Yu Guanghao, Ming Zhaokai, Qiao Dan, Cheng Zhiguo, Li Liandi, Guo Wei, Ye Xiaoqiang, Ma Wei, Chen Guangxin, Ren Mingming, Xing Jian, Tan Wenchang, Zhao Dongliang
Medical Image College, Mudanjiang Medical University, Mudanjiang, Heilongjiang, China.
Medical Imaging Department, Qiqihar First Hospital, Qiqihar, Heilongjiang, China.
Front Bioeng Biotechnol. 2025 Apr 3;13:1559963. doi: 10.3389/fbioe.2025.1559963. eCollection 2025.
Myocardial bridge (MB) is a segment of an otherwise extramyocardial blood vessel that traverses the myocardium. This congenital condition typically lacks obvious clinical manifestations during adolescence. However, as individuals age, the accumulated myocardial pressure on the coronary arteries can lead to non-obstructive coronary ischemia, angina pectoris, and even heart failure. Early diagnosis is crucial for assessing the risk of cardiovascular events.
This study performed a morphological analysis of MB in 75 patients using dual-source Computed Tomographic Angiography (CTA). Through geometric three-dimensional reconstruction, measurements and statistical analyses were conducted on muscle bridge length, depth, length-to-depth ratio, cross-sectional area, and coronary artery curvature.
This study explores the morphological differences among normal individuals, those with superficial MB, and those with deep MB during diastole and systole under varying conditions of myocardial coronary coupling. The study found that the compression degree is greatest in the deep MB group, with the average compression level being approximately 17 times that of normal individuals and about 4.6 times that of patients with superficial MB.
The differences in the average cross-sectional area are more significant than those in the minimum cross-sectional area. The depth of the MB is more closely related to the degree of compression, suggesting that clinical intervention and attention should be focused on deep MBs.
心肌桥（MB）是一段走行于心肌内的原本位于心肌外的血管。这种先天性疾病在青少年时期通常缺乏明显的临床表现。然而，随着个体年龄增长，冠状动脉上累积的心肌压力可导致非阻塞性冠状动脉缺血、心绞痛，甚至心力衰竭。早期诊断对于评估心血管事件风险至关重要。
本研究使用双源计算机断层血管造影（CTA）对75例患者的心肌桥进行了形态学分析。通过几何三维重建，对肌桥长度、深度、长深比、横截面积和冠状动脉曲率进行了测量和统计分析。
本研究探讨了在不同心肌-冠状动脉耦合条件下，正常个体、浅表心肌桥患者和深部心肌桥患者在舒张期和收缩期的形态学差异。研究发现，深部心肌桥组的压迫程度最大，平均压迫水平约为正常个体的17倍，约为浅表心肌桥患者的4.6倍。
平均横截面积的差异比最小横截面积的差异更显著。心肌桥的深度与压迫程度的关系更为密切，这表明临床干预和关注应集中在深部心肌桥上。
