(Therapeutic Development and Bioimaging thematic programmes of the Semmelweis University)
Szakterületek:
Szív- és érsebészet
Although myocardial bridging (MB) has been intensively investigated using different
methods, the effect of bridge morphology on long-term outcome is still doubtful. We
aimed at describing the anatomical differences in coronary angiography between symptomatic
and non-symptomatic LAD myocardial bridges and to investigate the influence of clinical
and morphological factors on long-term mortality. In our retrospective, long-term,
single center study we found relevant MB on the left anterior descendent (LAD) coronary
artery in 146 cases during a two-year period, when 11,385 patients underwent coronary
angiography due to angina pectoris. Patients were divided into two groups: those with
myocardial bridge only (LAD-MBneg, n = 78) and those with associated obstructive coronary
artery disease (LAD-MBpos, n = 68). Clinical factors, morphology of bridge by quantitative
coronary analysis and ten-year long mortality data were collected. The LAD-MBneg group
was associated with younger age and decreased incidence of diabetes mellitus, as well
as with increased minimal diameter to reference diameter ratio (LAD-MBneg 54.5 (13.1)%
vs. LAD-MBpos 46.5 (16.4)%, p = 0.016), while there was a tendency towards longer
lesions and higher vessel diameter values compared to the LAD-MBpos group. The LAD-MBpos
group was associated with increased mortality compared to the LAD-MBneg group. The
analysis of our data showed that morphological parameters of LAD bridge did not influence
long-term mortality, either in the overall population or in the LAD-MBneg patients.
Morphological parameters of LAD bridge did not influence long-term mortality outcomes;
therefore, it suggests that anatomical differences might not predict long-term outcomes
and should not influence therapy.