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De Ornelas B, Sucato V, Vadalà G, Buono A, Galassi AR. Myocardial Bridge and Atherosclerosis, an Intimal Relationship. Curr Atheroscler Rep 2024; 26:353-366. [PMID: 38822987 DOI: 10.1007/s11883-024-01219-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2024] [Indexed: 06/03/2024]
Abstract
PURPOSE OF REVIEW This review investigates the relationship between myocardial bridges (MBs), intimal thickening in coronary arteries, and Atherosclerotic cardiovascular disease. It focuses on the role of mechanical forces, such as circumferential strain, in arterial wall remodeling and aims to clarify how MBs affect coronary artery pathology. REVIEW FINDINGS MBs have been identified as influential in modulating coronary artery intimal thickness, demonstrating a protective effect against thickening within the MB segment and an increase in thickness proximal to the MB. This is attributed to changes in mechanical stress and hemodynamics. Research involving arterial hypertension models and vein graft disease has underscored the importance of circumferential strain in vascular remodeling and intimal hyperplasia. Understanding the complex dynamics between MBs, mechanical strain, and vascular remodeling is crucial for advancing our knowledge of coronary artery disease mechanisms. This could lead to improved management strategies for cardiovascular diseases, highlighting the need for further research into MB-related vascular changes.
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Affiliation(s)
- Benjamin De Ornelas
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
| | - Vincenzo Sucato
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Giuseppe Vadalà
- Division of Cardiology, University Hospital "P. Giaccone", Palermo, Italy
| | - Andrea Buono
- Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Institute, Brescia, Italy
| | - Alfredo Ruggero Galassi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
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Rojas-Granados A, Pérez-Campos E, Sanchez-Sanchez M, Chávez MAM, Pérez-Campos-Mayoral L, Ángeles-Castellanos M. Prevalence of myocardial bridges in the Mexican population: A morphometric and histological analysis. Morphologie 2024; 108:100760. [PMID: 38157748 DOI: 10.1016/j.morpho.2023.100760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Myocardial bridge (MB) is described as an abnormal band of myocardium covering a variable portion of any coronary artery. METHODS The current study explores the presence of MB throughout the coronary arterial system and provides a morphometric description through instrumented dissection of a sample of 100 human hearts. The study shows a higher prevalence of MB in the Mexican population than in previous reports. RESULTS In the total sample (n=100), MB was identified in 96% of it. A total of 421 MBs were observed, with a mean of 4.38mm (±0.28) per dissected heart. The most frequently affected vessel is the anterior interventricular artery where a total of 52 MBs were found, of the total sample studied. DISCUSSION The high prevalence of MB among Mexican patients could be the result of a genetic association for this population or the neoformation of MB after birth due to lifestyle-associated factors. Further studies are required to better understand the high prevalence of MB among Mexican subjects.
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Affiliation(s)
- A Rojas-Granados
- Departamento de Anatomia, Facultad de Medicina. Universidad Nacional Autónoma de México, México, Mexico
| | - E Pérez-Campos
- Tecnológico Nacional de México/IT, Oaxaca, Oaxaca City, Mexico
| | - M Sanchez-Sanchez
- Posgrado Facultad de Odontologia, Universidad Autónoma Benito Juárez de Oaxaca, Oaxaca, Mexico
| | - M A M Chávez
- Facultad de Medicina y Cirugia, Universidad Autónoma Benito Juárez de Oaxaca, Oaxaca, Mexico
| | - L Pérez-Campos-Mayoral
- Facultad de Medicina y Cirugia, Universidad Autónoma Benito Juárez de Oaxaca, Oaxaca, Mexico
| | - M Ángeles-Castellanos
- Departamento de Anatomia, Facultad de Medicina. Universidad Nacional Autónoma de México, México, Mexico; Departamento de Innovacion en Material Biologico Humano, Facultad de Medicina, Universidad Nacional Autonoma de Mexico, México, Mexico.
