RESUMEN
BACKGROUND: Myocardial bridging is a cardiac anomaly where a segment of epicardial coronary arteries runs through the myocardium and can rarely cause MI. Takotsubo syndrome is a stress-induced cardiomyopathy that can mimic MI. Catecholamine surge during stress can contribute to Takotsubo syndrome, but whether this surge can trigger an inconspicuous myocardial bridging to manifest symptomatically remains unclear, and alternately, whether a myocardial bridge might cause worsening of Takotsubo syndrome is also a matter that needs further research. CASE PRESENTATION: We report the case of a patient who initially presented with features of acute exacerbation of bronchiectasis and subsequently developed symptoms and ECG features suggestive of acute myocardial infarction. Echocardiography revealed features of takotsubo syndrome, and complete myocardial bridging was revealed via coronary angiography. The patient was managed conservatively with pharmacological treatment, and after a few days, echocardiographic features were reversed. As such, the diagnosis shifted toward Takotsubo syndrome with myocardial stunning due to co-existent myocardial bridging. CONCLUSION: We report a rare case of a patient with acute bronchiectasis exacerbation with features suggestive of acute myocardial infarction who had findings of Takotsubo syndrome and complete myocardial bridging. In the beginning, it was difficult to determine whether the symptoms arose due to acute MI resulting from myocardial bridging or were solely due to takotsubo syndrome because of stress from bronchiectasis. Although myocardial bridging is often overlooked as an etiology for acute MI, this case highlights the importance of expanding the differential diagnosis to myocardial bridging in the work-up for the cause of acute MI and how Takotsubo syndrome can mimic acute MI and pose a diagnostic challenge.
Asunto(s)
Angiografía Coronaria , Puente Miocárdico , Infarto del Miocardio , Valor Predictivo de las Pruebas , Cardiomiopatía de Takotsubo , Humanos , Cardiomiopatía de Takotsubo/fisiopatología , Cardiomiopatía de Takotsubo/diagnóstico , Cardiomiopatía de Takotsubo/diagnóstico por imagen , Cardiomiopatía de Takotsubo/terapia , Cardiomiopatía de Takotsubo/etiología , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/complicaciones , Infarto del Miocardio/fisiopatología , Infarto del Miocardio/etiología , Diagnóstico Diferencial , Puente Miocárdico/complicaciones , Puente Miocárdico/diagnóstico por imagen , Puente Miocárdico/diagnóstico , Puente Miocárdico/fisiopatología , Aturdimiento Miocárdico/diagnóstico , Aturdimiento Miocárdico/etiología , Aturdimiento Miocárdico/fisiopatología , Femenino , Resultado del Tratamiento , Electrocardiografía , Anciano , MasculinoRESUMEN
BACKGROUND: Clinical events such as angina pectoris, acute coronary syndrome, and sudden death caused by myocardial bridge (MB) have attracted increasing attention. It is still a challenge to diagnose whether MB can cause the symptoms of patients with MB. For most MB patients, medication remains the primary treatment. CASE PRESENTATION: This article reports a case of chest pain in a patient with MB in the middle segment of the left anterior descending artery (LADm) with moderate stenosis in the proximal segment (LADp). Through functional assessment, we found that neither MB nor fixed stenosis had sufficient effect on coronary blood flow to cause myocardial ischemia, but their synergistic effect resulted in myocardial ischemia. Finally, a stent was implanted in LADp and good clinical results were achieved. CONCLUSIONS: For symptomatic patients with MB combined with fixed stenosis, functional evaluation may be necessary, which has significant guiding significance for treatment strategy selection. For asymptomatic patients, early detection of myocardial ischemia may also improve the prognosis of patients.
