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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Evaluation of myocardial bridges with 64-slice computed tomography coronary angiography
Fatih Bayrak1, Muzaffer Degertekin, Elif Eroglu
1Yeditepe University Hospital, Cardiology Department, Istanbul, Turkey.
Insights
Myocardial bridging (MB) is a common finding in coronary arteries, and this study used 64-slice computed tomography to analyze its characteristics. Researchers found that MB may protect the distal segments of bridged arteries from atherosclerosis.
Area of Science:
- Cardiovascular Imaging
- Interventional Cardiology
- Radiology
Background:
- Myocardial bridging (MB) is a congenital anomaly where a segment of a coronary artery travels through the heart muscle.
- The relationship between MB and coronary artery disease (CAD) remains an area of investigation.
Purpose of the Study:
- To characterize myocardial bridging (MB) using 64-slice computed tomography (CT).
- To investigate the association between MB and atherosclerotic coronary artery disease (CAD).
Main Methods:
- 990 patients undergoing CT coronary angiography for suspected CAD were evaluated for MB.
- Axial, curved multiplanar reconstruction, and 3D volume-rendered images were used for MB assessment.
- Prevalence of atherosclerotic plaques in segments proximal and distal to MB was analyzed.
Main Results:
- Myocardial bridging was identified in 22.5% of patients, with most located in the left anterior descending (LAD) artery.
- No significant difference in proximal LAD atherosclerosis was observed between patients with and without MB.
- A significantly lower prevalence of atherosclerotic plaques was found in the distal LAD segments of patients with MB.
Conclusions:
- 64-slice CT coronary angiography effectively visualizes MB and its relationship with atherosclerotic plaques.
- MB does not appear to increase the risk of proximal coronary atherosclerosis.
- MB may offer a protective effect against atherosclerosis in the distal segments of the bridged coronary artery.
Objective:
The aim of this study is to report the characteristics of myocardial bridging (MB) using 64-slice computed tomography and to demonstrate the association between atherosclerotic coronary artery disease (CAD) and MB.
Methods And Results:
In 990 consecutive patients who underwent multi-slice computed tomography (MSCT) coronary angiography for suspected or known coronary artery disease, myocardial bridge evaluation was performed with axial, curved multiplanar reconstruction and three-dimensional volume-rendered images. 265 bridged segments were identified in 223 (22.5%) patients. Multiple MBs on left coronary arteries were found in 41 patients. Most of the MBs were in the LAD (62.6%), followed by the obtuse marginal artery (14.7%) and diagonal artery (14.3%). The average length of MBs was 14 +/- 7 mm, and the average depth was 1.6 +/- 11 mm. No significant difference was observed between patients with and without MB on the middle LAD in respect of age, gender, prevalence of diabetes, hyperlipidaemia, hypertension, current smoking and prevalence of atherosclerotic plaques at the proximal LAD. On the other hand, prevalence of atherosclerotic plaques at the distal LAD were significantly lower in patients with MB on the middle LAD (3.5% vs. 19.7%, P: 0.0001).
Conclusions:
The presence and morphological characteristics of MB and its relation with atherosclerotic plaques in the involved coronary artery can be comprehensively analysed with 64-slice computed tomography coronary angiography. Atherosclerosis is a common finding in segments proximal to MB, but the prevalence of plaques in equivalent segments (proximal LAD in our study) is not higher than in patients under similar coronary artery disease risk and without MB. On the other hand, prevalence of atherosclerotic plaques at the distal LAD was significantly lower in our patients with MB on the middle LAD. Finally, we suggest that rather than causing proximal atherosclerosis, MB might have a more important role in the protection of distal segments of the bridged arteries from atherosclerosis.
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