The Correlation Between Myocardial Bridge And Coronary Atherosclerosis Using Dual Source CT

Objective: To investigate the correlation between myocardial bridge and coronary atherosclerosis using dual source computed tomography(DSCT).And made clear the diagnostic value of myocardial bridge.Methods: We collected and analyzed 315 patients in the Second Affiliated hospital of our university from January to December in 2015.All of the patients underwent dual source computed tomography coronary angiography(DSCTCA)examination.A retrospective analysis method was used in this study.All the cases were divided into four groups,myocardial bridge(MB)and coronary atherosclerosis(CAS)in left anterior descending coronary artery(LAD)group,MB in LAD group,normal group(no MB no CAS),CAS in LAD group.The baseline clinical characteristics(gender,age,presence of hypertension,diabetes mellitus,dyslipidemia,smoking history,coronary calcification score,the length and thickness of MB,the degree of the pressure on the MCA)were reviewed and analyzed.MB and CAS in LAD group included 54 cases,including 24(44.4%)male,39(72.2%)patients with hypertension,11(20.4%)patients with diabetes,22(40.7%)patients with smoking history,30(55.6%)patients with dyslipidemia.MB in LAD group included 65 cases,including27(41.5%)male,26(40.0%)patients with hypertension,6(9.2%)patients with diabetes,19(29.2%)patients with smoking history,28(43.1%)patients with dyslipidemia.Normal group included 81 cases,including 32(39.5%)male,34(42.0%)patients with hypertension,10(12.3%)patients with diabetes,16(19.8%)patients with smoking history,30(37.0%)patients with dyslipidemia.CAS in LAD group included115 cases,including 67(58.3%)male,75(65.2%)patients with hypertension,33(28.7%)patients with diabetes,54(47.0%)patients with smoking history,61(53.0%)patients with dyslipidemia.Excluded standard: MB in LAD without CAS and atherosclerosis in other branches of coronary artery;CAS in LAD and MB in other branches of coronary artery;MB or/and CAS in other branches of coronary artery and without MB or CAS in LAD;Non-calcified plaques in coronary artery and without MB or CAS in LAD;The patients who unable to provide with complete clinical data for this study.The patients who had any one of the condition above should be excluded.All the statistical analyses were performed using SPSS 21.0.Results: 1.MB and CAS in LAD group:average age(65.31±9.12),calcification score93.92(109.00),The length of MB was(23.65±3.62)mm,the thickness of MB was(2.22±0.38)mm,and the degree of the pressure on the MCA was(49.31±9.43)%.MB in LAD group :average age(56.77±10.24),The length of MB was(22.10±3.14)mm,the thickness of MB was(1.96±0.26)mm,and the degree of the pressure on the MCA was(42.20±7.03)%.The average age of Normal group was(56.67±10.67).CAS in LAD group: average age(62.76±9.61),calcification score 51.00(102.90).2.Patients in the four groups were compared in terms of gender,age,hypertension,diabetes,and smoking history.A two-tailed p-value of <0.05(?=0.05 as the test standard)was considered to be statistically significant.Therefore,it was necessary to carry out multiple comparisons of multiple clinical data(the test standard of count data is adjusted to ? '=0.0083).The results are as follows: Comparison of MB and CAS in LAD group and MB in LAD group,hypertension(P< 0.001),age(P <0.001)were statistically significant,and the thickness of MB(P=0.016)and the degree of the pressure on the MCA(P = 0.012)were statistically significant.but smoking history(P = 0.245),diabetes(P = 0.115),gender(P = 0.853)and the length of MB(P= 0.166)were not statistical significance.Comparison of MB and CAS in LAD group and normal group,hypertension(P=0.001),age(P < 0.001)were statistically significant,but smoking history(P = 0.011),diabetes(P = 0.232)and gender(P =0.596)were not statistical significance.Comparison of MB and CAS in LAD group and CAS in LAD group,hypertension(P=0.385),diabetes(P = 0.267),smoking history(P = 0.509),gender(P = 0.101)and age(P =0.120)were not statistical significance.Comparison of MB in LAD group and normal group,hypertension(P=0.866),diabetes(P = 0.604),smoking history(P = 0.242),gender(P = 0.866)and age(P =0.951)were not statistically significant.Comparison of MB in LAD group and CAS in LAD group,hypertension(P=0.002),diabetes(P = 0.002),age(P < 0.001)were statistically significant,but smoking history(P = 0.027)and gender(P = 0.043)were not statistical significance.Comparison of normal group(no MB no CAS)and CAS in LAD group,hypertension(P=0.001),smoking history(P < 0.001),diabetes(P= 0.008)and age(P < 0.001)were statistical significance except for gender(P =0.013).There was not statistically significant among four groups of dyslipidemia(p=0.076).Calcification score(P=0.01)was statistically significant between MB and CAS in LAD group and CAS in LAD group.Conclusion: Myocardial bridge with other risk factors of coronary arteriosclerosis promotes the formation of calcified plaques,thus,MB is also one of the risk factors of CAS.