Skip to main content
Top
Published in: Heart and Vessels 4/2020

Open Access 01-04-2020 | Original Article

Myocardial bridging is an independent predictor of positive spasm provocation testing by intracoronary ergonovine injections: a retrospective observational study

Authors: Riku Arai, Hiroto Kano, Shinya Suzuki, Hiroaki Semba, Takuto Arita, Naoharu Yagi, Takayuki Otsuka, Shunsuke Matsuno, Minoru Matsuhama, Yuko Kato, Tokuhisa Uejima, Yuji Oikawa, Yasuo Okumura, Junji Yajima, Takeshi Yamashita

Published in: Heart and Vessels | Issue 4/2020

Login to get access

Abstract

The relationship between myocardial bridging (MB) and coronary spasms during spasm provocation testing (SPT) remains unclear. We aimed to investigate whether MB was correlated with the SPT by ergonovine (ER) injections in a retrospective observational study. Of the 3340 patients who underwent a first coronary angiography, 166 underwent SPT using ER injections and were divided into 2 groups: MB(+) (n = 23), and MB(−) (n = 143). MB was defined as an angiographic reduction in the diameter of the coronary artery during systole. The patients who had severe organic stenosis in the left anterior descending coronary artery were excluded. The MB(+) group more frequently had diabetes mellitus and chronic kidney disease, and a thicker interventricular septum thickness. The rate of SPT-positivity was higher in the MB(+) group than MB(−) group (56.5% vs. 22.4%, P = 0.001). A multivariate regression analysis showed that the presence of MB was independently associated with SPT-positivity (odds ratio 5.587, 95% confidence interval 2.061–15.149, P = 0.001). In conclusion, coronary spasms during provocation tests with ER independently correlated with the MB. MB may predict coronary spasms.
Literature
1.
go back to reference Tarantini G, Migliore F, Cademartiri F, Fraccaro C, Iliceto S (2016) Left anterior descending artery myocardial bridging: a clinical approach. J Am Coll Cardiol 68:2887–2899CrossRef Tarantini G, Migliore F, Cademartiri F, Fraccaro C, Iliceto S (2016) Left anterior descending artery myocardial bridging: a clinical approach. J Am Coll Cardiol 68:2887–2899CrossRef
2.
go back to reference Ishikawa Y, Kawawa Y, Kohda E, Shimada K, Ishii T (2011) Significance of the anatomical properties of a myocardial bridge in coronary heart disease. Circ J 75:1559–1566CrossRef Ishikawa Y, Kawawa Y, Kohda E, Shimada K, Ishii T (2011) Significance of the anatomical properties of a myocardial bridge in coronary heart disease. Circ J 75:1559–1566CrossRef
3.
go back to reference Berry JF, von Mering GO, Schmalfuss C, Hill JA, Kerensky RA (2002) Systolic compression of the left anterior descending coronary artery: a case series, review of the literature, and therapeutic options including stenting. Catheter Cardiovasc Interv 56:58–63CrossRef Berry JF, von Mering GO, Schmalfuss C, Hill JA, Kerensky RA (2002) Systolic compression of the left anterior descending coronary artery: a case series, review of the literature, and therapeutic options including stenting. Catheter Cardiovasc Interv 56:58–63CrossRef
4.
go back to reference Tauth J, Sullebarger T (1997) Myocardial infarction associated with myocardial bridging: case history and review of the literature. Catheter Cardiovasc Diagn 40:364–367CrossRef Tauth J, Sullebarger T (1997) Myocardial infarction associated with myocardial bridging: case history and review of the literature. Catheter Cardiovasc Diagn 40:364–367CrossRef
5.
