Skip to main content
Erschienen in: Journal of Nuclear Cardiology 6/2011

01.12.2011 | Original Article

Myocardial perfusion GSPECT imaging in patients with myocardial bridging

verfasst von: Rafał Gawor, MD, PhD, Jacek Kuśmierek, MD, PhD, Anna Płachcińska, PhD, Małgorzata Bieńkiewicz, PhD, Jarosław Drożdż, MD, PhD, Grzegorz Piotrowski, MD, Krzysztof Chiżyński, MD, PhD

Erschienen in: Journal of Nuclear Cardiology | Ausgabe 6/2011

Einloggen, um Zugang zu erhalten

Abstract

Background

The aim of this study was to investigate the incidence, reversibility, and severity of LV perfusion abnormalities in patients with isolated myocardial bridges using a gated myocardial perfusion SPECT study (GSPECT).

Methods

A retrospective study involved 42 patients without history of myocardial infarction, with isolated myocardial bridges detected in coronary angiography and no substantial evidence of atherosclerotic changes in coronary arteries. In all patients a gated SPECT study was performed at both rest and stress, after intravenous administration of 99mTc MIBI. Reconstructed slices were analyzed using a 20-segment model of the left ventricle.

Results

Incidence and severity of stress-induced ischemia were related to degree of artery constriction (P = .002 and .00014, respectively). Perfusion abnormalities were detected only in patients with critical narrowing (≥50%) of artery (in 12 out of 28, i.e., 43% of patients). Summed stress scores (SSS) ranged from 4 to 11 (mean 7), indicating slight or moderate defect intensity. Only 1 patient presented with a SSS value of 31 (severe defect). Perfusion defects were stress induced in 70 out of 72 (97%) segments with abnormal perfusion.

