ArticleCirculation. Cardiovascular interventions2021
Feasibility and Validity of Computed Tomography-Derived Fractional Flow Reserve in Patients With Severe Aortic Stenosis: The CAST-FFR Study.
Article in Circulation. Cardiovascular interventions, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Coronary CTA and CT-FFR in trans-catheter aortic valve implantation candidates: a systematic review and meta-analysis.European radiology · 2025Pooled it
- Agreement of Fractional Flow Reserve Estimated by Computed Tomography With Invasively Measured Fractional Flow Reserve: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2024Pooled it
- Invasive Evaluation of Coronary Artery Disease in Severe Aortic Stenosis-A Narrative Review.Journal of clinical medicine · 2026Review
- How to Individualize Coronary Assessment and Revascularization in Severe AS Patients Undergoing TAVI in the Era of Lifetime Management?Journal of clinical medicine · 2026Review
- Computed Tomography Coronary Angiography as a Gatekeeper for Invasive Coronary Assessment Before Transcatheter Aortic Valve Implantation.Medicina (Kaunas, Lithuania) · 2026Review
- Cardiovascular CT in Bicuspid Aortic Valve Disease: A State-of-the-Art Narrative Review of Advances, Clinical Integration, and Future Directions.Journal of clinical medicine · 2026Review
- Aortic Valve Calcification Scores versus CT-FFR: Prediction of Major Adverse Cardiovascular Events after Transcatheter Aortic Valve Replacement.Cardiology · 2026Article
- Management of Coronary Artery Disease in Patients With Severe Aortic Stenosis.Korean circulation journal · 2025Review
- Clinical Impact of CT-Based FFR in Everyday Cardiology: Bridging Computation and Decision-Making.Biomedicines · 2025Review
- Coronary Artery Disease and Transcatheter Aortic Valve Replacement.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Review
- Predictors of Diagnostic Inaccuracy of Detecting Coronary Artery Stenosis by Preprocedural CT Angiography in Patients Prior to Transcatheter Aortic Valve Implantation.Diagnostics (Basel, Switzerland) · 2025Article
- Real-world application of CCTA with CT-FFR for coronary assessment pre-TAVI: the CT2TAVI study.The international journal of cardiovascular imaging · 2025Observational
- Management of Coronary Artery Disease in the Context of Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-analysis of Percutaneous Coronary Intervention Timing and an Algorithmic Approach to Management.Interventional cardiology (London, England) · 2025Review
- The impact of transcatheter aortic valve replacement on changes of coronary computed tomography-derived fractional flow reserve.Annals of medicine · 2024Observational
- Selective FFRThe international journal of cardiovascular imaging · 2024Article
- Computed Tomography-Derived Fractional Flow Reserve: Developing A Gold Standard for Coronary Artery Disease Diagnostics.Reviews in cardiovascular medicine · 2024Review
- Interrater Variability of ML-Based CT-FFR in Patients without Obstructive CAD before TAVR: Influence of Image Quality, Coronary Artery Calcifications, and Location of Measurement.Journal of clinical medicine · 2024Article
- Combined Computed Coronary Tomography Angiography and Transcatheter Aortic Valve Implantation (TAVI) Planning Computed Tomography Reliably Detects Relevant Coronary Artery Disease Pre-TAVI.Journal of clinical medicine · 2024Article
- Coronary Artery Disease Assessment via On-Site CT Fractional Flow Reserve in Patients Undergoing Transcatheter Aortic Valve Replacement.Radiology. Cardiothoracic imaging · 2024Article
- How to address the coronaries in TAVI candidates: can the need for revascularization be safely determined by CT angiography only?European heart journal. Imaging methods and practice · 2024Review
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundCoronary artery disease is common in patients with severe aortic stenosis. Computed tomography-derived fractional flow reserve (CT-FFR) is a clinically used modality for assessing coronary artery disease, however, its use has not been validated in patients with severe aortic stenosis. This study assesses the safety, feasibility, and validity of CT-FFR in patients with severe aortic stenosis.
methodsProspectively recruited patients underwent standard-protocol invasive FFR and coronary CT angiography (CTA). CTA images were analyzed by central core laboratory (HeartFlow, Inc) for independent evaluation of CT-FFR. CT-FFR data were compared with FFR (ischemia defined as FFR ≤0.80).
resultsForty-two patients (68 vessels) underwent FFR and CTA; 39 patients (92.3%) and 60 vessels (88.2%) had interpretable CTA enabling CT-FFR computation. Mean age was 76.2±6.7 years (71.8% male). No patients incurred complications relating to premedication, CTA, or FFR protocol. Mean FFR and CT-FFR were 0.83±0.10 and 0.77±0.14, respectively. CT calcium score was 1373.3±1392.9 Agatston units. On per vessel analysis, there was positive correlation between FFR and CT-FFR (Pearson correlation coefficient,
conclusionsCT-FFR is safe and feasible in patients with severe aortic stenosis. Our data suggests that the diagnostic accuracy of CT-FFR in this cohort potentially enables its use in clinical practice and provides the foundation for future research into the use of CT-FFR for coronary evaluation pre-aortic valve replacement.
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