Chatzizisis Yiannis S, Giannoglou George D
Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Can J Cardiol. 2009 Apr;25(4):219-22. doi: 10.1016/s0828-282x(09)70065-0.
Myocardial bridging constitutes a congenital, usually benign, coronary abnormality defined as a segment of a major epicardial coronary artery that follows an intramural course through the myocardium. On the basis of clinical and histopathological data, myocardial bridges appear to be spared from atherosclerosis. Although the mechanisms involved are largely unknown, the surrounding myocardium appears to be a key factor by generating a unique atheroprotective hemodynamic microenvironment within bridges. The main components of this environment include low tensile stress and high shear stress. Reduced coronary wall motion due to external support of the surrounding myocardium may also play a role. Better investigation of these mechanisms in appropriate animal models is anticipated to advance our understanding of the pathophysiology of atherosclerosis, providing a framework for the development of new atheroprotective strategies.
心肌桥是一种先天性的、通常为良性的冠状动脉异常，定义为主要的心外膜冠状动脉的一段走行于心肌内。根据临床和组织病理学数据，心肌桥似乎不易发生动脉粥样硬化。尽管其中涉及的机制大多未知，但周围心肌似乎是一个关键因素，它在心肌桥内产生独特的抗动脉粥样硬化血流动力学微环境。这种环境的主要成分包括低拉伸应力和高剪切应力。由于周围心肌的外部支撑导致冠状动脉壁运动减少也可能起作用。预计在合适的动物模型中对这些机制进行更好的研究，将增进我们对动脉粥样硬化病理生理学的理解，为开发新的抗动脉粥样硬化策略提供框架。
