Study of Prevalence, Risk Factors and Angiographic Profile of Patients with Myocardial Bridges in a Tertiary Care Hospital, Dhaka, Bangladesh

Solaiman Hossain; Moeen Uddin Ahmed; Md. Abdul Mannan; Md. Shahimur Parvez; Debasish Debnath; Md. Mahidur Rahman; Anup Kumar Das

doi:doi:10.11648/j.ccr.20200402.16

Study of Prevalence, Risk Factors and Angiographic Profile of Patients with Myocardial Bridges in a Tertiary Care Hospital, Dhaka, Bangladesh

Solaiman Hossain, Moeen Uddin Ahmed, Md. Abdul Mannan, Md. Shahimur Parvez, Debasish Debnath, Md. Mahidur Rahman, Anup Kumar Das

Published in Cardiology and Cardiovascular Research (Volume 4, Issue 2)

Received: 28 March 2020 Accepted: 23 April 2020 Published: 15 May 2020

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Abstract

Background: Band of Myocardial tissue overlying a segment of an epicardial coronary artery is termed myocardial bridge (MB). The aim of this study was to identify the prevalence, risk factors and angiographic profile of patients with myocardial bridge in a tertiary care hospital, Dhaka, Bangladesh. Materials and Methods: This retrospective observational study included a total of 1480 patients with suspected coronary artery disease admitted to Enam Medical College and Hospital, Savar, Dhaka, Bangladesh for coronary angiography between April 2016 to June 20019 of them 43 cases were found to have myocardial bridge. Coronary compression was defined as a maximum systolic luminal compression ≥50%. In this population, 43 patients had systolic luminal compression ≥50%, and all 43 patients were selected for the study to determine the prevalence and risk factors of MB and recorded coronary angiogram was reviewed to see the angiographic location of MB, length of MB and number of vessels involved. Results: In this study incidence of MB was 2.9%. The risk factors associated with MB hypertension were 33 (76.74%), diabetes mellitus 28 (65.11%), hyperlipidaemia 18 (41.86%), family history of CAD 15 (34.88%), smoking history 22 (51.16%). Located of MB in LAD were 34 (79.06%), LCX 07 (16.27%) and RCA 02 (4.65%). The MB were in single vessel 38 (88.37%) and double vessels 05 (11.62%). MBs with atherosclerotic stenosis in LAD were 18 (41.86%), LCX 02 (4.65%), RCA 01 (2.32%) and severity of MB stenosis were in LAD 50 -70% were 27 (62.79%), >70% were 07 (16.27%), LCX 50-70% were 06 (13.95%) and >70% was 01 (2.32%) and RCA 50-70% was 02 (4.65%). The length of MBs segment <10 mm were 06 (13.95%), 10-20 mm were 25 (58.19%) and >20 mm were 12 (27.90%). Conclusion: In this study the prevalence of MB was 2.91%, commonly presented with chronic stable angina. The most risk factors of myocardial bridges were hypertension, diabetes mellitus, hyperlipidaemia, family history and smoking history. In coronary angiography most of the patient of MB was present in association of acute coronary syndrome with documented coronary artery disease and was mainly located in LAD mid segment and the length of MB was mostly 10-20 mm. Further large numbers of case are needed to validate the result of the study.

Published in	Cardiology and Cardiovascular Research (Volume 4, Issue 2)
DOI	10.11648/j.ccr.20200402.16
Page(s)	67-70
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Coronary Angiogram, Chronic Stable Angina, Coronary Artery Disease

