Functional coronary imaging · London
CT-FFR HeartFlow, AI-derived fractional flow reserve from a CTCA — avoiding many invasive angiograms.
HeartFlow CT-FFR uses computational fluid dynamics on your CT coronary angiogram data to derive fractional flow reserve for every coronary segment — replacing many invasive angiograms and stress tests.
Why patients choose us
- 01
The right hands
We route you to a consultant cardiologist working with the HeartFlow team — the people who interpret CT-FFR every week decide the answer.
- 02
Often answers same-week
CT-FFR post-processing turnaround is typically 24–48 hours, with a consultant cardiology review to follow.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
What HeartFlow CT-FFR is, in six lines.
The essentials — the definition, the threshold, and what makes CT-FFR different from every other coronary test.
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Definition
AI-derived fractional flow reserve computed from your CT coronary angiogram using computational fluid dynamics.
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NICE MTG32 endorsed
NICE Medical Technologies guidance MTG32 supports HeartFlow CT-FFR for stable chest pain.
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Threshold
CT-FFR values < 0.80 indicate functionally significant coronary stenosis.
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Reduces invasive angiography
Real-world data show around a 30% reduction in downstream invasive coronary angiograms.
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No extra scan needed
CT-FFR is post-processing only — no extra radiation, contrast or clinic visit on top of your CTCA.
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Reported by cardiology + HeartFlow
The HeartFlow analysis is integrated into a consultant cardiology report — not read in isolation.
The problem
Anatomy alone doesn’t tell you if a narrowing matters.
A CTCA shows the coronary anatomy; CT-FFR tells you which of those narrowings actually reduce blood flow — the question that decides medical therapy vs PCI vs surgery.
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Stable chest pain?
CT-FFR triages who really needs an invasive angiogram — and who doesn’t.
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Intermediate CTCA lesion?
HeartFlow answers the functional question the CTCA can’t, without another scan.
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Weighing PCI vs medical therapy?
Segment-level CT-FFR values map directly onto revascularisation decisions.
The journey
From CTCA to CT-FFR report — what happens, in order.
One dataset, one HeartFlow analysis, one integrated cardiology report — usually within days.
Phase 1 · Before analysis
CTCA and secure upload
Phase 2 · HeartFlow analysis
AI + fluid dynamics
Phase 3 · After
Cardiology plan
- 01
Before
CT coronary angiogram acquired
A high-quality CTCA is performed on a modern scanner — the input dataset for the CT-FFR analysis.
- 02
Before
Anonymised data uploaded to HeartFlow
Your CTCA dataset is de-identified and securely uploaded to the HeartFlow analysis service.
- 03
Analysis
AI segmentation and fluid-dynamics modelling
HeartFlow segments your coronary tree and runs computational fluid dynamics to derive FFR at every point along every vessel.
- 04
Analysis
CT-FFR reported per coronary segment
Segment-level CT-FFR values are returned on an anatomical model of your own coronary tree.
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After
Cardiology review
A consultant cardiologist integrates the CT-FFR values with your CTCA, symptoms and risk profile.
- 06
After
Decision on medical therapy vs PCI
Reassurance and medical therapy where CT-FFR is preserved; invasive angiography and PCI where it isn’t.
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After
Structured follow-up
A written plan for symptoms, risk-factor optimisation and any repeat imaging.
Typical end-to-end: 3–7 days. Urgent cases: same week.
What it shows
The eight things HeartFlow CT-FFR actually answers.
Segment-level FFR values, lesion-specific significance, and the pattern of disease across the whole coronary tree.
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Segment-level CT-FFR values
A functional FFR value at every point along every named coronary artery.
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Lesion-specific functional significance
Which anatomical narrowings are actually reducing flow — and which aren’t.
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Diffuse disease pattern
Identifies diffuse atheroma that lowers FFR across a whole vessel rather than a single lesion.
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Left main and 3-vessel FFR profile
Characterises left main and multi-vessel disease with a functional readout, not just anatomy.
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Post-stent haemodynamics
Assesses the functional result downstream of previously stented segments.
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Serial FFR trends
Compares CT-FFR over time when previous HeartFlow analyses are available.
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Reduces need for invasive angiography
A preserved CT-FFR often removes the need for an invasive coronary angiogram.
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Red flag: multiple segments with CT-FFR < 0.75 — MDT and cardiology / surgical review
Multi-segment, low CT-FFR values need an MDT with interventional cardiology and cardiac surgery.
Treatment options and next steps
What a CT-FFR result actually changes.
From reassurance through medical therapy to invasive angiography, PCI and surgery — where each pathway starts.
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Reassurance if all CT-FFR > 0.80
Normal functional FFR across every segment — a strong negative test that often ends the ischaemia work-up.
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Optimal medical therapy
Statin, antiplatelet, blood-pressure and glucose optimisation guided by your CTCA and CT-FFR profile.
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Invasive coronary angiography
Referred for invasive angiography where CT-FFR is < 0.75 in one or more segments.
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PCI for lesion-specific ischaemia
Percutaneous coronary intervention targeted to the lesions that CT-FFR shows are functionally significant.
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CABG for multi-vessel disease
Surgical revascularisation for left main and multi-vessel disease with a low CT-FFR profile.
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Cardiovascular risk optimisation
Lipids, blood pressure, HbA1c, weight and lifestyle — the substrate under any coronary plan.
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Cardiac rehabilitation
Structured exercise and education after revascularisation or a high-risk CT-FFR result.
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Follow-up CTCA + CT-FFR
Repeat imaging with a new HeartFlow analysis to monitor progression or response to therapy.
