Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Myocardial bridges: optimization of diagnostic approaches. Role of multispiral computed tomography

Authors: Boсkeria L.A., Makarenko V.N., Kurbanova B.G.

Company:
1 Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
2 Republican Specialized Scientific and Practical Medical Center of Cardiology, Tashkent, Republic Uzbekistan

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2022-19-3-221-230

UDC: 616.127-073.756.8

Link: Clinical Physiology of Blood Circulaiton. 2022; 3 (19): 221-230

Quote as: Boсkeria L.A., Makarenko V.N., Kurbanova B.G. Myocardial bridges: optimization of diagnostic approaches. Role of multispiral computed tomography. Clinical Physiology of Circulation. 2022; 19 (3): 221–30 (in Russ.). DOI: 10.24022/1814-6910-2022-19-3-221-230

Received / Accepted:  28.03.2022 / 15.07.2022

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Abstract

Objective. The diagnostic efficacy of multislice computed tomography (MSCT) in patients with symptomatic myocardial bridges (MB).

Material and methods. Sixty-seven patients (68.7% of men) with complaints of retrosternal pain underwent a comprehensive study (invasive coronary angiography, MSCT). The age of the patients averaged 51.5 ± 11.2 year. The length and depth of the “tunneled” coronary artery (CA) were determined, and the MB muscle index (MMI) was calculated (length × depth). Dynamic narrowing of the CA was divided according to the degree of compression: <50%; 50–69% and ≥70%.

Results. The length of myocardial bridges averaged 24.95 ± 0.99 mm (from 12 mm to 42.1 mm). The length of the MB in the assessment of MSCT was 24.95 ± 7.18 mm versus 26.2 ± 5.3 mm according to the coronary angiography data. The average difference was 0.93 mm (95% CI -1.8–4.3). According to MSCT data, the thickness of the myocardium in the middle part of the bridges averaged 2.47 ± 0.99 mm (range 1.1–5.2 mm). Myocardial thickness MB 2.49 ± 7.18 mm (from 1.1 mm to 5.2 mm). MBs were classified as: superficial (n = 57) or deep (n =10), short (n = 36) or long (n = 31). FC of angina depends on the depth of the CA (p = 0.04353), from the dynamic narrowing of the CA (p = 0.0378), as well as from the MMI value (p = 0.0258). Threshold values of the spacecraft location depth – 2.1 mm, dynamic narrowing of the CA – 57%, length – 22.7 mm, MMI – 66.3.

Conclusion. Our study showed a high diagnostic efficiency of MSCT in determining the morphometric parameters of the MB and in determining their threshold values as a predictive risk assessment for the development of myocardial ischemia.

About Authors

  • Leo A. Bockeria, Dr. Med. Sci., Professor, Academician of RAS and RAMS, President; ORCID
  • Vladimir N. Makarenko, Dr. Med. Sci., Professor, Head of Department of Computed and Magnetic Resonance Imaging; ORCID
  • Веrnаrа G. Kurbanova, Head of Department of Radiation Diagnostics; ORCID

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