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Angiographically evident atherosclerotic stenosis associated with myocardial bridging (MB) and risk factors for the artery stenosis located proximally to MB: an observational study [Anatol J Cardiol]
Anatol J Cardiol. 2014; 14(1): 40-47 | DOI: 10.5152/akd.2013.4702  

Angiographically evident atherosclerotic stenosis associated with myocardial bridging (MB) and risk factors for the artery stenosis located proximally to MB: an observational study

Heng Hong1, Ming-Sheng Wang1, Qun Liu1, Jing- Cheng Shi2, Hai-Ming Ren1, Zhi-Min Xu3
1Department of Cardiology, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing-China
2Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha-China
3Department of Cardiology, Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing-China

Objective: The purpose of this study was to determine the prevalence of coronary angiographically evident atherosclerotic stenosis associated with myocardial bridging (MB) and to explore related risk factors of coronary artery stenosis located proximally to MB. Methods: Overall, 603 patients with MB-mural coronary arteries (MB-MCAs) diagnosed by angiography initially were enrolled in this observational study during May 2004 to May 2009. One-way ANOVA, t-test, Pearson correlation test and stepwise multiple regression analysis were performed to explore related risk factors. Results: Totally 644 MB-MCAs were examined. Prevalence of lesions located distally to MBs was significantly lower than those proximally to MBs [36 (5.9%) vs. 382 (62.4%), p<0.001]. Diastolic vessel diameters in MB segments were significantly smaller than reference segments(p<0.001. Ulcer-like lesion was found in MB-MCA in 1 patient. Multivariate analysis suggested that vascular bifurcation lesions, the degree of narrowing and the number of diseased coronary vessels of non-MB-MCA arteries, age, low-density lipoprotein cholesterol (LDL-C)/high density lipoprotein cholesterol (HDL-C), male, course of diabetes, and systolic narrow rate(SNR) of MB-MCAs were positively related with the narrow degree of the first coronary artery stenosis (FCAS) located proximally to MBs (all p<0.05). Vascular bifurcation lesions, the degree of narrowing and the number of diseased coronary vessels of non-MB-MCA arteries, age, LDL-C/HDL-C, male, diabetes and dyslipidemia were positively related with the narrow degree of the most severe coronary artery stenosis(MSCAS) located proximally to MB (all p<0.05). Conclusion: The intramural and distal portions of a bridged artery are not the forbidden zone of artery atherosclerosis formation. SNR of MB-MCA may be one of the important decision factors to coronary artery stenosis located proximally to MB.

Keywords: Myocardial bridging, atherosclerosis, coronary angiography, regression analysis


Miyokardiyal köprülemenin proksimalinde lokalize arter stenozlarının risk faktörleri ve miyokardiyal köprüleme ile ilişkili aterosklerotik stenozun anjiyografik kanıtı

Heng Hong1, Ming-Sheng Wang1, Qun Liu1, Jing- Cheng Shi2, Hai-Ming Ren1, Zhi-Min Xu3
1Department of Cardiology, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing-China
2Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha-China
3Department of Cardiology, Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing-China

Amaç: Bu çalışmanın amacı miyokardiyal köprüleme (MK) ile ilgili koroner arter darlığının ilgili risk faktörlerini bulmak ve MK ile ilişkili aterosklerotik darlığın koroner anjiyografide yaygınlığının kanıtını tayin etmekti. Yöntemler: Başlangıçta, anjiyografi ile tanınmış MK-mural koroner arterli (MK-MKA) 603 hasta Mayıs 2004 ile Mayıs 2009 arasında bu gözlemsel çalışmaya alındı. Tek yönlü ANOVA, t-testi, Pearson korelasyon testi ve çoklu aşamalı regresyon analizleri ilgili risk faktörlerini ortaya çıkarmak için uygulandı. Bulgular: Toplam 644 MK-MKA incelendi. MK’nin distalinde lokalize olmuş lezyonların yaygınlığı MK’nin proksimalindekilerden anlamlı olarak daha azdı [36 (%5,9) karşılık 382 (%62,4), p<0,001]. MK segmentlerinde diyastolik damar çapları referans segmentlerden anlamlı olarak daha küçüktü (p≤0,001). Ülser benzeri lezyon bir MK-MKA’lı hastada bulundu. Multivaryant analiz vasküler bifurkasyon lezyonlarının, non-MK-MKA’nın hastalanmış koroner damarlarının sayısı ve dar olma derecesi, yaş, düşük dansiteli lipoprotein kolesterol (DDL-K)/yüksek dansiteli lipoprotein kolesterol (YDL-K), erkek, diyabetin süresi ve MK-MKA’nın sistolik daralma oranı (SDO) MK’ye proksimal yerleşimli birinci koroner arter darlığının daralma derecesi ile pozitif ilişkide olduğunu telkin etti (p<0,05). Vasküler bifurkasyon lezyonları, non-MK-MKA’nin hastalıklı koroner damarlarının sayısı ve daralma derecesi, yaş, DDL-K/YDL-K, erkek, diyabet ve dislipidemi MK’ya proksimal lokalizasyonlu çok şiddetli koroner arter darlığının daralma derecesi ile pozitif ilişkili idi (p<0,05). Sonuç: Köprülenmiş arterlerin intramural ve distal bölümleri arterin ateroskleroz oluşumu için yasak bölgeler değildir. MK-MKA’nın SDO MK’ye proksimal yerleşimli koroner arter darlığına önemli karar faktörlerinden biri olabilir.

Anahtar Kelimeler: Miyokardiyal köprüleme, ateroskleroz, koroner anjiyografi, regresyon analizi


Heng Hong, Ming-Sheng Wang, Qun Liu, Jing- Cheng Shi, Hai-Ming Ren, Zhi-Min Xu. Angiographically evident atherosclerotic stenosis associated with myocardial bridging (MB) and risk factors for the artery stenosis located proximally to MB: an observational study. Anatol J Cardiol. 2014; 14(1): 40-47


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