CCTA continues to transform cardiac imaging, interventional cardiology
Coronary CT angiography (CCTA) is poised to drive a fundamental shift in how cardiology evaluates, stratifies and treats patients, according to Mirvat Alasnag, MD, director of the catheterization laboratory and research at King Fahd Armed Forces Hospital in Jeddah, Saudi Arabia, director of TCT Middle East and a member of Society of Cardiovascular CT (SCCT) Education Committee. She spoke to Cardiovascular Business during TCT 2025 in San Francisco.
Speaking about the evolving role of cardiac CT, Alasnag said years of work by SCCT have laid the groundwork for broader adoption of the technology across cardiology subspecialties. Both a cardiac imager and an interventional cardiologist, she said CCTA now plays a key role for her in both the diagnosis of heart disease and treatment planning in the cath lab.
“I think SCCT really has put the genuine effort and done all the legwork for it,” Alasnag said, noting her own two decades of involvement with the society. She said SCCT has helped practicing cardiologists understand and apply the growing body of evidence supporting CT, while also identifying where important gaps remain.
Alasnag highlighted the need for more research into ethnic and sex-based differences in coronary and structural heart disease. She also pointed to risk stratification as a key area where CCTA could reshape care, primarily driven by the AI-enabled analysis of CCTA coronary plaque imaging.
“I think an important area of research is understanding the role of CT and noninvasive tools to risk stratify patients and look at these plaques that they have, the consistency of the plaque, the vulnerability of the plaque, and be able to quantify it,” Alasnag explained.
That information, she added, could help guide preventive therapies and improve patient education.
From an interventional cardiology perspective, Alasnag said CCTA is increasingly influencing procedural planning and decision-making in the cath lab.
“I am an interventional cardiologist by practice. I've also got my boards in CT,” she said. “And so very early on in my career, I understood that these are not parallel fields. There's a lot of crosstalk between both fields and, actually, it served me well.”
She explained that CT is now used to plan structural heart interventions, including device selection, sizing and vascular access routes. It is also increasingly being used to evaluate coronary anatomy and disease extent.
“Even now, we're looking at noninvasive means to functionally assess, do physiologic testing on these lesions and decide which ones need to be addressed with stenting and which don't,” Alasnag said.
As a result, she expects increasing integration between imaging and interventional practice.
“In the future, we're going to see significant overlap between these two fields, interventional cardiology and cardiac CT and imaging,” she said.
That convergence is already evident in the growing number of interventional cardiologists seeking to interpret CT scans themselves.
Alasnag emphasized that this trend reinforces the importance of collaborative care.
“I do think we're finally understanding that the heart team is one that functions together in terms of CT, in terms of patient analysis and so on,” she said.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]