Evaluation of myocardial bridges with 64-slice computed tomography coronary angiography

Bayrak, Fatih; Değertekin, Muzaffer; Eroğlu, Elif; Güneysu, Tahsin; Sevinc, Deniz; Gemici, Gökmen; Mutlu, Bülent; Aytaclar, Semih

doi:10.2143/ac.64.3.2038019

Cited by 27 publications

(19 citation statements)

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“…Similar to previous autopsy,1, 16 angiographic,5 and multidetector computed tomography17 reports, we found a greater plaque burden in the LAD segment proximal to the MB than within the tunneled LAD segment. This preferential location of atherosclerotic plaque in relation to the MB is attributed partially to hemodynamic disturbances caused by MB muscle contraction.…”

Section: Discussionsupporting

confidence: 91%

Functional Versus Anatomic Assessment of Myocardial Bridging by Intravascular Ultrasound: Impact of Arterial Compression on Proximal Atherosclerotic Plaque

Yamada

Tremmel

Tanaka

et al. 2016

JAHA

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BackgroundThe presence of a myocardial bridge (MB) has been shown to promote atherosclerotic plaque formation proximal to the MB, presumably because of hemodynamic disturbances provoked by retrograde blood flow toward this segment in cardiac systole. We aimed to determine the anatomic and functional properties of an MB related to the extent of atherosclerosis assessed by intravascular ultrasound.Methods and ResultsWe enrolled 100 patients with angina but no significant obstructive coronary artery disease who had an intravascular ultrasound–detected MB in the left anterior descending artery (median age 54 years, 36% male). The MB was identified with intravascular ultrasound by the presence of an echolucent band (halo). Anatomically, the MB length was 22±13 mm, and halo thickness was 0.7±0.6 mm. Functionally, systolic arterial compression was 23±12%. The maximum plaque burden up to 20 mm proximal to the MB entrance was significantly greater than the maximum plaque burden within the MB segment. Among the intravascular ultrasound–defined MB properties, arterial compression was the sole MB parameter that demonstrated a significant positive correlation with maximum plaque burden up to 20 mm proximal to the MB entrance (r=0.254, P=0.011 overall; r=0.545, P<0.001 low coronary risk). In multivariate analysis, adjusting for clinical characteristics and coronary risk factors, arterial compression was independently associated with maximum plaque burden up to 20 mm proximal to the MB entrance.ConclusionsIn patients with an MB in the left anterior descending artery, the percentage of arterial compression is related directly to the burden of atherosclerotic plaque located proximally to the MB, particularly in patients who otherwise have low coronary risk. This may prove helpful in identifying high‐risk MB patients.

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Section: Discussionsupporting

confidence: 91%

Functional Versus Anatomic Assessment of Myocardial Bridging by Intravascular Ultrasound: Impact of Arterial Compression on Proximal Atherosclerotic Plaque

Yamada

Tremmel

Tanaka

et al. 2016

JAHA

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“…Despite the exceptionally high detection rate (58% and 44%) of MB by MDCT reported by Kim et al (20) and Lubarsky et al (24), the usual depiction rate using MDCT ranges from 4% to 31% (10-18, 21-23, 25-27, 36-39). The previous study using DSCT by Lu et al (19) showed that the depiction rate of MB was 30%, and the MB was diagnosed when at least half of the coronary artery was embedded within the myocardium.…”

Section: Discussionmentioning

confidence: 90%

Myocardial Bridging of the Left Anterior Descending Coronary Artery: Depiction Rate and Morphologic Features by Dual-Source CT Coronary Angiography

Hwang

Roh

et al. 2010

Korean J Radiol

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ObjectiveTo evaluate the depiction rate and morphologic features of myocardial bridging (MB) of the left anterior descending coronary artery (LAD) using dual-source CT (DSCT).Materials and MethodsCT scans from a total of 1,353 patients who underwent DSCT were reviewed retrospectively for LAD-MB. Seventy-eight patients were excluded due to poor image quality or poor enhancement of the coronary artery. The length and depth of the MB were analyzed and classified as superficial or deep with respect to the depth (≤ 1 or > 1 mm) of the LAD tunneled segment. Superficial MB was subdivided into complete or incomplete types according to full or partial encasement of the myocardium.ResultsOf the 1,275 patients included in this study, 557 cases of MB were found from 536 patients (42%). Superficial MB was observed in 368 of 557 (66%) cases, and deep MB was seen in 189 of 557 (34%) cases. Superficial MB showed 2 types: complete (128 of 368, 35%) and incomplete (240 of 368, 65%). The mean length of a tunneled segment for superficial MB was 16.4 ± 8.6 mm. The mean length and depth of a tunneled segment for deep MB were 27.6 ± 12.8 mm and 3.0 ± 1.4 mm, respectively. The incidence of atherosclerotic plaques in a 2-cm-long segment proximal to MB was 16%.ConclusionThe depiction rate of LAD-MB using DSCT in a large series of patients was 42%, with two-thirds of MB segments being the superficial type.

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“…Although bridged segments are spared from atherosclerosis, there is evidence to suggest there is endothelial dysfunction at the site of the bridge [55] and atherosclerosis may be more frequent in segments proximal to bridging [56,57].…”

Section: Deep Myocardial Bridgingmentioning

confidence: 99%

CT coronary angiography in the investigation of chest pain — Beyond coronary artery atherosclerosis; A pictorial review

Kanaganayagam

Ngo

Alsafi

et al. 2014

International Journal of Cardiology

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Evaluation of myocardial bridges with 64-slice computed tomography coronary angiography

Cited by 27 publications

References 0 publications

Functional Versus Anatomic Assessment of Myocardial Bridging by Intravascular Ultrasound: Impact of Arterial Compression on Proximal Atherosclerotic Plaque

Functional Versus Anatomic Assessment of Myocardial Bridging by Intravascular Ultrasound: Impact of Arterial Compression on Proximal Atherosclerotic Plaque

Myocardial Bridging of the Left Anterior Descending Coronary Artery: Depiction Rate and Morphologic Features by Dual-Source CT Coronary Angiography

CT coronary angiography in the investigation of chest pain — Beyond coronary artery atherosclerosis; A pictorial review

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