Angiographic Prevalence and Clinical Profile of Myocardial Bridge – A Study on North Indian Population

Abstract

The present study assessed the prevalence, clinical and angiographic outlines in patients who were diagnosed with myocardial bridge (MB) on coronary angiogram. Methods: We carried out a single-center, observational prospective study at a tertiary care facility in India.Among 4456 coronary angiographies performed over the time, we have enrolled total 110 patients who were diagnosed with MB of the coronary artery. MB was defined as at least 50% greater luminal diameter of coronary artery in systolic phase than the diastolic phase. Quantitative angiography was performed to quantify characteristics of MB. Results: The coronary angiographic prevalence of MB was observed as 2.47%(110/4456) of which 81.82% in left anterior descending artery (LAD) while 18.18%in either left circumflex (LCX) or right coronary artery (RCA).The mean length of bridged segment was 28.3±9.5 mm for LAD MB and 28.6±7.6 mm for LCX/RCA MB. Among all LAD and LCX/RCA bridges, 84.4%(n=76) and 80%(n=16) were in the mid segment of respective arteries. In patients with LAD bridges, 70(77.7%) patients had significant atherosclerosis of which 42.8%(n=30) was in the vessel proximal to the bridge. The patients with LCX/RCA bridge, 38.4% (n=5) had significant atherosclerosis in vessel proximal to MB. Significant atherosclerosis in the tunnelled artery was not reported in any patients. Conclusion: The current study reported 2.47% angiographic prevalence of MB on north Indian patients and also confirms past findings that the majority of MB were in the middle segment of the LAD and that atherosclerosis was frequently observed in the proximal segment of the bridge.