Comparison of fractional myocardial mass, a vessel-specific myocardial mass-at-risk, with coronary angiographic scoring systems for predicting myocardial ischemia

• Published in: Journal of cardiovascular computed tomography 2020-07, Vol.14 (4), p.322-329
• Main Authors: Kim, Hyung Yoon, Doh, Joon-Hyung, Lim, Hong-Seok, Nam, Chang-Wook, Shin, Eun-Seok, Koo, Bon-Kwon, Lee, Joo Myung, Park, Taek Kyu, Yang, Jeong Hoon, Song, Young Bin, Hahn, Joo-Yong, Choi, Seung Hyuk, Gwon, Hyeon-Cheol, Lee, Sang-Hoon, Kim, Sung Mok, Choe, Yeonhyeon, Choi, Jin-Ho
• Format: Article
• Language: English
• Subjects: Angiographic scores; Fractional myocardial mass; Myocardial ischemic burden
• ISSN: 1934-5925; 1876-861X
• DOI: 10.1016/j.jcct.2019.11.001

The burden of coronary artery disease has been assessed by various semi-quantitative angiographic scores, which are frequently different each other. A non-invasive and quantitative modality may substitute angiographic sores for prognostic implication and decision of revascularization strategy. We compared fractional myocardial mass (FMM) with angiographic scores for predicting myocardial ischemia. In this multicenter registry, 411 patients who underwent coronary computed tomography angiography (CCTA) were followed by invasive coronary angiography and fractional flow reserve (FFR) measurement. CCTA–derived %FMM with diameter stenosis≥70% (%FMM-70) or ≥50% (%FMM-50) were compared with 9 angiographic scores (APPROACH, Duke Jeopardy, BARI, CASS, SYNTAX, Jenkins, BCIS-1, Leaman, Modified Duke) and were tested regarding their performance for predicting FFR≤0.80. The performance of %FMM-70 and %FMM-50 were similar to most angiographic scores (%FMM-70, c-statistics = 0.74; %FMM-50, 0.73; angiographic scores, 0.68–0.77). The frequency of FFR≤0.80 increased consistently according to %FMM-70, %FMM-50, and all angiographic scores (p