Comparison of fractional myocardial mass, a vessel-specific myocardial mass-at-risk, with coronary angiographic scoring systems for predicting myocardial ischemia
- Authors
- Kim, HY[Kim, Hyung Yoon]; Doh, JH[Doh, Joon-Hyung]; Lim, HS[Lim, Hong-Seok]; Nam, CW[Nam, Chang-Wook]; Shin, ES[Shin, Eun-Seok]; Koo, BK[Koo, Bon-Kwon]; Lee, JM[Lee, Joo Myung]; Park, TK[Park, Taek Kyu]; Yang, JH[Yang, Jeong Hoon]; Song, YB[Song, Young Bin]; Hahn, JY[Hahn, Joo-Yong]; Choi, SH[Choi, Seung Hyuk]; Gwon, HC[Gwon, Hyeon-Cheol]; Lee, SH[Lee, Sang-Hoon]; Kim, SM[Kim, Sung Mok]; Choe, Y[Choe, Yeonhyeon]; Choi, JH[Choi, Jin-Ho]
- Issue Date
- Jul-2020
- Publisher
- ELSEVIER SCIENCE INC
- Keywords
- Fractional myocardial mass; Angiographic scores; Myocardial ischemic burden
- Citation
- JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY, v.14, no.4, pp.322 - 329
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY
- Volume
- 14
- Number
- 4
- Start Page
- 322
- End Page
- 329
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/3953
- DOI
- 10.1016/j.jcct.2019.11.001
- ISSN
- 1934-5925
- 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.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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