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International Journal of Cardiology Jul 2020
Topics: Coronary Artery Disease; Echocardiography, Stress; Humans; Myocardial Bridging; Prospective Studies; Retrospective Studies
PubMed: 32276771
DOI: 10.1016/j.ijcard.2020.03.076 -
Myocardial bridging as a common phenotype of hypertrophic cardiomyopathy has no effect on prognosis.The American Journal of the Medical... Jun 2014The prognostic significance of myocardial bridging in hypertrophic cardiomyopathy (HCM) remains controversial. This investigation sought to evaluate the impact of...
BACKGROUND
The prognostic significance of myocardial bridging in hypertrophic cardiomyopathy (HCM) remains controversial. This investigation sought to evaluate the impact of myocardial bridging on prognosis of patients with HCM.
METHODS
A total of 298 adult patients (73% male, mean age, 53 ± 12 years) with HCM were retrospectively enrolled at Fuwai Hospital from 1999 to 2011. Myocardial bridging was evaluated by coronary angiography. Follow-up data were collected by telephone interviews and mailed questionnaires.
RESULTS
Thirty-four (11%, 34/298) patients were determined with myocardial bridging and the middle of left anterior descending artery was the most frequently involved segment (77%, 26/34). Patients with myocardial bridging were younger than those without bridging (48 ± 9 versus 54 ± 12 years, P = 0.001). During the follow-up of 4.2 ± 2.3 years (range, 0.7-12.2 years), the presence of myocardial bridging was not evidently associated with increased risk for all-cause death (P = 0.54), cardiovascular death (P = 0.60), sudden cardiac death (P = 0.53) and deterioration of heart failure (P = 0.84).
CONCLUSIONS
Myocardial bridging was a relatively common morphological component of HCM but not a predictor for adverse clinical outcomes.
Topics: Adult; Aged; Aged, 80 and over; Cardiomyopathy, Hypertrophic; Cohort Studies; Female; Follow-Up Studies; Humans; Male; Middle Aged; Myocardial Bridging; Phenotype; Prognosis; Retrospective Studies; Young Adult
PubMed: 24270076
DOI: 10.1097/MAJ.0000000000000194 -
Indian Journal of Pathology &... 2022Myocardial bridging (MB) is a relatively uncommon congenital anomaly where a segment of the coronary artery dips inside the myocardium and takes a tunneled course under...
Myocardial bridging (MB) is a relatively uncommon congenital anomaly where a segment of the coronary artery dips inside the myocardium and takes a tunneled course under a bridge of the myocardium. This leads to the compression of the coronary artery during systole resulting in hemodynamic changes and their clinical manifestations. However, it is an incidental finding but can present with multiple complications like myocardial ischemia, infarction, and sudden death, primarily when associated with other risk factors like left ventricular hypertrophy of the heart. Therefore, a careful examination of the heart is essential for evaluating the clinical significance of the MB. Here, we presented a case of a 30-year-old young female who had a sudden death, and her histological examination of the heart showed MB of left anterior descending coronary artery (LAD).
Topics: Adult; Coronary Vessels; Death, Sudden; Female; Histological Techniques; Humans; Myocardial Bridging; Myocardium; Risk Factors
PubMed: 35074984
DOI: 10.4103/IJPM.IJPM_1177_20 -
Surgical and Radiologic Anatomy : SRA Jan 2010The aim of the study was to evaluate the prevalence, length, depth, and location of myocardial bridging of the coronary arteries using 128-multi detector computed...
PURPOSE
The aim of the study was to evaluate the prevalence, length, depth, and location of myocardial bridging of the coronary arteries using 128-multi detector computed tomography coronary angiography.
METHODS
The study cohort consisted of 875 patients who underwent coronary computed tomography angiography (CTA) for various indications. We evaluated the presence, length, and location of complete and incomplete bridging. In cases of complete bridging the thickness of the overlying muscle was also measured.
RESULTS
From a total of 875 subjects, 184 subjects (21%) were found to a single myocardial bridge. Complete bridging was detected in 161 patients (18.4%) and incomplete bridging in 23 patients (2.6%). The coronary arteries involved were the mid portion of the left anterior descending artery (LAD) (67.9%), the distal portion of the LAD (28.8%), and the proximal portion of the LAD (3.2%). No myocardial bridging was detected in other arteries in our study. The mean length and maximum myocardial thickness overlying the complete bridging were 20.9 mm (range 8-32 mm) and 2.6 mm (range 1.2-5.3 mm), respectively. The mean length of the incomplete bridging was 17 mm (range 9-2.3 mm).
CONCLUSIONS
Multi detector computed tomography is a reliable non-invasive modality for diagnosing myocardial bridging. The prevalence of myocardial bridging in this patient group was 21%. Our results are in agreement with those reported in pathologic studies, the gold standard for detecting this anomaly.
Topics: Adult; Aged; Aged, 80 and over; Coronary Angiography; Female; Humans; Male; Middle Aged; Myocardial Bridging; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 19690794
DOI: 10.1007/s00276-009-0542-7 -
European Heart Journal Jul 2009
Topics: Cardiomyopathy, Hypertrophic; Death, Sudden, Cardiac; Humans; Myocardial Bridging; Risk Factors
PubMed: 19491131
DOI: 10.1093/eurheartj/ehp216 -
Journal of Nuclear Cardiology :... Oct 2023
Utility of myocardial blood flow assessment with dynamic CZT single photon emission computed tomography in patients with myocardial bridging: Is this 'wishful thinking' in this dynamic situation?