go back to reference Cutler D, Wallace JM (1997) Myocardial bridging in a young patient with sudden death. Clin Cardiol 20:581–583CrossRef Cutler D, Wallace JM (1997) Myocardial bridging in a young patient with sudden death. Clin Cardiol 20:581–583CrossRef
6.
go back to reference Ural E, Bildirici U, Celikyurt U, Kilic T, Sahin T, Acar E, Kahraman G, Ural D (2009) Long-term prognosis of non-interventionally followed patients with isolated myocardial bridge and severe systolic compression of the left anterior descending coronary artery. Clin Cardiol 32:454–457CrossRef Ural E, Bildirici U, Celikyurt U, Kilic T, Sahin T, Acar E, Kahraman G, Ural D (2009) Long-term prognosis of non-interventionally followed patients with isolated myocardial bridge and severe systolic compression of the left anterior descending coronary artery. Clin Cardiol 32:454–457CrossRef
7.
go back to reference Kodama K, Morioka N, Hara Y, Shigematsu Y, Hamada M, Hiwada K (1998) Coronary vasospasm at the site of myocardial bridge—report of two cases. Angiology 49:659–663CrossRef Kodama K, Morioka N, Hara Y, Shigematsu Y, Hamada M, Hiwada K (1998) Coronary vasospasm at the site of myocardial bridge—report of two cases. Angiology 49:659–663CrossRef
8.
go back to reference Teragawa H, Fukuda Y, Matsuda K, Hirao H, Higashi Y, Yamagata T, Oshima T, Matsuura H, Chayama K (2003) Myocardial bridging increases the risk of coronary spasm. Clin Cardiol 26:377–383CrossRef Teragawa H, Fukuda Y, Matsuda K, Hirao H, Higashi Y, Yamagata T, Oshima T, Matsuura H, Chayama K (2003) Myocardial bridging increases the risk of coronary spasm. Clin Cardiol 26:377–383CrossRef
9.
go back to reference Kim JW, Seo HS, Na JO, Suh SY, Choi CU, Kim EJ, Rha SW, Park CG, Oh DJ (2008) Myocardial bridging is related to endothelial dysfunction but not to plaque as assessed by intracoronary ultrasound. Heart 94:765–769CrossRef Kim JW, Seo HS, Na JO, Suh SY, Choi CU, Kim EJ, Rha SW, Park CG, Oh DJ (2008) Myocardial bridging is related to endothelial dysfunction but not to plaque as assessed by intracoronary ultrasound. Heart 94:765–769CrossRef
11.
go back to reference Sara JDS, Corban MT, Prasad M, Prasad A, Gulati R, Lerman LO, Lerman A (2019) The prevalence of myocardial bridging associated with coronary endothelial dysfunction in patients with chest pain and non-obstructive coronary artery disease. EuroIntervention. https://doi.org/10.4244/eij-d-18-00920 CrossRef Sara JDS, Corban MT, Prasad M, Prasad A, Gulati R, Lerman LO, Lerman A (2019) The prevalence of myocardial bridging associated with coronary endothelial dysfunction in patients with chest pain and non-obstructive coronary artery disease. EuroIntervention. https://​doi.​org/​10.​4244/​eij-d-18-00920 CrossRef
12.
go back to reference Saito Y, Kitahara H, Shoji T, Tokimasa S, Nakayama T, Sugimoto K, Fujimoto Y, Kobayashi Y (2017) Relation between severity of myocardial bridge and vasospasm. Int J Cardiol 248:34–38CrossRef Saito Y, Kitahara H, Shoji T, Tokimasa S, Nakayama T, Sugimoto K, Fujimoto Y, Kobayashi Y (2017) Relation between severity of myocardial bridge and vasospasm. Int J Cardiol 248:34–38CrossRef
13.
go back to reference Bourassa MG, Butnaru A, Lesperance J, Tardif JC (2003) Symptomatic myocardial bridges: overview of ischemic mechanisms and current diagnostic and treatment strategies. J Am Coll Cardiol 41:351–359CrossRef Bourassa MG, Butnaru A, Lesperance J, Tardif JC (2003) Symptomatic myocardial bridges: overview of ischemic mechanisms and current diagnostic and treatment strategies. J Am Coll Cardiol 41:351–359CrossRef
