Concurrent Myocardial Bridging and Coronary Artery Disease: A Study of an Iranian Population
-
Danial Chaleshi
,
Fahimeh samadi
,
Amir Ali Ghaemi
,
Negin Parsa
,
Aysan Zareiye
,
Mohammad Reza Motamedzade
,
Mohammadtaghi Sarebanhassanabadi
,
Hossein Nough
Abstract
Background: Myocardial bridging (MB) has been associated with acute coronary syndrome, ischemia, arrhythmia, and even sudden death. This study investigated the prevalence of MB and its complications and manifestations.
Methods: This cross-sectional study was conducted on symptomatic coronary patients who underwent angiography between March 2022 and March 2023 at Afshar or Shahid Sadoughi hospitals in Yazd, Iran. The angiographic reports of all patients were evaluated. Cases with MB were selected, and their angiographic films were assessed by an interventional cardiologist for diagnostic accuracy. Baseline, radiological, and clinical characteristics were also evaluated. Data were collected and analyzed using SPSS, version 20.0. The dependent variable was stratified based on independent variables using the χ2 test.
Results: Out of 3750 symptomatic patients, 165 (4.4%) were diagnosed with MB. Among these, 111 (67.3%) were male, and the mean age was 56.87±10.06 years. A total of 152 patients had MB in the left anterior descending artery, representing the highest occurrence proportion at 92.1%. The most common types of coronary artery disease (CAD) diagnosed included mono-vessel disease and slow flow, accounting for 35.1% and 25.8%, respectively. There was no significant frequency distribution of CAD co-occurrence based on baseline and radiological features (P>0.050).
Conclusion: This study provides valuable insights into the prevalence of MB in Iran and its co-occurrence with CAD. While some findings align with previous research, certain discrepancies warrant further investigation.
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11. Yuan SM. Myocardial Bridging. Braz J Cardiovasc Surg 2016;31:60-62.
12. Alegria JR, Herrmann J, Holmes DR Jr, Lerman A, Rihal CS. Myocardial bridging. Eur Heart J 2005;26:1159-1168.
13. Morales AR, Romanelli R, Boucek RJ. The mural left anterior descending coronary artery, strenuous exercise and sudden death. Circulation 1980;62:230-237.
14. Shabestari AA, Akhlaghpoor S, Tayebivaljozi R, Fattahi Masrour F. Prevalence of Congenital Coronary Artery Anomalies and Variants in 2697 Consecutive Patients Using 64-Detector Row Coronary CTAngiography. Iran J Radiol 2012;9:111-121.
15. Erdem K, Ozbay Y. Prevalence and Characteristics of Coronary Artery Anomalies Using Invasive Coronary Angiography in 6237 Consecutive Patients in a Single Center in Turkey. Arch Iran Med 2018;21:240-245.
16. Takamura K, Fujimoto S, Nanjo S, Nakanishi R, Hisatake S, Namiki A, Ishikawa Y, Ishii T, Yamazaki J. Anatomical characteristics of myocardial bridge in patients with myocardial infarction by multi-detector computed tomography. Circ J 2011;75:642-648.
17. Darabian S, Amirzadegan A, Sadeghian H, Sadeghian S, Raissi Dehkordi M, Goodarzynejad H. Clinical and Angiographic Characteristics of Myocardial Bridges: a Descriptive Report of 19 Cases and Follow-up Outcomes. J Tehran Heart Cent 2007;2:105-110.
18. Shakya S, Gajurel RM, Poudel CM, Shrestha H, Devkota S, Thapa S, Manandhar B, Khanal R. Prevalence of Myocardial Bridging in Angiography Study. J Nepal Health Res Counc 2023;20:774-778.
19. Matta A, Canitrot R, Nader V, Blanco S, Campelo-Parada F, Bouisset F, Lhermusier T, Elbaz M, Carrie D, Roncalli J. Left anterior descending myocardial bridge: Angiographic prevalence and its association to atherosclerosis. Indian Heart J 2021;73:429-433.
20. Ciçek D, Kalay N, Müderrisoğlu H. Incidence, clinical characteristics, and 4-year follow-up of patients with isolated myocardial bridge: a retrospective, single-center, epidemiologic, coronary arteriographic follow-up study in southern Turkey. Cardiovasc Revasc Med 2011;12:25-28.
21. Darabont RO, Vișoiu IS, Magda ȘL, Stoicescu C, Vintilă VD, Udroiu C, Vinereanu D. Implications of Myocardial Bridge on Coronary Atherosclerosis and Survival. Diagnostics (Basel) 2022;12:948.
22. Asokan PK, Goyal KK. Prevalence and clinical characteristics of patients with myocardial bridging in a population from North Kerala. Journal of Indian College of Cardiology 2018;8:61-63.
