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Exploring the link between myocardial bridging and left ventricular hypertrophy: Congenital factors or remodelling?
Burak Acar1, Ozgür Cakir2, Umut Celikyurt3
1Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey. burakacarmd@yahoo.com.
Insights
Myocardial bridging (MB) severity, measured by MB muscle index, is linked to left ventricular hypertrophy (LVH) in patients undergoing coronary computed tomography angiography. This finding suggests a potential association between MB and LVH.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Myocardial bridging (MB) is increasingly detected via coronary computed tomography angiography (CCTA).
- While MB is linked to cardiomyopathies, its association with left ventricular hypertrophy (LVH) is not well-established.
- Understanding this relationship is crucial for cardiovascular health assessment.
Purpose of the Study:
- To investigate the relationship between myocardial bridging (MB) severity and left ventricular hypertrophy (LVH).
- To evaluate MB in patients referred for coronary computed tomography angiography (CCTA).
Main Methods:
- A cross-sectional study of 227 patients diagnosed with MB via 640-slice CCTA.
- MB severity was quantified using the MB muscle index (MMI).
- Left ventricular hypertrophy (LVH) was assessed using transthoracic echocardiography.
Main Results:
- Myocardial bridging (MB) was present in all patients, typically on the left anterior descending artery.
- Left ventricular hypertrophy (LVH) was identified in 36.1% of patients.
- Patients with LVH exhibited a significantly higher MB muscle index (MMI) compared to those without LVH (P=0.022).
- Positive correlations were found between left ventricular mass index and MB length (r=0.414), MMI (r=0.310), and age (r=0.191).
Conclusions:
- Myocardial bridging (MB) is a common finding in CCTA examinations.
- The severity of myocardial bridging (MB) is significantly associated with left ventricular hypertrophy (LVH).
- These findings highlight a potential link between MB severity and cardiac remodeling.
Background:
Myocardial bridging (MB) was considered a congenital anomaly and was found with increased frequency in coronary computed tomography angiography. Some case studies reported an association of MB with various cardiomyopathies. However, the association between MB severity and left ventricular hypertrophy remains unclear.
Aims:
This cross-sectional study aimed to evaluate whether myocardial bridge is related to left ventricular hypertrophy in patients referred for coronary computed tomography angiography (CCTA).
Methods:
This cross-sectional study included 227 patients (age 53.2 [11.1] years, 48% female) who underwent 640-slice CCTA and were diagnosed with MB. MB severity was measured as MB muscle index (MMI) (MB length × MB thickness), and left ventricular hypertrophy (LVH) was assessed with transthoracic echocardiography.
Results:
MB segments were detected in all patients on the left anterior descending artery. CCTA was performed to exclude coronary artery disease in most patients (90%; n = 206). Eighty-two (36.1 %) had LVH, and MMI was significantly higher in patients with LVH than those without LVH (27.3 [19.5-38.9] vs. 24 [13.8-37.1]; P = 0.022, respectively). There was a positive correlation between the left ventricular mass index and myocardial bridge length (r = 0.414; P = 0.001), MB index (r = 0.310; P <0.001), and the age of the patients (r = 0.191; P = 0.004). MB thickness and MMI were also positively correlated with relative wall thickness.
Conclusion:
MB is a common finding, and its severity is associated with left ventricular hypertrophy in patients undergoing CCTA.
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