Prevalence and characterization of myocardial bridging detected on cardiac ct

Congress:

ESCR 2019

Poster Number:

P-0025

Type:

Poster Abstract

Keywords:

Congenital, Statistics, Contrast agent-intravenous, Computer Applications-3D, CT-Angiography, CT, CAD, Cardiovascular system, Cardiac, Anatomy

Authors:

E. Detorakis¹, I. Papadopoulou², R. Illing³; ¹Iraklion/GR, ²Heraklion/GR, ³Budapest/HU

DOI:

DOI-Link:

https://dx.doi.org/

Fig. 6: Figure 1. Superficial myocardial bridge of the proximal segment of LAD. A....

Fig. 2: Figure 2. Multiplanar reconstruction images at the level of the LAD where a...

Fig. 3: Figure 3. A and C. Volume rendering technique of two different patients with...

Fig. 4

Purpose

Myocardial bridging (MB) is a congenital anomaly in which a segment of a coronary artery is covered by myocardium, mostly occurring in the mid-portion of the left anterior descending (LAD) coronary artery (1). We aimed to retrospectively study the prevalence of MB in local population and to identify if there is any correlation between this image finding and clinical symptoms.

Methods and Materials

Between April 2018 and March 2019 ninety-eight patients (64 men, 34 women) with low to intermediate risk of coronary artery disease (CAD) underwent cardiac CT in our department on a 128-slice CT scanner (GE Optima CT 660). The average age of the population was 48.5 years (range 44 to 66 years) and the median 52 years, and the average body mass index was 26. A beta-blocker was administrated orally 40-90 min before the examination in those patients with a heart rate higher than 65bpm. A...

Results

Myocardial bridging was detected in 52 of 98 patients (53%). In all cases the intramuscular segment was of the superficial type and involved the mid part of the LAD artery. No MB was recorded in LAD branches of other coronary arteries. The length of MB was calculated between 1 and 4 cm (mean length 2.2 cm) (Figure 1 and 2). In 48 out of 52 patients the lumen diameter seemed reduced, while in those patients where retrospective ECG-gated protocol was used, a further reduction of...

Conclusion

A high prevalence of myocardial bridging of the superficial type was detected in our study population, involving in all cases the mid part of the LAD artery with a mean length of 2cm. The presence of MB was strongly correlated with episodes of chest pain/discomfort, especially in CAD-RADS 0 patients, presenting a diameter reduction of LAD diameter along the MB segment. Larger scale studies need to be performed, as well as additional diagnostic imaging techniques, such as the non-invasive fractional flow reserve CT (FFR-CT), to...

Personal Information

Efstathios E. Detorakis, MD, PhD Consultant Radiologist Affidea Heraklion Crete Greece email: [email protected]

References

1. Möhlenkamp S, Hort W, Ge J, Erbel R. Update on myocardial bridging.Circulation.2002;106:2616–2622. 2. Nakanishi R, Rajani R, Ishikawa Y, Ishii T, Berman DS. Myocardial bridging on coronary CTA: an innocent bystander or a culprit in myocardial infarction? J Cardiovasc Comput Tomogr. 2012 Jan-Feb;6(1):3-13. doi: 10.1016/j.jcct.2011.10.015. Epub 2011 Nov 20. 3. Forsdahl SH, Rogers IS, Schnittger I, Tanaka S, Kimura T, Pargaonkar VS, Chan FP, Fleischmann D Tremmel JA, Becker HC. diameter reduction of LAD diameter along the MB segmentMyocardial Bridges on Coronary Computed Tomography...