Significance of anatomical properties of myocardial bridge on atherosclerosis evolution in the left anterior descending coronary artery

Ishikawa, Yukio; Akasaka, Yoshikiyo; Ito, Kinji; Akishima, Yuri; Kimura, Masayo; Kiguchi, Hideko; Fujimoto, Ai; Ishii, Toshiharu

doi:10.1016/j.atherosclerosis.2005.07.024

Cited by 83 publications

(84 citation statements)

References 23 publications

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“…Altogether, the data suggest that MB is associated with the decreased development of atherosclerosis under and proximal to the tunnelled artery, although it is unclear whether this is an independent factor [35]. It seems that MB located within 5 cm from the left coronary ostium may prevent atherosclerosis in the proximal part of LAD [36].…”

Section: Myocardial Bridging and Coronary Lesionsmentioning

confidence: 87%

Prevalence and predictors of bridging of coronary arteries in a large Indonesian population, as detected by 64-slice computed tomography scan

et al. 2012

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Background Multislice computed tomography (MSCT) can be used to detect myocardial bridging (MB) of coronary arteries. However, most published studies included small cohorts and did not collect data about predictors. We investigated prevalence and predictors of MB in an Indonesian population. Methods All patients who had MSCT at Cinere Hospital, Jakarta, Indonesia between 2006 and 2009 were included in a prospective registry. MB was defined when at least half of the coronary artery was imbedded within the myocardium with a normal epicardial course of the proximal and distal portion. Results Of the 934 patients (mean age 53 years, 37.8 % female), MB could be observed in 152 patients (16.3 %). Patients with MB were younger compared with those without MB. Coronary risk factors were not different between the two groups. Coronary calcifications and moderate to severe coronary stenoses were less prevalent in patients with MB, also after adjusting for differences in age. At the time of diagnosis, only a few patients with MB were treated with beta-blockers (35 %) or calcium channel blockers (13 %). Conclusions Prevalence of myocardial bridging as detected by MSCT is relatively high. Patients with MB were younger and had a lower prevalence of coronary sclerosis. MB could be the cause of their unexplained symptoms. Follow-up studies are necessary to assess the symptoms of these patients, their response to treatment and the incidence of (coronary) events. MSCT can be used to identify patients for potential new treatment strategies.

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Section: Myocardial Bridging and Coronary Lesionsmentioning

confidence: 87%

Prevalence and predictors of bridging of coronary arteries in a large Indonesian population, as detected by 64-slice computed tomography scan

et al. 2012

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“…The influence of the abnormal MC proximal hoop stress caused by MB on the coronary artery disease has not been reported and the influence of MB on the effect of interventional therapy with severe atherosclerosis at proximal MB is not clear [20][21][22].…”

Section: Conclusion and Discussionmentioning

confidence: 99%

In Vitro Simulation Research on the Hoop Stress of Myocardial Bridge — Coronary Artery

et al. 2014

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An analog device which can simulate myocardium bridge oppresses mural coronary artery is designed. The device can be used to research the dynamic changes of the proximal and distal hoop stresses. Meanwhile, the independent regulation of the hoop stresses is realized. The "myocardial bridge -coronary artery" analog device is built to adjust the external pressure of the simulated coronary artery and the oppression level of the myocardial bridge and to record the changes of the hoop stresses. The In vitro simulation experiment indicate that the anomaly of hoop stress mainly occurs in the proximal end. As the oppression level increases, the mean proximal hoop stress and the oscillatory value (maximum-minimum) increase obviously. The "myocardial bridge -coronary artery" analog device can provide a method to study the influence of the hoop stress on the mural coronary artery in vitro. Предложено аналоговое устройство, которое может имитировать угнетение миокардиальным мостом стенки коронарной артерии. Устройство может быть использовано для исследования динамических изменений проксимального и дистального кольцевых напряжений. Между тем, реализуется независимое регулирование кольцевых напряжений. "Миокардиальный мост -коронарная артерия" аналоговое устройство создано для регулировки внешнего давления смоделированной коронарной артерии и угнетение уровня миокардиального моста и для записи изменений кольцевых напряжений. In vitro имитационного эксперимент указывают на то, что аномалия кольцевых стресс возникает в основном в проксимальном конце. По мере того, как уровень угнетения повышается, среднее проксимальное кольцевое напряжение и колебатель-ного значение (максимум-минимум), соответственно, увеличивается. "Мио-кардиальный мост -коронарная артерия" аналоговое устройство может обеспечить метод для изучения влияния кольцевого напряжения на стенки коронарной артерии in vitro. Russ Российский кардиологический журнал 2014, 7 (111), Англ.: 51-54Ключевые слова: стенка коронарной артерии, миокардиальный мост, гемо-динамика, кольцевое напряжение. IntroductionThe normal coronary artery and its branches are usually located under the epicardium. When a section of the coronary artery covered by the superficial myocardium is located in the myocardium, the coronary artery is called mural coronary artery (MC) and the myocardium is called myocardial bridge (MB).A patient needs treatment when MC stenosis is over 50%. Sometimes the effect of drug therapy is poor for some MB patients and a part of MB patients even cannot tolerate drug therapy, so percutaneous transluminal coronary angioplasty or stent implantation is usually used for them. Coronary artery stent implantation not only can correct the abnormal MC hemodynamic, but also can make the MC blood flow return to normal. However, 10% -50% of the patients may develop stent restenosis after receiving coronary artery stent implantation and even more seriously, the coronary artery rupture may happen in or after the treatment [1][2][3].