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3
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Koesbandono, Lukito AA, Muljadi R, Yuniarti M, Sindunata NA, Sarikie A, Pratama TA, Thio RS, Christanti J, Octavius GS. High Prevalence of Myocardial Bridging Detected in an Indonesian Population Using Multi-Detector Computed Tomography. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:794. [PMID: 38792977 PMCID: PMC11123036 DOI: 10.3390/medicina60050794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Myocardial bridging (MB) is still not yet considered a significant finding in Indonesia both radiographically and clinically. Hence, this article aims to assess the prevalence of MB using multi-detector computed tomography (MDCT) and look at factors contributing to stenosis amongst patients with MB. Materials and Methods: This study is cross-sectional in a single centre, with consecutive sampling, looking at all patients who underwent a multi-detector computed tomography (MDCT) scan from February 2021 until February 2023. GraphPad Prism version 9.0.0 for Windows (GraphPad Software, Boston, MA, USA) was used to analyse the results. Results: There are 1029 patients with an MB, yielding a prevalence of 44.3% (95%CI 42.3-46.4). The left anterior descending vessel is the most commonly implicated, with 99.6%. Among those with stenosis, the middle portion of the bridging vessel is the most common site of stenosis (n = 269), followed by the proximal portion (n = 237). The severity of stenosis is more often moderate, with 30-50% (n = 238). Females (odds ratio [OR] of 1.8, 95%CI 1.4-2.3; p-value < 0.0001), older age (t-value 5.6, p-value < 0.0001), symptomatic patients (OR 1.4, 95% CI 1.1-1.9; p-value = 0.013), and higher mean coronary artery calcium score (t-value 11.3, p-value < 0.0001) are more likely to have stenosis. The degree of stenosis is significantly higher in the proximal stenosis group than in the middle stenosis group (t-value 27, p-value < 0.0001). Conclusions: Our research demonstrates that MB may prevent atheromatosis of the coronary segment distal to the MB and predispose the development of atherosclerosis in the section proximal to the bridge.
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Affiliation(s)
- Koesbandono
- Interventional Radiology Division, Department of Radiology, Faculty of Universitas Pelita Harapan, Tangerang 15811, Indonesia
- Department of Radiology, Siloam Hospital Lippo Village, Tangerang 15811, Indonesia
| | - Antonia Anna Lukito
- Department of Cardiology and Vascular Medicine, Siloam Hospital Lippo Village, Tangerang 15810, Indonesia
| | - Rusli Muljadi
- Department of Radiology, Siloam Hospital Lippo Village, Tangerang 15811, Indonesia
- Thoracic and Cardiovascular Imaging Division, Department of Radiology, Faculty of Universitas Pelita Harapan, Tangerang 15811, Indonesia
| | - Mira Yuniarti
- Department of Radiology, Siloam Hospital Lippo Village, Tangerang 15811, Indonesia
- Thoracic and Cardiovascular Imaging Division, Department of Radiology, Faculty of Universitas Pelita Harapan, Tangerang 15811, Indonesia
| | | | - Andreyano Sarikie
- Department of Radiology, Faculty of Universitas Pelita Harapan, Tangerang 15811, Indonesia
| | | | - Reynaldy Santosa Thio
- Department of Radiology, Faculty of Universitas Pelita Harapan, Tangerang 15811, Indonesia
| | - Jessica Christanti
- Department of Radiology, Faculty of Universitas Pelita Harapan, Tangerang 15811, Indonesia
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Matta A, Roncalli J, Carrié D. Update review on myocardial bridging: New insights. Trends Cardiovasc Med 2024; 34:10-15. [PMID: 35697237 DOI: 10.1016/j.tcm.2022.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 11/30/2022]
Abstract
Myocardial bridging (MB) is a common congenital abnormality that remains asymptomatic in a large proportion of patients. The peak of clinical manifestation occurs during the third and fourth decades of life. MB provokes myocardial ischemia through different mechanisms including supply-demand mismatch, endothelial dysfunction, coronary microvascular dysfunction and external mechanical compression. The association between MB and atherosclerotic disease is controversial. Recent studies established a significant association of MB with myocardial infarction and non-obstructive coronary artery disease. The first line medical treatment is based on beta-blockers and calcium channel blockers. Ivabradine is used in second line therapy. Invasive approaches involving percutaneous coronary intervention, coronary artery bypass graft and myotomy are performed in patients with symptoms refractory to maximally tolerated medical treatment. The choice of revascularization technique depends on anatomical characteristics, clinical condition and physician experience. Available data derived from anecdotal evidence view the lack of randomized clinical trials.
