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心肌桥

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心肌桥(MB)是指不正常覆盖在冠状动脉上的心肌带。心肌桥患者通常无症状，但这种异常生理结构与劳累性心绞痛、急性冠状动脉综合征、心律失常、晕厥，甚至心脏猝死相关。有关MB的病理生理学、发生率及预测因子、诊疗策略、影像学测量及对不同患者群预后的影响可参考如下文献：


2014年“Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies”汇总了当代MB的病理生理学及诊疗策略。


2018年10月“Fractional flow reserve derived from CCTA may have a prognostic role in myocardial bridging”评估了经CCTA测量的cFFR在预测心肌桥患者中的价值。


2019年1月“The Prevalence of Myocardial Bridging Associated with Coronary Endothelial Dysfunction in Patients with Chest Pain and Non-Obstructive Coronary Artery Disease”揭示了MB在胸痛和非阻塞性CAD患者中的发生率（208名观察患者中有14.2%人 ），并指出心肌桥与该患者群的心外膜和微血管内皮功能异常相关。


2019年2月“Myocardial bridging of the left anterior descending coronary artery is associated with reduced myocardial perfusion reserve: a 13N-ammonia PET study”定量评价了覆盖在左前降支上的MB对左心室心肌灌注的影响。


2019年2月“Optical coherence tomography and intravascular ultrasound assessment of the anatomic size and wall thickness of a muscle bridge segment”通过OCT和IVUS明确心肌桥段的血管解剖结构。介绍与相邻的非MB段相比，MB段的冠状动脉既短又薄，解释这样的解剖结构可能造成支架置入术中严重冠状动脉穿孔频次的增加。


2019年3月“Machine Learning Using CT-FFR Predicts Proximal Atherosclerotic Plaque Formation Associated With LAD Myocardial Bridging”介绍了使用CT-FFR预测前降支心肌桥近端动脉粥样硬化斑块形成的可能。

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