{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T05:46:54Z","timestamp":1792129614835,"version":"4.4.0"},"reference-count":10,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Myocardial bridging (MB) is increasingly recognized as a potential cause of ischemia through heterogeneous mechanisms, yet real\u2010world management remains heterogeneous. We surveyed interventional cardiologists to describe contemporary MB practice, focusing on functional assessments, perceived value, and barriers to the \u201cfull\u2010physiology\u201d approach, and priorities for standardization and research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To characterize contemporary MB management among interventional cardiologists, focusing on physiology approaches, imaging strategies, and perceived barriers to implementation and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An anonymized online survey was conducted among interventional cardiologists from 28 Italian centers. Items covered MB\u2010specific functional assessment strategies, therapies, implementation barriers, operational infrastructure, and research interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety\u2010three cardiologists responded (mean age 38.8\u2009\u00b1\u20098.6 years; 82.8% male). Pressure\u2010based indices were widely used for epicardial CAD, but phenotyping in MB was uncommon: 57.0% performed physiology in &lt;\u200910% of MB cases, and 19.4% never did. Epicardial MB assessment relied mainly on adenosine\u2010FFR (33.3%) or iFR (31.2%), whereas stress\u2010enhanced protocols were rarely used. Although intracoronary acetylcholine testing was commonly used in general practice (79.6%), only 49.5% of respondents reported using it to assess MB\u2010related coronary spasm, and most did so in only a small proportion of cases. CMD testing in MB was rare (&lt;\u200910% in 66.7%). Despite this, most respondents (87.1%) endorsed \u201cfull\u2010physiology\u201d as useful for mechanism identification and personalized therapy, but cited evidence uncertainty, procedural time, and limited experience as key barriers. Operational readiness was low (dedicated protocols: 26.9%; registries: 39.8%; routine capture: 34.4%). Willingness to join a randomized trial was high (93.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite the widespread availability of invasive functional assessment tools and operators' recognition of their relevance, their use in MB remains limited and heterogeneous, reflecting the lack of evidence\u2010based guidance and underscoring the need for dedicated mechanistic studies and standardized invasive workflows.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70943","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T05:08:19Z","timestamp":1792127299000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Invasive Evaluation of Myocardial Bridging: A Multicenter Italian Survey of Interventional Cardiologists' Practices"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5165-3003","authenticated-orcid":false,"given":"Stefano","family":"Elia","sequence":"first","affiliation":[{"name":"Department of Translational Medicine Universit\u00e0 del Piemonte Orientale Novara Italy"},{"name":"Thoraco\u2010Cardio\u2010Vascular Department Azienda Ospedaliero\u2010Universitaria Maggiore della Carit\u00e0 Novara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8568-8130","authenticated-orcid":false,"given":"Gaetano","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine Universit\u00e0 del Piemonte Orientale Novara Italy"},{"name":"Thoraco\u2010Cardio\u2010Vascular Department Azienda Ospedaliero\u2010Universitaria Maggiore della Carit\u00e0 Novara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renzo","family":"Laborante","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education S\u00f6dersjukhuset, Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2556-4809","authenticated-orcid":false,"given":"Donato Antonio","family":"Paglianiti","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine Universit\u00e0 del Piemonte Orientale Novara Italy"},{"name":"Thoraco\u2010Cardio\u2010Vascular Department Azienda Ospedaliero\u2010Universitaria Maggiore della Carit\u00e0 Novara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0510-8569","authenticated-orcid":false,"given":"Stefano","family":"Righetti","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Fondazione IRCCS San Gerardo dei Tintori Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6391-422X","authenticated-orcid":false,"given":"Cristina","family":"Aurigemma","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6319-4119","authenticated-orcid":false,"given":"Daniela","family":"Trabattoni","sequence":"additional","affiliation":[{"name":"Department of Invasive Cardiology Centro Cardiologico Monzino, IRCCS Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Andreini","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Cardiac Imaging IRCCS Galeazzi Sant'Ambrogio Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4435-1235","authenticated-orcid":false,"given":"Arturo","family":"Cesaro","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Campania \u201cLuigi Vanvitelli\u201d Caserta Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Rognoni","sequence":"additional","affiliation":[{"name":"Division of Cardiology Ospedale degli Infermi, ASL Biella Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gioel G.","family":"Secco","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit dell'Ospedale SS Antonio Biagio e Cesare, Arrigo Alessandria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6646-9317","authenticated-orcid":false,"given":"Fabrizio","family":"D'Ascenzo","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Division of Cardiology, AOU Citt\u00e0 Della Salute E Della Scienza University of