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Affiliation(s)
- Anthony Matta
- Department of cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France; Department of cardiology, Intercommunal Hospital Centre Castres-Mazamet, Castres, France; Faculty of medicine, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Jerome Roncalli
- Department of cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
| | - Didier Carrié
- Department of cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France.
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Çetin N, Özlek B, Özdemir İH, Yıldız BS, Yavuz V, Tıkız H. Comparison of Framingham risk score and atherogenic indices as a predictor of atherosclerosis in patients with myocardial bridge in left anterior descending artery. Acta Cardiol 2022; 77:342-349. [PMID: 34210253 DOI: 10.1080/00015385.2021.1945763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Myocardial bridge (MB) is generally considered as a benign condition, but it may trigger atherosclerosis, especially in the adjacent proximal coronary artery segment. In this study, we aimed to investigate whether the Framingham risk score (FRS) or atherogenic indices are risk factors for coronary atherosclerosis in patients with MB in the left anterior descending coronary artery (LAD). METHODS We performed a retrospective study evaluating 155 patients who have MB in LAD. The patients were evaluated in two groups according to the presence of atherosclerosis (74 patients in atherosclerotic group vs. 81 patients in non-atherosclerotic group). Baseline characteristics, FRS and atherogenic indices were reviewed between groups. Significant independent risk factors for coronary atherosclerosis were investigated by logistic regression analysis. RESULTS Patients in atherosclerotic group were significantly older (58.15 ± 10.04 vs. 50.22 ± 9.27 years, p < .001) and 74.3% of the patients were male. While the mean FRS in the atherosclerotic group was 21.20 ± 8.81, it was 12.79 ± 8.61 in the non-atherosclerotic group (p < .001). Among the atherogenic indices, only LDL-c/HDL-c ratio was significantly higher in the atherosclerotic group (3.49 ± 1.2 vs. 3.11 ± 0.98, p:.033). Multivariable analysis showed that age (OR: 1.08, 95% CI 1.03-1.13, p < .001) and FRS (OR: 1.06, 95% CI 1.01-1.11, p:.012) were independently associated with the presence of atherosclerotic lesion. CONCLUSIONS FRS is an easily applicable predictor in clinical practice that indicates the presence of coronary atherosclerosis in patients with MB in LAD.
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Affiliation(s)
- Nurullah Çetin
- Department of Cardiology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Bülent Özlek
- Department of Cardiology, Training and Research Hospital, Mugla Sitki Kocman University, Mugla, Turkey
| | | | - Bekir Serhat Yıldız
- Department of Cardiology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Veysel Yavuz
- Department of Cardiology, Akhisar Mustafa Kirazoglu State Hospital, Manisa, Turkey
| | - Hakan Tıkız
- Department of Cardiology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
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Darabont RO, Vișoiu IS, Magda ȘL, Stoicescu C, Vintilă VD, Udroiu C, Vinereanu D. Implications of Myocardial Bridge on Coronary Atherosclerosis and Survival. Diagnostics (Basel) 2022; 12:diagnostics12040948. [PMID: 35453995 PMCID: PMC9026775 DOI: 10.3390/diagnostics12040948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/03/2022] [Accepted: 04/07/2022] [Indexed: 12/04/2022] Open
Abstract
