Author/Authors :
Eftekhar-Vaghefi, Hassan Department of Anatomy - School of Medicine - Kerman University of Medical Sciences, Kerman, Iran , Pourhoseini, Somayeh Department of Anatomy - School of Medicine - Kerman University of Medical Sciences, Kerman, Iran , Movahedi, Maryam Department of Cardiology - School of Medicine - Shiraz University of Medical Sciences, Shiraz, Iran , Hooshmand, Shohre Cardiovascular Research Center - Shiraz University of Medical Sciences, Shiraz, Iran , Ostovan, Mohammad Ali Cardiovascular Research Center - Shiraz University of Medical Sciences, Shiraz, Iran , Dehghani, Pooyan Department of Cardiology - School of Medicine - Shiraz University of Medical Sciences, Shiraz, Iran , Ostovan, Nikan Cardiovascular Research Center - Shiraz University of Medical Sciences, Shiraz, Iran
Abstract :
Introduction: Myocardial bridge (MB) is a congenital anomaly in which a segment of a coronary
artery is surrounded by myocardium. In our study, we want to use conventional coronary angiography
(CCA) to describe morphologic characteristics of MB (unidentified or identified) in the patients with
documented evidence of MB in coronary computed tomography angiography (CCTA).
Methods: The present study was designed as cross-sectional and was conducted on 47 patients
with documented evidence of MB in CCTA, who were referred to Nemazee and Faghihi hospitals
for performing coronary angiography during a one year period. We compared the morphologic
characteristics of tunneled segments, which were missed at CCA (unidentified), and the tunneled
segments which were identified with CCA.
Results: In sum, MB was found in 16 (34%) patients at CCA (identified), and it was not found in 31
(66%) patients (unidentified) based on compression sign. No significant correlation was found between
the percentage of systolic compression and the length and depth of the tunneled segment in identified
group (r=0.73, P = 0.18; r=1.09, P = 0.15; respectively). Degree of atherosclerotic plaque formation
(diameter stenosis, percentage) (mean, 0.25 (25%) ±0.29; range, 0-0.98) of the tunneled segments
in unidentified group was significantly more than the same degree (mean, 0.07 (7%) ±0.13; range,
0-0.41) of the identified group (P = 0.03). The measurement of the trapezoid area under the tunneled
segment with this formula [(MB length+ intramyocardial segment) ×depth/2] had significant relation
with systolic compression (r=0.304, P = 0.03) and defined the cut-off value of 250 mm2 as the value of
significant difference in detecting myocardial bridging with CCA.
Conclusion: Our results showed that in most of identified MBs in CCA the tunneled segment area
was equal and more than 250 mm2. In addition, the degree of atherosclerotic plaque of the tunneled
segments at CCA was significantly more in unidentified group.
