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Article ; Online: Predictors of adverse cardiac events of coronary myocardial bridging diagnosed with computed tomography angiography.

Andreini, Daniele / Conte, Edoardo / Monizzi, Giovanni / Prestini, Blanca / Ratti, Angelo / Belmonte, Marta / Melotti, Eleonora / Doldi, Marco / Marchetti, Davide / Schillaci, Matteo / Nicoli, Flavia / Mastrangelo, Angelo / Paolisso, Pasquale / Gigante, Carlo / Novembre, Maria Laura / Baggiano, Andrea / Mancini, Maria Elisabetta / Annoni, Andrea / Formenti, Alberto /

Pizzamiglio, Francesca / Pontone, Gianluca / Zeppilli, Paolo / Bartorelli, Antonio L / Mushtaq, Saima

International journal of cardiology

2024 Volume 406, Page(s) 131997

Abstract: Aims: Myocardial bridging (MB) is a frequent congenital anomaly of the epicardial coronary arteries commonly considered a benign condition. However, in some cases a complex interplay between anatomical, clinical and physiology factors may lead to ... ...

Abstract	Aims: Myocardial bridging (MB) is a frequent congenital anomaly of the epicardial coronary arteries commonly considered a benign condition. However, in some cases a complex interplay between anatomical, clinical and physiology factors may lead to adverse events, including sudden cardiac death. Coronary CT angiography (CCTA) emerged as the gold standard noninvasive imaging technique for the evaluation of MB. Aim of the study was to evaluate MB prevalence and anatomical features in a large population of patients who underwent CCTA for suspected CAD and to identify potential anatomical and clinical predictors of adverse cardiac events at long-term follow-up. Methods and results: Two-hundred and six patients (mean age 60.3 ± 11.8 years, 128 male) with MB diagnosed at CCTA were considered. A long MB was defined as ≥25 mm of overlying myocardium, whereas a deep MB as ≥2 mm of overlying myocardium. The study endpoint was the sum of the following adverse events: cardiac death, bridge-related acute coronary syndrome, hospitalization for angina or bridge-related ventricular arrhythmias and MB surgical treatment. Of the 206 patients enrolled in the study, 9 were lost to follow-up, whereas 197 (95.6%) had complete follow-up (mean 7.01 ± 3.0 years) and formed the analytic population. Nineteen bridge-related events occurred in 18 patients (acute coronary syndrome in 7, MB surgical treatment in 2 and hospitalization for bridge-related events in 10). Typical angina at the time of diagnosis and long MB resulted as significant independent predictors of adverse outcome. Conclusions: Typical angina and MB length ≥ 25 mm were independent predictors of cardiac events.
MeSH term(s)	Humans ; Male ; Myocardial Bridging/diagnostic imaging ; Myocardial Bridging/complications ; Myocardial Bridging/epidemiology ; Female ; Middle Aged ; Computed Tomography Angiography/methods ; Aged ; Follow-Up Studies ; Coronary Angiography/methods ; Predictive Value of Tests ; Retrospective Studies
Language	English
Publishing date	2024-03-29
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	779519-1
ISSN	1874-1754 ; 0167-5273
ISSN (online)	1874-1754
ISSN	0167-5273
DOI	10.1016/j.ijcard.2024.131997
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Zs.A 1673: Show issues

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Article ; Online: Preoperative angiography-derived fractional flow reserve may predict coronary artery bypass grafting occlusion and disease progression.

Mushtaq, Saima / Gigante, Carlo / Conte, Edoardo / Capovilla, Teresa Maria / Sonck, Jeroen / Tanzilli, Alessandra / Barbato, Emanuele / Monizzi, Giovanni / Belmonte, Marta / De Bruyne, Bernard / Bartorelli, Antonio L / Schillaci, Matteo / Marchetti, Davide / Carerj, Maria Ludovica / Pontone, Gianluca / Collet, Carlos / Andreini, Daniele

Journal of cardiovascular medicine (Hagerstown, Md.)

