Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2021

Open Access 01-12-2021 | Angiography | Research article

Myocardial bridging of the left anterior descending coronary artery as a risk factor for atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy: a matched case–control study

Authors: Changrong Nie, Changsheng Zhu, Qiulan Yang, Minghu Xiao, Yanhai Meng, Shuiyun Wang

Published in: BMC Cardiovascular Disorders | Issue 1/2021

Login to get access

Abstract

Background

Myocardial bridging (MB) is associated with various forms of arrhythmia. However, whether MB is a risk factor for atrial fibrillation (AF) in patients with hypertrophic obstructive cardiomyopathy (HOCM) remains unknown. This study aimed to identify the relationship between myocardial bridging of the left anterior descending coronary artery (MB-LAD) and AF in patients with HOCM.

Methods

We reviewed the medical records of 1925 patients diagnosed with HOCM at Fuwai Hospital from January 2012 to March 2019. Patients with coronary artery disease, a history of heart surgery, and those who had not been subjected to angiography were excluded. Finally, 105 patients with AF were included in this study. The control group was matched in a ratio of 3:1 based on age and gender.

Results

Forty-three patients were diagnosed with MB-LAD in this study. The presence of MB was significantly higher in patients with AF than in those without AF (19.0% vs. 7.3%; p = 0.001), although MB compression and MB length did not differ between the two groups. In conditional multivariate logistic analysis, MB (odds ratio [OR] 2.33; 95% confidence interval [CI] 1.08–5.01; p = 0.03), pulmonary arterial hypertension (OR 2.63; 95% CI 1.26–5.47; p = 0.01), hyperlipidemia (OR 1.83; 95% CI 1.12–3.00; p = 0.016), left atrial diameter (OR 1.09; 95% CI 1.05–1.13; p < 0.001), and interventricular septal thickness (OR 1.06; 95% CI 1.003–1.12; p = 0.037) were independent risk factors for AF in patients with HOCM.

