To Explore the Influencing Factors of Pericoronary Adipose Tissue and Noninvasive Fractional Flow Reserve on the Progression of Coronary Heart Disease Based on 320-Slice Coronary CTA

Abstract

Background: The objective of the study was to measure pericoronal adipose tissue parameters, fractional flow reserve with coronary artery computed tomographic angiography (CTA), and difference of fractional flow reserve with coronary artery CTA, by using high-performance 320-slice coronary CTA combined with semiautomatic quantitative software and explore the relationship between them and progression of coronary artery disease. Methods: According to the inclusion criteria, 118 patients with complete data were selected. According to the results of coronary angiography during follow-up review, the patients were divided into coronary artery disease progression group (n = 43) and coronary artery disease stable group (n = 75), and the clinical baseline data, pericoronal adipose tissue volume, pericoronal adipose tissue fat attenuation index, fractional flow reserve with coronary artery CTA, and difference of fractional flow reserve with coronary artery CTA were compared between the 2 groups. According to univariate and multivariate logistic regression analyses, the risk factors related to coronary artery disease progression were screened out from pericoronal adipose tissue parameters and noninvasive hemodynamic characteristics (fractional flow reserve with coronary artery CTA and difference of fractional flow reserve with coronary artery CTA). Results: There was no significant difference in baseline clinical data between the progression group and the stable group (P > .05). The left anterior descending artery-fat attenuation index-40 mm, left anterior descending artery-fat attenuation index-70 mm, left circumflex artery-fat attenuation index-70 mm, right coronary artery-fat attenuation index-70 mm, and difference of fractional flow reserve with coronary artery CTA in the progression group were higher than those in the stable group, while fractional flow reserve with coronary artery CTA was lower than that in the stable group, and the differences were statistically significant (P< .05). After adjusting for several factors, the results showed that left anterior descending artery-fat attenuation index-40 mm (P= .002; odds ratio = 1.237; 95% CI: 1.081-1.415), right coronary artery-fat attenuation index-70 mm (P= .039; odds ratio = 1.119; 95% CI: 1.006-1.246), fractional flow reserve with coronary artery CTA (P= .001; odds ratio = 0.708; 95% CI: 0.581-0.846), and difference of fractional flow reserve with coronary artery CTA (P < .001; odds ratio = 1.846; 95% CI: 1.394-2.445) were related to the progression of coronary artery disease. Compared with the above 5 indicators, the area under curve (AUC) of the above indicators combined is larger (0.897). Conclusions: Quantitative pericoronal adipose tissue parameters and noninvasive hemodynamic characteristics based on 320-slice coronary CTA can be used as the basis for predicting the progression of coronary artery disease.