Topics: Humans; Myocardial Bridging; Tomography, Emission-Computed, Single-Photon; Coronary Artery Disease; Myocardial Perfusion Imaging; Cadmium; Tellurium
PubMed: 37340234
DOI: 10.1007/s12350-023-03319-y -
BMC Cardiovascular Disorders Aug 2021Myocardial bridging (MB) is associated with various forms of arrhythmia. However, whether MB is a risk factor for atrial fibrillation (AF) in patients with hypertrophic...
Myocardial bridging of the left anterior descending coronary artery as a risk factor for atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy: a matched case-control study.
BACKGROUND
Myocardial bridging (MB) is associated with various forms of arrhythmia. However, whether MB is a risk factor for atrial fibrillation (AF) in patients with hypertrophic obstructive cardiomyopathy (HOCM) remains unknown. This study aimed to identify the relationship between myocardial bridging of the left anterior descending coronary artery (MB-LAD) and AF in patients with HOCM.
METHODS
We reviewed the medical records of 1925 patients diagnosed with HOCM at Fuwai Hospital from January 2012 to March 2019. Patients with coronary artery disease, a history of heart surgery, and those who had not been subjected to angiography were excluded. Finally, 105 patients with AF were included in this study. The control group was matched in a ratio of 3:1 based on age and gender.
RESULTS
Forty-three patients were diagnosed with MB-LAD in this study. The presence of MB was significantly higher in patients with AF than in those without AF (19.0% vs. 7.3%; p = 0.001), although MB compression and MB length did not differ between the two groups. In conditional multivariate logistic analysis, MB (odds ratio [OR] 2.33; 95% confidence interval [CI] 1.08-5.01; p = 0.03), pulmonary arterial hypertension (OR 2.63; 95% CI 1.26-5.47; p = 0.01), hyperlipidemia (OR 1.83; 95% CI 1.12-3.00; p = 0.016), left atrial diameter (OR 1.09; 95% CI 1.05-1.13; p < 0.001), and interventricular septal thickness (OR 1.06; 95% CI 1.003-1.12; p = 0.037) were independent risk factors for AF in patients with HOCM.
CONCLUSIONS
The presence of MB is an independent risk factor for AF in patients with HOCM. The potential mechanistic link between MB and the development of AF warrants further investigation.
Topics: Atrial Fibrillation; Cardiomyopathy, Hypertrophic; Case-Control Studies; Confidence Intervals; Coronary Angiography; Coronary Vessels; Female; Humans; Logistic Models; Male; Middle Aged; Myocardial Bridging; Retrospective Studies; Risk Factors
PubMed: 34362314
DOI: 10.1186/s12872-021-02185-1 -
Cureus Jul 2023Myocardial bridging (MB) is a condition where the coronary artery is intramural instead of its natural course through the epicardium. Here, we present a case of a...
Myocardial bridging (MB) is a condition where the coronary artery is intramural instead of its natural course through the epicardium. Here, we present a case of a 25-year-old male without any medical history who presented with intermittent substernal chest discomfort on exertion. EKG was suggestive of ST changes in leads V1-V4 with right axis deviation. A left heart catheterization revealed myocardial bridging of the midportion of the left anterior descending artery. Myocardial bridging is commonly not associated with severe complications. However, it is imperative to diagnose it appropriately, especially in cases of chest pain, and provide immediate treatment to prevent mortality and morbidity.
PubMed: 37546119
DOI: 10.7759/cureus.41452 -
Arquivos Brasileiros de Cardiologia Sep 2023
Topics: Humans; Myocardial Bridging
PubMed: 37672467
DOI: 10.36660/abc.20230426 -
Interactive Cardiovascular and Thoracic... Mar 2013A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was 'Is CABG an effective alternative for the... (Review)
Review
A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was 'Is CABG an effective alternative for the treatment of myocardial bridging?' Altogether, only six papers were identified using the reported search that represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes, and results of these papers are tabulated; these studies reported the outcome of myotomy and coronary artery bypass grafting (CABG) for myocardial bridging. All of these studies were retrospective reports of the results of surgical intervention in patients with myocardial bridging. They showed that the incidence of myocardial bridging was less than 1-1.5% in patients with angina requiring angiography, and 7-9% of these patients had refractory angina despite medical treatment and required surgery. The evidence on the treatment of this congenital condition that mainly affects the middle segment of left anterior descending artery is limited, and there are no treatment guidelines currently available. Stenting of the tunnelled segment has shown high failure rates in approximately half of the cases. Current evidence in the literature suggests that surgery is the mainstay treatment for myocardial bridging. Surgery is performed either as supra-arterial myotomy and de-roofing of the muscle bands on- or off-pump, or as coronary artery bypass grafting of the affected coronary artery beyond the tunnelled segment. Although no mortality was reported with either of these operations, surgical myotomy on deep and extensive myocardial bridges carries the risk of entering the right ventricle, bleeding and aneurysm formation. In addition, in a small percentage of the patients undergoing myotomy, angina recurred. Despite the possibility of competitive flow in the native coronary artery after CABG for myocardial bridging, we did not identify any evidence demonstrating graft occlusion after CABG for myocardial bridging. In conclusion, in extensive and deep myocardial bridgings, CABG may be the treatment of choice that carries low risk, limited complications and excellent symptomatic relief.
Topics: Adult; Benchmarking; Cardiac Surgical Procedures; Coronary Artery Bypass; Evidence-Based Medicine; Female; Humans; Male; Myocardial Bridging; Patient Selection; Risk Assessment; Risk Factors; Treatment Outcome
PubMed: 23171516
DOI: 10.1093/icvts/ivs459