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Incidence and clinical significance of myocardial bridging with ECG-gated 16-row MDCT coronary angiography

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Abstract

Aims The aims of this study were to evaluate the incidence and the clinical significance of myocardial bridging in 401 patients with chest pain examined with 16-row Multidetector CT (MDCT) coronary angiography. Material and methods Four hundred nine consecutive patients who had chest pain or symptoms suggestive of coronary artery disease were involved in this study. Patients with heart rates ≥65 beats/min received 25–50 mg of atenolol orally 1 h before the scan. CT coronary angiography was performed with a 16-row MDCT scanner. CT coronary angiographic images were evaluated by consensus of two radiologists, who were blinded to clinical information. Clinical correlation was made between the presence and type of myocardial bridging on MDCT and the clinical results based on history, examination, and any subsequent clinical workup at the 2-month follow-up by a consensus of two physicians. Results Among the 401 patients, 23 (5.7%) cases of myocardial bridging were detected. Twenty-one (5.2%) cases of myocardial bridging were located at the middle third of the left anterior descending coronary artery (LAD), one (0.25%) case was at the proximal third of the LAD, and one (0.25%) case was at the distal third of the LAD. Superficial bridging was identified in 15 patients and deep bridging in 8. The length of tunneled artery was between 5 and 27 mm, with a mean of 15.7 mm, and the depth of tunneled artery was between 1.0 and 7.0 mm, with a mean of 3.2 mm. Out of four patients whose chest pain was assumed to be associated with myocardial bridging, three patients had deep bridging. In the other 19 patients with bridging, alternative causes of chest pain were present. Conclusions We found the incidence of myocardial bridging in this patient group to be 5.7%. Larger multicenter studies are required to evaluate the incidence of myocardial bridging and to determine a link between myocardial bridging and chest pain.

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Abbreviations

CAD:

Coronary artery disease

LAD:

Left anterior descending coronary artery

LCx:

Left circumflex artery

MDCT:

Multidetector CT

MIP:

Maximum intensity projection

MPR:

Multiplanar reformation

MRI:

Magnetic resonance imaging

RCA:

Right coronary artery

SPECT:

Single photon emission computed tomography

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Authors and Affiliations

  1. Department of Radiology, Dongsan Medical Center, Keimyung University, 194 Dongsan-dong, Jung-gu, Daegu, 700-712, Republic of Korea

    Sung-Min Ko & Jin-Soo Choi

  2. Department of Cardiology, Dongsan Medical Center, Keimyung University, Daegu, Republic of Korea

    Chang-Wook Nam & Seung-Ho Hur

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  1. Sung-Min Ko
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  2. Jin-Soo Choi
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Correspondence to Sung-Min Ko.

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Ko, SM., Choi, JS., Nam, CW. et al. Incidence and clinical significance of myocardial bridging with ECG-gated 16-row MDCT coronary angiography. Int J Cardiovasc Imaging 24, 445–452 (2008). https://doi.org/10.1007/s10554-007-9272-2

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  • DOI: https://doi.org/10.1007/s10554-007-9272-2

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