Clinical significance of myocardial squeezing of the coronary artery.

HASHIMOTO Akihisa, TAKEKOSHI Noboru, MURAKAMI Eiji

doi:10.1536/ihj.25.913

We investigated the coronary angiography (CAG) of 1, 022 patients to clarify the clinical significance of myocardial squeezing and obtained the following results. 1) Of 1, 022 patients undergoing CAG, 164 patients (16.0%) had myocardial squeezing of the left anterior descending artery (LAD) and 16 patients (1.6%) had only the first septal perforating branches producing a squeezing of the artery during systole. The association of myocardial squeezing of the LAD with different diagnosis was anterior chest pain syndrome (26.6%), arrhythmia (23.6%), cardiomyopathy (21.7%), angina pectoris (15.8%) and myocardial infarction (6.9%). 2) The degree of narrowing of the LAD was classified into 4 grades; 25-49%: 36 patients (22.0%), 50-74%: 82 patients (50.0%), 75-89%: 35 patients (21.3%) and greater than 90%: 11 patients (6.7%). 3) The morphology of the vessel subjected to myocardial squeezing was classified into 4 patterns on CAG. Type A is localized narrowing. Type B is bead-like narrowing. Type C is diffuse narrowing. Type D is tapering and obstructive narrowing. All type D patients had the septal perforating branches. 4) We investigated whether only myocardial squeezing has ischemic ST-T segment changes in the ECG. Fifty-five of 87 patients (63.2%) with myocardial squeezing of greater than 75% and organic stenosis of less than 50% of the LAD had ischemic changes in the ECG during exercise or pacing-induced tachycardia. 5) There was no special feature between myocardial squeezing and subjective symptoms.

Clinical significance of myocardial squeezing of the coronary artery.

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