{
  "abstract": "Background: Coronary disease that is non-obstructive at baseline may progress, while luminal stenosis alone does not capture local pericoronary tissue characteristics or lesion-specific functional impairment.\n\nObjective: To assess associations of lesion-specific pericoronary adipose tissue (PCAT) attenuation and CT-derived fractional flow reserve (CT-FFR) with imaging-defined stenosis progression and to evaluate an exploratory multivariable model.\n\nMethods: This retrospective single-center study included 201 patients undergoing serial coronary computed tomography angiography with selected target lesions classified as minimal or mild at baseline. In progressors, the lesion with the greatest follow-up progression was selected; in non-progressors, the lesion with the greatest baseline stenosis was selected. Thus, target-lesion selection was outcome dependent. Lesion-specific PCAT and CT-FFR were quantified using dedicated automated software after target-lesion identification. Five logistic models specified before reanalysis fitting were fitted in a common complete-case population ( n = 191), and Model E retained nine predictors. Internal performance was assessed with 2,000 patient-level bootstrap resamples.\n\nResults: Progression occurred in 115 of 201 patients. In Model E, less-negative PCAT attenuation (odds ratio [OR] per 10-HU increase, 1.552; 95% CI, 1.137–2.119; P = 0.006) and lower CT-FFR (OR per 0.05 decrease, 1.360; 95% CI, 1.041–1.778; P = 0.024) were associated with progression; age showed an inverse conditional association (OR per 10-year increase, 0.509; 95% CI, 0.346–0.749; P < 0.001). Model E had an apparent AUC of 0.767 (95% CI, 0.700–0.834) and an optimism-corrected AUC of 0.722 (95% bootstrap interval, 0.659–0.787). The corrected Brier score was 0.217 (0.189–0.251), calibration intercept −0.0002 (−0.354 to 0.361), and calibration slope 0.779 (0.539–1.100). Versus Model B, corrected Δ AUC was 0.053 (−0.005 to 0.088), indicating apparent improvement with uncertainty.\n\nConclusions: Less-negative lesion-specific PCAT attenuation and lower CT-FFR were associated with imaging-defined stenosis progression. The combined model showed moderate optimism-corrected discrimination, but incremental discrimination remained uncertain. Because lesion selection in progressors incorporated follow-up information and no external validation was available, this internally derived model is exploratory and is not a clinically validated decision tool.",
  "abstract_shown": true,
  "affiliations": [
    "Department of CT Radiology, The First Hospital of Shanxi Medical University",
    "College of Medical Imaging, Shanxi Medical University"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jun Wang"
    },
    {
      "affs": [
        1
      ],
      "name": "Kenan Song"
    },
    {
      "affs": [
        0
      ],
      "name": "Sheng He"
    },
    {
      "affs": [
        0
      ],
      "name": "Suping Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Yanjun Hou"
    },
    {
      "affs": [
        0
      ],
      "name": "Wenqing Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Jian Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Li Feng"
    },
    {
      "affs": [
        0
      ],
      "name": "Wenfeng Wei"
    },
    {
      "affs": [
        0
      ],
      "name": "Zengyu Jiang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/f0zffvgcye9bj.bib",
  "cited_by": 0,
  "doi": "10.3389/fcvm.2026.1954142",
  "fulltext_url": null,
  "id": "f0zffvgcye9bj",
  "issns": [
    "2297-055X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fcvm.2026.1954142/full",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-09",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/f0zffvgcye9bj.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:23:33Z",
      "native_id": "10.3389/fcvm.2026.1954142",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fcvm.2026.1954142/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2297-055X",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Associations of lesion-specific pericoronary adipose tissue attenuation and CT-derived fractional flow reserve with coronary stenosis progression: a retrospective selected-lesion study",
  "title_text": "Associations of lesion-specific pericoronary adipose tissue attenuation and CT-derived fractional flow reserve with coronary stenosis progression: a retrospective selected-lesion study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:23:33Z",
  "url": "https://research.draconitic.com/paper/f0zffvgcye9bj",
  "venue": "Frontiers in Cardiovascular Medicine",
  "versions": []
}