Conclusion

Perfusion abnormalities were observed in ab. 40% of patients with critical (≥50%) narrowing of artery affected by bridging and were mild, stress induced.
Literatur
1.
Zurück zum Zitat Kramer JR, Kitazime H, Proudfit WL, et al. Clinical significance of isolated coronary bridges: Benign and frequent condition involving the left anterior descending artery. Am Heart J 1982;103:283-8.PubMedCrossRef Kramer JR, Kitazime H, Proudfit WL, et al. Clinical significance of isolated coronary bridges: Benign and frequent condition involving the left anterior descending artery. Am Heart J 1982;103:283-8.PubMedCrossRef
2.
Zurück zum Zitat Angelini P, Trivellato M, Donis J, Lauchman RD. Myocardial bridges: A review. Progr Cardiovasc Dis 1981;26:75-88.CrossRef Angelini P, Trivellato M, Donis J, Lauchman RD. Myocardial bridges: A review. Progr Cardiovasc Dis 1981;26:75-88.CrossRef
3.
Zurück zum Zitat Lozano I, Baz JA, Palop RL, et al. Long-term prognosis of patients with myocardial bridge and angiographic milking of the left anterior descending coronary artery. Rev Esp Cardiol 2002;55:359-64.PubMed Lozano I, Baz JA, Palop RL, et al. Long-term prognosis of patients with myocardial bridge and angiographic milking of the left anterior descending coronary artery. Rev Esp Cardiol 2002;55:359-64.PubMed
4.
Zurück zum Zitat Tauth J, Sullebarger T. Myocardial infarction associated with myocardial bridging. Catheter Cardiovasc Diag 1997;40:364-7.CrossRef Tauth J, Sullebarger T. Myocardial infarction associated with myocardial bridging. Catheter Cardiovasc Diag 1997;40:364-7.CrossRef
5.
Zurück zum Zitat Bestetti RB, Costa RS, Kazara OK, Oliveira JS. Can isolated myocardial bridging of the left anterior descending coronary artery be associated with sudden death during exercise. Acta Cardiol 1991;46:27-30.PubMed Bestetti RB, Costa RS, Kazara OK, Oliveira JS. Can isolated myocardial bridging of the left anterior descending coronary artery be associated with sudden death during exercise. Acta Cardiol 1991;46:27-30.PubMed
6.
Zurück zum Zitat Morales A, Romandelli R, Boucek R. The mural left anterior descending coronary artery, strenuous exercise and sudden death. Circulation 1980;62:230-9.PubMed Morales A, Romandelli R, Boucek R. The mural left anterior descending coronary artery, strenuous exercise and sudden death. Circulation 1980;62:230-9.PubMed
7.
Zurück zum Zitat Ferreira AG, Trotter SE, König B, Décourt LV, Fox K, Olsen EGJ. Myocardial bridges: Morphological and functional aspects. Br Heart J 1991;66:364-7.PubMedCrossRef Ferreira AG, Trotter SE, König B, Décourt LV, Fox K, Olsen EGJ. Myocardial bridges: Morphological and functional aspects. Br Heart J 1991;66:364-7.PubMedCrossRef
8.
Zurück zum Zitat Erbel R, Rupprecht HJ, Ge J, Gerber T, Görge G, Meyer J. Coronary artery shape and flow changes induced by myocardial bridging. Echocardiography 1993;10:71-7.CrossRef Erbel R, Rupprecht HJ, Ge J, Gerber T, Görge G, Meyer J. Coronary artery shape and flow changes induced by myocardial bridging. Echocardiography 1993;10:71-7.CrossRef
9.
Zurück zum Zitat Ge J, Erbel R, Rupprecht HJ, et al. Comparison of intravascular ultrasound and angiography in the assessment of myocardial bridging. Circulation 1994;89:1725-32.PubMed Ge J, Erbel R, Rupprecht HJ, et al. Comparison of intravascular ultrasound and angiography in the assessment of myocardial bridging. Circulation 1994;89:1725-32.PubMed
10.
Zurück zum Zitat Schwarz ER, Klues HG, von Dahl J, et al. Functional angiographic and intracoronary doppler flow characteristics in symptomatic patients with myocardial bridging: Effect of short-term intravenous beta-blocker medication. J Am Coll Cardiol 1996;27:1637-45.PubMedCrossRef Schwarz ER, Klues HG, von Dahl J, et al. Functional angiographic and intracoronary doppler flow characteristics in symptomatic patients with myocardial bridging: Effect of short-term intravenous beta-blocker medication. J Am Coll Cardiol 1996;27:1637-45.PubMedCrossRef
11.
Zurück zum Zitat Bestetti RB, Costa RS, Zucolotto S, et al. Fatal outcome associated with autopsy proven myocardial bridging of the left anterior descending coronary artery. Eur Heart J 1989;10:573-83.PubMed Bestetti RB, Costa RS, Zucolotto S, et al. Fatal outcome associated with autopsy proven myocardial bridging of the left anterior descending coronary artery. Eur Heart J 1989;10:573-83.PubMed
