Coronary artery diseaseComparison of Angiographic and Intravascular Ultrasonic Detection of Myocardial Bridging of the Left Anterior Descending Coronary Artery
Section snippets
Methods
From May 2003 to October 2007, 331 patients with de novo coronary lesions located in the LAD underwent diagnostic or preinterventional IVUS at the Columbia University Medical Center (New York, New York). IVUS studies of these patients were reviewed, and 75 MBs were identified. This study was approved by the institutional review board; written informed consent was obtained from all patients. Patient demographics were confirmed by hospital chart review at the time of the procedure. Coronary risk
Results
Clinical characteristics and indications for coronary angiography are listed in Table 1. In general, these patients had advanced atherosclerosis with multiple coronary risk factors.
IVUS-detectable MB segments, i.e., echocardiographically lucent muscle band surrounding the LAD and systolic compression of the LAD (Figure 1, Figure 2, Figure 3), were present in 23% of patients (75 of 331). Comparing the IVUS images with the corresponding angiograms, the location of MB was in the middle segment of
Discussion
Although the criteria for detection of an MB differ among pathology, IVUS, and angiography, the main findings of the present study follow. (1) IVUS-detectable MBs were present in 23% of LADs in patients with advanced coronary atherosclerosis. This is similar to the frequency of an autopsy-detectable intramyocardial course of the LAD. (2) Most IVUS-detected MBs were angiographically silent with a normal LAD appearance. (3) Angiographically silent MBs were more often located distal to an
References (29)
- et al.
Myocardial bridging of the coronary arteries
Clin Radiol
(1989) The angiographic prevalence of myocardial bridging in man
Chest
(1982)- et al.
Myocardial bridges: a review
Prog Cardiovasc Dis
(1983) - et al.
Clinical significance of isolated coronary bridges: benign and frequent condition involving the left anterior descending artery
Am Heart J
(1982) - et al.
Angiographic evidence of myocardial squeezing accompanying tachyarrhythmia as a possible cause of myocardial infarction
Chest
(1978) - et al.
Myocardial bridging and milking effect of the left anterior descending coronary artery: normal variant or obstruction?
Am J Cardiol
(1976) - et al.
Relation of myocardial bridges and loops on the coronary arteries to coronary occulsions
Am Heart J
(1961) - et al.
American College of Cardiology Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies (IVUS)A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents
J Am Coll Cardiol
(2001) The mural coronary
Am Heart J
(1951)- et al.
Detection of myocardial bridge and evaluation of its anatomical properties by coronary multislice spiral computed tomography
Eur J Radiol
(2007)
The prevalence and anatomical patterns of intramuscular coronary arteries: a coronary computed tomography angiographic study
J Am Coll Cardiol
Coronary anomalies: incidence, pathophysiology, and clinical relevance
Circulation
Myocardial bridges and ischemic heart disease
Eur Heart J
Myocardial bridging as a cause of paroxysmal atrioventricular block
J Am Coll Cardiol
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