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Association of Coronary Computed Tomography-Defined Myocardial Bridge With Pre- and Post-Procedural Fractional Flow Reserve in Patients Undergoing Elective Percutaneous Coronary Intervention.
Sakamoto, Tatsuya; Usui, Eisuke; Hoshino, Masahiro; Hada, Masahiro; Nagamine, Tatsuhiro; Hanyu, Yoshihiro; Nogami, Kai; Ueno, Hiroki; Setoguchi, Mirei; Tahara, Tomohiro; Matsuda, Kazuki; Mineo, Takashi; Wakasa, Nobutaka; Sugiyama, Tomoyo; Yonetsu, Taishi; Sasano, Tetsuo; Kakuta, Tsunekazu.
Afiliação
  • Sakamoto T; Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital.
  • Usui E; Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital.
  • Hoshino M; Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital.
  • Hada M; Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital.
  • Nagamine T; Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital.
  • Hanyu Y; Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital.
  • Nogami K; Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital.
  • Ueno H; Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital.
  • Setoguchi M; Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital.
  • Tahara T; Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital.
  • Matsuda K; Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital.
  • Mineo T; Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital.
  • Wakasa N; Department of Clinical Laboratory, Tsuchiura Kyodo General Hospital.
  • Sugiyama T; Department of Cardiovascular Medicine, Tokyo Medical and Dental University.
  • Yonetsu T; Department of Cardiovascular Medicine, Tokyo Medical and Dental University.
  • Sasano T; Department of Cardiovascular Medicine, Tokyo Medical and Dental University.
  • Kakuta T; Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital.
Circ J ; 88(11): 1842-1852, 2024 Oct 25.
Article em En | MEDLINE | ID: mdl-38763754
ABSTRACT

BACKGROUND:

Myocardial bridge (MB) is a common coronary anomaly characterized by a tunneled course through the myocardium. Coronary computed tomography angiography (CCTA) can identify MB. The impact of MB detected by CCTA on coronary physiological parameters before and after percutaneous coronary intervention (PCI) is unknown. METHODS AND

RESULTS:

We investigated 141 consecutive patients who underwent pre-PCI CCTA and fractional flow reserve (FFR)-guided elective PCI for de novo single proximal lesions in the left anterior descending artery (LAD). We compared clinical demographics and physiological parameters between patients with and without CCTA-defined MB. MB was identified in 46 (32.6%) patients using pre-PCI CCTA. The prevalence of diabetes was higher among patients with MB. Median post-PCI FFR values were significantly lower among patients with than without MB (0.82 [interquartile range 0.79-0.85] vs. 0.85 [interquartile range 0.82-0.89]; P=0.003), whereas pre-PCI FFR values were similar between the 2 groups. Multivariable linear regression analysis revealed that the presence of MB and greater left ventricular mass volume in the LAD territory were independently associated with lower post-PCI FFR values. Multivariable logistic regression analysis also revealed that the presence of MB and lower pre-PCI FFR values were independent predictors of post-PCI FFR values ≤0.80.

CONCLUSIONS:

CCTA-defined MB independently predicted both lower post-PCI FFR as a continuous variable and ischemic FFR as a categorical variable in patients undergoing elective PCI for LAD.
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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Reserva Fracionada de Fluxo Miocárdico / Ponte Miocárdica / Intervenção Coronária Percutânea Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Circ J Assunto da revista: ANGIOLOGIA / CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Reserva Fracionada de Fluxo Miocárdico / Ponte Miocárdica / Intervenção Coronária Percutânea Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Circ J Assunto da revista: ANGIOLOGIA / CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article