Myocardial Bridging

A malformation that is characterized by a muscle bridge over a segment of the CORONARY ARTERIES. Systolic contractions of the muscle bridge can lead to narrowing of coronary artery; coronary compression; MYOCARDIAL ISCHEMIA; MYOCARDIAL INFARCTION; and SUDDEN CARDIAC DEATH.

Also Known As:

Bridging, Myocardial; Bridgings, Myocardial; Myocardial Bridgings

Networked: 134 relevant articles (4 outcomes, 9 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Coronary Artery Disease (Coronary Atherosclerosis)
2.	Ischemia
3.	Myocardial Infarction
4.	Spasm (Spasms)
5.	Coronary Stenosis (Coronary Artery Stenosis)

Experts

1.	Lerman, Amir: 3 articles (01/2020 - 06/2005)
2.	Duygu, Hamza: 3 articles (01/2016 - 06/2007)
3.	Aleksandric, Srdjan B: 2 articles (12/2021 - 01/2021)
4.	Banovic, Marko D: 2 articles (12/2021 - 01/2021)
5.	Beleslin, Branko D: 2 articles (12/2021 - 01/2021)
6.	Djordjevic-Dikic, Ana D: 2 articles (12/2021 - 01/2021)
7.	Dobric, Milan R: 2 articles (12/2021 - 01/2021)
8.	Giga, Vojislav L: 2 articles (12/2021 - 01/2021)
9.	Nedeljkovic, Milan A: 2 articles (12/2021 - 01/2021)
10.	Orlic, Dejan N: 2 articles (12/2021 - 01/2021)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Myocardial Bridging:

