Relationship Between the Length and Depth of Myocardial Bridging and the Degree of Proximal Coronary Artery Stenosis Using Coronary Computed Tomography Angiography

Authors

  • Teodorus Alfons Pratama Radiology Specialist Program, Faculty of Medicine, Pelita Harapan University, Jakarta, Indonesia
  • Rusli Muljadi Department of Radiology, Pelita Harapan University, Jakarta, Indonesia
  • Koesbandono Department of Radiology, Pelita Harapan University, Jakarta, Indonesia
  • Antonia Anna Lukito Department of Cardiology and Vascular Medicine, Pelita Harapan University, Jakarta, Indonesia
  • Andree Kurniawan Department of Internal Medicine, Pelita Harapan University, Jakarta, Indonesia

DOI:

https://doi.org/10.19166/med.v15i3.11154

Keywords:

myocardial bridging, proximal stenosis, ccta, mb length

Abstract

Background:

Myocardial bridging (MB) is a congenital anomaly of the coronary arteries that results in dynamic compression during the cardiac cycle. This condition accelerates the development of atherosclerosis, particularly in the proximal coronary segment. Evidence regarding the relationship between MB morphology and the degree of stenosis based on coronary CT angiography (CCTA) remains limited and inconsistent. This study aimed to evaluate the association between MB length and depth and the degree of proximal coronary artery stenosis using CCTA at Siloam Lippo Village Hospital.

 

Methods:

This was an observational analytic study with a cross-sectional design. Samples were obtained through consecutive sampling of patients aged ≥18 years who underwent CCTA between 2024 and 2025. Data were analysed using the Mann-Whitney U test for comparison of means, with a p-value <0.05 considered statistically significant.

 

Result:

A total of 144 patients met the inclusion criteria. MB was most commonly found in the mid-left anterior descending (mid-LAD) segment, with a mean depth of 1.18 mm and a mean length of 14.67 mm. Most proximal stenosis cases were categorized as non-significant (<50%). Mann-Whitney U analysis showed that MB depth was significantly associated with the degree of proximal stenosis (p = 0.006), whereas MB length was not (p = 0.345). The interaction between these variables, represented as MB area, showed a stronger correlation with the degree of stenosis (p = 0.004).

 

Conclusion:

MB is associated with the degree of proximal coronary artery stenosis as assessed by CCTA. These findings may improve risk stratification and support more appropriate clinical management in patients with MB.

References

1. Evbayekha EO. A comprehensive review of myocardial bridging: exploring diagnostic and treatment modalities. Cureus. 2023.

2. Sternheim D. Myocardial bridging: diagnosis, functional assessment, and management. JACC State-of-the-Art Review. Journal of the American College of Cardiology. 2021.

3. Santucci A. The myocardial bridge: incidence, diagnosis, and prognosis of a pathology of uncertain clinical significance. European Heart Journal Supplements. 2022.

4. Yu G, Ming Z, Qiao D, Cheng Z, Li L, Guo W, et al. Morphological analysis of myocardial bridging leading to myocardial ischemia: myocardial coronary coupling. Frontiers in Bioengineering and Biotechnology. 2025.

5. Nakaura T. Myocardial bridging is associated with coronary atherosclerosis in the segment proximal to the site of bridging. Journal of Cardiology. 2014.

6. Lee MS, Chen CH. Myocardial bridging: an up-to-date review. The Journal of Invasive Cardiology. 2015.

7. Huang Z, Cao B, Yang Y, Ding Y, Du X, Wang W, et al. Prognostic value of myocardial bridging versus non-obstructive coronary artery disease: a long-term follow-up study. Scientific Reports. 2025.

8. Montone RA, Gurgoglione FL, Del Buono MG, Rinaldi R, Meucci MC, Iannaccone G, et al. Interplay between myocardial bridging and coronary spasm in patients with myocardial ischemia and non-obstructive coronary arteries: pathogenic and prognostic implications. Journal of the American Heart Association. 2021 Jul 20;10(14). doi:10.1161/JAHA.120.020535.

9. Hostiuc S, Rusu MC, Hostiuc M, Negoi RI, Negoi I. Cardiovascular consequences of myocardial bridging: a meta-analysis and meta-regression. Scientific Reports. 2017 Nov 7;7(1). doi:10.1038/s41598-017-13958-0.

10. Mishra A, Jafri S, Mateen S, et al. Myocardial bridging in patients undergoing coronary angiography for coronary artery disease. Cureus. 2024 May 11;16(5):e60087. doi:10.7759/cureus.60087.

11. Yang TL, Hao WR, Chen CC, Fang YA, Leu HB, Liu JC, et al. Myocardial bridging increases the risk of adverse cardiovascular events in patients without coronary atherosclerosis. Life. 2024 Jun 26;14(7):811. doi:10.3390/life14070811.

12. Nafakhi H. Myocardial bridge characteristics and coronary atherosclerotic markers. Puvodni Sdeleni. 2019.

Downloads

Published

2026-06-20

How to Cite

Pratama, T. A., Muljadi, R., Koesbandono, K., Lukito, A. A., & Kurniawan, A. (2026). Relationship Between the Length and Depth of Myocardial Bridging and the Degree of Proximal Coronary Artery Stenosis Using Coronary Computed Tomography Angiography. Medicinus, 15(3), 1–7. https://doi.org/10.19166/med.v15i3.11154

Issue

Section

Clinical Research