Morphological Changes Associated with Hemodynamically Significant Myocardial Bridges in Sudden Cardiac Death

Hostiuc, Sorin; Curcă, George Cristian; Dermengiu, Dan; Dermengiu, Silvia; Hostiuc, Mihaela; Rusu, Mugurel Constantin

doi:10.1055/s-0030-1270703

Cited by 30 publications

(29 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Various studies suggested that, to have hemodynamic significance, a MB has to have some particular morphological characteristics (especially length and thickness) . Our study showed that a “typical” myocardial bridge has around 19 mm in length and 2.5 mm in thickness, values that can be considered hemodynamically significant .…”

Section: Discussionmentioning

confidence: 49%

“…Most authors suggested that MB is a benign condition, even though some found a positive correlation with myocardial ischemia (4-7), AMI (8), or other major adverse cardiac events (9,10). In forensic autopsies, it is sometimes considered a cause of sudden death and is often reported as such in scientific articles, especially in association with other congenital cardiac or coronary anomalies (11)(12)(13)(14)(15)(16)(17)(18)(19)(20). It is considered an inborn anomaly, being found in studies on human fetuses (21), and it appears to reflect particular developmental processes within the heart (22).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Myocardial Bridging: A Meta‐Analysis of Prevalence

Hostiuc

Negoi

Rusu

et al. 2017

Journal of Forensic Sciences

View full text Add to dashboard Cite

The main objective of this article was to analyze prevalence data about myocardial bridging (MB) in published studies. To this purpose, we performed a meta-analysis of studies published in English literature that contained data about the prevalence of MB and its anatomical characteristics. The overall prevalence was 19% (CI: 17-21%); autopsy studies revealed an overall prevalence of 42% (CI: 30-55%), CT studies 22% (CI: 18-25%), and coronary angiography 6% (CI: 5-8%). Most bridges were located on the left anterior descending artery (82% overall, 63% on autopsy studies), had a mean thickness of 2.47 mm and a mean length of 19.3 mm. In conclusion, autopsy studies should be the gold standard in evaluating the actual prevalence of myocardial bridges, while in vivo high-resolution CT scanning should be preferred to coronary angiography studies.

show abstract

Section: Discussionmentioning

confidence: 49%

mentioning

confidence: 99%

Myocardial Bridging: A Meta‐Analysis of Prevalence

Hostiuc

Negoi

Rusu

et al. 2017

Journal of Forensic Sciences

View full text Add to dashboard Cite

show abstract

“…The recent histopathologic studies indicated that myocardial fibrosis and interstitial edema can occur in the area of MB (26). Similarly, in a report by Hostiuc et al (27), significant myocardial fibrosis and interstitial edema were demonstrated in the bridged segment in patients who had sudden cardiac death. Death in these patients was emphasized to be related to increased electrical instability due to myocardial fibrosis.…”

Section: Discussionmentioning

confidence: 70%

The Relationship Between Myocardial Bridge and Electrocardiographic Tp-e Interval, Tp-e/QT and Tp-e/ QTc Ratio

Yıldırım¹,

İpek²,

Kalkan³

et al. 2017

Haseki

View full text Add to dashboard Cite

Ad dressforCor res pon den ce/Ya z›fl maAd re si:ErkanTp-e interval is the distance between the peak and the end of the T wave in electrocardiography. Tp-e/QT and Tp-e/QTc ratios are used as electrocardiographic indicators of ventricular arrhythmias. We have studied the effect of coronary angiographic features (the degree of stenosis and length of MB) of MB on myocardial repolarization parameters. Methods:The study group consisted of 53 patients with isolated MB and 58 patients with normal coronary arteries. Results:The QT interval and QTc were similar between the groups, however, Tp-e interval (92.72±14.72 and 79.59±12.12, respectively; p<0.001) and Tp-e/QT (0.24±0.041 and 0.21±0.025, respectively; p<0.001) and Tp-e/QTc (0.22±0.037 and 0.19±0.025, respectively; p<0.001) ratios were found to be significantly increased in MB group compared to the control group. In the comparison of the MB patients with critical and those with noncritical stenosis, Tp-e interval (100.69±10.79, 80.57±11.25, respectively; p<0.001) and Tp-e/QT (0.266±0.033, 0.219±0.037, respectively; p<0.001) and Tp-e/QTc (0.244±0.029, 0.196±0.027, respectively; p<0.001) ratios were higher in the MB with critical stenosis group. Conclusion:Our results indicate that these parameters can be practical ECG markers of ventricular arrhythmias in patients with MB. Keywords: Myocardial bridge, critical stenosis, Tp-e intervalGiriş: Miyokardial bridge (MB) genellikle asemptomatiktir ve iyi huylu olarak bilinir ancak egzersizin indüklediği ventriküler taşikardi, ani ölüm gibi ciddi klinik durumlara neden olabilir. Tp-e intervali elektrokardiyografide T dalgasının tepesi ile sonu arasındaki mesafedir. Tp-e/QT ve Tp-e/QTc oranları ventriküler aritmilerin elektrokardiyografik göstergesi olarak kullanılır. Biz MB'nin koroner anjiyografik özelliklerinin (MB'nin darlık derecesi ve uzunluğu) miyokardiyal repolarizasyon parametreleri üzerindeki etkisini araştırdık.Yöntemler: Bu çalışma izole MB'li 53 ve normal koroner artere sahip 58 hastadan oluşmaktadır. Bulgular:QT intervali ve QTc gruplar arasında benzerdi, Tp-e intervali (92,72±14,72 ve 79,59±12;12, p<0,001), Tp-e/QT (0,24±0,041 ve 0,21±0,025; p<0,001) ve Tp-e/QTc (0,22±0,037 ve 0,19±0,025; p<0,001) kontrol grubu ile karşılaştırıldığında MB grubunda belirgin olarak artmış bulundu. Kritik ve kritik olmayan darlığı bulunan MB hastaları karşılaştırıldığında, Tp-e intervali (100,69±10,79; 80,57±11,25; p<0,001), Tp-e/QT (0,266±0,033; 0.219±0,037; p<0,001) ve Tp-e/ QTc (0,244±0,029; 0,196±0,027; p<0,001) kritik darlığı olan MB hastalarında daha yüksekti.Sonuç: Sonuçlarımız MB hastalarında bu parametrelerin ventriküler aritmilerin pratik elektrokardiyografi belirteçleri olabileceğini göstermiştir.