1.	Dobutamine FDA LinkGeneric 03/01/1997 - "For the evaluation of the haemodynamic importance of myocardial bridging, intracoronary Doppler flow velocity measurements and angiography during dobutamine stress may be helpful in clinical decision making." 12/30/2021 - "Coronary Flow Velocity Reserve Using Dobutamine Test for Noninvasive Functional Assessment of Myocardial Bridging." 01/01/2021 - "Out of 7 false positive dobutamine stress echocardiograms, two were in patients with myocardial bridging. " 12/15/2016 - "To consider hemodynamic assessment of myocardial bridging (MB) adequate, it is believed that inotropic stimulation with dobutamine should be estimated because its dynamic nature depends on the degree of extravascular coronary compression. " 01/01/2014 - "Fractional flow reserve with dobutamine challenge and coronary microvascular endothelial dysfunction in symptomatic myocardial bridging."
2.	Propranolol (Inderal)FDA LinkGeneric 07/01/1986 - "Further studies are needed to assess the efficacy of beta-blocker therapy in patients with myocardial bridging and the use of intravenous propranolol at the time of coronary angiography may have practical implications in selecting drug therapy for patients with symptomatic myocardial bridging."
3.	Calcium Channel Blockers (Blockers, Calcium Channel)IBA 06/01/2012 - "Efficacy of calcium channel blockers in the treatment of the myocardial bridging: a pilot study." 09/01/2009 - "Medical treatments of coronary myocardial bridging (CMB) generally include beta-blockers and calcium channel blockers. "
4.	Dipyridamole (Persantine)FDA LinkGeneric 10/01/1999 - "CONCLUSIONS: Perfusion abnormalities on dipyridamole TI-201 SPECT are observed in LAD or its branches in patients with high-grade myocardial bridging. " 10/01/1999 - "MATERIALS AND METHODS: Dipyridamole TI-201 SPECT images of 12 patients with myocardial bridging (> or = 50% systolic narrowing) were evaluated. " 10/01/1999 - "Dipyridamole TI-201 SPECT findings were evaluated in patients with myocardial bridging to assess perfusion abnormalities during dipyridamole stress. " 10/01/1999 - "Dipyridamole TI-201 SPECT imaging in patients with myocardial bridging" 11/01/1997 - "Despite the presence of severe myocardial bridging, coronary flow reserve increased substantially two minutes after the infusion of dipyridamole (0.56 mg/kg iv for 4 minutes). "
5.	Phenobarbital (Luminal)FDA Link 12/01/2011 - "Systolic luminal narrowing and morphologic characteristics of myocardial bridging of the mid-left anterior descending coronary artery by dual-source computed tomography." 11/01/1991 - "Each angiogram was reviewed for luminal irregularities or discrete stenoses, for the loss of third-order branching, and for the presence of myocardial bridging or calcification of vessels. " 11/01/2013 - "The objective of this study was to determine the long-term efficacy and dynamics of systolic and diastolic luminal changes within the bridged segments of coronary arteries after intracoronary stenting with drug-eluting stent (DES) in patients (pts) with symptomatic myocardial bridging (SMB) in the absence of coronary atherosclerosis. " 10/01/1987 - "In nine of the 24 subjects the slope corresponded to the number of significantly narrowed coronary arteries (greater than 75% reduction in luminal diameter); in 12 of the remaining 15 subjects who had no coronary narrowing, there were cardiac lesions which included cardiac enlargement, aortic valve disease, myocarditis, pericarditis, myocardial bridging and conduction defects.(ABSTRACT TRUNCATED AT 250 WORDS)"
6.	Ergonovine (Ergometrine)IBA 04/01/2002 - "A coronary angiogram showed a myocardial bridging in the left anterior descending artery and coronary vasospasm was reproduced after intracoronary ergonovine injection in the circumflex coronary artery. " 04/01/2020 - "Myocardial bridging is an independent predictor of positive spasm provocation testing by intracoronary ergonovine injections: a retrospective observational study." 04/01/1991 - "The aim of this study was to detect coronary spasm by provocative ergometrine testing in 4 patients, all male, aged 21 to 49 years, average 39 years old, who had anterior myocardial infarction associated with myocardial bridging of the LAD artery without atheromatous coronary stenosis. "
7.	Nitroglycerin (Dynamite)FDA LinkGeneric 08/01/2003 - "Myocardial bridging was defined as a > 15% reduction in coronary arterial diameter during systole after intracoronary injection of nitroglycerin. " 12/01/1999 - "Myocardial bridging is characterized by the following morphological and functional signs: a specific, echolucent half moon phenomenon over the bridge segment, which exists throughout the cardiac cycle; systolic compression of the bridge segment of the coronary artery; accelerated flow velocity at early diastole (finger-tip phenomenon); no or reduced systolic antegrade flow; decreased diastolic/systolic velocity ratio; retrograde flow in the proximal segment, which is provoked and enhanced by nitroglycerin injection." 08/01/1999 - "Nitroglycerin is known to augment vessel wall squeezing at the site with coronary-myocardial bridging (CMB). " 11/01/1994 - "The other 58 patients received 0.2 mg nitroglycerin (NTG) intracoronarily and 30 micrograms/ml orciprenalin (ORC) intravenously up to a heart rate of 130/min. Repeated angiography revealed systolic compression of the LAD due to myocardial bridging (MB) in 40% (25 of 62). " 11/01/2020 - "Invasive coronary angiography now demonstrated apparent myocardial bridging associated with a severe fixed stenosis of the LAD without change in diameter with nitroglycerin injection. "
8.	Vasodilator Agents (Vasodilators)IBA 01/01/2021 - "Functional Assessment of Myocardial Bridging With Conventional and Diastolic Fractional Flow Reserve: Vasodilator Versus Inotropic Provocation." 12/15/2016 - "Noninvasive assessment of myocardial bridging by coronary flow velocity reserve with transthoracic Doppler echocardiography: vasodilator vs. inotropic stimulation." 06/01/2015 - "Myocardial bridging is not associated with reduced myocardial perfusion during vasodilator stress. " 04/01/1988 - "We suggest that coronary vasodilators may induce perfusion defects in patients with myocardial bridging and should be avoided in such patients." 09/04/2023 - "A coronary angiography demonstrated the presence of myocardial bridging (MB), a well-known congenital coronary anomaly that is able to generate MI during exercise (but not in provocative testing using coronary artery vasodilators, such as dipyridamole). "
9.	Acetylcholine (Acetylcholine Chloride)FDA Link 01/01/2011 - "The interplay of endothelial dysfunction, coronary vasoconstriction and myocardial bridging was detected by intracoronary acetylcholine test and IVUS. " 01/01/2012 - "In both patients, acetylcholine challenge clearly revealed both the presence and the severity of myocardial bridging while producing several recognizable degrees of abnormal spastic tendency.Both" 10/01/2007 - "In 81 patients with myocardial bridging (44 men; mean age 57.2 years) and 195 control patients without bridging and atherosclerotic lesions confirmed by angiography (97 men; mean age 58.4 years), spasm provocation testing was done by incremental acetylcholine infusion into the left coronary artery. " 01/01/2008 - "Myocardial bridging was evaluated at rest, during intracoronary acetylcholine infusion, through coronary flow velocity and flow reserve measurements, and during dobutamine stress. "
10.	Adrenergic Agents (Adrenergic Drugs)IBA 06/01/1996 - "We sought to define the effects of short-term beta-adrenergic blocking medication on intracoronary flow characteristics, clinical symptoms and angiographic diameter changes in patients with severe myocardial bridging of the left anterior descending coronary artery. " 11/01/1994 - "Nearly always coronary compression by myocardial bridging is only evident after adrenergic stimulation or after afterload reduction. " 01/24/2009 - "Adrenergic stimulation or afterload reduction by nitroglycerin facilitates diagnosis of myocardial bridging by increasing coronary compression. "

