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

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 Chin...

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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
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Zhou, Fan
Tang, Chun
Xu, Peng
Zhou, Chang
Zhang, Long
description 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 (
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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 (&lt;70% diameter occlusion) and high stenosis (P &gt; 0.05 for all). However, positive predictive value was lower in the low stenosis (&lt;70%) group (0.37 [0.20-0.58] vs. 0.90 [0.72-0.97] in the high stenosis group, P &lt; 0.001). Negative predictive value, in contrast, was higher in the low stenosis group (0.98 [0.87-1.00] vs. 0.75 [0.43-0.93], P = 0.024). The Bland-Altman analysis showed a slight difference between iFRCT and invasive FFR (0.04 in the overall analysis and all subgroup analyses, with an exception of 0.05 in the long MB subgroup). Conclusion: iFRCT has a high diagnostic performance in detecting MB related lesion-specific ischemia.</description><identifier>ISSN: 2470-7511</identifier><identifier>ISSN: 2470-752X</identifier><identifier>EISSN: 2470-752X</identifier><identifier>DOI: 10.4103/cp.cp_6_20</identifier><language>eng</language><publisher>Wolters Kluwer India Pvt. Ltd</publisher><ispartof>Cardiology plus, 2020-01, Vol.5 (1), p.33-41</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27900,27901</link.rule.ids></links><search><creatorcontrib>Zhang, Xin</creatorcontrib><creatorcontrib>Zhou, Fan</creatorcontrib><creatorcontrib>Tang, Chun</creatorcontrib><creatorcontrib>Xu, Peng</creatorcontrib><creatorcontrib>Zhou, Chang</creatorcontrib><creatorcontrib>Zhang, Long</creatorcontrib><title>Diagnostic performance of coronary computed tomography angiography-derived instantaneous wave-free ratio for myocardial bridge</title><title>Cardiology plus</title><description>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 (&lt;70% diameter occlusion) and high stenosis (P &gt; 0.05 for all). However, positive predictive value was lower in the low stenosis (&lt;70%) group (0.37 [0.20-0.58] vs. 0.90 [0.72-0.97] in the high stenosis group, P &lt; 0.001). Negative predictive value, in contrast, was higher in the low stenosis group (0.98 [0.87-1.00] vs. 0.75 [0.43-0.93], P = 0.024). The Bland-Altman analysis showed a slight difference between iFRCT and invasive FFR (0.04 in the overall analysis and all subgroup analyses, with an exception of 0.05 in the long MB subgroup). Conclusion: iFRCT has a high diagnostic performance in detecting MB related lesion-specific ischemia.</description><issn>2470-7511</issn><issn>2470-752X</issn><issn>2470-752X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNptkM1Lw0AQxRdRsNRe_Av2LKTuR5Jt8CT1EwpeFLwtm91JXNtkw2za0It_u5FWT8LAPJg3D96PkEvO5iln8tp2c9vpXAt2QiYiVSxRmXg__dOcn5NZjJ-MMcHzhZJqQr7uvKnbEHtvaQdYBWxMa4GGitqAoTW4H0XTbXtwtA9NqNF0H3tq2tofdeIA_W48-zb2ph0HwjbSwewgqRCAoul9oGM0bfbBGnTebGiJ3tVwQc4qs4kwO-4peXu4f10-JauXx-fl7SqxXMg-SfNFxhcp5IVSKiuhFJJJWaSKCygMgGJCKgVVyUrLQOSZM0rIwijnQIAQckquDrkWQ4wIle7QN2M5zZn-gadHckd4o_nmYB7CpgeM6812ANQNuHUbhn8-tJT6l6P8BmC4e80</recordid><startdate>20200101</startdate><enddate>20200101</enddate><creator>Zhang, Xin</creator><creator>Zhou, Fan</creator><creator>Tang, Chun</creator><creator>Xu, Peng</creator><creator>Zhou, Chang</creator><creator>Zhang, Long</creator><general>Wolters Kluwer India Pvt. Ltd</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20200101</creationdate><title>Diagnostic performance of coronary computed tomography angiography-derived instantaneous wave-free ratio for myocardial bridge</title><author>Zhang, Xin ; Zhou, Fan ; Tang, Chun ; Xu, Peng ; Zhou, Chang ; Zhang, Long</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c123t-4685184e697775beb2303394712e9aee702377efb0bc0e265da7239a7dde2e223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Xin</creatorcontrib><creatorcontrib>Zhou, Fan</creatorcontrib><creatorcontrib>Tang, Chun</creatorcontrib><creatorcontrib>Xu, Peng</creatorcontrib><creatorcontrib>Zhou, Chang</creatorcontrib><creatorcontrib>Zhang, Long</creatorcontrib><collection>CrossRef</collection><jtitle>Cardiology plus</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Xin</au><au>Zhou, Fan</au><au>Tang, Chun</au><au>Xu, Peng</au><au>Zhou, Chang</au><au>Zhang, Long</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic performance of coronary computed tomography angiography-derived instantaneous wave-free ratio for myocardial bridge</atitle><jtitle>Cardiology plus</jtitle><date>2020-01-01</date><risdate>2020</risdate><volume>5</volume><issue>1</issue><spage>33</spage><epage>41</epage><pages>33-41</pages><issn>2470-7511</issn><issn>2470-752X</issn><eissn>2470-752X</eissn><abstract>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 (&lt;70% diameter occlusion) and high stenosis (P &gt; 0.05 for all). However, positive predictive value was lower in the low stenosis (&lt;70%) group (0.37 [0.20-0.58] vs. 0.90 [0.72-0.97] in the high stenosis group, P &lt; 0.001). Negative predictive value, in contrast, was higher in the low stenosis group (0.98 [0.87-1.00] vs. 0.75 [0.43-0.93], P = 0.024). The Bland-Altman analysis showed a slight difference between iFRCT and invasive FFR (0.04 in the overall analysis and all subgroup analyses, with an exception of 0.05 in the long MB subgroup). Conclusion: iFRCT has a high diagnostic performance in detecting MB related lesion-specific ischemia.</abstract><pub>Wolters Kluwer India Pvt. Ltd</pub><doi>10.4103/cp.cp_6_20</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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title Diagnostic performance of coronary computed tomography angiography-derived instantaneous wave-free ratio for myocardial bridge
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