• April 2018

    FFRct: Fractional Flow Reserve Analysis Without the Cath Lab​

With CT-derived fractional flow reserve (FFRct) analysis, Baylor Scott & White The Heart Hospital – Plano provides insight into the impact blockages have on blood flow in the heart – all without a trip to the cath lab. Especially for intermediate blockages, this advanced, noninvasive technology offers cardiologists critical information to determine if a blockage is not significant.

For many years, CT angiography has provided anatomic information, such as the location of plaque accumulations or areas with progressive narrowing. However, without FFRct analysis, it does not provide the physiological impact of those blockages on the heart. To measure the physiological impact, either a stress imaging modality or an invasive coronary angiogram in the cath lab would be required.

“In the cath lab, physicians can test pressure drops across the blockages through fractional flow reserve and get an objective measurement to decide whether a blockage is or is not significant,” said Ambaris​h​ Gopal, MD, Medical Director, Advanced Cardiovascular Imaging CT Program. “This methodology is now available with CT and can be used in the right clinical setting after analyzing the CT Coronary data for certain types of blockages.”

FFRct and Intermediate Blockages​

FRct is beneficial for patients with coronary artery blockages that are estimated to be in the intermediate range. CT coronary angiography by itself has an excellent negative predictive value. If the FFRct is calculated to be more than 0.8, the blockage is not considered significant.

“The instances where FFRct is of real benefit is areas in the gray zone where it is undetermined if the blockage is non-obstructive or if it is significant,” Dr. Gopal said. “That is where FFRct is useful as a tie-breaker. In the indeterminate or intermediate scenarios, FFRct usually has a place in the right clinical setting.”

From the patient perspective, undergoing a CT scan for FFRct analysis is no different than a standard CT angiogram. Using the images derived from the scan, computer algorithms solve millions of complex equations to assess the impact of blockages on blood flow. In most cases, Baylor Scott & White The Heart Hospital – Plano performs the test on high-end fast scanners that provide a very low radiation dose.

Early Identification Through Advanced Imaging

Coronary CT angiography is an important non-invasive tool that helps not only in coronary artery blockages but also provides information that is very useful in the field of preventive cardiology offered to our guests by the Global Heart Health Center at Baylor Scott & White Heart – Plano.

“If we know blockages are there in the making, we can take appropriate countermeasures and go after the things that are causing those early blockages in the first place, and prevent heart disease causing heart attacks and its complications,” Dr. Gopal said.

Through the advanced cardiac imaging program Baylor Scott & White Heart – Plano, the hospital provides advanced technology to partner with physicians in keeping patients healthy.

“Our advanced cardiovascular imaging helps diagnose problems in a timely manner so that they can be fixed in a timely manner,” Dr. Gopal said. “We want to identify problems before they happen so that we can help create a personalized plan for guests and work with their physician to provide quality care.”

Advanced cardiac imaging is available on an outpatient basis in Plano and McKinney.

Find out more about the advanced cardiac imaging program​ at Baylor Scott & White Heart – Plano.

Contributing Authors

Ambarish Gopal, MD, FACC, FSCCT, FSCAI
MMedical Director, Advanced Cardiovascular Imaging CT Program
Baylor Scott & White The Heart Hospital Baylor – Plano