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High Prevalence and Clinical Implication of Myocardial Bridging in Patients with Early Repolarization

Jiwon Seo1, Junbeom Park2, Jaewon Oh1

  • 1Department of Internal Medicine, Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea.

Yonsei Medical Journal
|November 23, 2016
PubMed

Insights

Myocardial bridging (MB) is significantly associated with early repolarization (ER) in patients undergoing coronary angiography. Notched ER patterns are linked to MB in the left anterior descending artery, suggesting a potential link to cardiac events.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Diagnostic Imaging

Background:

  • Early repolarization (ER) is increasingly linked to myocardial ischemia.
  • Myocardial bridging (MB), a congenital anomaly causing coronary artery compression, can manifest as ischemic symptoms.
  • Understanding the relationship between ER and MB is crucial for diagnosing and managing cardiac conditions.

Purpose of the Study:

  • To investigate the association between myocardial bridging (MB) and early repolarization (ER) in patients.
  • To determine the prevalence and prognostic implications of MB in patients with and without ER.

Main Methods:

  • A cohort of 1303 patients undergoing coronary angiography was analyzed.
  • Prevalence of MB was compared between patients with ER (n=142) and without ER (n=1161).
  • Multivariate analysis identified independent predictors of MB and ER.

Main Results:

  • MB was found in 38% of ER patients versus 17% of non-ER patients (p<0.001).
  • MB was independently associated with ER (OR: 2.9, p<0.001).
  • Notched ER was more common in MB involving the mid-LAD (69.8% vs. 30.2%, p=0.03).
  • Cardiac events were more frequent in ER patients (6.3% vs. 1.9%).
  • MB was observed in 22% of sudden death patients with ER compared to 0% without ER.

Conclusions:

  • Myocardial bridging is independently associated with early repolarization in patients without structural heart disease.
  • Notched ER patterns correlate with MB in the mid-left anterior descending artery.
  • A higher prevalence of MB was noted in ER patients experiencing cardiac events, warranting further investigation.
Abstract

Keywords:
Early repolarizationmyocardial bridgingsudden cardiac deathtachycardiaventricularventricular fibrillation

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