Correlation between myocardial bridge of the left anterior descending coronary artery and parameters of its proximal perivascular adipose tissue

doi:10.3969/j.issn.1004-583X.2026.04.003

Abstract

Abstract:

Objective To investigate the correlation between superficial myocardial bridge (MB) of the left anterior descending artery (LAD) and parameters of its proximal perivascular adipose tissue using coronary CT angiography. Methods A total of 295 patients clinically suspected of coronary atherosclerotic heart disease who underwent coronary CT angiography at the Fifth Division Hospital of Xinjiang Production and Construction Corps between May 2023 and September 2025 were enrolled. No coronary plaques were detected on CT angiography. According to the presence or absence of MB in the LAD, the patients were divided into an MB group (n=134) and a non-MB group (n=161). Sex, age, body mass index, fat attenuation index (FAI), and fat volume (FV) were compared between the two groups. Multiple linear regression was used to determine whether sex, age, body mass index, and left anterior descending-myocardial bridge (LAD-MB) length affected proximal perivascular adipose tissue FAI and FV in the MB group. Results Compared with the non-MB group, the MB group had higher FAI and lower FV (P<0.01). Multiple linear regression analysis showed that LAD-MB length was associated with FAI in the MB group (P<0.05), whereas age, sex, and body mass index were not (P>0.05). Age, sex, body mass index, and LAD-MB length were not associated with FV (P>0.05). Conclusion FAI and FV may serve as potential imaging biomarkers for assessing MB-related vascular inflammation.

Key words: myocardial bridging, left anterior descending, surrounding adipose tissue, coronary CT angiography

CLC Number:

R541.1

Ding Qiufen, Yang Zhenyu, Li Cuiqin, Wang Jian. Correlation between myocardial bridge of the left anterior descending coronary artery and parameters of its proximal perivascular adipose tissue[J]. Clinical Focus, 2026, 41(4): 307-311.

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URL: https://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2026.04.003

https://www.lchc.cn/EN/Y2026/V41/I4/307

Figures/Tables 6

Fig.1 Schematic diagram of CTA measurement of LAD-MB-related parameters and selection of the region of interest in proximal perivascular adipose tissue a. Straightened image showing LAD-MB length; b. Curved image showing LAD and measurement of FAI and FV; c. Axial image showing LAD and measurement of FAI and FV; d. Measurement of FAI and FV on multiple axial planes; e. Measurement of FAI and FV in the vascular segment approximately 40 mm from the starting point of the LAD in the straightened view

Tab.1 Comparison of clinical characteristics between the two groups

组别	例数	男性[例(%)]	年龄(岁)	体质量指数(kg/m²)	FAI(HU)	FV(mm³)
MB组	134	70(52.2)	54.840±10.302	26.920±2.839	-77.226±15.834	938.312±207.100
无MB组	161	78(48.4)	54.950±8.679	27.040±3.601	-83.107±7.332	1 228.513±350.473
χ²/ $t$ 值		0.421	-0.104	-0.315	-4.203	-8.436
$P$ 值		0.517	0.918	0.753	<0.01	<0.01

Tab.1 Comparison of clinical characteristics between the two groups

组别	例数	男性[例(%)]	年龄(岁)	体质量指数(kg/m²)	FAI(HU)	FV(mm³)
MB组	134	70(52.2)	54.840±10.302	26.920±2.839	-77.226±15.834	938.312±207.100
无MB组	161	78(48.4)	54.950±8.679	27.040±3.601	-83.107±7.332	1 228.513±350.473
χ²/ $t$ 值		0.421	-0.104	-0.315	-4.203	-8.436
$P$ 值		0.517	0.918	0.753	<0.01	<0.01

Tab. 2 Multiple linear regression analysis of factors influencing FAI in the MB group

项目	$β$	$B$	95% $C I$	$t$ 值	$P$ 值
常量	-	-87.069	-105.244~-68.894	-9.479	0.000
年龄	0.083	0.064	-0.072~0.200	0.934	0.352
性别	0.028	0.455	-2.425~3.334	0.313	0.755
体质量指数	-0.006	-0.016	-0.536~0.505	-0.060	0.952
LAD-MB长度	0.184	0.201	0.012~0.390	2.105	0.037

Tab. 2 Multiple linear regression analysis of factors influencing FAI in the MB group

项目	$β$	$B$	95% $C I$	$t$ 值	$P$ 值
常量	-	-87.069	-105.244~-68.894	-9.479	0.000
年龄	0.083	0.064	-0.072~0.200	0.934	0.352
性别	0.028	0.455	-2.425~3.334	0.313	0.755
体质量指数	-0.006	-0.016	-0.536~0.505	-0.060	0.952
LAD-MB长度	0.184	0.201	0.012~0.390	2.105	0.037

Fig.2 Standardized residual plot for the dependent variable FAI

Tab.3 Multiple linear regression analysis of factors influencing FV in the MB group

项目	$β$	$B$	95% $C I$	$t$ 值	$P$ 值
常量	-	268.063	-130.277~666.403	1.332	0.185
年龄	0.064	1.291	-1.692~4.274	0.856	0.393
性别	-0.026	-10.753	-73.864~52.358	-0.337	0.737
体质量指数	-0.061	-4.443	-15.851~6.966	-0.771	0.442
LAD-MB长度	-0.101	-2.845	-6.981~1.291	-1.361	0.176

Tab.3 Multiple linear regression analysis of factors influencing FV in the MB group

