Dynamic Stress Perfusion CT for Detection of Inducible Myocardial Ischemia
Condition: Coronary Artery Disease
MeSH terms: Coronary Artery Disease; Myocardial Ischemia; Ischemia
Study type: Observational

Summary: 
      The purpose of this study is to determine the diagnostic accuracy of MPICT for the detection
      of hemodynamically relevant coronary stenosis (as determined by invasive FFR) in patients
      with suspected or known CAD clinically referred for invasive angiography.
    

Detailed description: 
      Rationale: Cardiac computed tomography (CT) provides accurate assessment of the coronary
      arteries and detects significant coronary stenosis with high diagnostic accuracy. However,
      the hemodynamic relevance of these stenotic lesion remains unclear, although highly relevant
      for clinical decision-making. Recent technical developments with third-generation dual-source
      CT allow to determine myocardial perfusion during hyperemia and thus for assessment of the
      hemodynamic relevance of coronary lesions using a dynamic acquisition mode. To date, there is
      only very limited evidence of the feasibility of this approach stemming from single-center
      studies with varying standards of reference.

      Objective: To determine the diagnostic accuracy of MPICT for the detection of hemodynamically
      relevant coronary stenosis (as determined by invasive FFR) in patients with suspected or
      known CAD clinically referred for invasive angiography. In an optional sub-study the
      diagnostic accuracy of MPICT for the detection of myocardial perfusion defects as determined
      by cardiac magnetic resonance imaging (CMRI) will be investigated.

      Study design: Observational cohort study with fractional flow reserve (FFR) during invasive
      angiography as the reference standard.

      Study population: Patients with known or suspected CAD clinically referred for invasive
      angiography.

      Main study parameters: Myocardial perfusion defect on dynamic CT perfusion imaging, and
      diagnostic accuracy as compared invasive FFR.

      Co Principle Investigators Koen Nieman MD PhD, Erasmus University Medical Center Fabian
      Bamberg MD PhD, University of Tübingen.

      Investigators Valerie Schmidt-Honndorf PhD, University of Tübingen Tobias Geisler MD PhD,
      University of Tübingen Joost Daemen MD PhD, Erasmus University Medical Center Adriaan Coenen
      MD, Erasmus University Medical Center Stephan Achenbach MD PhD, Erlangen University Micheala
      M. Hell MD, Erlangen University Rozemarijn Vliegenthart MD PhD, UMC Groningen Pim van der
      Harst MD PhD, UMC Groningen Francesca Pugliese MD PhD, Queen Mary University of London Kakuya
      Kitagawa MD PhD, Mie University Hatem Alkadhi MD PhD, University Hospital Zurich, Switzerland
      Robert Manka MD PhD, University Hospital Zurich, Switzerland
    

Intervention name(s): Diagnostic detection of coronary artery disease
Intervention type(s): Other
Intervention description(s): Myocardial perfusion defect on dynamic CT perfusion imaging, and diagnostic accuracy as compared invasive FFR.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients with know or suspect coronary artery diseased, referred for invasive coronary
        angiography.
      
Keywords: Coronary; Artery; Computed tomography; FFR; CT myocardial perfusion; Dynamic