23. Nam P, Choi BG, Choi SY, Byun JK, Mashaly A, Park Y, Jang WY, Kim W, Choi JY, Park EJ, Na JO, Choi CU, Lim HE, Kim EJ, Park CG, Seo HS, Oh DJ, Rha SW. The impact of myocardial bridge on coronary artery spasm and long-term clinical outcomes in patients without significant atherosclerotic stenosis. Atherosclerosis 2018;270:8-12.
24. Rinaldi R, Princi G, La Vecchia G, Bonanni A, Chiariello GA, Candreva A, Gragnano F, Calabrò P, Crea F, Montone RA. MINOCA Associated with a Myocardial Bridge: Pathogenesis, Diagnosis and Treatment. J Clin Med 2023;12:3799.
25. Hostiuc S, Rusu MC, Hostiuc M, Negoi RI, Negoi I. Cardiovascular consequences of myocardial bridging: A meta-analysis and meta-regression. Sci Rep 2017;7:14644.
26. Corban MT, Hung OY, Eshtehardi P, Rasoul-Arzrumly E, McDaniel M, Mekonnen G, Timmins LH, Lutz J, Guyton RA, Samady H. Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies. J Am Coll Cardiol 2014;63:2346-2355.
27. Bárczi G, Becker D, Sydó N, Ruzsa Z, Vágó H, Oláh A, Merkely B. Impact of Clinical and Morphological Factors on Long-Term Mortality in Patients with Myocardial Bridge. J Cardiovasc Dev Dis 2022;9:129.
2. Roberts W, Charles SM, Ang C, Holda MK, Walocha J, Lachman N, Tubbs RS, Loukas M. Myocardial bridges: A meta-analysis. Clin Anat 2021;34:685-709.
3. Parapid B, Kanjuh VI. Myocardial Bridge: Friend, Enemy, or Frenemy? Arq Bras Cardiol 2023;120:e20230426.
4. Wang X, Rastegar H, Rowin EJ, Robich M, Gonzalez-Ciccarelli LF, Cobey FC. Myocardial Bridge or Something Else? J Cardiothorac Vasc Anesth 2022;36:332-337.
5. Matta A, Nader V, Canitrot R, Delmas C, Bouisset F, Lhermusier T, Blanco S, Campelo-Parada F, Elbaz M, Carrie D, Galinier M, Roncalli J. Myocardial bridging is significantly associated to myocardial infarction with non-obstructive coronary arteries. Eur Heart J Acute Cardiovasc Care 2022;11:501-507.
6. Aden D, Phulware RH, Mittal S, Ahuja A. Myocardial bridging - Sudden unexpected death of a young girl: A case report. Indian J Pathol Microbiol 2022;65:157-159.
7. Hostiuc S, Negoi I, Rusu MC, Hostiuc M. Myocardial Bridging: A Meta-Analysis of Prevalence. J Forensic Sci 2018;63:1176-1185.
8. Javadrashid R, Tarzamni MK, Aslanabadi N, Ghaffari M, Salehi A, Sorteji K. Myocardial bridging and coronary artery anomalies detected by ECG-gated 64-row multidetector computed tomography angiography in symptomatic patients. Folia Morphol (Warsz) 2009;68:201-206.
9. Kim HJ, Lee MH, Jo SH, Seo WW, Kim HL, Lee KY, Yang TH, Her SH, Han SH, Lee BK, Park KH, Rha SW, Gwon HC, Choi DJ, Baek SH. Effect of Significant Coronary Artery Stenosis on Prognosis in Patients with Vasospastic Angina: A Propensity Score-Matched Analysis. J Clin Med 2021;10:3341.
10. Bozkurt B, Coats AJS, Tsutsui H, Abdelhamid CM, Adamopoulos S, Albert N, Anker SD, Atherton J, Böhm M, Butler J, Drazner MH, Michael Felker G, Filippatos G, Fiuzat M, Fonarow GC, Gomez-Mesa JE, Heidenreich P, Imamura T, Jankowska EA, Januzzi J, Khazanie P, Kinugawa K, Lam CSP, Matsue Y, Metra M, Ohtani T, Francesco Piepoli M, Ponikowski P, Rosano GMC, Sakata Y, Seferović P, Starling RC, Teerlink JR, Vardeny O, Yamamoto K, Yancy C, Zhang J, Zieroth S. Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure: Endorsed by the Canadian Heart Failure Society, Heart Failure Association of India, Cardiac Society of Australia and New Zealand, and Chinese Heart Failure Association. Eur J Heart Fail 2021;23:352-380.
11. Yuan SM. Myocardial Bridging. Braz J Cardiovasc Surg 2016;31:60-62.
12. Alegria JR, Herrmann J, Holmes DR Jr, Lerman A, Rihal CS. Myocardial bridging. Eur Heart J 2005;26:1159-1168.
13. Morales AR, Romanelli R, Boucek RJ. The mural left anterior descending coronary artery, strenuous exercise and sudden death. Circulation 1980;62:230-237.
