Correlation between hemodynamics assessed by FAI combined with CT-FFR and plaque characteristics in coronary artery stenosis

Abstract

Abstract Background While both CT-FFR and FAI are found to be associated with the development of CAD, their relationship with hemodynamics and plaque characteristics remains unclear. The present study aims to investigate the relationship between hemodynamics assessed by FAI combined with CT-FFR and plaque characteristics in functionally significant coronary artery stenosis. Methods This retrospective study included 130 patients with suspected coronary heart disease, who were admitted to the Department of Cardiology of our hospital and underwent coronary computed tomography angiography (CCTA) from January 2022 to December 2023. Clinical baseline data and relevant auxiliary examination results were collected, and CCTA, FAI, and CT-FFR data were analyzed to investigate the relationship between these imaging parameters and both the hemodynamics and plaque characteristics of coronary artery lesions. Results From 130 patients, a total of 207 diseased vessels were analyzed and classified based on CAD-RADS grading: 128 vessels exhibited stenosis of less than 50%, and 79 exhibited stenosis exceeding 50%. Patients with more than one lesion of > 50% stenosis were classified into the myocardial ischemia group (44 cases), and the rest were categorized as the non-myocardial ischemia group (86 cases). Compared to the non-myocardial ischemia group, patients in the myocardial ischemia group were significantly older (p 50% stenosis, ΔCT-FFR was lower in vessels with 50% stenosis, and the median CT-FFR was significantly lower in vessels with > 50% stenosis than in vessels with 50% stenosis compared to vessels with 50% stenosis, primarily located in the LAD, while calcified plaques were predominantly observed in vessels with 50% stenosis, plaques were longer, the degree of luminal stenosis was greater, and both the total volume and burden of plaques were significantly greater than in vessels with 50% stenosis was higher than in vessels with < 50% stenosis (p < 0.001). Conclusion FAI is associated with coronary artery stenosis and myocardial ischemia, and may serve as a novel indicator for identifying myocardial ischemia. Both FAI and CT-FFR demonstrated strong predictive abilities in significant coronary stenosis.

Keywords

• Coronary artery disease
• Coronary computed tomography angiography (CCTA)
• Pericoronary adipose tissue (PCAT)
• Fat attenuation index (FAI)
• CT derived fractional flow reserve (CT-FFR)