Anatomical characteristics of myocardial loops in the adults

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

Aim. To establish structural features and adjacent anatomy of myocardial loops in the adult and elderly human hearts.

Methods. We studied 100 hearts obtained from adult and elderly people who died from non-cardiac causes. We dissected subepicardial blood vessels and their intramural segments on 60 formalin-fixed hearts. The rate of the cone artery directly originating in the aorta (third coronary artery) was recorded. The number of myocardial loops, their localization and length were determined. We made histological sections from 40 heart specimens from areas of the coronary groove containing myocardial loops. The shortest distances from the coronary sinus and myocardium of the left atrium to the artery, the thickness of the loops, the cross-sectional area of the artery and perivascular space and the ratio of these parameters were measured. The statistical significance of differences was assessed by using the Mann–Whitney U-test. The relationship between the two qualitative features was identified using the Pearsons χ2 test. The Spearman’s rank correlation coefficient (R) was used for the correlation analysis.

Results. Macroscopically, myocardial loops were found in 12 (20%) hearts out of 60. More often, they were determined on specimens where the cone artery directly originating in the aorta. Histological examination revealed myocardial loops in 10 (25%) hearts out of 40. They were located above the arteries accompanying the coronary sinus. Their length varied from 8.5 to 44.53 mm (Me=16.68 mm), thickness from 0.16 to 0.58 mm (Me=0.31 mm). Two types of myocardial loops (arterial and arteriovenous), differing in thickness (p=0.045), were distinguished.

Conclusion. The myocardial loops are predominantly located on the diaphragmatic surface of the heart in the left half of the coronary groove over the arteries accompanying the coronary sinus, while the artery can pass in the myocardial loop separately from the veins or in the “sleeve” of the coronary sinus; the presence of myocardial loops is associated with the independent aortic origin of the cone artery.

Full Text

Restricted Access

About the authors

E G Dmitrieva

Ural State Medical University; Ural Federal University

Author for correspondence.
Email: anmayak@mail.ru
Russian Federation, Ekaterinburg, Russia; Ekaterinburg, Russia

A A Iakimov

Ural State Medical University; Ural Federal University

Email: anmayak@mail.ru
Russian Federation, Ekaterinburg, Russia; Ekaterinburg, Russia

References

  1. Kolbin A.S., Mosikyan A.A., Tatarsky B.A. Socioeconomic Burden of Atrial Fibrillations in Russia: Seven-Year Trends (2010–2017). Vestnik aritmologii. 2018; (92): 42–48. (In Russ.) doi: 10.25760/VA-2018-92-42-48.
  2. Isakov S.V., Bagdasaryan A.Yu., Gordeev M.L. Operatsiya MAZE IV: MAZE IV procedure: modified technique. Kardiologiya i serdechno-sosudistaya khirurgiya. 2017; 10 (5): 12–15. (In Russ.) doi: 10.17116/kardio201710512-15.
  3. Revishvili A.Sh., Serguladze S.Yu., Shmul' A.V., Labartkava E.Z., Chkholariya G.D., Matsonashvili T.R., Matsonashvili G.R. Anatomical variation of the inferior isthmus of the heart. Annaly aritmologii. 2007; 4 (3): 16–22. (In Russ.)
  4. Gorustovich O.A., Snezhickiy V.A., Okolokulak E.S. Myocardial bridges: ana­tomical, pathophysiological and clinical features. Kardio­logiya v Belarusi. 2016; 8 (1): 108–116. (In Russ.)
  5. Hostiuc S., Rusu M.C., Hostiuc M., Negoi R.I., Negoi I. Cardiovascular consequences of myocardial bri­dging: A meta-analysis and meta-regression. Sci. Rep. 2017; 7: 14644. doi: 10.1038/s41598-017-13958-0.
  6. Bokerija L.A., Bokerija O.L., Mozhina A.A., Tetvadze I.V. Myocardial bridges. Embryology, anatomy, pathophysiology. Bjulleten' NCSSH im. A.N. Bakuleva RAMN. 2010; 11 (6): 62–71. (In Russ.)
  7. Kagan I.I., Tyutyunnikova N.N. Myocardial bridges and loops as an integral part of topography of heart coronary arteries and their branches. Morfologiya. 2017; 152 (4): 27–31. (In Russ)
  8. Jiang L., Zhang M., Zhang H., Shen L., Shao Q., Shen L., He B. A potential protective element of myocardial bridge against severe obstructive atherosclerosis in the whole coronary system. BMC Cardiovasc. Dis. 2018; 18: 105. doi: 10.1186/s12872-018-0847-8.
  9. Watanabe Y., Arakawa T., Kageyama I., Aizawa Y., Kumaki K., Miki A., Terashima T. Gross anatomical study on the human myocardial bridges with special reference to the spatial relationship among coronary arteries, cardiac veins, and autonomic nerves. Clin. Anat. 2016; 29 (3): 333–341. doi: 10.1002/ca.22662.
  10. Ma E.S., Ma G.L., Yu H.W., Wu W., Li K. Assessment of myocardial bridge and mural coronary artery using ECG-gated 256-slice CT angiography: a retrospective study. Sci. World J. 2013; 2013: 947876. doi: 10.1155/2013/947876.
  11. Tiryakioğlu M., Aliyu M.N. Myocardial bridge. Folia Morphol. 2020; 79 (2): 411–414. doi: 10.5603/FM.a2019.0080.
  12. Nishida N., Hata Y. A case of sudden unexpec­ted death with the presence of multiple myocardial bri­dges. Int. J. Clin. Cardiol. 2017; 4: 099. doi: 10.23937/2378-2951/1410099.
  13. Acunã L.E.B., Aristeguieta L.M.R., Tellez S.B. Morphological description and clinical implications of myocardial bridges: An anatomical study in Colombians. Arq. Bras. Cardiol. 2009; 92 (4): 242–248. doi: 10.1590/S0066-782X2009000400002.
  14. Teofilovski-Parapid G., Jankovic R., Kanjuhc V., Virmani R., Danchinf N., Prates N., Simic D.V., Parapid B. Myocardial bridges, neither rare nor isolated — Autopsy study. Ann. Anat. 2017; 210: 25–31. doi: 10.1016/j.aanat.2016.09.007.
  15. Ishizawa A., Zhou M., Suzuki R., Abe H. Arterial system of the atrium in the human heart. Anat. Sci. Int. 2014; 89 (3): 183–190. doi: 10.1007/s12565-013-0221-y.

Supplementary files

Supplementary Files
Action
1. Рис. 1. Петля миокарда (обозначена стрелками), образованная миокардом левого ушка сердца (1) и задней стенки левого предсердия (2), окружает огибающую ветвь левой венечной артерии (3). Большая вена сердца (4) расположена сзади от артерии

Download (20KB)
2. Рис. 2. Участок венечной борозды на уровне формирования венечного синуса. Варианты формирования петель миокарда. А. Артериальный вариант. Б. Артериовенозный вариант. 1 — венечная артерия; 2 — венечный синус; 3 — петля миокарда; 4 — «муфта» венечного синуса; 5 — задняя стенка левого предсердия. Окраска пикрофуксином по Ван-Гизону. Увеличение ×40

Download (48KB)

© 2021 Eco-Vector





This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies