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Nomogram to predict recurrent chest pain in patients with myocardial bridging

European Radiology (2022)Cite this article

Abstract

Objective

Patients with myocardial bridging (MB) frequently experience recurrent chest pain, even in those without coronary heart disease. This study aims to predict the risk of recurrent chest pain in patients with MB by using a novel predictive nomogram.

Methods

This retrospective study enrolled 250 patients with acute chest pain who underwent coronary computed tomography angiography (CCTA) between January and December 2018, including 111 patients with MB and 139 control patients. Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regression analyses were used to screen for significant parameters that were included to develop a novel predictive nomogram model. Receiver operating characteristic curve, calibration curve, and decision curve analyses were used to evaluate the performance and clinical utility of the nomogram.

Results

A predictive nomogram was constructed in 111 patients with MB, 34 of whom (30.9%) had recurrent chest pain. The significant predictors screened out by the LASSO regression included age, sex, branch type MB, and systolic compression index. The area under the curves (AUCs) for recurrent chest pain at 12, 24, and 36 months were 0.688, 0.742, and 0.729, respectively, indicating remarkable accuracy of the nomogram. The calibration curve and decision curve analyses indicated a good agreement with the observations and utility of the nomogram.

Conclusions

This study presents a high-accuracy nomogram to predict recurrent chest pain in patients with MB. This model incorporates clinical risk factors and CT imaging features and can be conveniently used to facilitate the individualised prediction.

Key Points

• Symptomatic patients with myocardial bridging often present with recurrent chest pain.

• The potential predictors of recurrent chest pain in patients with myocardial bridging were age, sex, branch type MB, and systolic compression index.

• Nomogram based on clinical CT imaging features is valuable to predict recurrent chest pain in patients with myocardial bridging.

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Abbreviations

ACEs:

Adverse cardiac events

ACS:

Acute coronary syndromes

AUC:

Area under the curve

CAD:

Coronary artery disease

CAD-RADS:

Coronary Artery Disease Reporting and Data System

CCA:

Conventional coronary angiography

CCTA:

Coronary computed tomography angiography

LAD:

Left anterior descending artery

LASSO:

Least absolute shrinkage and selection operator

MB:

Myocardial bridging

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Funding

The authors state that this work has not received any funding.

Author information

Author notes

  1. Jun Qian and Jun Yang contributed equally to this study as co-corresponding authors.

  2. Shun Dai and Zhengguang Xiao contributed equally to this study.

Authors and Affiliations

  1. Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Changning District, Shanghai, 200336, China

    Shun Dai, Zhengguang Xiao, Weiwu Yao, Qian Jun & Jun Yang

  2. Department of Radiology, East Hospital, Tongji University School of Medicine, Shanghai, 200120, China

    Chuanzhi Chen

  3. Department of Cardiology, Shanghai Tongji Hospital, Tongji University School of Medicine, No. 389 Xincun Road, Putuo District, Shanghai, 200333, China

    Qian Jun

Authors
  1. Shun Dai
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  2. Zhengguang Xiao
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  3. Chuanzhi Chen
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  4. Weiwu Yao
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  5. Qian Jun
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  6. Jun Yang
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Corresponding authors

Correspondence to Qian Jun or Jun Yang.

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Guarantor

The scientific guarantor of this publication is Jun Qian.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• cross-sectional study / diagnostic or prognostic study / observational

• performed at one institution

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Dai, S., Xiao, Z., Chen, C. et al. Nomogram to predict recurrent chest pain in patients with myocardial bridging. Eur Radiol (2022). https://doi.org/10.1007/s00330-022-09305-1

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  • DOI: https://doi.org/10.1007/s00330-022-09305-1

Keywords

  • Myocardial bridging
  • Chest pain
  • Computed tomography angiography
  • Nomograms