12.
Zurück zum Zitat Haager PK, Schwarz ER, von Dahl J, et al. Long-term angiographic and clinical follow-up in patients with stent implantation for symptomatic myocardial bridging. Heart 2000;84:403-8.PubMedCrossRef Haager PK, Schwarz ER, von Dahl J, et al. Long-term angiographic and clinical follow-up in patients with stent implantation for symptomatic myocardial bridging. Heart 2000;84:403-8.PubMedCrossRef
13.
Zurück zum Zitat Berry JF, von Mering GO, Schmalfuss C, et al. Systolic compression of the left anterior descending coronary artery: A case series, review of the literature, and therapeutic options including stenting. Catheter Cardiovas Interv 2002;56:58-63.CrossRef Berry JF, von Mering GO, Schmalfuss C, et al. Systolic compression of the left anterior descending coronary artery: A case series, review of the literature, and therapeutic options including stenting. Catheter Cardiovas Interv 2002;56:58-63.CrossRef
14.
Zurück zum Zitat Wan L, Wu Q. Institutional report—coronary myocardial bridge, surgery or stenting? Interact Cardio Vasc Thorac Surg 2005;4:517-20.CrossRef Wan L, Wu Q. Institutional report—coronary myocardial bridge, surgery or stenting? Interact Cardio Vasc Thorac Surg 2005;4:517-20.CrossRef
15.
Zurück zum Zitat Bakir I, Riza Karaci A, Altin F, et al. Supracoronary myotomy for myocardial bridges in the setting of hypertrophic cardiomyopathy: Off-pump experience. J Cardiovasc Surg 2008;49:549-53. Bakir I, Riza Karaci A, Altin F, et al. Supracoronary myotomy for myocardial bridges in the setting of hypertrophic cardiomyopathy: Off-pump experience. J Cardiovasc Surg 2008;49:549-53.
16.
Zurück zum Zitat Anagnostopoulos C, Harbinson M, Kelion A, et al. Procedure guidelines for radionuclide myocardial perfusion imaging. Heart 2004;90:1-10.CrossRef Anagnostopoulos C, Harbinson M, Kelion A, et al. Procedure guidelines for radionuclide myocardial perfusion imaging. Heart 2004;90:1-10.CrossRef
17.
Zurück zum Zitat Smanio PE, Watson DD, Segalla DL, et al. Value of gating of technetium-99m sestamibi single-photon emission computed tomographic imaging. J Am Coll Cardiol 1997;30:1687-92.PubMedCrossRef Smanio PE, Watson DD, Segalla DL, et al. Value of gating of technetium-99m sestamibi single-photon emission computed tomographic imaging. J Am Coll Cardiol 1997;30:1687-92.PubMedCrossRef
18.
Zurück zum Zitat Matsumoto N, Berman DS, Kavanagh PB, et al. Quantitative assessment of motion artifacts and validation of a new motion-correction program for myocardial perfusion SPECT. J Nucl Med 2001;42:687-94.PubMed Matsumoto N, Berman DS, Kavanagh PB, et al. Quantitative assessment of motion artifacts and validation of a new motion-correction program for myocardial perfusion SPECT. J Nucl Med 2001;42:687-94.PubMed
19.
Zurück zum Zitat Momose M, Nakajima K, Nishimura T. Prognostic significance of stress myocardial Gated SPECT among Japanese patients referred for coronary angiography: A study of data from the J-ACCESS database. Eur J Nucl Med Mol Imaging 2009;36:1320-37. Momose M, Nakajima K, Nishimura T. Prognostic significance of stress myocardial Gated SPECT among Japanese patients referred for coronary angiography: A study of data from the J-ACCESS database. Eur J Nucl Med Mol Imaging 2009;36:1320-37.
20.
Zurück zum Zitat Vallejo E, Morales M, Sanchez I, et al. Myocardial perfusion SPECT imaging in patients with myocardial bridging. J Nucl Cardiol 2005;12:318-23.PubMedCrossRef Vallejo E, Morales M, Sanchez I, et al. Myocardial perfusion SPECT imaging in patients with myocardial bridging. J Nucl Cardiol 2005;12:318-23.PubMedCrossRef
21.
Zurück zum Zitat Huang WS, Chang HD, Yang SP, et al. Abnormal 201TL myocardial singlr photon emission computed tomography in energetic male patients with myocardial bridge. Nucl Med Commun 2002;23:1123-8.PubMedCrossRef Huang WS, Chang HD, Yang SP, et al. Abnormal 201TL myocardial singlr photon emission computed tomography in energetic male patients with myocardial bridge. Nucl Med Commun 2002;23:1123-8.PubMedCrossRef
22.
Zurück zum Zitat Soran O, Gulgun P, Cetin E, et al. The incidence and significance of myocardial bridge in a prospectively designed population of patients undergoing coronary angiography for chest pain. Tokai J Exp Clin Med 2000;25:57-60.PubMed Soran O, Gulgun P, Cetin E, et al. The incidence and significance of myocardial bridge in a prospectively designed population of patients undergoing coronary angiography for chest pain. Tokai J Exp Clin Med 2000;25:57-60.PubMed
