A 44-year-old woman without any cardiovascular risk factors, presented with effort angina for 2 months. Coronary computed tomographic angiography (CCTA) showed 70% stenosis of the proximal left anterior descending (LAD) artery by non-calcified plaque, and N-13 ammonia positron emission tomography (PET) demonstrated the reversible perfusion defect in the LAD territory (Panels B and C). Invasive coronary angiography revealed diffuse intermediate stenosis in the LAD. Fractional flow reserve (FFR) was 0.73, and the gradual increase of FFR was observed during pull-back pressure tracing under hyperaemia (Panel A, yellow line). Intravascular ultrasound revealed diffuse plaque in left main and LAD with negative remodelling. The minimal lumen area was 3.0 mm² with plaque burden of 55%. Based on the lesion characteristics and the patient’s preference, revascularization was deferred and medical treatment with aspirin, ezetimibe/simvastatin, and diltiazem was maintained.

中文翻译：

---

完全消退冠状动脉粥样硬化。

一名44岁的女性，无任何心血管危险因素，出现了2个月的努力性心绞痛。冠状动脉计算机断层血管造影（CCTA）显示非钙化斑块导致左前降支（LAD）近端狭窄70％，N-13氨正电子发射断层显像（PET）显示LAD区域可逆性灌注缺损（图B和C）。冠状动脉造影检查显示LAD弥漫性中间狭窄。分数血流储备（FFR）为0.73，在充血下抽回压力追踪过程中观察到FFR逐渐增加（图A，黄线）。血管内超声显示左主干和LAD弥漫性斑块，阴性重塑。最小管腔面积为3.0 mm ²斑块负担为55％。根据病变特征和患者的喜好，推迟血运重建，并维持阿司匹林，依泽替米贝/辛伐他汀和地尔硫卓的药物治疗。