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Estenosis Coronaria , Puente Miocárdico , Humanos , Estenosis Coronaria/fisiopatología , Estenosis Coronaria/diagnóstico por imagen , Estenosis Coronaria/terapia , Estenosis Coronaria/etiología , Puente Miocárdico/complicaciones , Puente Miocárdico/fisiopatología , Puente Miocárdico/diagnóstico por imagen , Resultado del Tratamiento , Masculino , Stents , Angiografía Coronaria , Persona de Mediana Edad , Isquemia Miocárdica/fisiopatología , Isquemia Miocárdica/etiología , Isquemia Miocárdica/terapia , Isquemia Miocárdica/diagnóstico por imagen , Intervención Coronaria Percutánea/instrumentación , Anciano , Índice de Severidad de la EnfermedadRESUMEN
OBJECTIVE: To compare the performance between CT-derived fractional flow reserve (CT-FFR) and ΔCT-FFR measurements in patients with deep myocardial bridging (MB) along the left anterior descending artery, and explore the potential predictors of discordance. METHODS: 175 patients with deep MB who underwent coronary computed tomography angiography (CCTA) and CT-FFR assessment were included. Clinical, anatomical and atherosclerotic variables were compared between patients with concordant and discordant CT-FFR and ΔCT-FFR. RESULTS: 30.9 % patients were discordantly classified, in which 94.4 % patients were classified as CT-FFR+/â³CT-FFR-. The discordant group showed significantly higher upstream stenosis degree, distance from MB to the aorta, â³CT-FFR (P 0.007, 0.009 and 0.002, respectively), and lower CT-FFR (P < 0.001). In multivariate analysis, upstream stenosis degree (P 0.023, OR 1.628, 95 % CI: 1.068-2.481) and distance from MB to the aorta (P 0.001, OR 1.04, 95 % CI: 1.016-1.064) were independent predictors for discordance between CT-FFR and ΔCT-FFR. CONCLUSION: The discordance between CT-FFR and ΔCT-FFR measurements underscores the challenges in clinical decision-making, necessitating tailored approaches for MB evaluation.
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Angiografía por Tomografía Computarizada , Angiografía Coronaria , Reserva del Flujo Fraccional Miocárdico , Puente Miocárdico , Humanos , Reserva del Flujo Fraccional Miocárdico/fisiología , Masculino , Femenino , Persona de Mediana Edad , Angiografía por Tomografía Computarizada/métodos , Puente Miocárdico/diagnóstico por imagen , Puente Miocárdico/fisiopatología , Puente Miocárdico/complicaciones , Angiografía Coronaria/métodos , Estudios Retrospectivos , Anciano , Valor Predictivo de las PruebasRESUMEN
BACKGROUND: Myocardial bridging (MB) is accompanied by the dynamic extravascular compression of epicardial coronary arteries, leading to intracoronary hemodynamic disturbance with abnormal coronary flow profiles. We aimed to evaluate the prognostic implications of resistive reserve ratio (RRR), a composite measure of flow and pressure parameters that represents the vasodilatory capacity of the coronary arteries, in patients with angina with nonobstructive coronary artery disease (ANOCA) and MB, in comparison with coronary flow reserve (CFR). METHODS AND RESULTS: In this retrospective cohort study, we included patients with ANOCA who underwent coronary reactivity testing, where MB was identified by transient constriction in coronary artery segments between systole and diastole. Abnormal CFR and RRR were defined as <2.5 and <2.62, respectively. Major adverse cardiac events, including cardiovascular death, stroke, myocardial infarction, heart failure, and late revascularization, served as outcomes. Among 1251 patients with ANOCA, 191 (15.3%) had MB. The prevalence of abnormal CFR or RRR was not significantly different between patients with and without MB (P=0.144 and P=0.398, respectively). Over a median follow-up time of 6.9 years, abnormal RRR predicted major adverse cardiac events in patients with MB (hazard ratio [HR], 4.38 [95% CI, 1.71-11.21]; P=0.002) and without MB (HR, 1.91 [95% CI, 1.38-2.64]; P<0.001). Abnormal CFR predicted major adverse cardiac events in patients without MB (HR, 2.15 [95% CI, 1.54-3.00]; P<0.001), whereas it was not predictive of major adverse cardiac events in patients with MB (HR, 2.29 [95% CI, 0.93-5.65]; P=0.073). CONCLUSIONS: In patients with ANOCA and MB, impaired RRR was superior to impaired CFR in distinguishing patients at a higher risk of future adverse events, suggesting that RRR may serve as a risk stratification tool in patients with MB and ANOCA.
