Multidetector Computed Tomography Findings of Myocardial Bridge and Its Relationship With Coronary Calcification

This study aimed to evaluate the prevalence and anatomical characteristics of myocardial bridge (MB) using multidetector computed tomography (MDCT) and to investigate its relationship with coronary artery calcification and atherosclerotic burden.

We retrospectively analyzed 7024 patients who underwent MDCT for cardiac complaints between November 2010 and December 2020. The length and thickness of MBs were measured, and coronary calcification was quantified using the Agatston score. Patients were categorized according to the degree of coronary stenosis (< 50% or ≥ 50%) to assess the association between MB and calcification severity.

The prevalence of MB was 7.7% (542 patients). The most common complaints in patients with MB were atypical chest pain (76%) and stable angina (24%). MB was most commonly detected in the middle segment of the LAD artery (65.68%). Mild atherosclerotic plaque (31%), moderate atherosclerotic plaque (13%), and severe atherosclerotic plaque and stenosis (5%) were present in 51% of patients with MB. Significant calcification was found in 23% of MB patients, who had higher calcification scores, particularly those with coronary artery stenosis greater than 50%.

MDCT serves as an effective noninvasive method not only for detecting MB but also for evaluating concomitant coronary calcification and early atherosclerotic changes. Early identification of calcification in MB patients may guide individualized cardiovascular assessment, focusing on noninvasive imaging, risk factor control, and preventive therapy similar to standard protocols for atherosclerosis management.