14.
go back to reference Scanlon PJ, Faxon DP, Audet AM, Carabello B, Dehmer GJ, Eagle KA, Legako RD, Leon DF, Murray JA, Nissen SE, Pepine CJ, Watson RM, Ritchie JL, Gibbons RJ, Cheitlin MD, Gardner TJ, Garson A Jr, Russell RO Jr, Ryan TJ, Smith SC Jr (1999) ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac Angiography and Interventions. J Am Coll Cardiol 33:1756–1824CrossRef Scanlon PJ, Faxon DP, Audet AM, Carabello B, Dehmer GJ, Eagle KA, Legako RD, Leon DF, Murray JA, Nissen SE, Pepine CJ, Watson RM, Ritchie JL, Gibbons RJ, Cheitlin MD, Gardner TJ, Garson A Jr, Russell RO Jr, Ryan TJ, Smith SC Jr (1999) ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac Angiography and Interventions. J Am Coll Cardiol 33:1756–1824CrossRef
15.
go back to reference (2014) Guidelines for diagnosis and treatment of patients with vasospastic angina (Coronary Spastic Angina) (JCS 2013). Circ J 78: 2779–2801 (2014) Guidelines for diagnosis and treatment of patients with vasospastic angina (Coronary Spastic Angina) (JCS 2013). Circ J 78: 2779–2801
16.
go back to reference Sueda S, Oshita A, Izoe Y, Kohno H, Fukuda H (2006) Survey of coronary spasm in Japan before the establishment of spasm guidelines: analysis of questionnaires throughout Japan. J Cardiol 48:333–343PubMed Sueda S, Oshita A, Izoe Y, Kohno H, Fukuda H (2006) Survey of coronary spasm in Japan before the establishment of spasm guidelines: analysis of questionnaires throughout Japan. J Cardiol 48:333–343PubMed
17.
go back to reference Xiang DC, Gong ZH, He JX, Ruan YJ, Xie ZH (2009) Characteristics of stress tests and symptoms in patients with myocardial bridge and coronary artery spasm. Coron Artery Dis 20:27–31CrossRef Xiang DC, Gong ZH, He JX, Ruan YJ, Xie ZH (2009) Characteristics of stress tests and symptoms in patients with myocardial bridge and coronary artery spasm. Coron Artery Dis 20:27–31CrossRef
18.
go back to reference Sueda S, Kohno H (2018) Relationships between more than 90% coronary luminal narrowing induced by ergonovine provocation test and ECG ischemic change as well as chest symptoms. Heart Vessels 33:95–101CrossRef Sueda S, Kohno H (2018) Relationships between more than 90% coronary luminal narrowing induced by ergonovine provocation test and ECG ischemic change as well as chest symptoms. Heart Vessels 33:95–101CrossRef
19.
go back to reference Koyama T, Tanaka A, Yoshida H, Oyama JI, Toyoda S, Sakuma M, Inoue T, Otsuka Y, Node K (2018) Comparison of the effects of linagliptin and voglibose on endothelial function in patients with type 2 diabetes and coronary artery disease: a prospective, randomized, pilot study (EFFORT). Heart Vessels 33:958–964CrossRef Koyama T, Tanaka A, Yoshida H, Oyama JI, Toyoda S, Sakuma M, Inoue T, Otsuka Y, Node K (2018) Comparison of the effects of linagliptin and voglibose on endothelial function in patients with type 2 diabetes and coronary artery disease: a prospective, randomized, pilot study (EFFORT). Heart Vessels 33:958–964CrossRef
20.
go back to reference Tabata N, Hokimoto S, Akasaka T, Arima Y, Sakamoto K, Yamamoto E, Tsujita K, Izumiya Y, Yamamuro M, Kojima S, Kaikita K, Ogawa H (2016) Differential impact of peripheral endothelial dysfunction on subsequent cardiovascular events following percutaneous coronary intervention between chronic kidney disease (CKD) and non-CKD patients. Heart Vessels 31:1038–1044CrossRef Tabata N, Hokimoto S, Akasaka T, Arima Y, Sakamoto K, Yamamoto E, Tsujita K, Izumiya Y, Yamamuro M, Kojima S, Kaikita K, Ogawa H (2016) Differential impact of peripheral endothelial dysfunction on subsequent cardiovascular events following percutaneous coronary intervention between chronic kidney disease (CKD) and non-CKD patients. Heart Vessels 31:1038–1044CrossRef