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Enfermedad de la Arteria Coronaria , Puente Miocárdico , Humanos , Femenino , Masculino , Estudios Retrospectivos , Persona de Mediana Edad , Enfermedad de la Arteria Coronaria/fisiopatología , Enfermedad de la Arteria Coronaria/diagnóstico , Pronóstico , Anciano , Puente Miocárdico/fisiopatología , Puente Miocárdico/complicaciones , Puente Miocárdico/diagnóstico , Resistencia Vascular/fisiología , Reserva del Flujo Fraccional Miocárdico/fisiología , Circulación Coronaria/fisiología , Vasos Coronarios/fisiopatología , Vasos Coronarios/diagnóstico por imagen , Factores de Riesgo , Valor Predictivo de las Pruebas , Angiografía CoronariaRESUMEN
BACKGROUND: The aim of this study is to analyze the process and frontiers of research in myocardial bridges (MB) to identify future research directions in the last 3 decades. METHODS: Relevant literature on MB combined with myocardial infarction (MI) was searched from 1991 to 2023 in the Web of Science database, and was analyzed by bibliometric analysis using VOSviewer, CiteSpace, and the R package "bibliometrix." RESULTS: A total of 1233 English articles were included in this study. The number of published articles showed an increasing trend yearly. From 2017 to 2022, the annual publication volume rose rapidly, and in 2021 the publication volume even reached 95 articles, which was the highest in all years. These publications were from 68 countries and 1854 institutions, with the leading country being the U.S. and the leading institution being Columbia University. Myoho Clinical International has a close collaborative relationship with Columbia University, while in recent years, the Harvard Medical School has explored the study of MB combined with MI. Annals of Thoracic Surgery was the journal with the highest number of publications, and Takayama Hiroo and Naka Yoshifumi were the authors with the highest number of publications. The most common keywords were MI, cardiogenic shock, and MB. CONCLUSIONS: Our findings can help researchers explore the current status of MB combined with MI research and choose new survey routes for upcoming studies. Prevalence and prognosis, mechanism of MB combined with MI and molecular mechanism may become the focus of future research. In addition, more research and cooperation are needed worldwide.
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Bibliometría , Puente Miocárdico , Infarto del Miocardio , Humanos , Puente Miocárdico/complicacionesRESUMEN
PURPOSE OF REVIEW: This review investigates the relationship between myocardial bridges (MBs), intimal thickening in coronary arteries, and Atherosclerotic cardiovascular disease. It focuses on the role of mechanical forces, such as circumferential strain, in arterial wall remodeling and aims to clarify how MBs affect coronary artery pathology. REVIEW FINDINGS: MBs have been identified as influential in modulating coronary artery intimal thickness, demonstrating a protective effect against thickening within the MB segment and an increase in thickness proximal to the MB. This is attributed to changes in mechanical stress and hemodynamics. Research involving arterial hypertension models and vein graft disease has underscored the importance of circumferential strain in vascular remodeling and intimal hyperplasia. Understanding the complex dynamics between MBs, mechanical strain, and vascular remodeling is crucial for advancing our knowledge of coronary artery disease mechanisms. This could lead to improved management strategies for cardiovascular diseases, highlighting the need for further research into MB-related vascular changes.
