Abstract
To identify factors that can affect systolic compression of myocardial bridging (MB) of the mid-left anterior descending (LAD) coronary artery with dual-source computed tomography (DSCT). Patients with mid-LAD MB (n = 198) detected by DSCT were studied. MB was classified as incomplete superficial (IS), complete superficial (CS), and deep (D) type. The depth and length of the mid-LAD MB segment in diastole, luminal reduction of the tunneled LAD segment in systole, and degree of systolic left ventricular (LV) wall thickening were all analyzed. Correlation between the depth, length, degree of systolic LV wall thickening, and luminal narrowing in the systolic phase was evaluated. Eighty-one (40.9%) MB were IS, 37 (18.7%) were CS, and 80 (40.4%) were D type. Significant differences in the degree of luminal narrowing in the systolic phase were found among the three MB types (IS, 19.9 ± 10.1%; CS, 26.9 ± 12.1%; D, 36.6 ± 13.8%; P < 0.0001). The luminal narrowing in the systolic phase correlated with the depth (r = 0.56) and percentage of systolic LV wall thickening (r = 0.44), but was not related to length (r = 0.28). In addition to the degree of LV systolic wall thickening and depth of MB, the types of MB also affect luminal narrowing in the systolic phase.
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Abbreviations
- CCTA:
-
Cardiac computed tomography angiography
- DSCT:
-
Dual-source computed tomography
- ECG:
-
Electrocardiography
- ICA:
-
Invasive coronary angiography
- LAD:
-
Left anterior descending
- LV:
-
Left ventricular
- MDCT:
-
Multi-detector computed tomography
- MB:
-
Myocardial bridging
- VHD:
-
Valvular heart disease
References
Mohlenkamp S, Hort W, Ge J et al (2002) Update on myocardial bridging. Circulation 106(20):2616–2622
Polacek P, Kralove H (1961) Relation of myocardial bridges and loops on the coronary arteries to coronary occulsions. Am Heart J 61:44–52
Kracoff OH, Ovsyshcher I, Gueron M (1987) Malignant course of a benign anomaly: myocardial bridging. Chest 92(6):1113–1115
Kramer JR, Kitazume H, Proudfit WL et al (1982) Clinical significance of isolated coronary bridges: benign and frequent condition involving the left anterior descending artery. Am Heart J 103(2):283–288
Bestetti RB, Oliveira JS (1989) Myocardial bridging of a coronary artery—a not-so-benign anomaly. Chest 95(3):706–707
Alegria JR, Herrmann J, Holmes DR Jr et al (2005) Myocardial bridging. Eur Heart J 26(12):1159–1168
Tauth J, Sullebarger T (1997) Myocardial infarction associated with myocardial bridging: case history and review of the literature. Cathet Cardiovasc Diagn 40(4):364–367
Noble J, Bourassa MG, Petitclerc R et al (1976) Myocardial bridging and milking effect of the left anterior descending coronary artery: normal variant or obstruction? Am J Cardiol 37(7):993–999
Rossi L, Dander B, Nidasio GP et al (1980) Myocardial bridges and ischemic heart disease. Eur Heart J 1(4):239–245
Bestetti RB, Finzi LA, Amaral FT et al (1987) Myocardial bridging of coronary arteries associated with an impending acute myocardial infarction. Clin Cardiol 10(2):129–131
Kim JW, Park CG, Suh SY et al (2007) Comparison of frequency of coronary spasm in Korean patients with versus without myocardial bridging. Am J Cardiol 100(7):1083–1086
Ishii T, Asuwa N, Masuda S et al (1998) The effects of a myocardial bridge on coronary atherosclerosis and ischaemia. J Pathol 185(1):4–9
Amoroso G, Battolla L, Gemignani C et al (2004) Myocardial bridging on left anterior descending coronary artery evaluated by multidetector computed tomography. Int J Cardiol 95(2–3):335–337
Goitein O, Lacomis JM (2005) Myocardial bridging: noninvasive diagnosis with multidetector CT. J Comput Assist Tomogr 29(2):238–240
Kantarci M, Duran C, Durur I et al (2006) Detection of myocardial bridging with ECG-gated MDCT and multiplanar reconstruction. AJR Am J Roentgenol 186(6 Suppl 2):S391–S394
Zeina AR, Odeh M, Blinder J et al (2007) Myocardial bridge: evaluation on MDCT. AJR Am J Roentgenol 188(4):1069–1073
Ko SM, Choi JS, Nam CW et al (2008) Incidence and clinical significance of myocardial bridging with ECG-gated 16-row MDCT coronary angiography. Int J Cardiovasc Imaging 24(4):445–452
Hwang JH, Ko SM, Roh HG et al (2010) Myocardial bridging of the left anterior descending coronary artery: depiction rate and morphologic features by dual-source CT coronary angiography. Korean J Radiol 11(5):514–521
Leschka S, Koepfli P, Husmann L et al (2008) Myocardial bridging: depiction rate and morphology at CT coronary angiography—comparison with conventional coronary angiography. Radiology 246(3):754–762
Kim PJ, Hur G, Kim SY et al (2009) Frequency of myocardial bridges and dynamic compression of epicardial coronary arteries: a comparison between computed tomography and invasive coronary angiography. Circulation 119(10):1408–1416
Liu SH, Yang Q, Chen JH et al (2010) Myocardial bridging on dual-source computed tomography: degree of systolic compression of mural coronary artery correlating with length and depth of the myocardial bridge. Clin Imaging 34(2):83–88
Matt D, Scheffel H, Leschka S et al (2007) Dual-source CT coronary angiography: image quality, mean heart rate, and heart rate variability. AJR Am J Roentgenol 189(3):567–573
Konen E, Goitein O, Sternik L et al (2007) The prevalence and anatomical patterns of intramuscular coronary arteries: a coronary computed tomography angiographic study. J Am Coll Cardiol 49(5):587–593
Geiringer E (1951) The mural coronary. Am Heart J 41(3):359–368
Qian JY, Zhang F, Dong M et al (2009) Prevalence and characteristics of myocardial bridging in coronary angiogram—data from consecutive 5525 patients. Chin Med J (Engl) 122(6):632–635
Ferreira AG Jr, Trotter SE, Konig B Jr et al (1991) Myocardial bridges: morphological and functional aspects. Br Heart J 66(5):364–367
Morales AR, Romanelli R, Tate LG et al (1993) Intramural left anterior descending coronary artery: significance of the depth of the muscular tunnel. Hum Pathol 24(7):693–701
Kawawa Y, Ishikawa Y, Gomi T et al (2007) Detection of myocardial bridge and evaluation of its anatomical properties by coronary multislice spiral computed tomography. Eur J Radiol 61(1):130–138
Zhang LJ, Yang GF, Zhou CS et al (2009) Multiphase evaluation of myocardial bridging with dual-source computed tomography. Acta Radiol 50(7):775–780
Angelini P, Trivellato M, Donis J et al (1983) Myocardial bridges: a review. Prog Cardiovasc Dis 26(1):75–88
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Kim, S.S., Ko, S.M., Song, M.G. et al. Systolic luminal narrowing and morphologic characteristics of myocardial bridging of the mid-left anterior descending coronary artery by dual-source computed tomography. Int J Cardiovasc Imaging 27 (Suppl 1), 73–83 (2011). https://doi.org/10.1007/s10554-011-9959-2
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DOI: https://doi.org/10.1007/s10554-011-9959-2