ArticleEuropean heart journal. Cardiovascular Imaging2023
Importance of plaque volume and composition for the prediction of myocardial ischaemia using sequential coronary computed tomography angiography/positron emission tomography imaging.
Article in European heart journal. Cardiovascular Imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 7 citations in OpenAlex.
- Artificial intelligence-guided quantitative coronary CT assessment to rule-in or rule-out myocardial ischaemia.European heart journal. Cardiovascular Imaging · 2026Article
- Plaque Progression and Rupture in Obstructive Coronary Artery Disease: A Review of Current Imaging Modalities.Reviews in cardiovascular medicine · 2026Review
- Non-invasive diagnostic value of pericoronary fat attenuation index for identifying culprit lesions in acute coronary syndrome.European journal of radiology open · 2025Article
- Coronary Computed Tomography Angiography Atherosclerotic Plaque Volume as A Predictor of Myocardial Blood Flow Impairment in Non-Obstructive Coronary Artery Disease.Reviews in cardiovascular medicine · 2025Article
- Cardiovascular imaging research and innovation in 2023.European heart journal. Imaging methods and practice · 2024Review
- Current Toolset in Predicting Acute Coronary Thrombotic Events: The "Vulnerable Plaque" in a "Vulnerable Patient" Concept.Life (Basel, Switzerland) · 2023Review
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Authors and funding
13 authors at 5 institutions in 4 countries.
Funding
Abstract
aimsCoronary atherosclerosis with a large necrotic core has been postulated to reduce the vasodilatory capacity of vascular tissue. In the present analysis, we explored whether total plaque volume and necrotic core volume on coronary computed tomography angiography (CCTA) are independently associated with myocardial ischaemia on positron emission tomography (PET). METHODS AND
resultsFrom a registry of symptomatic patients with suspected coronary artery disease and clinically indicated CCTA with sequential [15O]H2O PET myocardial perfusion imaging, we quantitatively measured diameter stenosis, total and compositional plaque volumes on CCTA. Primary endpoint was myocardial ischaemia on PET, defined as an absolute stress myocardial blood flow ≤2.4 mL/g/min in ≥1 segment. Multivariable prediction models for myocardial ischaemia were consecutively created using logistic regression analysis (stenosis model: diameter stenosis ≥50%; plaque volume model: +total plaque volume; plaque composition model: +necrotic core volume). A total of 493 patients (mean age 63 ± 8 years, 54% men) underwent sequential CCTA/PET imaging. In 153 (31%) patients, myocardial ischaemia was detected on PET. Diameter stenosis ≥50% (P < 0.001) and necrotic core volume (P = 0.029) were independently associated with myocardial ischaemia, while total plaque volume showed borderline significance (P = 0.052). The plaque composition model (χ2 = 169) provided incremental value for the prediction of ischaemia when compared with the stenosis model (χ2 = 138, P < 0.001) and plaque volume model (χ2 = 164, P = 0.021).
conclusionThe volume of necrotic core on CCTA independently and incrementally predicts myocardial ischaemia on PET, beyond diameter stenosis alone.
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