Increased TIMI frame count of coronary arteries in patients with myocardial bridging

Year 2019, , 490 - 496, 04.05.2019

Ekrem Aksu Hakan Güneş

https://doi.org/10.18621/eurj.388556

Abstract

Objectives: Myocardial bridging (MB) is associated with recurrent chest pain and
cardiovascular events. Recently it has been proposed that MB has the features
of vasospastic coronary artery characterized with reduced coronary flow reserve
and endothelial dysfunction. In this study, an evaluation was made of the
angiographic Thrombolysis in
Myocardial Infarction (TIMI) frame
counts (TFCs) of patients with normal angiogram and those with MB.

Methods: The study was conducted as a retrospective analysis of the demographic,
laboratory, and angiographic features of consecutive patients who underwent
coronary angiography between January 2014 and December 2017 in Necip Fazıl City
Hospital and Sütçü Imam University, Kahramanmaraş, Turkey.

Results: The except for
age (51.1 ± 11.6 years vs 56.8 ± 11.4 years) (p = 0.011), no difference was determined between the groups in
respect of laboratory parameters and demographic features. TFCs of LAD (42.9 ± 6.1
vs 54.5 ± 11.5. p < 0.001), Cx (19.4
± 4.5 vs 24.4 ± 7.1, p < 0.001),
and RCA (26.8 ± 6.2 vs 32.5 ± 8.9, p <
0.001), and corrected TFC of LAD artery (25.2 ± 3.6 vs 32.0 ± 6.8, p < 0.001) were observed to be
significantly increased in patients with MB compared to patients with normal
coronary flow. Multiple regression analysis revealed that MB was the only
determinant of increased corrected TFC of LAD artery (r=0.537, Adjusted r=0.281, p < 0.001).

Conclusions: Patients with MB had
abnormally slow coronary flow demonstrated by increased TFC. This finding may
explain the recurrent angina and cardiovascular events of patients with MB. It
may also explain the reversible myocardial perfusion defects which are
associated with recurrent cardiovascular events in patients with MB. 

Keywords

Myocardial bridging, thrombolysis in myocardial infarction, TIMI frame count, coronary flow, recurrent angina

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