Predictors of discordance between CT-derived fractional flow reserve (CT-FFR) and △CT-FFR in deep coronary myocardial bridging

IF 1.8 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical Imaging Pub Date : 2024-08-21 DOI:10.1016/j.clinimag.2024.110264

Qingbo Sun , Jing Zhang , Wanbing Wang , Yeqing Qi , Jinhao Lyu , Xinghua Zhang , Tao Li , Xin Lou

{"title":"Predictors of discordance between CT-derived fractional flow reserve (CT-FFR) and △CT-FFR in deep coronary myocardial bridging","authors":"Qingbo Sun , Jing Zhang , Wanbing Wang , Yeqing Qi , Jinhao Lyu , Xinghua Zhang , Tao Li , Xin Lou","doi":"10.1016/j.clinimag.2024.110264","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To compare the performance between CT-derived fractional flow reserve (CT-FFR) and ΔCT-FFR measurements in patients with deep myocardial bridging (MB) along the left anterior descending artery, and explore the potential predictors of discordance.</p></div><div><h3>Methods</h3><p>175 patients with deep MB who underwent coronary computed tomography angiography (CCTA) and CT-FFR assessment were included. Clinical, anatomical and atherosclerotic variables were compared between patients with concordant and discordant CT-FFR and ΔCT-FFR.</p></div><div><h3>Results</h3><p>30.9 % patients were discordantly classified, in which 94.4 % patients were classified as CT-FFR+/△CT-FFR-. The discordant group showed significantly higher upstream stenosis degree, distance from MB to the aorta, △CT-FFR (<em>P</em> 0.007, 0.009 and 0.002, respectively), and lower CT-FFR (<em>P</em> < 0.001). In multivariate analysis, upstream stenosis degree (<em>P</em> 0.023, OR 1.628, 95 % CI: 1.068–2.481) and distance from MB to the aorta (<em>P</em> 0.001, OR 1.04, 95 % CI: 1.016–1.064) were independent predictors for discordance between CT-FFR and ΔCT-FFR.</p></div><div><h3>Conclusion</h3><p>The discordance between CT-FFR and ΔCT-FFR measurements underscores the challenges in clinical decision-making, necessitating tailored approaches for MB evaluation.</p></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"114 ","pages":"Article 110264"},"PeriodicalIF":1.8000,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Imaging","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0899707124001943","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

To compare the performance between CT-derived fractional flow reserve (CT-FFR) and ΔCT-FFR measurements in patients with deep myocardial bridging (MB) along the left anterior descending artery, and explore the potential predictors of discordance.

Methods

175 patients with deep MB who underwent coronary computed tomography angiography (CCTA) and CT-FFR assessment were included. Clinical, anatomical and atherosclerotic variables were compared between patients with concordant and discordant CT-FFR and ΔCT-FFR.

Results

30.9 % patients were discordantly classified, in which 94.4 % patients were classified as CT-FFR+/△CT-FFR-. The discordant group showed significantly higher upstream stenosis degree, distance from MB to the aorta, △CT-FFR (P 0.007, 0.009 and 0.002, respectively), and lower CT-FFR (P < 0.001). In multivariate analysis, upstream stenosis degree (P 0.023, OR 1.628, 95 % CI: 1.068–2.481) and distance from MB to the aorta (P 0.001, OR 1.04, 95 % CI: 1.016–1.064) were independent predictors for discordance between CT-FFR and ΔCT-FFR.

Conclusion

The discordance between CT-FFR and ΔCT-FFR measurements underscores the challenges in clinical decision-making, necessitating tailored approaches for MB evaluation.

查看原文本刊更多论文

冠状动脉深层心肌桥接中 CT 导出的分数血流储备（CT-FFR）与△CT-FFR 不一致的预测因素

方法纳入 175 例接受冠状动脉计算机断层扫描（CCTA）和 CT-FFR 评估的深部心肌桥接（MB）患者。结果30.9%的患者分类不一致，其中94.4%的患者被分类为CT-FFR+/△CT-FFR-。不一致组的上游狭窄程度、MB 到主动脉的距离、△CT-FFR 都明显较高（P 分别为 0.007、0.009 和 0.002），而 CT-FFR 则较低（P < 0.001）。在多变量分析中，上游狭窄程度（P 0.023，OR 1.628，95 % CI：1.068-2.481）和 MB 到主动脉的距离（P 0.001，OR 1.04，95 % CI：1.016-1.064）是 CT-FFR 和 ΔCT-FFR 不一致的独立预测因素。结论 CT-FFR 和 ΔCT-FFR 测量结果不一致凸显了临床决策中的挑战，因此有必要采用量身定制的方法对 MB 进行评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Imaging 医学-核医学

CiteScore

4.60

自引率

0.00%

发文量

265

审稿时长

35 days

期刊介绍： The mission of Clinical Imaging is to publish, in a timely manner, the very best radiology research from the United States and around the world with special attention to the impact of medical imaging on patient care. The journal''s publications cover all imaging modalities, radiology issues related to patients, policy and practice improvements, and clinically-oriented imaging physics and informatics. The journal is a valuable resource for practicing radiologists, radiologists-in-training and other clinicians with an interest in imaging. Papers are carefully peer-reviewed and selected by our experienced subject editors who are leading experts spanning the range of imaging sub-specialties, which include: -Body Imaging- Breast Imaging- Cardiothoracic Imaging- Imaging Physics and Informatics- Molecular Imaging and Nuclear Medicine- Musculoskeletal and Emergency Imaging- Neuroradiology- Practice, Policy & Education- Pediatric Imaging- Vascular and Interventional Radiology