Background: In this study, we aimed to describe the impact of MBs on atherosclerosis and survival, in patients with coronary artery disease (CAD). Methods: We retrospectively studied 1920 consecutive patients who underwent conventional coronary angiography for suspected CAD. Atherosclerotic load (AL), defined as the sum of degrees of stenosis, and general atherosclerotic load (GAL), representing the sum of AL, were compared between patients with MB and a control group without MB; patients in these groups were similar in age and sex. We assessed survival at 10 years after the last enrolled patient. Results: Prevalence of MB was 3.96%, predominantly in the mid-segment of left anterior descendent artery (LAD). In the presence of MB, GAL was lower (158.1 ± 93.7 vs. 205.3 ± 117.9, p = 0.004) with a lesser AL in the proximal (30.3 ± 39.9 vs. 42.9 ± 41.1, p = 0.038) and mid-segments (8.1 ± 20.0 vs. 25.3 ± 35.9, p < 0.001) of LAD. Based on a Multinominal Logistic Regression, we found that the presence of MB on LAD (regardless of its location on this artery) is a protective factor against atherosclerotic lesions, decreasing the probability of significant stenosis, especially of those ≥70%, on the entire artery (B −1.539, OR 4660; 95% CI = 1.873−11.595, p = 0.001) and on each of its segments as well: proximal LAD (B −1.275, OR 0.280; 95% CI = 0.015−5.073; p = 0.038), mid-LAD (B −1.879, OR 6.545; 95% CI = 1.492−28.712; p = 0.013) and distal LAD (B −0.900, OR 2.459, 95% CI = 2.459−2.459, p = 0.032). However, 10-year survival was similar between groups (76.70% vs. 74.30%, p = 0.740). Conclusion: The presence of MB on LAD proved to be a protective factor against atherosclerosis for the entire artery and for each of its segments, but it does not influence long-term survival in patients with CAD.
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Affiliation(s)
- Roxana Oana Darabont
- Department of Cardiology and Cardiovascular Surgery, University of Medicine and Pharmacy “Carol Davila”, 37 Dionisie Lupu, 030167 Bucharest, Romania; (Ș.L.M.); (C.S.); (V.D.V.); (D.V.)
- Department of Cardiology, University Emergency Hospital of Bucharest, 169 Splaiul Independenței, 050098 Bucharest, Romania; (I.S.V.); (C.U.)
- Correspondence: ; Tel.: +40-723-441-315
| | - Ionela Simona Vișoiu
- Department of Cardiology, University Emergency Hospital of Bucharest, 169 Splaiul Independenței, 050098 Bucharest, Romania; (I.S.V.); (C.U.)
| | - Ștefania Lucia Magda
- Department of Cardiology and Cardiovascular Surgery, University of Medicine and Pharmacy “Carol Davila”, 37 Dionisie Lupu, 030167 Bucharest, Romania; (Ș.L.M.); (C.S.); (V.D.V.); (D.V.)
- Department of Cardiology, University Emergency Hospital of Bucharest, 169 Splaiul Independenței, 050098 Bucharest, Romania; (I.S.V.); (C.U.)
| | - Claudiu Stoicescu
- Department of Cardiology and Cardiovascular Surgery, University of Medicine and Pharmacy “Carol Davila”, 37 Dionisie Lupu, 030167 Bucharest, Romania; (Ș.L.M.); (C.S.); (V.D.V.); (D.V.)
- Department of Cardiology, University Emergency Hospital of Bucharest, 169 Splaiul Independenței, 050098 Bucharest, Romania; (I.S.V.); (C.U.)
| | - Vlad Damian Vintilă
- Department of Cardiology and Cardiovascular Surgery, University of Medicine and Pharmacy “Carol Davila”, 37 Dionisie Lupu, 030167 Bucharest, Romania; (Ș.L.M.); (C.S.); (V.D.V.); (D.V.)
- Department of Cardiology, University Emergency Hospital of Bucharest, 169 Splaiul Independenței, 050098 Bucharest, Romania; (I.S.V.); (C.U.)
| | - Cristian Udroiu
- Department of Cardiology, University Emergency Hospital of Bucharest, 169 Splaiul Independenței, 050098 Bucharest, Romania; (I.S.V.); (C.U.)
| | - Dragoș Vinereanu
- Department of Cardiology and Cardiovascular Surgery, University of Medicine and Pharmacy “Carol Davila”, 37 Dionisie Lupu, 030167 Bucharest, Romania; (Ș.L.M.); (C.S.); (V.D.V.); (D.V.)