2023 Volume 24, Issue 9, Page(s) 651–658

Abstract: Background: Graft occlusion after coronary artery bypass grafting (CABG) has been associated with competitive flow of native coronary arteries.: Objectives: To assess with coronary computed tomography angiography (CCTA) graft occlusion and coronary ... ...

Abstract	Background: Graft occlusion after coronary artery bypass grafting (CABG) has been associated with competitive flow of native coronary arteries. Objectives: To assess with coronary computed tomography angiography (CCTA) graft occlusion and coronary artery disease (CAD) progression of native vessels after CABG and their relationship with angiography-derived vessel fractional flow reserve (vFFR) performed before surgery. Methods: Between 2006 and 2018, serial vFFR analyses were obtained before CABG in each major native coronary vessel from two institutions. All patients underwent follow-up CCTA. Results: In 171 consecutive patients, serial preoperative angiograms were suitable for vFFR analysis of 298 grafted and 59 nongrafted vessels. Median time between CABG and CCTA was 2.1 years. Preoperative vFFR was assessed in 131 left anterior descending artery (LAD), 132 left circumflex artery (LCX) and 94 right coronary aretry (RCA) and was less than 0.80 in 255 of 298 bypassed vessels. Graft occlusion was observed at CCTA in 28 of 298 grafts. The median preoperative vFFR value of native coronaries was higher in occluded compared with patent grafts (0.75 vs. 0.60, P < 0.001) and was associated with graft. The best vFFR cut-off to predict graft occlusion was 0.67. Progression of CAD was higher in grafted than in nongrafted vessels (89.6 vs. 47.5%, P < 0.001). Pre-CABG vFFR predicted disease progression of grafted native vessels (AUC = 0.83). Conclusion: Preoperative vFFR derived from invasive coronary angiography was able to predict graft occlusion and CAD progression of grafted coronary arteries.
MeSH term(s)	Humans ; Fractional Flow Reserve, Myocardial ; Coronary Occlusion ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/surgery ; Coronary Artery Bypass/adverse effects ; Coronary Angiography ; Disease Progression
Language	English
Publishing date	2023-08-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2223461-5
ISSN	1558-2035 ; 1558-2027
ISSN (online)	1558-2035
ISSN	1558-2027
DOI	10.2459/JCM.0000000000001509
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Zs.A 5210: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Diagnostic accuracy of subendocardial vs. transmural myocardial perfusion defect for the detection of in-stent restenosis or progression of coronary artery disease after percutaneous coronary intervention.

Journal of cardiovascular computed tomography

2023 Volume 17, Issue 4, Page(s) 277–280

Abstract: Background: The ADVANTAGE study demonstrated in a cohort of stented patients a diagnostic accuracy of stress myocardial CT perfusion (CTP) significantly higher than that of coronary CT angiography (CCTA) for the detection of in-stent restenosis (ISR) or ...