Turin Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3007-5313","authenticated-orcid":false,"given":"Gianluca","family":"Massaro","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tor Vergata University Hospital Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5916-8882","authenticated-orcid":false,"given":"Roberto","family":"Scarsini","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology University of Verona Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3594-2853","authenticated-orcid":false,"given":"Paolo","family":"Canova","sequence":"additional","affiliation":[{"name":"Cardiovascular Department Ospedale Papa Giovanni XXIII Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Vergallo","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV) IRCCS Ospedale Policlinico San Martino Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Galli","sequence":"additional","affiliation":[{"name":"Department of Medical\u2010Surgical Sciences and Biotechnologies Sapienza University of Rome Latina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Musumeci","sequence":"additional","affiliation":[{"name":"Cardiology Division AO Ordine Mauriziano Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5404-3968","authenticated-orcid":false,"given":"Giuseppe","family":"Patti","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine Universit\u00e0 del Piemonte Orientale Novara Italy"},{"name":"Thoraco\u2010Cardio\u2010Vascular Department Azienda Ospedaliero\u2010Universitaria Maggiore della Carit\u00e0 Novara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3774-8330","authenticated-orcid":false,"given":"Domenico","family":"D'Amario","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine Universit\u00e0 del Piemonte Orientale Novara Italy"},{"name":"Thoraco\u2010Cardio\u2010Vascular Department Azienda Ospedaliero\u2010Universitaria Maggiore della Carit\u00e0 Novara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2022.970422","article-title":"Comprehensive Functional and Anatomic Assessment of Myocardial Bridging: Unlocking the Gordian Knot","volume":"9","author":"Ciliberti G.","year":"2022","journal-title":"Frontiers in Cardiovascular Medicine"},{"issue":"2","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research Electronic Data Capture (REDCap): A Metadata\u2010Driven Methodology and Workflow Process for Providing Translational Research Informatics Support","volume":"42","author":"Harris P. A.","year":"2009","journal-title":"Journal of Biomedical Informatics"},{"issue":"3","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","DOI":"10.2196\/jmir.6.3.e34","article-title":"Improving the Quality of Web Surveys: The Checklist for Reporting Results of Internet E\u2010Surveys (CHERRIES)","volume":"6","author":"Eysenbach G.","year":"2004","journal-title":"Journal of Medical Internet Research"},{"issue":"2","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/S0735-1097(03)00588-6","article-title":"Importance of Diastolic Fractional Flow Reserve and Dobutamine Challenge in Physiologic Assessment of Myocardial Bridging","volume":"42","author":"Escaned J.","year":"2003","journal-title":"Journal of the American College of Cardiology"},{"issue":"13","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.120.020597","article-title":"Functional Assessment of Myocardial Bridging With Conventional and Diastolic Fractional Flow Reserve: Vasodilator Versus Inotropic Provocation","volume":"10","author":"Aleksandric S. B.","year":"2021","journal-title":"Journal of the American Heart Association"},{"issue":"5","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1136\/hrt.73.5.462","article-title":"High Wall Shear Stress Proximal to Myocardial Bridging and Atherosclerosis: Intracoronary Ultrasound and Pressure Measurements","volume":"73","author":"Ge J.","year":"1995","journal-title":"Heart"},{"issue":"37","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"3504","DOI":"10.1093\/eurheartj\/ehaa503","article-title":"An EAPCI Expert Consensus Document on Ischaemia With Non\u2010Obstructive Coronary Arteries in Collaboration With European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation Endorsed by Coronary Vasomotor Disorders International Study Group","volume":"41","author":"Kunadian V.","year":"2020","journal-title":"European Heart Journal"},{"issue":"7","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"811","DOI":"10.3390\/life14070811","article-title":"Myocardial Bridging Increases the Risk of Adverse Cardiovascular Events in Patients Without Coronary Atherosclerosis","volume":"14","author":"Yang T. L.","year":"2024","journal-title":"Life"},{"issue":"14","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.120.020535","article-title":"Interplay Between Myocardial Bridging and Coronary Spasm in Patients With Myocardial Ischemia and Non\u2010Obstructive Coronary Arteries: Pathogenic and Prognostic Implications","volume":"10","author":"Montone R. A.","year":"2021","journal-title":"Journal of the American Heart Association"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"H48","DOI":"10.1093\/eurheartjsupp\/suac059","article-title":"Myocardial Bridge Evaluation Towards Personalized Medicine: Study Design and Preliminary Results of the RIALTO Registry","volume":"24","author":"D'Amario D.","year":"2022","journal-title":"European Heart Journal Supplements"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70943","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.70943","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70943","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T05:08:21Z","timestamp":1792127301000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70943"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,15]]},"references-count":10,"alternative-id":["10.1002\/ccd.70943"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70943","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,15]]},"assertion":[{"value":"2026-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ccd.70943"}}