aceAI-based CT-FFR assessment of hemodynamic impact in LAD myocardial bridging patients
Source article: Sex differences in CT-FFR of myocardial bridging with or without atherosclerosis: an AI-based quantitative study
Background: Myocardial bridging (MB) is a prevalent coronary anomaly with potential links to major adverse cardiac events. While computed tomography-derived fractional flow reserve (FFRCT) offers a non-invasive functional assessment, current evidence predominantly treats MB as a homogeneous entity, overlooking potential sex differences in hemodynamic impact. Existing studies often fail to distinguish between isolated MB and MB with concomitant atherosclerosis, and rarely employ sex-stratified analyses. This stud…
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"Myocardial bridges" by Doriot et al. is licensed under CC BY 2.0. https://creativecommons.org/licenses/by/2.0/
A retrospective study of 300 patients with left anterior descending artery myocardial bridging and 104 controls used an AI-based platform, Shukun-FFRCT, to obtain whole-vessel and segmental FFRCT values and relate them to bridging morphology and sex.
The work matters because myocardial bridging is linked to major adverse cardiac events and current practice often treats it as homogeneous; showing that females with isolated bridging have greater distal flow alteration and that bridging length disproportionately raises abnormal FFRCT risk in females points to need for sex-aware risk stratification, while the single-center retrospective design and LAD-only focus leave uncertainty about broader applicability.
- Study included 300 LAD-MB patients split into isolated MB (n=155) and MB with atherosclerosis (n=145) plus 104 normal CCTA controls.
- AI platform Shukun-FFRCT provided whole-vessel and segmental FFRCT proximal to, within, and distal to bridging.
- Females with isolated MB showed more pronounced distal hemodynamic alterations than males, while no sex difference was seen when atherosclerosis coexisted.
- MB length was independent risk factor for FFRCT <0.8, with each 1-mm increase raising risk 5.3% in males and 11.3% in females.
An AI-based platform for CT-derived fractional flow reserve enabled noninvasive, sex-stratified quantification of hemodynamic impact in LAD myocardial bridging, showing distinct distal flow patterns and supporting risk stratification.
In patients with LAD myocardial bridging, longer bridging length increased risk of abnormal FFRCT, with a larger effect in females, and females with isolated bridging had more pronounced distal hemodynamic compromise.
The rundown
Researchers retrospectively analyzed 300 LAD-MB cases and 104 normal CCTA controls, using cardiac function post-processing software for morphology and Shukun-FFRCT for whole-vessel and local FFRCT values proximal, within, and distal to bridging.
Statistical testing included t-tests, ANOVA, Mann-Whitney U and binary logistic regression stratified by FFRCT <0.8, finding no systolic-diastolic phase differences and no sex differences in the MB with atherosclerosis group.
By the July 2026 publication date, the observed results indicated sex significantly influences FFRCT in isolated LAD-MB, with MB length as independent predictor, providing preliminary evidence rather than a prospective outcome trial.
Retrospective cohort limited to LAD-MB patients and findings described as preliminary, limiting generalizability beyond this anatomy and design.
Sources
- Peer-reviewedQuantitative Imaging in Medicine and Surgery2026-07-01
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