Background Large discrepancy of the incidence of myocardial bridging （MB） has been reported either among the postmortem studies or among the studies with coronary angiogram. This study was to investigate the prevale...Background Large discrepancy of the incidence of myocardial bridging （MB） has been reported either among the postmortem studies or among the studies with coronary angiogram. This study was to investigate the prevalence of MB in large number of coronary angiograms and the angiographic characteristics of MB.Methods A total of 5525 consecutive patients who underwent first diagnostic coronary angiography from January 2003 to March 2006 in Zhongshan Hospital were enrolled in this study. MB was diagnosed when the angiographical ＂milking effect＂, defined as the systolic compression and complete or partly release of the compression in diastole, was seen in the epicardial coronary arteries. Angiography was routinely repeated after intracoronary injection of 200 pg nitroglycerin. The systolic compression and length of MB were compared before and after the administration of nitroglycerin and also before and after stent implantation in patients with significant stenosis in segment proximal to the MB.Results Among 5525 patients, MBs were found in a total of 888 patients angiographically with the prevalence of 16.1%. Atherosclerotic lesions were found more often in the segment proximal to the MB with 344/854 （40.3%） patients than in the segment distal to the MB with 47/854 （5.5%） （P 〈0.01）. The systolic compression （（43.3±13.7）% at baseline vs （54.2±14.0）% after nitroglycerine） and the average length （（20.9±7.5） mm at baseline vs （22.7±8.0） mm after nitroglycerine） of the MB segment were increased after intracoronary injection of nitroglycerin （both P 〈0.01）. Stent implantation was performed in 88 patients with significant stenosis in the segment proximal to the MB. The systolic compression and the length of the MB segment were increased after stenting compared with those before stenting （systolic compression, （49.4±14.6）% at baseline vs （57.3±12.3）% after stenting, and length of MB, （19.5±6.1） mm at baseline vs （21.8±6.3） mm after stenting, P 〈0.0展开更多
Background Myocardial bridging with systolic compression of the left anterior descending coronary artery （LAD） may be associated with myocardial ischaemia. The clinical outcome in patients with surgical treatment fo...Background Myocardial bridging with systolic compression of the left anterior descending coronary artery （LAD） may be associated with myocardial ischaemia. The clinical outcome in patients with surgical treatment for symptomatic myocardial bridging remains undetermined. This study assessed the middle- and long-term results of surgical treatment for symptomatic myocardial bridging. Methods From 1997 to 2006, 37 463 patients received selective coronary angiography in the Fuwai Cardiovascular Hospital, Beijing, China. Of these, 484 patients had angiographic diagnosis of myocardial bridging. Of the 484 patients, 35 underwent surgery for treatment of myocardial bridging with significant systolic arterial compression. Among the surgical treatment patients, 24 presented with other cardiac disorders, and the remaining 11 symptomatic patients with isolated myocardial bridging were included in the follow-up study. Results The angiographic prevalence of myocardial bridging was 1.3% in this study. The coronary angiographies of the 11 patients revealed myocardial bridging in the middle segment of LAD causing systolic compression 〉75% （ranging from 75% to 90%）. The mean age of patients was 48,4 years. Surgical myotomy was performed in 3 patients and coronary artery bypass grafting （CABG） in 8 patients. Eight patients were operated on with an off-pump approach and 3 with a cardiopulmonary bypass technique after median sternotomy. Conversion to on-pump CABG surgery was necessary in 1 patient because of perforation of the right ventricle. The left internal mammary artery was used in all patients with CABG. The acute clinical success rate was 100% with respect to the absence of myocardial infarction, death or other major in-hospital complications. All of the patients were followed up clinically. The median follow-up was 35.3 months （range： 6 to 120 months）. Nine patients were free from symptoms and one of them continued taking beta blockers. The remaining 2 patients with myotomy had atypical chest pain. One rec展开更多
Background Muscle fibers overlying the intramyocardial segment of an epicardial coronary artery are termed myocardial bridging （MB）. Variable prevalence of MB has been described at autopsy and angiographic series wi...Background Muscle fibers overlying the intramyocardial segment of an epicardial coronary artery are termed myocardial bridging （MB）. Variable prevalence of MB has been described at autopsy and angiographic series with small and large sample size studies. In addition, no similar study was reported in Chinese population. The aim of this study was to investigate the angiographic prevalence of MB in consecutive 37 106 Chinese patients with chest pain from our center. Methods We conducted an observational study to evaluate the consecutive cases with MB among patients undergone selective coronary angiography, and analyzed the angiograhic prevalence and clinical features of MB in this study of very large sample size. Results Among 37 105 patients with chest pain we found 1002 cases with 1011 MBs in a retrospective manner, and the overall prevalence was 2.70%. Although more than 99% （991/1002） of patients had single bridge, 8 cases were found to have more than two MBs （seven with two, and one with three）. Altogether 54.39% of cases （545/1002） had MB without atherosclerotic lesions, and 96.24% （973/1011） of bridging located in the left anterior descending coronary artery （LAD）, mainly in the middle of LAD （792/1011,78.33%）. According to Nobel classification, of the single bridge （n=-991）, 〈50% of obstruction was predominant （471/991,47.52%）. Totally 50%-69% accounted for 34.81% （345/991）, 〉70% of obstruction was 17.65% （175/991）. Conclusions These data showed that the prevalence of angiographically detectable MB in Chinese patients with chest pain was similar to those of the previous studies, with 2.7% prevalence in this very large sample size.展开更多
