From the Department of Pathology, Toho University School of Medicine, Tokyo, Japan (Y.A-F., Y.I., T.M., Y.A.)
From the Department of Pathology, Toho University School of Medicine, Tokyo, Japan (Y.A-F., Y.I., T.M., Y.A.).
Arterioscler Thromb Vasc Biol. 2018 Jun;38(6):1407-1414. doi: 10.1161/ATVBAHA.118.310933. Epub 2018 Apr 5.
The aim of this study was to investigate the influence of a myocardial bridge (MB) on atherosclerosis development in the left anterior descending artery of the normal heart and the importance of traditional risk factors (RFs). An additional objective was to determine the correlation between intimal thickening and luminal narrowing.
The left anterior descending artery from 150 autopsied hearts was treated with formalin perfusion fixation, and each left anterior descending artery was serially cross-sectioned. The intima-media and luminal stenosis ratios were examined using computer-assisted histomorphometry. The luminal stenosis ratio was closely correlated with the intima-media ratio (=0.792; <0.001). When an MB was present, the luminal stenosis ratios proximal to the MB in the RF (+) group were significantly greater than those in the RF (-) group (=0.022 by a multiple comparison test), but there were no differences between the RF (+) and RF (-) groups when an MB was absent. In addition, the site of the greatest stenosis in the MB (+) RF (+) group was 2.5 cm proximal to the MB entrance. Multivariate analyses indicated that age was an independent factor for luminal stenosis ratios ≥50% and 60% (=0.002 and 0.029, respectively). Furthermore, the presence of an MB plus RFs was an independent factor for a luminal stenosis ratio ≥70% (=0.037).
An MB enhances left anterior descending artery atherosclerosis development at a site proximal to the MB entrance, particularly in subjects who have some RFs.
本研究旨在探讨心肌桥（MB）对正常心脏左前降支动脉粥样硬化发展的影响，以及传统危险因素（RFs）的重要性。另一个目的是确定内膜增厚与管腔狭窄之间的相关性。
用甲醛灌注固定法处理 150 例尸检心脏的左前降支，将每支左前降支连续横切。使用计算机辅助组织形态计量学检查内-中膜和管腔狭窄比。管腔狭窄比与内-中膜比密切相关（=0.792；<0.001）。当存在 MB 时，RF（+）组 MB 近端的管腔狭窄比明显大于 RF（-）组（多重比较检验，=0.022），但当不存在 MB 时，RF（+）组和 RF（-）组之间没有差异。此外，MB（+）RF（+）组中最大狭窄部位位于 MB 入口近端 2.5cm 处。多变量分析表明，年龄是管腔狭窄比≥50%和≥60%的独立因素（=0.002 和 0.029）。此外，MB 加 RFs 的存在是管腔狭窄比≥70%的独立因素（=0.037）。
MB 增强了 MB 入口近端左前降支动脉粥样硬化的发展，尤其是在存在某些 RFs 的情况下。
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