Impact of Heterogeneous Plaque Deposition on Computed Tomography Derived Fractional Flow Reserve

L/P ratio, which indicates the proportion of lumen volume to plaque volume of the vessel, is lower in lesion than in per-lesion (RCA, 0.9 vs. 7.7; LAD, 1.4 vs. 8.1; and LCX, 0.9 vs. 8.0). For lesion located in the middle segments of the three major vessels, FFR_CT drops from 0.97 to 0.78 for RCA, from 0.94 to 0.55 for LAD, and from 0.99 to 0.72 for LCX, respectively. Invasive coronary angiography shows moderate stenosis in the middle segment of the RCA but no significant obstructive coronary disease at the sites where FFR_CT showed a substantial decline in the LAD and LCX. CCTA indicates coronary CT angiography; ICA, invasive coronary angiography; LAD, left anterior descending artery; LCX, left circumflex artery; RCA, right coronary artery; SOCAD, significant obstructive coronary disease.