Type of Article : Original Research
Year: 2015 | Volume 3 | Issue 2 | Page No. 1092-1098
Date of Publication: 30-06-2015
DOI: http://dx.doi.org/10.16965/ijar.2015.159
PERCENTAGE INCIDENCE, MORPHOLOGY AND MORPHOMETRY OF MYOCARDIAL BRIDGES: A CADAVERIC STUDY
Sujatha. M *1, T. Jayachandra Pillai 2, L. Anandakumar 3, V. Subhadra Devi 4.
*1 Ph.D. Scholar, Department of Anatomy, S.V. Medical College, Tirupati, Andhra Pradesh, India.
2 Professor & Head, Department of Anatomy, S.V. Medical College,Tirupati, Andhra Pradesh, India.
3 Associate Professor, Department of Forensic Medicine, RIMS Medical College, Kadapa, Andhra Pradesh, India.
4 Professor & Head, Dept of Anatomy, SVIMS, Sri Padmavathi Medical College for women, Tirupati, Andhra Pradesh India.
Address: Ms. Sujatha Manupati, Ph.D. Scholar, Department of Anatomy,
Sri Venkateswara Medical College, Tirupati, Andhra Pradesh. India. Mobile No.: +919246943011.
E-Mail: manupatisujatha@gmail.com
Abstract
Introduction: Myocardial bridging is the term used when a segment of major epicardial coronary artery runs intramuscularly under the tunnel formed by fibers of myocardium that bridges instead of it’s normal or routine epicardial path. In the literature there are varying reports on clinical implications of myocardial bridges from protection against atherosclerosis to myocardial ischemia, as well as leading to infarction and sudden cardiac death.
Materials and Methods: 150 adult formalin fixed human hearts which were available in the department of Anatomy and Forensic Medicine, S.V.Medical College, Tirupati, Andhra Pradesh, India. These hearts were dissected and observed for the presence, location, type, number and direction of myocardial bridges and their association with coronary dominance. With the help of digital calipers morphometric parameters (length, width& thickness) of myocardial bridges and length of blood vessel underneath the myocardial bridge were measured, noted and photographs were taken.
Results: The overall incidence of myocardial bridges was 20.6%( 31/150). Among these 18.6% (28/31) were on left anterior descending (LAD) artery and 2% (03/31) were on posterior interventricular (PIV) artery. The direction of muscle fibers in the bridges were oblique to the direction of the coronary vessels in majority of cases. Length, width and thickness of myocardial bridges were in the range of 12 – 69.7mm, 3.74 – 8.6mm and1.3 – 3.87mmrespectively.
Conclusions: Myocardial bridges may be associated with wide range of clinical problems. Contraction of myocardial bridge may results in vascular compression and myocardial ischemia. Knowledge on morphology and morphometric details of myocardial bridges facilitates cardiologists in diagnosis, planning therapeutic strategies and prognostic predictions.
KEY WORDS: Coronary dominance, left anterior descending (LAD) artery, posterior interventricular artery (PIV), myocardial bridge (MB).
References
- Ishimori T, Raizner AF, Chabine RA, Awadeh M. Luch R. Myocardial bridges in man: clinical correlations and angiographic accentuation with nitroglycerine. CathetcardiovascDiagn, 1977;3:59-65. [PubMed]
- Kuhn FE, Rgan K. Mohler ER, III. Satler LF, Lu Dy. Rackley CE. Evidence for endothelial dysfunction and enhanced vasoconstrution in myocardial bridges. Am Heart J, 1991;122:1764-1766. [PubMed].
- Baptista CA, Didio LJ. The relationship between the directions of myocardial bridges and of the branches of the coronary arteries in the human heart. SurgRadiolAnat,1922;14:137-140. [PubMed].
- IshiiT, Hosoda Y. The signification of myocardial bridge upon atherosclerosis in the left anterior descending coronary artery. J Path, 1986;148:279-291. [PubMed].
- Laifer L.I, Weiner BH. Percutaneous trans luminal coronary angioplasty of a coronary artery stenosis at the site of myocardial bridging. Cardiology, 1991;79:245-248.[PubMed].
- Ferreira A.G Jr, Trotter SE, Konig B Jr, De court LV, Foxk, Olsen EG. Myocardial bridges: morphological and functional aspects. Br Heart J, 1991;66:364-367.
- Rayman HC. Dissertation de vasiscorispropriis, Haller Bibl Anat, 1737;2:366.
- Portman W, Ingrid J. Intramunal coronary vessels in the angiogram. Fortschr Geb Rontgenstr Nuklearmed, 1960;92:129-133.[PubMed].
- Geiringer E. The mural coronary. Am Heart J. 1951;41:359-41.
