Open AccessMyocardial bridging increases the risk of coronary spasm
Author(s) -
Teragawa Hiroki,
Fukuda Yukihiro,
Matsuda Keiji,
Hirao Hidekazu,
Higashi Yukihito,
Yamagata Togo,
Oshima Tetsuya,
Matsuura Hideo,
Chayama Kazuaki
Publication year - 2003
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4950260806
Subject(s) - medicine , cardiology , provocation test , myocardial bridge , chest pain , myocardial bridging , artery , myocardial infarction , coronary angiography , alternative medicine , pathology
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 > 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 midsegment 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.