心肌桥研究的新进展

正常情况下,冠状动脉及其分支,一般走行于心外膜下脂肪组织中。心肌桥是指冠脉某一段或其分支的某一段走行于心肌纤维中,该心肌纤维束称为心肌桥。1737年Reyman在尸检中发现心肌桥,1960年Portmann和Iwig首先报道了心肌桥的影像学表现——收缩期狭窄。长期以来,心肌桥被认为是一种良性病变,现有诸多报道指出心肌桥可以引起急性冠脉综合征、严重的心律失常甚至猝死。很多研究认为肌桥对该段的冠脉有“保护”作用,而在肌桥的近端易形成动脉粥样硬化。随着新技术(如经血管超声及冠脉多普勒导丝研究)的发展,揭示了心肌桥的解剖学特点和病理生理过程。治疗方面包括药物、支架及手术等。

Advances in Myocardial Bridging

Normally, a segment of coronary artery, or a branch thereof, runs through the fatty tissue beneath the epicardium. Myocardial bridging is defined as a segment of a major coronary artery which goes intramurally through the myocardium beneath the muscle bridge. This muscle is called myocardial bridging.It was recognized at autopsy by Reyman in 1737 and was first described angiographically by Portmann and Iwig in 1960. The main angiographic finding is systolic compression of the involved epicardial coronary artery. Traditionally, myocardial bridging has been considered a benign condition, but the following complications have been reported: acute coronary syndromes, arrhythmias, and sudden death. New techniques, such as intravascular ultrasonography and intracoronary Doppler studies, have revealed new characteristics and pathophysiological processes. Treatment generally includes medicine, stents and surgical operations.