Myocardial bridging is associated with alteration in coronary vasoreactivity

Joerg Herrmann, Stuart T. Higano, Ryan J. Lenon, Charanjit S. Rihal, Amir Lerman

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Shear stress alteration has been recognized as a predisposing factor for the impairment of endothelial function. Myocardial bridging is a congenital condition associated with alteration in shear stress, however, its impact upon vasoreactivity remains undetermined. This was a case-control designed study with 29 patients with myocardial bridging and 58 patients without myocardial bridging. Endothelium-dependent and endothelium-independent changes in coronary artery diameters, blood flow and wall shear stress were determined after intracoronary infusion of acetylcholine (ACH, 10 -6-10 -4 mol/L) and nitroglycerine (NTG, 200 μg). Coronary flow velocity reserve (CFVR) was determined after intracoronary injection of adenosine (18-36 μg). In response to ACH, there was more epicardial vasoconstriction at the myocardial bridging site compared with the proximal and distal segments (-29.6 ± 21.7 vs. -9.6 ± 22.5 and -17.4 ± 21.5%, p < 0.05) and compared with the control group (-29.6 ± 21.7 vs. -5.9 ± 36.5%, p < 0.001). The response to NTG and CFVR was the same in the case and the control group. Wall shear rate (WSR) was higher in the MB site at baseline and in response to ACH. MB is characterised by enhanced WSR and impairment in endothelium-dependent vasorelaxation. These functional alterations may add to the severity of structural lumen compression and thus to the clinical presentation of this congenital abnormality.

Original languageEnglish (US)
Pages (from-to)2134-2142
Number of pages9
JournalEuropean Heart Journal
Volume25
Issue number23
DOIs
StatePublished - Dec 2004

Fingerprint

Myocardial Bridging
Endothelium
Control Groups
Nitroglycerin
Vasoconstriction
Vasodilation
Causality
Adenosine
Acetylcholine
Case-Control Studies
Coronary Vessels
Injections

Keywords

  • Angina pectoris
  • Blood flow
  • Endothelial dysfunction
  • Myocardial bridging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Myocardial bridging is associated with alteration in coronary vasoreactivity. / Herrmann, Joerg; Higano, Stuart T.; Lenon, Ryan J.; Rihal, Charanjit S.; Lerman, Amir.

In: European Heart Journal, Vol. 25, No. 23, 12.2004, p. 2134-2142.

Research output: Contribution to journalArticle

Herrmann, Joerg ; Higano, Stuart T. ; Lenon, Ryan J. ; Rihal, Charanjit S. ; Lerman, Amir. / Myocardial bridging is associated with alteration in coronary vasoreactivity. In: European Heart Journal. 2004 ; Vol. 25, No. 23. pp. 2134-2142.
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