Original articleMyocardial perfusion SPECT imaging in patients with myocardial bridging
Section snippets
Study Population
We included 16 consecutive patients from 2000 to 2003 with typical symptoms of angina and normal arteries as documented by coronary angiography but myocardial bridging of the midportion of the left anterior descending artery (LAD) with more than 50% narrowing during systole. All patients had had at least one previous hospital admission because of exertional chest pain with significant ST-segment depression of greater than 0.1 mV or T-wave inversion in the anterior leads. No patients had
Patient Characteristics
The clinical characteristics of the patients are listed in Table 1. Patients were predominantly men, with a high prevalence of hypertension (69%). The mean angiographic systolic occlusion (mSO) within the myocardial bridges was 73% ± 9.7% (median systolic occlusion, 75%, range, 51% to 82%). Most of the patients had left ventricular hypertrophy (LVH), and patients with a median systolic occlusion higher than 75% had a higher mean septal thickness than patients with a median systolic occlusion
Discussion
In this study, in which all of the patients had typical angina and normal arteries but myocardial bridging of the midportion of the LAD, myocardial ischemia was induced with exercise stress MPI in 88% of patients and with dipyridamole stress MPI in 81% of patients. In contrast, previous studies demonstrated perfusion abnormalities in only 33% to 65% of patients with myocardial bridging in whom MPI was performed.11, 16, 17 Significant technical and clinical differences may explain the
Acknowledgment
We thank the technologists of the nuclear cardiology department for their technical assistance. We also gratefully acknowledge Patricia Vallejo for her careful review of the manuscript.
The authors have indicated they have no financial conflicts of interest.
References (23)
- et al.
Myocardial bridging as a cause of acute transient left heart dysfunction
Chest
(1999) - et al.
Angiographic evidence of myocardial squeezing accompanying tachyarrhythmia as a possible cause of myocardial infarction
Chest
(1978) - et al.
Symptomatic myocardial bridgesoverview of ischemic mechanisms and current diagnostic and treatment strategies
J Am Coll Cardiol
(2003) - et al.
Standardized myocardial segmentation and nomenclature for tomographic imaging of the hearta statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association
J Nucl Cardiol
(2002) - et al.
Myocardial bridging does not predict sudden death in children with hypertrophic cardiomyopathy but is associated with more severe cardiac disease
J Am Coll Cardiol
(2000) - et al.
Myocardial bridging in adult patients with hypertrophic cardiomyopathy
J Am Coll Cardiol
(2003) The angiographic prevalence of myocardial bridging in man
Chest
(1982)- et al.
Functional, angiographic and intracoronary Doppler flow characteristics in symptomatic patients with myocardial bridgingeffect of short-term intravenous beta-blocker medication
J Am Coll Cardiol
(1996) - et al.
Importance of diastolic fractional flow reserve and dobutamine challenge in physiologic assessment of myocardial bridging
J Am Coll Cardiol
(2003) Disertario de vasis cordis propriis. Med Diss Univ Göttingen
Bibl Anat
(1737)