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孤立性心肌桥患者的发病率、临床特征及4年随访:土耳其南部一项回顾性、单中心、流行病学、冠状动脉造影随访研究

Incidence, clinical characteristics, and 4-year follow-up of patients with isolated myocardial bridge: a retrospective, single-center, epidemiologic, coronary arteriographic follow-up study in southern Turkey.

作者信息

Ciçek Davran, Kalay Nihat, Müderrisoğlu Haldun

机构信息

Department of Cardiology, Başkent University School of Medicine, Antalya, Turkey.

出版信息

Cardiovasc Revasc Med. 2011 Jan-Feb;12(1):25-8. doi: 10.1016/j.carrev.2010.01.006. Epub 2010 Oct 20.

Abstract

INTRODUCTION

Myocardial bridge is a rare coronary anomaly that is generally considered to be benign. The true incidence and long-term prognosis are still under debate. Therefore, we investigated the prevalence and prognosis of patients with isolated myocardial bridge in our center.

METHOD

This study is a retrospective, angiographic follow-up which includes 14,250 patients. Median follow-up was 4 years. The typical angiographic finding of myocardial bridging (MB) is systolic narrowing of an epicardial artery. Exclusion criterion was myocardial bridge with coronary artery disease (CAD). The primary end point was major cardiac events (death, myocardial infarction, and revascularization).

RESULTS

Myocardial bridge was observed in 118 (0.83%) patients without CAD. The median age was 56.2. There were 30 (25.5%) male and 88 (74.5%) female patients. The arterial segment that was most frequently involved was the left anterior descending artery, as evident in 91 patients (77.2%). Most of the myocardial bridge produces a systolic narrowing between 30% and 50%. There was no major adverse cardiac event nor a need for any revascularization in the follow-up period with medical treatment.

CONCLUSION

Isolated myocardial bridge is a benign and rare coronary anomaly. However, further studies are needed to detect long-term prognosis.

摘要

引言

心肌桥是一种罕见的冠状动脉异常,通常被认为是良性的。其真实发病率和长期预后仍存在争议。因此,我们在本中心调查了孤立性心肌桥患者的患病率和预后。

方法

本研究是一项回顾性血管造影随访研究,纳入了14250例患者。中位随访时间为4年。心肌桥(MB)典型的血管造影表现是心外膜动脉收缩期狭窄。排除标准为合并冠状动脉疾病(CAD)的心肌桥。主要终点是重大心脏事件(死亡、心肌梗死和血运重建)。

结果

在118例(0.83%)无CAD的患者中观察到心肌桥。中位年龄为56.2岁。男性患者30例(25.5%),女性患者88例(74.5%)。最常受累的动脉节段是左前降支动脉,91例(77.2%)患者可见。大多数心肌桥产生30%至50%的收缩期狭窄。在随访期间接受药物治疗,未发生重大不良心脏事件,也无需进行任何血运重建。

结论

孤立性心肌桥是一种良性且罕见的冠状动脉异常。然而,需要进一步研究以检测其长期预后。

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