Coronary artery disease remains the leading cause of death around the world, even during the COVID-19 pandemic, and it is therefore essential that we continue our quest to improve the prevention, diagnosis, management and outcome of coronary artery disease. Fifty years ago, in 1971, the first CT scan was performed on a machine invented by Sir Godfrey Hounsfield who, even in those early days, realised the potential of CT to assess the heart and coronary arteries.1 Technological advances mean that it is now possible to obtain extensive information on the presence, severity and characteristics of atherosclerotic plaque from coronary CT angiography (CCTA). In addition, it is also possible to use computational modelling to obtain an estimate of fractional flow reserve from static CCTA images (FFRCT). CCTA now plays a central role in the assessment and management of patients with symptoms of suspected coronary artery disease in both national and international guidelines. However, the role of FFRCT in clinical practice is less certain. Nørgaard et al 2 present a meta-analysis of the prognostic information provided by FFRCT from a single vendor (HeartFlow) in 5460 patients from 5 observational studies and registries. Coronary artery disease was prevalent in the population, with 72% having at least one stenosis >50% on CCTA and 61% having a positive FFRCT of ≤0.80. Overall event rates were low, with myocardial infarction or all-cause mortality occurring in 0.6% of FFRCT negative patients and 1.4% of FFRCT positive patients. Patients with FFRCT ≤0.80 were threefold more likely to experience myocardial infarction, unplanned coronary revascularisation and major adverse cardiac events, although there was no demonstrable difference in all-cause mortality. In addition, lower FFR …

中文翻译：

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计算机断层扫描血流储备分数的预后价值

即使在 COVID-19 大流行期间，冠状动脉疾病仍然是世界范围内死亡的主要原因，因此，我们必须继续努力改善冠状动脉疾病的预防、诊断、管理和结果。五十年前，即 1971 年，第一次 CT 扫描是在 Godfrey Hounsfield 爵士发明的机器上进行的，即使在早期，他也意识到 CT 评估心脏和冠状动脉的潜力。1 技术进步意味着现在通过冠状动脉 CT 血管造影 (CCTA) 可以获得有关动脉粥样硬化斑块的存在、严重程度和特征的广泛信息。此外，还可以使用计算模型从静态 CCTA 图像 (FFRCT) 获得血流储备分数的估计值。目前，CCTA 在国家和国际指南中在评估和管理疑似冠状动脉疾病症状的患者方面发挥着核心作用。然而，FFRCT 在临床实践中的作用尚不明确。Nørgaard 等人 2 对来自单一供应商 (HeartFlow) 的 FFRCT 提供的预后信息进行了荟萃分析，该信息涉及来自 5 项观察性研究和登记的 5460 名患者。冠状动脉疾病在人群中普遍存在，72% 的人在 CCTA 上至少有一个狭窄>50%，61% 的人 FFRCT 阳性≤0.80。总体事件发生率较低，FFRCT 阴性患者发生心肌梗死或全因死亡的比例为 0.6%，FFRCT 阳性患者的发生率为 1.4%。FFRCT ≤0.80 的患者发生心肌梗死、计划外冠状动脉血运重建和主要不良心脏事件的可能性增加三倍，尽管全因死亡率没有明显差异。此外，较低的 FFR……