多排螺旋 CT 分析心肌桥合并心肌梗死患者的心肌桥解剖学特征。

Anatomical characteristics of myocardial bridge in patients with myocardial infarction by multi-detector computed tomography.

机构信息

Department of Cardiovascular Medicine, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ohta-ku, Tokyo 143-8541, Japan.

出版信息

Circ J. 2011;75(3):642-8. doi: 10.1253/circj.cj-10-0679. Epub 2011 Jan 27.

DOI:10.1253/circj.cj-10-0679

PMID:21282876

Abstract

BACKGROUND

Recent development of multi-detector computed tomography (MDCT) has made the detection of myocardial bridge (MB) easier on the left anterior descending coronary artery (LAD). The LAD segment proximal to the MB is well known to be susceptible to atherosclerosis. Anatomical characteristics of MB on LAD in patients with myocardial infarction (MI) were examined by MDCT.

METHODS AND RESULTS

Subjects were 43 MI patients who had MB in the LAD and comprised 2 groups: 14 with culprit lesions in the LAD proximal to MB (culprit group) and 29 without culprit lesions in the LAD (non-culprit group). MB length, MB thickness, and the distance from the orifice of left main trunk (LMT) to MB entrance were compared. Age and coronary risk factors showed no significant difference between the 2 groups. MB length (P=0.011), MB thickness (P=0.035), and index of the length multiplied by thickness of MB (P=0.031) were significantly greater in the culprit group. The distance from the orifice of the LMT to MB entrance was significantly shorter in the culprit group (P=0.006).

CONCLUSIONS

Anatomical properties of MB, such as length and thickness of MB as well as MB location, are associated with the formation of culprit lesions of LAD proximal to MB in MI.

摘要

背景

多排螺旋计算机断层扫描（MDCT）的最新发展使得左前降支（LAD）上心肌桥（MB）的检测变得更加容易。众所周知，MB 近端的 LAD 段易发生动脉粥样硬化。通过 MDCT 检查了心肌梗死（MI）患者 LAD 上 MB 的解剖特征。

方法和结果

研究对象为 43 例 LAD 存在 MB 的 MI 患者，分为 2 组：14 例 MB 近端的 LAD 存在罪犯病变（罪犯组），29 例 LAD 不存在罪犯病变（非罪犯组）。比较了 MB 长度、MB 厚度和左主干（LMT）开口至 MB 入口的距离。两组间年龄和冠心病危险因素无显著差异。罪犯组 MB 长度（P=0.011）、MB 厚度（P=0.035）和 MB 长度与厚度乘积指数（P=0.031）显著增大。罪犯组 LMT 开口至 MB 入口的距离明显缩短（P=0.006）。