de Agustín José Alberto, Marcos-Alberca Pedro, Fernández-Golfín Covadonga, Bordes Sara, Feltes Gisela, Almería Carlos, Rodrigo José Luis, Arrazola Juan, Pérez de Isla Leopoldo, Macaya Carlos, Zamorano José
Instituto Cardiovascular, Hospital Universitario San Carlos, Madrid, España.
Rev Esp Cardiol (Engl Ed). 2012 Oct;65(10):885-90. doi: 10.1016/j.recesp.2012.02.013. Epub 2012 May 31.
The relationship between myocardial bridging and symptoms is still unclear. The purpose of our study was to assess the relationship between myocardial bridging detected by multidetector computed tomography and symptoms in a patient population with chest pain syndrome.
The study enrolled 393 consecutive patients without previous coronary artery disease studied for chest pain and referred to multidetector computed tomography between January 2007 and December 2010. Noninvasive coronary angiography was performed using multidetector computed tomography. Myocardial bridging was defined as part of a coronary artery completely surrounded by myocardium on axial and multiplanar reformatted images.
Mean age was 64.6 (12.4) years and 44.8% were male. Multidetector computed tomography detected 86 myocardial bridging images in 82 of the 393 patients (20.9%). Left anterior descending was the most frequent coronary artery involved (87.2%). The prevalence of myocardial bridging was significantly higher in patients without significant atherosclerotic coronary stenosis on multidetector computed tomography (24.9% vs 15.0%; P=.02). Patients with myocardial bridging were younger (60.3 [13.8] vs 65.8 [11.9]; P<.001), had less prevalence of hyperlipidemia (29.3% vs 41.8%; P=.03), and more prevalence of cardiomyopathy (6.1% vs 1.6%, P=.02) compared with patients without myocardial bridging on multidetector computed tomography.
Multidetector computed tomography is an easy and reliable tool for comprehensive in vivo diagnosis of myocardial bridging. The results of the present study suggest myocardial bridging is the cause of chest pain in a subgroup of younger aged patients with less prevalence of hyperlipidemia and more prevalence of cardiomyopathy than patients with significant atherosclerotic coronary artery disease on multidetector computed tomography. Full English text available from:www.revespcardiol.org.
心肌桥与症状之间的关系仍不明确。我们研究的目的是评估在胸痛综合征患者群体中，多排螺旋计算机断层扫描检测到的心肌桥与症状之间的关系。
本研究纳入了393例既往无冠心病且因胸痛接受检查并于2007年1月至2010年12月期间接受多排螺旋计算机断层扫描的连续患者。使用多排螺旋计算机断层扫描进行无创冠状动脉造影。心肌桥定义为在轴向和多平面重组图像上冠状动脉的一部分被心肌完全包围。
平均年龄为64.6（12.4）岁，44.8%为男性。多排螺旋计算机断层扫描在393例患者中的82例（20.9%）检测到86个心肌桥图像。左前降支是最常受累的冠状动脉（87.2%）。在多排螺旋计算机断层扫描上无显著动脉粥样硬化性冠状动脉狭窄的患者中，心肌桥的患病率显著更高（24.9%对15.0%；P = 0.02）。与多排螺旋计算机断层扫描上无心肌桥的患者相比，有心肌桥的患者更年轻（60.3 [13.8]对65.8 [11.9]；P < 0.001），高脂血症患病率更低（29.3%对41.8%；P = 0.03），心肌病患病率更高（6.1%对1.6%，P = 0.02）。
多排螺旋计算机断层扫描是一种用于心肌桥全面活体诊断的简便可靠工具。本研究结果表明，在多排螺旋计算机断层扫描上，心肌桥是年龄较轻、高脂血症患病率较低且心肌病患病率高于有显著动脉粥样硬化性冠状动脉疾病患者的亚组胸痛的原因。完整英文文本可从：www.revespcardiol.org获取。
