Numerical simulation of myocardial bridging in patients with hypertrophic cardiomyopathy

A myocardial bridge (MB), a congenital anomaly of the coronary artery, occurs when a segment of the epicardial coronary artery goes underneath the myocardium. MBs are often observed in the middle part of the left anterior descending (LAD) artery. MB squeezes the vessel wall periodically and induces hemodynamic abnormalities which are correlated with angina and myocardial ischemia. The level of hemodynamics disturbances induced by MB depends on the myocardial bridge length, the degree of myocardial contractility, thickness, and location [1]. Hypertrophic cardiomyopathy (HCM), characterized by abnormal thickening of the heart wall, is a leading cause of death in patients of all ages [2]. The prevalence and severity of myocardial bridging are higher among patients with HCM, up to 30% [3]. Therefore, understanding the effects of MB in HCM patients is of clinical significance. The purpose of this study was to determine the role of MB on coronary hemodynamics in HCM patients with various level of MB using computational fluid dynamics (CFD) modeling. We analyzed three HCM patients with MB in the middle LAD who underwent coronary angiography at Fuwai hospital (Tab. 1). All patients had a significant MB (diameter stenosis ≥ 50%) as diagnosed by arteriography. © 2019 Tech Science Press. All rights reserved.