{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T15:46:56Z","timestamp":1776440816631,"version":"3.51.2"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009232","name":"University of Debrecen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009232","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Cardiovasc Imaging"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Myocardial bridging (MB) causes coronary artery compression in systole, potentially resulting in angina and arrhythmias. Stent implantation in patients with MB may offer short-term improvement of symptoms, but carries a high risk of restenosis. We present a symptomatic patient with MB who was assessed by a novel angiography-based functional index that incorporates both the diastolic and systolic phases of the heart cycle \u2013 termed \u201ccardiac cycle weighted \u00b5QFR\u201d (\u00b5QFRccw). In addition to the observed dynamic systolic narrowing of the left anterior descending artery (LAD), a fixed stenotic (atherosclerotic) component was suspected due to mild diastolic diameter reduction. Invasive physiological measurements during adenosine and dobutamine provocation were also performed. Following administration of 200\u00a0\u00b5g ic. adenosine, the FFR was measured as 0.74, while during a 40\u00a0\u00b5g\/bwkg\/min dobutamine iv. infusion it was measured as 0.83. The measured FFR during adenosine-induced hyperemia was found to be very close in value to the calculated \u00b5QFRccw (0.74 vs. 0.75). This case demonstrates the potential utility of the image-based cardiac-cycle weighted \u00b5QFR in MB evaluation. In our opinion, the discordance between the significant invasive adenosine FFR and the non-significant dobutamine FFR results may indicate a fixed atherosclerotic component of the lesion, which could support the consideration of stenting despite the potential risk of restenosis.<\/jats:p>","DOI":"10.1007\/s10554-025-03420-y","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T22:15:20Z","timestamp":1748297720000},"page":"1833-1837","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cardiac cycle weighted \u039cQFR for the assessment of functional relevance of the myocardial bridge"],"prefix":"10.1007","volume":"41","author":[{"given":"\u00c1ron","family":"\u00dcveges","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e1s","family":"\u00c1goston","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bal\u00e1zs","family":"Tar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bogl\u00e1rka","family":"Tam\u00e1s","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00e1ty\u00e1s","family":"Magyari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanis\u0142aw","family":"Bartu\u015b","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shengxian","family":"Tu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsolt","family":"K\u0151szegi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"3420_CR1","doi-asserted-by":"crossref","unstructured":"Evbayekha EO, Nwogwugwu E, Olawoye A, Bolaji K, Adeosun AA, Ajibowo AO, Nsofor GC, Chukwuma VN, Shittu HO, Onuegbu CA, Adedoyin AM, Okobi OE A comprehensive review of myocardial bridging: exploring diagnostic and treatment modalities. Cureus 2023 Aug. 8; 15(8): e43132","DOI":"10.7759\/cureus.43132"},{"key":"3420_CR2","doi-asserted-by":"crossref","unstructured":"Kunamneni PB, Rajdev S, Krishnan P, Moreno PR, Kim MC, Sharma SK, Kini AS Outcome of intracoronary stenting after failed maximal medical therapy in patients with symptomatic myocardial Bridge. Catheter Cardiovasc Interv 2008 Feb. 1; 71(2):185\u2013190","DOI":"10.1002\/ccd.21358"},{"issue":"4","key":"3420_CR3","doi-asserted-by":"publisher","first-page":"e57","DOI":"10.1016\/j.jtcvs.2014.12.054","volume":"149","author":"CN Ekeke","year":"2015","unstructured":"Ekeke CN, Noble S, Mazzaferri E, Crestanello JA (2015) Myocardial bridging over the left anterior descending:myotomy, bypass, or both? J Thorac Cardiovasc Surg 