{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T04:35:52Z","timestamp":1773894952036,"version":"3.50.1"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":43,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005633","name":"Finnish Foundation for Cardiovascular Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005633","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Finnish State Research Funding","award":["VTR 13403"],"award-info":[{"award-number":["VTR 13403"]}]},{"DOI":"10.13039\/501100002341","name":"Research Council of Finland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"publisher","award":["P500PM_210788"],"award-info":[{"award-number":["P500PM_210788"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005609","name":"University of Turku","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005609","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Cleerly Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The relationship between the extent and composition of coronary atherosclerosis and the severity of myocardial ischaemia remains incompletely understood. We assessed whether artificial intelligence-guided coronary computed tomography angiography\u2013derived plaque burden and composition correlate with ischaemia severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We included 837 symptomatic patients undergoing coronary computed tomography angiography and subsequent 15O-water positron emission tomography myocardial perfusion imaging. Artificial intelligence\u2013guided coronary computed tomography angiography was used to quantify plaque features\u2014diameter stenosis, percent atheroma volume (PAV), percent non-calcified plaque volume (NCPV), and percent calcified plaque volume (CPV)\u2014per patient and per major coronary artery (LAD, LCx, RCA). Ischaemia severity was classified into four categories based on regional hyperaemic myocardial blood flow. Increasing severity of ischaemia was associated with higher diameter stenosis and plaque burden (PAV, NCPV, CPV) on patient level and in all major coronary territories (overall P &amp;lt; 0.001). The LAD consistently demonstrated higher atherosclerotic burden as compared to the LCx and RCA. Ordinal logistic regression confirmed that diameter stenosis (OR 1.02\u20131.03, P &amp;lt; 0.001) and NCPV (OR 1.04\u20131.05, P = 0.011\u20130.031) were significant predictors of ischaemia severity in all coronary arteries, while CPV was predictive only in the LAD and RCA (OR 1.03\u20131.04, P = 0.002\u20130.015).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Artificial intelligence\u2013guided coronary computed tomography angiography\u2013derived measures of plaque burden and stenosis are associated with the severity of myocardial ischaemia, although overlapping distributions across ischaemia severity indicate that anatomical imaging alone may be insufficient for accurate phenotyping of flow-limiting CAD. These findings encourage for the integration of functional imaging with quantitative plaque analysis for a more comprehensive evaluation of coronary artery disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjimp\/qyaf139","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T12:59:48Z","timestamp":1762952388000},"source":"Crossref","is-referenced-by-count":2,"title":["Coronary artery stenosis, plaque burden, and severity of myocardial ischemia"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2002-8699","authenticated-orcid":false,"given":"Tanja","family":"Kero","sequence":"first","affiliation":[{"name":"Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala University , Uppsala ,","place":["Sweden"]},{"name":"PET Center\/Medical Imaging Center, Uppsala University Hospital , 75185 Uppsala ,","place":["Sweden"]},{"name":"Turku PET Centre, Turku University Hospital and University of Turku , Turku ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juhani","family":"Knuuti","sequence":"additional","affiliation":[{"name":"Turku PET Centre, Turku University Hospital and University of Turku , Turku ,","place":["Finland"]},{"name":"InFlames Flagship, University of Turku , Turku ,","place":["Finland"]},{"name":"Department of Clinical Physiology, Nuclear Medicine, and PET, Turku University Hospital , Turku ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0045-6596","authenticated-orcid":false,"given":"Sarah","family":"B\u00e4r","sequence":"additional","affiliation":[{"name":"Turku PET Centre, Turku University Hospital and University of Turku , Turku ,","place":["Finland"]},{"name":"Department of Cardiology, Bern University Hospital Inselspital , Bern ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeroen J","family":"Bax","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Leiden ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2488-0893","authenticated-orcid":false,"given":"Antti","family":"Saraste","sequence":"additional","affiliation":[{"name":"Turku PET Centre, Turku University Hospital and University of Turku , Turku ,","place":["Finland"]},{"name":"Heart Center, Turku University Hospital, University of Turku , Turku ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5819-4635","authenticated-orcid":false,"given":"Teemu","family":"Maaniitty","sequence":"additional","affiliation":[{"name":"Turku PET Centre, Turku University Hospital and University of Turku , Turku ,","place":["Finland"]},{"name":"Department of Clinical Physiology, Nuclear Medicine, and PET, Turku University Hospital , 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