Quantitative computed tomography angiography evaluation of the coronary fractional flow reserve in patients with left anterior descending artery myocardial bridging

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging Pub Date : 2024-02-14 DOI:10.1111/cpf.12872

Dan Zhang, Xin Tian, Meng-Ya Li, Wen-Song Zheng, Yang Yu, Hao-Wen Zhang, Tong Pan, Bu-Lang Gao, Cai-Ying Li

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Abstract

Purpose

To quantitatively investigate the effect of myocardial bridge (MB) in the left anterior descending artery (LAD) on the fractional flow reserve (FFR).

Materials and Methods

Three-hundred patients with LAD MB who had undergone coronary artery CT angiography (CCTA) were retrospectively enroled, and 104 normal patients were enroled as the control. The CCTA-derived fractional flow reserve (FFRCT) was measured at the LAD 10 mm proximal (FFR1) and 20–40 mm distal (FFR3) to the MB and at the MB location (FFR2).

Results

FFR2 and FFR3 of the MB (with BM only) and MBLA (with both MB and atherosclerosis) groups were significantly (p < 0.01) lower than those of the control. The FFR3 distal to the MB was significantly lower (p < 0.01) than that of the control. The FFRCT of the whole LAD in the MBLA group was significantly (p < 0.05) lower than that of the MB and control group (p < 0.05). MB length (OR 1.061) and MB muscle index (odds ratio or OR 1.007) were two risk factors for abnormal FFRCT, and MB length was a significant independent risk factor for abnormal FFRCT (OR = 1.077). LAD stenosis degree was a risk factor for abnormal FFRCT values (OR 3.301, 95% confidence interval [CI] 1.441–7.562, p = 0.005) and was also a significant independent risk factor (OR = 3.369, 95% CI: 1.392–8.152; p = 0.007) for abnormal FFRCT.

Conclusion

MB significantly affects the FFRCT of distal coronary artery. For patients with MB without atherosclerosis, the MB length is a risk factor significantly affecting FFRCT, and for patients with MB accompanied by atherosclerosis, LAD stenotic severity is an independent risk factor for FFRCT.

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左前降支动脉心肌桥接患者冠状动脉分数血流储备的定量计算机断层扫描血管造影评估。

目的：定量研究左前降支动脉（LAD）心肌桥（MB）对分数血流储备（FFR）的影响：回顾性登记了300名接受过冠状动脉CT血管造影（CCTA）检查的LAD MB患者，并登记了104名正常患者作为对照。CCTA衍生的分数血流储备（FFRCT）在距MB近端10毫米（FFR1）和远端20-40毫米（FFR3）处以及MB位置（FFR2）处进行测量：结果：MB（仅有基底膜）组和 MBLA（既有 MB 又有动脉粥样硬化）组的 FFR2 和 FFR3 显著（p 结论：MB 对 FFRCT 有显著影响：MB 对冠状动脉远端 FFRCT 有明显影响。对于无动脉粥样硬化的 MB 患者，MB 长度是明显影响 FFRCT 的危险因素，而对于伴有动脉粥样硬化的 MB 患者，LAD 狭窄严重程度是影响 FFRCT 的独立危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Physiology and Functional Imaging 医学-生理学

CiteScore

3.40

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.