Ural Ertan, Bildirici Ulas, Celikyurt Umut, Kilic Teoman, Sahin Tayfun, Acar Eser, Kahraman Göksel, Ural Dilek
Kocaeli University Medical Faculty, Department of Cardiology, Umuttepe/Kocaeli, Turkey.
Clin Cardiol. 2009 Aug;32(8):454-7. doi: 10.1002/clc.20570.
The aim of this study was to investigate the long-term prognosis of non-interventionally followed patients with myocardial bridge and angiographic milking of the left anterior descending (LAD) coronary artery.
All of the coronary angiography records from May 2000 to November 2007 were reevaluated and patients who had more than 70% narrowing during systole on LAD were eligible for the present study. Follow-up was carried out by physical examination, echocardiography, and treadmill exercise testing. The clinical situations of the patients, medical treatment at the time of follow-up, and experienced events (death, myocardial infarction, or revascularization) were recorded.
There were 59 eligible patients (44 male, 74.6%). The mean age of the patients was 54 +/- 11 years. The bridges were located in the proximal, mid, and distal portion of the LAD in 17 (28.8%), 20 (33.9%), and 22 (37.3%) patients, respectively. Distributions of the narrowing degree were as follows: between 70% to 89% in 33 (56%) patients and 90% to 100% in 26 (44%) patients. Mean follow-up duration of the group was 37 +/- 13 months (range 15-65 mo). The clinical presentation during follow-up was stable angina in 9 (15.3%) cases, atypical angina in 12 (20.3%), atypical chest pain in 13 (22%), dyspnea in 3 (5.1%), and syncope in 3 (5.1%) cases. There were no experienced events and/or hospitalizations related to cardiac disease. Echocardiographic examination revealed normal systolic ventricular function. Only 17 (28.8%) patients continued to use medication. Most of them were on beta-blocker therapy.
Patients with myocardial bridges and angiographic milking of the LAD coronary artery have a good long-term prognosis.
本研究旨在调查非介入随访的心肌桥合并左前降支（LAD）冠状动脉造影“挤奶”现象患者的长期预后。
对2000年5月至2007年11月期间的所有冠状动脉造影记录进行重新评估，LAD在收缩期狭窄超过70%的患者符合本研究条件。通过体格检查、超声心动图和跑步机运动试验进行随访。记录患者的临床情况、随访时的医疗治疗以及经历的事件（死亡、心肌梗死或血运重建）。
有59例符合条件的患者（44例男性，占74.6%）。患者的平均年龄为54±11岁。心肌桥分别位于LAD近端、中段和远端的患者有17例（28.8%）、20例（33.9%）和22例（37.3%）。狭窄程度分布如下：70%至89%的患者有33例（56%），90%至100%的患者有26例（44%）。该组的平均随访时间为37±13个月（范围15 - 65个月）。随访期间的临床表现为稳定型心绞痛9例（15.3%）、非典型心绞痛12例（20.3%）、非典型胸痛13例（22%）、呼吸困难3例（5.1%）、晕厥3例（5.1%）。没有发生与心脏病相关的事件和/或住院情况。超声心动图检查显示心室收缩功能正常。只有17例（28.8%）患者继续用药。他们中的大多数接受β受体阻滞剂治疗。
心肌桥合并LAD冠状动脉造影“挤奶”现象的患者具有良好的长期预后。
