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Yong ASC, Pargaonkar VS, Wong CCY, et al. Abnormal shear stress and residence time are associated with proximal coronary atheroma in the presence of myocardial bridging. Int J Cardiol. 2021;340:7-13doi: 10.1016/j.ijcard.2021.08.011.
Yong, A. S. C., Pargaonkar, V. S., Wong, C. C. Y., Javadzdegan, A., Yamada, R., Tanaka, S., Kimura, T., Rogers, I. S., Sen, I., Kritharides, L., Schnittger, I., & Tremmel, J. A. (2021). Abnormal shear stress and residence time are associated with proximal coronary atheroma in the presence of myocardial bridging. International journal of cardiology, 3407-13. https://doi.org/10.1016/j.ijcard.2021.08.011
Yong, Andy S C, et al. "Abnormal shear stress and residence time are associated with proximal coronary atheroma in the presence of myocardial bridging." International journal of cardiology vol. 340 (2021): 7-13. doi: https://doi.org/10.1016/j.ijcard.2021.08.011
Yong ASC, Pargaonkar VS, Wong CCY, Javadzdegan A, Yamada R, Tanaka S, Kimura T, Rogers IS, Sen I, Kritharides L, Schnittger I, Tremmel JA. Abnormal shear stress and residence time are associated with proximal coronary atheroma in the presence of myocardial bridging. Int J Cardiol. 2021 Oct 01;340:7-13. doi: 10.1016/j.ijcard.2021.08.011. Epub 2021 Aug 08. PMID: 34375705.
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Int J Cardiol. 2021 Oct 01;340:7-13. doi: 10.1016/j.ijcard.2021.08.011. Epub 2021 Aug 08.

Abnormal shear stress and residence time are associated with proximal coronary atheroma in the presence of myocardial bridging.

International journal of cardiology

Andy S C Yong, Vedant S Pargaonkar, Christopher C Y Wong, Ashkan Javadzdegan, Ryotaro Yamada, Shigemitsu Tanaka, Takumi Kimura, Ian S Rogers, Itsu Sen, Leonard Kritharides, Ingela Schnittger, Jennifer A Tremmel

Affiliations

  1. Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia; Department of Cardiology, Concord Hospital, The University of Sydney, Sydney, Australia.
  2. Department of Medicine, Stanford School of Medicine, Stanford, CA, USA.
  3. Department of Cardiology, Concord Hospital, The University of Sydney, Sydney, Australia.
  4. Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
  5. Department of Medicine, Stanford School of Medicine, Stanford, CA, USA. Electronic address: [email protected].

PMID: 34375705 DOI: 10.1016/j.ijcard.2021.08.011

Abstract

BACKGROUND: Atheromatous plaques tend to form in the coronary segments proximal to a myocardial bridge (MB), but the mechanism of this occurrence remains unclear. This study evaluates the relationship between blood flow perturbations and plaque formation in patients with an MB.

METHODS AND RESULTS: A total of 92 patients with an MB in the mid left anterior descending artery (LAD) and 20 patients without an MB were included. Coronary angiography, intravascular ultrasound, and coronary physiology measurements were performed. A moving-boundary computational fluid dynamics algorithm was used to derive wall shear stress (WSS) and peak residence time (PRT). Patients with an MB had lower WSS (0.46 ± 0.21 vs. 0.96 ± 0.33 Pa, p < 0.001) and higher maximal plaque burden (33.6 ± 15.0 vs. 14.2 ± 5.8%, p < 0.001) within the proximal LAD compared to those without. Plaque burden in the proximal LAD correlated significantly with proximal WSS (r = -0.51, p < 0.001) and PRT (r = 0.60, p < 0.001). In patients with an MB, the site of maximal plaque burden occurred 23.4 ± 13.3 mm proximal to the entrance of the MB, corresponding to the site of PRT.

CONCLUSIONS: Regions of low WSS and high PRT occur in arterial segments proximal to an MB, and this is associated with the degree and location of coronary atheroma formation.

Copyright © 2021. Published by Elsevier B.V.

Keywords: Intravascular ultrasound; Myocardial bridge; Stable angina

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