EXPLORING MYOCARDIAL BRIDGES CHARACTERISTICS IN NORTH-EASTERN ROMANIA. A RETROSPECTIVE ANALYSIS
Abstract
Myocardial bridges are defined by a segment of the coronary artery taking an intramuscular route, diverging from its usual superficial path over the myocardial tissue and, instead, traversing through the myocardium itself. Currently, their true prevalence remains uncertain and challenging to estimate accurately. Their dynamic presentation shapes the diversity of clinical manifestations, resulting in highly variable expressions among individuals. Materials and methods: We conducted a retrospective analysis of myocardial bridge characteristics in patients undergoing coronary computed tomography angiography (CCTA) at the “Prof. Dr. George I.M. Georgescu” Institute of Cardiovascular Diseases in Iasi, Romania, from 2012 to 2022. Additionally, we sought to investigate any potential correlation between the presence of myocardial bridges and the development of atherosclerosis and coronary artery disease. Results: Out of the 66 patients with myocardial bridges, 44 were males, accounting for 66.7% of the total cases. The average age was of 59.42 years (± 11.84 years). In 97% of cases, the left anterior descending artery (LAD) was affected, primarily at its middle segment (60.6%). The mean width measured 3.02±1.22 mm and the mean length was 20.33±9.25 mm. A significant elevation in the average calcium score level was observed among males (p=0.025). Individuals with myocardial bridge thickness over 5 mm showed significantly higher average calcium scores (p=0.025). Conclusions: Using CCTA improves the detection of clinically significant myocardial bridges, with the middle segment of the left anterior descending artery being the primary site in most cases. The study suggests a potential link between myocardial bridges thickness and higher coronary artery calcium scores, prompting further exploration. Correlations with atherosclerosis and hypertension require deeper investigation for a comprehensive understanding of myocardial bridges clinical impact.
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