SIGNIFICANCE OF HYPERCHOLESTEROLEMIA IN THE DEVELOPMENT OF ATHEROSCLEROTIC PLAQUE AT THE SITE PROXIMAL TO THE MYOCARDIAL BRIDGE

Subhash Gyawali, Hai-Rong Wang*, Fazal Razi Edavana, Zhi-li Jin, Tu Pei, Wen-Hao Song, Yao Gong, Lin Zhang and Meichun Zhang

ABSTRACT

Objective: The main aim of this study was to investigate whether myocardial bridge (MB) is an independent risk factor for the development of atherosclerotic plaque (AP) proximal to the bridge site in the left anterior descending coronary artery (LAD), and the significance of increased levels of cholesterol in the formation of AP in LAD coronary artery. Methods: This is a retrospective study performed with data from January 2015 to June 2017 in Zhongnan Hospital of Wuhan University. Our study had a total of 83 adult patients. Patients were subdivided into MB, MB & AP and AP groups. The relationship between MB and coronary atherosclerosis was compared with serum levels of lipid profile parameters. Results: Among the total 83 patients, 40 patients had MB only, 19 patients had MB&AP and 24 patients had AP only. TC (MB only 4.21 ± 0.55mmol/L, MB&AP 4.90 ± 0.74mmol/L, and AP only 5.05 ± 0.91mmol/L; P < .001), LDL-C (MB only 2.53 ± 0.58mmol/L, MB&AP 3.20 ± 0.60mmol/L, and AP only 3.41 ± 0.78mmol/L; P < .001), and TG (MB only 1.32 ± 0.50mmol/L, MB&AP 1.85 ± 0.73mmol/L, and AP only 2.08 ± 1.00mmol/L; P < .001) were significantly higher in patients with MB&AP and AP only compared to MB only. TC, LDL-C, and TG were significantly correlated with the type of coronary artery disease (CAD) in correlation analysis, while LDL-C and TG were significantly correlated with the type of CAD in regression analysis. Conclusion: In patients with hypercholesterolemia, atherosclerosis was more susceptible in the segment proximal to MB in the LAD, and MB in the mid-LAD is an independent risk factor for coronary atherosclerosis in the proximal LAD.

Keywords: Myocardial Bridge, Coronary Artery Disease, Hypercholesterolemia, Atherosclerotic Plaque.