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Andreini D, Conte E, Monizzi G, Prestini B, Ratti A, Belmonte M, Melotti E, Doldi M, Marchetti D, Schillaci M, Nicoli F, Mastrangelo A, Paolisso P, Gigante C, Novembre ML, Baggiano A, Mancini ME, Annoni A, Formenti A, Pizzamiglio F, Pontone G, Zeppilli P, Bartorelli AL, Mushtaq S. Predictors of adverse cardiac events of coronary myocardial bridging diagnosed with computed tomography angiography. Int J Cardiol 2024; 406:131997. [PMID: 38556216 DOI: 10.1016/j.ijcard.2024.131997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/06/2024] [Accepted: 03/27/2024] [Indexed: 04/02/2024]
Abstract
AIMS Myocardial bridging (MB) is a frequent congenital anomaly of the epicardial coronary arteries commonly considered a benign condition. However, in some cases a complex interplay between anatomical, clinical and physiology factors may lead to adverse events, including sudden cardiac death. Coronary CT angiography (CCTA) emerged as the gold standard noninvasive imaging technique for the evaluation of MB. Aim of the study was to evaluate MB prevalence and anatomical features in a large population of patients who underwent CCTA for suspected CAD and to identify potential anatomical and clinical predictors of adverse cardiac events at long-term follow-up. METHODS AND RESULTS Two-hundred and six patients (mean age 60.3 ± 11.8 years, 128 male) with MB diagnosed at CCTA were considered. A long MB was defined as ≥25 mm of overlying myocardium, whereas a deep MB as ≥2 mm of overlying myocardium. The study endpoint was the sum of the following adverse events: cardiac death, bridge-related acute coronary syndrome, hospitalization for angina or bridge-related ventricular arrhythmias and MB surgical treatment. Of the 206 patients enrolled in the study, 9 were lost to follow-up, whereas 197 (95.6%) had complete follow-up (mean 7.01 ± 3.0 years) and formed the analytic population. Nineteen bridge-related events occurred in 18 patients (acute coronary syndrome in 7, MB surgical treatment in 2 and hospitalization for bridge-related events in 10). Typical angina at the time of diagnosis and long MB resulted as significant independent predictors of adverse outcome. CONCLUSIONS Typical angina and MB length ≥ 25 mm were independent predictors of cardiac events.
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Affiliation(s)
- Daniele Andreini
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
| | - Edoardo Conte
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Division of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | - Giovanni Monizzi
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Division of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | - Blanca Prestini
- Division of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | - Angelo Ratti
- Division of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | - Marta Belmonte
- Sports Medicine Unit, Catholic University of the Sacred Heart, Rome, Italy
| | - Eleonora Melotti
- Division of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | - Marco Doldi
- Division of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | - Davide Marchetti
- Division of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | - Matteo Schillaci
- Division of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | - Flavia Nicoli
- Division of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | - Angelo Mastrangelo
- Division of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | - Pasquale Paolisso
- Division of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | - Carlo Gigante
- Division of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | - Maria Laura Novembre
- Division of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | | | | | | | | | | | | | - Paolo Zeppilli
- Sports Medicine Unit, Catholic University of the Sacred Heart, Rome, Italy
| | - Antonio L Bartorelli
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Division of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
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Nemat A, Majeedi A, Sediqi AW, Zeng Q. A Case of Symptomatic Myocardial Bridge Treated with Calcium Channel Blocker. Int Med Case Rep J 2022; 15:259-262. [PMID: 35669125 PMCID: PMC9166896 DOI: 10.2147/imcrj.s360819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/25/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Arash Nemat
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
- Department of Cardiology, Ariana Medical Complex, Kabul, Afghanistan
- Department of Microbiology, Kabul University of Medical Sciences, Kabul, Afghanistan
- Arash Nemat, Department of Cardiology, Ariana Medical Complex, Kabul, Afghanistan, Email
| | - Atiqullah Majeedi
- Department of Cardiology, Ariana Medical Complex, Kabul, Afghanistan
| | - Abdul Wahed Sediqi
- Department of Cardiology, Ariana Medical Complex, Kabul, Afghanistan
- Department of Cardiology, Ali Abad Teaching Hospital, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Qingchun Zeng
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
- Correspondence: Qingchun Zeng, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, People’s Republic of China, Email
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