Evaluation of the correlation among the association of myocardial bridge and coronary artery disease location, the association of myocardial bridge and coronary artery disease in patients with myocardial bridge with coronary angiography

The coronary artery that runs through epicardial adipose tissue is often covered in part with myocardial tissue. This structure is known as a myocardial bridge and it is regarded as a common anatomic variant. Traditionally, myocardial bridging has been considered a benign condition,but the following complications have been reported: acute myocardial infarction, ventricular tachycardia, syncope, atrioventricular conduction block and sudden cardiac death. It is widely accepted that an MB sometimes causes coronary heart disease either from direct compression of the MB at cardiac systole or by enhancement of the natural progression of coronary atherosclerosis. In this study we aimed to find out the relationship between the presence of an MB in the coronary arteries and the occurrence of CHD, specifically addressing the importance of the anatomical properties of the MB.Methods: We performed a retrospective analysis of patients who underwent coronary angiography that have myocardial bridge and also coronary heart disease to evaluate the correlation of atherosclerotic lesion location and myocardial bridge in a large sample size.Results: Among 7058 patients we found 347 cases of myocardialbridging in a retrospective manner. The total prevalence of MB was 3,3% in our series. Although, 96% of patients with myocardial bridging had the tunnelled segment in the left anterior descending coronary artery (LAD) as expected, the rate of occurrence of the bridges on the D1-D2 segments and on the distal part of the D2 segment were nearly (39,2% and 55,3%,respectively).In our study we found % 33.1 of patients with myocardial bridge had obstructive coronary artery disease at same time and atherosclerotic lesion was % 93 occurred proximal of bridged segment.Conclusion: Myocardial bridge probability should be considered in young patients presenting with angina or if the same symptoms are persistent in the patients without more than one risk factor for coronary artery disease. Myocardial bridge may initiate the development of atherosclerotic lesion or may facilitate progression of atherosclerosis in the proximal segment of the vessel. The risk of acute coronary syndrome rises when atherosclerosis is superimposed on MB. Myocardial bridge should be considered in the young patients, presenting with angina or its equivalents without atherosclerotic lesions on coronary angiography.