Our vetted network
A small panel of centres, we picked them.
Cardiology centres that run HeartFlow CT-FFR routinely — not once in a blue moon. Introductions made privately, once we understand your case.
Selection criteria
How we choose every centre in our network.
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Consultant cardiologists working routinely with HeartFlow CT-FFR
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Scanners and protocols validated for HeartFlow analysis
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Structured cardiology + HeartFlow report, not a standalone CTCA report
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Onward pathway to invasive angiography, PCI and cardiac surgery where CT-FFR demands it
Red flags and caveats
The findings and situations that change the plan.
Where CT-FFR gives you the answer, where it can’t, and the results that need urgent cardiology and MDT review — not a routine follow-up.
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Multiple segments CT-FFR < 0.75
Widespread, low CT-FFR values need an urgent cardiology and MDT review — not a routine follow-up slot.
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Left main CT-FFR < 0.80
A functionally significant left main lesion is a red-flag finding and changes the whole treatment pathway.
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Ostial disease
Ostial lesions are technically harder to interpret and often need invasive confirmation.
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Serial-lesion cross-talk
Sequential lesions in the same vessel can interact — HeartFlow accounts for this, but interpretation still needs experience.
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CT quality inadequate for analysis
Motion, misalignment or breath-holding artefacts can make a CTCA unsuitable for CT-FFR — repeat imaging may be needed.
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Very heavy calcification
Dense calcification can degrade the CTCA input and limits the accuracy of the derived FFR values.
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Post-CABG graft failure
Graft assessment is a specific use case — CT-FFR is not a first-line test for isolated graft failure.
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Rapid symptom progression
Crescendo angina or new rest pain is a hospital problem, not a private outpatient one.
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Contrast-induced kidney injury
The CTCA itself uses iodinated contrast — kidney function and hydration matter, even though CT-FFR adds no extra contrast.
Reading your report
A CT-FFR report can look intimidating. It isn’t.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report is written for your doctor, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Indication and risk factors
Your details, the reason for the scan, and the cardiovascular risk factors that shape interpretation.
- 02 Technique
CTCA acquisition and HeartFlow analysis
Which scanner and protocol were used, and confirmation that the dataset was suitable for CT-FFR.
- 03 Findings
Segment-level CT-FFR values
Vessel-by-vessel description with CT-FFR values on an anatomical model of your coronary tree.
- 04 Impression
The conclusion: read this first
Whether functional ischaemia is present, and the concrete next step — read this first.
Sources
The guidelines behind this page.
- NICE Medical Technologies guidance MTG32. HeartFlow FFRCT for estimating fractional flow reserve from coronary CT angiography.
- European Society of Cardiology. Guidelines on the management of chronic coronary syndromes.
- American Heart Association. Coronary artery disease resources.
- HeartFlow ADVANCE Registry — real-world clinical outcomes data.
Last reviewed 2026-07-30. Next review scheduled 2027-07-30. Reading time 6 minutes.
Frequently asked
Everything we get asked about HeartFlow CT-FFR.
Quick answers on what CT-FFR is, the 0.80 threshold, NICE approval, and when it can — and can’t — replace an invasive angiogram.
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What is HeartFlow CT-FFR?
HeartFlow CT-FFR is an AI-derived fractional flow reserve calculated from your CT coronary angiogram data using computational fluid dynamics. It gives a functional FFR value at every point along every named coronary artery without any extra scanning.
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Do I need an extra scan?
No. CT-FFR is post-processing only — it uses the CTCA dataset you have already had. There is no additional radiation, contrast or clinic visit for the HeartFlow analysis itself.
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What does a CT-FFR value < 0.80 mean?
A CT-FFR value below 0.80 in a coronary segment indicates that the narrowing at that point is functionally significant — that is, it is reducing blood flow enough to matter, and revascularisation is often considered.
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Is HeartFlow CT-FFR NICE approved?
Yes. NICE Medical Technologies guidance MTG32 endorses HeartFlow FFRCT for estimating fractional flow reserve from CT coronary angiography in patients with stable, recent-onset chest pain.
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Can CT-FFR replace an invasive angiogram?
Often, yes. When CT-FFR is preserved across all segments, an invasive coronary angiogram is frequently avoided. Where CT-FFR is low, invasive angiography and PCI are usually the next step — CT-FFR is a triage, not a substitute for every case.
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When is CT-FFR not suitable?
CT-FFR needs a CTCA of adequate quality — motion, misalignment, breath-holding artefact or very heavy coronary calcification can make the dataset unsuitable for analysis. Graft assessment after CABG is also a specific use case and not a first-line indication.
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In practice, in London
The honest picture around CT ffr heartflow in London
With CT ffr heartflow, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. Waiting lists on the NHS for CT ffr heartflow vary widely by borough and by how the GP letter reads. Privately in London, we can normally offer a slot inside the same week, sometimes within 48 hours if there’s a cancellation. The difference isn’t clinical quality — the consultants are frequently the same faces you’d see on the NHS — it’s the calendar.
In practice, a private CT ffr heartflow appointment in London means a named consultant, a proper hour in the room (or the equivalent on a video call), and a report you can actually read. Most of the imaging suites and endoscopy units we use sit within a mile of Harley Street or in Chelsea and Fulham, and turnaround on findings is measured in days, not weeks. For CT ffr heartflow specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
We’re careful about what a private pathway for CT ffr heartflow can and can’t promise. It can compress a wait, put you in front of a subspecialist quickly, and get a proper report in your hands within a week. It can’t rewrite what the imaging or the bloods say. Setting that expectation up front tends to make the whole experience less stressful.
Nearby in the library