文摘Background Large discrepancy of the incidence of myocardial bridging （MB） has been reported either among the postmortem studies or among the studies with coronary angiogram. This study was to investigate the prevalence of MB in large number of coronary angiograms and the angiographic characteristics of MB.Methods A total of 5525 consecutive patients who underwent first diagnostic coronary angiography from January 2003 to March 2006 in Zhongshan Hospital were enrolled in this study. MB was diagnosed when the angiographical ＂milking effect＂, defined as the systolic compression and complete or partly release of the compression in diastole, was seen in the epicardial coronary arteries. Angiography was routinely repeated after intracoronary injection of 200 pg nitroglycerin. The systolic compression and length of MB were compared before and after the administration of nitroglycerin and also before and after stent implantation in patients with significant stenosis in segment proximal to the MB.Results Among 5525 patients, MBs were found in a total of 888 patients angiographically with the prevalence of 16.1%. Atherosclerotic lesions were found more often in the segment proximal to the MB with 344/854 （40.3%） patients than in the segment distal to the MB with 47/854 （5.5%） （P 〈0.01）. The systolic compression （（43.3±13.7）% at baseline vs （54.2±14.0）% after nitroglycerine） and the average length （（20.9±7.5） mm at baseline vs （22.7±8.0） mm after nitroglycerine） of the MB segment were increased after intracoronary injection of nitroglycerin （both P 〈0.01）. Stent implantation was performed in 88 patients with significant stenosis in the segment proximal to the MB. The systolic compression and the length of the MB segment were increased after stenting compared with those before stenting （systolic compression, （49.4±14.6）% at baseline vs （57.3±12.3）% after stenting, and length of MB, （19.5±6.1） mm at baseline vs （21.8±6.3） mm after stenting, P 〈0.0
文摘Background Myocardial bridging with systolic compression of the left anterior descending coronary artery （LAD） may be associated with myocardial ischaemia. The clinical outcome in patients with surgical treatment for symptomatic myocardial bridging remains undetermined. This study assessed the middle- and long-term results of surgical treatment for symptomatic myocardial bridging. Methods From 1997 to 2006, 37 463 patients received selective coronary angiography in the Fuwai Cardiovascular Hospital, Beijing, China. Of these, 484 patients had angiographic diagnosis of myocardial bridging. Of the 484 patients, 35 underwent surgery for treatment of myocardial bridging with significant systolic arterial compression. Among the surgical treatment patients, 24 presented with other cardiac disorders, and the remaining 11 symptomatic patients with isolated myocardial bridging were included in the follow-up study. Results The angiographic prevalence of myocardial bridging was 1.3% in this study. The coronary angiographies of the 11 patients revealed myocardial bridging in the middle segment of LAD causing systolic compression 〉75% （ranging from 75% to 90%）. The mean age of patients was 48,4 years. Surgical myotomy was performed in 3 patients and coronary artery bypass grafting （CABG） in 8 patients. Eight patients were operated on with an off-pump approach and 3 with a cardiopulmonary bypass technique after median sternotomy. Conversion to on-pump CABG surgery was necessary in 1 patient because of perforation of the right ventricle. The left internal mammary artery was used in all patients with CABG. The acute clinical success rate was 100% with respect to the absence of myocardial infarction, death or other major in-hospital complications. All of the patients were followed up clinically. The median follow-up was 35.3 months （range： 6 to 120 months）. Nine patients were free from symptoms and one of them continued taking beta blockers. The remaining 2 patients with myotomy had atypical chest pain. One rec
文摘Background Muscle fibers overlying the intramyocardial segment of an epicardial coronary artery are termed myocardial bridging （MB）. Variable prevalence of MB has been described at autopsy and angiographic series with small and large sample size studies. In addition, no similar study was reported in Chinese population. The aim of this study was to investigate the angiographic prevalence of MB in consecutive 37 106 Chinese patients with chest pain from our center. Methods We conducted an observational study to evaluate the consecutive cases with MB among patients undergone selective coronary angiography, and analyzed the angiograhic prevalence and clinical features of MB in this study of very large sample size. Results Among 37 105 patients with chest pain we found 1002 cases with 1011 MBs in a retrospective manner, and the overall prevalence was 2.70%. Although more than 99% （991/1002） of patients had single bridge, 8 cases were found to have more than two MBs （seven with two, and one with three）. Altogether 54.39% of cases （545/1002） had MB without atherosclerotic lesions, and 96.24% （973/1011） of bridging located in the left anterior descending coronary artery （LAD）, mainly in the middle of LAD （792/1011,78.33%）. According to Nobel classification, of the single bridge （n=-991）, 〈50% of obstruction was predominant （471/991,47.52%）. Totally 50%-69% accounted for 34.81% （345/991）, 〉70% of obstruction was 17.65% （175/991）. Conclusions These data showed that the prevalence of angiographically detectable MB in Chinese patients with chest pain was similar to those of the previous studies, with 2.7% prevalence in this very large sample size.
