RESUMO
BACKGROUND: Myocardial bridge (MB) is described as an abnormal band of myocardium covering a variable portion of any coronary artery. METHODS: The current study explores the presence of MB throughout the coronary arterial system and provides a morphometric description through instrumented dissection of a sample of 100 human hearts. The study shows a higher prevalence of MB in the Mexican population than in previous reports. RESULTS: In the total sample (n=100), MB was identified in 96% of it. A total of 421 MBs were observed, with a mean of 4.38mm (±0.28) per dissected heart. The most frequently affected vessel is the anterior interventricular artery where a total of 52 MBs were found, of the total sample studied. DISCUSSION: The high prevalence of MB among Mexican patients could be the result of a genetic association for this population or the neoformation of MB after birth due to lifestyle-associated factors. Further studies are required to better understand the high prevalence of MB among Mexican subjects.
Assuntos
Ponte Miocárdica , Humanos , México/epidemiologia , Masculino , Feminino , Prevalência , Ponte Miocárdica/epidemiologia , Ponte Miocárdica/patologia , Pessoa de Meia-Idade , Adulto , Idoso , Vasos Coronários/anatomia & histologia , Idoso de 80 Anos ou mais , Miocárdio/patologia , Adulto JovemRESUMO
BACKGROUND: Myocardial bridges represent a hotly debated research topic. Myocardial bridges are considered to be a vascular heart variation due to its intermittent or enduring reducing of the arterial lumen, with a possible ischemic effect. METHODS: 154 hearts were studied, having been extracted as fresh autopsy material. Coronary arteries were injected with synthetic resin and cleaned by extracting the pericardial fat. RESULTS: 92 myocardial bridges were observed in 62 hearts (40.3%). Average myocardial bridge length was 19.9 mm. Myocardial bridges varied per artery from one myocardial bridge in 42 hearts (27.3%), two myocardial bridges in 11 hearts (7.2%), three myocardial bridges in 8 hearts (5.2%) and four myocardial bridges in 1 heart (0.7%). Most myocardial bridges coincided with the anterior interventricular artery in its proximal and intermediate segments in 61 cases (39.6%) and left diagonal artery in 11 cases (7.2%). Arteries emitted just before myocardial bridges (pre-bridge branch) in 50 cases (54.3%) of the sample, with an average caliber of 1.41 mm. A third coronary artery was present in 46 cases (29.8%) of total sample. A higher frequency of myocardial bridges was found in hearts with a third coronary artery. CONCLUSION: It is necessary to consider the clinical importance of the variations considering the arterial distribution and associated clinical implications.
Assuntos
Ponte Miocárdica/patologia , Adolescente , Adulto , Idoso , Distribuição de Qui-Quadrado , Colômbia/epidemiologia , Vasos Coronários/patologia , Feminino , Humanos , Masculino , Ponte Miocárdica/epidemiologia , Adulto JovemRESUMO
AIMS: There is conflicting data regarding the prevalence and characteristics of coronary artery anomalies (CAAs). We sought to explore the prevalence and characteristics of major and minor CAAs using computed tomography coronary angiography (CCTA). METHODS AND RESULTS: We prospectively studied 577 patients in sinus rhythm referred for control of stents or for screening due to the presence of multiple risk factors (53%), or due to chest pain, equivalent symptoms or inconclusive stress tests (47%). 40 and 64 slice CT scanners were used. The mean age was 61 +/- 11 years and 81% were male. We identified CAAs in 121 (21.0%) patients. Anomalous origination of a coronary artery from the opposite sinus (ACAOS) were identified in 6/577 (1%) patients. Coronary ectasia or aneurysm was present in 10/577 (1.7%) patients. One-hundred and nine intramuscular segments (MB) were found in 100/577 (17.3%) patients. Coronary hypoplasia was identified in 3/577 (0.5%) patients, all involving the RCA, and 3/577 (0.5%) patients had an absent left main coronary artery. None of the segments with ACAOS (proximal segment) or MB had atherosclerotic plaque. CONCLUSIONS: CAAs were highly prevalent along the coronary tree and anatomical characteristics that might help stratify the risk and guide therapy of CAAs could be easily identified with CCTA.