Therapies and Procedures

1.	Therapeutics 02/01/2008 - "The aim of the present study was to study the outcome of coronary stenting in patients with symptomatic myocardial bridging refractory to standard medical therapy. " 06/21/2023 - "In patients with ischaemic symptoms in the absence of alternative explanations, a detailed assessment of myocardial bridging with invasive physiology should be performed to define the significance of the lesion and guide tailored medical therapy. " 10/01/2017 - "Although myocardial bridging (MB) is usually considered as benign, initial medical therapy and following surgical treatment in drug-refractory cases has been widely accepted for managing symptomatic MB. " 01/01/2009 - "There is no widely accepted classification to guide therapy in patients with symptomatic myocardial bridging (MB). " 12/01/2005 - "Also included in this report is a review of the epidemiology, pathophysiology, diagnosis and therapy for symptomatic myocardial bridging."
2.	Coronary Artery Bypass (Coronary Artery Bypass Surgery) 01/01/2021 - "Minimally invasive coronary artery bypass grafting via a lower ministernotomy for left anterior descending artery myocardial bridging: mid-term results." 05/01/2013 - "We aimed to evaluate the graft patency rate following coronary artery bypass grafting (CABG) to the left anterior descending artery (LAD) with proximal myocardial bridging (MB). " 05/01/2013 - "Results of coronary artery bypass grafting in myocardial bridging of left anterior descending artery." 03/01/2013 - "The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes, and results of these papers are tabulated; these studies reported the outcome of myotomy and coronary artery bypass grafting (CABG) for myocardial bridging. " 01/01/2021 - "Coronary artery bypass grafting or supra-arterial myotomy is now suggested as a better therapeutic option in myocardial bridging (MB) when medical treatment fails to control symptoms. "
3.	Drug Therapy (Chemotherapy) 12/01/2023 - "Unlocking Promising Therapies: Drug-Eluting Stents in Medically Refractory Angina Patients With Myocardial Bridging." 07/01/2018 - "Chest Pain During Chemotherapy: A Case of Severe Myocardial Bridging." 07/01/1985 - "We describe a case of myocardial bridging of the anterior descending coronary artery associated with a non-obstructive hypertrophic cardiomyopathy which was corrected by surgery because of a poor response to standard drug therapy. " 07/01/1986 - "Further studies are needed to assess the efficacy of beta-blocker therapy in patients with myocardial bridging and the use of intravenous propranolol at the time of coronary angiography may have practical implications in selecting drug therapy for patients with symptomatic myocardial bridging."
4.	Myotomy 04/01/2015 - "Myocardial bridging over the left anterior descending: Myotomy, bypass, or both?" 08/01/2010 - "Robotic-assisted surgical myotomy in a 27-year-old man with myocardial bridging of the left anterior descending coronary artery." 09/01/2008 - "We report the results of surgery and midterm outcome in two patients with symptomatic myocardial bridging who underwent off-pump supra-arterial myotomy. " 09/01/2008 - "Off-pump supra-arterial myotomy for myocardial bridging." 02/20/2008 - "Myotomy through heart-port access for myocardial bridging."
5.	Drug-Eluting Stents 11/01/2013 - "Five-year angiographic and clinical follow-up of patients with drug-eluting stent implantation for symptomatic myocardial bridging in absence of coronary atherosclerotic disease." 06/12/2007 - "Drug eluting stent implantation for the treatment of symptomatic myocardial bridging is associated with favorable peri-procedural results and short-term outcomes." 03/30/2005 - "Symptomatic myocardial bridging--a niche indication for drug-eluting stents?" 03/01/2010 - "We successfully rescued a patient whose coronary artery perforated following implantation of a drug-eluting stent (DES), by deploying a stent-graft in symptomatic myocardial bridging. " 03/01/2010 - "Coronary artery perforation following implantation of a drug-eluting stent rescued by deployment of a covered stent in symptomatic myocardial bridging."