Prevalenza dei decorsi miocardici e relazione con l’aterosclerosi coronarica studiate mediante angiografia coronarica con TC a 64 strati

Purpose. This study aimed to assess the prevalence and characteristics of myocardial bridging in patients who underwent multislice computed tomography coronary angiography (MSCT-CA) and to evaluate the correlation between bridged coronary segments and atherosclerosis. Materials and methods. A total of 277 patients (mean age 60±11 years) we consecutively examined with 64-slice MSCT-CA for suspected or known coronary atherosclerosis were retrospectively reviewed for myocardial bridging. Segments proximal and distal to the bridging were evaluated for atherosclerotic plaque, as were the remaining coronary segments. Results. Myocardial bridging was present in 82 patients (30%, mean age 59±12). Bridges were of variable length ( 2 cm 10%) and depth (superficial 69%, intramyocardial 31%) and frequently localised in the mid-distal segment of the left anterior descending artery (95%). Myocardial bridging cannot be considered a significant risk factor for coronary atherosclerosis (odds ratio 0.49) compared with traditional cardiovascular risk factors. Coronary segments proximal to the bridge showed no atherosclerotic disease (33%), positive remodelling (27%), 50% stenosis (20%). We identified 12 noncalcified, 32 mixed and 17 calcified plaques. The distal segments were Riassunto Obiettivo. Scopo del nostro lavoro e stimare la prevalenza e le caratteristiche dei ponti miocardici in una popolazione consecutiva di pazienti sottoposti ad angiografia coronarica mediante tomografia computerizzata multistrato (AC-TCMS), nonche valutare la relazione tra i decorsi miocardici e l’aterosclerosi coronarica. Materiali e metodi. In una popolazione di 277 pazienti (eta media 60±11), sottoposti consecutivamente ad AC-TCMS con scanner a 64-strati per malattia aterosclerotica coronarica sospetta o nota, e stata ricercata la presenza di decorsi miocardici. Sono state valutate le placche aterosclerotiche presenti nei segmenti prossimali e distali al decorso miocardico, nonche nei restanti segmenti coronarici. Risultati. Ottantadue pazienti (30%, eta media 59±12) presentano decorso miocardico superficiale (69%) o intramiocardico (31%), con lunghezza variabile ( 2 cm: 10%), frequentemente localizzato nel tratto medio-distale dell’arteria coronaria discendente anteriore (95%). Il ponte miocardico non rappresenta un fattore di rischio significativo di aterosclerosi coronarica (odds ratio 0,49) rispetto ai tradizionali fattori di rischio cardiovascolare. I segmenti prossimali mostrano: assenza di malattia (33%), rimodellamento positivo (27%), stenosi <50% (20%) o CARDIAC RADIOLOGY CARDIORADIOLOGIA Radiol med (2009) 114:1024–1036 DOI 10.1007/s11547-009-0446-y Prevalence of myocardial bridging and correlation with coronary atherosclerosis studied with 64-slice CT coronary angiography Prevalenza dei decorsi miocardici e relazione con l’aterosclerosi coronarica studiate mediante angiografia coronarica con TC a 64 strati L. La Grutta • G. Runza • G. Lo Re • M. Galia • V. Alaimo • E. Grassedonio • T.V. Bartolotta R. Malago • C. Tedeschi • F. Cademartiri • M. De Maria • A.E. Cardinale • R. Lagalla M. Midiri Department of Radiology, DIBIMEL, University Hospital “P. Giaccone”, Via del Vespro 127, 90127 Palermo, Italy Department of Radiology, University of Verona, Italy Department of Cardiology, San Gennaro Hospital, Naples, Italy Department of Radiology and Cardiology, University Hospital, Parma, Italy Department of Radiology and Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands Correspondence to: L. La Grutta, Tel. : +39-091-6552349, Fax: +39-091-6552324, e-mail: ludovicolagrutta@hotmail.it Received: 24 September 2008 / Accepted: 13 January 2009 / Published online: 20 August 2009 © Springer-Verlag 2009 significantly less affected (p<0.0001). Conclusions. MSCT-CA is a reliable, noninvasive method that is able to depict myocardial bridging and associated atherosclerotic plaque in the proximal segments.