Coronary artery diseaseEvaluation of Myocardial Bridging of the Left Anterior Descending Coronary Artery by 64-Slice Multidetector Computed Tomographic Angiography
Section snippets
Methods and Results
Multidetector computed tomographic coronary angiograms were retrospectively analyzed in 300 consecutive patients who underwent CTA for routine clinical purposes. MB was defined as a segment of the coronary artery partially or completely surrounded by myocardium (Figure 1, Figure 2). MB analysis included location, length, depth, and mean diameter using arterial segments before and after MB as reference. For comparison of concomitant atherosclerosis, patients were divided into those with MB
Discussion
This is the largest study using CTA for the evaluation of MB and the first to examine the relation of MB to atherosclerotic plaque. The prevalence of MB in our study was similar to that in pathologic studies,1, 2, 3, 4 thus validating CTA for the diagnosis of MB. These findings confirm the most recent study, which reported a prevalence of 30.5% using a similar method.5 The 8.5% prevalence of deep MB, seen in our study, better correlates with angiographic and ultrasound data and is very likely
References (8)
- et al.
Clinical significance of isolated coronary bridges: benign and frequent condition involving the left anterior descending artery
Am Heart J
(1982) The angiographic prevalence of myocardial bridging in man
Chest
(1982)- et al.
The prevalence and anatomical patterns of intramuscular coronary arteries
J Am Coll Cardiol
(2007) - et al.
Update on Myocardial Bridging
Circulation
(2002)
Cited by (27)
Coronary plaque burden of the left anterior descending artery in patients with or without myocardial bridge: A case-control study based on coronary CT-angiography
2021, International Journal of CardiologyMyocardial bridging is associated with coronary atherosclerosis in the segment proximal to the site of bridging
2014, Journal of CardiologyCitation Excerpt :In fact, the levels of endothelial vasoactive agents such as nitric oxide synthase, endothelin-1, and angiotensin-converting enzyme were significantly higher in proximal segments than in the tunneled artery [24]. Some previous reports denied the influence of myocardial bridging on the presence of atherosclerotic lesions in the non-bridged segments [27,28]. However, this may have been due to the characteristics of patients enrolled in these studies.
Relationship between myocardial bridges and reduced coronary atherosclerosis in patients with angina pectoris
2013, International Journal of CardiologyCitation Excerpt :The inverse association between MBs and local calcium scores was independent of age, gender, and total coronary artery calcium score, but was influenced by the thickness of local perivascular adipose tissue. The absence of atherosclerosis in coronary artery segments covered by an MB has been reported in post-mortem and imaging studies [1,3,5–9,23]. By comparing bridged LAD segments to matched control segments, we could confirm that the absence of atherosclerosis is due to the MB and is not a random observation.
Myocardial bridging on coronary cta: An innocent bystander or a culprit in myocardial infarction?
2012, Journal of Cardiovascular Computed TomographyA head-to-head comparison between 64-slice multidetector computed tomographic and conventional coronary angiographies in measurement of myocardial bridge
2010, International Journal of CardiologyCitation Excerpt :Although intracoronary ultrasound and Doppler can visualize and quantify the morphologic and functional features of MB [11,20], they are invasive studies with some risks and complications. As non-invasive MDCT-CA has implemented better resolution and shorter examination times, MDCT-CA has emerged a favorable detection modality of MB [6–8]. In the present study, the frequency of MB observed on MDCT-CA (25%) was in good agreement with that determined in previous autopsy series [4,5].
Left anterior descending coronary artery myocardial bridging by multislice computed tomography: Correlation with clinical findings
2010, European Journal of RadiologyCitation Excerpt :The prevalence of LAD myocardial bridging by MSCT in our study was with 23% about 10–20 folds higher compared invasive angiography (0.5–2.5%) [1], and was similar to recently published data reporting 26% and 30.5% detection rates [15,16]. The highest prevalence of LAD myocardial bridges by MSCT with 44% (including patients with significant stenosis) was recently reported by Lubarsky et al. [17], but another study found only 17% LAD bridges in asymptomatic patients [24]. The lower prevalence of myocardial bridges identified on invasive angiography compared to MSCT may be related to the fact that the pathognomic “milking-phenomenon” is an indirect diagnostic criterion because invasive angiography does not allow direct visualization of the myocardium.