Objective To investigate the feasibility of coronary computed tomography angiography (CCTA) in the patients with heart failure (grade Ⅲ). Methods A total of 40 patients with clinical diagnosis of heart failure (grade Ⅲ) who were admitted into Liaocheng People′s Hospital from January 2017 to December 2019 were prospectively randomly divided into two groups. Patients in group A (n=20) received low-dose test bolus technology (20 mL contrast medium) and were monitored for the peak time (T₁). Patients in group B were monitored with bolus tracking technology for the descending aorta at 4-chamber imaging planes with a trigger delay of 1.1s (T₂). Contrast agent was injected at body weight × 0.85 ml/kg within 12 s for all patients. No signal was given for holding breath during the scan. The two groups were compared for trigger time, volume of contrast medium, CT values of the left ascending aorta, SD, signal-to-noise ratio(SNR), assessment of image quality (5-point Likert scale with 5 for the best and 1 for the worst) and effective radiation dose(ED). SPSS statistics 19.0 was used for data analysis. Depending on the data type, t-test, χ²test or Mann-whitney U test was used for comparison between groups. Results T₁ and T₂ were not significantly different between the two groups. The volume of contrast medium used in group B was less than that in group A [(60.32±10.35) vs (80.21±8.28) ml], the difference being statistically significant (P＜0.01). There was no significant difference in the radiation dose of coronary artery scan between the two groups(P＞0.05). The radiation dose of monitoring scan of group A were significantly higher than group B [(0.42±0.02) vs 0.23±0.04) mSv, P＜0.01)]. For objective image quality, CT values of ascending aorta, image noise, SNR were not different between the two groups (all P＞0.05). Subjective image quality of two groups also showed no significant difference in three main coronaries (right coronary artery, left anterior descending branch and left circumflex artery; all P＞0.05). Conclusion The application of free-breathing CCTA combined with bolus tracking technology significantly reduces total usage of contrast medium,reduces the scanning step, and has high stability for patients with heart failure.