21.
go back to reference Yasue H, Touyama M, Shimamoto M, Kato H, Tanaka S (1974) Role of autonomic nervous system in the pathogenesis of Prinzmetal's variant form of angina. Circulation 50:534–539CrossRef Yasue H, Touyama M, Shimamoto M, Kato H, Tanaka S (1974) Role of autonomic nervous system in the pathogenesis of Prinzmetal's variant form of angina. Circulation 50:534–539CrossRef
22.
go back to reference Okumura K, Yasue H, Ishizaka H, Ogawa H, Fujii H, Yoshimura M (1992) Endothelium-dependent dilator response to substance P in patients with coronary spastic angina. J Am Coll Cardiol 20:838–844CrossRef Okumura K, Yasue H, Ishizaka H, Ogawa H, Fujii H, Yoshimura M (1992) Endothelium-dependent dilator response to substance P in patients with coronary spastic angina. J Am Coll Cardiol 20:838–844CrossRef
23.
go back to reference Shimokawa H (2000) Cellular and molecular mechanisms of coronary artery spasm: lessons from animal models. Jpn Circ J 64:1–12CrossRef Shimokawa H (2000) Cellular and molecular mechanisms of coronary artery spasm: lessons from animal models. Jpn Circ J 64:1–12CrossRef
24.
go back to reference Yoshimura M, Yasue H, Nakayama M, Shimasaki Y, Ogawa H, Kugiyama K, Saito Y, Miyamoto Y, Ogawa Y, Kaneshige T, Hiramatsu H, Yoshioka T, Kamitani S, Teraoka H, Nakao K (2000) Genetic risk factors for coronary artery spasm: significance of endothelial nitric oxide synthase gene T-786–%3eC and missense Glu298Asp variants. J Investig Med 48:367–374PubMed Yoshimura M, Yasue H, Nakayama M, Shimasaki Y, Ogawa H, Kugiyama K, Saito Y, Miyamoto Y, Ogawa Y, Kaneshige T, Hiramatsu H, Yoshioka T, Kamitani S, Teraoka H, Nakao K (2000) Genetic risk factors for coronary artery spasm: significance of endothelial nitric oxide synthase gene T-786–%3eC and missense Glu298Asp variants. J Investig Med 48:367–374PubMed
25.
go back to reference Herrmann J, Higano ST, Lenon RJ, Rihal CS, Lerman A (2004) Myocardial bridging is associated with alteration in coronary vasoreactivity. Eur Heart J 25:2134–2142CrossRef Herrmann J, Higano ST, Lenon RJ, Rihal CS, Lerman A (2004) Myocardial bridging is associated with alteration in coronary vasoreactivity. Eur Heart J 25:2134–2142CrossRef
26.
go back to reference Ortega J, Hartman J, Rodriguez J, Maitland D (2008) Post-treatment hemodynamics of a basilar aneurysm and bifurcation. Ann Biomed Eng 36:1531–1546CrossRef Ortega J, Hartman J, Rodriguez J, Maitland D (2008) Post-treatment hemodynamics of a basilar aneurysm and bifurcation. Ann Biomed Eng 36:1531–1546CrossRef
27.
go back to reference Fry DL (1969) Certain histological and chemical responses of the vascular interface to acutely induced mechanical stress in the aorta of the dog. Circ Res 24:93–108CrossRef Fry DL (1969) Certain histological and chemical responses of the vascular interface to acutely induced mechanical stress in the aorta of the dog. Circ Res 24:93–108CrossRef
28.
go back to reference Ohyama K, Matsumoto Y, Takanami K, Ota H, Nishimiya K, Sugisawa J, Tsuchiya S, Amamizu H, Uzuka H, Suda A, Shindo T, Kikuchi Y, Hao K, Tsuburaya R, Takahashi J, Miyata S, Sakata Y, Takase K, Shimokawa H (2018) Coronary adventitial and perivascular adipose tissue inflammation in patients with vasospastic angina. J Am Coll Cardiol 71:414–425CrossRef Ohyama K, Matsumoto Y, Takanami K, Ota H, Nishimiya K, Sugisawa J, Tsuchiya S, Amamizu H, Uzuka H, Suda A, Shindo T, Kikuchi Y, Hao K, Tsuburaya R, Takahashi J, Miyata S, Sakata Y, Takase K, Shimokawa H (2018) Coronary adventitial and perivascular adipose tissue inflammation in patients with vasospastic angina. J Am Coll Cardiol 71:414–425CrossRef