References

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[3]	Cranicianu A. Anatomische Studien über die Coronararterien undexperimentelle Untersuchungen über ihre Durchgängigkeit. Virc- hows Arch A Pathol Anat 1922; 238: 1-8.
[4]	Schulte MA, Waller BF, Hull MT, Pless JE. Origin of the left anterior descending coronary artery from the right aortic sinus with intra-myocardial tunneling to the left side of the heart via the ventricular septum: A case against clinical and morphologic significance of myocardial bridging. Am Heart J 1985; 110: 499-501.
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[8]	Den Dulk K, Brugada P, Braat S, Heddle B, Wellens HJ. Myocardial bridging as a cause of paroxysmal A-V block. J Am Coll Cardiol 1983; 1: 965-9.
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[10]	Cutler D, Wallace JM. Myocardial bridging in a young patient with sudden death. Clin Cardiol 1997; 20: 581-3.
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[14]	Juillière Y, Berder V, Suty-Selton C, Buffet P, Danchin N, Cherrier F. Isolated myocardial bridges with angiographic milking of left anterior descending coronary artery: a long-term follow-up study. Am He- art J 1995; 129: 663-5.
[15]	Channer KS, Bukis E, Hartnell G, Rees JR. Myocardial bridging of the coronary arteries. Clin Radiol 1989; 40: 355-359.
[16]	Zoghi M, Duygu H, Nalbantgil S, Kirilmaz B, Turk U, Ozerkan F, Akilli A, Akin M, Turkoglu C: Impaired endothelial function in patients with myocardial bridge. Echocardiography 2006; 23: 577-581.
[17]	Angelini P, Trivellato M, Donis J, Leachman RD. Myocardial bridges: a review. Prog Cardiovasc Dis 1983; 26: 75-88.
[18]	Iversen S, Hake U, Mayer E, Erbel R, Diefenbach C, Oelert H. Surgical treatment of myocardial bridging cousing coronary artery obstruction. Am J Cardiol 1976; 37: 993–9.
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Solaiman Hossain, Moeen Uddin Ahmed, Md. Abdul Mannan, Md. Shahimur Parvez, Debasish Debnath, et al. (2020). Study of Prevalence, Risk Factors and Angiographic Profile of Patients with Myocardial Bridges in a Tertiary Care Hospital, Dhaka, Bangladesh. Cardiology and Cardiovascular Research, 4(2), 67-70. https://doi.org/10.11648/j.ccr.20200402.16

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Solaiman Hossain; Moeen Uddin Ahmed; Md. Abdul Mannan; Md. Shahimur Parvez; Debasish Debnath, et al. Study of Prevalence, Risk Factors and Angiographic Profile of Patients with Myocardial Bridges in a Tertiary Care Hospital, Dhaka, Bangladesh. Cardiol. Cardiovasc. Res. 2020, 4(2), 67-70. doi: 10.11648/j.ccr.20200402.16

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AMA Style

Solaiman Hossain, Moeen Uddin Ahmed, Md. Abdul Mannan, Md. Shahimur Parvez, Debasish Debnath, et al. Study of Prevalence, Risk Factors and Angiographic Profile of Patients with Myocardial Bridges in a Tertiary Care Hospital, Dhaka, Bangladesh. Cardiol Cardiovasc Res. 2020;4(2):67-70. doi: 10.11648/j.ccr.20200402.16

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@article{10.11648/j.ccr.20200402.16,
  author = {Solaiman Hossain and Moeen Uddin Ahmed and Md. Abdul Mannan and Md. Shahimur Parvez and Debasish Debnath and Md. Mahidur Rahman and Anup Kumar Das},
  title = {Study of Prevalence, Risk Factors and Angiographic Profile of Patients with Myocardial Bridges in a Tertiary Care Hospital, Dhaka, Bangladesh},
  journal = {Cardiology and Cardiovascular Research},
  volume = {4},
  number = {2},
  pages = {67-70},
  doi = {10.11648/j.ccr.20200402.16},
  url = {https://doi.org/10.11648/j.ccr.20200402.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20200402.16},
  abstract = {Background: Band of Myocardial tissue overlying a segment of an epicardial coronary artery is termed myocardial bridge (MB). The aim of this study was to identify the prevalence, risk factors and angiographic profile of patients with myocardial bridge in a tertiary care hospital, Dhaka, Bangladesh. Materials and Methods: This retrospective observational study included a total of 1480 patients with suspected coronary artery disease admitted to Enam Medical College and Hospital, Savar, Dhaka, Bangladesh for coronary angiography between April 2016 to June 20019 of them 43 cases were found to have myocardial bridge. Coronary compression was defined as a maximum systolic luminal compression ≥50%. In this population, 43 patients had systolic luminal compression ≥50%, and all 43 patients were selected for the study to determine the prevalence and risk factors of MB and recorded coronary angiogram was reviewed to see the angiographic location of MB, length of MB and number of vessels involved. Results: In this study incidence of MB was 2.9%. The risk factors associated with MB hypertension were 33 (76.74%), diabetes mellitus 28 (65.11%), hyperlipidaemia 18 (41.86%), family history of CAD 15 (34.88%), smoking history 22 (51.16%). Located of MB in LAD were 34 (79.06%), LCX 07 (16.27%) and RCA 02 (4.65%). The MB were in single vessel 38 (88.37%) and double vessels 05 (11.62%). MBs with atherosclerotic stenosis in LAD were 18 (41.86%), LCX 02 (4.65%), RCA 01 (2.32%) and severity of MB stenosis were in LAD 50 -70% were 27 (62.79%), >70% were 07 (16.27%), LCX 50-70% were 06 (13.95%) and >70% was 01 (2.32%) and RCA 50-70% was 02 (4.65%). The length of MBs segment 20 mm were 12 (27.90%). Conclusion: In this study the prevalence of MB was 2.91%, commonly presented with chronic stable angina. The most risk factors of myocardial bridges were hypertension, diabetes mellitus, hyperlipidaemia, family history and smoking history. In coronary angiography most of the patient of MB was present in association of acute coronary syndrome with documented coronary artery disease and was mainly located in LAD mid segment and the length of MB was mostly 10-20 mm. Further large numbers of case are needed to validate the result of the study.},
 year = {2020}
}

