Coronary computed tomography angiography (CCTA) is the optimal non-invasive test to rule out coronary artery disease (CAD). Decisions to perform coronary revascularization have traditionally been based upon ischemia testing. This review summarizes the latest observations and trials evaluating the suitability of CCTA to select patients for invasive coronary angiography (ICA) and subsequent revascularization.</p><p><strong>Recent findings: </strong>Recent data shows that beyond stenosis, whole-heart quantification and characterization of coronary atherosclerotic plaque improves the estimation of myocardial ischemia. This comprehensive evaluation of the coronary artery tree has greater diagnostic accuracy for invasive fractional flow reserve (FFR) than conventional stress tests. Further, clinical trials have demonstrated that the performance of CCTA in patients with a clinical indication for ICA results in more effective patient care and significantly lower costs.</p><p><strong>Summary: </strong>Besides the excellent ability to rule out CAD, recent data shows that quantification and characterization of the coronary artery tree results in high accuracy for ischemia and that CCTA-guided care to select patients for ICA and revascularization is effective. Trials evaluating revascularization based on CCTA findings may be needed.</p>\",\"PeriodicalId\":51842,\"journal\":{\"name\":\"Current Cardiovascular Imaging Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2019-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1007/s12410-019-9497-1\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Cardiovascular Imaging Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s12410-019-9497-1\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2019/5/14 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Cardiovascular Imaging Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12410-019-9497-1","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2019/5/14 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Coronary Computed Tomography Angiography as a Gatekeeper to Coronary Revascularization: Emphasizing Atherosclerosis Findings Beyond Stenosis.
Purpose of review: Coronary computed tomography angiography (CCTA) is the optimal non-invasive test to rule out coronary artery disease (CAD). Decisions to perform coronary revascularization have traditionally been based upon ischemia testing. This review summarizes the latest observations and trials evaluating the suitability of CCTA to select patients for invasive coronary angiography (ICA) and subsequent revascularization.
Recent findings: Recent data shows that beyond stenosis, whole-heart quantification and characterization of coronary atherosclerotic plaque improves the estimation of myocardial ischemia. This comprehensive evaluation of the coronary artery tree has greater diagnostic accuracy for invasive fractional flow reserve (FFR) than conventional stress tests. Further, clinical trials have demonstrated that the performance of CCTA in patients with a clinical indication for ICA results in more effective patient care and significantly lower costs.
Summary: Besides the excellent ability to rule out CAD, recent data shows that quantification and characterization of the coronary artery tree results in high accuracy for ischemia and that CCTA-guided care to select patients for ICA and revascularization is effective. Trials evaluating revascularization based on CCTA findings may be needed.
期刊介绍：
Cardiovascular imaging technologies now play an expanded role in clinical practice. Beyond the diagnosis of a disease process, these techniques are rapidly transitioning to help guide therapy. The journal aims to keep readers current with rapidly evolving advances in instrumentation and imaging procedures that support the expanded role of these technologies in clinical practice. The journal intends to place the entire area of cardiovascular imaging in its proper prospective by establishing the indications and limitations of each imaging technique and by summarizing recent clinical advances.
We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field, including cardiac magnetic resonance, nuclear imaging, echocardiography, cardiac computed tomography, intravascular, molecular, and hybrid imaging. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An Editorial Board of internationally diverse members ensures that topics include emerging research and suggests topics of special interest to their country/region. We also provide commentaries from well-known figures in the field.
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