Bibliometric analysis of research hotspots in coronary artery CT fractional flow reserve for diagnosing myocardial ischemia in coronary artery disease.

OBJECTIVE

This study aimed to conduct a comprehensive bibliometric analysis to map the global research landscape, identify evolving hotspots, and forecast future trends in the application of coronary computed tomography-derived fractional flow reserve (CT-FFR) for diagnosing myocardial ischemia in coronary artery disease (CAD).

METHODS

A systematic literature search was performed in the Web of Science Core Collection for publications from 2015 to 2025, using an expanded strategy combining CT-FFR terms with synonyms for myocardial ischemia and CAD. Bibliometric data visualization and analysis were conducted using CiteSpace and VOSviewer to examine publication trends, national/institutional contributions, collaborative networks, core journals, keyword co-occurrence, and citation bursts.

RESULTS

From an initial retrieval of 730 records, 582 eligible publications (405 articles, 117 reviews) were included. Annual publication output showed sustained growth with a compound annual growth rate (CAGR) of 6.4%. The United States led in publication volume (n = 231) and total citations, followed by China in output (n = 143), though with lower average citation impact. International collaboration was prominent, with the US, China, and Italy forming central hubs. JACC: Cardiovascular Imaging was the leading journal in both output and influence. Keyword analysis confirmed "Fractional Flow Reserve," "Coronary Artery Disease," and "Diagnostic Performance" as core themes. Burst detection revealed a clear evolution: early research (2015-2018) focused on technical validation (e.g., "dual source ct"), while recent trends (2022-2025) shifted towards clinical integration, with strong bursts for "stable chest pain," "diagnosis," and "coronary computed tomography angiography."

CONCLUSION

This bibliometric analysis delineates a dynamic and growing CT-FFR research field, marked by a transition from technological exploration to clinical guideline-directed application. The findings highlight distinct geographic patterns of productivity and influence, and clarify the evolution of research priorities towards personalized, ischemia-guided patient management. Future research is anticipated to focus on multimodal integration with plaque and perfusion imaging, artificial intelligence-driven workflow solutions, and evidence generation in complex patient cohorts to solidify clinical adoption.