Distal-vessel fractional flow reserve by computed tomography to monitor epicardial coronary artery disease
Authors' conclusion
Distal-vessel FFR-CT permits the integrative assessment of epicardial atherosclerotic plaque burden in a vessel-specific manner and can be followed serially to determine changes in global CAD.
Study context
- Population
- Patients with serial coronary computed tomography angiography (CTA) scans ≥2 years apart over a 14-year periodmedian interval 5.2 years
- Participants
- 71 patients
- Outcome
- Feasibility of distal-vessel FFR-CT as a serially followed integrated measure of epicardial coronary artery disease (CAD); CTA and clinical predictors of distal-vessel FFR-CT and its changes
Methodological detailsAI-enabled quantitative coronary CTA, analysed blindly
- AI-enabled quantitative coronary CTA, analysed blindly
Main finding
As reported in the abstract
Change in distal-vessel FFR-CT at CT2
No significant change
45.3%
Improvement
27.8%
Worsening
26.9%
Observational data: associations, not effects.
Further findings
Predictors of distal-vessel fractional flow reserve by computed tomography (FFR-CT) ≤ 0.80 (stenosis diameter ratio, lumen volume, low density plaque volume, age)
- Multivariable model AUC at CT1
- 0.820
- Multivariable model AUC at CT2
- 0.799
Predictors of change in distal-vessel FFR-CT
- Improvement: decrease in high-risk plaque, increases in lumen volume and remodelling index (AUC)
- 0.865
- Worsening: increases in stenosis diameter ratio, medium density calcified plaque volume and total cholesterol (AUC)
- 0.707
Original publication
Distal-vessel fractional flow reserve by computed tomography to monitor epicardial coronary artery disease. Eur Heart J Cardiovasc Imaging. Published 14 September 2023. doi:10.
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