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Prognostic impact of myocardial bridge on long-term mortality and morbidity: A meta-analysis and systematic review

Yasir Salah Alam1, Hussein Nafakhi2,3, Liwaa Mahdi4

  • 1Department of Internal medicine, Faculty of Medicine, University of Kufa, P.O. Box 21, Kufa, Iraq.

The International Journal of Cardiovascular Imaging
|March 3, 2026
PubMed

Insights

Myocardial bridges (MB) are linked to major adverse cardiac events (MACE), but not all-cause or cardiovascular death. Diagnostic methods and patient risk factors influence this association, highlighting the need for careful evaluation of MB in clinical practice.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Medical Diagnostics

Background:

  • The clinical significance of myocardial bridges (MB) is debated due to inconsistent reporting.
  • Variations in patient populations and diagnostic techniques complicate MB's relevance.
  • This study addresses the uncertainty surrounding MB's association with long-term health outcomes.

Purpose of the Study:

  • To evaluate the relationship between myocardial bridges (MB) and long-term mortality and morbidity.
  • To analyze the impact of different diagnostic methods and patient subgroups on MB's clinical relevance.
  • To clarify the association of MB with all-cause death (ACD), cardiovascular death (CVD), and major adverse cardiac events (MACE).

Main Methods:

  • A systematic literature review was performed, including studies published up to December 2024.
  • The search focused on studies investigating the link between MB and adverse cardiac outcomes (ACD, CVD, MACE).
  • Meta-analysis and subgroup analyses were conducted to pool data and explore heterogeneity.

Main Results:

  • 22 studies with 37,940 participants were analyzed.
  • Myocardial bridges (MB) showed no significant association with all-cause death (ACD) or cardiovascular death (CVD).
  • MB was significantly associated with major adverse cardiac events (MACE) (HR: 1.958).
  • Conventional coronary angiography detected MB linked to higher MACE risk (HR: 1.992), unlike multi-detector computed tomography.
  • In high-risk groups (hypertrophic cardiomyopathy, high-risk CAD), MB significantly increased MACE risk (HRs: 2.174 and 3.435, respectively).

Conclusions:

  • Myocardial bridges (MB) are associated with an increased risk of major adverse cardiac events (MACE).
  • No significant association was found between MB and isolated all-cause death (ACD) or cardiovascular death (CVD).
  • Diagnostic method and patient risk profile are critical factors in assessing MB's clinical impact.
Abstract

Keywords:
Meta-analysisMorbidityMortalityMyocardial bridge

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