Skip to main content
SpringerLink
Log in

Investigation and review of myocardial bridges in adult cadaver hearts and angiographs

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

We aimed to compare the myocardial bridges (MBs) both in the coronary angiography and cadavers.

Methods

Morphological (length, thickness, deepness, the angle between the long axis of vessel and location) and angiographic properties (length, degree of systolic obstruction, frequency) of the MBs were evaluated in 50 adult cadaver hearts and in 1,321 cineangiograms.

Results

Myocardial bridges were observed in 32 of the cadaver hearts (64%) and 100 of cineangiograms (7.57%). It was observed that MBs caused significant coronary stenosis in 34 of 100 individuals leading to the prevalence of significant MB to be (2.5%) in angiography. The MBs that are above the left anterior descending artery in cadaver were classified as superficial MB (77.4%) and deep MB (22.6%). In cineangiogram, the average length of MB (MBL) was determined as 10.32 ± 4.62 mm.

Conclusion

The presence of MB, MBL and degree of luminal narrowing were not associated with the age and gender. Deepness and thickness were a major determinant of significancy of systolic obstruction by MBs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Alegria JR, Herrmann J, Holmes DR Jr, Lerman A, Rihal CS (2005) Myocardial bridging. Eur Heart J 26:1159–1168

    Article  PubMed  Google Scholar 

  2. Angelini P, Trivellato M, Donis J, Leachman RD (1983) Myocardial bridges: a review. Prog Cardiovasc Dis 26(1):75–88

    Article  CAS  PubMed  Google Scholar 

  3. Baptista CAC, Didio LJA (1992) The relationship between the directions of myocardial bridges and of the branches of the coronary arteries in the human heart. Surg Radiol Anat 14(2):137–140

    Article  CAS  PubMed  Google Scholar 

  4. Bezerra AJC, DiDio LJA, Piva L (1989) Myocardial bridge over the right coronary artery in man. Surg Radiol Anat 11:271–273

    Article  CAS  PubMed  Google Scholar 

  5. Bezerra AJC, Prates JC, DiDio LJA (1987) Incidence and clinical significance of bridges of myocardium over the coronary arteries and their branches. Surg Radiol Anat 9:273–280

    Article  CAS  PubMed  Google Scholar 

  6. Bourassa MG, Butnaru A, Lesperance J, Tardif JC (2003) Symptomatic myocardial bridges: overview of ischemic mechanisms and current diagnostic and treatment strategies. J Am Coll Cardiol 41(3):351–359

    Article  PubMed  Google Scholar 

  7. Cay S, Oztürk S, Cihan G, Kisacik HL, Korkmaz S (2006) Angiographic prevalence of myocardial bridging. Anadolu Kardiyol Derg 6:9–12

    PubMed  Google Scholar 

  8. Diefenbach C, Erbel R, Treese N, Bollenbach E, Meyer J (1994) Incidence of myocardial bridges after adrenergic stimulation and decreasing afterload in patients with angina pectoris, but normal coronary arteries. Z Kardiol 83(11):809–815 (abstract)

    CAS  PubMed  Google Scholar 

  9. Edwards JC, Burnsides C, Swarm RL, Lansing AI (1956) Arteriosclerosis in the intramural and extramural portions of coronary arteries in the human heart. Circulation 8:235–241

    Google Scholar 

  10. Eggebrecht H, Von Birgelen C, Ge J, Baumgart D, Erbel R (2002) Postextrasystolic potentiation of vessel compression in myocardial bridging: detection by intravascular sonography. J Clin Ultrasound 30(5):312–316

    Article  PubMed  Google Scholar 

  11. Fabre A, Sheppard MN (2006) Sudden adult death syndrome and other non-ischaemic causes of sudden cardiac death. Heart 92:316–320

    Article  CAS  PubMed  Google Scholar 

  12. Ferreira AG Jr, Trotter SE, Konig B Jr, Decourt LV, Fox K, Olsen EGJ (1991) Myocardial bridges: morphological and functional aspects. Br Heart J 66:364–367

    Article  PubMed  Google Scholar 

  13. Ge J, Erbel R, Rupprecht HJ, Koch L, Kearney P, Görge G, Haude M, Meyer J (1994) Comparison of intravascular ultrasound and angiography in the assessment of myocardial bridging. Circulation 89(4):1725–1732