Abstract	Background: The ADVANTAGE study demonstrated in a cohort of stented patients a diagnostic accuracy of stress myocardial CT perfusion (CTP) significantly higher than that of coronary CT angiography (CCTA) for the detection of in-stent restenosis (ISR) or CAD progression vs. quantitative coronary angiography (QCA). This is a pre-defined subanalysis of the ADVANTAGE aimed at assessing the difference in terms of diagnostic accuracy vs. QCA of a subendocardial vs. a transmural perfusion defect using static stress CTP. Methods: We enrolled consecutive patients who previously underwent coronary stenting and were referred for QCA. All patients underwent stress CTP and rest CTP + CCTA. The diagnostic accuracy of CCTA and CTP were evaluated in territory-based and patient-based analyses. We compared the diagnostic accuracy of "subendocardial" perfusion defect, defined as hypo-enhancement encompassing >25% but <50% of the transmural myocardial thickness within a specific coronary territory vs. "transmural" perfusion defect, defined as hypo-enhancement encompassing >50% of the transmural thickness. Results: In 150 patients (132 men, mean age 65.1 ± 9.1 years), the diagnostic accuracy of subendocardial vs. transmural perfusion defect in a vessel-based analysis was 93.5% vs. 87.7%, respectively (p < 0.0001). The sensitivity and specificity of subendocardial vs. transmural defect were 87.9% vs. 46.9% (p < 0.001) and 94.9% vs. 97.9% (p = 0.004), respectively. In a patient-based analysis, the diagnostic accuracy of the subendocardial vs. transmural approach was 86.6% vs. 68% (p < 0.0001). Conclusions: This study shows that detection of a subendocardial perfusion defect as compared to a transmural defect is significantly more accurate to identify coronary territories with ISR or CAD progression.
MeSH term(s)	Male ; Humans ; Middle Aged ; Aged ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/therapy ; Coronary Restenosis/diagnostic imaging ; Coronary Restenosis/etiology ; Predictive Value of Tests ; Coronary Angiography ; Computed Tomography Angiography ; Constriction, Pathologic ; Percutaneous Coronary Intervention/adverse effects ; Perfusion ; Myocardial Perfusion Imaging ; Coronary Stenosis
Language	English
Publishing date	2023-05-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2394360-9
ISSN	1876-861X ; 1934-5925
ISSN (online)	1876-861X
ISSN	1934-5925
DOI	10.1016/j.jcct.2023.05.005
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Article: The Role of Multimodality Imaging for Percutaneous Coronary Intervention in Patients With Chronic Total Occlusions.

Melotti, Eleonora / Belmonte, Marta / Gigante, Carlo / Mallia, Vincenzo / Mushtaq, Saima / Conte, Edoardo / Neglia, Danilo / Pontone, Gianluca / Collet, Carlos / Sonck, Jeroen / Grancini, Luca / Bartorelli, Antonio L / Andreini, Daniele

Frontiers in cardiovascular medicine

2022 Volume 9, Page(s) 823091

Abstract: Background: Percutaneous coronary intervention (PCI) of Chronic total occlusions (CTOs) has been traditionally considered a challenging procedure, with a lower success rate and a higher incidence of complications compared to non-CTO-PCI. An accurate and ...

Abstract	Background: Percutaneous coronary intervention (PCI) of Chronic total occlusions (CTOs) has been traditionally considered a challenging procedure, with a lower success rate and a higher incidence of complications compared to non-CTO-PCI. An accurate and comprehensive evaluation of potential candidates for CTO-PCI is of great importance. Indeed, assessment of myocardial viability, left ventricular function, individual risk profile and coronary lesion complexity as well as detection of inducible ischemia are key information that should be integrated for a shared treatment decision and interventional strategy planning. In this regard, multimodality imaging can provide combined data that can be very useful for the decision-making algorithm and for planning percutaneous CTO recanalization. Aims: The purpose of this article is to appraise the value and limitations of several non-invasive imaging tools to provide relevant information about the anatomical characteristics and functional impact of CTOs that may be useful for the pre-procedural assessment and follow-up of candidates for CTO-PCI. They include echocardiography, coronary computed tomography angiography (CCTA), nuclear imaging, and cardiac magnetic resonance (CMR). As an example, CCTA can accurately delineate CTO location and length, distal coronary bed, vessel tortuosity and calcifications that can predict PCI success, whereas stress CMR, nuclear imaging and stress-CT can provide functional evaluation in terms of myocardial ischemia and viability and perfusion defect extension.
Language	English
Publishing date	2022-05-02
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2022.823091
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Article ; Online: Prevalence and prognosis of structural heart disease among athletes with negative T waves and normal transthoracic echocardiography.

Clinical research in cardiology : official journal of the German Cardiac Society

2023 Volume 113, Issue 5, Page(s) 706–715

Abstract: Introduction: The aim of the present study was to evaluate the prevalence and prognosis of structural heart disease (SHD) among competitive athletes with negative T waves without pathological findings at transthoracic echocardiogram.: Methods: From a ...

