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正常情况下,冠状动脉及其分支,一般走行于心外膜下脂肪组织中。心肌桥是指冠脉某一段或其分支的某一段走行于心肌纤维中,该心肌纤维束称为心肌桥。1737年Reyman在尸检中发现心肌桥,1960年Portmann和Iwig首先报道了心肌桥的影像学表现——收缩期狭窄。长期以来,心肌桥被认为是一种良性病变,现有诸多报道指出心肌桥可以引起急性冠脉综合征、严重的心律失常甚至猝死。很多研究认为肌桥对该段的冠脉有“保护”作用,而在肌桥的近端易形成动脉粥样硬化。随着新技术(如经血管超声及冠脉多普勒导丝研究)的发展,揭示了心肌桥的解剖学特点和病理生理过程。治疗方面包括药物、支架及手术等。
Under normal circumstances, the coronary artery and its branches, generally walking in the subepicardial fat tissue. Myocardial bridge refers to a segment of the coronary artery or a branch of its walking in the myocardial fibers, the myocardial fiber bundle called the myocardial bridge. In 1737, Reyman found the myocardial bridge at autopsy. In 1960, Portmann and Iwig first reported the imaging findings of myocardial bridge - systolic narrowing. For a long time, myocardial bridge is considered as a benign lesion, there are many reports that myocardial bridge can cause acute coronary syndrome, severe arrhythmia or even sudden death. Many studies suggest that the muscle bridge on this section of the coronary artery has a “protective” role, but in the proximal muscle tend to form atherosclerosis. With the development of new technologies (such as transvascular ultrasound and coronary Doppler guidewire), the anatomic features and pathophysiological processes of the myocardial bridge have been revealed. Treatment includes drugs, stents and surgery.