Multifocal coronary artery myocardial bridging involving the right coronary and left anterior descending arteries detected by ECG-gated 64 slice multidetector CT coronary angiography

Rychter, Kelly; Salanitri, John; Edelman, Robert R.

doi:10.1007/s10554-006-9086-7

Cited by 17 publications

(8 citation statements)

References 13 publications

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“…To date, symptomatic MB cases have been seen in conjunction with conditions of physiological deterioration, such as coronary stenosis by MB contraction, coronary spasm under the MB, and tachycardia during strenuous conditions 4 other than coronary atherosclerosis. 9,10,[13][14][15][16][17][18] However, the present study clearly demonstrates that MBs with a large MMI predispose a person to MI occurrence through modulation of spontaneously developing atherosclerosis. The intima-media ratio in this group increased from the ostium up to 2.0 cm and decreased gradually toward the apex.…”

Section: Discussionmentioning

confidence: 85%

“…By multidetector CT imaging, symptomatic MB cases, mainly resulting from myocardial infarction (MI) without coronary atherosclerosis, have been reported. 9,10 In most of these cases, the bridged LAD showed no fixed intimal lesion but demonstrated vigorous compression by MB contraction during systole. 4 Such symptomatic MBs are located more proximally in the LAD and tend to be longer and/or thicker.…”

Section: Editorial See P 357 Clinical Perspective On P 383mentioning

confidence: 99%

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Anatomic Properties of Myocardial Bridge Predisposing to Myocardial Infarction

Ishikawa

Akasaka²,

Suzuki³

et al. 2009

Circulation

169

134

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Background-A myocardial bridge (MB) that partially covers the course of the left anterior descending coronary artery (LAD) sometimes causes myocardial ischemia, primarily because of hemodynamic deterioration, but without atherosclerosis. However, the mechanism of occurrence of myocardial infarction (MI) as a result of an MB in patients with spontaneously developing atherosclerosis is unclear. Methods and Results-One hundred consecutive autopsied MI hearts either with MBs [MI(ϩ)MB(ϩ) group; nϭ46] orwithout MBs (nϭ54) were obtained, as were 200 normal hearts, 100 with MBs [MI(Ϫ)MB(ϩ) group] and 100 without MBs. By microscopy on LADs that were consecutively cross-sectioned at 5-mm intervals, the extent and distribution of LAD atherosclerosis were investigated histomorphometrically in conjunction with the anatomic properties of the MB, such as its thickness, length, and location and the MB muscle index (MB thickness multiplied by MB length), according to MI and MB status. In the MI(ϩ)MB(ϩ) group, the MB showed a significantly greater thickness and greater MB muscle index (PϽ0.05) than in the MI(Ϫ)MB(ϩ) group. The intima-media ratio (intimal area/medial area) within 1.0 cm of the left coronary ostium was also greater (PϽ0.05) in the MI(ϩ)MB(ϩ) group than in the other groups. In addition, in the MI(ϩ)MB(ϩ) group, the location of the segment that exhibited the greatest intima-media ratio in the LAD proximal to the MB correlated significantly (PϽ0.001) with the location of the MB entrance, and furthermore, atherosclerosis progression in the LAD proximal to the MB was largest at 2.0 cm from the MB entrance. Conclusions-In the proximal LAD with an MB, MB muscle index is associated with a shift of coronary disease more proximally, an effect that may increase the risk of MI. (Circulation. 2009;120:376-383.)Key Words: myocardium Ⅲ myocardial infarction Ⅲ anatomy Ⅲ atherosclerosis T he coronary artery that runs through epicardial adipose tissue is often covered in part with myocardial tissue. This structure is known as a myocardial bridge (MB) 1 ; it exists almost exclusively in the left anterior descending coronary artery (LAD), 2 and it is regarded as a common anatomic variant rather than a congenital anomaly. 3 The frequency of an MB in the LAD is high, sometimes Ͼ50% by autopsy, 2 but it is Ͻ5% by angiography. 4 Because MBs have been identified angiographically indirectly through a "milking effect" phenomenon induced by systolic compression of the MB, a thin or short MB is often missed. 4 The use of other invasive imaging, such as intracoronary ultrasound and Doppler, has improved MB detection. 5,6 More recently, multidetector computed tomography (CT) has been used noninvasively to detect the MB itself directly, 7 and surprisingly, the use of multidetector CT for myocardial ischemia increases Editorial see p 357 Clinical Perspective on p 383The clinical outcome of patients with MBs has been considered benign 4 ; however, the significance of an MB to myocardial ischemia remains controversial. By multidetector CT imaging,...

