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TRUVACE RECORD VERSION
record: TRV-2026-0331
version: 1
kind: certified
reason: Certified into the record
timestamp: 2026-07-20T08:46:28.206802Z
status: published
lens: trace
sector: health
headline: Sex differences in CT-FFR of myocardial bridging with or without atherosclerosis: an AI-based quantitative study
dek: 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…
gain_title: 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.
problem_title: 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.
trace_subject: AI-based CT-FFR assessment of hemodynamic impact in LAD myocardial bridging patients
gain_reading: 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.
gain_evidence: whole-vessel and local segments (proximal to MB, within MB, and distal to MB) FFRCT values were obtained via an AI-based platform (Shukun-FFRCT) | sex significantly influences FFRCT in LAD-MB patients | These findings provide preliminary evidence to inform risk stratification of MB
problem_reading: 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.
problem_evidence: Females with isolated MB exhibit more pronounced distal hemodynamic alterations | MB length was an independent risk factor for FFRCT abnormalities in both sexes | Each 1-mm increase in MB length raised the risk of FFRCT abnormality by 5.3% in males [odds ratio (OR) =1.053, 95% confidence interval (CI): 1.004-1.104, P=0.033] and 11.3% in females (OR =1.113, 95% CI: 1.024-1.209, P=0.011)
quick_read: 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.
limitation: Retrospective cohort limited to LAD-MB patients and findings described as preliminary, limiting generalizability beyond this anatomy and design.
tag: Model-prefilled trace
key_points: 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.
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.
sources:
- peer_reviewed | Quantitative Imaging in Medicine and Surgery | https://doi.org/10.21037/qims-2026-0713 | 2026-07-01
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