Non-invasive fractional flow reserve in vessels without severe obstructive stenosis is associated with coronary plaque burden |
| |
Institution: | 1. National Heart Center Singapore, Singapore;2. Singapore Clinical Research Institute, Singapore;3. Duke-NUS Medical School, Singapore;4. Department of Radiology and Cardiology, Erasmus University Medical Center, Rotterdam, Netherland;5. First Department of Medicine-Cardiology, University Medical Centre Mannheim, affiliated at the DZHK (German Centre for Cardiovascular Research), Mannheim, Germany;6. Heart & Vascular Center, Medical University of South Carolina, Charleston, SC, United States;7. California Medical Innovation Institute, San Diego, CA, United States |
| |
Abstract: | AimsNon-invasive fractional flow reserve derived from coronary CT angiography (FFRCT) has been shown to be predictive of lesion-specific ischemia as assessed by invasive fractional flow reserve (FFR). However, in practice, clinicians are often faced with an abnormal distal FFRCT in the absence of a discrete obstructive lesion. Using quantitative plaque analysis, we sought to determine the relationship between an abnormal whole vessel FFRCT (V-FFRCT) and quantitative measures of whole vessel atherosclerosis in coronary arteries without obstructive stenosis.MethodsFFRCT was calculated in 155 consecutive patients undergoing coronary CTA with ≥25% but less than 70% stenosis in at least one major epicardial vessel. Semi-automated software was used to quantify plaque volumes (total plaque TP], calcified plaque CP], non-calcified plaque NCP], low-density non-calcified plaque LD-NCP]), remodeling index RI], maximal contrast density difference CDD] and percent diameter stenosis %DS]. Abnormal V-FFRCT was defined as a minimum value of ≤0.75 across the vessel (at the most distal region where FFRCT was computed).ResultsVessels with abnormal V-FFRCT had higher per-vessel TP (554 vs 331 mm3), CP (59 vs 25 mm3), NCP (429 vs 295 mm3), LD-NCP (65 vs 35 mm3) volume and maximum CDD (21 vs 14%) than those with normal V-FFRCT (median, p < 0.05 for all). Using a multivariate analysis to adjust for CDD and %DS, all measures of plaque volume were predictive of abnormal V-FFRCT (OR 2.09, 1.36, 1.95, 1.95 for TP, CP, NCP and LD-NCP volume, respectively; p < 0.05 for all).ConclusionAbnormal V-FFRCT in vessels without obstructive stenosis is associated with multiple markers of diffuse non-obstructive atherosclerosis, independent of stenosis severity. Whole vessel FFRCT may represent a novel measure of diffuse coronary plaque burden. |
| |
Keywords: | Fractional flow reserve Plaque characteristics Diffuse atherosclerosis CTA"} {"#name":"keyword" "$":{"id":"kwrd0030"} "$$":[{"#name":"text" "_":"Computed tomography angiography coronary CT angiography -derived fractional flow reserve NCP"} {"#name":"keyword" "$":{"id":"kwrd0060"} "$$":[{"#name":"text" "_":"non-calcified plaque LD-NCP"} {"#name":"keyword" "$":{"id":"kwrd0070"} "$$":[{"#name":"text" "_":"low-density non-calcified plaque CP"} {"#name":"keyword" "$":{"id":"kwrd0080"} "$$":[{"#name":"text" "_":"calcified plaque CDD"} {"#name":"keyword" "$":{"id":"kwrd0090"} "$$":[{"#name":"text" "_":"contrast density difference SD"} {"#name":"keyword" "$":{"id":"kwrd0100"} "$$":[{"#name":"text" "_":"standard deviation TP"} {"#name":"keyword" "$":{"id":"kwrd0110"} "$$":[{"#name":"text" "_":"total plaque RI"} {"#name":"keyword" "$":{"id":"kwrd0120"} "$$":[{"#name":"text" "_":"remodeling index %DS"} {"#name":"keyword" "$":{"id":"kwrd0130"} "$$":[{"#name":"text" "_":"percent diameter stenosis |
本文献已被 ScienceDirect 等数据库收录! |
|