Clinical Trial Summary
Myocardial bridge (MB) is a congenital anomaly of epicardial circulation characterized by an
intramural course of a coronary segment. This anatomical arrangement causes the artery to be
squeezed during systole potentially causing flow impairment and ischemia. For this study, MB
is defined as the presence of systolic compression in an epicardial vessel causing at least
50% of caliber reduction from diastole. MB can be disabling as it worsens the quality of
life. Early detection of this congenital condition is crucial, and an invasive functional
assessment of the ischemic burden should be considered to evaluate the need for medical or
surgical therapy.
This is an observational study, involving four Italian centres. Study Objectives are: To
assess the risk of future cardiovascular complications in patients with MB referred for
coronary angiography and the role of beta-blocker therapy; To describe the clinical and
anatomical characteristics of patients presenting with MB; To determine the impact of
cardiovascular medications on symptoms in patients with MB; To describe the anatomical and
clinical features associated with the invasive evidence of ischemia in patients with MB; To
assess the relation between invasively documented ischemia and clinical manifestations in
patients with the MB. Inclusion Criteria: patients referred to undergo ICA (for both elective
or urgent indications) for suspected coronary artery disease found to have an MB with or
without other epicardial lesions amenable to revascularization; Age above 18 y.o.; Ability to
provide Informed Consent. Exclusion Criteria are Patients with life expectancy below 12
months and Patients with severe valvular heart disease. The primary endpoint is the incidence
of MACE defined as the composite of cardiac death, myocardial infarction, cardiac
hospitalization, and target vessel revascularization. The secondary endpoint is evaluating
the Rate of patients with SAQ < 70 and the Rate of patients with "high-risk features" on CT
scan.
