Association of coronary artery disease phenotypes with myocardial perfusion defects and impaired myocardial blood flow - A hybrid CCTA-CTFFR and 13N-NH3 PET/CT study

Abstract Background/Introduction Non-invasive, quantitative and objective phenotyping of the longitudinal distribution of coronary artery disease (CAD) is feasible using the CCTA-based Simulated Pressure Loss Index (CT-SPLI) a novel metric derived from CT-based fractional flow reserve (CT-FFR) estimates. By combining the magnitude and extend of longitudinal epicardial pressure losses, CT-SPLI provides a continuous metric from 0 to 1; values close to 0 represent diffuse CAD, whereas values close to 1 represent focal CAD. Purpose The aim of this study is to describe the associations of non-invasively assessed CAD phenotypes with myocardial ischemia and pathological myocardial blood flow derived from positron emission tomography/computed tomography-myocardial perfusion imaging (PET/CT-MPI). Methods A total of 169 patients who underwent hybrid CCTA and 13N-NH3 PET/CT-MPI for evaluation of suspected chronic coronary syndrome were retrospectively included. CT-FFR analysis and CT-SPLI calculation were performed in 362 coronary arteries with plaques and luminal diameter stenosis ≥ 20% to