title: Impaired endothelial function in patients with myocardial bridge.
abstract: OBJECTIVE
  The relationship between myocardial bridging (MB) and ischemic heart disease is still controversial. In this study, we aimed to evaluate the existing atherosclerosis and noninvasive endothelial function of brachial artery in patients with MB.
  
  
  METHODS
  The present study included 50 patients (group I) who had MB in left anterior descending (LAD) on coronary angiography. All of the coronary artery segments were evaluated by intravascular ultrasound (IVUS). Endothelial function was assessed with measurement of flow-mediated dilatation (FMD) and nitrate-dependent dilatation in the brachial artery. The study also included 30 healthy control subjects (group II). Patients in the group I were further subdivided into two subgroups based on the findings on IVUS: group IA included 20 patients without atherosclerotic lesions and group IB included 30 patients with atherosclerotic coronary artery disease in addition to MB.
  
  
  RESULTS
  FMD values were found to be significantly lower in the patients with MB (group I) than in the control (6.4 +/- 3% vs 11 +/- 4%, P <0.001). In regard to FMD values in subgroups, FMD was 7 +/- 2% in the group IA and 5.8 +/- 1% in the group IB (P = 0.023). On IVUS, atherosclerotic plaque was found proximal to the bridge in the same coronary artery segment in addition to MB in 75% of the patients in group I (group IB). No atherosclerotic plaque was found in within or distal segments of MB.
  
  
  CONCLUSIONS
  Endothelial function is impaired in patients with MB and there is an increased tendency for atherosclerosis proximal to the bridge in the patients with MB. Endothelial dysfunction is more severe in the patients with atherosclerosis proximal to the bridge.
authors.affiliation: Department of Cardiology, Ege University Medical Faculty, Izmir, Turkey.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Zoghi
authors.forename: Hamza
authors.initials: H
authors.lastname: Duygu
authors.forename: Sanem
authors.initials: S
authors.lastname: Nalbantgil
authors.forename: Bahadir
authors.initials: B
authors.lastname: Kirilmaz
authors.forename: Ugur
authors.initials: U
authors.lastname: Turk
authors.forename: Filiz
authors.initials: F
authors.lastname: Ozerkan
authors.forename: Azem
authors.initials: A
authors.lastname: Akilli
authors.forename: Mustafa
authors.initials: M
authors.lastname: Akin
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Turkoglu
mesh_terms: D000286:Administration, Sublingual; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D003937:Diagnosis, Differential; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018084:Ultrasonography, Interventional; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology*; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D007548:Isosorbide Dinitrate