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The morphologic and functional features of LAD myocardial bridging at multi-detector computed tomography coronary
Alper Aydın1, Rahmi Çubuk2, Mehmet Mahir Atasoy2
1Department of Cardiology, Bahçeşehir University Faculty of Medicine, İstanbul, Turkey. dralperaydin@gmail.com.
Insights
Myocardial bridging (MB) depth, evaluated by MDCT coronary angiography, correlates with systolic compression. However, MB morphologic features do not predict coronary artery disease (CAD) presence.
Area of Science:
- Cardiovascular Imaging
- Cardiac Anatomy
- Interventional Cardiology
Background:
- Myocardial bridging (MB) is a congenital anomaly where a segment of a coronary artery tunneled within the myocardium.
- The clinical significance of MB and its association with atherosclerosis remain areas of active investigation.
Purpose of the Study:
- To retrospectively assess morphologic and functional characteristics of MB using multi-detector computed tomography (MDCT) coronary angiography.
- To investigate the relationship between MB morphologic features and the presence of atherosclerosis in the coronary arteries.
Main Methods:
- Retrospective analysis of 191 consecutive patients undergoing MDCT coronary angiography.
- Detailed evaluation of MB morphologic features, including depth, length, and distance from the left coronary ostium.
- Correlation analysis between MB characteristics, systolic compression, and coronary artery disease (CAD) presence.
Main Results:
- MB was detected in 41 patients (21.5%), predominantly in the left anterior descending artery.
- A significant correlation was observed between the percentage of systolic compression and the depth of the tunneled MB segment (r=0.538, p<0.01).
- No significant relationship was found between MB morphologic features (depth, length, distance from ostium) and the presence of proximal CAD.
Conclusions:
- MDCT coronary angiography effectively visualizes MB morphologic and functional attributes.
- MB depth is a key determinant of systolic compression, while other morphologic features do not appear to influence compression or predict CAD.
- Further research is warranted to elucidate the precise role of MB in the pathogenesis of coronary atherosclerosis.
Objectives:
The aim of this study was to retrospectively evaluate the morphologic and functional features of myocardial bridging (MB) and to investigate the impact of morphologic features on presence of atherosclerosis with multi-detector computed tomography (MDCT) coronary angiography.
Study Design:
The study population consisted of 191 consecutive patients. Besides coronary lesions, morphologic features of the MB (depth, length and the distance of the tunneled artery from the left coronary ostium) were analyzed.
Results:
MDCT detected MB on left anterior descending artery in 41 patients (21.5%). The prevalence of atherosclerotic plaques proximal to the MB of LAD was 49% (20/41). There was a statistically significant correlation between percentage of systolic compression and depth of the tunneled segment (r=0.538, p<0.01). There was no relation between distance of the tunneled segment from the ostium and degree of systolic compression. No significant correlation was found between percentage of systolic compression and length of the tunneled segment (r=0.058, p=0.721). Morphologic features of MB were not related to the presence of CAD in proximal segments.
Conclusion:
MDCT coronary angiography depicts the morphologic and functional features of the MB in detail. The depth of MB segment was correlated with systolic compression of MB. There was no relationship between distance of the tunneled segment from the ostium and systolic compression.
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