Comprehensive assessment of vasospastic angina using coronary computed tomography angiography: synergistic value of the presence of myocardial bridge, perivascular inflammation, and myocardial extracellular volume fraction
Authors' conclusion
A multi-parametric CCTA approach potentially identifies patients at high risk for VSA. The significant association of the transmural ECV gradient with VSA suggests that myocardial remodelling imaging provides a novel diagnostic window into the cumulative myocardial impact of vasospasm, independent of active adipose tissue inflammation and the presence of MB.
Study context
- Population
- Angina with non-obstructive coronary arteries (ANOCA) patients who underwent coronary computed tomography angiography (CCTA) with a dedicated ECV protocol, followed by an invasive spasm provocation testpatients analysed, 27 diagnosed with vasospastic angina (VSA)
- Participants
- 100 patients
- Comparison
- CCTA parameters as predictors of VSA
- VSAn = 27
Methodological detailsconsecutive
- Consecutive
Main finding
As reported in the abstract
Independent predictors of VSA (multivariable logistic regression)
Odds ratio (95% CI)P value
Transmural ECV gradient
1.12(1.01–1.25)
P < 0.05Presence of myocardial bridging (MB)
3.49(1.25–9.74)
P < 0.05High FAI-RCA (> −70.95 Hounsfield units [HU])
5.79(2.06–16.30)
P < 0.05Further findings
Incremental diagnostic value of transmural ECV gradient
- Integration of transmural ECV gradient provided incremental diagnostic value beyond FAI-RCA and myocardial bridging (MB), as assessed by the Net Reclassification Improvement and Integrated Discrimination Improvement
Patient characteristics
- Mean age
- 65.3 ± 11.8 years
- Male
- 55%
Original publication
Comprehensive assessment of vasospastic angina using coronary computed tomography angiography: synergistic value of the presence of myocardial bridge, perivascular inflammation, and myocardial extracellular volume fraction. Eur Heart J Cardiovasc Imaging. Published 14 July 2026. doi:10.
Summarised from the published abstract; every number is checked against it