Correlation between CT-derived fractional flow reserve and myocardial strain in ischemic heart disease patients with single coronary artery stenosis assessed based on CCTA.

Abstract

Purpose: We aimed to investigate the correlation between CT-derived fractional flow reserve (CTFFR) and myocardial strain in patients with single coronary artery stenosis and to investigate the diagnostic value of CTFFR in identifying impaired myocardial strain.

Methods: We selected 89 patients, categorized into three groups based on the affected coronary artery: 36 with left anterior descending (LAD), 23 with left circumflex (LCX), and 30 with right coronary artery (RCA) stenosis, along with 25 healthy controls. We investigated correlations between CTFFR and both global and regional myocardial strain parameters. Additionally, we assessed the ability of the CTFFR to detect impaired myocardial strain in these patients.

Results: In this study, no significant difference was found in overall myocardial strain between the patient and control groups. However, regional longitudinal strain (LS) and circumferential strain (CS) in the myocardial areas supplied by stenotic coronary arteries was significantly lower in each patient group compared to the others (P < 0.001). The CTFFR exhibited a strong negative correlation with both regional and global myocardial strain, with a stronger association for regional strain. Particularly in group LAD, CTFFR in optimal diastole phase (CTFFR-D) was negatively correlated with Endo-LS (r = -0.66, P < 0.001). Receiver operator characteristic curve (ROC) analysis indicated that CTFFR were effective in diagnosing impaired myocardial strain, particularly LS.

Conclusion: There is a strong correlation between CTFFR, which is a functional measure for assessing coronary artery stenosis, and myocardial strain. CTFFR can identify impaired myocardial strain and can be used as an indirect indicator of myocardial ischemia.