Physiological Evaluation of Anomalous Aortic Origin of a Coronary Artery Using Computed Tomography-Derived Fractional Flow Reserve
Background With the emergence of coronary computed tomography (CT) angiography, anomalous aortic origin of a coronary artery (ANOCOR) is more frequently diagnosed. Fractional flow reserve derived from CT (FFRCT) is a noninvasive functional test providing anatomical and functional evaluation of the overall coronary tree. These unique features of anatomical and functional evaluation derived from CT could help for the management of patients with ANOCOR. We aimed to retrospectively evaluate the physiological and clinical impact of FFRCT analysis in the ANOCOR registry population. Methods and Results The ANOCOR registry included patients with ANOCOR detected during invasive coronary angiography or coronary CT angiography between January 2010 and January 2013, with a planned 5-year follow-up. We retrospectively performed FFRCT analysis in patients with coronary CT angiography of adequate quality. Follow-up was performed with a clinical composite end point (cardiac death, myocardial infarction, and unplanned revascularization). We obtained successful FFRCT analyses and 5-year clinical follow-up in 54 patients (average age, 60±13 years). Thirty-eight (70%) patients had conservative treatment, and 16 (30%) patients had coronary revascularization after coronary CT angiography. The presence of an ANOCOR course was associated with a moderate reduction of FFRCT value from 1.0 at the ostium to 0.90±0.10 downstream the ectopic course and 0.82±0.11 distally. No significant difference in FFRCT values was identified between at-risk and not at-risk ANOCOR. After a 5-year follow-up, only one unplanned percutaneous revascularization was reported. Conclusions The presence of ANOCOR was associated with a moderate hemodynamic decrease of FFRCT values and associated with a low risk of cardiovascular events after a 5-year follow-up in this middle-aged population.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
Journal of the American Heart Association - 10(2021), 7 vom: 06. Apr., Seite e018593 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Adjedj, Julien [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 18.10.2021 Date Revised 18.10.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1161/JAHA.120.018593 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM322855950 |
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| 100 | 1 | |a Adjedj, Julien |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Physiological Evaluation of Anomalous Aortic Origin of a Coronary Artery Using Computed Tomography-Derived Fractional Flow Reserve |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 18.10.2021 | ||
| 500 | |a Date Revised 18.10.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Background With the emergence of coronary computed tomography (CT) angiography, anomalous aortic origin of a coronary artery (ANOCOR) is more frequently diagnosed. Fractional flow reserve derived from CT (FFRCT) is a noninvasive functional test providing anatomical and functional evaluation of the overall coronary tree. These unique features of anatomical and functional evaluation derived from CT could help for the management of patients with ANOCOR. We aimed to retrospectively evaluate the physiological and clinical impact of FFRCT analysis in the ANOCOR registry population. Methods and Results The ANOCOR registry included patients with ANOCOR detected during invasive coronary angiography or coronary CT angiography between January 2010 and January 2013, with a planned 5-year follow-up. We retrospectively performed FFRCT analysis in patients with coronary CT angiography of adequate quality. Follow-up was performed with a clinical composite end point (cardiac death, myocardial infarction, and unplanned revascularization). We obtained successful FFRCT analyses and 5-year clinical follow-up in 54 patients (average age, 60±13 years). Thirty-eight (70%) patients had conservative treatment, and 16 (30%) patients had coronary revascularization after coronary CT angiography. The presence of an ANOCOR course was associated with a moderate reduction of FFRCT value from 1.0 at the ostium to 0.90±0.10 downstream the ectopic course and 0.82±0.11 distally. No significant difference in FFRCT values was identified between at-risk and not at-risk ANOCOR. After a 5-year follow-up, only one unplanned percutaneous revascularization was reported. Conclusions The presence of ANOCOR was associated with a moderate hemodynamic decrease of FFRCT values and associated with a low risk of cardiovascular events after a 5-year follow-up in this middle-aged population | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a anomalous aortic origin of coronary arteries | |
