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Advancements in cardiac computed tomography angiography (CCTA) have enabled the extraction of physiological data from an anatomy-based imaging modality. This review outlines the key methodologies for deriving fractional flow reserve (FFR) from CCTA, with a focus on two primary methods: 1) computational fluid dynamics-based FFR (CT-FFR) and 2) plaque-derived ischemia assessment using artificial intelligence and quantitative plaque metrics. These techniques have expanded the role of CCTA beyond anatomical assessment, allowing for concurrent evaluation of coronary physiology without the need for invasive testing. This review provides an overview of the principles, workflows, and limitations of each technique and aims to inform on the current state and future direction of non-invasive coronary physiology assessment.
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http://dx.doi.org/10.1016/j.jcct.2025.07.001 | DOI Listing |
Am J Cardiol
September 2025
Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua Medical School, Padua, Italy. Electronic address:
Introduction: A myocardial bridge (MB) is a condition where a segment of an epicardial coronary artery passes through the myocardial muscle. While traditionally regarded as benign, MBs have been associated with various cardiovascular conditions. Therefore, assessing their hemodynamic impact is crucial for informed treatment decisions.
View Article and Find Full Text PDFCardiovasc Drugs Ther
September 2025
Department of Cardiology of The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China.
Backgrounds: The management of non-culprit vessels (NCV) among individuals with acute myocardial infarction (AMI) remains an unsolved problem. Angiography-derived physiological assessments developed recently may help address this issue. Our study aims to measure angiography-derived fractional flow reserve (Angio-FFR) and angiography-derived index of microcirculatory resistance (Angio-IMR) in NCVs of AMI patients and explore their prognostic values and necessity.
View Article and Find Full Text PDFJ Am Heart Assoc
September 2025
KHP Centre for Translational Medicine, King's College London British Heart Foundation, Cardiovascular Division, Department of Clinical Pharmacology St Thomas' Hospital London United Kingdom.
Background: The aim of this study was to investigate the associations between pulse pressure (PP) and age-related structural brain changes including brain volumes, white matter hyperintensities (WMH), fractional anisotropy, silent brain lesions, microbleeds, cerebral blood flow and metabolism, and beta-amyloid accumulation.
Methods: Systematic review of PubMed (MEDLINE), Scopus, and Ovid Embase (from inception to January 2023) and references of included studies among adult populations was conducted. Findings were summarized narratively and by performing a fixed-effects meta-analysis.
Am J Cardiol
September 2025
Faculty of Medicine, Istanbul University, Istanbul, Turkey; Department of Cardiology, Acibadem International Hospital, Istanbul, Turkey. Electronic address:
Although physiologic evaluation (e.g., fractional flow reserve) of intermediate lesions is well established in other coronary arteries, the left main coronary artery (LMCA) exhibits diagnostic challenges, hindering development of physiology-based decision-making algorithms.
View Article and Find Full Text PDFEchocardiography
September 2025
Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Background: Identification of significant coronary artery stenosis (CAS) in patients with chronic coronary syndromes (CCS) is crucial for clinical management. Myocardial work (MW) is a new noninvasive method reflecting myocardial metabolism and has been applied in myocardial ischemia. We aimed to explore the value of global MW during vasodilator stress echocardiography in detecting significant CAS.
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