Coronary Artery Disease Clinical Trial
Official title:
Myocardial Mass Determination of the Different Coronary Territories by FFRct and Invasive Measurement of Absolute Coronary Blood Flow. A Clinical Registry
The background for performing the present study is to compare the mass calculations by CT scanning and by invasive absolute blood flow measurements and thereby corroborating both methods.
Although knowledge about the myocardial mass (in grams) of the different territories
belonging to the major coronary arteries, is of clinical importance to estimate risk of
coronary interventions (PCI, CABG) and to determine area of necrosis after myocardial
infarction, no invasive methodology has been available so far for reliable assessment of
mass.
Especially in the setting of percutaneous coronary intervention (PCI), it would be valuable
to have information about the absolute and relative myocardial mass distal to the location
where the intervention is planned. Such information is valuable for risk estimation and can
also be helpful in multivessel disease to determine the most adequate way of
revascularization.
Both MRI and CT scanning have claimed to be able to estimate myocardial mass non-invasively,
but by the lack of any gold standard, none of these methods could be validated in vivo so
far.
A relatively new development in CT technology is the calculation of fractional flow reserve
(FFR) by CT scanning, according to a sophisticated algorithm developed by Heartflow Inc. One
of the baseline assumptions in that algorithm is that myocardial mass is proportional to
resting blood flow, which seems a plausible assumption from a rational physiological point of
view.
More recently, invasive calculation of absolute blood flow has become possible as well as
resistance measurement of the (microcirculation of the) myocardium.
Using that invasive technology (explained in the appendix to this protocol), it can be
assumed that measuring absolute maximum blood flow in a coronary artery as well as fractional
flow reserve for different territories or for different spots within one major coronary
artery, provides a basis for relative mass calculation. The background for performing the
present study is to compare these mass calculations by CT scanning and by invasive
measurements, thereby corroborating both methods.
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