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. 2022 Jan 3;8:810625. doi: 10.3389/fcvm.2021.810625

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Copyright © 2022 Zhao, Gao, Xu, Yang, Song, Jiang, Xu, Hu, Li, Chen, Li, Zhang, Fan and Lu.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Case of CT-FFR estimating coronary lesions with severe calcification. Example of a 66-year-old female with stable chest pain. The CAC scores of LAD, LCX, and RCA were 599.6, 216.4, and 716.2. CCTA showed multiple calcified and mixed plaques causing more than 70% stenosis in the proximal and mid LAD. CT-FFR demonstrated functional ischemia (CT-FFR = 0.63) caused by LAD stenosis, and confirmed by FFR (FFR = 0.77). The deviation of CT-FFR was 0.14 in the situation of severe coronary calcification. With the widely-accepted threshold of ischemia ( ≤ 0.8), CT-FFR made a correct dichotomous diagnosis. LAD, left anterior descending coronary artery; LCX, left circumflex artery; RCA, right coronary artery; CT-FFR, computed tomography derived fractional flow reserve; FFR, fractional flow reserve; CAC, coronary artery calcium; CTA, computed tomography angiography.