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Assessment of coronary stenoses by computational fluid dynamics and its relationship with stress myocardial perfusion with adenosine by 320-detectors row CT

Grant number: 12/03297-1
Support type:Scholarships abroad - Research
Effective date (Start): October 01, 2012
Effective date (End): September 14, 2013
Field of knowledge:Health Sciences - Medicine - Medical Radiology
Principal researcher:Tiago Augusto Magalhães
Grantee:Tiago Augusto Magalhães
Host: João Augusto Costa Lima
Home Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
Research place: Johns Hopkins University (JHU), United States  

Abstract

Computational Fluid Dynamics (CFD) is the science that studies the behavior of fluids and related phenomena using simulations and mathematical equations. Recently, it became possible to apply this method in the evaluation of coronary artery disease (CAD), using computed tomography coronary angiography (CTCA). This technique has been called "FFR-CT," in reference to the invasive method used during cardiac catheterization (coronary angiography) for assessment of coronary stenoses (FFR - Fractional Flow Reserve). Objectives: 1) To evaluate the diagnostic performance of FFR-CT compared to reference methods for assessing coronary artery disease (coronary angiography and myocardial scintigraphy -SPECT) using a pooled analysis of coronary stenosis matched to a myocardial perfusion defect, 2) correlate FFR-CT results with the findings of myocardial computed tomography perfusion (MCTP). Methods: 100 studies of multicenter CORE320 trial will be selected to perform the CFD and quantification of FFR-CT, using dedicated computer algorithms. Twenty studies will be compared with the traditional FFR (invasive) for validation. Tests will be done at a per vessel and per patient level, using the combination of the results of invasive coronary angiography and SPECT as reference, with a stenosis >50% related to a perfusion defect in the same territory defining positivity for disease. The values of FFR-CT defining obstructive CAD will be considered <0.80. (AU)