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Relationship between myocardial bridge compression severity and haemodynamic perturbations.
Ashkan Javadzadegan1,2, Abouzar Moshfegh1,2,3, Hamid Hassanzadeh Afrouzi4,5
1a Faculty of Medicine and Health Sciences , Macquarie University , Sydney , NSW , Australia.
Computer Methods in Biomechanics and Biomedical Engineering
|March 19, 2019
Summary
Myocardial bridging (MB) severity impacts coronary hemodynamics. Increased vessel compression in MB leads to reduced shear stress and prolonged blood residence time in the proximal segment.
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
- Medical Imaging
Background:
- Myocardial bridging (MB) is a congenital anomaly where a segment of a coronary artery travels through the heart muscle.
- The hemodynamic consequences of varying MB severity are not fully understood.
- Understanding these effects is crucial for assessing clinical significance and potential interventions.
Purpose of the Study:
- To investigate how increasing myocardial bridging severity affects coronary hemodynamics.
- To analyze alterations in blood residence time and shear stress in relation to vessel compression.
Main Methods:
- Utilized angiography and intravascular ultrasound in 10 patients with myocardial bridging.
- Developed computational fluid dynamics models of myocardial bridging.
- Performed transient simulations to derive blood residence time and shear stress distributions.
Main Results:
- Increased bridge compression correlated with decreased proximal shear stress and increased proximal blood residence time.
- Major systolic compression (>27.38%CRave) showed significantly lower proximal shear stress (0.37±0.23 Pa) and higher residence time (0.0037±0.0069 s) compared to minor compression.
- Major compression led to higher shear stress within the bridge segment (2.49±2.06 Pa) versus minor compression (1.13±0.89 Pa).
Conclusions:
- A direct relationship exists between myocardial bridging compression severity and proximal hemodynamic changes.
- Increased systolic vessel compression is associated with reduced shear stress and elevated blood residence time.
- These findings highlight the hemodynamic impact of MB severity on coronary blood flow patterns.
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