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Published on: August 28, 2018
The prevalence of myocardial bridging on multidetector computed tomography and its relation to coronary plaques
Ravindran Rajendran1, Madhav Hegde2
1Trichy SRM Medical College Hospital & Research Centre, Irungalur, Trichy, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.
Insights
Myocardial bridging, a condition where heart muscle covers an artery, was found in 10% of patients. Contrary to the hypothesis, the segment near myocardial bridges showed fewer plaques, with a lower length-to-depth ratio in those with plaques.
Area of Science:
- Cardiovascular research
- Medical imaging analysis
- Coronary artery disease epidemiology
Background:
- Myocardial bridging is a congenital anomaly where a segment of a coronary artery travels through the heart muscle.
- The association between myocardial bridging and coronary atherosclerosis remains a subject of investigation.
Purpose of the Study:
- To investigate the prevalence of myocardial bridging across different ethnic groups.
- To determine if the segment proximal to myocardial bridging is more susceptible to atherosclerotic plaque formation.
Main Methods:
- Retrospective analysis of 4500 patients undergoing CT coronary angiography.
- Comparison of clinical data and coronary angiography findings between patients with and without myocardial bridging.
- Calculation of the length-to-depth ratio (RA-MA ratio) for bridged segments.
Main Results:
- The prevalence of myocardial bridging was 10%, most commonly in the mid left anterior descending artery (LAD).
- The prevalence of atherosclerotic plaques proximal to the bridged segment (37.8%) was lower than in patients without myocardial bridging (48.7%).
- A significantly lower RA-MA ratio was observed in patients with proximal atherosclerotic plaques compared to those without.
Conclusions:
- Myocardial bridging prevalence in the study population was 10%, with the mid LAD being the most affected segment.
- The study did not support the hypothesis that the segment proximal to myocardial bridging is more prone to plaque formation.
- Coronary plaque prevalence and distribution in the LAD were similar in patients with and without myocardial bridging.
Purpose:
To test the hypothesis that the prevalence of myocardial bridging varies between ethnic groups, and that the segment proximal to the myocardial bridge is more prone to plaque formation.
Material And Methods:
A total of 4500 patients who had undergone computerised tomography (CT) coronary angiography at our institute were studied for myocardial bridging. Data on the clinical profile and indication for CT coronary angiography in myocardial bridging were collected. Patients with and without proximal disease were compared using the chi-square test for ordinal variables and Student's t-test for continuous variables. The length to depth ratio (RA-MA ratio) of the bridged segment was determined.
Results:
The prevalence of atherosclerotic plaques in the segment proximal to the bridged segment was 37.8%, which was lower than the prevalence of 48.7% for plaques in the corresponding segments among patients without myocardial bridging. The average length of the bridged segment was 15.5 ± 5 mm, and that for patients with and without proximal plaques was 13 ± 4 and 16 ± 6 mm (p = 0.1), respectively. Similarly, the average depth of the segments with and without proximal plaques was 1.8 ± 0.6 mm and 1.4 ± 0.5 mm (p = 0.06), respectively. Only the RA-MA ratio (8 ± 3 vs. 13 ± 6, p = 0.01) was significantly lower in patients with atherosclerotic plaques.
Conclusions:
The prevalence in our study population was 10%, with mid left anterior descending artery (LAD) being the most common segment involved. Moreover, the prevalence and distribution of coronary plaques in LAD were similar in patients with and without myocardial bridging.
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