Cardiac computed tomography angiography (CCTA or CTA) has emerged as a first-line tool for diagnosing, treating, and evaluating the prognosis of various cardiac diseases. In this special issue of JSCAI, "The Role of Cardiac Computed Tomography Angiography in Diagnosis, Treatment, and Prognosis of Cardiac Disease", experts detail the broad spectrum of uses of this imaging modality, acknowledging the role of this test in current clinical and procedural practice, including:
- Risk stratification
- Ruling out coronary artery disease in patients with chest pain
- Assessing plaque morphology and hemodynamics of coronary stenosis
- Planning percutaneous coronary and structural interventions
- Cardiac surgical planning
- Pediatric, infectious, and congenital heart disease
"We're using CTA more and more for diagnosis, prognosis, and procedure planning. Since its launch two years ago, JSCAI has established itself as the premier journal for interventional cardiology. In addition to featuring prominent experts, this phenomenal special issue provides a platform for early- and mid-career superstars," said Dr. Alexandra Lansky, MD, MSCAI, founding editor-in-chief of JSCAI and professor of medicine and director of Heart and Vascular clinical research at the Yale School of Medicine. "The special JSCAI issue allows us to delve into a specific interest area, bring more attention to that space, and encourage submissions from specialists who might not otherwise submit to JSCAI."
In their opening editorial, guest editors Dr. Jonathon A. Leipsic, MD and Dr. Natalia Pinilla, MD, PhD encourage readers to experience the many diagnostic, planning, and prognostic possibilities that CCTA offers, as well as ongoing efforts to ease acquisition, improve image quality, develop dedicated analysis software, and incorporate artificial intelligence into the interpretation.
"We are at the point that CCTA technology is amazing, the image quality and additional information goes beyond anatomy, and now we are at an inflection point for the entire interventional cardiology community to understand the power and the potential of this technology. I don't think it's been incorporated in patient care as much as it should—yet," said Dr. Pinilla, an interventional cardiologist at Hamilton Health Science/Niagara Health and associate professor of medicine at McMaster University. "With this JSCAI special issue, we want to make the community aware of the many indications, to include both diagnostic and functional assessment of coronary stenosis, for PCI and structural procedures planning, selecting patient for invasive testing, as well as validating results of interventional and surgical procedures. In the future, we may be able to plan procedures entirely with this noninvasive method of CCTA."
"This is an exciting time, with CCTA providing an opportunity to drive more efficient and thoughtful cath lab utilization. There's tremendous interest amongst interventionalists that wasn't there five years ago, and it's obviously played a major role in TAVR and transcatheter valve interventions. We are seeing greater interest in planning PCI and characterizing plaque and understanding risk and mechanisms of myocardial infarction using this technology," said Dr. Leipsic, chair of the department of radiology for Providence Health Care and professor of radiology and cardiology at the University of British Columbia, where he is the vice chair of research.
The issue includes comprehensive reviews, original research, and case reports:
- Efficacy of Coronary Calcium Score in Predicting Coronary Artery Morphology in Patients with Obstructive Coronary Artery Disease (https://doi.org/10.1016/j.jscai.2024.101308)
- Noninvasive Coronary Physiological Assessment Derived from Computed Tomography (https://doi.org/10.1016/j.jscai.2024.101304)
- Utility of Artificial Intelligence Plaque Quantification: Results of the DECODE Study (https://doi.org/10.1016/j.jscai.2024.101296)
- Advanced CT Imaging for the Assessment of Calcific Coronary Artery Disease and PCI Planning (https://doi.org/10.1016/j.jscai.2024.101299)
- Cardiac Computed Tomography Angiography in the Evaluation of Coronary Artery Disease: An Interventional Perspective (https://doi.org/10.1016/j.jscai.2024.101301)
- Validation Study of Two Artificial Intelligence–Based Preplanning Methods for Transcatheter Aortic Valve Replacement Procedures (https://doi.org/10.1016/j.jscai.2023.101289)
- Computed Tomography in Infectious Endocarditis (https://doi.org/10.1016/j.jscai.2023.101292)
- Virtual Reality Remote Collaboration for Preprocedural Planning of Complex Percutaneous Congenital Interventions: A Case Series (https://doi.org/10.1016/j.jscai.2024.101302)
- Pulmonary Arteriovenous Malformation in an Unrepaired Tetralogy of Fallot: Diagnostic Implications (https://doi.org/10.1016/j.jscai.2024.101303)
- Association of Relative Left Ventricular Outflow Tract Area and Transcatheter Aortic Valve Replacement Related Paravalvular Leak (https://doi.org/10.1016/j.jscai.2023.101294)
- Using Artificial Intelligence to Optimize the Use of Cardiac Investigations in Patients with Suspected Coronary Artery Disease (https://doi.org/10.1016/j.jscai.2024.101305)
- Coronary Computed Tomography Angiography Solving Ambiguity in Chronic Total Occlusion Percutaneous Coronary Intervention (https://doi.org/10.1016/j.jscai.2023.101261)
- Surgical Ligation of a Large Coronary-Cameral Fistula Suspected of Causing Coronary Steal Phenomenon (https://doi.org/10.1016/j.jscai.2024.101300)
- Feasibility and Utility of Anatomical and Physiological Evaluation of Coronary Disease with Cardiac CT in Severe Aortic Stenosis (FUTURE-AS Registry): Rationale and Design (https://doi.org/10.1016/j.jscai.2023.101293)
- Gated Computed Tomography Evaluation of the Aortic Root for Treatment Planning of Patients with Aortic Stenosis (https://doi.org/10.1016/j.jscai.2024.101298)
To access the issue, visit www.jscai.org/issue/S2772-9303(24)X0004-6
About SCAI: The Society for Cardiovascular Angiography and Interventions is a professional organization representing more than 4,000 invasive and interventional cardiology professionals in approximately 75 nations. SCAI's mission is to promote excellence in invasive/interventional cardiovascular medicine through physician education and representation, and advancement of quality standards to enhance patient care.
