Physiological significance of pericoronary inflammation in epicardial functional stenosis and global coronary flow reserve

• Published in: Scientific reports Vol. 11; no. 1; p. 19026
• Main Authors: Kanaji, Yoshihisa, Sugiyama, Tomoyo, Hoshino, Masahiro, Misawa, Toru, Nagamine, Tatsuhiro, Yasui, Yumi, Nogami, Kai, Ueno, Hiroki, Hirano, Hidenori, Hada, Masahiro, Yamaguchi, Masao, Hamaya, Rikuta, Usui, Eisuke, Yonetsu, Taishi, Sasano, Tetsuo, Kakuta, Tsunekazu
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 24.09.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 631/443/1338/2100; 692/4019/2776; Adipose tissue; Adipose Tissue - physiopathology; Aged; Angiography; Arteriosclerosis; Atherosclerosis - etiology; Cardiovascular disease; Cardiovascular diseases; Computed tomography; Computed Tomography Angiography; Coronary artery; Coronary Artery Disease - physiopathology; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - physiopathology; Coronary Vessels - physiopathology; Creatinine; Disease Progression; Female; Fractional Flow Reserve, Myocardial; Heart; Heart diseases; Humanities and Social Sciences; Humans; Hyperemia; Inflammation; Magnetic resonance imaging; Magnetic Resonance Imaging, Cine; Male; Middle Aged; multidisciplinary; Patients; Physiology; Prognosis; Retrospective Studies; Science; Science (multidisciplinary); Stenosis; Ventricle
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-97849-5

Both fractional flow reserve (FFR) and global coronary flow reserve (g-CFR) provide prognostic information in patients with stable coronary artery disease (CAD). Inflammation plays a vital role in impaired endothelial dysfunction and atherosclerotic progression, potentially predicting cardiovascular mortality. This study aimed to evaluate the physiological significance of pericoronary adipose tissue inflammation assessed by CT attenuation (PCATA) in epicardial functional stenosis severity and g-CFR in patients with CAD. A total of 131 CAD patients with a single de novo epicardial coronary stenosis who underwent coronary CT-angiography (CCTA), phase-contrast cine-magnetic resonance imaging (PC-CMR) and FFR measurement were studied. PCATA was assessed using the mean CT attenuation value. G-CFR was obtained by quantifying absolute coronary sinus flow (ml/min/g) by PC-CMR at rest and during maximum hyperemia. Median FFR, g-CFR, and PCATA values were 0.75, 2.59, and − 71.3, respectively. Serum creatinine, NT-proBNP, left ventricular end-diastolic volume, and PCATA were independently associated with g-CFR. PCATA showed a significant incremental predictive efficacy for impaired g-CFR (< 2.0) when added to the clinical risk model. PCATA was significantly associated with g-CFR, independent of FFR. Our results suggest the pathophysiological mechanisms linking perivascular inflammation with g-CFR in CAD patients.