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      Prevalence of myocardial bridging associated with coronary endothelial dysfunction in patients with chest pain and non-obstructive coronary artery disease

      Author(s): , , , , , ,
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      Journal: EuroIntervention
      Publisher: Europa Digital & Publishing

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          Abstract

          Myocardial bridging (MB), characterised by the epicardial coronary vessel diving into the myocardium, is present in up to one third of adults and is associated with angina and acute coronary syndromes. MB is accompanied by altered blood flow mechanics and regional changes in wall sheer stress. The purpose of this study was to determine the association between myocardial bridging and coronary endothelial dysfunction.

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          Long-term follow-up of patients with mild coronary artery disease and endothelial dysfunction.

          J Suwaidi, S Hamasaki, S T Higano … (2000)
          Coronary endothelial dysfunction is characterized by vasoconstrictive response to the endothelium-dependent vasodilator acetylcholine. Although endothelial dysfunction is considered an early phase of coronary atherosclerosis, there is a paucity of information regarding the outcome of these patients. Thus, this study was designed to evaluate the outcome of patients with mild coronary artery disease on the basis of their endothelial function. Follow-up was obtained in 157 patients with mildly diseased coronary arteries who had undergone coronary vascular reactivity evaluation by graded administration of intracoronary acetylcholine, adenosine, and nitroglycerin and intracoronary ultrasound at the time of diagnostic study. Patients were divided on the basis of their response to acetylcholine into 3 groups: group 1 (n=83), patients with normal endothelial function; group 2 (n=32), patients with mild endothelial dysfunction; and group 3 (n=42), patients with severe endothelial dysfunction. Over an average 28-month follow-up (range, 11 to 52 months), none of the patients from group 1 or 2 had cardiac events. However, 6 (14%) with severe endothelial dysfunction had 10 cardiac events (P<0.05 versus groups 1 and 2). Cardiac events included myocardial infarction, percutaneous or surgical coronary revascularization, and/or cardiac death. Severe endothelial dysfunction in the absence of obstructive coronary artery disease is associated with increased cardiac events. This study supports the concept that coronary endothelial dysfunction may play a role in the progression of coronary atherosclerosis.
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            Update on myocardial bridging.

            Stefan Möhlenkamp, W Hort, Raimund Erbel … (2002)
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              Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies.

              Michel T. Corban, Olivia Hung, Parham Eshtehardi … (2014)
              Patients with myocardial bridging are often asymptomatic, but this anomaly may be associated with exertional angina, acute coronary syndromes, cardiac arrhythmias, syncope, or even sudden cardiac death. This review presents our understanding of the pathophysiology of myocardial bridging and describes prevailing diagnostic modalities and therapeutic options for this challenging clinical entity.
              Article 0 comments Cited 82 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Title: EuroIntervention
                Abbreviated Title: EuroIntervention
                Publisher: Europa Digital & Publishing
                ISSN (Print): 1774-024X
                Publication date Created: February 2020
                Publication date (Print): February 2020
                Volume: 15
                Issue: 14
                Pages: 1262-1268
                Article
                DOI: 10.4244/EIJ-D-18-00920
                PubMed ID: 30636680
                SO-VID: 849630a8-80f8-4ad1-9a73-c15ca3c70176
                Copyright © © 2020
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