23.
Zurück zum Zitat Lauer WJ, Carlson TA. Images in cardiovascular medicine. Myocardial bridging. Circulation 1998;98:821-33.PubMed Lauer WJ, Carlson TA. Images in cardiovascular medicine. Myocardial bridging. Circulation 1998;98:821-33.PubMed
24.
Zurück zum Zitat Berman DS, Germano G. An approach to the interpretation and reporting of gated myocardial perfusion SPECT. In: Berman DS, Germano G, editors. Clinical gated cardiac SPECT. Armonk, NY: Futura Publishing Company, Inc; 1999. p. 147-82. Berman DS, Germano G. An approach to the interpretation and reporting of gated myocardial perfusion SPECT. In: Berman DS, Germano G, editors. Clinical gated cardiac SPECT. Armonk, NY: Futura Publishing Company, Inc; 1999. p. 147-82.
25.
Zurück zum Zitat Schwarz ER, Klues HG, von Dahl J, et al. Functional characteristics of myocardial bridging a combined angiographic and intracoronary Doppler flow study. Eur Heart J 2007;18:434-42. Schwarz ER, Klues HG, von Dahl J, et al. Functional characteristics of myocardial bridging a combined angiographic and intracoronary Doppler flow study. Eur Heart J 2007;18:434-42.
26.
Zurück zum Zitat Klues HG, Schwarz ER, Dahl J, et al. Disturbed intracoronaty hemodynamics in myocardial bridging. Early normalization by intracoronary stent placement. Circulation 1997;96:2905-13.PubMed Klues HG, Schwarz ER, Dahl J, et al. Disturbed intracoronaty hemodynamics in myocardial bridging. Early normalization by intracoronary stent placement. Circulation 1997;96:2905-13.PubMed
27.
Zurück zum Zitat Ge J, Jeremias A, Rupp A, et al. New signs characteristic of myocardial bridging demonstrated by intracoronary ultrasound and Doppler. Eur Heart J 1999;20:1707-11.PubMedCrossRef Ge J, Jeremias A, Rupp A, et al. New signs characteristic of myocardial bridging demonstrated by intracoronary ultrasound and Doppler. Eur Heart J 1999;20:1707-11.PubMedCrossRef
28.
Zurück zum Zitat Rivitz SM, Yasuda T. Predictive value of dipyridamole thallium imaging in a patient with myocardial bridging but without fixed obstructive coronary artery disease. J Nucl Med 1992;33:1905-13.PubMed Rivitz SM, Yasuda T. Predictive value of dipyridamole thallium imaging in a patient with myocardial bridging but without fixed obstructive coronary artery disease. J Nucl Med 1992;33:1905-13.PubMed
29.
Zurück zum Zitat Turkington TG, Bowsher JE. New technologies in nuclear medicine. In: Sandler MP, Coleman RE, Patton JA, Wackers FJTH, Gottschalk A, editors. Diagnostic nuclear medicine. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2003. p. 85-93. Turkington TG, Bowsher JE. New technologies in nuclear medicine. In: Sandler MP, Coleman RE, Patton JA, Wackers FJTH, Gottschalk A, editors. Diagnostic nuclear medicine. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2003. p. 85-93.
30.
Zurück zum Zitat Hachamovitch R, Berman DS, Leslee JS, et al. Incremental prognostic value of myocardial perfusion single photon emission computer tomography for the prediction of cardiac death: Differential stratification for risk of cardiac death and myocardial infarction. Circulation 1998;97:535-43.PubMed Hachamovitch R, Berman DS, Leslee JS, et al. Incremental prognostic value of myocardial perfusion single photon emission computer tomography for the prediction of cardiac death: Differential stratification for risk of cardiac death and myocardial infarction. Circulation 1998;97:535-43.PubMed
Metadaten
Titel
Myocardial perfusion GSPECT imaging in patients with myocardial bridging
verfasst von
Rafał Gawor, MD, PhD
Jacek Kuśmierek, MD, PhD
Anna Płachcińska, PhD
Małgorzata Bieńkiewicz, PhD
Jarosław Drożdż, MD, PhD
Grzegorz Piotrowski, MD
Krzysztof Chiżyński, MD, PhD
Publikationsdatum
01.12.2011
Verlag
Springer-Verlag
Erschienen in
Journal of Nuclear Cardiology / Ausgabe 6/2011
Print ISSN: 1071-3581
Elektronische ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-011-9406-8

Weitere Artikel der Ausgabe 6/2011

Journal of Nuclear Cardiology 6/2011 Zur Ausgabe

Nuclear Cardiology in the Literature

A selection of recent original research papers

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.