Myocardial Bridging in Children with Hypertrophic Cardiomyopathy — A Risk Factor for Sudden Death

Yetman, Anji T.; McCrindle, Brian W.; MacDonald, Cathy; Freedom, Robert M.; Gow, Robert M.

doi:10.1056/nejm199810223391704

Cited by 228 publications

(154 citation statements)

References 49 publications

(62 reference statements)

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“…Several studies have defined MB as coronary artery narrowing of > 50%. [27][28][29] However, we have adopted this less restrictive definition for the following reasons: (1) We usually used the right anterior oblique caudal view to monitor changes in coronary diameter in response to drug infusion. Because MB is frequently present over the mid segment of the left anterior descending coronary arteries (LAD), apparent systolic narrowing of the MB segment may be less in the right anterior oblique caudal view than in the cranial views.…”

Section: Definitionsmentioning

confidence: 99%

Myocardial bridging increases the risk of coronary spasm

Teragawa

Fukuda

Matsuda

et al. 2003

Clinical Cardiology

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SummaryBackground: Myocardial bridging (MB) has been associated with cardiac events. Whether coronary spasm is one factor contributing to those events is unknown.Hypothesis: This study investigated whether the likelihood of coronary spasm is increased in patients with MB.Methods: A spasm-provocation test was performed by infusing acetylcholine into the left coronary artery in 114 Japanese patients with chest pain. The test result was defined as positive when the diameter of the coronary artery was reduced by ≥ 50% and ST-segment changes were documented. Myocardial bridging was defined as a > 15% reduction in coronary arterial diameter during systole after intracoronary injection of nitroglycerin.Results: Myocardial bridging was identified in 41 patients (36%) and was located in the mid-segment of the left anterior descending coronary artery (LAD) in all patients. Patients with MB experienced coronary spasm more frequently than patients without MB (MB+: 73%; MBϪ: 40%, p = 0.0006). Furthermore, among patients with a positive spasm-provocation test, coronary spasm occurred more frequently in the midsegment of the LAD in patients with MB than in those without MB (MB+: 73%; MBϪ: 45%, p = 0.0259). Multivariate regression analysis demonstrated that MB was a predictor of coronary spasm (odds ratio: 3.478, p = 0.0088).

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Section: Definitionsmentioning

confidence: 99%

Myocardial bridging increases the risk of coronary spasm

Teragawa

Fukuda

Matsuda

et al. 2003

Clinical Cardiology

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“…Endomyocardial biopsy and histology [24,26,57], angiography [58], and genetic testing [57] may provide additional valuable information to support the echocardiograph method in the confirmatory diagnosis of pediatric cardiomyopathy.…”

Section: Diagnostic Methodsmentioning

confidence: 99%

“…Sixteen (16) prospective or retrospective studies meeting the inclusion criteria were included in this meta-analysis [12,24,26,30,31,[54][55][56][57][58][59][60][61][62][63][64]. Altogether, the studies investigated a total sample of 6,665 patients aged younger than 18 years with pediatric cardiomyopathies having mean high mortality rate of 12% within five years of diagnosis.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Echocardiographic defined left ventricular dysfunction (also used in the recruitment of pediatric patients constituting the PCMR data), was the dominant method of diagnosis adopted by 14 studies (87.5%) [12,24,26,30,31,[54][55][56][59][60][61][62][63][64]. The remaining two studies adopted genetic testing and biopsy [57] and angiography [58]. A majority of the studies (44%), investigated pediatric HCM phenotype, 31% investigated pediatric DCM, 19% pediatric RCM and the remaining 6% investigated left ventricular non-compaction.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Other poor predictors of prognosis include myocardial bridging [12,58], family history, greater wall thickness [62,64], chest pain, syncope without congestive heart failure [60] and presence of muscular dystrophinopathies such as Duchenne and Becker muscular dystrophy [55].…”

Section: Prognostic Predictorsmentioning

confidence: 99%

See 2 more Smart Citations

Pediatric cardiomyopathies: A review of literature on clinical status and meta-analysis of diagnosis and clinical management methods

Albakri¹

2018

Pediatr Dimensions

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Cardiomyopathies define a heterogeneous group of heart muscle disorders. They are an important cause of heart failure and a leading indication for heart transplantation in pediatric patients. Research on cardiomyopathy has however focused on the adult populations with fewer dedicated clinical trials investigating pediatric cardiomyopathy. Diagnosis and clinical management of pediatric cardiomyopathy are also challenging because of the lack of specific methods for diagnosis and treatment. Assessment of ventricular structure using absolute values in adults are not useful in children because of their constantly changing body surface area. Therapies developed for adults applied to pediatric patients also have had varied clinical outcomes. This paper therefore reviews existing research evidence on pediatric cardiomyopathy, with the objective of broadening its clinical understanding and management.

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Hypertrophic Cardiomyopathy

Maron¹

2002

JAMA

1,920

1,374

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Substantial understanding has evolved regarding the epidemiology and clinical course of HCM, as well as novel treatment strategies that may alter its natural history. An appreciation that HCM, although an important cause of death and disability at all ages, does not invariably convey ominous prognosis and is compatible with normal longevity should dictate a large measure of reassurance for many patients.

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Myocardial Bridging in Children with Hypertrophic Cardiomyopathy — A Risk Factor for Sudden Death

Abstract: Myocardial bridging is associated with a poor outcome in children with hypertrophic cardiomyopathy. Our observations suggest that bridging is associated with myocardial ischemia

Cited by 228 publications

References 49 publications

Myocardial bridging increases the risk of coronary spasm

Myocardial bridging increases the risk of coronary spasm

Pediatric cardiomyopathies: A review of literature on clinical status and meta-analysis of diagnosis and clinical management methods

Hypertrophic Cardiomyopathy

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