Myocardial Bridging Assessed by Multidetector Computed Tomography: Likely Cause of Chest Pain in Younger Patients With Low Prevalence of Dyslipidemia

Journal of Forensic Sciences

Negoi

Rusu

et al. 2017

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.

Section: Resultsmentioning

confidence: 99%

Myocardial Bridging: A Meta‐Analysis of Prevalence

Journal of Forensic Sciences

Negoi

Rusu

et al. 2017

“…The MB located in the LAD artery accounts for 60.4–93% of MB (11–14,23). In this study, 79.4% of MBs were identified in the LAD artery, which was similar to the result (79.7%) of a large-sample study using a similar CT machine (23).…”

Section: Discussionmentioning

confidence: 99%

“…Studies regarding the correlation between MB characteristics on CT and clinical findings are rare with only small sample sizes, producing contradictory results (14,20). For example, de Agustin et al.…”

Section: Introductionmentioning

confidence: 99%

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Measurements of myocardial bridges on computed tomography predict presence of clinical symptoms and outcomes of adverse heart events: a retrospective study in a large population from China

Liu

Chen

et al. 2016

Acta Radiol

Background Clinical-radiological correlation of myocardial bridge (MB) remains unclear. Purpose To correlate clinical symptoms and outcomes of MBs with computed tomography (CT) coronary angiography findings. Material and Methods A total of 2092 patients with CT coronary angiography were collected. Patients were divided into symptomatic and asymptomatic groups, adverse heart events (AHE) and non-AHE groups, MB and non-MB groups, as well as left anterior descending (LAD)-MB and non-LAD-MB groups. Statistical analyses were performed to identify inter-group differences, and clinical-radiological correlations of MBs or mural coronary arteries (MCAs). Results The prevalence of MB, the MCA stenosis either in systole or in diastole, and the ratio of LAD-MB were significantly higher in the symptomatic group than in the asymptomatic group, and higher in the AHE group than in the non-AHE group ( P all <0.05). MB thickness, systolic MCA stenosis, and diastolic MCA stenosis were independent variables predicting clinical symptoms ( P < 0.05), with diastolic MCA stenosis having the highest diagnostic performance, when cutting at 24.6%. The corresponding sensitivity and specificity were 87.8% and 90.6%, respectively. Diastolic MCA stenosis independently indicated outcome of AHE (odds ratio, 1.047; P < 0.001). Conclusion Measurements of MB-MCA by CT predict the presence of clinical symptoms and outcomes of AHE, with diastolic MCA stenosis possessing the greatest performance.

“…De Agustin et al . showed that subjects with chest pain and without severe coronary artery stenosis are significantly more likely to have MB compared to those with severe CAD; moreover, in the MB subgroup hyperlipidemia was considerably less often found compared to the group of subjects without MB 76 . Tang et al .…”

Section: Discussionmentioning

confidence: 96%

Cardiovascular consequences of myocardial bridging: A meta-analysis and meta-regression

Rusu

et al. 2017

Sci Rep

Myocardial bridging, a congenital abnormality in which a coronary artery tunnels through the myocardial fibres was usually considered a benign condition. Many studies suggested a potential hemodynamic significance of myocardial bridging and some, usually case reports, implied a possible correlation between it and various cardiovascular pathologies like acute myocardial infarction, ventricular rupture, life-threatening arrhythmias, hypertrophic cardiomyopathy, apical ballooning syndrome or sudden death. The main objective of this article is to evaluate whether myocardial bridging may be associated with significant cardiac effects or if it is strictly a benign anatomical variation. To this purpose, we performed a meta-analysis (performed using the inverse variance heterogeneity model) and meta-regression, on scientific articles selected from three main databases (Scopus, Web of Science, Pubmed). The study included 21 articles. MB was associated with major adverse cardiac events - OR = 1.52 (1.01–2.30), and myocardial ischemia OR = 3.00 (1.02–8.82) but not with acute myocardial infarction, cardiovascular death, ischemia identified using imaging techniques, or positive exercise stress testing. Overall, myocardial bridging may have significant cardiovascular consequences (MACE, myocardial ischemia). More studies are needed to reveal/refute a clear association with MI, sudden death or other cardiovascular pathologies.