Coronary Computed Tomography Angiography From Clinical Uses to Emerging Technologies JACC State-of-the-Art Review

• Type of Material: Article
• Authors: Khaled M Abdelrahman, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda; Marcus Y Chen, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda; Amit K Dey, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda; Renu Virmani, CVPath Institute; Aloke Finn, Emory University; Ramzi Y Khamis, Imperial College London; Andrew D Choi, George Washington University; James K Min, New York-Presbyterian Hospital; Michelle C Williams, University of Edinburgh; Andrew J Buckler, Elucid Bioimaging; Charles A Taylor, HeartFlow Inc; Campbell Rogers, HeartFlow Inc; Habib Samady, Emory University; Charalambos Antoniades, University of Oxford; Leslee Shaw, Emory University; Matthew J Budoff, Harbor-UCLA Medical Center; Udo Hoffmann, Harvard Medical School; Ron Blankstein, Harvard Medical School; Jagat Narula, Icahn School of Medicine at Mount Sinai; Nehal N Mehta, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
• Language: English
• Date: 2020-09-08
• Publisher: ELSEVIER SCIENCE INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Published by Elsevier on Behalf of The American College of Cardiology Foundation.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jacc.2020.06.076
• Title of Journal or Parent Work: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
• Volume: 76
• Issue: 10
• Start Page: 1226
• End Page: 1243
• Keywords: DIAGNOSTIC PERFORMANCE; ARTERIAL INFLAMMATION; CARDIOVASCULAR-DISEASE; Cardiac & Cardiovascular Systems; Life Sciences & Biomedicine; Science & Technology; coronary artery disease; FRACTIONAL FLOW RESERVE; ATHEROSCLEROTIC PLAQUE; RADIATION-EXPOSURE; WALL SHEAR-STRESS; Cardiovascular System & Cardiology; ACUTE MYOCARDIAL-INFARCTION; coronary computed tomography angiography; CHEST-PAIN; atherosclerosis; CT ANGIOGRAPHY

Abstract

Evaluation of coronary artery disease (CAD) using coronary computed tomography angiography (CCTA) has seen a paradigm shift in the last decade. Evidence increasingly supports the clinical utility of CCTA across various stages of CAD, from the detection of early subclinical disease to the assessment of acute chest pain. Additionally, CCTA can be used to noninvasively quantify plaque burden and identify high-risk plaque, aiding in diagnosis, prognosis, and treatment. This is especially important in the evaluation of CAD in immune-driven conditions with increased cardiovascular disease prevalence. Emerging applications of CCTA based on hemodynamic indices and plaque characterization may provide personalized risk assessment, affect disease detection, and further guide therapy. This review provides an update on the evidence, clinical applications, and emerging technologies surrounding CCTA as highlighted at the 2019 National Heart, Lung and Blood Institute CCTA Summit.