Abstract 18902: CT Derived Atherosclerotic Plaque Burden and Morphology Are Associated With Impaired Myocardial Blood Flow Using [15O]H2O PET and Fractional Flow Reserve, Independent of Luminal Obstruction

Introduction: Next to coronary lesion severity, atherosclerotic plaque characteristics may influence downstream myocardial perfusion. Hypothesis: We assessed the hypothesis that quantitative plaque burden and plaque morphology using coronary computed tomography angiography (CCTA) is associated with quantitative myocardial perfusion using [15O]H2O positron emission tomography (PET) as well as invasively derived fractional flow reserve (FFR). Methods: 208 patients (63% men, age 58 ± 8.7 years) with suspected coronary artery disease were prospectively included. All patients underwent 256-slice CCTA, [15O]H2O PET, and invasive FFR measurements. CCTA derived quantitative plaque burden and morphology were assessed using commercially available software. Results: Atherosclerotic plaques were present in 179 (86%) patients and 414 of 610 (68%) evaluable coronary arteries. On a per-vessel basis, traditional coronary stenosis indices such as plaque length and volume, minimal lumen area, plaque burden, and stenosis pe...