Author + information
- Mhairi Katrina Doris,
- Yuka Otaki,
- Balaji Tamarappoo,
- Yoav Arnson,
- Heidi Gransar,
- Frances Wang,
- Sean Hayes,
- John Friedman,
- Louise Thomson,
- Piotr Slomka,
- Damini Dey and
- Daniel Berman
Background: Automated coronary plaque analysis can provide comprehensive assessments of plaque characteristics in individual lesions and entire arteries. Segmental quantitative plaque characteristics have been shown to add to stenosis severity in predicting lesion-specific measures of ischemia using CT coronary angiography (CTA)-derived fractional flow reserve (FFRCT); however, the relationship between whole vessel plaque characteristics and FFRCT has not been assessed.
Methods: Quantitative plaque characteristics and FFRCT were assessed in 100 consecutive patients (75 men, 66±9 years) undergoing CTA. Whole coronary artery plaque quantification was analyzed in 231 vessels with visually apparent plaque. Plaque volumes [non-calcified (NCP), low density NCP (LDNCP), calcified (CP), and total plaque], maximal contrast density difference (CDD) [defined as maximum percent difference in luminal contrast density across a lesion compared to a proximal reference cross section] and percent diameter stenosis were quantified using semi-automated software (Autoplaque). Obstructive stenosis was defined as diameter stenosis ≥50%. FFRCT was measured commercially (HeartFlow) from conventionally acquired CTA. Impaired FFRCT was defined as FFRCT≤0.75 across the length of a vessel.
Results: There were 50 vessels with and 181 vessels without obstructive disease. The frequency of impaired FFRCT was 30% in vessels with obstructive stenosis and 10% in vessels with non-obstructive disease. Vessels with abnormal FFRCT had higher quantitative stenosis (49% vs. 24%), NCP volume (430 vs. 285 mm3), LDNCP volume (57 vs. 29 mm3), CP (57 vs. 23 mm3), total plaque volume (558 vs. 324 mm3), and higher CDD (24% vs. 14%), (median, P<0.05 for all). In multivariable analysis, total plaque volume and CDD were independent predictors of abnormal vessel FFRCT, after adjusting for stenosis (odds ratio for total plaque volume:5.2, 95% CI 1.1-24; P=0.04; odds ratio for CDD:2.4, 95% CI 1.5-3.8; P<0.001).
Conclusions: Using automated quantitative coronary plaque assessment, whole vessel CDD and total plaque volume are predictive of FFRCT across entire coronary arteries, after adjusting for stenosis severity.
Moderated Poster Contributions
Non Invasive Imaging Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 10:45 a.m.-10:55 a.m.
Session Title: Noninvasive Assessment of Coronary Flow Reserve: Clinical Implications
Abstract Category: 27. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography
Presentation Number: 1136M-09
- 2017 American College of Cardiology Foundation