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Myocardial perfusion GSPECT imaging in patients with myocardial bridging

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

The aim of this study was to investigate the incidence, reversibility, and severity of LV perfusion abnormalities in patients with isolated myocardial bridges using a gated myocardial perfusion SPECT study (GSPECT).

Methods

A retrospective study involved 42 patients without history of myocardial infarction, with isolated myocardial bridges detected in coronary angiography and no substantial evidence of atherosclerotic changes in coronary arteries. In all patients a gated SPECT study was performed at both rest and stress, after intravenous administration of 99mTc MIBI. Reconstructed slices were analyzed using a 20-segment model of the left ventricle.

Results

Incidence and severity of stress-induced ischemia were related to degree of artery constriction (P = .002 and .00014, respectively). Perfusion abnormalities were detected only in patients with critical narrowing (≥50%) of artery (in 12 out of 28, i.e., 43% of patients). Summed stress scores (SSS) ranged from 4 to 11 (mean 7), indicating slight or moderate defect intensity. Only 1 patient presented with a SSS value of 31 (severe defect). Perfusion defects were stress induced in 70 out of 72 (97%) segments with abnormal perfusion.

Conclusion

Perfusion abnormalities were observed in ab. 40% of patients with critical (≥50%) narrowing of artery affected by bridging and were mild, stress induced.

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References

  1. Kramer JR, Kitazime H, Proudfit WL, et al. Clinical significance of isolated coronary bridges: Benign and frequent condition involving the left anterior descending artery. Am Heart J 1982;103:283-8.

    Article  PubMed  CAS  Google Scholar 

  2. Angelini P, Trivellato M, Donis J, Lauchman RD. Myocardial bridges: A review. Progr Cardiovasc Dis 1981;26:75-88.

    Article  Google Scholar 

  3. Lozano I, Baz JA, Palop RL, et al. Long-term prognosis of patients with myocardial bridge and angiographic milking of the left anterior descending coronary artery. Rev Esp Cardiol 2002;55:359-64.

    PubMed  Google Scholar 

  4. Tauth J, Sullebarger T. Myocardial infarction associated with myocardial bridging. Catheter Cardiovasc Diag 1997;40:364-7.

    Article  CAS  Google Scholar 

  5. Bestetti RB, Costa RS, Kazara OK, Oliveira JS. Can isolated myocardial bridging of the left anterior descending coronary artery be associated with sudden death during exercise. Acta Cardiol 1991;46:27-30.

    PubMed  CAS  Google Scholar 

  6. Morales A, Romandelli R, Boucek R. The mural left anterior descending coronary artery, strenuous exercise and sudden death. Circulation 1980;62:230-9.

    PubMed  CAS  Google Scholar 

  7. Ferreira AG, Trotter SE, König B, Décourt LV, Fox K, Olsen EGJ. Myocardial bridges: Morphological and functional aspects. Br Heart J 1991;66:364-7.

    Article  PubMed  Google Scholar 

  8. Erbel R, Rupprecht HJ, Ge J, Gerber T, Görge G, Meyer J. Coronary artery shape and flow changes induced by myocardial bridging. Echocardiography 1993;10:71-7.

    Article  Google Scholar 

  9. Ge J, Erbel R, Rupprecht HJ, et al. Comparison of intravascular ultrasound and angiography in the assessment of myocardial bridging. Circulation 1994;89:1725-32.

    PubMed  CAS  Google Scholar 

  10. Schwarz ER, Klues HG, von Dahl J, et al. Functional angiographic and intracoronary doppler flow characteristics in symptomatic patients with myocardial bridging: Effect of short-term intravenous beta-blocker medication. J Am Coll Cardiol 1996;27:1637-45.

    Article  PubMed  CAS  Google Scholar 

  11. Bestetti RB, Costa RS, Zucolotto S, et al. Fatal outcome associated with autopsy proven myocardial bridging of the left anterior descending coronary artery. Eur Heart J 1989;10:573-83.

    PubMed  CAS  Google Scholar 

  12. Haager PK, Schwarz ER, von Dahl J, et al. Long-term angiographic and clinical follow-up in patients with stent implantation for symptomatic myocardial bridging. Heart 2000;84:403-8.

    Article  PubMed  CAS  Google Scholar 

  13. Berry JF, von Mering GO, Schmalfuss C, et al. Systolic compression of the left anterior descending coronary artery: A case series, review of the literature, and therapeutic options including stenting. Catheter Cardiovas Interv 2002;56:58-63.

    Article  Google Scholar 

  14. Wan L, Wu Q. Institutional report—coronary myocardial bridge, surgery or stenting? Interact Cardio Vasc Thorac Surg 2005;4:517-20.

    Article  Google Scholar 

  15. Bakir I, Riza Karaci A, Altin F, et al. Supracoronary myotomy for myocardial bridges in the setting of hypertrophic cardiomyopathy: Off-pump experience. J Cardiovasc Surg 2008;49:549-53.

    CAS  Google Scholar 

  16. Anagnostopoulos C, Harbinson M, Kelion A, et al. Procedure guidelines for radionuclide myocardial perfusion imaging. Heart 2004;90:1-10.