29.
go back to reference Ohyama K, Matsumoto Y, Nishimiya K, Hao K, Tsuburaya R, Ota H, Amamizu H, Uzuka H, Takahashi J, Ito K, Shimokawa H (2016) Increased coronary perivascular adipose tissue volume in patients with vasospastic angina. Circ J 80:1653–1656CrossRef Ohyama K, Matsumoto Y, Nishimiya K, Hao K, Tsuburaya R, Ota H, Amamizu H, Uzuka H, Takahashi J, Ito K, Shimokawa H (2016) Increased coronary perivascular adipose tissue volume in patients with vasospastic angina. Circ J 80:1653–1656CrossRef
30.
go back to reference Maimaituxun G, Shimabukuro M, Fukuda D, Yagi S, Hirata Y, Iwase T, Takao S, Matsuura T, Ise T, Kusunose K, Tobiume T, Yamaguchi K, Yamada H, Soeki T, Wakatsuki T, Harada M, Sata M (2018) Local thickness of epicardial adipose tissue surrounding the left anterior descending artery is a simple predictor of coronary artery disease—new prediction model in combination with framingham risk score. Circ J 82:1369–1378CrossRef Maimaituxun G, Shimabukuro M, Fukuda D, Yagi S, Hirata Y, Iwase T, Takao S, Matsuura T, Ise T, Kusunose K, Tobiume T, Yamaguchi K, Yamada H, Soeki T, Wakatsuki T, Harada M, Sata M (2018) Local thickness of epicardial adipose tissue surrounding the left anterior descending artery is a simple predictor of coronary artery disease—new prediction model in combination with framingham risk score. Circ J 82:1369–1378CrossRef
31.
go back to reference Masuda T, Ishikawa Y, Akasaka Y, Itoh K, Kiguchi H, Ishii T (2001) The effect of myocardial bridging of the coronary artery on vasoactive agents and atherosclerosis localization. J Pathol 193:408–414CrossRef Masuda T, Ishikawa Y, Akasaka Y, Itoh K, Kiguchi H, Ishii T (2001) The effect of myocardial bridging of the coronary artery on vasoactive agents and atherosclerosis localization. J Pathol 193:408–414CrossRef
32.
go back to reference Rogers IS, Tremmel JA, Schnittger I (2017) Myocardial bridges: overview of diagnosis and management. Congenit Heart Dis 12:619–623CrossRef Rogers IS, Tremmel JA, Schnittger I (2017) Myocardial bridges: overview of diagnosis and management. Congenit Heart Dis 12:619–623CrossRef
34.
go back to reference Corban MT, Hung OY, Eshtehardi P, Rasoul-Arzrumly E, McDaniel M, Mekonnen G, Timmins LH, Lutz J, Guyton RA, Samady H (2014) Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies. J Am Coll Cardiol 63:2346–2355CrossRef Corban MT, Hung OY, Eshtehardi P, Rasoul-Arzrumly E, McDaniel M, Mekonnen G, Timmins LH, Lutz J, Guyton RA, Samady H (2014) Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies. J Am Coll Cardiol 63:2346–2355CrossRef
Metadata
Title
Myocardial bridging is an independent predictor of positive spasm provocation testing by intracoronary ergonovine injections: a retrospective observational study
Authors
Riku Arai
Hiroto Kano
Shinya Suzuki
Hiroaki Semba
Takuto Arita
Naoharu Yagi
Takayuki Otsuka
Shunsuke Matsuno
Minoru Matsuhama
Yuko Kato
Tokuhisa Uejima
Yuji Oikawa
Yasuo Okumura
Junji Yajima
Takeshi Yamashita
Publication date
01-04-2020
Publisher
Springer Japan
Published in
Heart and Vessels / Issue 4/2020
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-019-01518-7

Other articles of this Issue 4/2020

Heart and Vessels 4/2020 Go to the issue