Evaluation of the Hemodynamic Significance of Myocardial Bridge by Coronary Blood Fractional Flow Reserve

Completed

• Conditions: Myocardial Bridge
• Interventions: Diagnostic Test: FFR and d-FFR

• Registration Number: NCT04958395
• Lead Sponsor: Peking University Third Hospital

Brief Summary

This study clarified the influence of myocardial bridge on coronary hemodynamics by clarifying FFR and d-FFR to guide clinical intervention and treatment.

Detailed Description

Myocardial bridge is a congenital anatomical abnormality, which is generally considered to be a benign change, but individual can cause angina, myocardial infarction and even sudden death. Previously, it was believed that the degree of myocardial ischemia induced by myocardial bridge was related to factors such as the location, length, and systolic stenosis of the myocardial bridge shown by coronary angiography.However, in recent years, more and more evidence has suggested that there is a high degree of mismatch between anatomical stenosis and its function.Studies have shown that FFR and d-FFR can accurately evaluate the functional significance of stenotic lesions.This study intends to enroll patients who underwent coronary angiography due to chest pain and confirmed the left anterior descending artery (LAD) simple myocardial bridge systolic stenosis ≥30%, and the pressure guide wire was used to measure the FFR and d-FFR of the myocardial bridge lesion under static and dobutamine stress.Analyze the relationship between these functional parameters and the anatomical morphological characteristics of the myocardial bridge and other possible clinical influencing factors, and explore the influence of the morphological characteristics of the myocardial bridge on myocardial hemodynamics，so as to clarify the degree of myocardial bridge shown by angiography may induce obvious myocardial ischemia, which requires clinical intensive intervention.

Study Timeline

• Status Verified: 2014-11
• Study Start: 2014-11-01
• Primary Completion: 2015-10-31
• Study Completion: 2015-10-31
• Study First Submitted: 2021-06-27
• Study First Submitted QC: 2021-07-08
• Last Update Submitted: 2021-07-08
• Study First Posted: 2021-07-12
• Last Update Posted: 2021-07-12

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

• Patients with chest pain aged ≥18 years old, regardless of gender;
• Coronary angiography shows a solitary myocardial bridge with systolic diameter stenosis ≥30% in LAD;
• Have the ability to complete an ECG exercise test;
• Sign informed consent and are willing to participate in the intended study.

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Exclusion Criteria

• Patients with acute coronary syndrome;
• Coronary angiography shows that the diameter of atherosclerosis in the non-myocardial bridge area of LAD is ≥30%;
• RCA or LCX has severe fixed stenosis, diameter stenosis ≥70% or FFR<0.75, and no interventional therapy is accepted;
• Hypertrophic obstructive cardiomyopathy or more than moderate heart valve disease;
• Atrial fibrillation or severe slow or rapid arrhythmia;
• Heart failure with NYHA ≥ Grade III;
• Uncontrolled hypertension or systolic blood pressure <100mmHg;
• Asthma or severe chronic obstructive pulmonary disease;
• Severe liver and kidney dysfunction;
• Allergic to contrast agents.

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Myocardial bridge	FFR and d-FFR	Measure FFR and d-FFR

Primary Outcome Measures

Name	Time	Method
Morphological index of myocardial bridge	All indicators were completed within 1 week of coronary angiography.	The minimum lumen diameter of the target vessel

Secondary Outcome Measures

Name	Time	Method
Exercise electrocardiogram	72 hours after coronary angiography	ST segment depression time