Evaluation of the morphological and clinical features of left anterior descending myocardial bridging with multi-detector computed tomography

Abstract

Aim The aim of the study was to assess the incidence, localization, depth, length of myocardial bridging (MB) with left anterior descending (LAD), systolic compression ratio, atherosclerotic plaque localization and degree of stenosis by 256-slice multi-detector computed tomography (MDCT). Material and methods Computed tomography (CT) scans from a total of 3947 patients who underwent MDCT were reviewed retrospectively for LAD MB. A diastolic and systolic dataset with the best image quality was selected. Myocardial bridge was defined as a coronary artery with an intra-myocardial course. Myocardial bridging was divided into “deep” or “superficial”. The length and depth of the bridging segment were calculated. For each bridging segment, the presence of atherosclerosis was saved in a 2-cm-long segment proximal to the entry of the bridging segment. The degree of stenosis made by atherosclerotic plaques was determined. Results LAD myocardial bridging was detected in 410 (10.4%) patients. Among these, 97 (23.7%) patients had a deep and 313 (76.3%) patients had a superficial course. The mean LAD MB length was 20.28 ±9.63 mm and the depth was 1.72 ±1.11 mm. The systolic and diastolic mean diameter difference was 0.193 mm and the average compression ratio was 9.44%. Atherosclerotic plaques were found in 167 (40.7%) of 410 LAD MB. Atherosclerotic plaques were found in 50.5% of deep MB and 37.7% of superficial MB. Conclusions 256-slice MDCT coronary angiography has a high sensitivity to show myocardial bridging in LAD localization, to determine length, depth, compression ratio, atherosclerotic plaque localization and degree of stenosis.

A bibliometric analysis of myocardial bridge combined with myocardial infarction

“…MDCT is currently a rapid and adequate test for the diagnosis of MB, which allows the evaluation of the coronary arteries and their relationship with other anatomical structures. [ 42 ] As a noninvasive test, it is comparable to IVUS in terms of accuracy and can be considered as an alternative to CAG in the diagnosis of MB. [ 43 ] This test performs image reconstruction after scanning, and MB is diagnosed when coronary arteries are covered by myocardium of varying thickness, with narrowing of the lumen during systole and re-dilation of the lumen during diastole.…”

The Intramyocardial Left Anterior Descending Artery: Prevalence, Early and Mid-Term Surgical Outcomes After Coronary Artery Bypass Procedures: A Retrospective Single-Center Study

“…The intramyocardial bridge is considered a congenital coronary anomaly, it is described as a segment of a major epicardial coronary artery that passes deeply into the myocardium. 1 It was first recognised by Reyman et al in an autopsy and then described in angiography images by Portman et al 2,3 Although it can be observed in any epicardial artery, it is most commonly reported in the mid-section of the left anterior descending artery (LAD). 4 The revascularisation of the LAD affects both the early and late postoperative outcomes of coronary artery bypass grafting (CABG).…”

Assessment of myocardial bridging and the pericoronary fat attenuation index on coronary computed tomography angiography: predicting coronary artery disease risk

“…Eventually, platelet aggregation and lipoprotein deposition contribute to atherosclerosis in the coronary artery proximal to the MB [ 6 ]. Currently, coronary computed tomography angiography (CCTA) is considered to be an excellent tool in the noninvasive evaluation of MB parameters due to its effective visualization of MBs [ 7 ]. However, the value of radiological MB parameters in predicting coronary atherosclerosis risk is controversial.…”