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New system devised to guide doctors treating patients with symptomatic myocardial bridging
Date:6/26/2008

y included 157 patients who had myocardial bridging (MB) and no evidence of other heart disease or coronary artery disease. This is believed to be the largest group of MB patients in the literature and with a five-year follow-up the longest observation period described in the medical literature. Another 100 patients without MB, artery disease or other heart disease made up a control group.

The researchers reviewed the patients' clinical histories for symptoms of typical angina (chest pain during stress with relief at rest); atypical angina (non-exertional chest pain); non-specific symptoms, such as palpitations and fatigue; or no symptoms. They evaluated results from non-invasive tests, such as EKGs, exercise stress tests or nuclear SPECT scans (Thallium 201 scintigraphy in single photon emission computer tomography), angiograms and invasive tests measuring different hemodynamic 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 non-invasive 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 i
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Contact: Sandy Van
sandy@prpacific.com
800-880-2397
Cedars-Sinai Medical Center
Source:Eurekalert

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