Bachmann Bundle and Its Arterial Supply: Imaging with Multidetector CT—Implications for Interatrial Conduction Abnormalities and Arrhythmias
| Autor: | Jagat Narula, Farhood Saremi, Subramaniam C. Krishnan, Amir Abolhoda, Stephanie Channual, Swaminatha V. Gurudevan |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Heart disease Coronary Vessel Anomalies Coronary Disease Coronary Angiography Coronary artery disease Electrocardiography Internal medicine Confidence Intervals medicine Humans Radiology Nuclear Medicine and imaging Heart Atria cardiovascular diseases Retrospective Studies medicine.diagnostic_test business.industry Arrhythmias Cardiac Atrial fibrillation Middle Aged medicine.disease Institutional review board Sinuatrial node Stenosis medicine.anatomical_structure Cardiology Radiographic Image Interpretation Computer-Assisted Female Radiology Tomography X-Ray Computed business Artery |
| Zdroj: | Radiology. 248:447-457 |
| ISSN: | 1527-1315 0033-8419 |
| DOI: | 10.1148/radiol.2482071908 |
| Popis: | To retrospectively investigate anatomy of Bachmann Bundle (BB) and its vascular supply at 64-section multidetector computed tomography (CT) in healthy patients and patients with abnormalities.The institutional review board approved this HIPAA-compliant study and waived informed consent. Clinical histories, electrocardiograms (ECGs), and coronary 64-section multidetector CT angiograms in 317 patients were reviewed (healthy group, 164; group with abnormalities, 153). Among patients with abnormalities, 68 had atrial fibrillation (AF) or interatrial conduction block (IAB) (P wave duration,or=120 msec), 46 had severe coronary artery disease (CAD) (or=70% stenosis of coronary artery giving rise to sinuatrial node [SAN] artery), and 39 had severe CAD and an abnormal ECG (AF or IAB). Length, anteroposterior and superoinferior diameters, attenuation, and vascular supply of BB were studied. Student t test for continuous variables and contingency tables for categorical variables were used.BB was visualized, to greater degree, in the healthy group (90.2% vs 73.9% for group with abnormalities, P.001). Visualization of BB was similar among subgroups with abnormalities: 71.7% in patients with severe CAD, 73.5% in patients with abnormal ECG, and 76.9% in patients with severe CAD and abnormal ECG. BB measurements were similar for both groups. Patients with nonvisualized BB displayed lower overall mean attenuation in the region, with -30.6 HU +/- 33.4 (standard deviation), but mean attenuation in healthy patients was 51.3 HU +/- 59.9 (P.001). This finding suggests fatty infiltration. BB and BB region were mainly supplied by the right SAN artery (55.5%), followed by the left SAN artery (39.6%) and both SAN arteries (4.9%). In the group with abnormalities, there was a significant difference for SAN artery nonvisualization between those with and without identifiable BB (P = .001).BB and its vascular supply can easily be demarcated on cardiac CT images. BB was visualized less in patients with severe CAD and abnormal ECG, a finding that suggests that disease of BB fibers may play a role in development of atrial arrhythmias. |
| Databáze: | OpenAIRE |
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