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Multimodality Imaging in the Assessment of the Physiological Significance of Myocardial Bridging

  • Nuclear Cardiology (V Dilsizian, Section Editor)
  • Published:
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Abstract

In myocardial bridging (MB) a segment of the coronary artery is covered by the myocardium. MB can be seen as a systolic compression by invasive coronary angiography (ICA) or as an intramural course by computed tomography angiography (CTA). Intramural course is a common incidental finding in CTA studies. Only minority of the bridging segments are associated with systolic compression causing a possible impairment of myocardial perfusion. The relationship between myocardial blood flow and MB is complex and poorly evaluated by anatomic imaging. Furthermore, provocation tests are frequently needed to uncover systolic compression. Fractional flow reserve can be used to assess the hemodynamic significance of MB. Nuclear perfusion imaging can demonstrate flow abnormalities associated with MB. Stress echocardiography can demonstrate ischemic wall motion abnormalities. They can be complemented by hybrid imaging with CTA to distinguish epicardial coronary artery disease and MB. This article will review different imaging modalities for the evaluation of the physiologic significance of MB.

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Acknowledgments

The study was financially supported by the Academy of Finland Centre of Excellence on Cardiovascular and Metabolic Diseases, the Finnish Foundation for Cardiovascular Research, and the Turku University Hospital.

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Authors and Affiliations

  1. Turku PET Centre, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20520, Turku, Finland

    Valtteri Uusitalo, Antti Saraste & Juhani Knuuti

  2. Heart Center, Turku University Hospital, University of Turku, Turku, Finland

    Antti Saraste

  3. Department of Clinical Physiology, Nuclear Medicine and PET, Turku University Hospital, University of Turku, Turku, Finland

    Juhani Knuuti

Authors
  1. Valtteri Uusitalo
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Correspondence to Valtteri Uusitalo.

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Conflict of Interest

Valtteri Uusitalo declares no conflict of interest.

Antti Saraste reports personal fees from GE, Novartis, Abbott, Actelion, and Lilly.

Juhani Knuuti reports grants from Cardirad Oy and personal fees from GE Healthcare.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Nuclear Cardiology

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Uusitalo, V., Saraste, A. & Knuuti, J. Multimodality Imaging in the Assessment of the Physiological Significance of Myocardial Bridging. Curr Cardiol Rep 18, 2 (2016). https://doi.org/10.1007/s11886-015-0685-6

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  • DOI: https://doi.org/10.1007/s11886-015-0685-6

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