Conclusions

The presence of MB is an independent risk factor for AF in patients with HOCM. The potential mechanistic link between MB and the development of AF warrants further investigation.
Literature
1.
go back to reference Tarantini G, Migliore F, Cademartiri F, Fraccaro C, Iliceto S. Left anterior descending artery myocardial bridging: a clinical approach. J Am Coll Cardiol. 2016;68:2887–99.CrossRef Tarantini G, Migliore F, Cademartiri F, Fraccaro C, Iliceto S. Left anterior descending artery myocardial bridging: a clinical approach. J Am Coll Cardiol. 2016;68:2887–99.CrossRef
2.
go back to reference Semsarian C, Ingles J, Maron MS, Maron BJ. New perspectives on the prevalence of hypertrophic cardiomyopathy. J Am Coll Cardiol. 2015;65:1249–54.CrossRef Semsarian C, Ingles J, Maron MS, Maron BJ. New perspectives on the prevalence of hypertrophic cardiomyopathy. J Am Coll Cardiol. 2015;65:1249–54.CrossRef
3.
go back to reference Kitazume H, Kramer JR, Krauthamer D, El Tobgi S, Proudfit WL, Sones FM. Myocardial bridges in obstructive hypertrophic cardiomyopathy. Am Heart J. 1983;106(1 Pt 1):131–5.CrossRef Kitazume H, Kramer JR, Krauthamer D, El Tobgi S, Proudfit WL, Sones FM. Myocardial bridges in obstructive hypertrophic cardiomyopathy. Am Heart J. 1983;106(1 Pt 1):131–5.CrossRef
4.
go back to reference Maron BJ. Clinical course and management of hypertrophic cardiomyopathy. N Engl J Med. 2018;379:655–68.CrossRef Maron BJ. Clinical course and management of hypertrophic cardiomyopathy. N Engl J Med. 2018;379:655–68.CrossRef
5.
go back to reference Vaidya K, Semsarian C, Chan KH. Atrial fibrillation in hypertrophic cardiomyopathy. Heart Lung Circ. 2017;26:975–82.CrossRef Vaidya K, Semsarian C, Chan KH. Atrial fibrillation in hypertrophic cardiomyopathy. Heart Lung Circ. 2017;26:975–82.CrossRef
6.
go back to reference Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, et al. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011;124:e783-831.PubMed Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, et al. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011;124:e783-831.PubMed
7.
go back to reference January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of cardiology/American heart association task force on practice guidelines and the heart rhythm society. Circulation. 2014;130:2071–104.CrossRef January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of cardiology/American heart association task force on practice guidelines and the heart rhythm society. Circulation. 2014;130:2071–104.CrossRef
8.
go back to reference Ong KC, Geske JB, Hebl VB, Nishimura RA, Schaff HV, Ackerman MJ, et al. Pulmonary hypertension is associated with worse survival in hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging. 2016;17:604–10.CrossRef Ong KC, Geske JB, Hebl VB, Nishimura RA, Schaff HV, Ackerman MJ, et al. Pulmonary hypertension is associated with worse survival in hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging. 2016;17:604–10.CrossRef
9.
go back to reference Wang J, Sun X, Xiao M, Zhang M, Chen H, Zhu C, et al. Regional left ventricular reverse remodeling after myectomy in hypertrophic cardiomyopathy. Ann Thorac Surg. 2016;102:124–31.CrossRef Wang J, Sun X, Xiao M, Zhang M, Chen H, Zhu C, et al. Regional left ventricular reverse remodeling after myectomy in hypertrophic cardiomyopathy. Ann Thorac Surg. 2016;102:124–31.CrossRef
10.
go back to reference Garg L, Gupta M, Sabzwari SRA, Agrawal S, Agarwal M, Nazir T, et al. Atrial fibrillation in hypertrophic cardiomyopathy: prevalence, clinical impact, and management. Heart Fail Rev. 2019;24:189–97.CrossRef Garg L, Gupta M, Sabzwari SRA, Agrawal S, Agarwal M, Nazir T, et al. Atrial fibrillation in hypertrophic cardiomyopathy: prevalence, clinical impact, and management. Heart Fail Rev. 2019;24:189–97.CrossRef
