New System Devised To Guide Doctors Treating Patients With Symptomatic Myocardia... (c parameters using microtransducers with...)

New System Devised To Guide Doctors Treating Patients With Symptomatic Myocardial Bridging

Date:7/1/2008

c parameters using microtransducers within the arteries of the heart.

They found that clinical symptoms, EKGs and non-invasive stress tests are not specific for diagnosing myocardial bridging, but in patients who have myocardial bridging, clinical symptoms correlated with results from qualitative coronary angiography (QCA) and blood flow studies such as intracoronary Doppler and intravascular ultrasound.

Previous attempts to develop classification systems revolved around subjective criteria, such as the estimated percent of artery narrowing and/or the length of the compressed segment of artery.

"Classifications based on visual evaluation are subject to quantitative error and do not accurately assess arterial function. In our classification system, we incorporated clinical symptoms and results of both noninvasive and invasive diagnostic tests. Qualitative coronary angiography and intracoronary Doppler hemodynamics were able to assess the functional significance of myocardial bridging," Schwarz said.

The researchers placed the 157 MB patients into three categories:

58 were in class A - Having clinical symptoms but no objective signs of ischemia.
62 were in class B - Having clinical symptoms and objective signs of ischemia by non-invasive stress tests.
37 were in class C - Having clinical symptoms and objective altered intracoronary hemodynamics, based on angiography and intracoronary Doppler - with or without signs of ischemia by noninvasive stress tests.

Based on initial observations and five-year follow-up, the cardiologists propose a new diagnostic work-up and therapeutic strategy:

Type A: No further diagnostic work or therapy is needed.
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