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Myocardial bridging in obstructive hypertrophic cardiomyopathy: a risk factor for myocardial fibrosis.
Song, Changpeng; Wang, Shengwei; Guo, Xinli; Huang, Manyun; Zheng, Xinxin; Lu, Jie; Ji, Keshan; Zhao, Shihua; Cui, Jingang; Wang, Shuiyun; Huang, Xiaohong.
Afiliación
  • Song C; Department of Special Medical Treatment Center in Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, People's Republic of China.
  • Wang S; Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vascular Diseases, Beijing, People's Republic of China.
  • Guo X; Department of Special Medical Treatment Center in Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, People's Republic of China.
  • Huang M; Department of Special Medical Treatment Center in Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, People's Republic of China.
  • Zheng X; Department of Special Medical Treatment Center in Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, People's Republic of China.
  • Lu J; Department of Special Medical Treatment Center in Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, People's Republic of China.
  • Ji K; Department of Magnetic Resonance Imaging in Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
  • Zhao S; Department of Magnetic Resonance Imaging in Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
  • Cui J; Department of Special Medical Treatment Center in Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, People's Republic of China. doctorcjg@163.com.
  • Wang S; Department of Cardiovascular Surgery in Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China. wsymd@me.com.
  • Huang X; Department of Special Medical Treatment Center in Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, People's Republic of China. huangxhfuwai@163.com.
BMC Med ; 22(1): 86, 2024 Feb 27.
Article en En | MEDLINE | ID: mdl-38413945
ABSTRACT

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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cardiomiopatía Hipertrófica / Puente Miocárdico Límite: Humans / Middle aged Idioma: En Revista: BMC Med Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cardiomiopatía Hipertrófica / Puente Miocárdico Límite: Humans / Middle aged Idioma: En Revista: BMC Med Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido