For patients with proximal atherosclerotic lesions, machine learning-based computed tomography (CT) angiography-derived fractional flow reserve (FFR) can diagnose functional ischemia with myocardial bridging and atherosclerotic disease, according to a study published in the Canadian Journal of Cardiology.
Researchers aimed to assess the diagnostic ability of machine learning-based CT angiography-derived FFR to detect functional ischemia in myocardial bridging, and then compare those results with the results of the invasive FFR procedure in patients with left anterior descending myocardial bridging.
Patients underwent a coronary CT angiography, an invasive coronary angiography with FFR measurements, and a clinical exam. Myocardial bridging was measured from images and classified as superficial or deep and short or long. Coronary CT angiography data sets were used to measure FFR and then inputted into a machine-learning platform. Plaque calcification was evaluated using an arterial cross-section of the most severe lesion and then classified as none, mild, moderate, severe, or very severe.
Of the 104 patients with left anterior descending myocardial bridging included in this study, 72.1% were men, the mean age was 61.2 years old, 85.6% had superficial myocardial bridging, and 53.8% had short myocardial bridging. CT angiography-derived FFR showed functional ischemia in 52.9% of vessels, and invasive FFR showed functional ischemia in 46.2% of vessels.
Using invasive FFR as the reference, CT angiography-derived FFR had a sensitivity of 0.96, a specificity of 0.84, an accuracy of 0.89, a positive predictive value of 0.84, and a negative predictive value of 0.96. No differences were found when analyzing superficial and deep myocardial bridging or short and long myocardial bridging (all P >.05). The accuracy of the CT angiography-derived FFR based on levels of stenosis, was 0.89 in vessels with a stenosis <50%, 0.82 in vessels with a stenosis of 50% to 69%, and 0.96 in vessels with a stenosis 70%.
Correlation comparison indicated a slight mean difference between invasive FFR and CT angiography-derived FFR of 0.014 in all myocardial bridge vessels, of 0.013 in vessels with a stenosis of 50% to 69%, of 0.014 in vessels with stenosis 70%, of 0.019 in the superficial, deep, and short myocardial bridge vessels, and of 0.007 in the long myocardial bridge vessels. Overall, the intraclass correlation coefficient was 0.775 (P <.001) between CT angiography-derived FFR and invasive FFR.
Limitations of this study include the relatively small sample size, the retrospective nature of the study, potential incomplete vasodilation in some patients not including interobserver agreement, calculating invasive FFR in the rest condition, and potential variables in the coronary CT angiography image quality.
The researchers concluded [machine learning-based CT angiography-derived FFR] has high diagnostic performance to identify functional ischemia in vessels with [myocardial bridge] and concomitant proximal atherosclerotic disease compared with invasive FFR, but at this time, more studies are necessary before clinical use.
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors disclosures.
Reference
Zhou F, Wang YN, Schoepf UJ, et al. Diagnostic performance of machine learning based CT-FFR in detecting ischemia in myocardial bridging and concomitant proximal atherosclerotic disease.Can J Cardiol. 2019;35(11):1523-1533.
View original post here:
Detecting Ischemia in Myocardial Bridging With CT Angiography-Derived FFR - The Cardiology Advisor
- Best 30 Cardiology in Secaucus, NJ with Reviews - YP.com - April 12th, 2018 [April 12th, 2018]
- Cardiology | Weill Cornell Medicine - April 14th, 2018 [April 14th, 2018]
- Cardiology Conferences 2018 | Cardiology Meetings 2018 ... - April 26th, 2018 [April 26th, 2018]
- Dr. Anil Goel, MD - Birmingham, MI - Cardiology & Clinical ... - April 26th, 2018 [April 26th, 2018]
- Clinical Physiology (Cardiology) MSc/PGDip | Middlesex ... - May 15th, 2018 [May 15th, 2018]
- Cardiology Conferences 2018 | Upcoming Cardiology ... - May 16th, 2018 [May 16th, 2018]
- Clinical Cardiology Section | Cleveland Clinic - May 27th, 2018 [May 27th, 2018]
- Journal of Clinical and Experimental Cardiology - Open ... - June 6th, 2018 [June 6th, 2018]
- Cardiology Summit 2018 | Cardiology Conferences | Heart ... - June 23rd, 2018 [June 23rd, 2018]
- Cardiology Clinical and Research Faculty Members ... - June 26th, 2018 [June 26th, 2018]
- Cardiology Conferences 2018 | Cardiology Congress 2018 ... - June 26th, 2018 [June 26th, 2018]
- About Us - New Jersey Cardiology Associates - July 8th, 2018 [July 8th, 2018]
- About Us - Ventura Clinical Trials - August 16th, 2018 [August 16th, 2018]
- Clinical Cardiology Made Ridiculously Simple: Michael A ... - August 22nd, 2018 [August 22nd, 2018]
- Clinical Cardiology - American Society of Preventive Cardiology - October 2nd, 2018 [October 2nd, 2018]
- Heart Surgery Hospital in india | Cardiology Treatment ... - October 7th, 2018 [October 7th, 2018]
- Clinical Cardiology - American Society of Preventive ... - December 3rd, 2018 [December 3rd, 2018]
- Guideline Clinical App - American College of Cardiology - December 7th, 2018 [December 7th, 2018]
- Journal of Clinical and Experimental Cardiology- Open ... - December 12th, 2018 [December 12th, 2018]
- Clinical Cardiology - Baptist Health - December 30th, 2018 [December 30th, 2018]
- Cardiology at Cancun: Topics in Clinical Cardiology - February 5th, 2019 [February 5th, 2019]
- Department of Cardiovascular Medicine, KU School of Medicine - March 10th, 2019 [March 10th, 2019]
- Towards Health Equality: Improving the Management of Cardiovascular Diseases in Women - International Atomic Energy Agency - September 21st, 2019 [September 21st, 2019]
- Lifetime Risk of PAD Varies by Race, but All Are Vulnerable to Traditional Risk Factors - TCTMD - September 21st, 2019 [September 21st, 2019]
- DEFINE-HF: Dapagliflozin Improves Function and QoL, but Not Biomarkers, in HFrEF - TCTMD - September 21st, 2019 [September 21st, 2019]
- Combining Nature and Technology, Luye Medical and Cleveland Clinic Join to Build a Future Hospital in Shanghai - Yahoo Finance - September 21st, 2019 [September 21st, 2019]
- Will Renal Denervation for Hypertension Rise Again? - Medscape - September 21st, 2019 [September 21st, 2019]
- Obstructive Sleep Apnea, Sleep Symptoms, and their Association with Cardiovascular Disease - DocWire News - September 21st, 2019 [September 21st, 2019]
- CNE expands pulmonary, sleep services with Brigham & Women's physicians - Warwick Beacon - September 21st, 2019 [September 21st, 2019]
- What I Am Most Looking Forward to at TCT 2019 - TCTMD - September 21st, 2019 [September 21st, 2019]
- Serelaxin Not Linked to CV Mortality Reduction in Patients Hospitalized for Acute HF - The Cardiology Advisor - September 21st, 2019 [September 21st, 2019]
- Sacubitril-Valsartan Not Linked to Lower Hospitalization Risk, CV Death in HFpEF - The Cardiology Advisor - September 21st, 2019 [September 21st, 2019]
- FDA clears multiuse angiography systems from Siemens Healthineers - DOTmed HealthCare Business News - September 21st, 2019 [September 21st, 2019]
- Balloon Pulmonary Angioplasty Effective for Chronic Thromboembolic PH - The Cardiology Advisor - September 21st, 2019 [September 21st, 2019]
- RWJBarnabas Health, St. Luke's University Health launch clinical affiliation - FierceHealthcare - September 21st, 2019 [September 21st, 2019]
- Bilirubin: A Novel Indicator of Infective Endocarditis Adverse Outcomes - The Cardiology Advisor - September 21st, 2019 [September 21st, 2019]
- Major Bleeding Mostly Early, Not Severe With Rivaroxaban Plus Aspirin in COMPASS - TCTMD - September 21st, 2019 [September 21st, 2019]
- Community-based Care Model Reduces CVD Risk - Managed Healthcare Executive - September 21st, 2019 [September 21st, 2019]
- American College of Cardiology Steps Up: Equal Pay, Opportunities for All - TCTMD - September 21st, 2019 [September 21st, 2019]
- FDA Approves Novo Nordisk's Oral Semaglutide, First GLP-1 in Pill Form - AJMC.com Managed Markets Network - September 21st, 2019 [September 21st, 2019]
- A New Drug for HF? DEFINE-HF Bolsters Dapagliflozin Cardio Cred - Medscape - September 21st, 2019 [September 21st, 2019]
- Seeking Synergy: Bringing Cardiology into Your Enterprise Imaging Strategy - Health Imaging - September 21st, 2019 [September 21st, 2019]
- TCT 2019 Day Two: Transcatheter Valves, New and Old - TCTMD - September 30th, 2019 [September 30th, 2019]
- Transcatheter Options Best for Tricuspid Regurgitation in Matched Registry Analysis - TCTMD - September 30th, 2019 [September 30th, 2019]
- Bypass Surgery and Coronary Stenting Yield Comparable 10-Year Survival - Diagnostic and Interventional Cardiology - September 30th, 2019 [September 30th, 2019]
- TAVR Improves Health Status Over Surgery in Low-Risk Patients at 1 Year: PARTNER 3 - TCTMD - September 30th, 2019 [September 30th, 2019]
- Eidos Therapeutics to Present Interim Analysis of the Ongoing Phase 2 Open-Label Extension Study of AG10 in Patients with TTR Amyloid Cardiomyopathy... - September 30th, 2019 [September 30th, 2019]
- Off Script: The New Gatekeepers of Procedural Education - TCTMD - September 30th, 2019 [September 30th, 2019]