14. Shabestari AA, Akhlaghpoor S, Tayebivaljozi R, Fattahi Masrour F. Prevalence of Congenital Coronary Artery Anomalies and Variants in 2697 Consecutive Patients Using 64-Detector Row Coronary CTAngiography. Iran J Radiol 2012;9:111-121.
15. Erdem K, Ozbay Y. Prevalence and Characteristics of Coronary Artery Anomalies Using Invasive Coronary Angiography in 6237 Consecutive Patients in a Single Center in Turkey. Arch Iran Med 2018;21:240-245.
16. Takamura K, Fujimoto S, Nanjo S, Nakanishi R, Hisatake S, Namiki A, Ishikawa Y, Ishii T, Yamazaki J. Anatomical characteristics of myocardial bridge in patients with myocardial infarction by multi-detector computed tomography. Circ J 2011;75:642-648.
17. Darabian S, Amirzadegan A, Sadeghian H, Sadeghian S, Raissi Dehkordi M, Goodarzynejad H. Clinical and Angiographic Characteristics of Myocardial Bridges: a Descriptive Report of 19 Cases and Follow-up Outcomes. J Tehran Heart Cent 2007;2:105-110.
18. Shakya S, Gajurel RM, Poudel CM, Shrestha H, Devkota S, Thapa S, Manandhar B, Khanal R. Prevalence of Myocardial Bridging in Angiography Study. J Nepal Health Res Counc 2023;20:774-778.
19. Matta A, Canitrot R, Nader V, Blanco S, Campelo-Parada F, Bouisset F, Lhermusier T, Elbaz M, Carrie D, Roncalli J. Left anterior descending myocardial bridge: Angiographic prevalence and its association to atherosclerosis. Indian Heart J 2021;73:429-433.
20. Ciçek D, Kalay N, Müderrisoğlu H. Incidence, clinical characteristics, and 4-year follow-up of patients with isolated myocardial bridge: a retrospective, single-center, epidemiologic, coronary arteriographic follow-up study in southern Turkey. Cardiovasc Revasc Med 2011;12:25-28.
21. Darabont RO, Vișoiu IS, Magda ȘL, Stoicescu C, Vintilă VD, Udroiu C, Vinereanu D. Implications of Myocardial Bridge on Coronary Atherosclerosis and Survival. Diagnostics (Basel) 2022;12:948.
22. Asokan PK, Goyal KK. Prevalence and clinical characteristics of patients with myocardial bridging in a population from North Kerala. Journal of Indian College of Cardiology 2018;8:61-63.
23. Nam P, Choi BG, Choi SY, Byun JK, Mashaly A, Park Y, Jang WY, Kim W, Choi JY, Park EJ, Na JO, Choi CU, Lim HE, Kim EJ, Park CG, Seo HS, Oh DJ, Rha SW. The impact of myocardial bridge on coronary artery spasm and long-term clinical outcomes in patients without significant atherosclerotic stenosis. Atherosclerosis 2018;270:8-12.
24. Rinaldi R, Princi G, La Vecchia G, Bonanni A, Chiariello GA, Candreva A, Gragnano F, Calabrò P, Crea F, Montone RA. MINOCA Associated with a Myocardial Bridge: Pathogenesis, Diagnosis and Treatment. J Clin Med 2023;12:3799.
25. Hostiuc S, Rusu MC, Hostiuc M, Negoi RI, Negoi I. Cardiovascular consequences of myocardial bridging: A meta-analysis and meta-regression. Sci Rep 2017;7:14644.
26. Corban MT, Hung OY, Eshtehardi P, Rasoul-Arzrumly E, McDaniel M, Mekonnen G, Timmins LH, Lutz J, Guyton RA, Samady H. Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies. J Am Coll Cardiol 2014;63:2346-2355.
27. Bárczi G, Becker D, Sydó N, Ruzsa Z, Vágó H, Oláh A, Merkely B. Impact of Clinical and Morphological Factors on Long-Term Mortality in Patients with Myocardial Bridge. J Cardiovasc Dev Dis 2022;9:129.
| Files | ||
| Issue | Vol 19 No 3 (2024): J Teh Univ Heart Ctr | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jthc.v19i3.16864 | |
| Keywords | ||
| Myocardial bridging Acute coronary syndrome Angiography | ||
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How to Cite
1.
Chaleshi D, samadi F, Ghaemi AA, Parsa N, Zareiye A, Motamedzade MR, Sarebanhassanabadi M, Nough H. Concurrent Myocardial Bridging and Coronary Artery Disease: A Study of an Iranian Population. J Tehran Heart Cent. 2024;19(3):206-210.
