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Submitted: 02 Nov 2018
Revision: 05 Jul 2019
Accepted: 02 Aug 2019
ePublished: 24 Aug 2019
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J Cardiovasc Thorac Res. 2019;11(3): 203-208.
doi: 10.15171/jcvtr.2019.34
PMID: 31579460
PMCID: PMC6759614
  Abstract View: 268
  PDF Download: 174

Original Article

Comparison of detection percentage and morphology of myocardial bridge between conventional coronary angiography and coronary CT angiography

Seyed Hassan Eftekhar-Vaghefi 1 ORCID logo, Somayeh Pourhoseini 1, Maryam Movahedi 2, Shohre Hooshmand 3, Mohammad Ali Ostovan 3, Pooyan Dehghani 2,3 * , Nikan Ostovan 3

1 Department of Anatomy, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
2 Department of Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
3 Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Introduction: Myocardial bridge (MB) is a congenital anomaly in which a segment of a coronary artery is surrounded by myocardium. In our study, we want to use conventional coronary angiography (CCA) to describe morphologic characteristics of MB (unidentified or identified) in the patients with documented evidence of MB in coronary computed tomography angiography (CCTA).
Methods: The present study was designed as cross-sectional and was conducted on 47 patients with documented evidence of MB in CCTA, who were referred to Nemazee and Faghihi hospitals for performing coronary angiography during a one year period. We compared the morphologic characteristics of tunneled segments, which were missed at CCA (unidentified), and the tunneled segments which were identified with CCA.
Results: In sum, MB was found in 16 (34%) patients at CCA (identified), and it was not found in 31 (66%) patients (unidentified) based on compression sign. No significant correlation was found between the percentage of systolic compression and the length and depth of the tunneled segment in identified group (r=0.73, P = 0.18; r=1.09, P = 0.15; respectively). Degree of atherosclerotic plaque formation (diameter stenosis, percentage) (mean, 0.25 (25%) ±0.29; range, 0-0.98) of the tunneled segments in unidentified group was significantly more than the same degree (mean, 0.07 (7%) ±0.13; range, 0-0.41) of the identified group (P = 0.03). The measurement of the trapezoid area under the tunneled segment with this formula [(MB length+ intramyocardial segment) ×depth/2] had significant relation with systolic compression (r=0.304, P = 0.03) and defined the cut-off value of 250 mm2 as the value of significant difference in detecting myocardial bridging with CCA.
Conclusion: Our results showed that in most of identified MBs in CCA the tunneled segment area was equal and more than 250 mm2. In addition, the degree of atherosclerotic plaque of the tunneled segments at CCA was significantly more in unidentified group.
Keywords: Myocardial bridge, CT Angiography, Coronary Angiography
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