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Puente Miocárdico , Humanos , Puente Miocárdico/fisiopatología , Puente Miocárdico/complicaciones , Vasos Coronarios/fisiopatología , Vasos Coronarios/patología , Enfermedad de la Arteria Coronaria/fisiopatología , Túnica Íntima/patología , Animales , Aterosclerosis/fisiopatología , Remodelación Vascular/fisiología , Estrés MecánicoRESUMEN
Background and Objectives: Myocardial bridging (MB) is still not yet considered a significant finding in Indonesia both radiographically and clinically. Hence, this article aims to assess the prevalence of MB using multi-detector computed tomography (MDCT) and look at factors contributing to stenosis amongst patients with MB. Materials and Methods: This study is cross-sectional in a single centre, with consecutive sampling, looking at all patients who underwent a multi-detector computed tomography (MDCT) scan from February 2021 until February 2023. GraphPad Prism version 9.0.0 for Windows (GraphPad Software, Boston, MA, USA) was used to analyse the results. Results: There are 1029 patients with an MB, yielding a prevalence of 44.3% (95%CI 42.3-46.4). The left anterior descending vessel is the most commonly implicated, with 99.6%. Among those with stenosis, the middle portion of the bridging vessel is the most common site of stenosis (n = 269), followed by the proximal portion (n = 237). The severity of stenosis is more often moderate, with 30-50% (n = 238). Females (odds ratio [OR] of 1.8, 95%CI 1.4-2.3; p-value < 0.0001), older age (t-value 5.6, p-value < 0.0001), symptomatic patients (OR 1.4, 95% CI 1.1-1.9; p-value = 0.013), and higher mean coronary artery calcium score (t-value 11.3, p-value < 0.0001) are more likely to have stenosis. The degree of stenosis is significantly higher in the proximal stenosis group than in the middle stenosis group (t-value 27, p-value < 0.0001). Conclusions: Our research demonstrates that MB may prevent atheromatosis of the coronary segment distal to the MB and predispose the development of atherosclerosis in the section proximal to the bridge.
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Tomografía Computarizada Multidetector , Puente Miocárdico , Humanos , Indonesia/epidemiología , Femenino , Masculino , Persona de Mediana Edad , Estudios Transversales , Prevalencia , Puente Miocárdico/epidemiología , Puente Miocárdico/diagnóstico por imagen , Tomografía Computarizada Multidetector/métodos , Adulto , Anciano , Estenosis Coronaria/diagnóstico por imagen , Estenosis Coronaria/epidemiologíaAsunto(s)
Angiografía por Tomografía Computarizada , Angiografía Coronaria , Puente Miocárdico , Valor Predictivo de las Pruebas , Humanos , Puente Miocárdico/diagnóstico por imagen , Puente Miocárdico/fisiopatología , Puente Miocárdico/complicaciones , Vasos Coronarios/diagnóstico por imagen , Masculino , Interpretación de Imagen Radiográfica Asistida por Computador , Persona de Mediana Edad , Femenino , Reproducibilidad de los ResultadosRESUMEN
AIMS: Myocardial bridging (MB) is a frequent congenital anomaly of the epicardial coronary arteries commonly considered a benign condition. However, in some cases a complex interplay between anatomical, clinical and physiology factors may lead to adverse events, including sudden cardiac death. Coronary CT angiography (CCTA) emerged as the gold standard noninvasive imaging technique for the evaluation of MB. Aim of the study was to evaluate MB prevalence and anatomical features in a large population of patients who underwent CCTA for suspected CAD and to identify potential anatomical and clinical predictors of adverse cardiac events at long-term follow-up. METHODS AND RESULTS: Two-hundred and six patients (mean age 60.3 ± 11.8 years, 128 male) with MB diagnosed at CCTA were considered. A long MB was defined as ≥25 mm of overlying myocardium, whereas a deep MB as ≥2 mm of overlying myocardium. The study endpoint was the sum of the following adverse events: cardiac death, bridge-related acute coronary syndrome, hospitalization for angina or bridge-related ventricular arrhythmias and MB surgical treatment. Of the 206 patients enrolled in the study, 9 were lost to follow-up, whereas 197 (95.6%) had complete follow-up (mean 7.01 ± 3.0 years) and formed the analytic population. Nineteen bridge-related events occurred in 18 patients (acute coronary syndrome in 7, MB surgical treatment in 2 and hospitalization for bridge-related events in 10). Typical angina at the time of diagnosis and long MB resulted as significant independent predictors of adverse outcome. CONCLUSIONS: Typical angina and MB length ≥ 25 mm were independent predictors of cardiac events.
