BACKGROUND Myocardial bridge(MB)will compress the mural coronary artery(MCA)during the systole and cause myocardial ischemia.In the diagnosis of coronary heart disease(CHD),because the structure of MB is difficult to ...BACKGROUND Myocardial bridge(MB)will compress the mural coronary artery(MCA)during the systole and cause myocardial ischemia.In the diagnosis of coronary heart disease(CHD),because the structure of MB is difficult to be observed by coronary angiography(CAG),the clinical study of the influence of MB on CHD is lacking.With the advancement of computed tomography coronary angiography technology,detailed observations of the MB anatomy have realized.AIM To explore the main influencing factors of MB-related CHD and to find potential indicators for predicting MB-related CHD.METHODS A total of 1718 patients with suspected CHD due to the symptoms of myocardial ischemia were enrolled as subjects.Patients diagnosed with CHD were included in a CHD group,and patients with no significant abnormalities were included in a control group.In the CHD group,patients were divided into an MB-CHD subgroup if MB-related CHD was found.In the control group,patients were divided into a simple MB subgroup if MB was found.The patient's clinical data and MB-related indicators,including the branch of MB,MB type(superficial/deep type),MB length,MB thickness,systolic and diastolic compression of the MCA,and MCA systolic stenosis rate were recorded and compared.Logistic regression analysis was used to explore the independent influencing factors of MD-related CHD.ROC curve was used to analyze the diagnostic efficacy of potential indicators for MB-related CHD.RESULTS There were 1060 cases in the CHD group and 658 cases in the control group,and there were 236 cases in the MB-CHD subgroup and 52 cases in the simple MB subgroup.Multivariate logistic regression analysis showed that the combined MB had a significant effect on the occurrence of CHD(P<0.05).MB thickness,systolic compression,diastolic compression,and MCA systolic stenosis rate had significant effects on the occurrence of MB-related CHD(P<0.05).The area under the curve(AUC)of the combination of these influencing factors for the diagnosis of MB-related CHD was 0.959,which was significantly higher than the AUCs of the four indicators separately(P<0.05).The sensitivity was 97.06%and the specificity was 87.63%.CONCLUSION MB thickness,systolic compression,diastolic compression,and MCA systolic stenosis are independent influencing factors for MB-related CHD.The combination of these factors has potential diagnostic value for MB-related CHD.展开更多
AIM: To assess the incidence, location, morphology and clinical association of myocardial bridging in a Saudi population using coronary computed tomographic angiography(CCTA). METHODS: A total of 350 CCTA of Saudi pat...AIM: To assess the incidence, location, morphology and clinical association of myocardial bridging in a Saudi population using coronary computed tomographic angiography(CCTA). METHODS: A total of 350 CCTA of Saudi patients were included in this study(236 men, 114 women) with a mean age of 56.3 years. All patients were examined for appropriateness criteria of CCTA indications(typical chest pain, recent onset cardiomyopathy, left bundle branch block, etc.). The scans were retrospectively reviewed for the presence of myocardial bridging and any other pathological association. RESULTS: Myocardial bridging was found in 89 of 350(22.5%) patients. Most of the intramuscular segments were of the superficial type and found in the mid left anterior descending(LAD)(24.6%), followed by distal LAD(3.7%), diagonal branches(2%), ramus intermedius artery(1.4%) and obtuse marginal artery(0.8%). No myocardial bridging was detected in the right coronary or circumflex arteries. No significant differences were found between males and females(P = 0.14). Coronary artery atherosclerosis was found in 51 of 89(57.3%) patients with MB. Atherosclerotic plaques were not detected in the intramuscular or distal segment of bridging arteries. Dynamic compression was observed in 35(94.5%) patients with full encasement. No evidence of myocardial hypoperfusion was found in the territories supplied by the bridging arteries. CONCLUSION: CCTA is excellent in analyzing myocardial bridging in a Saudi population and the results are comparable to other populations. However, finding the real incidence may need a large multicenter study.展开更多
文摘BACKGROUND Myocardial bridge(MB)will compress the mural coronary artery(MCA)during the systole and cause myocardial ischemia.In the diagnosis of coronary heart disease(CHD),because the structure of MB is difficult to be observed by coronary angiography(CAG),the clinical study of the influence of MB on CHD is lacking.With the advancement of computed tomography coronary angiography technology,detailed observations of the MB anatomy have realized.AIM To explore the main influencing factors of MB-related CHD and to find potential indicators for predicting MB-related CHD.METHODS A total of 1718 patients with suspected CHD due to the symptoms of myocardial ischemia were enrolled as subjects.Patients diagnosed with CHD were included in a CHD group,and patients with no significant abnormalities were included in a control group.In the CHD group,patients were divided into an MB-CHD subgroup if MB-related CHD was found.In the control group,patients were divided into a simple MB subgroup if MB was found.The patient's clinical data and MB-related indicators,including the branch of MB,MB type(superficial/deep type),MB length,MB thickness,systolic and diastolic compression of the MCA,and MCA systolic stenosis rate were recorded and compared.Logistic regression analysis was used to explore the independent influencing factors of MD-related CHD.ROC curve was used to analyze the diagnostic efficacy of potential indicators for MB-related CHD.RESULTS There were 1060 cases in the CHD group and 658 cases in the control group,and there were 236 cases in the MB-CHD subgroup and 52 cases in the simple MB subgroup.Multivariate logistic regression analysis showed that the combined MB had a significant effect on the occurrence of CHD(P<0.05).MB thickness,systolic compression,diastolic compression,and MCA systolic stenosis rate had significant effects on the occurrence of MB-related CHD(P<0.05).The area under the curve(AUC)of the combination of these influencing factors for the diagnosis of MB-related CHD was 0.959,which was significantly higher than the AUCs of the four indicators separately(P<0.05).The sensitivity was 97.06%and the specificity was 87.63%.CONCLUSION MB thickness,systolic compression,diastolic compression,and MCA systolic stenosis are independent influencing factors for MB-related CHD.The combination of these factors has potential diagnostic value for MB-related CHD.
文摘AIM: To assess the incidence, location, morphology and clinical association of myocardial bridging in a Saudi population using coronary computed tomographic angiography(CCTA). METHODS: A total of 350 CCTA of Saudi patients were included in this study(236 men, 114 women) with a mean age of 56.3 years. All patients were examined for appropriateness criteria of CCTA indications(typical chest pain, recent onset cardiomyopathy, left bundle branch block, etc.). The scans were retrospectively reviewed for the presence of myocardial bridging and any other pathological association. RESULTS: Myocardial bridging was found in 89 of 350(22.5%) patients. Most of the intramuscular segments were of the superficial type and found in the mid left anterior descending(LAD)(24.6%), followed by distal LAD(3.7%), diagonal branches(2%), ramus intermedius artery(1.4%) and obtuse marginal artery(0.8%). No myocardial bridging was detected in the right coronary or circumflex arteries. No significant differences were found between males and females(P = 0.14). Coronary artery atherosclerosis was found in 51 of 89(57.3%) patients with MB. Atherosclerotic plaques were not detected in the intramuscular or distal segment of bridging arteries. Dynamic compression was observed in 35(94.5%) patients with full encasement. No evidence of myocardial hypoperfusion was found in the territories supplied by the bridging arteries. CONCLUSION: CCTA is excellent in analyzing myocardial bridging in a Saudi population and the results are comparable to other populations. However, finding the real incidence may need a large multicenter study.