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“…3). 7,21,23,32,33) Hemodynamic changes across the entrance to MB have been variously focused as the mechanism of atherosclerosis suppression. Such changes may generate high shear stress in the LAD intima beneath MB because blood fl ow velocity in the LAD increases under these conditions at both systole and diastole, 34) and systolic compression of MB is followed by delayed MB relaxation during diastole.…”

Section: Coronary Artery Imaging In Clinical Practicementioning

confidence: 99%

“…35) The cross-sectioned cut-surface of atherosclerotic lesions proximal to MB is usually eccentric (Fig. 5), 14,23,33) indicating that this segment 52%-55.6% in South America 25,28) and 45%-58.3% in the Orient. 22,23) In addition, they are consistently found regardless of age and sex.…”

Section: Coronary Artery Imaging In Clinical Practicementioning

confidence: 99%

“…We histomorphometrically studied 200 autopsied normal hearts with MB in the LAD and 100 normal hearts without MB, all of which were free of cardiovascular diseases, to determine basic associations between MB and the both topographic and quantitative atherosclerotic changes in the LAD. 33) We assessed cross-sections of the LAD at 5 mm intervals together with the surrounding MB for the entire length of the LAD, the extent of intimal thickening in each LAD segment, and measured the anatomical properties of MB, such as the location within the LAD, length and thickness. 33) Atherosclerosis was distinctly suppressed in the LAD intima beneath MB irrespective of MB anatomic properties.…”

Section: Effect Of Mb On the Occurrence Of Myocardial Ischemiamentioning

confidence: 99%

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Myocardial Bridge as a Structure of “Double-Edged Sword” for the Coronary Artery

Ishii

Ishikawa

Akasaka

2014

Annals of Vascular Diseases

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Myocardial bridge (MB) is a chance anatomical structure, comprised of the myocardial tissue, with which the coronary artery running in epicardial adipose tissue is partly covered. It is predominantly present in the left anterior descending artery (LAD) and recognizable through imaging techniques as changes in blood fl ow within the LAD that arises from MB contraction at cardiac systole. Such changes in blood fl ow infl uence the pathophysiology of coronary circulation and atherosclerosis development, thus generating controversy as to whether MB predisposes individual to myocardial infarction (MI). However, recent histomorphometric studies have shown that the individual anatomic properties of MB, such as location, length and thickness, consistently play a critical role in the occurrence of MI. This review article comprehensively addresses the pathophysiological mechanisms of MI occurrence together with the benign suppressive effect of coronary atherosclerosis by MB.

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Significance of anatomical properties of myocardial bridge on atherosclerosis evolution in the left anterior descending coronary artery

Cited by 83 publications

References 23 publications

Prevalence and predictors of bridging of coronary arteries in a large Indonesian population, as detected by 64-slice computed tomography scan

Prevalence and predictors of bridging of coronary arteries in a large Indonesian population, as detected by 64-slice computed tomography scan

In Vitro Simulation Research on the Hoop Stress of Myocardial Bridge — Coronary Artery

Myocardial Bridge as a Structure of “Double-Edged Sword” for the Coronary Artery

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