Abstract	Introduction: The aim of the present study was to evaluate the prevalence and prognosis of structural heart disease (SHD) among competitive athletes with negative T waves without pathological findings at transthoracic echocardiogram. Methods: From a prospective register of 450 athletes consecutively evaluated during a second-level cardiological examination, we retrospectively identified all subjects with the following inclusion criteria: (1) not previously known cardiovascular disease; (2) negative T waves in leads other than V1-V2; (3) normal transthoracic echocardiogram. Patients underwent cardiac MRI and CT. The primary endpoint was the diagnosis of definite SHD after multimodality imaging evaluation. A follow-up was collected for a combined end-point of sudden death, resuscitated sudden cardiac death and hospitalization for any cardiovascular causes. Results: A total of 55 competitive athletes were finally enrolled (50 males, 90%) with a mean age of 27.5 ± 14.1 years. Among the population enrolled 16 (29.1%) athletes had a final diagnosis of SHD. At multivariate analysis, only deep negative T waves remained statistically significant [OR (95% CI) 7.81 (1.24-49.08), p = 0.0285]. Contemporary identification of deep negative T waves and complex arrhythmias in the same patients appeared to have an incremental diagnostic value. No events were collected at 49.3 ± 12.3 months of follow-up. Conclusions: In a cohort of athletes with negative T waves at ECG, cardiac MRI (and selected use of cardiac CT) enabled the identification of 16 (29.1%) subjects with SHD despite normal transthoracic echocardiography. Deep negative T waves and complex ventricular arrhythmias were the only clinical characteristic associated with SHD diagnosis.
MeSH term(s)	Male ; Humans ; Adolescent ; Young Adult ; Adult ; Retrospective Studies ; Prevalence ; Electrocardiography ; Heart Diseases/diagnosis ; Arrhythmias, Cardiac ; Death, Sudden, Cardiac/etiology ; Athletes ; Echocardiography/methods ; Prognosis
Language	English
Publishing date	2023-08-15
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2213295-8
ISSN	1861-0692 ; 1861-0684
ISSN (online)	1861-0692
ISSN	1861-0684
DOI	10.1007/s00392-023-02282-5
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Article: Quantitative Evaluation of COVID-19 Pneumonia Lung Extension by Specific Software and Correlation with Patient Clinical Outcome.

Annoni, Andrea Daniele / Conte, Edoardo / Mancini, Maria Elisabetta / Gigante, Carlo / Agalbato, Cecilia / Formenti, Alberto / Muscogiuri, Giuseppe / Mushtaq, Saima / Guglielmo, Marco / Baggiano, Andrea / Bonomi, Alice / Pepi, Mauro / Pontone, Gianluca / Andreini, Daniele

Diagnostics (Basel, Switzerland)

2021 Volume 11, Issue 2

Abstract: Lung infection named as COVID-19 is an infectious disease caused by the most recently discovered coronavirus 2 (SARS-CoV-2). CT (computed tomography) has been shown to have good sensitivity in comparison with RT-PCR, particularly in early stages. However, ...

Abstract	Lung infection named as COVID-19 is an infectious disease caused by the most recently discovered coronavirus 2 (SARS-CoV-2). CT (computed tomography) has been shown to have good sensitivity in comparison with RT-PCR, particularly in early stages. However, CT findings appear to not always be related to a certain clinical severity. The aim of this study is to evaluate a correlation between the percentage of lung parenchyma volume involved with COVID-19 infection (compared to the total lung volume) at baseline diagnosis and correlated to the patient's clinical course (need for ventilator assistance and or death). All patients with suspected COVID-19 lung disease referred to our imaging department for Chest CT from 24 February to 6 April 2020were included in the study. Specific CT features were assessed including the amount of high attenuation areas (HAA) related to lung infection. HAA, defined as the percentage of lung parenchyma above a predefined threshold of -650 (HAA%, HAA/total lung volume), was automatically calculated using a dedicated segmentation software. Lung volumes and CT findings were correlated with patient's clinical course. Logistic regressions were performed to assess the predictive value of clinical, inflammatory and CT parameters for the defined outcome. In the overall population we found an average infected lung volume of 31.4 ± 26.3% while in the subgroup of patients who needed ventilator assistance and who died as well as the patients who died without receiving ventilator assistance the volume of infected lung was significantly higher 41.4 ± 28.5 and 72.7 ± 36.2 (
Language	English
Publishing date	2021-02-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics11020265
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Article ; Online: Comprehensive Evaluation of Left Ventricle Dysfunction by a New Computed Tomography Scanner: The E-PLURIBUS Study.