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TY - JOUR
T1 - Study of Prevalence, Risk Factors and Angiographic Profile of Patients with Myocardial Bridges in a Tertiary Care Hospital, Dhaka, Bangladesh
AU - Solaiman Hossain
AU - Moeen Uddin Ahmed
AU - Md. Abdul Mannan
AU - Md. Shahimur Parvez
AU - Debasish Debnath
AU - Md. Mahidur Rahman
AU - Anup Kumar Das
Y1 - 2020/05/15
PY - 2020
N1 - https://doi.org/10.11648/j.ccr.20200402.16
DO - 10.11648/j.ccr.20200402.16
T2 - Cardiology and Cardiovascular Research
JF - Cardiology and Cardiovascular Research
JO - Cardiology and Cardiovascular Research
SP - 67
EP - 70
PB - Science Publishing Group
SN - 2578-8914
UR - https://doi.org/10.11648/j.ccr.20200402.16
AB - Background: Band of Myocardial tissue overlying a segment of an epicardial coronary artery is termed myocardial bridge (MB). The aim of this study was to identify the prevalence, risk factors and angiographic profile of patients with myocardial bridge in a tertiary care hospital, Dhaka, Bangladesh. Materials and Methods: This retrospective observational study included a total of 1480 patients with suspected coronary artery disease admitted to Enam Medical College and Hospital, Savar, Dhaka, Bangladesh for coronary angiography between April 2016 to June 20019 of them 43 cases were found to have myocardial bridge. Coronary compression was defined as a maximum systolic luminal compression ≥50%. In this population, 43 patients had systolic luminal compression ≥50%, and all 43 patients were selected for the study to determine the prevalence and risk factors of MB and recorded coronary angiogram was reviewed to see the angiographic location of MB, length of MB and number of vessels involved. Results: In this study incidence of MB was 2.9%. The risk factors associated with MB hypertension were 33 (76.74%), diabetes mellitus 28 (65.11%), hyperlipidaemia 18 (41.86%), family history of CAD 15 (34.88%), smoking history 22 (51.16%). Located of MB in LAD were 34 (79.06%), LCX 07 (16.27%) and RCA 02 (4.65%). The MB were in single vessel 38 (88.37%) and double vessels 05 (11.62%). MBs with atherosclerotic stenosis in LAD were 18 (41.86%), LCX 02 (4.65%), RCA 01 (2.32%) and severity of MB stenosis were in LAD 50 -70% were 27 (62.79%), >70% were 07 (16.27%), LCX 50-70% were 06 (13.95%) and >70% was 01 (2.32%) and RCA 50-70% was 02 (4.65%). The length of MBs segment 20 mm were 12 (27.90%). Conclusion: In this study the prevalence of MB was 2.91%, commonly presented with chronic stable angina. The most risk factors of myocardial bridges were hypertension, diabetes mellitus, hyperlipidaemia, family history and smoking history. In coronary angiography most of the patient of MB was present in association of acute coronary syndrome with documented coronary artery disease and was mainly located in LAD mid segment and the length of MB was mostly 10-20 mm. Further large numbers of case are needed to validate the result of the study.
VL - 4
IS - 2
ER -

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Author Information

Solaiman Hossain

Department of Cardiology, Enam Medical College and Hospital, Savar, Dhaka, Bangladesh
Moeen Uddin Ahmed

Department of Cardiology, Enam Medical College and Hospital, Savar, Dhaka, Bangladesh
Md. Abdul Mannan

Department of Cardiology, Shaheed M. Monsur Ali Medical College, Sirajgonj, Bangladesh
Md. Shahimur Parvez

Department of Cardiology, Enam Medical College and Hospital, Savar, Dhaka, Bangladesh
Debasish Debnath

Department of Cardiology, Enam Medical College and Hospital, Savar, Dhaka, Bangladesh
Md. Mahidur Rahman