    CAS  PubMed  Google Scholar 

  14. Ge J, Jeremias A, Rupp A, Abels M, Baumgart D, Liu F, Haude M, Görge G, von Birgelen C, Sack S, Erbel R (1999) New signs characteristic of myocardial bridging demonstrated by intracoronary ultrasound and Doppler. Eur Heart J 20:1707–1716

    Article  CAS  PubMed  Google Scholar 

  15. Geiringer E (1951) The mural coronary. Am Heart J 41:359–368

    Article  CAS  PubMed  Google Scholar 

  16. Irvin RG (1982) The angiographic prevalence of myocardial bridging in man. Chest 81:198–202

    Article  CAS  PubMed  Google Scholar 

  17. Ishii T, Hosoda Y (1986) The significance of myocardial bridges upon atherosclerosis in the left anterior descending coronary artery. J Pathol 148:279–291

    Article  CAS  PubMed  Google Scholar 

  18. Ishimori T, Raizner AE, Chahine RA, Awdeh M, Luchi RJ (1977) Myocardial bridges in man: clinical correlations and angiographic accentuation with nitroglycerin. Cathet Cardiovasc Diagn 3(1):59–65

    Article  CAS  PubMed  Google Scholar 

  19. Juilliere Y, Berder V, Suty-Selton C, Buffet P, Danchin N, Cherrier F (1995) Isolated myocardial bridges with angiographic milking of the left anterior descending coronary artery: a long-term follow-up study. Am Heart J 129(4):663–665

    Article  CAS  PubMed  Google Scholar 

  20. Kawawa Y, Ishikawa Y, Gomi T, Nagamoto M, Terada H, Ishii T, Kohda E (2007) Detection of myocardial bridge and evaluation of its anatomical properties by coronary multislice spiral computed tomography. Eur J Radiol 61(1):130–138

    Article  PubMed  Google Scholar 

  21. Kosinski A, Gryzbiak M (2001) Myocardial bridges in the human heart: morphological aspects. Folia Morphol 60(1):65–68

    CAS  Google Scholar 

  22. Kramer JR, Kitazume H, Proudfit WL, Sones FM Jr (1982) Clinical significance of isolated coronary bridges: benign and frequent condition involving the left anterior descending artery. Am Heart J 103:283–288

    Article  CAS  PubMed  Google Scholar 

  23. Lee SS, Wu TL (1972) The role of the mural coronary artery in prevention of coronary atherosclerosis. Arch Pathol 93:32–35

    CAS  PubMed  Google Scholar 

  24. Leon F, Salazar H, Moreira W, Angelini P (2006) Daughter, you broke my heart: accidental thrombosis at a muscular bridge. Tex Heart Inst J 33(4):380–382

    PubMed  Google Scholar 

  25. Lima VJ, Cavalcanti JS, Tashiro T (2002) Myocardial bridges and their relationship to the anterior interventricular branch of the left coronary artery. Arq Bras Cardiol 79(3):215–222

    Article  PubMed  Google Scholar 

  26. Mavi A, Sercelik A, Ayalp R, Karben Z, Batyraliev T, Gumusburun E (2008) The angiographic aspects of myocardial bridges in Turkish patients who have undergone coronary angiography. Ann Acad Med Singap 37:49–53

    PubMed  Google Scholar 

  27. Morales AR, Romanelli R, Boucek RJ (1980) The mural left anterior descending coronary artery, strenuous exercise and sudden death. Circulation 62(2):230–237

    CAS  PubMed  Google Scholar 

  28. Möhlenkamp S, Hort W, Ge J, Erbel R (2002) Update on myocardial bridging. Circulation 106(20):2616–2622

    Article  PubMed  Google Scholar 

  29. Noble J, Bourassa MG, Petitclerc R, Dyrda I (1976) Myocardial bridging and milking effect of the left anterior descending coronary artery: Normal variant or obstruction. Am J Cardiol 37(7):993–999

    Article  CAS  PubMed  Google Scholar 

  30. Polacek P (1961) Relation of myocardial bridges and loops on the coronary arteries to coronary occlusions. Am Heart J 61(1):44–52

