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| Dr Ihdayhid and Associate Professor Ko |
MonashHeart interventional cardiology fellow and Monash
University PhD candidate Dr Abdul Ihdayhid was recognised for his
ground-breaking research into coronary artery disease, receiving two highly
prestigious awards in Perth last week, following on from winning the Young Investigator Award at the Society of Cardiovascular Computed Tomography last month in Washington D.C.
Dr Ihdayhid was awarded the most highly regarded Ralph
Reader Prize at the annual scientific meeting of the Cardiac Society of
Australia & New Zealand (CSANZ) as well as the prestigious Geoff Mews
Memorial Fellows’ Prize at the Australia & New Zealand Endovascular
Therapies Meeting (ANZET) for his research into assessing the functional
significance of coronary artery disease.
Patients with suspected angina (chest pain caused by reduced
blood flow to the heart) usually need further tests to determine if they have
coronary artery disease, as well as the functional significance of the
narrowing of the arteries.
“The functional significance represents the degree to which
a narrowing affects blood flow to the heart muscle—and this is a strong
predictor of long term outcomes and the benefit from potential treatments,”
said Dr Ihdayhid.
The current accepted gold standard for assessing the blood
flow and functional significance of a coronary narrowing is using fractional
flow reserve (FFR), only obtained during invasive coronary angiography using a
specialised pressure wire inserted into the coronary artery.
Dr Ihdayhid said CT coronary angiography (CTCA) is rapidly
becoming the first-line test for investigating coronary artery disease.
“It is an excellent test for ruling out disease, however in
the presence of a narrowing it has limited ability at determining the degree of
blood flow limitation.”
“Patients often need undergo further tests to determine the
functional significance, associated with potential side effects, inconvenience
to the patient and overall cost to the health system,” Dr Ihdayhid said.
In a world-first, Dr Ihdayhid’s research has shown an
alternative technique, known as CT Derived Fractional Flow Reserve, is a novel
and non-invasive method for determining FFR with superior diagnostic performance,
and importantly, with no potential side effects and reduced cost to the health
system.
“There are two emerging techniques that provide us with the
ability to assess both anatomy and function using a CTCA: CT Stress Myocardial
Perfusion (CTP) and CT Derived Fractional Flow Reserve (CT-FFR).”
“CTP requires two scans performed 20 minutes apart and a
medication to maximise coronary blood flow.
This is associated with increased side-effects, contrast and radiation
exposure to patients,” Dr Ihdayhid said.
Dr
Ihdayhid’s research investigated CT-FFR as a novel non-invasive method for
determining FFR.
“Current
CT-FFR techniques require the use of a supercomputer and external off-site
processing with a turn-around time of around 24-48 hours, hence reducing its
clinical utility.”
“MonashHeart
has been collaborating with Toshiba Medical Japan in developing a world-first
point of care CT-FFR technique that can be performed on-site and within 30
minutes of CTCA acquisition.”
“Our
recently published work has demonstrated that it is highly accurate when
compared to FFR determined invasively.”
Dr
Ihdayhid said their results demonstrated that CT-FFR had superior diagnostic
performance at detecting functionally significant disease when compared to CTP
and they achieved these results in less time and with less contrast and
radiation exposure.
“These
results take us one step closer to utilising a resting CTA in delivering both
anatomical and functional information in a single, rapid, safe and accurate
investigation,” Dr Ihdayhid said.
The
Monash research team has finished recruiting 500 prospective patients with
suspected coronary artery disease in whom they will perform a CT-FFR analysis
to assess the real-world feasibility and utility of this cutting-edge
technique.
Dr
Ihdayhid said if the results are promising, their next step will be a
multi-centre randomized control trial.
Dr
Ihdayhid acknowledges the tremendous and ongoing support of his PhD supervisor,
Associate Professor Brian Ko, Consultant Interventional Cardiologist at
MonashHeart.
