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

胸痛可能是与心脏血管狭窄（冠状动脉疾病[CAD]）相关的症状。这种胸痛，称为心绞痛，可能导致生活质量下降，如果没有得到适当的诊断和管理，可能导致心脏病发作。冠心病仍然是当今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。冠状动脉计算机断层扫描血管造影术（CCTA）是一种对心脏血管进行成像的检查。它是心绞痛患者的主要测试，因为它非常适合说明心脏血管是否正常，并且可以让患者放心。然而，当狭窄的存在CCTA缺乏能力，告诉他们是否引起病人的症状。一种新技术，CT衍生的血流储备分数（FFRCT）使用CCTA图像制作心脏血管的3D模型，显示是否存在导致症状的心脏血流限制。国家健康与护理卓越研究所（NICE）建议在胸痛途径中使用FFRCT。然而，由于资金限制和不确定性，这种新技术的使用仍然有限，因为它在NHS中的好处。这项研究旨在确定新的FFRCT技术的安全性和可靠性，为患者提供更快的诊断时间，减少进一步测试的需要，从而为NHS提供良好的价值。

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.