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Angiografía por Tomografía Computarizada , Angiografía Coronaria , Puente Miocárdico , Valor Predictivo de las Pruebas , Humanos , Masculino , Puente Miocárdico/diagnóstico por imagen , Puente Miocárdico/complicaciones , Puente Miocárdico/epidemiología , Femenino , Persona de Mediana Edad , Angiografía por Tomografía Computarizada/métodos , Anciano , Estudios de Seguimiento , Angiografía Coronaria/métodos , Estudios RetrospectivosRESUMEN
We performed this cohort study to investigate whether the myocardial bridge (MB) affects the fat attenuation index (FAI) and to determine the optimal cardiac phase to measure the volume and the FAI of pericoronary adipose tissue (PCAT). The data of 300 patients who were diagnosed with MB of the left anterior descending (LAD) coronary artery were retrospectively analyzed. All of patients were divided into the MB group and the MB with atherosclerosis group. In addition, 104 patients with negative CCTA results were enrolled as the control group. There was no significant difference between FAI values measured in systole and diastole (P > 0.05). There was no significant difference in FAI among the MB group, the MB with atherosclerosis group, and the control group (P > 0.05). In MB with atherosclerosis group, LAD stenosis degree (< 50%) (OR = 0.186, 95% CI 0.036-0.960; P = 0.045) and MB located in the distal part of LAD opening (OR = 0.880, 95% CI 0.789-0.980; P = 0.020) were protective factors of FAI value. A distance (from the LAD opening to the proximal point of the MB) of 29.85 mm had the highest predictive value for abnormal FAI [area under the curve (AUC), 0.798], with a sensitivity of 81.1% and a specificity of 74.6%.
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Aterosclerosis , Enfermedad de la Arteria Coronaria , Puente Miocárdico , Humanos , Angiografía Coronaria/métodos , Estudios de Cohortes , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Vasos Coronarios , Tejido AdiposoAsunto(s)
Síndrome Coronario Agudo , Anomalías de los Vasos Coronarios , Puente Miocárdico , Infarto del Miocardio , Humanos , Síndrome Coronario Agudo/diagnóstico por imagen , Síndrome Coronario Agudo/etiología , Síndrome Coronario Agudo/terapia , Resultado del Tratamiento , Infarto del Miocardio/etiología , Anomalías de los Vasos Coronarios/complicaciones , Angiografía Coronaria/efectos adversosAsunto(s)
Oclusión Coronaria , Puente Miocárdico , Intervención Coronaria Percutánea , Humanos , Puente Miocárdico/diagnóstico por imagen , Puente Miocárdico/terapia , Resultado del Tratamiento , Intervención Coronaria Percutánea/efectos adversos , Oclusión Coronaria/diagnóstico por imagen , Oclusión Coronaria/terapia , Angiografía CoronariaRESUMEN
PURPOSE: To quantitatively investigate the effect of myocardial bridge (MB) in the left anterior descending artery (LAD) on the fractional flow reserve (FFR). MATERIALS AND METHODS: Three-hundred patients with LAD MB who had undergone coronary artery CT angiography (CCTA) were retrospectively enroled, and 104 normal patients were enroled as the control. The CCTA-derived fractional flow reserve (FFRCT) was measured at the LAD 10 mm proximal (FFR1) and 20-40 mm distal (FFR3) to the MB and at the MB location (FFR2). RESULTS: FFR2 and FFR3 of the MB (with BM only) and MBLA (with both MB and atherosclerosis) groups were significantly (p < 0.01) lower than those of the control. The FFR3 distal to the MB was significantly lower (p < 0.01) than that of the control. The FFRCT of the whole LAD in the MBLA group was significantly (p < 0.05) lower than that of the MB and control group (p < 0.05). MB length (OR 1.061) and MB muscle index (odds ratio or OR 1.007) were two risk factors for abnormal FFRCT, and MB length was a significant independent risk factor for abnormal FFRCT (OR = 1.077). LAD stenosis degree was a risk factor for abnormal FFRCT values (OR 3.301, 95% confidence interval [CI] 1.441-7.562, p = 0.005) and was also a significant independent risk factor (OR = 3.369, 95% CI: 1.392-8.152; p = 0.007) for abnormal FFRCT. CONCLUSION: MB significantly affects the FFRCT of distal coronary artery. For patients with MB without atherosclerosis, the MB length is a risk factor significantly affecting FFRCT, and for patients with MB accompanied by atherosclerosis, LAD stenotic severity is an independent risk factor for FFRCT.