11.
go back to reference Roh E, Chung HS, Lee JS, Kim JA, Lee Y-B, Hong S-H, et al. Total cholesterol variability and risk of atrial fibrillation: a nationwide population-based cohort study. PLoS ONE. 2019;14:e0215687.CrossRef Roh E, Chung HS, Lee JS, Kim JA, Lee Y-B, Hong S-H, et al. Total cholesterol variability and risk of atrial fibrillation: a nationwide population-based cohort study. PLoS ONE. 2019;14:e0215687.CrossRef
12.
go back to reference Balse E, El-Haou S, Dillanian G, Dauphin A, Eldstrom J, Fedida D, et al. Cholesterol modulates the recruitment of Kv1.5 channels from Rab11-associated recycling endosome in native atrial myocytes. Proc Natl Acad Sci U S A. 2009;106:14681–6.CrossRef Balse E, El-Haou S, Dillanian G, Dauphin A, Eldstrom J, Fedida D, et al. Cholesterol modulates the recruitment of Kv1.5 channels from Rab11-associated recycling endosome in native atrial myocytes. Proc Natl Acad Sci U S A. 2009;106:14681–6.CrossRef
13.
go back to reference Wettwer E, Hála O, Christ T, Heubach JF, Dobrev D, Knaut M, et al. Role of IKur in controlling action potential shape and contractility in the human atrium: influence of chronic atrial fibrillation. Circulation. 2004;110:2299–306.CrossRef Wettwer E, Hála O, Christ T, Heubach JF, Dobrev D, Knaut M, et al. Role of IKur in controlling action potential shape and contractility in the human atrium: influence of chronic atrial fibrillation. Circulation. 2004;110:2299–306.CrossRef
14.
go back to reference Hissa B, Oakes PW, Pontes B, Ramírez-San Juan G, Gardel ML. Cholesterol depletion impairs contractile machinery in neonatal rat cardiomyocytes. Sci Rep. 2017;7:43764.CrossRef Hissa B, Oakes PW, Pontes B, Ramírez-San Juan G, Gardel ML. Cholesterol depletion impairs contractile machinery in neonatal rat cardiomyocytes. Sci Rep. 2017;7:43764.CrossRef
15.
go back to reference Medi C, Kalman JM, Ling LH, Teh AW, Lee G, Lee G, et al. Atrial electrical and structural remodeling associated with longstanding pulmonary hypertension and right ventricular hypertrophy in humans. J Cardiovasc Electrophysiol. 2012;23:614–20.CrossRef Medi C, Kalman JM, Ling LH, Teh AW, Lee G, Lee G, et al. Atrial electrical and structural remodeling associated with longstanding pulmonary hypertension and right ventricular hypertrophy in humans. J Cardiovasc Electrophysiol. 2012;23:614–20.CrossRef
16.
go back to reference Kanbayashi K, Minami Y, Haruki S, Maeda R, Itani R, Ashihara K, et al. Association of elevated pulmonary artery systolic pressure with stroke and systemic embolic events in patients with hypertrophic cardiomyopathy. Int J Cardiol. 2017;240:320–3.CrossRef Kanbayashi K, Minami Y, Haruki S, Maeda R, Itani R, Ashihara K, et al. Association of elevated pulmonary artery systolic pressure with stroke and systemic embolic events in patients with hypertrophic cardiomyopathy. Int J Cardiol. 2017;240:320–3.CrossRef
17.
go back to reference Olsson KM, Nickel NP, Tongers J, Hoeper MM. Atrial flutter and fibrillation in patients with pulmonary hypertension. Int J Cardiol. 2013;167:2300–5.CrossRef Olsson KM, Nickel NP, Tongers J, Hoeper MM. Atrial flutter and fibrillation in patients with pulmonary hypertension. Int J Cardiol. 2013;167:2300–5.CrossRef
18.
go back to reference Mitra A, Ghosh RK, Bandyopadhyay D, Ghosh GC, Kalra A, Lavie CJ. Significance of pulmonary hypertension in hypertrophic cardiomyopathy. Curr Probl Cardiol. 2020;45:100398.CrossRef Mitra A, Ghosh RK, Bandyopadhyay D, Ghosh GC, Kalra A, Lavie CJ. Significance of pulmonary hypertension in hypertrophic cardiomyopathy. Curr Probl Cardiol. 2020;45:100398.CrossRef
19.