- Rajendra Prasad VK, Joseph T.John, Supriya NK. Occurrence and Anatomical Distribution of Myocardial Bridges and Co-relation with Sudden Death and Coronary Atherosclerosis. International journal of Recent Trends in science and Technology, 2013;8(3):238-239.
- Loukas M, Curry B, Bowers M, Louis RG, Bartczak A, Kiedrowski M, Kamionek M, Fudalej M, Wagner T. The relationship of myocardial bridges to the coronary artery dominance in the adult human hearts. J Anat, 2006;209(1):43-50.
- H.Saidi, WK Ongeti, and J Ogengo. Morphology of human myocardial bridges and coronary artery disease. Afr health sci, 2010;10(3):242-247.
- Luis Ernesto Ballesteros Acuna ,Luis Miguel Ramirez, Saldarriaga Bladimir Tellez et al. Myocardial description and clinical implication of myocardial bridges: an anatomical study in colombian. Arq. Bras.Cardiol, 2009;92(4):242-248.
- Bandyopadhyay M, Piyali Das, Karabi Baral, Puronjoy Chakroborty. Morphological study of myocardial bridges on the coronary arteries. Indian Journal of Thoracic and Cardiovascular Surgery, 2010;26(3):193-197.
- Adam Kosinski, Marek Grzybiak. Myocardial bridges in the human heart: Morphological aspect. Folia Morphol, 2001;60(1): 65-68.
- Chandra sekhar KT & and Harsha BR. A cadaveric study on Muscle Bridges in human hearts. IJAPB, 2015.2(3):1-6.
- JuilliereY, Berder V, Suty-Selton C, Buffet P, Danchin N, Cherrier F. Isolated myocardial bridges with angiographic milking of the left anterior descending coronary artery: a long term follow up study. Am Heart J 1995:129(4):663-665.
- Rossi.L ,Danber.B, Nadasio.GP, Arbustini.F, ParisB, C.Vassanelli, C.Bounanno, A.Poppi. Myocardial bridges and ischemic heart disease. Eur Heart J, 1980;1(4):239-245.
- Kramer JR, Kitazume H, Proudfit WL, Sones FM. Clinical significance of isolated coronary bridges and frequent condition involving the left anterior descending artery. Am Heart J 1982;103(2):283-288.
- Kandregula Jyothirmai, V.Subhadradevi, K.Tyagaraju, S.Havila hasini, C.Jaipal, M.Reshma. Morphological and morphometric parameters of coronary arteries in human foetal hearts.Int J Res Health Sci, 2014; 2(1):126-132.
- Yusuf Ozgu Cakmak, Safiye Cavdar, Aymelek Yahn, Nuran Yener, Omer Ozdogmus. Myocardial bridges of the coronary arteries in the human fetal heart. Anat Sci Int, 2010; 85:140-144.
- Almira Lujinovic, Amela Kulenovic, Eldan Kapur, Refet Gojak. Morphological aspect of myocardial bridges. Bosn J Med Sci, 2013;13(4):212-217.
- Vaishaly K Bharambe, Vasanti Arole. The Study Of Myocardial Bridges. J. Anat. Soc. India, 2008; 57(1): 14-21.
- Dipal Arya, Krunal Chauhan, Meenakshi Bansal and CD Mehta. Morphological study on myocardial bridges and its clinical significance.Journal of surgery, 2013:2(1);32-37.
- Swayam Jothi Dorairaj S, Hemanth Kumar K, Rajeswara Rao N, Jacintha Antony, Sai Sucheethra D, SreeLekha D. Myocardial Bridges Over Interventricular Branches Of Coronary Arteries. Jour of Med Sc & tech 2012;1(1):26-29.
- Swaroop N, G.C.Poornima and M.J. Shashanka. Study of myocardial bridges in the hearts of the human cadavers. Global Journal of Medical Research 2014;14(1):25-28.
- Srivastava Monika, Dixit Asha, Sharma Vandana, Yadav Abijeet, Srivastava Dheeraj Kumar. A study to find out the incidence of myocardial bridges in the formalin fixed hearts and its correlates. IOSR Journal of Dental and Medical sciences, 2014;13(11):66-69.
- Vanildo ML, Cavaicant JS, and Tashiro. Myocardial bridges and their relationship to the anterior interventricular branch of the left coronary artery. Arquivos Braseleiros de Cardiologia, 2002;79(3):31-35.
Sujatha. M, T. Jayachandra Pillai, L. Anandakumar, V. Subhadra Devi. PERCENTAGE INCIDENCE, MORPHOLOGY AND MORPHOMETRY OF MYOCARDIAL BRIDGES: A CADAVERIC STUDY. Int J Anat Res 2015;3(2):1092-1098. DOI: 10.16965/ijar.2015.159