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Aterosclerosis , Enfermedad de la Arteria Coronaria , Estenosis Coronaria , Reserva del Flujo Fraccional Miocárdico , Puente Miocárdico , Humanos , Angiografía por Tomografía Computarizada/métodos , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Reserva del Flujo Fraccional Miocárdico/fisiología , Vasos Coronarios/diagnóstico por imagen , Estudios Retrospectivos , Puente Miocárdico/diagnóstico por imagen , Valor Predictivo de las Pruebas , Estenosis Coronaria/diagnóstico por imagen , Angiografía Coronaria/métodos , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND: Myocardial bridging (MB) is common in patients with hypertrophic cardiomyopathy (HCM). There are sparse data on the impact of MB on myocardial fibrosis in HCM. This study was designed to evaluate the relationship between MB and myocardial fibrosis in patients with obstructive HCM. METHODS: In this cohort study, retrospective data were collected from a high-volume HCM center. Patients with obstructive HCM who underwent septal myectomy and preoperative cardiac magnetic resonance (CMR) were screened from 2011 to 2018. RESULTS: Finally, 492 patients were included in this study, with an average age of 45.7 years. Of these patients, 76 patients had MB. MB occurred mostly in the left anterior descending artery (73/76). The global extent of late gadolinium enhancement (LGE) was correlated with the degree of systolic compression (r = 0.33, p = 0.003). Multivariable linear regression analysis revealed that the degree of systolic compression was an independent risk factor for LGE (ß = 0.292, p = 0.007). The LGE fraction of basal and mid anteroseptal segments in patients with severe MB (compression ratio ≥ 80%) was significantly greater than that in patients with mild to moderate MB (compression ratio < 80%). During a median follow-up of 28 (IQR: 15-52) months, 15 patients died. Kaplan-Meier analysis did not identify differences in all-cause death (log-rank p = 0.63) or cardiovascular death (log-rank p = 0.72) between patients undergoing MB-related surgery and those without MB. CONCLUSIONS: MB with severe systolic compression was significantly associated with a high extent of fibrosis in patients with obstructive HCM. Concomitant myotomy or coronary artery bypass grafting might provide excellent survival similar to that of patients without MB. Identification of patients with severe MB and providing comprehensive management might help improve the prognosis of patients with HCM.
