Revisit of the CatLet (Hexu) angiographic scoring system: a narrative review

He, Yong; Masuda, Shinichiro; Gao, Chao

doi:10.21037/jtd-22-1642

Cited by 1 publication

(3 citation statements)

References 14 publications

(28 reference statements)

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“… Diagonal branch size, LAD length, and RCA dominance were defined previously ( 13 ). Data are expressed as the mean ± SD or as n (%).…”

Section: Resultsmentioning

confidence: 99%

“…The principles of design and application of the CatLet angiographic scoring system have been fully described elsewhere ( 12 , 13 ). Its tutorial and calculator are available online ( http://www.catletscore.com ), and its features and calculations are briefly described in the following sections.…”

Section: Methodsmentioning

confidence: 99%

“…The limitations of using these methods, however, include the side effects of hyperemia-induced agents, additional costs, and vulnerability to microvascular resistance ( 11 ). The Coronary Artery Tree Description and Lesion Evaluation System (CatLet) angiographic scoring system (also known as Hexu ) was independently developed by our research team based on the 17-segment myocardial model, the rule of competitive blood supply, and the law of flow conservation ( 12 , 13 ). The unique aspects of the CatLet angiographic scoring system include its abilities (I) to semiquantify the blood supply territory based solely on coronary angiography, (II) to account for coronary variations, and (III) to account for coronary stenosis.…”

Section: Introductionmentioning

confidence: 99%

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Coronary Artery Tree Description and Lesion Evaluation (CatLet) score for functional evaluation of coronary stenosis: a comparison study with pressure wire fractional flow reserve

Wang,

Xu,

et al. 2024

Quant Imaging Med Surg

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Background Pressure wire fractional flow reserve (FFR) and its derivatives, such as quantitative flow ratio (QFR), computational pressure flow-derived FFR (caFFR), coronary angiography-derived FFR (FFR angio ), and computed tomography-derived FFR (FFR CT ), have been validated for identifying functionally significant stenosis and guiding revascularization strategy. The limitations of using these methods include the side effects of hyperemia-induced agents, additional costs, and vulnerability to microvascular resistance. FFR is related both to the degree of a stenotic coronary artery and to its subtended myocardial territory. Coronary Artery Tree Description and Lesion Evaluation (CatLet) score (also known as Hexu ) is a product of the degree of a stenosis and the weighting of the affected coronary artery (myocardial territory). Hence, we hypothesized that the CatLet score could predict hemodynamically significant coronary stenosis. Methods We retrospectively enrolled consecutive patients with stable coronary artery disease. They attended Sichuan Science City Hospital with at least one lesion of 50-90% diameter stenosis in a coronary artery of 2 mm or larger. FFR measurement was obtained during invasive coronary angiography. The CatLet score was obtained by multiplying a fixed value of 2.0 (for non-occlusive lesions) and the weight of the affected coronary artery. The primary endpoint was the CatLet score’s diagnostic accuracy in identifying hemodynamically significant coronary stenosis, with a pressure wire FFR of ≤0.80 being used as reference. Results We analyzed the FFR and CatLet scores from 206 vessels in 175 patients with stable coronary disease and intermediate coronary lesions. The per-vessel analysis revealed an overall good correlation between the CatLet score and the FFR [r=–0.61; 95% confidence interval (95% CI): –0.69 to –0.52; P<0.01]. We also noted a significant CatLet score-FFR correlation for each of the left anterior descending artery (LAD), left circumflex (LCX), and right coronary artery (RCA). With a CatLet score ≥10 as a predictor of FFR ≤0.80, the overall diagnostic accuracy included a sensitivity of 78.80% (95% CI: 67.00–87.90%), a specificity of 85.00% (95% CI: 78.00–90.50%), a positive likelihood ratio of 5.25, a negative likelihood ratio of 0.25, and an area under the curve of 0.90 (95% CI: 0.85–0.94). Equivalent vessel-specific results were also achieved for each of the LAD, LCX, and RCA. Conclusions The CatLet score, solely based on visual estimation of the results of coronary angiography, demonstrated good diagnostic performance with respect to myocardial ischemia. Its clinical values in guiding revascularization warrant further investigation.

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“… Diagonal branch size, LAD length, and RCA dominance were defined previously ( 13 ). Data are expressed as the mean ± SD or as n (%).…”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%