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首页> 外文期刊>The American Journal of Cardiology >Frequency and Significance of Myocardial Bridging and Recurrent Segment of the Left Anterior Descending Coronary Artery in Patients With Takotsubo Cardiomyopathy
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Frequency and Significance of Myocardial Bridging and Recurrent Segment of the Left Anterior Descending Coronary Artery in Patients With Takotsubo Cardiomyopathy

机译：Takotsubo心肌病患者心肌桥和冠状动脉左前降支复发节段的频率和意义

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摘要

Despite intensive research efforts, the causative mechanisms of takotsubo cardiomyopathy (TC) are still unknown. Recently, morphologic characteristics of the left anterior descending coronary artery (LAD) have been proposed as a potential pathophysiological, substrate. Hence, the aim of the present study was to evaluate the prevalence of myocardial bridging and LAD recurrent segments in a large cohort of patients with TC. A total of 161 patients with TC were matched for age and gender with 161 controls without coronary artery or valvular heart disease. Myocardial bridging was diagnosed according to indirect signs in coronary angiography. Furthermore, the LAD was evaluated regarding parts of the vessel outreaching the left ventricular apex (LAD recurrent segment). The prevalence of myocardial bridging was similar in the TC and control groups (11.8% vs 6.8%, p = 0.18). Any part of the LAD outreaching the left ventricular apex was observed in 55.6% of patients with TC compared with 35.4% in the control population (p <0.001). Moreover, the LAD supplied >= 25% of the inferior myocardial wall in 21 patients with TC (13.1%), whereas patients in the control group did not show this pattern of coronary circulation at all (p <0.001). Patients with TC with typical apical ballooning compared with those with atypical ballooning patterns demonstrated a higher prevalence of myocardial bridging (p = 0.04) but not LAD recurrent segments (p = 0.28). In conclusion, the prevalence of myocardial bridging in patients with TC is low and comparable with that in a matched control group. In contrast, LAD recurrent segments are significantly more frequent in patients with TC. (C) 2014 Elsevier Inc. All rights reserved.
机译：尽管进行了深入的研究，但takotsubo心肌病（TC）的病因机制仍未知。最近，左前降支冠状动脉（LAD）的形态特征已被提出作为潜在的病理生理学基质。因此，本研究的目的是评估一大批TC患者的心肌桥接和LAD复发节段的患病率。共有161例TC患者在年龄和性别上与161例无冠状动脉或瓣膜性心脏病的对照组相匹配。根据冠状动脉造影的间接体征诊断为心肌桥接。此外，对LAD评估了超出左心尖（LAD复发段）的部分血管。 TC组和对照组的心肌桥接患病率相似（11.8％vs 6.8％，p = 0.18）。在55.6％的TC患者中观察到LAD到达左心室顶点的任何部分，而在对照组中则为35.4％（p <0.001）。此外，在21例TC患者中，LAD占下心肌壁的> = 25％（13.1％），而对照组患者完全没有显示这种冠状动脉循环模式（p <0.001）。具有典型心尖膨胀的TC患者与具有非典型膨胀模式的TC患者相比，心肌桥接的患病率更高（p = 0.04），但没有LAD复发节段（p = 0.28）。总之，TC患者的心肌桥接患病率较低，与配对对照组相当。相比之下，TC患者的LAD复发节段明显更高。 （C）2014 Elsevier Inc.保留所有权利。

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