Transluminal attenuation gradient in coronary computed tomography angiography is a novel noninvasive approach to the identification of functionally significant coronary artery stenosis: a comparison with fractional flow reserve

Dennis TL Wong, Brian Ko, James Donald Cameron, Nitesh Nerlekar, Michael Chung Hang Leung, Yuvaraj Malaiapan, Marcus Crossett, Darryl P Leong, Stephen G Worthley, John Troupis, Ian T Meredith, Sujith Seneviratne

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110 Citations (Scopus)


The purpose of this study was to assess the diagnostic accuracy of TAG320 in predicting functional stenosis severity evaluated by fractional flow reserve (FFR). BACKGROUND: Coronary computed tomography angiography (CCTA) has limited specificity for predicting functionally significant stenoses. Recent studies suggest that contrast gradient attenuation along an arterial lesion, or transluminal attenuation gradient (TAG), may provide assessment of functional significance of coronary stenosis. The use of 320-detector row computed tomography (CT), enabling near isophasic, single-beat imaging of the entire coronary tree, may be ideal for TAG functional assessment of a coronary arterial stenosis. METHODS: We assessed the diagnostic accuracy of TAG320 using 320-row CCTA with FFR for the evaluation of functional stenosis severity in consecutive patients undergoing invasive coronary angiography and FFR for stable chest pain. The luminal radiological contrast attenuation (Hounsfield units [HU]) was measured at 5-mm intervals along the artery from ostium to a distal level where the cross-sectional area decreased to
Original languageEnglish
Pages (from-to)1271 - 1279
Number of pages9
JournalJournal of the American College of Cardiology
Issue number12
Publication statusPublished - 2013

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