Department of Cardiology, Enam Medical College and Hospital, Savar, Dhaka, Bangladesh
Anup Kumar Das

Department of Cardiology, Enam Medical College and Hospital, Savar, Dhaka, Bangladesh

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APA Style

Solaiman Hossain, Moeen Uddin Ahmed, Md. Abdul Mannan, Md. Shahimur Parvez, Debasish Debnath, et al. (2020). Study of Prevalence, Risk Factors and Angiographic Profile of Patients with Myocardial Bridges in a Tertiary Care Hospital, Dhaka, Bangladesh. Cardiology and Cardiovascular Research, 4(2), 67-70. https://doi.org/10.11648/j.ccr.20200402.16

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Solaiman Hossain; Moeen Uddin Ahmed; Md. Abdul Mannan; Md. Shahimur Parvez; Debasish Debnath, et al. Study of Prevalence, Risk Factors and Angiographic Profile of Patients with Myocardial Bridges in a Tertiary Care Hospital, Dhaka, Bangladesh. Cardiol. Cardiovasc. Res. 2020, 4(2), 67-70. doi: 10.11648/j.ccr.20200402.16

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AMA Style

Solaiman Hossain, Moeen Uddin Ahmed, Md. Abdul Mannan, Md. Shahimur Parvez, Debasish Debnath, et al. Study of Prevalence, Risk Factors and Angiographic Profile of Patients with Myocardial Bridges in a Tertiary Care Hospital, Dhaka, Bangladesh. Cardiol Cardiovasc Res. 2020;4(2):67-70. doi: 10.11648/j.ccr.20200402.16

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@article{10.11648/j.ccr.20200402.16,
  author = {Solaiman Hossain and Moeen Uddin Ahmed and Md. Abdul Mannan and Md. Shahimur Parvez and Debasish Debnath and Md. Mahidur Rahman and Anup Kumar Das},
  title = {Study of Prevalence, Risk Factors and Angiographic Profile of Patients with Myocardial Bridges in a Tertiary Care Hospital, Dhaka, Bangladesh},
  journal = {Cardiology and Cardiovascular Research},
  volume = {4},
  number = {2},
  pages = {67-70},
  doi = {10.11648/j.ccr.20200402.16},
  url = {https://doi.org/10.11648/j.ccr.20200402.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20200402.16},
  abstract = {Background: Band of Myocardial tissue overlying a segment of an epicardial coronary artery is termed myocardial bridge (MB). The aim of this study was to identify the prevalence, risk factors and angiographic profile of patients with myocardial bridge in a tertiary care hospital, Dhaka, Bangladesh. Materials and Methods: This retrospective observational study included a total of 1480 patients with suspected coronary artery disease admitted to Enam Medical College and Hospital, Savar, Dhaka, Bangladesh for coronary angiography between April 2016 to June 20019 of them 43 cases were found to have myocardial bridge. Coronary compression was defined as a maximum systolic luminal compression ≥50%. In this population, 43 patients had systolic luminal compression ≥50%, and all 43 patients were selected for the study to determine the prevalence and risk factors of MB and recorded coronary angiogram was reviewed to see the angiographic location of MB, length of MB and number of vessels involved. Results: In this study incidence of MB was 2.9%. The risk factors associated with MB hypertension were 33 (76.74%), diabetes mellitus 28 (65.11%), hyperlipidaemia 18 (41.86%), family history of CAD 15 (34.88%), smoking history 22 (51.16%). Located of MB in LAD were 34 (79.06%), LCX 07 (16.27%) and RCA 02 (4.65%). The MB were in single vessel 38 (88.37%) and double vessels 05 (11.62%). MBs with atherosclerotic stenosis in LAD were 18 (41.86%), LCX 02 (4.65%), RCA 01 (2.32%) and severity of MB stenosis were in LAD 50 -70% were 27 (62.79%), >70% were 07 (16.27%), LCX 50-70% were 06 (13.95%) and >70% was 01 (2.32%) and RCA 50-70% was 02 (4.65%). The length of MBs segment 20 mm were 12 (27.90%). Conclusion: In this study the prevalence of MB was 2.91%, commonly presented with chronic stable angina. The most risk factors of myocardial bridges were hypertension, diabetes mellitus, hyperlipidaemia, family history and smoking history. In coronary angiography most of the patient of MB was present in association of acute coronary syndrome with documented coronary artery disease and was mainly located in LAD mid segment and the length of MB was mostly 10-20 mm. Further large numbers of case are needed to validate the result of the study.},
 year = {2020}
}

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