go back to reference Sara JDS, Corban MT, Prasad M, Prasad A, Gulati R, Lerman LO, et al. Prevalence of myocardial bridging associated with coronary endothelial dysfunction in patients with chest pain and non-obstructive coronary artery disease. EuroIntervention J Eur Collab Work Gr Interv Cardiol Eur Soc Cardiol. 2020;15:1262–8. Sara JDS, Corban MT, Prasad M, Prasad A, Gulati R, Lerman LO, et al. Prevalence of myocardial bridging associated with coronary endothelial dysfunction in patients with chest pain and non-obstructive coronary artery disease. EuroIntervention J Eur Collab Work Gr Interv Cardiol Eur Soc Cardiol. 2020;15:1262–8.
20.
go back to reference Zhou F, Wang YN, Schoepf UJ, Tesche C, Tang CX, Zhou CS, et al. Diagnostic Performance of machine learning based CT-FFR in detecting ischemia in myocardial bridging and concomitant proximal atherosclerotic disease. Can J Cardiol. 2019;35:1523–33.CrossRef Zhou F, Wang YN, Schoepf UJ, Tesche C, Tang CX, Zhou CS, et al. Diagnostic Performance of machine learning based CT-FFR in detecting ischemia in myocardial bridging and concomitant proximal atherosclerotic disease. Can J Cardiol. 2019;35:1523–33.CrossRef
21.
go back to reference Monroy-Gonzalez AG, Alexanderson-Rosas E, Prakken NHJ, Juarez-Orozco LE, Walls-Laguarda L, Berrios-Barcenas EA, et al. Myocardial bridging of the left anterior descending coronary artery is associated with reduced myocardial perfusion reserve: a (13)N-ammonia PET study. Int J Cardiovasc Imaging. 2019;35:375–82.CrossRef Monroy-Gonzalez AG, Alexanderson-Rosas E, Prakken NHJ, Juarez-Orozco LE, Walls-Laguarda L, Berrios-Barcenas EA, et al. Myocardial bridging of the left anterior descending coronary artery is associated with reduced myocardial perfusion reserve: a (13)N-ammonia PET study. Int J Cardiovasc Imaging. 2019;35:375–82.CrossRef
22.
go back to reference Javadzadegan A, Moshfegh A, Qian Y, Kritharides L, Yong ASC. Myocardial bridging and endothelial dysfunction—computational fluid dynamics study. J Biomech. 2019;85:92–100.CrossRef Javadzadegan A, Moshfegh A, Qian Y, Kritharides L, Yong ASC. Myocardial bridging and endothelial dysfunction—computational fluid dynamics study. J Biomech. 2019;85:92–100.CrossRef
23.
go back to reference Brodsky SV, Roh L, Ashar K, Braun A, Ramaswamy G. Myocardial bridging of coronary arteries: a risk factor for myocardial fibrosis? Int J Cardiol. 2008;124:391–2.CrossRef Brodsky SV, Roh L, Ashar K, Braun A, Ramaswamy G. Myocardial bridging of coronary arteries: a risk factor for myocardial fibrosis? Int J Cardiol. 2008;124:391–2.CrossRef
24.
go back to reference Wang D, Sun JP, Lee AP, Ma GS, Yang XS, Yu C, et al. Evaluation of left ventricular function by three-dimensional speckle-tracking echocardiography in patients with myocardial bridging of the left anterior descending coronary artery. J Am Soc Echocardiogr Off Publ Am Soc Echocardiogr. 2015;28:674–82.CrossRef Wang D, Sun JP, Lee AP, Ma GS, Yang XS, Yu C, et al. Evaluation of left ventricular function by three-dimensional speckle-tracking echocardiography in patients with myocardial bridging of the left anterior descending coronary artery. J Am Soc Echocardiogr Off Publ Am Soc Echocardiogr. 2015;28:674–82.CrossRef
25.
go back to reference Sasaki N, Okumura Y, Watanabe I, Nagashima K, Sonoda K, Kogawa R, et al. Transthoracic echocardiographic backscatter-based assessment of left atrial remodeling involving left atrial and ventricular fibrosis in patients with atrial fibrillation. Int J Cardiol. 2014;176:1064–6.CrossRef Sasaki N, Okumura Y, Watanabe I, Nagashima K, Sonoda K, Kogawa R, et al. Transthoracic echocardiographic backscatter-based assessment of left atrial remodeling involving left atrial and ventricular fibrosis in patients with atrial fibrillation. Int J Cardiol. 2014;176:1064–6.CrossRef
26.