Andreini, Daniele / Conte, Edoardo / Mushtaq, Saima / Melotti, Eleonora / Gigante, Carlo / Mancini, Maria Elisabetta / Guglielmo, Marco / Lo Russo, Gerardo / Baggiano, Andrea / Annoni, Andrea / Formenti, Alberto / Magini, Alessandra / Pontone, Gianluca / Agostoni, Piergiuseppe / Bartorelli, Antonio L / Pepi, Mauro / Onuma, Yoshinobu / Serruys, Patrick W

JACC. Cardiovascular imaging

2022 Volume 16, Issue 2, Page(s) 175–188

Abstract: Background: Although cardiac magnetic resonance (CMR) is considered the gold standard for myocardial fibrosis detection, cardiac computed tomography (CCT) is emerging as a promising alternative.: Objectives: The purpose of this study was to assess ... ...

Abstract	Background: Although cardiac magnetic resonance (CMR) is considered the gold standard for myocardial fibrosis detection, cardiac computed tomography (CCT) is emerging as a promising alternative. Objectives: The purpose of this study was to assess feasibility and diagnostic accuracy of a comprehensive functional and anatomical evaluation with CCT as compared with CMR in patients with newly diagnosed left ventricular dysfunction (LVD). Methods: A total of 128 consecutive patients with newly diagnosed LVD were screened. Based on the exclusion criteria, 28 cases were excluded. CCT was performed within 10 days from CMR. Biventricular volumes and ejection fraction, and presence and pattern of delayed enhancement (DE), were determined, along with evaluation of coronary arteries among patients undergoing invasive angiography in the 6 months after CCT. Results: Six cases were excluded because of claustrophobia at CMR. Among the 94 patients who formed the study population, the concordance between CCT and CMR in suggesting the cause of the LVD was high (94.7%, 89/94 patients) in the overall population and was 100% for identifying ischemic cardiomyopathy. The CCT diagnostic rate for DE assessment was also high (96.7%, 1,544/1,598 territories) and similar to that of CMR (97.4%; P = 0.345, CCT vs CMR). Moreover, CCT showed high diagnostic accuracy in the detection of DE (94.8%, 95% CI: 93.6%-95.8%) in a territory-based analysis. Biventricular volumes and function parameters as measured by CCT and CMR were similar, without significant differences with the exception of a modest difference in RV volume. CCT was confirmed to be accurate for assessing arterial coronary circulation. The mean radiation exposure of the whole CCT was 7.78 ± 2.53 mSv (0.84 ± 0.24 mSv for DE). Conclusions: CCT performed with low-dose whole-heart coverage scanner and high-concentration contrast agent appears an effective noninvasive tool for a comprehensive assessment of patients with newly diagnosed LVD.
MeSH term(s)	Humans ; Heart Ventricles/diagnostic imaging ; Predictive Value of Tests ; Magnetic Resonance Imaging/methods ; Cardiomyopathies ; Contrast Media
Chemical Substances	Contrast Media
Language	English
Publishing date	2022-10-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2491503-8
ISSN	1876-7591 ; 1936-878X
ISSN (online)	1876-7591
ISSN	1936-878X
DOI	10.1016/j.jcmg.2022.08.005
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Zs.A 6846: Show issues

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Article: Plaque assessment by coronary CT angiography may predict cardiac events in high risk and very high risk diabetic patients: A long-term follow-up study

The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University Nutrition, metabolism, and cardiovascular diseases. 2022 Mar., v. 32, no. 3

2022

Abstract: The aim of the present study is to evaluate whether advanced coronary atherosclerosis analysis by CCTA may improve prognostic stratification among diabetic patients at high cardiovascular risk (CV risk). The study population consisted of 265 consecutive ... ...

