NICE recommends 3D heart imaging for diagnosing heart disease

BMJ 2016; 354 doi: (Published 26 August 2016) Cite this as: BMJ 2016;354:i4662
  1. Zosia Kmietowicz
  1. The BMJ

Medical software that helps doctors visualise the blood vessels in the heart without invasive tests could help to diagnose heart conditions in patients with chest pain and suspected angina, the National Institute for Health and Care Excellence (NICE) has said.

NICE says that 36 000 people in England could benefit from the new technology every year, saving the NHS around £7.7m (€9m; $10.2m) by avoiding some invasive investigations and treatment.

In draft guidance,1 NICE provisionally recommends HeartFlow FFRct, which uses data from standard cardiac computed tomography angiography imaging to create 3D models of a patient’s blood vessels. The images are used to estimate fractional flow reserve—the ratio between the maximum blood flow in a narrowed artery and the maximum blood flow in a normal artery—and results are available within 48 hours. Currently, fractional flow reserve is measured invasively by placing a pressure wire across a narrowed artery.

The company that makes HeartFlow FFRct said that using the new technology would reduce the need for revascularisation in some patients because it more accurately identifies whether stenoses are ischaemic than coronary angiography alone. An evaluation of the evidence by NICE’s medical technologies advisory committee agreed with this. And, with a reduced price of £700 a test, HeartFlow FFRct would be cheaper by £214 a patient than the current treatment pathway for all functional imaging tests (SPECT, MRI, and ECHO), the committee said.

Carole Longson, director of the NICE centre for health technology evaluation, said, “Accurately diagnosing the cause of chest pain is important for ensuring that the affected person receives appropriate care and treatment.

“The preliminary view of the independent committee is that HeartFlow FFRct is innovative, and using it in practice may simplify the series of tests used to diagnose the condition.

“Based on the evidence that the committee considered, they concluded that the device is highly accurate in diagnosing coronary artery disease and that it has the potential to reduce the need for invasive coronary investigations—which is good news for the patient.”

The consultation closes on 26 September 2016.


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