Coronary disease & ACSDiagnostic or prognostic study
Noninvasive Anatomical and Functional Imaging for Hemodynamic Relevance in Right Coronary Artery Anomalies
- Diagnostic accuracy study
- prospective
- single-centre
- consecutive patients
Authors' conclusion
Results of this cohort study suggest that in adults with R-AAOCA, a multimodality diagnostic imaging approach applicable in a stepwise manner, starting with CCTA, which offers high diagnostic performance to exclude hemodynamic relevance-and optionally complemented by functional imaging with modest diagnostic performance to rule in hemodynamic relevance-may help to reduce the need for invasive testing to a subset of patients.
Study context
- Population
- Consecutive adults with R-AAOCA with interarterial/intramural course and right coronary dominance, Bern, Switzerland, 2020–2025
- Participants
- 55 adults
- Comparison
- Coronary computed tomography angiography (CCTA) and nuclear imaging vs invasive fractional flow reserve (FFR)-dobutamine reference standard
- Outcome
- Hemodynamic relevance of the anomalous vessel (FFR-dobutamine ≤0.8)
Performance
As reported in the abstract
Diagnostic performance for FFR-dobutamine ≤0.8
| Test or model | Sensitivity | NPV | ROC curve | Specificity | Ruled out | Ischemia detected | PPV | Accuracy |
|---|---|---|---|---|---|---|---|---|
| CCTA | 100% | 100% | 0.82 | 57% | 23 cases (42%) | |||
| Nuclear imaging | 27% | 100% | 4 patients (7%) | 100% | 80% |
Further findings
- FFR-dobutamine values
- 0.87 · 15 events
Original publication
Noninvasive Anatomical and Functional Imaging for Hemodynamic Relevance in Right Coronary Artery Anomalies. JAMA Cardiol. Published 1 October 2025. doi:10.1001/jamacardio.2025.2993
Summarised from the published abstract; every number is checked against it