Cầu cơ động mạch vành tỷ lệ hiện mắc, đặc điểm lâm sàng và cận lâm sàng ở người việt nam

Cầu cơ động mạch vành, tỷ lệ hiện mắc, đặc điểm lâm sàng ,và cận lâm sàng, ở người việt nam

Prevalence and characteristics of myocardial bridge in patients undergoing percutaneous coronary angiography BS Nguyễn Văn Tuấn - BVQY 103 INTRODUCTION Myocardial bridge (MB): a muscle bridge over a segment of the coronary arteries that leads to narrowing of coronary artery Systolic Diastolic INTRODUCTION  Prevalence: • Autopsy: 5,4% ~ 85,7%* • Angiography: 0,5% ~ 16%  Clinical significance: * Jorge R Alegria (2005): Myocardial bridging, European Heart Journal 26, 1159-1168 INTRODUCTION INTRODUCTION INTRODUCTION Treatment of symptomatic patients: • Negative inotropic and/or negative chronotropic agents: Betablocker, calcium antagonists OBJECTIVE To investigate the prevalence, clinical and paraclinical characteristics of myocardial bridge in patients undergoing PCA SUBJECTS AND METHODS  SUBJECTS 1386 patients underwent PCA in Department of Cardiology, Military Hospital 103 from 1/2013 to 3/2016  METHODS • Descriptive, cross – sectional • Clinical and paraclinical examination • Percutaneous coronary angiography (PCA) SUBJECTS AND METHODS • Diagnosis of MB: Systolic compression of the artery with narrowing of the lumen and diastolic relaxation • Grading of angina pectoris: Canadian Cardiovascular Society (CCS) (1976) • Assessment of coronary artery stenosis * Mild: < 50% Moderate: 50 – 74% Severe: ≥ 75% *Kern MJ (2013), “The interventional cardiac catheterization handbook third edition” RESULTS Chart Myocardial bridge prevalence 1291 pts (93.2%) no MB MB 95 pts (6.8%) John R Kramer (1982): 12% (PCA) Atar E (2007): 17% (MSCT) Lazoura O (2010): 21% (MSCT) RESULTS Table General characteristic of participants (n = 95) Variable X ± SD or n (%) Age (year) 61.85 ± 12.45 Male 77 (81.1%) Concomitant diseases Hypertension 55 (57.9%) Type Diabetes Mellitus 13 (13.7%) Stable ischemic heart disease 14 (14.73%) RESULTS Table Grading of angina pectoris according to CCS (n = 81) CCS n (%) 35 (43.2%) 30 (37%) 15 (18.6%) (1.2%) Total 81 (100%) RESULTS Table ECG characteristic (n = 81) Variable ECG X ± SD or n (%) Normal 61 (75.3%) ST depression, T (-) 12 (14.8%) ST elevation (9.9%) Li Wan (2005): Abnormal ECG occurred in 10% patients RESULTS Table Echocardiography characteristic (n = 81) X ± SD or n (%) Variable Echocardiography LVDd (mm) 46.74 ± 5.98 LVDs (mm) 29.95 ± 6.38 EF (%) 63.76 ± 10.50 Regional wall dyskinesia (7.4%) LV dilatation 17 (20.9%) RESULTS Chart MB locations (n = 81) 1.20% 2.40% LAD1 LAD2 LAD3 LCX RCA OTHERS 2.40% 3.60% 30.10% Atar E (2007): 60% MB in LAD Lazoura O (2010): 100% MB in LAD, 68% in LAD2 60.30% RESULTS Table The degree of systolic coronary stenosis caused by MB (n = 81) Degree n (%) Mild (< 50%) 52 (64.19%) Moderate (50-74%) 20 (24.69%) Severe Total 75-89% (4.95%) ≥ 90% (6.17%) 81 (100%) RESULTS Table The relation between angina and coronary artery stenosis degree (n = 81) CCS 1-2 Mild and Moderate stenosis (n(%)) Severe stenosis (n(%)) 58 (71.6%) (8.6%) p > 0.05 CCS 3-4 14 (17.3%) (2.5%) CONCLUSION  The prevalence of MB is 6.8% of patients undergoing percutaneous coronary angiography  Most of MB was found in LAD  There was no relation between angina and coronary artery stenosis degree