Abstract:
BACKGROUND:Myocardial bridging (MB) has been associated with cardiac events. Whether coronary spasm is one factor contributing to those events is unknown. HYPOTHESIS:This study investigated whether the likelihood of coronary spasm is increased in patients with MB. METHODS:A spasm-provocation test was performed by infusing acetylcholine into the left coronary artery in 114 Japanese patients with chest pain. The test result was defined as positive when the diameter of the coronary artery was reduced by > or = 50% and ST-segment changes were documented. Myocardial bridging was defined as a > 15% reduction in coronary arterial diameter during systole after intracoronary injection of nitroglycerin. RESULTS:Myocardial bridging was identified in 41 patients (36%) and was located in the mid-segment of the left anterior descending coronary artery (LAD) in all patients. Patients with MB experienced coronary spasm more frequently than patients without MB (MB+: 73%; MB-: 40%, p = 0.0006). Furthermore, among patients with a positive spasm-provocation test, coronary spasm occurred more frequently in the mid-segment of the LAD in patients with MB than in those without MB (MB+: 73%; MB-: 45%, p = 0.0259). Multivariate regression analysis demonstrated that MB was a predictor of coronary spasm (odds ratio: 3.478, p = 0.0088). CONCLUSIONS:These results suggest that MB increases the risk of coronary spasm and that coronary spasm may be the proximate etiology of cardiac events associated with MB.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Teragawa H,Fukuda Y,Matsuda K,Hirao H,Higashi Y,Yamagata T,Oshima T,Matsuura H,Chayama Kdoi
10.1002/clc.4950260806subject
Has Abstractpub_date
2003-08-01 00:00:00pages
377-83issue
8eissn
0160-9289issn
1932-8737journal_volume
26pub_type
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