Morphological analysis of myocardial bridges and coronary arterial dominance in northeast Brazil

Abstract

Background: Coronary arterial dominance and myocardial bridges have clinical implications, since a left dominant pattern associated to the presence of myocardial bridges is often associated to a higher incidence of arteriosclerosis and higher mortality by myocardial infarction.

Objective: To determine the presence and position of myocardial bridges and their relation with coronary arterial dominance.

Methods: Fifty-seven human cadaveric hearts were analyzed into three groups, as follows: right dominance; left dominance; codominance. Each group was then divided into two subgroups: with or without myocardial bridges. Finally, each subgroup with myocardial bridges was classified according to the position of the myocardial bridge according to the main axis of the heart (proximal, middle and distal third).

Results: The right dominance occurred in most hearts (30 hearts-52,6%). Twenty-three myocardial bridges (40,3%) were identified and mostly occurred on left dominant hearts (22,8%). The pattern of coronary dominance presented a statistically significant correlation with the presence of myocardial bridges (P=0.048). The middle third of the heart axis showed the highest occurrence of myocardial bridges.

Conclusion: These findings suggest there is a clear relationship between the presence of myocardial bridges and left dominant pattern. Middle third of the heart axis present the higher occurrence of myocardial bridges. Knowledge of the myocardial bridges morphology is of great clinical significance, improving patient care.

Keywords: Anatomie; Anatomy; Circulation coronarienne; Coronary Circulation; Coronary Disease; Coronary Vessels; Maladie des artères coronaires; Myocardial Bridging; Pont myocardique; Vaisseaux coronaires.