title: Myocardial bridging is associated with coronary atherosclerosis in the segment proximal to the site of bridging.
abstract: BACKGROUND
  Myocardial bridging is a common finding on multi-detector computed tomography (MDCT). The segment proximal to a myocardial bridge is frequently atherosclerotic, although the tunneled segment is spared. This study aimed to investigate whether myocardial bridging identified by MDCT is an independent risk factor for coronary atherosclerosis.
  
  
  RESULTS
  Patients (n=188) with suspected coronary disease underwent MDCT using a 40-detector or 64-detector instrument. We reviewed the baseline characteristics (age, body mass index, smoking history, presence of hypertension, dyslipidemia, and diabetes mellitus) and the results of MDCT angiography. Two radiologists evaluated the coronary artery for myocardial bridging and coronary atherosclerosis and made a diagnosis by consensus. Significant independent risk factors for coronary atherosclerosis were investigated by multivariate logistic regression analysis. We identified 50 bridges in the middle segment of the left anterior descending artery (LAD). There were no patients with significant stenosis in the tunneled segment. Multivariate analysis showed that age, diabetes mellitus, and myocardial bridging in the mid-LAD were significantly associated with coronary atherosclerosis in the proximal LAD (p<0.05). Age, diabetes mellitus, and the absence of myocardial bridging in the mid-LAD were significantly associated with coronary atherosclerosis in the mid-LAD (p<0.05).
  
  
  CONCLUSIONS
  The segment proximal to a segment with myocardial bridging is frequently involved in atherosclerosis, although the tunneled segment is spared. Myocardial bridging in the mid-LAD is an independent risk factor for coronary atherosclerosis in the proximal LAD.
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan; Department of Diagnostic Radiology, Amakusa Medical Center, Kumamoto 863-0046, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakaura
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan; Department of Cardiovascular Medicine, National Health Insurance Aso Central Hospital, Aso City 869-2225, Japan. Electronic address: ynagayos@kumamoto-u.ac.jp.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nagayoshi
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Awai
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Utsunomiya
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kawano
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D003920:Diabetes Mellitus; D050171:Dyslipidemias; D005260:Female; D006801:Humans; D006973:Hypertension; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012307:Risk Factors; D012907:Smoking
keywords: Atherosclerosis; Computed tomography; Myocardial bridging; Risk factors