- Department of Cardiology, University Emergency Hospital of Bucharest, 169 Splaiul Independenței, 050098 Bucharest, Romania; (I.S.V.); (C.U.)
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Roberts W, Charles SM, Ang C, Holda MK, Walocha J, Lachman N, Tubbs RS, Loukas M. Myocardial bridges: A meta-analysis. Clin Anat 2021; 34:685-709. [PMID: 33078444 DOI: 10.1002/ca.23697] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 12/11/2022]
Abstract
Myocardial bridges are anatomical entities characterized by myocardium covering segments of coronary arteries. In some patients, the presence of a myocardial bridge is benign and is only incidentally found on autopsy. In other patients, however, myocardial bridges can lead to compression of the coronary artery during systolic contraction and delayed diastolic relaxation, resulting in myocardial ischemia. This ischemia in turn can lead to myocardial infarction, ventricular arrhythmias and sudden cardiac death. Myocardial bridges have also been linked to an increased incidence of atherosclerosis, which has been attributed to increased shear stress and the presence of vasoactive factors. Other studies however, demonstrated the protective roles of myocardial bridges. In this study, using systematic review and a meta-analytical approach we investigate the prevalence and morphology of myocardial bridges in both clinical imaging and cadaveric dissections. We also discuss the pathophysiology, clinical significance, and management of these anatomical entities.
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Affiliation(s)
- Wallisa Roberts
- Department of Medicine, Princess Royal Hospital, Apley Castle, Telford Shropshire, UK
| | - Stacey M Charles
- Department of Anatomical Sciences, St. George's University, School of Medicine, Grenada, West Indies
| | - Cassandra Ang
- Department of Medicine, Princess Royal Hospital, Apley Castle, Telford Shropshire, UK
| | - Mateusz K Holda
- HEART-Heart Embryology and Anatomy Research Team, Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland.,Division of Cardiovascular Sciences, The University of Manchester, England, UK
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University, Medical College, Krakow, Poland
| | - Nirusha Lachman
- Department of Clinical Anatomy and Department of Plastic Surgery, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA
| | - R Shane Tubbs
- Department of Anatomical Sciences, St. George's University, School of Medicine, Grenada, West Indies.,Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, School of Medicine, Grenada, West Indies.,Department of Anatomy, University of Warmia and Mazury, Olsztyn, Poland
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8
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Khadke S, Vidovic J, Patel V. Bridging the Gap in a Rare Cause of Angina. Eur Cardiol 2021; 16:e05. [PMID: 33737959 PMCID: PMC7967818 DOI: 10.15420/ecr.2020.33] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/26/2020] [Indexed: 11/09/2022] Open
Abstract
Myocardial bridging occurs when coronary arteries run intramurally. Episodes of tachycardia can cause a dynamic obstruction that extends into diastole, compromising coronary filling time, and subsequently leading to ischaemia. Myocardial ischaemia, acute coronary syndrome, coronary spasm, myocardial stunning, arrhythmia, takotsubo cardiomyopathy, and sudden cardiac death have all been reported with bridging. Atherosclerotic plaques develop proximally in the bridge due to low shear stress and high oscillatory wall-flow. Factors affecting atherosclerotic build-up include disrupted flow patterns (particularly flow recirculation, which exacerbates LDL internalisation), cell adhesion and monocyte adhesion to the endothelium. Endothelial health depends on arterial flow patterns, given that the vessel reacts differently to various flow types, as confirmed in 3D simulations. Medication is the first-line therapy, while surgical de-roofing and coronary bypass are reserved for severe stenosis. Distinguishing physiological arterial compression from pathological stenosis is essential. Deeper bridges correlating with recurrent angina with an instantaneous wave-free ratio ≤0.89 or fractional flow reserve ≤0.80 are treated.
