The prevalence of myocardial bridging on multidetector computed tomography and its relation to coronary plaques

Abstract

Purpose: To test the hypothesis that the prevalence of myocardial bridging varies between ethnic groups, and that the segment proximal to the myocardial bridge is more prone to plaque formation. Material and methods:A total of 4500 patients who had undergone computerised tomography (CT) coronary angiography at our institute were studied for myocardial bridging. Data on the clinical profile and indication for CT coronary angiography in myocardial bridging were collected. Patients with and without proximal disease were compared using the chi-square test for ordinal variables and Student's t-test for continuous variables. The length to depth ratio (RA-MA ratio) of the bridged segment was determined. Results:The prevalence of atherosclerotic plaques in the segment proximal to the bridged segment was 37.8%, which was lower than the prevalence of 48.7% for plaques in the corresponding segments among patients without myocardial bridging. The average length of the bridged segment was 15.5 ± 5 mm, and that for patients with and without proximal plaques was 13 ± 4 and 16 ± 6 mm (p = 0.1), respectively. Similarly, the average depth of the segments with and without proximal plaques was 1.8 ± 0.6 mm and 1.4 ± 0.5 mm (p = 0.06), respectively. Only the RA-MA ratio (8 ± 3 vs. 13 ± 6, p = 0.01) was significantly lower in patients with atherosclerotic plaques. Conclusions:The prevalence in our study population was 10%, with mid left anterior descending artery (LAD) being the most common segment involved. Moreover, the prevalence and distribution of coronary plaques in LAD were similar in patients with and without myocardial bridging.

Clinical Application of Coronary Computed Tomography Angiography in Patients with Suspected Coronary Artery Disease

“…10 A recent study including 4500 patients who had undergone CCTA found the prevalence of myocardial bridging to be 10%. 11 The present study detected bridging in 17 patients yielding a rate of 10%. The prevalence of anomalous coronary arteries in the general population has been reported to be 1.5% as detected by magnet resonance imaging and 2.6% as detected by CCTA.…”

Relationship between Different Degrees of Compression and Clinical Symptoms in Patients with Myocardial Bridge and the Risk Factors of Proximal Atherosclerosis

“…In recent years, it has been found that the myocardial bridge is closely related to a variety of clinical cardiovascular diseases. The myocardial bridge exerts compression on coronary artery, especially during systole, which can compress parietal coronary artery and cause angina pectoris, myocardial infarction, ventricular dysfunction, arrhythmia, and other symptoms [ 7 ]. However, because most patients with the myocardial bridge have no obvious clinical symptoms, they are often ignored by clinicians.…”

Coronary artery anomalies: a review of the literature and a proposal for a new classification

“…Regarding anatomical location, 67 to 98% of MBs are located in the ADA, most frequently in its proximal and middle segments. The Cx and RCA are affected less often 31,32 . Keeping in mind the high rate of MBs detected on autopsy, coronary computed tomography angiography is considered to be the most sensitive modality, compared with invasive coronary angiography and intravascular imaging, for general diagnostic purposes.…”