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Section: Discussionmentioning

confidence: 85%

Section: Editorial See P 357 Clinical Perspective On P 383mentioning

confidence: 99%

Anatomic Properties of Myocardial Bridge Predisposing to Myocardial Infarction

Ishikawa

Akasaka²,

Suzuki³

et al. 2009

Circulation

169

134

View full text Add to dashboard Cite

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“…MB have been considered in some works as a risk factor for the development of some cardiac conditions (Gow 2002, Rychter et al 2006.…”

Section: Introductionmentioning

confidence: 99%

Morphologic expression of the right coronary artery in horses. Comparative description with humans, pigs and other animal species

Gómez

Ballesteros

Estupiñán

2017

Austral j. vet. sci.

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ABSTRACT. The objective of this research was to characterise morphologically the right coronary artery and its branches in the horse. The right coronary arteries of 120 horse hearts were perfused with semi-synthetic resin (85% Palatal GP40L; 15% styrene) and mineral red dye. The morphological and biometric characteristics of the right coronary artery and its branches (digital calibrator) were assessed. The diameter of the right coronary artery was 6.72 ± 2.58 mm. The interventricular subsinusal branch ended at the apex in 94 specimens (78.4%). The right circumflex branch originated at the site of intersection of the subsinnusal interventricular sulcus and the atrioventricular septum, extended along the coronary sulcus with a convoluted trajectory, ended at the obtuse edge of the heart or even at the anterior aspect of the left ventricle in 62 hearts (52.5%), and at the middle segment of the left ventricle in 42 cases (35.6%), whereas in 14 samples (11.9%) it ended at the adjacent surface of the left ventricle. The right conus branch was found in 98 specimens (81.6%) and in 2 of them (1.7%) it emerged directly from the right aortic sinus (third coronary artery). The hearts exhibited right coronary dominance in 118 specimens (98.3%) and in 2 specimens (1.7%) the coronary dominance was balanced. No myocardial bridges were observed. The high incidence of right coronary dominance observed in this study is consistent with previous studies. Due to its similarity with the human heart, we may ratify the equine model for procedural and hemodynamic applications.Key words: horse, coronary artery, dominance, heart.RESUMEN. El objetivo de esta investigación fue caracterizar morfológicamente la arteria coronaria derecha del caballo y sus ramas. En 120 corazones de caballo se perfundieron las arterias coronarias derechas con resina semisintética (palatal GP40L al 85%; estireno al 15%) y color rojo mineral. Se evaluó las características morfológicas y biométricas de la arteria coronaria derecha y sus ramas (calibrador digital). El diámetro de la arteria coronaria derecha fue 6,72 +/-2,58 mm. La rama interventricular subsinusal finalizó en el ápex en 94 especímenes (78,4%). La rama circunfleja derecha se originó a nivel del sitio de cruce del surco interventricular subsinusal y el septum atrioventricular, se extendió a lo largo del surco coronario con una trayectoria contorneada y finalizando en el borde obtuso del corazón o incluso en la cara anterior del ventrículo izquierdo en 62 corazones (52,5%) y en el segmento medio del ventrículo izquierdo en 42 casos (35,6%), mientras que en 14 muestras (11,9%) esta finalizó en la superficie adyacente del ventrículo izquierdo. La rama derecha del cono, se encontró en 98 especímenes (81,6%) y en 2 corazones (1,7%) emergió directamente del seno aórtico derecho (tercera coronaria). Los corazones presentaron dominancia coronaria derecha en 118 muestras (98,3%) y en 2 casos (1,7%) la dominancia coronaria fue balanceada. No se observó puentes miocárdicos. La alta incidencia de dominancia coron...

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“…The disparity in the incidences from anatomical and angiographic studies may depend on the length and depth of myocardial bridging, and deep myocardial bridging is only detected on angiography [9]. Recently developed MDCT has permitted better evaluation of myocardial bridging [10][11]. Marked narrowing of the middle segment of LAD in our case was revealed in coronary angiography without milking effect, so myocardial bridging was not suggested in angiography.…”

Section: Discussionmentioning

confidence: 86%

Myocardial infarction in a young female with reninoma induced hypertension and myocardial bridging

Lee

Song

Seo

et al. 2006

Int J Cardiovasc Imaging

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We present a case of myocardial infarction in a young female with reninoma induced hypertension and myocardial bridging. Reninoma is a rare and curable cause of secondary hypertension. Currently developed multi-detector computed tomography (MDCT) has permitted better evaluation of myocardial infarction and myocardial bridging. Myocardial infarction associated with reninoma and myocardial bridging has not been reported, and we report this interesting case.

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Multifocal coronary artery myocardial bridging involving the right coronary and left anterior descending arteries detected by ECG-gated 64 slice multidetector CT coronary angiography

Cited by 17 publications

References 13 publications

Anatomic Properties of Myocardial Bridge Predisposing to Myocardial Infarction

Anatomic Properties of Myocardial Bridge Predisposing to Myocardial Infarction

Morphologic expression of the right coronary artery in horses. Comparative description with humans, pigs and other animal species

Myocardial infarction in a young female with reninoma induced hypertension and myocardial bridging

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