Paradoxical Computed Tomography-Derived Fractional Flow Reserve Changes Due to Vessel Morphology and Constituents

Toshimitsu Tsugu; Kaoru Tanaka; Yuji Nagatomo; Michel De Maeseneer; Johan de Mey

doi:10.5543/tkda.2022.02281

Paradoxical Computed Tomography-Derived Fractional Flow Reserve Changes Due to Vessel Morphology and Constituents

Toshimitsu Tsugu, Kaoru Tanaka, Yuji Nagatomo, Michel De Maeseneer, Johan de Mey

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Abstract

Computed tomography-derived fractional ﬂow reserve decreases from the proximal to the distal with coronary stenosis. According to the principles of ﬂuid dynamics, paradoxical computed tomography-derived fractional ﬂow reserve changes require an unconventional vessel mor-phology and speciﬁc site of the vessels with a high driving force. Therefore, only a few articles have reported a paradoxical increase of computed tomography-derived fractional ﬂow reserve. We present a case report of marked computed tomography-derived fractional ﬂow reserve elevation in the middle left anterior descending artery with a severe coronary stenosis. Computed tomography-derived fractional ﬂow reserve was 0.94 just proximal to the stenotic lesion and decreased to 0.65 at the maximum stenosis area but recovered to 0.80 in the distal segment. We speculated that the vessel morphology could have caused a pressure recovery phenomenon, resulting in paradoxical computed tomography-derived fractional ﬂow reserve changes.

Original language	English
Pages (from-to)	146-150
Number of pages <span style="color:red"p> <font size="1.5"> ✽ </span> </font>	5
Journal	Türk Kardiyoloji Dernegi Arşivi
Volume	51
Issue number	2
DOIs	https://doi.org/10.5543/tkda.2022.02281
Publication status	Published - 1 Mar 2023

Bibliographical note

Copyright:
This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine

Keywords

Humans
Fractional Flow Reserve, Myocardial
Coronary Angiography/methods
Coronary Stenosis/diagnostic imaging
Tomography, X-Ray Computed
Coronary Vessels/diagnostic imaging
Constriction, Pathologic
Computed Tomography Angiography/methods
Predictive Value of Tests
Coronary Artery Disease/pathology
Severity of Illness Index

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title = "Paradoxical Computed Tomography-Derived Fractional Flow Reserve Changes Due to Vessel Morphology and Constituents",

abstract = "Computed tomography-derived fractional ﬂow reserve decreases from the proximal to the distal with coronary stenosis. According to the principles of ﬂuid dynamics, paradoxical computed tomography-derived fractional ﬂow reserve changes require an unconventional vessel mor-phology and speciﬁc site of the vessels with a high driving force. Therefore, only a few articles have reported a paradoxical increase of computed tomography-derived fractional ﬂow reserve. We present a case report of marked computed tomography-derived fractional ﬂow reserve elevation in the middle left anterior descending artery with a severe coronary stenosis. Computed tomography-derived fractional ﬂow reserve was 0.94 just proximal to the stenotic lesion and decreased to 0.65 at the maximum stenosis area but recovered to 0.80 in the distal segment. We speculated that the vessel morphology could have caused a pressure recovery phenomenon, resulting in paradoxical computed tomography-derived fractional ﬂow reserve changes.",

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author = "Toshimitsu Tsugu and Kaoru Tanaka and Yuji Nagatomo and {De Maeseneer}, Michel and {de Mey}, Johan",

note = "Copyright: This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine",

year = "2023",

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AU - Tsugu, Toshimitsu

AU - Tanaka, Kaoru

AU - Nagatomo, Yuji

AU - De Maeseneer, Michel

AU - de Mey, Johan

N1 - Copyright: This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine

PY - 2023/3/1

Y1 - 2023/3/1

N2 - Computed tomography-derived fractional ﬂow reserve decreases from the proximal to the distal with coronary stenosis. According to the principles of ﬂuid dynamics, paradoxical computed tomography-derived fractional ﬂow reserve changes require an unconventional vessel mor-phology and speciﬁc site of the vessels with a high driving force. Therefore, only a few articles have reported a paradoxical increase of computed tomography-derived fractional ﬂow reserve. We present a case report of marked computed tomography-derived fractional ﬂow reserve elevation in the middle left anterior descending artery with a severe coronary stenosis. Computed tomography-derived fractional ﬂow reserve was 0.94 just proximal to the stenotic lesion and decreased to 0.65 at the maximum stenosis area but recovered to 0.80 in the distal segment. We speculated that the vessel morphology could have caused a pressure recovery phenomenon, resulting in paradoxical computed tomography-derived fractional ﬂow reserve changes.

AB - Computed tomography-derived fractional ﬂow reserve decreases from the proximal to the distal with coronary stenosis. According to the principles of ﬂuid dynamics, paradoxical computed tomography-derived fractional ﬂow reserve changes require an unconventional vessel mor-phology and speciﬁc site of the vessels with a high driving force. Therefore, only a few articles have reported a paradoxical increase of computed tomography-derived fractional ﬂow reserve. We present a case report of marked computed tomography-derived fractional ﬂow reserve elevation in the middle left anterior descending artery with a severe coronary stenosis. Computed tomography-derived fractional ﬂow reserve was 0.94 just proximal to the stenotic lesion and decreased to 0.65 at the maximum stenosis area but recovered to 0.80 in the distal segment. We speculated that the vessel morphology could have caused a pressure recovery phenomenon, resulting in paradoxical computed tomography-derived fractional ﬂow reserve changes.

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KW - Constriction, Pathologic

KW - Computed Tomography Angiography/methods

KW - Predictive Value of Tests

KW - Coronary Artery Disease/pathology

KW - Severity of Illness Index

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Paradoxical Computed Tomography-Derived Fractional Flow Reserve Changes Due to Vessel Morphology and Constituents

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