What question did this study set out to answer?

Q: What question did this study set out to answer?

To determine whether the lesion-specific peri-coronary fat attenuation index is associated with functional myocardial ischemia as identified by invasive fractional flow reserve.

November 3, 2021Frontiers in Cardiovascular MedicineOpen Access

Lesion-Specific Peri-Coronary Fat Attenuation Index Is Associated With Functional Myocardial Ischemia Defined by Abnormal Fractional Flow Reserve

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Why the study?

The association between abnormal invasive fractional flow reserve (FFR) and the fat attenuation index (FAI) of lesion-specific peri-coronary adipose tissue was unclear.

Does lesion-specific peri-coronary fat attenuation index predict functional myocardial ischemia defined by abnormal fractional flow reserve in patients undergoing coronary CTA?

Population

227 patients from seven centers undergoing CTA and subsequent ICA with FFR within 1 week

Comparison

Lesions with abnormal FFR (<0.8) vs lesions without abnormal FFR

Design

Multicenter retrospective observational study

Authors

SMShaowei MaChina Medical University XCXujiao ChenZhejiang Chinese Medical University YMYue MaMinistry of Education

Discussion

Member takes

Implication

FAI_lesion may refine CTA ischemia assessment; hypothesis-generating and should not yet change practice.

Key Points

To determine whether the lesion-specific peri-coronary fat attenuation index is associated with functional myocardial ischemia as identified by invasive fractional flow reserve.
Retrospective multicenter study evaluating 227 patients from seven centers who underwent coronary computed tomography angiography (CTA) and invasive coronary angiography with fractional flow reserve (FFR) within 1 week.
Quantified lesion-specific fat attenuation index (FAIlesion), lesion-free FAI (FAInormal), epicardial adipose tissue (EAT) volume and attenuation, plaque characteristics, and stenosis severity, defining functional ischemia as FFR < 0.8.
FAIlesion was significantly higher in ischemic lesions compared to non-ischemic lesions (-71 ± 8 HU vs. -76 ± 9 HU, p < 0.01), whereas FAInormal (-82 ± 11 HU vs. -81 ± 11 HU, p = 0.65) and total EAT parameters showed no significant differences.
CTA-assessed stenosis severity (OR 1.06, 95% CI 1.04–1.08, p < 0.01) and FAIlesion (OR 1.08, 95% CI 1.04–1.12, p < 0.01) independently predicted functional ischemia, achieving a combined diagnostic AUC of 0.820 versus 0.839 for invasive angiography (p = 0.39).

Structured PICO

Does lesion-specific peri-coronary fat attenuation index predict functional myocardial ischemia defined by abnormal fractional flow reserve in patients undergoing coronary CTA?

Population

227 patients from seven centers who underwent coronary computed tomography angiography (CTA) and subsequent invasive coronary angiography (ICA) and fractional flow reserve (FFR) measurement within 1 week.

Intervention

Lesion-specific peri-coronary fat attenuation index (FAI_lesion) and CTA-assessed stenosis severity

Comparator

Lesion-free FAI (FAI_normal), general epicardial adipose tissue (EAT) parameters, and ICA-assessed stenosis severity

Outcome

Functional myocardial ischemia defined by abnormal fractional flow reserve (FFR <0.8)surrogate

Lesion-specific peri-coronary fat attenuation index (FAI) derived from CTA is independently associated with abnormal FFR and improves the non-invasive diagnosis of functional myocardial ischemia.

Cite This Study

Ma et al. (2021) studied this question.

synapsesocial.com/papers/69d69d10e76a53de2732f74c https://doi.org/10.3389/fcvm.2021.755295

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Lesion-Specific Peri-Coronary Fat Attenuation Index Is Associated With Functional Myocardial Ischemia Defined by Abnormal Fractional Flow Reserve

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Lesion-Specific Peri-Coronary Fat Attenuation Index Is Associated With Functional Myocardial Ischemia Defined by Abnormal Fractional Flow Reserve

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

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