Study On The Correlation Of Plaque Incidence,plaque Properties And Parameters Between Superficial Myocardial Bridge And Anterior Segment Of Bridge

Objective Myocardial Bridge(MB)is a common congenital anatomic anomaly of the heart and blood vessels.It is most common in the middle of the Left Anterior Descending Branch(LAD)and most commonly in the superficial form.Research has shown that myocardial bridges are associated with Atherosclerosis(AS)and play a key role in the pathophysiology of arteriosclerosis,the aim of this study was to investigate the relationship between the incidence of plaque,plaque properties and parameters between the superficial myocardial bridge and the anterior segment of the left anterior descending branch.Objects and Methods A total of 208 patients who underwent CCTA between May and October 2022 were 2021.The patients were divided into two groups: non-myocardial bridge group(N=126)and superficial myocardial bridge group(N=82),no-plaque group(N=111)and plaque group(N=97).The patients’ age,sex,smoking,diabetes,hypertension and hyperlipidemia were recorded.The type of myocardial bridge on the CCTA images of patients with myocardial bridge was determined by two experienced imaging attending physicians.Image Reconstruction and patch analysis of CCTA images were carried out by using the digital image processing system(CCTA).Image Reconstruction includes Volume Rendering(VR),Multiplanar Reconstruction(MPR)and Curved planar Reconstruction(CPR).Plaque parameters included plaque properties(calcified plaque, non-calcified plaque,mixed plaque),plaque length,plaque volume,minimal lumen area(MLA),and stenosis degree(MLD).SPSS27.0 statistical software was used to process the data,and Shapiro-wilk test was used to Normality test the measurement data,which satisfied the normal distribution expressed as mean±standard deviation,the Independent-Sample t-test was used for statistical analysis.The measurement data that did not satisfy the normal distribution were expressed as median(upper and lower quartile),and the Mann-whitney U test was used for statistical analysis,statistical description in terms of rate or constituent ratio.Multivariate logistic regression analysis was used to analyze the influencing factors,and P<0.05 indicated the difference was statistically significant.Results There were 49 males(38.9%)and 77 females(61.1%)in the no-MB group.The average age was 57.68±9.83 years old.There were 21 cases(16.7%)with smoking history,17 cases(13.5%)with diabetes mellitus,56 cases(44.4%)with hypertension,the mean values of TG,TC,LDL-C and HDL-C were 1.67 mmol/L,5.02 mmol/L,2.97mmol/L and 1.37 mmol/L respectively.In the superficial MB group,there were 38males(46.3%)and 44 females(53.7%),the average age was 59.37±10.90,11 cases had smoking history(13.4%),20 cases had diabetes mellitus(24.4%),32 cases had hypertension(39.9%),the mean values of TG,TC and HDL-C were 1.51 mmol/L,4.78mmol/L,2.78mmol/L and 1.28mmol/L respectively.There were no significant differences in sex,age,smoking,diabetes,hypertension,TG,TC,LDL-C and HDL-C between the two groups(P<0.05).The detection rate of plaque was significantly different between the two groups(57.3%vs39.7%,P=0.013).The detection rate of non-calcified plaque was significantly different between the two groups(46.8%vs24.0%,P=0.033),but the detection rate of calcified plaque(29.8% vs 48.0%,P=0.066)and mixed plaque(23.4%vs26.0%,P=0.767)was not significantly different.There were no significant differences in plaque length(6.88(4.73,10.74)vs6.84(3.40.10.45),volume(10.34(2.77,32.68)vs12.82.2.75,40.16),P=0.854),MLA(1.35(0.53.3.23)vs1.39(0.43.33),P=0.753),MLD(42.00(27.00.54.00)vs36.50(22.75,52.25),P=0.539)between the two groups.Compared with the no-plaque group,there were significant differences in sex(male:51.5%vs33.3%;female:48.5%vs66.7%,P=0.008),age(61.19±10.02vs55.86±9.88,P<0.001),prevalence of diabetes(32.0%vs5.4%,P<0.001),hypertension(54.6% vs31.5%,P<0.001),presence or absence of superficial myocardial bridge(48.5%vs31.5%,P=0.013),LDL-C(3.00.0.67 vs 2.80.072,P=0.037),and age(32.0% vs 5.4%,P <0.001),there were no significant differences in smoking history(17.5% vs 13.5%,P=0.424),TG(1.57±0.82 vs1.64±0.86,P=0.533),TC(5.02±0.89vs4.84±0.86,P=0.133),HDL-C(1.31±0.35vs1.36±0.36,P=0.286).The results of multivariate logistic regression analysis showed that sex(male),age,diabetes mellitus,hypertension and superficial myocardial bridge were the important risk factors of plaque formation.Conclusion1.The superficial myocardial bridge in the middle segment of LAD is associated with the occurrence of plaque in the anterior segment of LAD.2.The detection rate of non-calcified plaque in superficial myocardial bridge group was higher than that in non-myocardial bridge group,but there was no significant difference in plaque length,volume,MLA and MLD.3.Sex(male),age,diabetes mellitus,hypertension and superficial myocardial bridge are important risk factors for plaque.