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Comparison of Fractional Myocardial Mass, a Vessel-Specific Myocardial Mass-At-Risk, With Coronary Angiographic Scoring Systems for Predicting Myocardial Ischemia

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Author(s)
Hyeon-Cheol GwonSeung Hyuk ChoiHyung Yoon KimJoon-Hyung DohHong-Seok LimChang-Wook NamEun-Seok ShinBon-Kwon KooJoo Myung LeeTaek Kyu ParkJeong Hoon YangYoung Bin SongJoo-Yong HahnSang-Hoon LeeSung Mok KimYeonhyeon ChoeJin-Ho Choi
Keimyung Author(s)
Nam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
Journal of cardiovascular computed tomography
Issued Date
2019
Keyword
Fractional myocardial massAngiographic scoresMyocardial ischemic burden
Abstract
Aims:
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.

Methods:
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.

Results:
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 < 0.001, all). The optimal cutoff of %FMM-50 and %FMM-70 for FFR≤0.80 were ≥36.3% and ≥8.7%, respectively. Using these cutoffs, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of %FMM-50 were 81%, 55%, 3%, 67%, 71%, and of %FMM-70 were 67%, 78%, 82%, 61%, 71%.

Conclusion:
%FMM was comparable to angiographic scores for prediction of functional stenosis defined by FFR≤0.80. The integration of the severity of stenosis and the amount of subtended myocardium may improve the detection of the functional significance of vessel.
Keimyung Author(s)(Kor)
남창욱
Publisher
School of Medicine (의과대학)
Citation
Hyeon-Cheol Gwon et al. (2019). Comparison of Fractional Myocardial Mass, a Vessel-Specific Myocardial Mass-At-Risk, With Coronary Angiographic Scoring Systems for Predicting Myocardial Ischemia. Journal of cardiovascular computed tomography. doi: 10.1016/j.jcct.2019.11.001
Type
Article
ISSN
1876-861X
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S1934592519300838
DOI
10.1016/j.jcct.2019.11.001
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42355
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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