Correlation between coronary computed tomographic angiography and fractional flow reserve

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology
• Radiology

Background:

• Coronary CT angiography (CCTA) is vital for evaluating coronary artery disease.
• Intermediate coronary artery stenosis presents a therapeutic challenge.
• Fractional flow reserve (FFR) is the gold standard for assessing lesion hemodynamic significance.

Purpose of the Study:

• To compare the diagnostic accuracy of CCTA with FFR in evaluating coronary artery stenoses.
• To determine quantitative CCTA parameters that correlate with FFR values.

Main Methods:

• 56 coronary artery stenoses in 42 patients were assessed using CCTA and FFR.
• CCTA quantitative analysis included diameter stenosis, area stenosis, minimal lumen diameter, minimal lumen area, lesion length, plaque volume, and plaque burden.
• Correlation and regression analyses were performed to compare CCTA metrics with FFR.

Main Results:

• FFR averaged 0.81±0.14, with 10 lesions showing abnormal FFR (<0.75).
• Significant correlations were found between FFR and CCTA metrics: area stenosis (r=-0.68), lesion length (r=-0.36), and plaque burden (r=-0.59).
• Area stenosis >73% and lesion length >10 mm were strong determinants of abnormal FFR, with high negative predictive values.

Conclusions:

• Quantitative CCTA measurements are significantly correlated with FFR.
• Established CCTA criteria can reliably exclude hemodynamically significant coronary artery stenoses.
• CCTA offers a non-invasive method to assess coronary lesion severity, potentially guiding therapeutic decisions.