149(4):e57\u2013e58. https:\/\/doi.org\/10.1016\/j.jtcvs.2014.12.054","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"4","key":"3420_CR4","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1536\/jhj.45.581","volume":"45","author":"H Kursaklioglu","year":"2004","unstructured":"Kursaklioglu H, Barcin C, Iyisoy A, Kose S, Amasyali B, Isik E (2004) Angiographic restenosis after myocardialbridge stenting. Jpn Heart J 45(4):581\u2013599. https:\/\/doi.org\/10.1536\/jhj.45.581","journal-title":"Jpn Heart J"},{"issue":"3","key":"3420_CR5","doi-asserted-by":"publisher","first-page":"e016046","DOI":"10.1161\/CIRCIMAGING.123.016046","volume":"17","author":"X Wu","year":"2024","unstructured":"Wu X, Wang K, Li G, Wu J, Jiang J, Gao F, Zhu L, Xu Q, Wang X, Xu M, Chen H, Ma L, Han X, Luo N, Tu S, Wang J, Hu X (2024) Diagnostic performance of Angiography-Derived quantitative flow ratio in complex coronary lesions. Circ Cardiovasc Imaging 17(3):e016046. https:\/\/doi.org\/10.1161\/CIRCIMAGING.123.016046","journal-title":"Circ Cardiovasc Imaging"},{"issue":"6","key":"3420_CR6","doi-asserted-by":"publisher","first-page":"685","DOI":"10.5603\/CJ.a2019.0113","volume":"27","author":"Q Qi","year":"2020","unstructured":"Qi Q, Liu G, Yuan Z, Liu L, Tu S, Zhao Q (2020) Quantitative flow ratio-guided surgical intervention in symptomatic myocardial bridging. Cardiol J 27(6):685\u2013692","journal-title":"Cardiol J"},{"key":"3420_CR7","doi-asserted-by":"crossref","unstructured":"Aleksandric SB, Djordjevic-Dikic AD, Dobric MR, Giga VL, Soldatovic, Ivan A, Vukcevic, Vladan, Tomasevic MV, Stojkovic SM, Orlic DN, Saponjski JD, Tesic MB, Banovic MD, Petrovic MT, Juricic SA, Nedeljkovic MA, Stankovic, Goran, Ostojic, Beleslin MC (2021) \/07\/06 Branko D. Functional Assessment of Myocardial Bridging With Conventional and Diastolic Fractional Flow Reserve: Vasodilator Versus Inotropic Provocation Journal of the American Heart Association;; 1013; e02059","DOI":"10.1161\/JAHA.120.020597"},{"issue":"6","key":"3420_CR8","doi-asserted-by":"publisher","first-page":"e006247","DOI":"10.1161\/CIRCINTERVENTIONS.117.006247","volume":"11","author":"G Tarantini","year":"2018","unstructured":"Tarantini G, Barioli A, Nai Fovino L, Fraccaro C, Masiero G, Iliceto S, Napodano M (2018) Unmasking myocardial Bridge-Related ischemia by intracoronary functional evaluation. Circ Cardiovasc Interv 11(6):e006247","journal-title":"Circ Cardiovasc Interv"},{"issue":"22","key":"3420_CR9","doi-asserted-by":"publisher","first-page":"2196","DOI":"10.1016\/j.jacc.2021.09.859","volume":"78","author":"D Sternheim","year":"2021","unstructured":"Sternheim D, Power DA, Samtani R, Kini A, Fuster V, Sharma S (2021) Myocardial bridging: diagnosis, functional assessment, and management: JACC State-of-the-Art review. J Am Coll Cardiol 78(22):2196\u20132212","journal-title":"J Am Coll Cardiol"}],"container-title":["The International Journal of Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10554-025-03420-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10554-025-03420-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10554-025-03420-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T16:13:39Z","timestamp":1757175219000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10554-025-03420-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,27]]},"references-count":9,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["3420"],"URL":"https:\/\/doi.org\/10.1007\/s10554-025-03420-y","relation":{},"ISSN":["1875-8312"],"issn-type":[{"value":"1875-8312","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,27]]},"assertion":[{"value":"14 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors confirm that they have obtained permission from the patient to publish this case report, following the Committee on Publication Ethics (COPE) guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Shengxian Tu is a cofounder of Pulse Medical, from which he has received research grants and has served as a consultant.The other authors have no conflicts of interest to declare relevant to the contents of this paper.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}