- Study Shows Safety and Efficacy of Near Infrared Spectroscopy (NIRS) Imaging to Identify Patients and Plaques at an Increased Risk for MACE - BioSpace - September 30th, 2019 [September 30th, 2019]
- The Heart of the Matter: Cardiovascular Fitness in Horses - United States Eventing Association - September 30th, 2019 [September 30th, 2019]
- Google parent Alphabet hires former FDA head Robert Califf to lead health strategy and policy - FierceHealthcare - September 30th, 2019 [September 30th, 2019]
- Inclisiran Benefits Patients With Familial Hypercholesterolemia and ASCVD - The Cardiology Advisor - September 30th, 2019 [September 30th, 2019]
- AUGUSTUS: Best Benefit With Apixaban, P2Y12 Inhibitor Dual Therapy - Medscape - September 30th, 2019 [September 30th, 2019]
- New TAVR System Safe and Effective for High-Risk Surgical Patients with Severe Aortic Stenosis - Newswise - September 30th, 2019 [September 30th, 2019]
- Dapagliflozin Improves Heart Failure-Related Health Status in HFrEF - The Cardiology Advisor - September 30th, 2019 [September 30th, 2019]
- Remote Ischemic Conditioning Did Not Improve 12 Month Clinical Outcomes After STEMI - The Cardiology Advisor - September 30th, 2019 [September 30th, 2019]
- Insights from the European Society of Cardiology congress | Speaking of Medicine - PLoS Blogs - September 30th, 2019 [September 30th, 2019]
- Smokers Have More Pulmonary Emboli, Leading to Higher Hospital Readmission Rates | - Diagnostic and Interventional Cardiology - October 22nd, 2019 [October 22nd, 2019]
- AZ's Farxiga gets heart failure prevention okay from FDA - PMLiVE - October 22nd, 2019 [October 22nd, 2019]
- Bayer Announces Recipients of the Pulmonary Hypertension Accelerated Bayer (PHAB) Awards at CHEST Annual Meeting 2019 - BioSpace - October 22nd, 2019 [October 22nd, 2019]
- The Epidemic Of The Metabolic Syndrome Among The Palestinians In The G | DMSO - Dove Medical Press - October 22nd, 2019 [October 22nd, 2019]
- Optina Diagnostics and the Montreal Heart Institute Partner to Develop a New Biomarker for Atherosclerosis - PRNewswire - October 22nd, 2019 [October 22nd, 2019]
- Even With Same Diagnosis, Women Get Half the Heart Attack Treatments as Men - AJMC.com Managed Markets Network - October 22nd, 2019 [October 22nd, 2019]
- Eva Dickerman, Andrew Weil - The New York Times - October 22nd, 2019 [October 22nd, 2019]
- EHR vendor Veradigm and partners creating new shared data tools for researchers - Healthcare IT News - October 22nd, 2019 [October 22nd, 2019]
- Evolocumab Well-tolerated as Add-on for Hypercholesterolemia Therapy - DocWire News - October 22nd, 2019 [October 22nd, 2019]
- Deborah Heart and Lung Center announces affiliation with Cleveland Clinic Heart & Vascular Institute - Health Essentials from Cleveland Clinic - October 22nd, 2019 [October 22nd, 2019]
- New Registry to Provide Insight into STEMI Occurrence, Treatment in North India | - Diagnostic and Interventional Cardiology - October 22nd, 2019 [October 22nd, 2019]
- Finding Your Best Fit in Cardiology - TCTMD - October 22nd, 2019 [October 22nd, 2019]
- Cardiology team expands to meet community need - The Union of Grass Valley - October 22nd, 2019 [October 22nd, 2019]
- Deaths After Ablation of Atrial Fibrillation 'Concerning' in Real-World Analysis - TCTMD - November 1st, 2019 [November 1st, 2019]
- Cutler Family gifts $15 million to University Hospitals to transform mens health care - Newswise - November 1st, 2019 [November 1st, 2019]
- Troponin Increases After Elective PCI Tied to Complexity, Extent of CAD - TCTMD - November 1st, 2019 [November 1st, 2019]
- Caregiving and the Soul of Medicine - Medscape - November 1st, 2019 [November 1st, 2019]
- STEMI Mortality Unaffected by Weekend, Weeknight, or Holiday Admission in France - TCTMD - November 1st, 2019 [November 1st, 2019]
- Cardiva Medical publishes positive results from the AMBULATE pivotal study Cardiology2.0 - Cardiology2.0 - November 1st, 2019 [November 1st, 2019]
- Gaps in Access to TAVR and SAVR: 'Something Needs to Be Done' - TCTMD - November 1st, 2019 [November 1st, 2019]
- Cardiva Medical Announces Publication of Data From the AMBULATE Pivotal Study in the Journal of the American College of Cardiology: Clinical... - November 1st, 2019 [November 1st, 2019]
- Raymond James 4 Analyst Favorite Health Care Picks With Huge Upside Potential - 24/7 Wall St. - November 7th, 2019 [November 7th, 2019]
- Global Computed Tomography (CT) Scanners Devices and Equipment Market Report 2020: Major Players are GE Healthcare, Koninklijke Philips, Hitachi,... - November 7th, 2019 [November 7th, 2019]