Diagnostic performance of coronary computed tomography angiography-derived instantaneous wave-free ratio for myocardial bridge

• Published in: Cardiology plus 2020-01, Vol.5 (1), p.33-41
• Main Authors: Zhang, Xin, Zhou, Fan, Tang, Chun, Xu, Peng, Zhou, Chang, Zhang, Long
• Format: Article
• Language: English
• ISSN: 2470-7511; 2470-752X; 2470-752X
• DOI: 10.4103/cp.cp_6_20

Purpose: The purpose of the study was to investigate the diagnostic performance of instantaneous wave-free ratio (iFR) based on coronary computed tomography (CT) angiography (CCTA) (iFRCT) for a myocardial bridge (MB). Materials and Methods: One hundred and fourteen patients with 115 MBs from 9 Chinese medical centers were prospectively included in this study. All patients underwent CCTA and subsequent invasive coronary angiography with fractional flow reserve (FFR). iFRCTs were measured at 2-4 cm distal to the lesions. Diagnostic performance of iFRCT was assessed using Bland-Altman analysis with invasive FFR as the reference in the entire sample, as well as in subgroups based on MB depth and length. Results: iFRCT has 0.90 sensitivity (95% confidence interval: 0.75-0.97), 0.73 specificity (0.62-0.83), and 0.79 accuracy (0.70-0.86) in the overall analysis. None of the three measures (sensitivity, specificity, and accuracy) differed significantly between superficial (≤2 mm) and deep MB, short (≤30 mm) and long MB, or low ( 0.05 for all). However, positive predictive value was lower in the low stenosis (