Correlation between depth of myocardial bridging and coronary angiography findings.
BACKGROUND
Myocardial bridging (MB) is a congenital anomaly in which a segment of coronary artery is surrounded by myocardium.


OBJECTIVE
To investigate the correlation between muscle thickness over the tunneled coronary artery (depth) in MB and the presence of milking effect (ME) and systolic narrowing ratio in catheter angiography (CA).


METHODS
The records of 36 patients who underwent a coronary computed tomography angiography (CTA) and following CA examination for suspicious ischemic coronary artery disease, between March 2005 and September 2007, were retrospectively evaluated. According to the depth of MB on CTA, patients were grouped into four groups: group 1, <1 mm; group 2, 1- <2 mm; group 3, 2- <4 mm; group 4, >or=4 mm. The presence of milking effect, systolic narrowing ratio, and atherosclerotic stenosis at CA were recorded. CTA and CA results were then compared to evaluate the correlation.


RESULTS
In total, ME was found in 15 arteries at CA (42%). There was no ME in group 1; it was present in 11% of group 2, 67% of group 3, and 100% of group 4. Starting from group 3, the percentage of likelihood of seeing the milking effect was 77%, and the percentage of systolic narrowing was between 30 and 70%. There was a significant correlation between depth of MB and systolic narrowing (P<0.01), while no significant correlation between length of MB and systolic narrowing was found (P=0.32). In seven of the 36 patients (group 1, 0; group 2, 1; group 3, 3; group 4, 3), clinical findings were related to pure MB.


CONCLUSIONS
The depth of MB is positively related to coronary narrowing and clinical ischemic findings.
Elmali
M
M
Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey. muzafel@yahoo.com.tr
Soylu
K
K
Gulel
O
O
Bayrak
I K
IK
Koprulu
D
D
Diren
H B
HB
Celenk
C
C
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000209:etiology; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000209:etiology*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D054084:Myocardial Bridging / Q000150:complications* / Q000175:diagnosis*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*