Coronary artery aneurysm combined with myocardial bridge:A case report

BACKGROUND Coronary artery aneurysm combined with myocardial bridge is a very rare clinical situation.The prognosis of this clinical situation is not yet clear.CASE SUMMARY A coronary artery aneurysm and myocardial bridge in the same segment of the coronary artery were found in a 54-year-old female patient who underwent coronary angiography and intravascular ultrasound examination.Through conservative treatment,the patient was discharged from the hospital smoothly,and she was in good condition during 5 mo of follow-up.CONCLUSION Coronary artery aneurysm combined with myocardial bridge seems to have a good prognosis,but due to the rarity of this clinical situation,further research and follow-up are needed.

Angiography-derived radial wall strain predicts coronary lesion progression in non-culprit intermediate stenosis

BACKGROUND Intermediate coronary lesions(ICLs)are highly prevalent but ported mixed prognosis.Radial strain has been associated with plaque vulnerability,yet its role in predicting lesion progression is largely unknown.The purpose of this study was to determine the predictive value of angiography-derived radial wall strain(RWS)for progression of untreated non-culprit ICLs.METHODS Post-hoc analysis was conducted in a study cohort including 603 consecutive patients with 808 ICLs identified at index procedure with angiographic follow-up of up to two years.RWS analysis was performed on selected angiographic frames with minimal foreshortening and vessel overlap.Lesion progression was defined as≥20%increase in percent diameter stenosis.RESULTS Lesion progression occurred in 49 ICLs(6.1%)with a median follow-up period of 16.8 months.Maximal RWS(RWSmax),frequently located at the proximal and throat plaque regions,distinguished progressive ICLs from silent ones.The largest area under the curve value of 0.75(95%CI:0.67–0.82,P<0.001)was reached at the optimal RWSmax cutoff value of>12.6%.According to this threshold,178 ICLs were classified as having a high strain pattern.Exposure to a high strain amplitude with RWS_(max)>12.6%was independently associated with an increased risk of lesion progression(adjusted HR=6.82,95%CI:3.67–12.66,P<0.001).CONCLUSIONS Assessment of RWS from coronary angiography is feasible and provides independent prognostic value in patients with untreated ICLs.