    Article  CAS  PubMed  Google Scholar 

  31. Porstmann W, Iwig J (1960) Die intramurale Koronarie im Angiogramm. Fortschr Rontgenstr 92:129–132

    Google Scholar 

  32. Qian JY, Zhang F, Dong M, Ma JY, Ge L, Liu XB, Fan B, Wang QB, Cui SJ, Ge JB (2009) Prevalence and characteristics of myocardial bridging in coronary angiogram—data from consecutive 5525 patients. Chin Med J Engl 122(6):632–635

    PubMed  Google Scholar 

  33. Reyman HC (1737) Dissertatio de vasis cordis propriis. Haller, Bibl Anat 2:366

  34. Rezayat P, Hassan D, Amirreza S, Susan H (2006) Myocardial bridge: surgical outcome and midterm follow up. Saudi Med J 27(10):1530–1533

    PubMed  Google Scholar 

  35. Rozenberg VD, Nepomnyashchikh LM (2002) Pathomorphology of myocardial bridges and their role in the pathogenesis of coronary disease. Bull Exp Biol Med 134(6):593–596

    Article  CAS  PubMed  Google Scholar 

  36. Ryan TJ, Bauman WB, Kennedy JW, Kereiakes DJ, King SB, McCallister BD, Smith SC Jr, Ullyot DJ (1993) Guidelines for percutaneous transluminal coronary angioplasty. A report of the American Heart Association/American College of Cardiology Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (committee on percutaneous transluminal coronary angioplasty). Circulation 88:2987–3007

    CAS  PubMed  Google Scholar 

  37. Santos LM, Araujo EC, Sousa LNU (2006) Multi-arterial myocardial bridge: Uncommon clinical and anatomical presentations. Arq Bras Cardiol 88(4):71–73

    Google Scholar 

  38. Vidal V, Leguerrier A, Bourdonnec C, Langella B, Rioux C, Logeais Y (1988) Angiographic and surgical aspects of compressive muscular bridges and intramyocardial paths of the anterior interventricular artery (based on 12 cases). Surg Radiol Anat 10:113–120

    Article  CAS  PubMed  Google Scholar 

  39. Wymore P, Yedlicka JW, Garcia-Medina V, Olivari MT, Hunter DW, Castaneda-Zuniga WR, Amplatz K (1989) The incidence of myocardial bridges in heart transplants. Cardiovasc Intervent Radiol 12:202–206

    Article  CAS  PubMed  Google Scholar 

  40. Zhang GH, Guo JF, Zhen Y, Li WD, Bao ZH, Jiang H, Qian JY, Fan B, Ge JB (2006) The hemodynamic effect of dobutamine stress on myocardial bridging-mural coronary artery. Zhonghua Xin Xue Guan Bing Za Zhi 34(10):899–901 (abstract)

    PubMed  Google Scholar 

Download references

Acknowledgments

We are grateful to Department of Anatomy, Ankara University, Medical Faculty and Department of Anatomy, Gülhane Military Medical Faculty and Department of Anatomy, Suleyman Demirel University, Medical Faculty for the use of the cadaver hearts and dissection rooms.

Author information

Authors and Affiliations

  1. Department of Anatomy, Meram Medical Faculty, Selcuk University, Konya, 42080, Turkey

    Zeliha Fazliogullari, Ahmet Kagan Karabulut, Ismihan Ilknur Uysal & Nadire Unver Dogan

  2. Department of Cardiology, Meram Medical Faculty, Selcuk University, Konya, Turkey

    Mehmet Kayrak & Bulent Behlul Altunkeser

Authors
  1. Zeliha Fazliogullari
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ahmet Kagan Karabulut
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mehmet Kayrak
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ismihan Ilknur Uysal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nadire Unver Dogan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bulent Behlul Altunkeser
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zeliha Fazliogullari.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fazliogullari, Z., Karabulut, A.K., Kayrak, M. et al. Investigation and review of myocardial bridges in adult cadaver hearts and angiographs. Surg Radiol Anat 32, 437–445 (2010). https://doi.org/10.1007/s00276-009-0590-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-009-0590-z

Keywords

Search

Navigation