Cardiology Letters 2025, 34(3):153-164

Introduction to FFR-CT HeartFlow

František Nehaj^{1, 2, 3, 4}, Derek Leslie Connolly^{3, 4}

¹ Oddelenie arytmológie a kardiostimulácie, Národný ústav srdcových a cievnych chorôb, a. s., Bratislava, Slovenská republika

² Klinika arytmológie, Lekárska Fakulta, Univerzita Komenského, Bratislava, Slovenská republika

³ University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, UK

⁴ Sandwell and West Birmingham Hospitals NHS Service Trust, Birmingham, UK

The emergence of non-invasive, computationally derived fractional flow reserve from computed tomography (FFR-CT) marks a significant breakthrough in clinical diagnostic and non-invasive medicine. FFR-CT is obtained from standard resting coronary CT scans, eliminating the need for additional pharmacological agents and invasive procedures. This technology represents a major advancement in the field of cardiology. Studies have demonstrated that FFR significantly influences the accuracy of CT coronary angiography (CCTA), leading to improved diagnostic precision. This work aims to review the FFR-CT imaging technique, with a specific focus on validated methodology known as HeartFlow. It will cover the principles and clinical indications of FFR-CT. Furthermore, it will discuss the application of this method in various clinical situations, such as acute coronary syndrome, coronary artery dissection, coronary anomalies, and ischemic heart disease.

Keywords: FFR-CT; HeartFlow; CCTA (Coronary Computed Tomography Angiogram); acute coronary syndrome; coronary artery disease; dissection; anomaly; ischemia

Published: March 1, 2025  Show citation