OR2-29
Coronary Computed Tomography Angiography Characteristics in Patients With Hypertrophic Cardiomyopathy With and Without Myocardial Bridging
Presenter
Prabhjot Hundal, MD, Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, WI
Prabhjot Hundal, MD1, Chaitanya Tumuluri, MBBS1, Niloufar Javadi, MD2, Matthew Peters, MD1, Steven Port, MD1, Arshad Jahangir, MD1, M. Fuad Jan, MBBS (Hons), MD, FSCAI1, A Jamil Tajik, MD1 and Patrycja Galazka, MD1, (1)Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, WI, (2)Aurora Health Care, Milwaukee, WI
Keywords: Hypertrophic Cardiomyopathy (HCM)
Background
Myocardial bridging (MB), which occurs where an epicardial coronary artery traverses into the myocardium, is described more often in hypertrophic cardiomyopathy (HCM) patients. Data on the plaque and coronary characteristics of HCM patients with left anterior descending artery (LAD) MB are limited.
Methods
We retrospectively analyzed all adult patients with HCM at our HCM center from January 2014 to January 2025 who had a coronary computed tomography angiogram (CCTA) available. Patients who had had a percutaneous coronary intervention or coronary artery bypass graft before the CCTA were excluded, and the cohort was divided into 2 groups: MB+ (LAD MB on CCTA) and MB- (no LAD MB).
Results
Of 244 patients with HCM, 68 (27.9%) were MB+ (mean age 51±15 years; 37% female sex) and 176 MB- (mean age 58±14 years; 47% female sex). The most common phenotype was basal septal (54% MB+, 65% MB-). Sixty-two MB+ and 140 MB- patients had genetic testing, with MB+ having more pathogenic genes (47% vs 24%, P<0.0001). The mean maximal septal wall thickness was higher in MB+ (23.3 vs 19.6 mm; P<0.0001), but the mean coronary artery calcium score (CACS) was lower (79 vs 487 AU; P<0.001). After CCTA, 39 MB+ patients were diagnosed with coronary artery disease compared with 128 MB- patients (P<0.0001). MB- had more LAD plaque (64% vs 41%; P<0.0001). Table 1 shows individual coronary artery vessel plaque characteristics.
Conclusions
MB+ patients had less LAD plaque burden, lower coronary artery calcium scores, more pathogenic genes, and more hypertrophy of the septum than MB- patients.
