Author + information
- Received September 17, 2018
- Revision received November 5, 2018
- Accepted November 7, 2018
- Published online June 3, 2019.
- Edward D. Nicol, MDa,
- Bjarne L. Norgaard, MD, PhDb,
- Philipp Blanke, MDc,
- Amir Ahmadi, MDd,
- Jonathon Weir-McCall, MBBS, PhDe,
- Pal Maurovich Horvat, MDf,
- Kelly Han, MDg,
- Jeroen J. Bax, MD, PhDh and
- Jonathon Leipsic, MDc,∗ ()
- aRoyal Brompton Hospital, London, United KingdomRoyal Brompton Hospital, London, United Kingdom
- bAarhus University Hospital, Aarhus Skejby, DenmarkbAarhus University Hospital, Aarhus Skejby, Denmark
- cDepartment of Radiology and Division of Cardiology, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Radiology and Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
- dMount Sinai, New York City, New YorkMount Sinai, New York City, New York
- ePapworth Hospital, Cambridge, United KingdomePapworth Hospital, Cambridge, United Kingdom
- fSemmelweiss University, Budapest, HungaryfSemmelweiss University, Budapest, Hungary
- gNorthwestern Hospital, Minneapolis, MinnesotagNorthwestern Hospital, Minneapolis, Minnesota
- hLeiden University Medical Center, Leiden, the NetherlandshLeiden University Medical Center, Leiden, the Netherlands
- ↵∗Address for correspondence:
Dr. Jonathon Leipsic, Department of Medical Imaging, St. Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada.
• Cardiac CT has seen rapid development over the last decade
• Advanced analytics, such as FFRCT, shear stress, and epicardial fat enhancement, have opened the potential for new opportunities around diagnosis and prognosis
• Artificial intelligence is unlocking a deeper understanding of atherosclerosis and risk
• CT strain and computational fluid dynamics for valve disease will significantly impact planning for structural heart disease interventions
Cardiovascular computed tomography (CCT) has undergone rapid maturation over the last decade and is now of proven clinical utility in the diagnosis and management of coronary artery disease, in guiding structural heart disease intervention, and in the diagnosis and treatment of congenital heart disease. The next decade will undoubtedly witness further advances in hardware and advanced analytics that will potentially see an increasingly core role for CCT at the center of clinical cardiovascular practice. In coronary artery disease assessment this may be via improved hemodynamic adjudication, and shear stress analysis using computational flow dynamics, more accurate and robust plaque characterization with spectral or photon-counting CT, or advanced quantification of CT data via artificial intelligence, machine learning, and radiomics. In structural heart disease, CCT is already pivotal to procedural planning with adjudication of gradients before and following intervention, whereas in congenital heart disease CCT is already used to support clinical decision making from neonates to adults, often with minimal radiation dose. In both these areas the role of computational flow dynamics, advanced tissue printing, and image modelling has the potential to revolutionize the way these complex conditions are managed, and CCT is likely to become an increasingly critical enabler across the whole advancing field of cardiovascular medicine.
Dr. Nicol is a consultant to GE Life Sciences for which he takes no personal compensation. Dr. Norgaard has institutional research grants from Siemens, Heartflow, and Edwards Lifesciences. Dr. Blanke is a consultant for Circle CVI, Edwards Lifesciences, Neovasc, and Tendyne. Dr. Han is a consultant for Edwards Lifesciences. Dr. Bax has received speaker fees from Abbott Vascular; and the Department of Cardiology of the Leiden University Medical Center has received unrestricted research grants from Biotronik, Boston Scientific, Medtronic, Edwards Lifesciences, and GE Healthcare. Dr. Leipsic is a consultant for and holds stock options in Circle CVI and Heartflow; and provides core laboratory services for Edwards Lifesciences, Medtronic, Abbott, and Neovasc for which he takes no personal compensation. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received September 17, 2018.
- Revision received November 5, 2018.
- Accepted November 7, 2018.
- 2019 American College of Cardiology Foundation
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