The following is the summary of “Systematic Review and Meta-Analysis of Cardiovascular Consequences of Myocardial Bridging in Hypertrophic Cardiomyopathy” published in the February 2023 issue of Cardiovascular Disease by Bruce, et al.
Myocardial bridging (MB) is a congenital variant commonly seen in hypertrophic cardiomyopathy (HCM) in which a portion of a coronary artery takes an irregular intramural course under a “bridge” of myocardium . The clinical effects of MB in HCM patients were the focus of this systematic review and meta-analysis. Myocardial infarction, cardiac death, and cardiac episodes without fatalities were the 3 kinds of outcomes studied. About 10 papers evaluating the outcomes of HCM patients with and without MB were pooled together for this meta-analysis.
About 4 databases were searched systematically to find relevant studies (PubMed, Scopus, Medline Complete, and Web of Science). A modified version of the Downs and Black method was used to evaluate the research; studies could receive a maximum of 23 points. Mean and standard deviation were 17.5 ± 1.3, respectively (good). The meta-analysis showed that MB was only linked with myocardial ischemia (odds ratio [OR] 1.89, 95% CI 1.03 to 3.44, P= 0.04) but not with cardiovascular mortality (odds ratio [OR] 1.70, 95% CI 0.56 to 5.15, P=0.35) or nonfatal adverse cardiac events.
The possible prognosis consequences of MB in HCM should not be discounted, especially in those with hemodynamically substantial bridges and/or severe underlying illness. Future research should verify imaging findings with clinical outcome data in order to define functional and morphologic thresholds by which MB may adversely influence prognosis.
Source: sciencedirect.com/science/article/pii/S0002914922011845