    Article  Google Scholar 

  17. Smanio PE, Watson DD, Segalla DL, et al. Value of gating of technetium-99m sestamibi single-photon emission computed tomographic imaging. J Am Coll Cardiol 1997;30:1687-92.

    Article  PubMed  CAS  Google Scholar 

  18. Matsumoto N, Berman DS, Kavanagh PB, et al. Quantitative assessment of motion artifacts and validation of a new motion-correction program for myocardial perfusion SPECT. J Nucl Med 2001;42:687-94.

    PubMed  CAS  Google Scholar 

  19. Momose M, Nakajima K, Nishimura T. Prognostic significance of stress myocardial Gated SPECT among Japanese patients referred for coronary angiography: A study of data from the J-ACCESS database. Eur J Nucl Med Mol Imaging 2009;36:1320-37.

    Google Scholar 

  20. Vallejo E, Morales M, Sanchez I, et al. Myocardial perfusion SPECT imaging in patients with myocardial bridging. J Nucl Cardiol 2005;12:318-23.

    Article  PubMed  Google Scholar 

  21. Huang WS, Chang HD, Yang SP, et al. Abnormal 201TL myocardial singlr photon emission computed tomography in energetic male patients with myocardial bridge. Nucl Med Commun 2002;23:1123-8.

    Article  PubMed  CAS  Google Scholar 

  22. Soran O, Gulgun P, Cetin E, et al. The incidence and significance of myocardial bridge in a prospectively designed population of patients undergoing coronary angiography for chest pain. Tokai J Exp Clin Med 2000;25:57-60.

    PubMed  CAS  Google Scholar 

  23. Lauer WJ, Carlson TA. Images in cardiovascular medicine. Myocardial bridging. Circulation 1998;98:821-33.

    PubMed  CAS  Google Scholar 

  24. Berman DS, Germano G. An approach to the interpretation and reporting of gated myocardial perfusion SPECT. In: Berman DS, Germano G, editors. Clinical gated cardiac SPECT. Armonk, NY: Futura Publishing Company, Inc; 1999. p. 147-82.

    Google Scholar 

  25. Schwarz ER, Klues HG, von Dahl J, et al. Functional characteristics of myocardial bridging a combined angiographic and intracoronary Doppler flow study. Eur Heart J 2007;18:434-42.

    Google Scholar 

  26. Klues HG, Schwarz ER, Dahl J, et al. Disturbed intracoronaty hemodynamics in myocardial bridging. Early normalization by intracoronary stent placement. Circulation 1997;96:2905-13.

    PubMed  CAS  Google Scholar 

  27. Ge J, Jeremias A, Rupp A, et al. New signs characteristic of myocardial bridging demonstrated by intracoronary ultrasound and Doppler. Eur Heart J 1999;20:1707-11.

    Article  PubMed  CAS  Google Scholar 

  28. Rivitz SM, Yasuda T. Predictive value of dipyridamole thallium imaging in a patient with myocardial bridging but without fixed obstructive coronary artery disease. J Nucl Med 1992;33:1905-13.

    PubMed  CAS  Google Scholar 

  29. Turkington TG, Bowsher JE. New technologies in nuclear medicine. In: Sandler MP, Coleman RE, Patton JA, Wackers FJTH, Gottschalk A, editors. Diagnostic nuclear medicine. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2003. p. 85-93.

    Google Scholar 

  30. Hachamovitch R, Berman DS, Leslee JS, et al. Incremental prognostic value of myocardial perfusion single photon emission computer tomography for the prediction of cardiac death: Differential stratification for risk of cardiac death and myocardial infarction. Circulation 1998;97:535-43.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, N. Copernicus Regional Hospital, Lodz, Poland

    Rafał Gawor MD, PhD & Grzegorz Piotrowski MD

  2. Department of Nuclear Medicine, Medical University of Lodz, Lodz, Poland

    Jacek Kuśmierek MD, PhD

  3. Department of Quality Control and Radiological Protection, Medical University of Lodz, Czechoslowacka 8/10, 92-216, Lodz, Poland

    Anna Płachcińska PhD & Małgorzata Bieńkiewicz PhD

  4. Department of Cardiology, Medical University of Lodz, Lodz, Poland

    Jarosław Drożdż MD, PhD

  5. Department of Invasive Cardiology, Medical University of Lodz, Lodz, Poland

    Krzysztof Chiżyński MD, PhD

Authors
  1. Rafał Gawor MD, PhD
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  2. Jacek Kuśmierek MD, PhD
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  3. Anna Płachcińska PhD
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  4. Małgorzata Bieńkiewicz PhD
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  5. Jarosław Drożdż MD, PhD
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  6. Grzegorz Piotrowski MD
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  7. Krzysztof Chiżyński MD, PhD
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Corresponding author

Correspondence to Anna Płachcińska PhD.

Additional information

See related editorial, doi:10.1007/s12350-011-9443-3.

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Gawor, R., Kuśmierek, J., Płachcińska, A. et al. Myocardial perfusion GSPECT imaging in patients with myocardial bridging. J. Nucl. Cardiol. 18, 1059–1065 (2011). https://doi.org/10.1007/s12350-011-9406-8

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  • DOI: https://doi.org/10.1007/s12350-011-9406-8

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