Combined Computed Tomography Angiography-Computed Tomography Perfusion in the Identification and Prognostic Assessment of Myocardial Bridging from the CORE320 Study: 5-Year Follow-Up - 03/11/23
, Rodrigo J. Cerci, MD c, Carolina Valdiviezo, MD d, Mohammad R. Ostovaneh, MD, MPH e, Andrea L. Vavere, MPH e, Henrique Doria de Vasconcellos, MD, MSc e, Matthew B. Matheson, MS e, f, Christopher Cox, PhD f, Julie M. Miller, MD e, Marcelo di Carli, MD g, Armin Arbab-Zadeh, MD e, Richard T. George, MD e, João A.C. Lima, MD e, Marcus Y. Chen, MD bRésumé |
Our objective is to use computed tomography angiography (CTA) and computed tomography perfusion (CTP) to identify the ischemic significance of myocardial bridging (MB). We also seek to determine the long-term prognostication of MB in the presence or absence of obstructive coronary artery disease (CAD). The CORE320, a prospective, multicenter study including 381 patients with known or suspected CAD clinically referred for invasive coronary angiography who underwent combined (CTA-CTP) and single-photon emission computed tomography before conventional coronary angiography. The incidence of MB was identified in 135 patients (35.4%) with 93.9% identified in the left anterior descending artery. MB were divided as partially encased versus fully encased. There was no difference in ischemia identified between partially encased MB and fully encased MB (37 [40%] vs 25 [35%], p = 0.54]. Ischemia was identified at similar rates in partially versus fully encased MB by single-photon emission computed tomography at (8 [9%] vs 8 [11%], p = 0.57] and CTP (34 [37%] vs 21 [30%], p = 0.33]. There was no difference in the primary outcome of 5-year outcome of combined incidence of myocardial infarction or death. The restricted mean survival time in patients with CTA with <50% stenosis with or without a MB was 4.906 years (95% confidence interval 4.759 to 5.000) and 4.891 years (95% confidence interval 4.718 to 5.000), respectively (p = 0.824). Cardiac computed tomography perfusion imaging can assess both anatomic and functional significance of myocardial bridging with diagnostic accuracy similar to current standard imaging. Furthermore, 5-year cardiovascular events were not different with the presence of MB in both obstructive and non-obstructive CAD.
Le texte complet de cet article est disponible en PDF.Keywords : cardiac CT perfusion, coronary artery disease, myocardial bridging, myocardial ischemia, coronary computed tomography angiography
Plan
| Funding: The main trial, the CORE320 study, was funded by Canon (formerly Toshiba) Medical Systems Corporation (Tokyo, Japan). Dr. Vavere reports financial support was provided by AstraZeneca Pharmaceuticals LP (Wilmington, Delaware). Dr. Lima reports financial support was provided by Canon Medical Systems Corporation. Dr. Chen reports financial support was provided by National Heart Lung and Blood Institute (Bethesda, Maryland). |
Vol 207
P. 314-321 - novembre 2023 Retour au numéro
Article précédent
- Use of the Carlino Technique in Chronic Total Occlusion Percutaneous Coronary Intervention
- Michaella Alexandrou, Athanasios Rempakos, Ahmed Al Ogaili, James W. Choi, Paul Poommipanit, Jaikirshan J. Khatri, Basem Elbarouni, Michael P. Love, Wissam Jaber, Stephane Rinfret, William Nicholson, Raj Chandwaney, Lorenzo Azzalini, Kathleen E. Kearney, Ahmed M. ElGuindy, Nidal Abi Rafeh, Oleg Krestyaninov, Dmitrii Khelimskii, Omer Goktekin, Sevket Gorgulu, Mauro Carlino, Luiz F. Ybarra, Jarrod D. Frizzell, Bavana V. Rangan, Olga C. Mastrodemos, Yader Sandoval, M. Nicholas Burke, Emmanouil S. Brilakis
- The Use of Quality Improvement Interventions in Reducing Rarely Appropriate Cardiac Imaging
- Mohammed Al-Sadawi, Michael Tao, Jesse Frye, Neda Dianati-Maleki, Noelle Mann
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?