Myocardial bridging assessed by multidetector computed tomography: likely cause of chest pain in younger patients with low prevalence of dyslipidemia.
OBJECTIVE
The relationship between myocardial bridging and symptoms is still unclear. The purpose of our study was to assess the relationship between myocardial bridging detected by multidetector computed tomography and symptoms in a patient population with chest pain syndrome.


METHODS
The study enrolled 393 consecutive patients without previous coronary artery disease studied for chest pain and referred to multidetector computed tomography between January 2007 and December 2010. Noninvasive coronary angiography was performed using multidetector computed tomography. Myocardial bridging was defined as part of a coronary artery completely surrounded by myocardium on axial and multiplanar reformatted images.


RESULTS
Mean age was 64.6 (12.4) years and 44.8% were male. Multidetector computed tomography detected 86 myocardial bridging images in 82 of the 393 patients (20.9%). Left anterior descending was the most frequent coronary artery involved (87.2%). The prevalence of myocardial bridging was significantly higher in patients without significant atherosclerotic coronary stenosis on multidetector computed tomography (24.9% vs 15.0%; P=.02). Patients with myocardial bridging were younger (60.3 [13.8] vs 65.8 [11.9]; P<.001), had less prevalence of hyperlipidemia (29.3% vs 41.8%; P=.03), and more prevalence of cardiomyopathy (6.1% vs 1.6%, P=.02) compared with patients without myocardial bridging on multidetector computed tomography.


CONCLUSIONS
Multidetector computed tomography is an easy and reliable tool for comprehensive in vivo diagnosis of myocardial bridging. The results of the present study suggest myocardial bridging is the cause of chest pain in a subgroup of younger aged patients with less prevalence of hyperlipidemia and more prevalence of cardiomyopathy than patients with significant atherosclerotic coronary artery disease on multidetector computed tomography. Full English text available from:www.revespcardiol.org.
Instituto Cardiovascular, Hospital Universitario San Carlos, Madrid, España. albertutor@hotmail.com
José Alberto
JA
de Agustín
Pedro
P
Marcos-Alberca
Covadonga
C
Fernández-Golfín
Sara
S
Bordes
Gisela
G
Feltes
Carlos
C
Almería
José Luis
JL
Rodrigo
Juan
J
Arrazola
Leopoldo
L
Pérez de Isla
Carlos
C
Macaya
José
J
Zamorano
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000209:etiology*; D003324:Coronary Artery Disease / Q000150:complications; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D050171:Dyslipidemias / Q000097:blood / Q000150:complications; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D054084:Myocardial Bridging / Q000150:complications / Q000000981:diagnostic imaging*