Comparison of frequency of coronary spasm in Korean patients with versus without myocardial bridging.
The longstanding compression-relaxation effects of myocardial bridging may produce endothelial dysfunction by direct stress on the endothelium. We tested the hypothesis that myocardial bridging induces endothelial dysfunction and subsequently increases the risk of coronary spasm and investigated the symptomatic response to medication in patients with documented myocardial bridging and coronary spasm. In 81 patients with myocardial bridging (44 men; mean age 57.2 years) and 195 control patients without bridging and atherosclerotic lesions confirmed by angiography (97 men; mean age 58.4 years), spasm provocation testing was done by incremental acetylcholine infusion into the left coronary artery. Spasm was documented in 62 of 81 patients with bridging and in 31 of 195 controls (p <0.001). A focal spasm was limited to the bridging segments compared with controls (p <0.001). In conclusion, the results of this study showed that myocardial bridging increased the risk of coronary spasm by endothelial dysfunction in the bridging segment.
Kim
Jin Won
JW
Cardiovascular Center, Korea University, Guro Hospital, Seoul, Republic of Korea.
Park
Chang Gyu
CG
Suh
Soon Yong
SY
Choi
Cheol Ung
CU
Kim
Eung Joo
EJ
Rha
Seung-Woon
SW
Seo
Hong Seog
HS
Oh
Dong Joo
DJ
D000109:Acetylcholine / Q000008:administration & dosage; D016022:Case-Control Studies; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging* / Q000209:etiology; D003331:Coronary Vessels / Q000187:drug effects; D004730:Endothelium, Vascular / Q000187:drug effects; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D012307:Risk Factors
D000109:Acetylcholine