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Affiliation(s)
- Sumanth Khadke
- Our Lady of Fatima University, Fatima College of MedicineManila, Philippines
| | | | - Vinod Patel
- Division of Cardiology, Mount Sinai HospitalsNew York, NY, US
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9
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Jiang L, Zhang M, Zhang H, Shen L, Shao Q, Shen L, He B. A potential protective element of myocardial bridge against severe obstructive atherosclerosis in the whole coronary system. BMC Cardiovasc Disord 2018; 18:105. [PMID: 29843607 PMCID: PMC5975619 DOI: 10.1186/s12872-018-0847-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Myocardial bridge (MB) is generally described as a congenital benign variation. Previous studies have suggested that MB prevents atherosclerotic plaques from accumulating within the bridge segment but promotes coronary stenosis in the proximal segment adjacent to MB. However, it is still not clear whether MB has positive or negative effects on severe obstructive atherosclerosis in the whole coronary artery system. METHODS In this study, 6774 patients with symptoms of angina who were clinically diagnosed coronary artery disease (CAD) or suspected CAD underwent coronary angiography (CAG) in our center. The presence of MB was diagnosed, and a retrospective analysis was performed between MB and severe obstructive CAD requiring percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) in the whole coronary system. RESULTS Among 6774 patients, 3583 (52.89%) were diagnosed with severe obstructive CAD (SOCAD) requiring a treatment of PCI or CABG and enrolled into the SOCAD group; and 3191 (47.11%) without SOCAD into the non-SOCAD group. Non-SOCAD and SOCAD groups had 512(16.05%) and 66(1.84%) patients with MB, respectively (P < 0.0001). The rate of SOCAD requiring PCI or CABG in patients with MB was much lower than that in patients without MB (11.42% vs. 56.76%, P < 0.0001). After adjusting for sex, age, diabetes mellitus, hypertension, and other risk factors, MB still had some positive role in preventing severe obstructive CAD (log-OR = - 2.134, p-value < 0.0001) through logistic regression. CONCLUSIONS Our results provided a clue that MB might act as a potential protective element against severe obstructive atherosclerosis in the whole coronary artery system.
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Affiliation(s)
- Lisheng Jiang
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Chest Hospital, Shanghai, China. .,Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
| | - Min Zhang
- Department of Clinical Medicine, Shanghai Medical School, Fudan University, Shanghai, China.,Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Hong Zhang
- Institution of Biostatistics, School of Life Science, Fudan University, Shanghai, China
| | - Lan Shen
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Chest Hospital, Shanghai, China.,Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Qin Shao
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Linghong Shen
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Chest Hospital, Shanghai, China.,Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Ben He
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Chest Hospital, Shanghai, China. .,Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
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10
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Teofilovski-Parapid G, Jankovic R, Kanjuh V, Virmani R, Danchin N, Prates N, Simic D, Parapid B. Myocardial bridges, neither rare nor isolated—Autopsy study. Ann Anat 2017; 210:25-31. [DOI: 10.1016/j.aanat.2016.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/25/2016] [Accepted: 09/26/2016] [Indexed: 02/06/2023]
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11
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Tohno Y, Tohno S, Minami T, Pakdeewong-Ongkana N, Suwannahoy P, Quiggins R. Different Accumulation of Elements in Proximal and Distal Parts of the Left Anterior Descending Artery Beneath the Myocardial Bridge. Biol Trace Elem Res 2016; 171:17-25. [PMID: 26343360 DOI: 10.1007/s12011-015-0498-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 08/28/2015] [Indexed: 01/31/2023]
Abstract
To elucidate the action of the myocardial bridge (MB) on the coronary artery, the authors first prepared the hearts with the MB located in the middle one third of the left anterior descending (LAD) artery and then investigated element accumulation in the LAD artery of the hearts with the MB by direct chemical analysis. Eighty-four formalin-fixed adult Thai hearts were dissected and the MBs were found in 39 of 84 hearts with a total of 44 MBs. The 37 MBs were located in the middle one third of the LAD artery. To examine the action of the MB on element accumulation in the LAD artery, the hearts with the MB which was located in the middle one third of the LAD artery and was longer than 1.5 cm were used as Materials. The left main coronary (LMC) and LAD arteries were removed from these hearts successively and the isolated arteries were divided into eight to ten segments. After incineration of arteries with nitric acid and perchloric acid, seven element contents of Ca, P, S, Mg, Zn, Fe, and Na were determined by inductively coupled plasma-atomic emission spectrometry. To examine the endothelial changes of the LAD artery, the inner surface of segments of the LAD artery was observed by scanning electron microscopy. It was found that the extent of accumulation of Ca, P, Zn, and Na was not uniform throughout the LAD artery and was higher in the proximal part than in the distal part with regard to the LAD artery beneath the MB (the tunneled LAD artery). The extent of accumulation of Ca, P, Zn, and Na in the proximal part of the tunneled LAD artery was similar to that in the segments proximal to the MB, whereas the extent of accumulation of Ca, P, Zn, and Na in the distal part of the tunneled LAD artery was similar to that in the segments distal to the MB.