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Cardiomiopatía Hipertrófica , Puente Miocárdico , Humanos , Persona de Mediana Edad , Miocardio/patología , Medios de Contraste , Estudios Retrospectivos , Estudios de Cohortes , Puente Miocárdico/complicaciones , Puente Miocárdico/diagnóstico por imagen , Puente Miocárdico/patología , Gadolinio , Cardiomiopatía Hipertrófica/complicaciones , Cardiomiopatía Hipertrófica/diagnóstico por imagen , Cardiomiopatía Hipertrófica/cirugía , Fibrosis , Factores de RiesgoAsunto(s)
Humanos , Masculino , Adolescente , Pediatría , Asma , Disnea , Puente Miocárdico , Espirometría , Examen FísicoRESUMEN
BACKGROUND: Myocardial bridge (MB) is described as an abnormal band of myocardium covering a variable portion of any coronary artery. METHODS: The current study explores the presence of MB throughout the coronary arterial system and provides a morphometric description through instrumented dissection of a sample of 100 human hearts. The study shows a higher prevalence of MB in the Mexican population than in previous reports. RESULTS: In the total sample (n=100), MB was identified in 96% of it. A total of 421 MBs were observed, with a mean of 4.38mm (±0.28) per dissected heart. The most frequently affected vessel is the anterior interventricular artery where a total of 52 MBs were found, of the total sample studied. DISCUSSION: The high prevalence of MB among Mexican patients could be the result of a genetic association for this population or the neoformation of MB after birth due to lifestyle-associated factors. Further studies are required to better understand the high prevalence of MB among Mexican subjects.
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Puente Miocárdico , Humanos , México/epidemiología , Masculino , Femenino , Prevalencia , Puente Miocárdico/epidemiología , Puente Miocárdico/patología , Persona de Mediana Edad , Adulto , Anciano , Vasos Coronarios/anatomía & histología , Anciano de 80 o más Años , Miocardio/patología , Adulto JovenRESUMEN
Hypertrophic cardiomyopathy (HCM) is a complex cardiac disorder, often associated with adverse outcomes, including sudden cardiac death. Myocardial bridging (MB), where a coronary artery segment traverses intramurally within the myocardium, complicates coronary blood flow dynamics. This retrospective study investigates the relationship between MB and HCM and their impact on percutaneous coronary intervention (PCI) outcomes. Data from the 2019 National Inpatient Sample (NIS), representing 20% of U.S. hospitalizations, was utilized. Patients with both HCM and MB undergoing PCI were identified and analyzed. The study assessed inpatient outcomes, including mortality, length of stay, hospital cost, and post-PCI complications (atrial fibrillation, acute kidney injury, bleeding, coronary dissection). Patients with HCM and MB exhibited distinct demographics. The study did not find significant associations between HCM/MB and inpatient mortality, length of stay, or hospital cost. However, HCM patients had a higher incidence of atrial fibrillation and acute kidney injury post-PCI (aOR 2.33, 95% CI 1.46 to 3.71, p ≤ 0.001). MB was linked to increased occurrences of acute heart failure (aOR 0.62, 95% CI 0.42-0.92, pâ¯=â¯0.02) and post-PCI bleeding (aOR 4.88, 95% CI 1.17-20.2, pâ¯=â¯0.03). This nationwide study reveals unique demographic profiles for HCM and MB patients. Notably, HCM patients face higher risks of post-PCI complications, including atrial fibrillation and acute kidney injury. These findings provide fresh insights into the MB-HCM relationship and its implications for PCI outcomes. They emphasize the need for tailored interventions and improved patient management in cases involving both HCM and MB.
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Lesión Renal Aguda , Fibrilación Atrial , Cardiomiopatía Hipertrófica , Puente Miocárdico , Intervención Coronaria Percutánea , Humanos , Intervención Coronaria Percutánea/efectos adversos , Estudios Retrospectivos , Puente Miocárdico/complicaciones , Puente Miocárdico/epidemiología , Fibrilación Atrial/complicaciones , Fibrilación Atrial/epidemiología , Hemorragia/etiología , Cardiomiopatía Hipertrófica/complicaciones , Cardiomiopatía Hipertrófica/cirugía , Lesión Renal Aguda/epidemiología , Lesión Renal Aguda/etiología , Factores de Riesgo , Resultado del TratamientoRESUMEN
Myocardial bridging is congenital anomaly characterized by segment of epicardial coronary arteries passing through the myocardium. Various ischemic conditions are related with this pathology. We report a case of myocardial bridging that was complicated with acute anterior myocardial infarction and a review of the literature. The patient was treated successfully with coronary bypass graft surgery after unsuccessful percutaneous intervention.