Linked Life Data

15754154

Source:http://linkedlifedata.com/resource/pubmed/id/15754154

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2005-3-8
pubmed:abstractText
Approximately 20-30% of patients with cardiac chest pain have a normal coronary angiogram. In about 5% of these patients, a myocardial bridge can be identified. The characteristic feature is systolic compression of an epicardial vessel, usually the left anterior descending artery (LAD), with the angiographic "milking effect". Using modern imaging techniques, such as intravascular ultrasound (IVUS), intracoronary Doppler ultrasound (ICD) and intracoronary pressure wires, the pathophysiological consequence of myocardial bridging could be established. While previously considered a clinically insignificant variant, ICD recordings demonstrated an increased flow velocity in the tunneled segment. Frame-by-frame IVUS analysis revealed a delayed relaxation after systolic compression, which may extend significantly into diastole. This explains both the impaired coronary flow reserve and ischemia. In IVUS, a circular or eccentric rhythmic compression of the vessel is visible, which may be partial or complete. Latest computed tomography technology can also be used to visualize myocardial bridging noninvasively. Provocation tests, such as application of nitroglycerin, orciprenaline, dobutamine or atrial stimulation, may augment systolic compression and explain symptoms and the beneficial effect of beta-blockers. In severe cases (i.e. limiting symptoms with ischemia despite medication), surgical myotomy may be performed after careful appraisal of the benefit-risk ratio. A high restenosis and complication rate associated with coronary stenting precludes a general recommendation of this interventional approach. Whether drug-eluting stents help to overcome this limitation remains to be shown. Long-term prognosis is good, although previous investigations have been performed in a limited number of cases only.
pubmed:language
ger
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Feb
pubmed:issn
0340-9937
pubmed:author
pubmed:issnType
Print
pubmed:volume
30
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
37-47
pubmed:dateRevised
2007-11-15
pubmed:meshHeading
pubmed:year
2005
pubmed:articleTitle
[Normal coronary angiography with myocardial bridging: a variant possibly relevant for ischemia].
pubmed:affiliation
Klinik für Kardiologie, Westdeutsches Herzzentrum Essen, Universität Duisburg-Essen. stefan.moehlenkamp@uni-essen.de
pubmed:publicationType
Journal Article, English Abstract, Review