show abstract

“…At present the exact mechanism of MCA and distal segment of the bridged artery usually free from atherosclerosis remains unclear. The mechanisms may include decreased blood flow and volume, increased endothelial shear stress and reduced bioavailability of nitric oxide and endothelin-1 (15,31). Although the protective effect of MB exists, the diastolic narrow rates ≥30% of MCAs in 8 patients, ulcer-like lesion in MCA in 1 patient and 36 lesions located distally to MBs were detected.…”

Section: Discussionmentioning

confidence: 99%

Angiographically evident atherosclerotic stenosis associated with myocardial bridging (MB) and risk factors for the artery stenosis located proximally to MB: an observational study

Hong

Wang²,

Li³

et al. 2013

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

Objective: The purpose of this study was to determine the prevalence of coronary angiographically evident atherosclerotic stenosis associated with myocardial bridging (MB) and to explore related risk factors of coronary artery stenosis located proximally to MB. Methods: Overall, 603 patients with MB-mural coronary arteries (MB-MCAs) diagnosed by angiography initially were enrolled in this observational study during May 2004 to May 2009. One-way ANOVA, t-test, Pearson correlation test and stepwise multiple regression analysis were performed to explore related risk factors. Results: Totally 644 MB-MCAs were examined. Prevalence of lesions located distally to MBs was significantly lower than those proximally to MBs [36 (5.9%) vs. 382 (62.4%), p<0.001]. Diastolic vessel diameters in MB segments were significantly smaller than reference segments p<0.001. Ulcer-like lesion was found in MB-MCA in 1 patient. Multivariate analysis suggested that vascular bifurcation lesions, the degree of narrowing and the number of diseased coronary vessels of non-MB-MCA arteries, age, low-density lipoprotein cholesterol (LDL-C)/high density lipoprotein cholesterol (HDL-C), male, course of diabetes, and systolic narrow rate (SNR) of MB-MCAs were positively related with the narrow degree of the first coronary artery stenosis (FCAS) located proximally to MBs (all p<0.05). Vascular bifurcation lesions, the degree of narrowing and the number of diseased coronary vessels of non-MB-MCA arteries, age, LDL-C/HDL-C, male, diabetes and dyslipidemia were positively related with the narrow degree of the most severe coronary artery stenosis(MSCAS) located proximally to MB (all p<0.05). Conclusion: The intramural and distal portions of a bridged artery are not the forbidden zone of artery atherosclerosis formation. SNR of MB-MCA may be one of the important decision factors to coronary artery stenosis located proximally to MB.

show abstract

Morphological Changes Associated with Hemodynamically Significant Myocardial Bridges in Sudden Cardiac Death

Cited by 30 publications

References 45 publications

Myocardial Bridging: A Meta‐Analysis of Prevalence

Myocardial Bridging: A Meta‐Analysis of Prevalence

The Relationship Between Myocardial Bridge and Electrocardiographic Tp-e Interval, Tp-e/QT and Tp-e/ QTc Ratio

Angiographically evident atherosclerotic stenosis associated with myocardial bridging (MB) and risk factors for the artery stenosis located proximally to MB: an observational study

Contact Info

Product

Resources

About