Abstract	The aim of the present study is to evaluate whether advanced coronary atherosclerosis analysis by CCTA may improve prognostic stratification among diabetic patients at high cardiovascular risk (CV risk). The study population consisted of 265 consecutive diabetic patients at high CV risk who underwent CCTA for suspected CAD between January 2011 and December 2016. For every patients both traditional and advanced, qualitative and quantitative coronary plaque analysis were performed. The occurrence of cardiac death, ACS, and non-urgent revascularization were recorded at follow-up. Among the 265 patients enrolled, 21 were lost to follow-up, whereas 244 (92%) had a complete follow-up (mean 45 ± 22 months) and were classified at high (n = 67) or very high cardiovascular risk (n = 177), according to ESC Guidelines. A total of 63 events were recorded (3 Cardiac Death, 3 NSTEMI, 8 unstable angina, 36 late non-urgent revascularization and 13 non-cardiac death) in 57 different patients. Elevated fibro-fatty plaque volume was the only predictor of events over age, gender and traditional risk factor when ACS and MACE were considered as end-points [HR (95% CI) 6.01 (1.65–21.87), p = 0.006 and 3.46 (2.00–5.97); p < 0.001]. The present study confirms the prognostic role of advance coronary atherosclerosis evaluation beyond risk factors and stenosis severity, even in diabetics. Despite the very high cardiovascular risk of study population, a not negligible portion (23%) of patients exhibited totally normal coronaries.
Keywords	angiography ; coronary artery disease ; death ; gender ; metabolism ; nutrition ; risk factors
Language	English
Dates of publication	2022-03
Size	p. 586-595.
Publishing place	Elsevier B.V.
Document type	Article
ZDB-ID	1067704-5
ISSN	0939-4753
ISSN	0939-4753
DOI	10.1016/j.numecd.2021.11.013
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Extent of lung involvement over severity of cardiac disease for the prediction of adverse outcome in COVID-19 patients with cardiovascular disease.

Andreini, Daniele / Conte, Edoardo / Mushtaq, Saima / Gigante, Carlo / Mancini, Maria Elisabetta / Annoni, Andrea / Stefanini, Giulio / Agalbato, Cecilia / Cosentino, Nicola / Pontone, Gianluca / Assanelli, Emilio / Pepi, Mauro

International journal of cardiology

2020 Volume 323, Page(s) 292–294

Abstract: Background: Aim of the present study was to assess if the presence of high cardiovascular risk, left ventricle systolic dysfunction or elevated BNP or Troponin are able to independently predict the outcome of patients with known cardiac disease and ... ...

