New technology allows greater detail at the level that previously would have required a minimally invasive angiogram.

Published: May 6, 2021 | Updated: September 22, 2022

Cardiologists have another tool to help determine how to help patients with symptoms of coronary artery disease, by modeling the blood flow through their arteries to predict how cholesterol buildup might affect them.

The added information can help determine whether patients would respond best to treatments that can include medication, minimally invasive placement of a stent to secure plaque on the wall of an artery or open heart coronary bypass surgery.

The noninvasive test uses images from a computerized tomography (CT) scan to create a 3D model of the arteries around the heart. With the 3D model, along with results of other tests, specialists at Norton Heart & Vascular Institute can decide on the next steps.

Other tools to aid in the diagnosis and treatment plan can include two CT scans that use iodine as a contrast to show the anatomy of the heart and coronary arteries — CT perfusion and CT coronary angiography.

The new test — fractional flow reserve derived from CT (FFRCT) — in some cases can prevent the need for a minimally invasive angiogram procedure to look at the inside of arteries. Norton Heart & Vascular Institute is the only program in the region to use the test, which is available at Norton Audubon Hospital, Norton Brownsboro Hospital and Norton Women’s & Children’s Hospital. It is due to be deployed at Norton Hospital in the fall.

“FFRCT analysis is another tool to help determine the extent of coronary artery disease and can give us even more precision to determine the next course of treatment,” said Jaime Warren, director of noninvasive cardiovascular services at Norton Heart & Vascular Institute. “Along with our existing tools, when appropriate, our cardiologists can gain a more complete picture with FFRCT.”

A study of more than 5,000 patients concluded that the FFRCT results prompted physicians to change their treatment plan in two-thirds of cases compared with CT coronary angiography (CCTA) alone. The study considered patients who showed symptoms of coronary artery disease and atherosclerosis on CCTA.

The study, published in European Heart Journal, was funded in part by HeartFlow, a provider of FFRCT analysis services. It concluded that using FFRCT resulted in fewer minimally invasive angiograms where no obstructive disease was present. It also predicted the need for a minimally invasive or open heart revascularization.