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.

血流储备分数 (FFR) 和整体冠状动脉血流储备 (g-CFR) 都可为稳定型冠状动脉疾病 (CAD) 患者提供预后信息。炎症在受损的内皮功能障碍和动脉粥样硬化进展中起着至关重要的作用，可能预测心血管死亡率。本研究旨在评估通过 CT 衰减 (PCATA) 评估的冠状动脉周围脂肪组织炎症对 CAD 患者心外膜功能性狭窄严重程度和 g-CFR 的生理意义。研究了 131 名患有单发心外膜冠状动脉狭窄的 CAD 患者，他们接受了冠状动脉 CT 血管造影 (CCTA)、相位对比电影磁共振成像 (PC-CMR) 和 FFR 测量。使用平均 CT 衰减值评估 PCATA。G-CFR 是通过在休息和最大充血期间通过 PC-CMR 量化绝对冠状窦流量 (ml/min/g) 获得的。中位 FFR、g-CFR 和 PCATA 值分别为 0.75、2.59 和 - 71.3。血清肌酐、NT-proBNP、左心室舒张末期容积和 PCATA 与 g-CFR 独立相关。当添加到临床风险模型中时，PCATA 对受损的 g-CFR (< 2.0) 显示出显着的增量预测功效。PCATA 与 g-CFR 显着相关，独立于 FFR。我们的研究结果表明了 CAD 患者血管周围炎症与 g-CFR 相关的病理生理机制。和 PCATA 与 g-CFR 独立相关。当添加到临床风险模型中时，PCATA 对受损的 g-CFR (< 2.0) 显示出显着的增量预测功效。PCATA 与 g-CFR 显着相关，独立于 FFR。我们的研究结果表明了 CAD 患者血管周围炎症与 g-CFR 相关的病理生理机制。和 PCATA 与 g-CFR 独立相关。当添加到临床风险模型中时，PCATA 对受损的 g-CFR (< 2.0) 显示出显着的增量预测功效。PCATA 与 g-CFR 显着相关，独立于 FFR。我们的研究结果表明了 CAD 患者血管周围炎症与 g-CFR 相关的病理生理机制。