Abstract	Background: Aim of the present study was to assess if the presence of high cardiovascular risk, left ventricle systolic dysfunction or elevated BNP or Troponin are able to independently predict the outcome of patients with known cardiac disease and COVID-19 pneumonia. Methods and results: From March 7th to April 28th, forty consecutive patients with known cardiac disease (chronic coronary artery disease, n=38; atrial fibrillation, n = 7; valvular disease, n = 13) referred to our emergency department for symptoms of suspected COVID-19, laboratory diagnosis of COVID-19 and typical signs of viral pneumonia at chest CT were enrolled in the study. The only predictor of the composite end-point (all cause of death + invasive ventilation + thromboembolic event) was the lung involvement % at chest CT (OR: 1.06; 95%CI: 1.01-1.11, P = 0.02). In the multivariate analysis, the lung involvement % at chest CT was the only independent predictor of the composite end-point (OR: 1.06; 95%CI: 1.01-1.11, P = 0.034). Conclusions: The extent of lung involvement by COVID-19 is the only independent predictor of adverse outcome of patients and is predominant over the severity of cardiac disease.
MeSH term(s)	Aged ; COVID-19/complications ; COVID-19/mortality ; Cardiovascular Diseases/complications ; Emergency Service, Hospital ; Female ; Hospitalization ; Humans ; Italy/epidemiology ; Lung/diagnostic imaging ; Male ; Multivariate Analysis ; Respiration, Artificial/statistics & numerical data ; Severity of Illness Index ; Thromboembolism/virology ; Tomography, X-Ray Computed
Keywords	covid19
Language	English
Publishing date	2020-10-08
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	779519-1
ISSN	1874-1754 ; 0167-5273
ISSN (online)	1874-1754
ISSN	0167-5273
DOI	10.1016/j.ijcard.2020.10.006
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Article ; Online: Graft patency and progression of coronary artery disease after CABG assessed by angiography-derived fractional flow reserve.

Gigante, Carlo / Mizukami, Takuya / Sonck, Jeroen / Nagumo, Sakura / Tanzilli, Alessandra / Bartunek, Jozef / Vanderheyden, Marc / Wyffels, Eric / Barbato, Emanuele / Pompilio, Giulio / Mushtaq, Saima / Bartorelli, Antonio / De Bruyne, Bernard / Andreini, Daniele / Collet, Carlos

International journal of cardiology

2020 Volume 316, Page(s) 19–25

Abstract: Background: Graft occlusion after coronary artery bypass graft surgery (CABG) has been associated with native coronary artery competitive flow.: Objectives: The present study aims to characterize the functional progression of coronary artery disease ( ...

Abstract	Background: Graft occlusion after coronary artery bypass graft surgery (CABG) has been associated with native coronary artery competitive flow. Objectives: The present study aims to characterize the functional progression of coronary artery disease (CAD) in native vessels after CABG, and to assess the relationship between preoperative FFR as derived from angiography and graft occlusion. Methods: Multicenter study of consecutive patients undergoing CABG between 2013 and 2018, in whom a follow-up angiogram had been performed. Serial vessel-fractional flow reserve (vFFR) analyses were obtained in each major native coronary vessel before and after CABG, excluding post-anastomotic segments and graft conduits. Results: In 73 patients, serial angiograms were suitable for vFFR analysis, including 118 grafted (86 arterial and 32 saphenous grafts) and 64 non-grafted vessels. The median time between CABG and follow-up angiography was 2.4 years [IQR 1.5, 3.3]. Functional CAD progression, by means of decline in vFFR, was observed in grafted but not in non-grafted vessels (delta vFFR in grafted vessels 0.10 [IQR 0.05, 0.18] vs. 0.01 [IQR -0.01, 0.03], in non-grafted vessels, p < 0.001). Preoperative vFFR predicted graft occlusion (AUC: 0.66, 95% CI 0.52 to 0.80, p = 0.031). Conclusions: In patients undergoing CABG, preoperative vFFR derived from conventional angiograms without use of pressure wire was able to predict graft occlusion. Graft occlusion was more frequent in vessels with high vFFR values. Grafted native coronary vessels exhibited accelerated functional CAD progression, whereas in non-grafted native coronaries the functional status remained unchanged.
MeSH term(s)	Coronary Angiography ; Coronary Artery Bypass/adverse effects ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/surgery ; Fractional Flow Reserve, Myocardial ; Graft Occlusion, Vascular/diagnostic imaging ; Graft Occlusion, Vascular/etiology ; Humans ; Vascular Patency
Language	English
Publishing date	2020-04-30
Publishing country	Netherlands
Document type	Journal Article ; Multicenter Study
ZDB-ID	779519-1
ISSN	1874-1754 ; 0167-5273
ISSN (online)	1874-1754
ISSN	0167-5273
DOI	10.1016/j.ijcard.2020.04.083
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