Comparison of intravascular ultrasound and angiography in the assessment of myocardial bridging.

Ge, Junbo; Erbel, Raimund; Rupprecht, H. J.; Koch, Lisa Langdon; Kearney, Peter; Görge, G; Haude, Michael; Meyer, Jürgen

doi:10.1161/01.cir.89.4.1725

Cited by 256 publications

(220 citation statements)

References 23 publications

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“…Ramos et al also observed a greater severity of atherosclerosis in the proximal segment of the myocardial bridging in comparison with other affected areas at autopsy. Moreover, Ge et al performed intravascular ultrasound in 14 patients with angiographic evidence of myocardial bridging in the left anterior descending artery (12). They reported that no atherosclerotic lesions were detected in the myocardial bridging or the distal segment in the 8 patients in whom the intravascular ultrasound catheter was successfully advanced through the entire myocardial bridging, but atherosclerotic plaques were found in the proximal segment in 12 of 14 patients.…”

Section: Discussionmentioning

confidence: 99%

Acute Myocardial Infarction Associated with Myocardial Bridging in a Young Adult

et al. 2004

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A 28-year-old man was admitted because of chest pain. Emergency coronary angiography showed a massive thrombus in the proximal segment and another occlusive thrombus in the distal segment of the left anterior descending artery. He was treated with thrombolytic therapy. Repeat coronary angiography showed disappearance of the thrombi in the proximal and distal segments and obvious myocardial bridging in the mid segment. Intravascular ultrasound revealed an atherosclerotic plaque in the segment immediately proximal to the myocardial bridging, but did not reveal any plaque within or distal to the site. He was discharged 12 days later.

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Section: Discussionmentioning

confidence: 99%

Acute Myocardial Infarction Associated with Myocardial Bridging in a Young Adult

et al. 2004

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“…First, MB may cause coronary obstruction during systole. Intracoronary Doppler flow measurements have shown that the diastolic flow velocities are increased in MB segments, 3,27,35 and the peak systolic intracoronary pressure has been reported to be elevated within MB segments. 3,27,36 Intravascular ultrasonography has shown that the cross-sectional area in MB segments is reduced during systole and that this reduction continues into early diastole.…”

Section: Cardiac Events Associated With Myocardial Bridgingmentioning

confidence: 99%

Myocardial bridging increases the risk of coronary spasm

Teragawa

Fukuda

Matsuda

et al. 2003

Clinical Cardiology

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SummaryBackground: Myocardial bridging (MB) has been associated with cardiac events. Whether coronary spasm is one factor contributing to those events is unknown.Hypothesis: This study investigated whether the likelihood of coronary spasm is increased in patients with MB.Methods: A spasm-provocation test was performed by infusing acetylcholine into the left coronary artery in 114 Japanese patients with chest pain. The test result was defined as positive when the diameter of the coronary artery was reduced by ≥ 50% and ST-segment changes were documented. Myocardial bridging was defined as a > 15% reduction in coronary arterial diameter during systole after intracoronary injection of nitroglycerin.Results: Myocardial bridging was identified in 41 patients (36%) and was located in the mid-segment of the left anterior descending coronary artery (LAD) in all patients. Patients with MB experienced coronary spasm more frequently than patients without MB (MB+: 73%; MBϪ: 40%, p = 0.0006). Furthermore, among patients with a positive spasm-provocation test, coronary spasm occurred more frequently in the midsegment of the LAD in patients with MB than in those without MB (MB+: 73%; MBϪ: 45%, p = 0.0259). Multivariate regression analysis demonstrated that MB was a predictor of coronary spasm (odds ratio: 3.478, p = 0.0088).

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“…14 The areas proximal to the bridge also appear prone to atherosclerotic lesions. 13,15,16 Our patient's angina was clinically refractory to medical therapy and he received an intracoronary stent. He developed two episodes of symptomatic restenosis necessitating CABG.…”

Section: Discussionmentioning

confidence: 92%