Assuntos
Angiografia Coronária/métodos , Anomalias dos Vasos Coronários/diagnóstico por imagem , Anomalias dos Vasos Coronários/epidemiologia , Vasos Coronários/patologia , Tomografia Computadorizada por Raios X , Idoso , Aneurisma Coronário/diagnóstico por imagem , Aneurisma Coronário/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ponte Miocárdica/diagnóstico por imagem , Ponte Miocárdica/epidemiologia , Prevalência , Estudos ProspectivosRESUMO
FUNDAMENTO: Pontes miocárdicas representam uma fonte de discussão em pesquisa. Pontes miocárdicas são consideradas uma variação cardíaca vascular devido à sua intermitente ou repetida redução do lúmen arterial, com um possível efeito isquêmico. OBJETIVO: O objetivo do presente estudo foi determinar a incidência de pontes miocárdicas na população miscigenada da Colômbia. MÉTODOS: 154 corações foram estudados, tendo sido extraídos em autópsias. As artérias coronárias foram injetadas com resina sintética e limpas através da extração da gordura pericárdica. RESULTADOS: 92 pontes miocárdicas foram observadas em 62 corações (40,3 por cento). O comprimento médio das pontes era de 19,9 mm. As pontes miocárdicas variaram por artéria, de uma ponte em 42 corações (27,3 por cento), duas pontes em 11 corações (7,2 por cento), três pontes em oito corações (5,2 por cento) e quatro pontes em um coração (0,7 por cento). A maioria das pontes encontrava-se com a artéria interventricular esquerda em seus segmentos proximal e intermediário em 61 casos (39,6 por cento) e com a artéria diagonal esquerda em 11 casos (7,2 por cento). As artérias se exteriorizavam em porção anterior às pontes miocárdicas (segmento pré-ponte) em 50 casos (54,3 por cento) da amostra, com uma média de 1,41 mm de calibre. Terceira artéria coronária estava presente em 46 casos (29,8 por cento) do total da amostra. Uma freqüência maior de pontes miocárdicas foi encontrada em corações com terceira artéria coronária. CONCLUSÃO: É necessário considerar a importância clínica das variações, tendo em vista a distribuição arterial e as implicações clínicas relacionadas.
BACKGROUND: Myocardial bridges represent a hotly debated research topic. Myocardial bridges are considered to be a vascular heart variation due to its intermittent or enduring reducing of the arterial lumen, with a possible ischemic effect. METHODS: 154 hearts were studied, having been extracted as fresh autopsy material. Coronary arteries were injected with synthetic resin and cleaned by extracting the pericardial fat. RESULTS: 92 myocardial bridges were observed in 62 hearts (40.3 percent). Average myocardial bridge length was 19.9 mm. Myocardial bridges varied per artery from one myocardial bridge in 42 hearts (27.3 percent), two myocardial bridges in 11 hearts (7.2 percent), three myocardial bridges in 8 hearts (5.2 percent) and four myocardial bridges in 1 heart (0.7 percent). Most myocardial bridges coincided with the anterior interventricular artery in its proximal and intermediate segments in 61 cases (39.6 percent) and left diagonal artery in 11 cases (7.2 percent). Arteries emitted just before myocardial bridges (pre-bridge branch) in 50 cases (54.3 percent) of the sample, with an average caliber of 1.41 mm. A third coronary artery was present in 46 cases (29.8 percent) of total sample. A higher frequency of myocardial bridges was found in hearts with a third coronary artery. CONCLUSION: It is necessary to consider the clinical importance of the variations considering the arterial distribution and associated clinical implications.
FUNDAMENTO: Puentes miocárdicos representan una fuente de discusión en investigación. Se consideran los puentes miocárdicos una variación cardiaca vascular en virtud de su intermitente o repetida reducción del lumen arterial, con un posible efecto isquémico. OBJETIVO: El objetivo del presente estudio fue determinar la incidencia de puentes miocárdicos en la población mestiza de Colombia. MÉTODOS: Se estudiaron 154 corazones, extraídos en autopsias. Se eyectó resina sintética en las arterias coronarias y seguidamente se las limpiaron con la extracción de la grasa pericárdica. RESULTADOS: Se observaron 92 puentes miocárdicos en 62 corazones (40,3 por ciento). La longitud promedio de los puentes era de 19,9 mm. Los puentes miocárdicos variaron de acuerdo con la arteria, en la siguiente proporción: un puente en 42 corazones (27,3 por ciento), dos puentes en 11 corazones (7,2 por ciento), tres puentes en ocho corazones (5,2 por ciento) y cuatro puentes en un corazón (0,7 por ciento). La mayoría de los puentes se encontraba con la arteria interventricular izquierda en sus segmentos proximal e intermediario -en 61 casos (39,6 por ciento); en 11, el puente se mostraba con la arteria diagonal izquierda (7,2 por ciento). Las arterias se exteriorizaban en porción anterior a los puentes miocárdicos (segmento pre-puente) en 50 casos (54,3 por ciento) de la muestra, con un promedio de 1,41 mm de espesor. La tercera arteria coronaria estaba presente en 46 casos (29,8 por ciento) del total de la muestra. Se encontró una frecuencia mayor de puentes miocárdicos en corazones con tercera arteria coronaria. CONCLUSIÓN: Es necesario considerar la importancia clínica de las variaciones, teniendo en cuenta la distribución arterial y las implicaciones clínicas relacionadas.