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Affiliation(s)
- Yoshiyuki Tohno
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Setsuko Tohno
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Takeshi Minami
- Laboratory of Environmental Biology, Department of Life Science, Faculty of Science and Engineering, Kinki University, Higashi-Osaka, Osaka, 577-8502, Japan
| | | | - Patipath Suwannahoy
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Ranida Quiggins
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
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Venturini E, Marabotti C, Magni L, Testa R, Kounis NG. Myocardial bridge as a trigger of Kounis syndrome. Int J Cardiol 2016; 202:87-9. [DOI: 10.1016/j.ijcard.2015.08.154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 08/21/2015] [Indexed: 02/08/2023]
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Watanabe Y, Arakawa T, Kageyama I, Aizawa Y, Kumaki K, Miki A, Terashima T. Gross anatomical study on the human myocardial bridges with special reference to the spatial relationship among coronary arteries, cardiac veins, and autonomic nerves. Clin Anat 2015; 29:333-41. [DOI: 10.1002/ca.22662] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 10/17/2015] [Accepted: 10/20/2015] [Indexed: 12/30/2022]
Affiliation(s)
- Yuko Watanabe
- Division of Anatomy and Neurobiology; Department of Physiology and Cell Biology; Kobe University Graduate School of Medicine; Kobe Japan
- Department of Rehabilitation Sciences; Kobe University Graduate School of Health Sciences; Kobe Japan
| | - Takamitsu Arakawa
- Department of Rehabilitation Sciences; Kobe University Graduate School of Health Sciences; Kobe Japan
| | - Ikuo Kageyama
- Department of Anatomy; School of Life Dentistry at Niigata, Nippon Dental University; Niigata Japan
| | - Yukio Aizawa
- Department of Anatomy; School of Life Dentistry at Niigata, Nippon Dental University; Niigata Japan
| | - Katsuji Kumaki
- Department of Physical Therapy; Niigata Graduate School of Rehabilitation; Niigata Japan
| | - Akinori Miki
- Department of Rehabilitation Sciences; Kobe University Graduate School of Health Sciences; Kobe Japan
| | - Toshio Terashima
- Division of Anatomy and Neurobiology; Department of Physiology and Cell Biology; Kobe University Graduate School of Medicine; Kobe Japan
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Abstract
PURPOSE OF REVIEW Experimental models have contributed enormously to basic immunology. However, the use of reductionist experiments has produced results that are not always successfully translated into the clinic. Recently, incorporation of more realistic clinical parameters in experimental designs has produced new insights relevant to cardiac transplantation. RECENT FINDINGS Experiments in mice have provided crucial insights into the concept that T cell responses to pathogens generate memory cells with cross-reactive specificities for histocompatibility antigens. These memory T cells are resistant to current immunosuppressive strategies. Memory T cells infiltrate grafts within hours after transplantation, and grafts subjected to clinically relevant periods of cold ischemia are more susceptible to injury by this cellular infiltrate. Early immune responses now can be investigated with improved 'humanized' mice. Mice with multiple knock-in genes for human cytokines support development of human monocytes, macrophages and natural killer cells in increased numbers and with better function. SUMMARY Better and more clinically relevant experimental designs are providing animal models tailored to address clinic exigencies.
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