文章摘要
王尚中.心肌桥合并动脉粥样硬化的研究进展[J].安徽医药,2020,24(2):213-216.
心肌桥合并动脉粥样硬化的研究进展
Research progress of myocardial bridge with atherosclerosis
  
DOI:10.3969/j.issn.1009?6469.2020.02.001
中文关键词: 心肌桥  心肌梗死  冠心病  动脉粥样硬化  肾上腺素能 β受体拮抗剂  钙通道阻滞药  壁面切应力  经皮冠状动脉介入治疗
英文关键词: Myocardial bridging  Myocardial infarction  Coronary disease  Atherosclerosis  Adrenergic beta?antagonists  Calcium channel blockers  Wall shear stress  Percutaneous coronary intervention
基金项目:
作者单位
王尚中 中国人民武装警察部队安徽省总队医院心血管内科安徽合肥 230061 
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中文摘要:
      心肌桥是一种先常见的解剖学变异,表现为心包脏层冠状动脉(最常见于左前降支中段)的一部分走形于心肌内。这种结构会导致心脏收缩时心肌内冠状动脉受到心肌的压迫,进而引起血流动力学改变。尽管这被认为是一种良性结构异常,并且无症状者居多,但也可能导致心绞痛、心肌缺血、急性冠状动脉综合征、冠脉痉挛、短暂心室功能不全、心律失常、晕厥甚至心源性猝死。血管内超声、光学相干断层成像、冠脉造影等技术可以提供病变形态组成的详细情况。在壁冠状动脉近端最易发展动脉粥样硬化病变,而在收缩期完全受压迫的壁冠状动脉内部则常幸免于此。近年来,多项研究报道表明,心肌桥可能是心肌梗死的解剖危险因素。该文就心肌桥合并动脉粥样硬化的病理生理机制及其临床主要治疗方案做一综述。
英文摘要:
      Myocardial bridge is a common anatomic variation that manifests as a portion of an epicardial coronary artery(most fre? quently in the middle of the left anterior descending artery)within the myocardium.This particular structure can cause the coronaryartery to be compressed by the myocardium when the heart contracts,which can lead to hemodynamic disorder.Although this is con? sidered a benign textural anomaly,and there are many asymptomatic subjects,but it can also lead to angina pectoris,myocardialischemia,acute coronary syndrome,coronary spasm,transient ventricular dysfunction,arrhythmia,and even sudden cardiac death. Coronary angiography and intravascular imaging like intra?vascular ultrasound and optical coherence tomography can provide de?tailed information of morphological composition of lesions.Atherosclerosis preferentially is most likely to develop immediately proxi?mal to proximal wall of the coronary arteries,while the interior of the wall coronary arteries that are completely compressed during the systole are often spared.In recent years,several studies have shown that myocardial bridge maybe an anatomic risk factor formyocardial infarction.This article reviews pathophysiology of myocardial bridging combined with atherosclerosis and describes pre?vailing therapeutic options for this challenging clinical entity.
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