| 650 | 4 | |a coronary computed tomography angiography | |
| 650 | 4 | |a fractional flow reserve | |
| 650 | 4 | |a fractional flow reserve computed tomography | |
| 700 | 1 | |a Hyafil, Fabien |e verfasserin |4 aut | |
| 700 | 1 | |a Halna du Fretay, Xavier |e verfasserin |4 aut | |
| 700 | 1 | |a Dupouy, Patrick |e verfasserin |4 aut | |
| 700 | 1 | |a Juliard, Jean-Michel |e verfasserin |4 aut | |
| 700 | 1 | |a Ou, Phalla |e verfasserin |4 aut | |
| 700 | 1 | |a Laissy, Jean-Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Muller, Olivier |e verfasserin |4 aut | |
| 700 | 1 | |a Wijns, William |e verfasserin |4 aut | |
| 700 | 1 | |a Aubry, Pierre |e verfasserin |4 aut | |
| 700 | 0 | |a Abnormal Coronary Origin investigators * |e verfasserin |4 aut | |
| 700 | 1 | |a Abi Khalil, W |e investigator |4 oth | |
| 700 | 1 | |a Aguirre, L |e investigator |4 oth | |
| 700 | 1 | |a Akesbi, A |e investigator |4 oth | |
| 700 | 1 | |a Aubry, P |e investigator |4 oth | |
| 700 | 1 | |a Banus, Y |e investigator |4 oth | |
| 700 | 1 | |a Belle, L |e investigator |4 oth | |
| 700 | 1 | |a Benamer, H |e investigator |4 oth | |
| 700 | 1 | |a Biron, Y |e investigator |4 oth | |
| 700 | 1 | |a Boiffard, E |e investigator |4 oth | |
| 700 | 1 | |a Bouallal, R |e investigator |4 oth | |
| 700 | 1 | |a Boudvillain, O |e investigator |4 oth | |
| 700 | 1 | |a Bourkaïb, R |e investigator |4 oth | |
| 700 | 1 | |a Brasselet, C |e investigator |4 oth | |
| 700 | 1 | |a Bressollette, E |e investigator |4 oth | |
| 700 | 1 | |a Brunel, P |e investigator |4 oth | |
| 700 | 1 | |a Champagnac, D |e investigator |4 oth | |
| 700 | 1 | |a Coco, M |e investigator |4 oth | |
| 700 | 1 | |a Commeau, P |e investigator |4 oth | |
| 700 | 1 | |a Cook, S |e investigator |4 oth | |
| 700 | 1 | |a Couppie, P |e investigator |4 oth | |
| 700 | 1 | |a de Poli, F |e investigator |4 oth | |
| 700 | 1 | |a Delorme, L |e investigator |4 oth | |
| 700 | 1 | |a Descoutures, F |e investigator |4 oth | |
| 700 | 1 | |a Didier, R |e investigator |4 oth | |
| 700 | 1 | |a Ducrocq, G |e investigator |4 oth | |
| 700 | 1 | |a Dupouy, P |e investigator |4 oth | |
| 700 | 1 | |a Durier, C |e investigator |4 oth | |
| 700 | 1 | |a El Mahmoud, R |e investigator |4 oth | |
| 700 | 1 | |a Estève, J-B |e investigator |4 oth | |
| 700 | 1 | |a Faurie, B |e investigator |4 oth | |
| 700 | 1 | |a Garbarz, E |e investigator |4 oth | |
| 700 | 1 | |a Georges, J-L |e investigator |4 oth | |
| 700 | 1 | |a Gérardin, B |e investigator |4 oth | |
| 700 | 1 | |a Gibault-Genty, G |e investigator |4 oth | |
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| 700 | 1 | |a Godin, M |e investigator |4 oth | |
| 700 | 1 | |a Goy, J-J |e investigator |4 oth | |
| 700 | 1 | |a Haffner-Debus, C |e investigator |4 oth | |
| 700 | 1 | |a Halna du Fretay, X |e investigator |4 oth | |
| 700 | 1 | |a Hanssen, M |e investigator |4 oth | |
| 700 | 1 | |a Hascoët, S |e investigator |4 oth | |
| 700 | 1 | |a Jacquemin, L |e investigator |4 oth | |
| 700 | 1 | |a Jeanneteau, J |e investigator |4 oth | |
| 700 | 1 | |a Joseph, T |e investigator |4 oth | |
| 700 | 1 | |a Juliard, J-M |e investigator |4 oth | |
| 700 | 1 | |a Karsenty, B |e investigator |4 oth | |
| 700 | 1 | |a Koning, R |e investigator |4 oth | |
| 700 | 1 | |a La Scala, E |e investigator |4 oth | |
| 700 | 1 | |a Leddet, P |e investigator |4 oth | |
| 700 | 1 | |a Lemesle, G |e investigator |4 oth | |
| 700 | 1 | |a Leurent, G |e investigator |4 oth | |
| 700 | 1 | |a Levy, R |e investigator |4 oth | |
| 700 | 1 | |a Livarek, B |e investigator |4 oth | |
| 700 | 1 | |a Loubeyre, C |e investigator |4 oth | |
| 700 | 1 | |a Maillard, L |e investigator |4 oth | |
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| 700 | 1 | |a Poulos, N |e investigator |4 oth | |
| 700 | 1 | |a Py, A |e investigator |4 oth | |
| 700 | 1 | |a Ranc, S |e investigator |4 oth | |
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| 700 | 1 | |a Staat, P |e investigator |4 oth | |
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| 700 | 1 | |a Togni, M |e investigator |4 oth | |
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| 700 | 1 | |a Varenne, O |e investigator |4 oth | |
| 700 | 1 | |a Voudris, V |e investigator |4 oth | |
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