Feasibility of FFR-CT and CCTA features to predict the hemodynamic changes of high take-off coronary artery

BackgroundHigh take-off coronary artery (HTCA) is a neglected coronary artery anomaly with debated clinical importance. Determining the pathophysiological significance of this anomaly remains challenging. The aim of this study was to explore clinical symptoms, anatomic features based on CCTA and FFR-CT which will help to predict significant hemodynamic change of HTCA. MethodsThis retrospective study recruited 72 patients with HTCA undergoing CCTA and invasive coronary angiography. Demographic, clinical characteristics, anatomic and functional features based on CCTA were collected to identified independent risk factors by multivariate logistical analysis. Receiver operating characteristic curve analysis was performed to determine the predictive accuracy of these factors. ResultsChest pain and the angle at the HTCA were identified as independent risk factors (p=0.005, p=0.002) associated hemodynamical significant HTCA. The value of FFR-CT was consistency with FFR in HTCA patients (VIF=73.811). The index of FFR-CT had significantly larger AUC than the index of chest pain (p=0.003) and similar AUC with the angel at the HTCA (p=0.059). Compared with combined index of angle at HTCA plus chest pain, FFR-CT had a larger AUC (p=0.000). The similar AUC was found between FFR-CT and the combined index of chest pain, angle at the HTCA plus FFR-CT (p=0.2359). ConclusionsFFR-CT, chest pain and angel at HTCA based on CCTA played a great role to predict significant hemodynamic changes of HTCA. FFR-CT had a superior diagnostic performance to predict abnormal hemodynamic changes in patients with HTCA.