No abstract available.
Myocardial Bridging

No abstract available.
Myocardial Bridging* ; Sleep Apnea, Obstructive* ; Spine*

No abstract available.
Myocardial Bridging* ; Sleep Apnea, Obstructive* ; Spine*

Coronary Vessel Anomalies ; Humans ; Myocardial Bridging

BACKGROUND

Myocardial bridging (MB) is a congenital coronary anomaly characterized by an epicardial coronary artery taking an intramuscular course, causing systolic compression of the tunneled segment. In comparison to coronary artery disease (CAD), myocardial bridges have been uncommonly associated with acute coronary syndromes and sudden cardiac death.Evidence of accelerated atherosclerotic plaque formation proximal to the bridged segment may increase the risk for future adverse cardiac events in these patients.

This Single–Center Retrospective Study included 323 adult in-patients who underwent coronary angiography for suspected myocardial ischemia in 2022. Clinical information and in-hospital outcomes were obtained by review of medical records.

Myocardial bridging was observed in 31 out of 323 patients (9.60%), with the majority in the mid-left anterior descending artery (87.10%). MB was more prevalent in females (56.62%), and these patients were younger than patients with obstructive CAD (56.9 versus 63.6 years). Chronic Coronary Syndrome was more prevalent in the MB group (82.62%). The coronary segment proximal to the area with MB showed the concurrent presence of obstructive CAD in 16.12% and non-obstructive CAD in 29.03% of cases. In-hospital mortality occurred in 4.44% of the studied population. However, there were no mortalities in the MB group.

Among patients admitted for suspected myocardial ischemia, 9.6% had MB. These patients were younger and, more often, female. Obstructive and non-obstructive CAD were noted in bridged vessels. Although patients with obstructive CAD have a higher risk of experiencing in-hospital death and cardiac complications, evidence of increased atherosclerotic plaque formation in bridged vessels has important implications for future adverse cardiac events and repeat hospitalizations in the MB population. Aggressive risk factor modification, emphasis on long-term follow-up, and the establishment of clinical practice guidelines are therefore necessary for patients with MB.

Coronary cameral fistula (CCF) is a rare anomaly, where a communication exists between an epicardial coronary artery and a cardiac chamber. Assessing the hemodynamic significance of the fistula is crucial to make a decision concerning the management process. We present two cases of CCF, draining into the left ventricle, in which the hemodynamic significance was assessed by a fractional flow reserve.
Coronary Vessels ; Fistula ; Heart Ventricles ; Hemodynamics ; Myocardial Bridging ; Myocardial Ischemia

BACKGROUNDSmall case series have suggested an association of coronary myocardial bridge (MB) with myocardial infarction (MI). However, the relationship between MB and major adverse cardiac events (MACE) remains largely unknown. The aim of this study was to assess the relationship between MB and MACE involving MI.

METHODSWe performed a systematic search of MEDLINE, PreMEDLINE, and all EMB Reviews as well as a reference list of relevant articles according to the SPICO (Study design, Patient, Intervention, Control-intervention, and Outcome) criteria using the following keywords: myocardial bridging, myocardial bridge, intramural coronary artery, mural coronary artery, tunneled coronary artery, coronary artery overbridging, etc. Bibliographies of the retrieved publications were additionally hand searched. Studies were included for the meta-analysis if they satisfied the following criteria: (1) they evaluate the association of MB with cardiovascular endpoint event; (2) they included individuals with MB and those without MB; 3) they excluded individuals with obstructive coronary artery disease (CAD). Studies were reviewed by a predetermined protocol including quality assessment. Dates were pooled using a random effect model.

RESULTSSeven observational studies that followed 5 486 patients eligible for the enrolled criteria were included from 7 136 initially identified articles. The prevalence of MB was 24.8% (1 363/5 486). During 0.5-7.0 years of follow-up of this cohort of population, crude outcome rates were 8.0% in the MB group and 7.7% in the non-MB group. The odds ratio of overall MACE and MI were 1.34 (95% confidence interval (CI): 0.57-3.17, P = 0.51, n = 7 studies) and 2.75 (95% CI: 1.08-7.02, P < 0.03, n = 5 studies) respectively for subjects of MB compared to non-MB.

CONCLUSIONRelationship between MB and MI appears to be a real one, although the study did not reveal a connection of MB to MACE, suggesting whether the necessity of antiplatelet therapy needs to be further studied in a larger cohort of patients with MB prospectively.

Coronary Vessel Anomalies ; diagnosis ; Diagnostic Imaging ; Humans ; Myocardial Bridging

A model of fluid dynamics related to the myocardial bridginged and mural coronary artery was designed and manufactured according to the physical principle and characteristic of the mural coronary artery. The model can imitate systematically well the effect of myocardial bridging on hemodynamic change of the mural coronary artery under different controlled experimental parameter. The methodology is proved to be feasible and has good prosperity of experimental study.
Coronary Vessels ; physiology ; Hemodynamics ; Humans ; Models, Cardiovascular ; Myocardial Bridging

Myocardial bridging is defined that short segments of coronary artery descend into the myocardium for a variable distance and each systolic contraction of these fibers can cause narrowing of the artery. Systolic narrow-ing may rarely be caused by connective tissue such as fibrous band. Myocardial ischemia, infarction and sudden death may be seen in some patients with myocardial bridging. Myocardial infarction in association with isolated myocardial bridges with systolic narrowing is uncommon. We report a case of Q wave myocardial infarction in a patient with angiographic systolic narrowing at the middle segment left anterior descending coronary artery which was caused by fibrous band.
Arteries ; Connective Tissue ; Coronary Vessels ; Death, Sudden ; Humans ; Infarction ; Myocardial Bridging* ; Myocardial Infarction* ; Myocardial Ischemia ; Myocardium