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Atherosclerotic pattern of coronary myocardial bridging assessed with CT coronary angiography

Ludovico La Grutta1, Giuseppe Runza, Massimo Galia

  • 1Department of Radiology, DIBIMEF, University Hospital P. Giaccone, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy. ludovicolagrutta@hotmail.it

The International Journal of Cardiovascular Imaging
|February 25, 2011
PubMed

Insights

Coronary myocardial bridging (MB) segments are free of atherosclerosis. Atherosclerotic patterns differ in segments near MB, suggesting MB influences coronary artery disease distribution.

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Pathology

Background:

  • Myocardial bridging (MB) is a congenital anomaly where a segment of a coronary artery tunneled within the myocardium.
  • The relationship between MB and the distribution of coronary atherosclerosis remains incompletely understood.
  • Non-invasive imaging modalities are crucial for evaluating coronary artery anatomy and disease.

Purpose of the Study:

  • To investigate the atherosclerotic pattern in patients with coronary myocardial bridging (MB) using CT Coronary Angiography (CT-CA).
  • To assess the distribution and characteristics of coronary plaques in relation to MB segments.
  • To compare atherosclerotic patterns in segments adjacent to MB with those in other coronary segments.

Main Methods:

  • Retrospective analysis of 254 patients who underwent 64-slice CT-CA.
  • Identification and assessment of myocardial bridging (MB) presence and location.
  • Evaluation of coronary plaque characteristics, including stenosis severity and remodeling, in segments proximal and distal to MB.

Main Results:

  • Myocardial bridging (MB) was identified in 29% of patients, predominantly in the mid-distal left anterior descending artery.
  • The MB segment itself was consistently free of atherosclerosis.
  • Segments proximal to MB showed varying degrees of atherosclerotic disease, including positive remodeling and stenoses.
  • Segments distal to MB exhibited a significantly different atherosclerotic pattern compared to proximal segments (P < 0.0001).
  • Atherosclerotic lesion patterns in segments 6 and 7 differed significantly between patients with and without MB (P < 0.05).

Conclusions:

  • CT Coronary Angiography (CT-CA) is a reliable non-invasive tool for demonstrating myocardial bridging (MB) and its associated atherosclerotic patterns.
  • The atherosclerotic distribution in coronary segments adjacent to myocardial bridging (MB) differs significantly from segments without MB.
  • Findings provide new insights into how myocardial bridging (MB) may influence the development and distribution of coronary atherosclerosis.

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