Ishii T, Hosoda Y, Osaka T, Imai T, Shimada H, Takami A, Yamada H
J Pathol. 1986 Apr;148(4):279-91. doi: 10.1002/path.1711480404.
The relation between myocardial bridges (MB) and atherosclerosis in the left anterior descending coronary artery (LAD) was explored using morphometric methods in 642 hearts. The location of myocardial bridges in the LAD was classified according to distribution as proximal, middle and distal. Myocardial bridges were found in 48 per cent of males and 36 per cent of females. When proximal myocardial bridging was present intimal thickening and macroscopic raised lesion were increased just before the bridge as compared with the corresponding site in the other two categories. Underneath bridges eccentric plaques and raised lesions are absent although there is often concentric intimal thickening. The overall frequency of myocardial infarction was the same in patients with and without myocardial bridges. However, when infarction occurred in the patients having bridges, it was almost confined to those in the proximal group despite this being infrequent in the general distribution of myocardial bridges in the left anterior descending artery. It is postulated that hypertension may enhance infarction in the case of myocardial bridges in the very proximal left anterior descending artery. It is concluded that the location of myocardial bridges greatly alters the distribution of physical force against the arterial wall and influences the extent of atherosclerosis.
采用形态测量学方法对642例心脏进行研究，以探讨心肌桥（MB）与左前降支冠状动脉（LAD）粥样硬化之间的关系。根据分布情况，将LAD中心肌桥的位置分为近端、中段和远端。在男性中发现心肌桥的比例为48%，在女性中为36%。当存在近端心肌桥时，与其他两类相应部位相比，桥前内膜增厚和肉眼可见的隆起病变增多。在心肌桥下，尽管常有同心性内膜增厚，但偏心性斑块和隆起病变并不存在。有心肌桥和无心肌桥患者的心肌梗死总体发生率相同。然而，当有心肌桥的患者发生梗死时，几乎仅限于近端组，尽管在左前降支动脉心肌桥的总体分布中这种情况并不常见。据推测，在左前降支动脉极近端存在心肌桥的情况下，高血压可能会增加梗死风险。研究得出结论，心肌桥的位置极大地改变了作用于动脉壁的物理力的分布，并影响动脉粥样硬化的程度。
