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

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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 languageEnglish
Pages (from-to)146-150
Number of pages5
JournalTürk Kardiyoloji Dernegi Arşivi
Volume51
Issue number2
DOIs
Publication statusPublished - 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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