伴心律失常症状心肌桥患者的冠状动脉计算机断层摄影术造影特点

Characteristics of Coronary CT Angiography in Patients With Myocardial Bridge Combining Arrhythmia

目的:探讨伴心律失常症状心肌桥患者的冠状动脉计算机断层摄影术(CTA)影像学特征。方法:收集表现有心律失常的心肌桥患者(有心律失常组)31例的临床及影像学资料,包括病历记录、心电图、心肌酶、超声心动图和CTA资料。重点研究其CTA影像学表现。另选取30例无心律失常单纯心肌桥患者(无心律失常组)作为对照。结果:有心律失常组31例患者均只表现为单纯心肌桥,排除了冠心病、瓣膜结构性心脏病及其它系统性疾病的病因。31例患者中心室颤动2例,心房颤动1例,室上性心动过速5例,室性心动过速23例。31例患者中17例为深埋型,14例为浅表型。与无心律失常组比较,有心律失常组回顾性心电门控心肌收缩末期直径和心肌舒张末期直径、CTA上其壁冠状动脉横断面管腔变窄率差异均无统计学意义(P>0.05)。结论:有心律失常心肌桥患者CTA表现无明显特点,CTA上显示的心肌桥病理解剖特点只是可用来解释部分心肌显著缺血引起的临床症状,不能完全解释心肌桥患者的心律失常。

Objective： To study the characteristics of coronary CT angiography （CTA） in patients with myocardial bridge （MB） with arrhythmia. Methods： Our study included 2 groups： MB＋arrhythmia group,n=31, clinical information as medical record, electrocardiogram （ECG）, myocardial enzyme, echocardiography and coronary CTA findings were collected; MB group, n=30, the MB patients were without arrhythmia. Results： In MB＋arrhythmia group, all patients were with mere MB, coronary artery disease, valve-structural heart diseases and other systemic diseases were excluded. There were 2/31 patients with ventricular fibrillation, 1 with atrial fibrillation, 5 with supraventricular tachycardia and 23 with ventricular tachycardia; 17/31 patients having deep type MB and 14 having superficial type MB. The myocardial systolic end diameter, diastolic end diameter by retrospective ECG gating and the stenosis at cross section of mural coronary MB by CTA were similar between 2 groups,P〉0.05. Conclusion： MB＋arrhythmia patients had no specific characteristics in coronary CTA; anatomical CTA feature may partly explain the myocardial ischemic symptom while couldn＇t clarify arrhythmia occurrence in relevant patients.