Myocardial bridging was more prevalent in hypertrophic cardiomyopathy than in non-HCM controls (41% vs 21%, P=0.002), but lacked a systematic association with sudden cardiac death (P=0.826).
Observational (n=255)
Does myocardial bridging associate with sudden cardiac death in patients with hypertrophic cardiomyopathy?
Myocardial bridging is a frequent morphological feature in hypertrophic cardiomyopathy but does not systematically associate with an increased risk of sudden cardiac death.
Absolute Event Rate: 41% vs 21%
p-value: p=0.002
AIMS: The clinical significance attributable to myocardial bridging of left anterior descending coronary artery in hypertrophic cardiomyopathy (HCM) remains controversial. METHODS AND RESULTS: Prevalence and depth of coronary artery bridges (CBs) were assessed in 255 hearts, including 115 with HCM (median age 29, range 5-90; 75% male), and 140 controls. Coronary artery bridges were more common in HCM (47/115; 41%) than in patients who died of a variety of non-HCM-related causes (21/100; 21%; P = 0.002), or in patients with congenital aortic stenosis and left ventricular (LV) hypertrophy (5/40; 12%; P = 0.001). Among the HCM hearts, CBs were present in 33 of 77 patients (43%) with sudden death, in 10 of 27 (37%) with heart failure death (or heart transplantation), and in 4 of 11 (36%) with other modes of death (P = 0.826). Deeply embedded CBs (> or =2 mm) occurred with similar frequency in HCM patients with sudden (21 of 77; 27%) or heart failure death (5 of 27; 13%; P = 0.191). In sudden death patients, the presence of CB was unrelated to gender (33% in women and 45% in men, P = 0.406) and age (41% or =18 years; P = 0.827). CONCLUSION: In this morphological analysis of more than 250 hearts, CBs are a frequent component of phenotypically expressed HCM, and more common than in other disorders with or without LV hypertrophy. Although no systematic association with HCM-related sudden death is evident, our findings do not exclude the possibility that CB could contribute to increased risk in some individual patients, potentially impacting management decision-making on a case-by-case basis.
Basso et al. (Thu,) conducted a observational in Hypertrophic cardiomyopathy (n=255). Hypertrophic cardiomyopathy vs. Non-HCM-related causes of death was evaluated on Presence of coronary artery bridges (p=0.002). Myocardial bridging was more prevalent in hypertrophic cardiomyopathy than in non-HCM controls (41% vs 21%, P=0.002), but lacked a systematic association with sudden cardiac death (P=0.826).