go back to reference Ling L-H, Kistler PM, Ellims AH, Iles LM, Lee G, Hughes GL, et al. Diffuse ventricular fibrosis in atrial fibrillation: noninvasive evaluation and relationships with aging and systolic dysfunction. J Am Coll Cardiol. 2012;60:2402–8.CrossRef Ling L-H, Kistler PM, Ellims AH, Iles LM, Lee G, Hughes GL, et al. Diffuse ventricular fibrosis in atrial fibrillation: noninvasive evaluation and relationships with aging and systolic dysfunction. J Am Coll Cardiol. 2012;60:2402–8.CrossRef
27.
go back to reference Shantsila E, Shantsila A, Blann AD, Lip GYH. Left ventricular fibrosis in atrial fibrillation. Am J Cardiol. 2013;111:996–1001.CrossRef Shantsila E, Shantsila A, Blann AD, Lip GYH. Left ventricular fibrosis in atrial fibrillation. Am J Cardiol. 2013;111:996–1001.CrossRef
28.
go back to reference Corban MT, Godo S, Burczak DR, Noseworthy PA, Toya T, Lewis BR, et al. Coronary endothelial dysfunction is associated with increased risk of incident atrial fibrillation. J Am Heart Assoc. 2020;9:e014850.CrossRef Corban MT, Godo S, Burczak DR, Noseworthy PA, Toya T, Lewis BR, et al. Coronary endothelial dysfunction is associated with increased risk of incident atrial fibrillation. J Am Heart Assoc. 2020;9:e014850.CrossRef
29.
go back to reference Skalidis EI, Hamilos MI, Karalis IK, Chlouverakis G, Kochiadakis GE, Vardas PE. Isolated atrial microvascular dysfunction in patients with lone recurrent atrial fibrillation. J Am Coll Cardiol. 2008;51:2053–7.CrossRef Skalidis EI, Hamilos MI, Karalis IK, Chlouverakis G, Kochiadakis GE, Vardas PE. Isolated atrial microvascular dysfunction in patients with lone recurrent atrial fibrillation. J Am Coll Cardiol. 2008;51:2053–7.CrossRef
30.
go back to reference Guazzi M, Arena R. Endothelial dysfunction and pathophysiological correlates in atrial fibrillation. Heart. 2009;95:102–6.CrossRef Guazzi M, Arena R. Endothelial dysfunction and pathophysiological correlates in atrial fibrillation. Heart. 2009;95:102–6.CrossRef
31.
go back to reference Corban MT, Hung OY, Eshtehardi P, Rasoul-Arzrumly E, McDaniel M, Mekonnen G, et al. Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies. J Am Coll Cardiol. 2014;63:2346–55.CrossRef Corban MT, Hung OY, Eshtehardi P, Rasoul-Arzrumly E, McDaniel M, Mekonnen G, et al. Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies. J Am Coll Cardiol. 2014;63:2346–55.CrossRef
32.
go back to reference Sharzehee M, Chang Y, Song J-P, Han H-C. Hemodynamic effects of myocardial bridging in patients with hypertrophic cardiomyopathy. Am J Physiol Heart Circ Physiol. 2019;317:H1282–91.CrossRef Sharzehee M, Chang Y, Song J-P, Han H-C. Hemodynamic effects of myocardial bridging in patients with hypertrophic cardiomyopathy. Am J Physiol Heart Circ Physiol. 2019;317:H1282–91.CrossRef
33.
go back to reference Javadzadegan A, Moshfegh A, Mohammadi M, Askarian M, Mohammadi M. Haemodynamic impacts of myocardial bridge length: a congenital heart disease. Comput Methods Programs Biomed. 2019;175:25–33.CrossRef Javadzadegan A, Moshfegh A, Mohammadi M, Askarian M, Mohammadi M. Haemodynamic impacts of myocardial bridge length: a congenital heart disease. Comput Methods Programs Biomed. 2019;175:25–33.CrossRef
34.
go back to reference Herrmann J, Higano ST, Lenon RJ, Rihal CS, Lerman A. Myocardial bridging is associated with alteration in coronary vasoreactivity. Eur Heart J. 2004;25:2134–42.CrossRef Herrmann J, Higano ST, Lenon RJ, Rihal CS, Lerman A. Myocardial bridging is associated with alteration in coronary vasoreactivity. Eur Heart J. 2004;25:2134–42.CrossRef
Metadata
Title
Myocardial bridging of the left anterior descending coronary artery as a risk factor for atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy: a matched case–control study
Authors
Changrong Nie
Changsheng Zhu
Qiulan Yang
Minghu Xiao
Yanhai Meng
Shuiyun Wang
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2021
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-021-02185-1

Other articles of this Issue 1/2021

BMC Cardiovascular Disorders 1/2021 Go to the issue