Myocardial bridging increases the risk of coronary spasm.

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 Cardiol

journal_title

Clinical cardiology

authors

Teragawa H,Fukuda Y,Matsuda K,Hirao H,Higashi Y,Yamagata T,Oshima T,Matsuura H,Chayama K

doi

10.1002/clc.4950260806

subject

Has Abstract

pub_date

2003-08-01 00:00:00

pages

377-83

issue

8

eissn

0160-9289

issn

1932-8737

journal_volume

26

pub_type

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