New signs characteristic of myocardial bridging demonstrated by intracoronary ultrasound and Doppler
J Ge1, A Jeremias, A Rupp
1Department of Cardiology, Division of Internal Medicine, University Essen, Essen, Germany.
European Heart Journal
|November 24, 1999
Summary
Myocardial bridging diagnosis is improved by identifying a unique "half moon" ultrasound sign and systolic compression. These findings, along with specific Doppler flow patterns, aid in diagnosing this coronary artery condition.
Area of Science:
- Cardiology
- Medical Imaging
- Vascular Physiology
Background:
- Discrepancies in myocardial bridging incidence reported between angiography (0.5%-2.5%) and autopsy (15%-85%).
- Need for improved diagnostic parameters for myocardial bridging syndrome.
Purpose of the Study:
- To investigate myocardial bridging morphology and flow characteristics using intravascular ultrasound (IVUS) and intracoronary Doppler.
- To identify feasible diagnostic parameters for myocardial bridging.
Main Methods:
- Intravascular ultrasound (IVUS) performed in 69 patients with suspected myocardial bridging.
- Intracoronary Doppler utilized in 48 patients to assess flow dynamics.
- Analysis of specific ultrasound phenomena and Doppler flow patterns.
Main Results:
- Identified a consistent 'half moon' echolucent area around myocardial bridges on IVUS.
- Observed systolic compression of the bridge segment with significant lumen reduction (36.4%).
- Detected an early diastolic 'finger tip' flow phenomenon and reduced/absent systolic antegrade flow with Doppler.
Conclusions:
- Myocardial bridging is characterized by a specific 'half moon' sign, systolic compression, and distinctive Doppler flow patterns.
- These findings provide reliable morphological and functional parameters for diagnosing myocardial bridging.
- Atherosclerotic involvement was noted in proximal segments, but not within the bridge itself.
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