Husmann, Lars

Kaufmann, Philipp A.

Nkoulou, Rene

Wolfrum, Mathias

RERO DOC Digital Library

2. Cleland JG, Bristow MR, Erdmann E, Remme WJ, Swedberg K, Waagstein F. Beta-blocking agents in heart failure. Should they be used and how? Eur Heart J 1996;17:1629–1639.3. Billman GE, Schwartz PJ, Stone HL. The effects of daily exercise on susceptibilityto sudden cardiac death. Circulation 1984;69:1182–1189.4. Braunwald E, Epstein SE, Glick G, Wechsler AS, Braunwald NS. Relief of anginapectoris by electrical stimulation of the carotid-sinus nerves. N Engl J Med1967;277:1278–1283.5. Zhang Y, Popovic ZB, Bibevski S, Fakhry I, Sica DA, Van Wagoner DR,Mazgalev TN. Chronic vagus nerve stimulation improves autonomic controland attenuates systemic inflammation and heart failure progression in a caninehigh-rate pacing model. Circ Heart Fail 2009;2:692–699.6. Li M, Zheng C, Sato T, Kawada T, Sugimachi M, Sunagawa K. Vagal nerve stimu-lation markedly improves long-term survival after chronic heart failure in rats. Cir-culation 2004;109:120–124.7. Schwartz PJ, De Ferrari GM. Vagal stimulation for heart failure: background andfirst in-man study. Heart Rhythm 2009;6(11 Suppl):S76–S81.8. De Ferrari GM, Crijns HJGM, Borggrefe M, Milasinovic G, Smid J, Zabel M,Gavazzi A, Sanzo A, Dennert R, Kuschyk J, Raspopovic S, Klein H, Swedberg K,Schwartz PJ. Chronic vagus nerve stimulation: a new and promising therapeuticapproach for chronic heart failure. Eur Heart J 2011;32:847–855. First publishedon 28 October 2010. doi:10.1093/eurheartj/ehq391.9. Beckers PJ,Denollet J, PossemiersNM,Wuyts FL, VrintsCJ,ConraadsVM.Combinedendurance–resistance training vs. endurance training in patients with chronic heartfailure: a prospective randomized study. Eur Heart J 2008;29:1858–1866.10. Duda MK, O’Shea KM, Tintinu A, Xu W, Khairallah RJ, Barrows BR, Chess DJ,Azimzadeh AM, Harris WS, Sharov VG, Sabbah HN, Stanley WC. Fish oil, butnot flaxseed oil, decreases inflammation and prevents pressure overload-inducedcardiac dysfunction. Cardiovasc Res 2009;81:319–327.11. Rupp H, Rupp TP, Alter P, Maisch B. N-3 polyunsaturated fatty acids and statins inheart failure. Lancet 2009;373:378–379.CARDIOVASCULAR FLASHLIGHT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .doi:10.1093/eurheartj/ehq423Online publish-ahead-of-print 1 December 2010Myocardial bridging causing infarction and ischaemiaLars Husmann1, Rene Nkoulou1, Mathias Wolfrum1, and Philipp A. Kaufmann1,2*1Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, CH-8091 Zurich, Switzerland and 2Zurich Center for Integrative Human Physiology (ZIHP), University ofZurich, Zurich, Switzerland* Corresponding author. Tel: +41 1 255 4196, Fax: +41 1 255 4428, Email: pak@usz.chThis paper was guest edited by Prof. Frank E. Rademakers, University Hospital Gasthuisberg, Leuven, BelgiumA 40-year-old woman with a long history of atypicalchest pain and no cardiac risk factors was referredfor cardiac work-up. Cardiac stress testing on atreadmill ergometer revealed T-wave inversion inleads V1–V3 and an intermittent left bundlebranch block. The patient was subsequentlyreferred to cardiac magnetic resonance imaging(MRI), which revealed normal myocardial perfusionat rest (Panel A). At maximum dobutamin stress (i.e.85% of age-predicted maximum heart rate),impaired left ventricular contractility and delayedperfusion were observed in the anteroseptal myo-cardium (Panel B), indicating myocardial ischaemia.Delayed imaging revealed late enhancement in thesubendocardial anteroseptal myocardium (arrowin Panel C), indicating a non-transmural myocardialscar. Invasive coronary angiography showednormal coronary arteries without systolic com-pression (images not shown); however, computedtomography coronary angiography (CTCA)revealed a myocardial bridging in the middle segment of the left anterior descending artery (arrow in Panel D). Finally, hybridCTCA/99mTc-Tetrofosmin single-photon emission computed tomography images were acquired using a 1-day dobutamin-stress/rest protocol, which confirmed MRI results by displaying a partially reversible perfusion defect (ischaemia) in the anteroseptal myo-cardium (demonstrated by the arrowheads in Panel E at rest, Panel F at dobutamin stress).This case illustrates a haemodynamic relevant myocardial bridging, causing a non-transmural myocardial infarction and astress-induced myocardial ischaemia in a young female patient. The patient was subsequently treated with calcium-channel blockersand reported reduced chest pain in the clinical follow-up.Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2010. For permissions please email: journals.permissions@oup.com.Editorial790

Myocardial bridging causing infarction and ischaemia

Abstract

Similar works

Full text

Available Versions

RERO DOC Digital Library