Can differences in corrected coronary opacification measured with computed tomography predict resting coronary artery...

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology
• Radiology

Background:

• Computed tomographic coronary angiography (CTCA) is used for detecting obstructive coronary artery disease.
• CTCA cannot reliably differentiate between anatomical and functional stenoses.

Purpose of the Study:

• To determine if corrected coronary opacification (CCO) differences within the coronary lumen can identify arteries with abnormal resting coronary flow.

Main Methods:

• Patients undergoing CTCA and invasive coronary angiography were enrolled.
• CCO differences were calculated and compared with coronary stenosis severity and Thrombolysis In Myocardial Infarction (TIMI) flow.
• Attenuation values of coronary lumen were measured and normalized to the aorta.

Main Results:

• CCO differences were greater in arteries with CTCA diameter stenoses ≥ 50% and TIMI flow grade < 3 compared to normal arteries.
• Abnormal coronary flow (TIMI flow grade < 3) was identified with 83.3% sensitivity and 91.2% specificity.
• The method achieved 88.5% accuracy with very good agreement (kappa = 0.75).

Conclusions:

• Changes in CCO across coronary stenoses appear to predict abnormal resting coronary blood flow (TIMI flow grade < 3).
• Further research is needed to assess its incremental diagnostic value and potential for measuring stress coronary blood flow.