Liu Guobing, Qu Yanjuan, Chen Xin, Liao Meiyan, Hu Huijuan, Cao Yiyuan, Tian Zhixiong
1 Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, PR China.
2 Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, PR China.
Acta Radiol. 2017 Sep;58(9):1068-1076. doi: 10.1177/0284185116682380. Epub 2016 Dec 14.
Background Clinical-radiological correlation of myocardial bridge (MB) remains unclear. Purpose To correlate clinical symptoms and outcomes of MBs with computed tomography (CT) coronary angiography findings. Material and Methods A total of 2092 patients with CT coronary angiography were collected. Patients were divided into symptomatic and asymptomatic groups, adverse heart events (AHE) and non-AHE groups, MB and non-MB groups, as well as left anterior descending (LAD)-MB and non-LAD-MB groups. Statistical analyses were performed to identify inter-group differences, and clinical-radiological correlations of MBs or mural coronary arteries (MCAs). Results The prevalence of MB, the MCA stenosis either in systole or in diastole, and the ratio of LAD-MB were significantly higher in the symptomatic group than in the asymptomatic group, and higher in the AHE group than in the non-AHE group ( P all <0.05). MB thickness, systolic MCA stenosis, and diastolic MCA stenosis were independent variables predicting clinical symptoms ( P < 0.05), with diastolic MCA stenosis having the highest diagnostic performance, when cutting at 24.6%. The corresponding sensitivity and specificity were 87.8% and 90.6%, respectively. Diastolic MCA stenosis independently indicated outcome of AHE (odds ratio, 1.047; P < 0.001). Conclusion Measurements of MB-MCA by CT predict the presence of clinical symptoms and outcomes of AHE, with diastolic MCA stenosis possessing the greatest performance.
背景 心肌桥(MB)的临床与放射学相关性仍不明确。目的 将MB的临床症状和预后与计算机断层扫描(CT)冠状动脉造影结果相关联。材料与方法 共收集2092例行CT冠状动脉造影的患者。患者被分为有症状组和无症状组、不良心脏事件(AHE)组和非AHE组、MB组和非MB组,以及左前降支(LAD)-MB组和非LAD-MB组。进行统计分析以确定组间差异以及MB或壁冠状动脉(MCA)的临床与放射学相关性。结果 有症状组的MB患病率、MCA收缩期或舒张期狭窄以及LAD-MB比例均显著高于无症状组,AHE组高于非AHE组(P均<0.05)。MB厚度、收缩期MCA狭窄和舒张期MCA狭窄是预测临床症状的独立变量(P<0.05),当截断值为24.6%时,舒张期MCA狭窄具有最高的诊断效能。相应的敏感度和特异度分别为87.8%和90.6%。舒张期MCA狭窄独立提示AHE的预后(比值比,1.047;P<0.001)。结论 CT测量MB-MCA可预测临床症状的存在及AHE的预后,其中舒张期MCA狭窄的效能最大。