Myocardial Bridge and the Progression of Atherosclerotic Plaque in the Proximal Segment
Myocardial bridge (MB) is occasionally recognized, especially of the left anterior descending artery (LAD) during cardiac catheterization when a physician notes systolic compression of a coronary artery. Pathologically MB occurs when a segment of the artery takes a short intramyocardial path rather than an epicardial course.1 Careful studies of MB document that both length and depth may be important, and these vary depending on the modalities used to assess, that is, angiography, computed tomography, or autopsy. We think the most accurate method of assessment of MB is computed tomography and the incidence of MB is 43% as reported by Liu et al,2 with highest presence involving the LAD (80%: proximal, 3%; mid, 58%; distal, 19%), followed by diagonal (12%), obtuse marginal (7%), and right coronary artery (2%). They also showed a good correlation with systolic compression and MB depth but not with length.
See accompanying article on page 1407
There is a higher incidence of cardiovascular events in patients with MB.1 The reasons have remained uncertain, …