MICA: CT-derived fractional flow reserve (FFRCT) for the improved management of chest pain patients

胸痛可能是一种与心脏血管狭窄(冠状动脉疾病[CAD])有关的症状。这种称为心绞痛的胸痛会导致生活质量下降，如果没有得到适当的诊断和处理，可能会导致心脏病发作。今天，冠心病仍然是英国最大的死亡原因，每4分钟就有一人死亡。指南建议使用测试来帮助诊断和管理胸痛“心绞痛”患者。冠状动脉CT血管造影术(CCTA)是一种对心脏血管进行成像的测试。它是心绞痛患者的主要检测手段，因为它能很好地判断心脏血管是否正常，并能让患者放心。然而，当存在狭窄时，CCTA无法判断它们是否导致了患者的症状。一种名为CT衍生的分数血流储备(FFRCT)的新技术使用CCTA图像来制作心脏血管的3D模型，以显示流向心脏的血液是否存在限制，从而导致症状。国家健康与护理卓越研究所(NICE)建议在胸痛途径中使用FRCT。然而，由于资金限制和不确定其在NHS中的好处，这种新技术的使用仍然有限。这项研究旨在确定新的FFRCT技术在多大程度上是安全可靠的，为患者提供更快的诊断时间，减少进一步测试的需要，从而对NHS具有良好的价值。

Chest pain may be a symptom that is related to a narrowing of the heart blood vessels (coronary artery disease [CAD]). This chest pain, known as angina, can result in a reduced quality of life and, if not diagnosed and managed appropriately, could result in a heart attack. Coronary disease remains the largest cause of death in the United Kingdom today, with one death every 4 minutes. Guidelines recommend the use of tests to help diagnose and manage chest pain 'angina' patients. Coronary computed tomography angiography (CCTA) is a test that takes images of the heart blood vessels. It is the main test for patients presenting with angina, as it is excellent at saying when the heart blood vessels are normal, and can be reassuring for patients. However, when narrowing's are present CCTA lacks the ability to tell whether they are causing the patient's symptoms. A new technology, CT-derived fractional flow reserve (FFRCT) uses the CCTA images to make a 3D model of the heart blood vessels that shows whether there is a limitation in the blood flow to the heart which is causing the symptoms. The National Institute for Health and Care Excellence (NICE) recommends the use of FFRCT in a chest pain pathway. However, use of this new technology remains limited due to funding restrictions and uncertainty as to its benefit in the NHS. This study aims to determine the extent to which the new FFRCT technology is safe and reliable, provides a quicker time to diagnosis for the patient, reduces the need for further tests and thus represents good value to the NHS.