Assessment of the Ischaemic Effects of Myocardial Bridge by Echocardiographic Exercise Stress Test.

Autor:	Lamendola P; Department of Cardiovascular Sciences, Fondazione Policlinico Universatario A Gemelli IRCCS Rome, Italy., Cambise N; Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore Rome, Italy., Di Renzo A; Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore Rome, Italy., Tinti L; Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore Rome, Italy., De Vita A; Department of Cardiovascular Sciences, Fondazione Policlinico Universatario A Gemelli IRCCS Rome, Italy.; Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore Rome, Italy., Tremamunno S; Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore Rome, Italy., Pastena P; Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore Rome, Italy., Belmusto A; Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore Rome, Italy., Montone R; Department of Cardiovascular Sciences, Fondazione Policlinico Universatario A Gemelli IRCCS Rome, Italy., Rinaldi R; Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore Rome, Italy., Villano A; Department of Cardiovascular Sciences, Fondazione Policlinico Universatario A Gemelli IRCCS Rome, Italy., Lanza GA; Department of Cardiovascular Sciences, Fondazione Policlinico Universatario A Gemelli IRCCS Rome, Italy.; Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore Rome, Italy.
Jazyk:	angličtina
Zdroj:	European cardiology [Eur Cardiol] 2024 Jun 19; Vol. 19, pp. e09. Date of Electronic Publication: 2024 Jun 19 (Print Publication: 2024).
DOI:	10.15420/ecr.2024.03
Abstrakt:	Background: Detection of myocardial bridge (MB) at angiography suggests it has a role in ischaemic-related symptoms in patients with angina without obstructive coronary artery disease. However, evidence that MB may cause myocardial ischaemia is limited. Methods: We studied 41 patients with MB of the left anterior descending coronary artery and otherwise normal coronary arteries. Fourteen patients with normal coronary arteries and without MB served as controls. All subjects underwent a maximal treadmill exercise stress test (EST) under ECG monitoring. Standard and speckle-tracking echocardiography were performed at baseline and immediately after peak EST. Results: EST duration and peak heart rate and systolic pressure were similar in the two groups. A positive EST (ST-segment depression .1 mm) was found in 18 patients in the MB group (43.9%) and none in the control group (p=0.001). No abnormalities in both left ventricle systolic and diastolic function were found between the two groups in the standard echocardiographic evaluation. Global and segmental (anterior, inferior) longitudinal strain (LS) did not differ at baseline between the groups. There was a small increase in global LS during EST in MB patients but not in the control group (p=0.01). Similar trends were found for regional LSs, with differences being significant for the medium (p=0.028) and apical (p=0.032) anterior segments. No differences in echocardiographic parameters and both global and segmental LSs were observed between MB patients with ischaemic ECG changes during EST versus those without. Conclusion: Our findings do not support the notion that MB results in significant degrees of myocardial ischaemia during maximal myocardial work. Competing Interests: Disclosure: GAL is on the European Cardiology Review editorial board; this did not influence peer review. All other authors have no conflicts of interest to declare. Data availability: Data are available on request from the corresponding author Authors’ contributions: Conceptualisation: GAL; data curation: NC, ST, PP, RM; formal analysis: GAL, ADV; investigation: PL; ADR, LT, RR; software: AV, AB; writing: GAL. Ethics: Ethical approval was obtained from the Ethics Committee of Fondazione Policlinico a. Gemelli IRCCS – Università Cattolica del Sacro Cuore (PRVOKE study; prot. 5804). The study was carried out in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki). Consent: Written informed consent was obtained from each patient who agreed to participate. (Copyright © The Author(s), 2024. Published by Radcliffe Group Ltd.)
Databáze:	MEDLINE
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