Cor Vasa 2019, 61(6):573-577 | DOI: 10.33678/cor.2019.005

Myocardial bridge characteristics and coronary atherosclerotic markers

Hussein Nafakhi^a, Yasir Salah Alam^a, Abdulameer A. Al-Mosawi^b, Hasan A. Al-Nafakh^b

^a Internal Medicine Department, Medicine College, University of Kufa, Najaf, Iraq

^b Radiology Department, Medicine College, University of Kufa, Najaf, Iraq

Background: The clinical significance of myocardial bridge (MB) on the whole coronary system and coronary atherosclerosis is still a matter of debate. This study aimed to investigate the possible association between MB characteristics (length, depth, proximal stenosis presence and site) with coronary atherosclerotic markers (coronary artery calcification [CAC], plaque, stenosis and pericardial fat volume [PFV]).

Patients and methods: From a total of 225 consecutive patients with suspected coronary artery disease who underwent 64-slice multi-detector CT (MDCT) angiography examination, 41 patients with MB were enrolled in the study.

Results: MB occurred most commonly in the left anterior descending artery (92.5%). The MB length showed no significant association with CAC, PFV, coronary plaque and stenosis severity. The MB depth showed a significant association with CAC (r = 0.4, p < 0.00), coronary plaque presence (p < 0.00) and coronary stenosis (p = 0.03), apart from proximal stenosis presence. There was no significant association between MB depth with PFV (r = 0.1, p = 0.4). MB proximal stenosis presence showed a significant association with total CAC (p < 0.00), coronary plaque presence (p < 0.00) and coronary stenosis presence at other sites (p < 0.00) while showed no significant association with PFV (p = 0.4). After adjustment for conventional cardiac risk factors, MB depth association with coronary stenosis and plaque and the association of MB proximal stenosis presence with CAC and plaque persisted.

Conclusion: MB depth and proximal stenosis presence were significantly associated with coronary plaque and stenosis presence. Follow up studies with control group is required to highlight the exact role of MB on whole coronary system.

Keywords: Coronary calcification, Myocardial bridge, Pericardial fat, Plaque, Markers

Received: February 12, 2019; Accepted: March 5, 2019; Published: December 15, 2019  Show citation