Myocardial bridges of the coronary arteries in the human fetal heart

Cakmak, Yusuf Özgür; Çavdar, Safiye; Yalın, Aymelek; Yener, Nuran; Özdoğmuş, Ömer

doi:10.1007/s12565-009-0069-3

Cited by 14 publications

(18 citation statements)

References 27 publications

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“…Cardiac arrhythmia and coronary artery spasm are triggered by autonomic nerve fibers innervating the myocardial bridges (Cao et al, ; Yasue et al, ), so the autonomic innervation of the heart near myocardial bridges is important. Myocardial bridges are also observed in human fetal hearts (Cakmak et al, ), suggesting that they form temporarily during the fetal period. Tian et al () revealed that coronary arteries and cardiac veins are formed from common precursor cells in the mouse, so it is also important to examine the course and distribution pattern of cardiac veins at the myocardial bridges.…”

Section: Introductionmentioning

confidence: 92%

Gross anatomical study on the human myocardial bridges with special reference to the spatial relationship among coronary arteries, cardiac veins, and autonomic nerves

et al. 2015

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Coronary arteries are frequently covered by cardiac muscles. This arrangement is termed a myocardial bridge. Previous studies have shown that myocardial bridges can cause myocardial ischemic diseases or cardiac arrhythmia, but the relevant pathogenic mechanisms remain unknown. We examined 60 hearts from Japanese cadavers macroscopically to clarify the spatial relationships among coronary arteries, cardiac veins and autonomic nerves. We found 86 myocardial bridges in 47 hearts from the 60 cadavers examined (78.3%). Next, we dissected out nine hearts with myocardial bridges in detail under the operating microscope. We found no additional branches of coronary arteries on the myocardial bridge surfaces. However, the cardiac veins, which usually accompany the coronary arteries, ran independently on the myocardial bridge surfaces in the same region. Cardiac autonomic nerves comprised two rami: one was associated with the coronary artery under the myocardial bridge and the other ran on the surface of the bridge. Such spatial relationships among the coronary arteries, cardiac veins and cardiac autonomic nerves at the myocardial bridges are quite similar to those in mouse embryo hearts.

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Section: Introductionmentioning

confidence: 92%

Gross anatomical study on the human myocardial bridges with special reference to the spatial relationship among coronary arteries, cardiac veins, and autonomic nerves

et al. 2015

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“…In forensic autopsies, it is sometimes considered a cause of sudden death and is often reported as such in scientific articles, especially in association with other congenital cardiac or coronary anomalies (11)(12)(13)(14)(15)(16)(17)(18)(19)(20). It is considered an inborn anomaly, being found in studies on human fetuses (21), and it appears to reflect particular developmental processes within the heart (22). The description of the morphological characteristics of MBs is extremely heterogeneous in the scientific literature.…”

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confidence: 99%

Myocardial Bridging: A Meta‐Analysis of Prevalence

Hostiuc

Negoi

Rusu

et al. 2017

Journal of Forensic Sciences

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The main objective of this article was to analyze prevalence data about myocardial bridging (MB) in published studies. To this purpose, we performed a meta-analysis of studies published in English literature that contained data about the prevalence of MB and its anatomical characteristics. The overall prevalence was 19% (CI: 17-21%); autopsy studies revealed an overall prevalence of 42% (CI: 30-55%), CT studies 22% (CI: 18-25%), and coronary angiography 6% (CI: 5-8%). Most bridges were located on the left anterior descending artery (82% overall, 63% on autopsy studies), had a mean thickness of 2.47 mm and a mean length of 19.3 mm. In conclusion, autopsy studies should be the gold standard in evaluating the actual prevalence of myocardial bridges, while in vivo high-resolution CT scanning should be preferred to coronary angiography studies.

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“…The higher frequency of MB detection at autopsy than with MDCT may be due to differences between these methods, because an MB thinner than 200 μm can only be detected by autopsy. Furthermore, MBs have already been recognized in the LAD of a neonate, 42 an infant suffering a myocardial infarction (MI), 43 and autopsied fetal hearts, 41 indicating that the MB is a chance congenital anatomical structure.…”

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confidence: 99%

Significance of the Anatomical Properties of a Myocardial Bridge in Coronary Heart Disease

Ishikawa

Kawawa

Kohda

et al. 2011

Circ J

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he myocardial bridge (MB) is an anatomical variant that often covers part of the left anterior descending coronary artery (LAD). 1 It occurs almost exclusively in the mid-portion of the LAD (Figure 1). 2,3 Muscular contraction of the MB itself alters blood flow within the LAD, as demonstrated by coronary angiography, and influences the distribution of hemodynamic stress. [3][4][5] It is widely accepted that an MB sometimes causes coronary heart disease (CHD), 2,5,6 either from direct compression of the MB at cardiac systole or by enhancement of the natural progression of coronary atherosclerosis in the LAD segment proximal to the MB. 2,5,7 Both mechanisms are closely associated with changes in hemodynamic stress driven by the force of the MB contraction through a combination of anatomical properties, such as the location, length, and thickness of the MB. 3,7,8 This review focuses on the relationship between the presence of an MB in the LAD and the occurrence of CHD, specifically addressing the importance of the anatomical properties of the MB as the common root for the 2 distinct mechanisms. In addition, therapeutic approaches to CHD caused by an MB are summarized, along with their outcomes. A myocardial bridge (MB), partially covering the coronary artery, is a congenital anatomical variant usually present in the left anterior descending coronary artery (LAD). MB causes coronary heart disease (CHD) by 2 distinct mechanisms influenced by the anatomical properties of the MB, such as its length, thickness, and location. One is direct MB compression of the LAD at cardiac systole, resulting in delayed arterial relaxation at diastole, reduced blood flow reserve, and decreased blood perfusion. The other is enhancement of coronary atherosclerosis causing stenosis of the LAD proximal to the MB, occurring because of endothelial injury arising from the abnormal hemodynamics provoked by retrograde blood flow up toward the left coronary ostium at cardiac systole. The magnitude of the effect of the 2 distinct mechanisms of the MB on LAD blood flow is prescribed by a common root of the MB-muscle mass volume generated by those properties. Furthermore, the anatomical properties of the MB are closely associated with the choice of treatment and therapeutic outcome in CHD patients having an MB. Thus, the anatomical properties of an MB should be considered in the diagnosis and management of CHD patients with this anomaly. (Circ J 2011; 75: 1559 - 1566

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Myocardial bridges of the coronary arteries in the human fetal heart

Cited by 14 publications

References 27 publications

Gross anatomical study on the human myocardial bridges with special reference to the spatial relationship among coronary arteries, cardiac veins, and autonomic nerves

Gross anatomical study on the human myocardial bridges with special reference to the spatial relationship among coronary arteries, cardiac veins, and autonomic nerves

Myocardial Bridging: A Meta‐Analysis of Prevalence

Significance of the Anatomical Properties of a Myocardial Bridge in Coronary Heart Disease

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