Jesper Møller Jensen

Coronary CT angiography derived FFR in patients with left main disease

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review



  • Katharina A Riedl, Department of Vascular Medicine, University Heart Center Hamburg, Eppendorf, Hamburg, Germany.
  • ,
  • Jesper M Jensen
  • Brian S Ko, Monash Heart, Monash Medical Center and Monash University, Victoria, Australia.
  • ,
  • Jonathon Leipsic, University of British Columbia
  • ,
  • Erik L Grove
  • Ole N Mathiassen
  • ,
  • Hans Erik Bøtker
  • Bjarne L Nørgaard

The presence of left main coronary artery disease (LMCAD) is associated with an unfavorable clinical outcome. The clinical utility of FFRCT testing for non-invasive physiological assessment in LMCAD remains largely unknown. In this single center observational study LMCAD patients were retrospectively identified between November 2015 and December 2017. We evaluated the relationship between LMCAD diameter stenosis and downstream FFRCT values, and the clinical consequences following FFRCT testing in patients with LMCAD. The composite endpoint (all-cause death, myocardial infarction, unplanned revascularization) was determined over a median follow-up of 1.1 years. LMCAD was registered in 432 of 3202 (13%) patients having coronary CTA. FFRCT was prescribed in 213 (49%), while 59 (14%) patients were referred directly to invasive angiography or myocardial perfusion imaging. FFRCT was performed in 195 (45%) patients. LM stenosis severity was inversely related to downstream FFRCT values. In patients with simple LMCAD with stenosis ≥ 50%, > 80% had FFRCT > 0.80 in non-diseased proximal and downstream segments (n = 7). No patients with simple LMCAD and FFRCT > 0.80 (n = 20) suffered an adverse clinical outcome. FFRCT testing in patients with LMCAD is feasible. LM stenosis severity is inversely related to FFRCT value. Patients with LMCAD and FFRCT > 0.80 have favorable clinical outcomes at short-term follow-up. Large-scale studies assessing the clinical utility and safety of deferring invasive catheterization following FFRCT testing in patients with LMCAD are warranted.

Original languageEnglish
JournalThe international journal of cardiovascular imaging
Pages (from-to)3299-3308
Number of pages10
Publication statusPublished - Nov 2021

    Research areas

  • Computed tomography angiography, Coronary angiography, Coronary artery disease, Fractional flow reserve, Left main, FRACTIONAL FLOW RESERVE, STENOSIS, PERFORMANCE, GUIDELINES, COMPUTED-TOMOGRAPHY ANGIOGRAPHY, SOCIETY, IMPACT, INTRAVASCULAR ULTRASOUND, OUTCOMES, ARTERY-DISEASE, Predictive Value of Tests, Humans, Tomography, X-Ray Computed, Coronary Stenosis/diagnostic imaging, Retrospective Studies, Severity of Illness Index, Computed Tomography Angiography, Coronary Artery Disease/diagnostic imaging, Coronary Angiography, Fractional Flow Reserve, Myocardial, Coronary Vessels/diagnostic imaging

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