title: Clinical significance of myocardial squeezing of the coronary artery.
abstract: We investigated the coronary angiography (CAG) of 1,022 patients to clarify the clinical significance of myocardial squeezing and obtained the following results. Of 1,022 patients undergoing CAG, 164 patients (16.0%) had myocardial squeezing of the left anterior descending artery (LAD) and 16 patients (1.6%) had only the first septal perforating branches producing a squeezing of the artery during systole. The association of myocardial squeezing of the LAD with different diagnosis was anterior chest pain syndrome (26.6%), arrhythmia (23.6%), cardiomyopathy (21.7%), angina pectoris (15.8%) and myocardial infarction (6.9%). The degree of narrowing of the LAD was classified into 4 grades; 25-49%: 36 patients (22.0%), 50-74%: 82 patients (50.0%), 75-89%: 35 patients (21.3%) and greater than 90%: 11 patients (6.7%). The morphology of the vessel subjected to myocardial squeezing was classified into 4 patterns on CAG. Type A is localized narrowing. Type B is bead-like narrowing. Type C is diffuse narrowing. Type D is tapering and obstructive narrowing. All type D patients had the septal perforating branches. We investigated whether only myocardial squeezing has ischemic ST-T segment changes in the ECG. Fifty-five of 87 patients (63.2%) with myocardial squeezing of greater than 75% and organic stenosis of less than 50% of the LAD had ischemic changes in the ECG during exercise or pacing-induced tachycardia. There was no special feature between myocardial squeezing and subjective symptoms.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000473:pathology / Q000503:physiopathology; D002648:Child; D017023:Coronary Angiography; D003327:Coronary Disease / Q000473:pathology / Q000503:physiopathology*; D003331:Coronary Vessels / Q000473:pathology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology / Q000503:physiopathology; D010146:Pain / Q000503:physiopathology; D013909:Thorax