National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
Department of Pathology, CVPath Institute, Gaithersburg, Maryland.
J Am Coll Cardiol. 2020 Sep 8;76(10):1226-1243. doi: 10.1016/j.jacc.2020.06.076.
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.
在过去十年中，使用冠状动脉计算机断层血管造影术（CCTA）评估冠状动脉疾病（CAD）已经发生了范式转变。越来越多的证据支持 CCTA 在 CAD 的各个阶段的临床应用，从早期亚临床疾病的检测到急性胸痛的评估。此外，CCTA 还可用于无创性定量斑块负荷和识别高危斑块，有助于诊断、预后和治疗。在免疫驱动的心血管疾病高发情况下，这一点尤为重要。基于血流动力学指数和斑块特征的 CCTA 新兴应用可能提供个性化风险评估、影响疾病检测并进一步指导治疗。本文综述了 2019 年美国国立心肺血液研究所 CCTA 峰会强调的 CCTA 的证据、临床应用和新兴技术。