项目	$β$	$B$	95% $C I$	$t$ 值	$P$ 值
常量	-	268.063	-130.277~666.403	1.332	0.185
年龄	0.064	1.291	-1.692~4.274	0.856	0.393
性别	-0.026	-10.753	-73.864~52.358	-0.337	0.737
体质量指数	-0.061	-4.443	-15.851~6.966	-0.771	0.442
LAD-MB长度	-0.101	-2.845	-6.981~1.291	-1.361	0.176

Fig.3 Standardized residual plot for the dependent variable FV

References 20

[1]	Rissi R, Gonsalves DG, Marques MJ, et al. Congenital morphological patterns of myocardial bridges[J]. Morphologie, 2023, 107(359): 100603. doi: 10.1016/j.morpho.2023.05.002.
[2]	Coerkamp CF, Verpalen VA, Kuipers RS, et al. Perivascular fat attenuation index (FAI) on computed tomography coronary angiography reclassifies individual cardiovascular risk estimation[J]. Int J Cardiol Cardiovasc Risk Prev, 2024, 24: 200360.doi: 10.1016/j.ijcrp.2024.200360.
[3]	Li Y, Yao W, Wang T, et al. Association of semaglutide treatment with coronary artery inflammation in type 2 diabetes mellitus patients: A retrospective study based on pericoronary adipose tissue attenuation[J]. Cardiovasc Diabetol, 2024, 23(1): 348.doi:10.1186/s12933-024-02445-2.
[4]	Zhao DH, Fan Q, Ning JX, et al. Myocardial bridge-related coronary heart disease: Independent influencing factors and their predicting value[J]. World J Clin Cases, 2019, 7(15): 1986-1995.doi:10.12998/wjcc.v7.i15.1986.
[5]	Roberts W, Charles SM, Ang C, et al. Myocardial bridges: A meta-analysis[J]. Clin Anat, 2021, 34(5): 685-709.doi:10.1002/ca.23697. pmid: 33078444
[6]	Çetin N, Özlek B, Özdemir İH, et al. Comparison of Framingham risk score and atherogenic indices as a predictor of atherosclerosis in patients with myocardial bridge in left anterior descending artery[J]. Acta Cardiol, 2022, 77(4): 342-349. doi:10.1080/00015385.2021.1945763.
[7]	Murtaza G, Mukherjee D, Gharacholou SM, et al. An updated review on myocardial bridging[J]. Cardiovasc Revasc Med, 2020, 21(9): 1169-1179.doi:10.1016/j.carrev.2020.02.014.
[8]	Wu S, Wu D, Li X. Unveiling the masquerading of myocardial bridging in cardiovascular diseases[J]. Rev Cardiovasc Med, 2025, 26(7): 36868.doi:10.31083/rcm36868.
[9]	McLaughlin T, Schnittger I, Nagy A, et al. Relationship between coronary atheroma, epicardial adipose tissue inflammation, and adipocyte differentiation across the human myocardial bridge[J]. J Am Heart Assoc, 2021, 10(22): e021003.doi:10.1161/jaha.121.021003.
[10]	Hillock-Watling C, Gotlieb AI. The pathobiology of perivascular adipose tissue (PVAT), the fourth layer of the blood vessel wall[J]. Cardiovasc Pathol, 2022, 61: 107459.doi:10.1016/j.carpath.2022.107459.
[11]	Simantiris S, Pappa A, Papastamos C, et al. Perivascular fat: A novel risk factor for coronary artery disease[J]. Diagnostics (Basel), 2024, 14(16):1830. doi: 10.3390/diagnostics14161830.
[12]	Cheng S, Ni J, Deng W, et al. Diagnostic ability of perivascular fat attenuation index in predicting atherosclerotic plaque formation proximal to myocardial bridging of the left anterior descending artery within 3 years[J]. Acad Radiol, 2023, 30(10): 2234-2242.doi:10.1016/j.acra.2023.06.019.
[13]	Zhang D, Tian X, Li MY, et al. Quantitative analysis of the relationship between the myocardial bridge and the FAI of pericoronal fat on computed tomography[J]. Sci Rep, 2024, 14(1): 5976.doi:10.1038/s41598-024-55005-9.
[14]	Napoli G, Pergola V, Basile P, et al. Epicardial and pericoronary adipose tissue, coronary inflammation, and acute coronary syndromes[J]. J Clin Med, 2023, 12(23):7212.doi:10.3390/jcm12237212.
[15]	Tan N, Marwick TH, Dey D, et al. Association of pericoronary adipose attenuation with major adverse cardiovascular events and high-risk plaque[J]. JACC Cardiovasc Imaging, 2025, 18(8): 884-894.doi:10.1016/j.jcmg.2025.04.008.
[16]	Kotanidis CP, Antoniades C. Perivascular fat imaging by computed tomography (CT): A virtual guide[J]. Br J Pharmacol, 2021, 178(21): 4270-4290.doi:10.1111/bph.15634.
[17]	Ding H, Yang Q, Shang K, et al. Estimation of shear stress by using a myocardial bridge-mural coronary artery simulating device[J]. Cardiol J, 2017, 24(5): 530-538.doi:10.5603/CJ.a2016.0084. pmid: 27714723
[18]	Feng D, Shang R, Hu L, et al. Predictive value of the perivascular fat attenuation index and delta-CT-FFR for the formation of atherosclerotic plaques proximal to left anterior descending myocardial bridges[J]. Quant Imaging Med Surg, 2025, 15(11): 11128-11139.doi:10.21037/qims-2024-2752.
[19]	Javadzadegan A, Moshfegh A, Mohammadi M, et al. Haemodynamic impacts of myocardial bridge length: A congenital heart disease[J]. Comput Methods Programs Biomed, 2019, 175: 25-33.doi:10.1016/j.cmpb.2019.03.017.
[20]	Yu G, Ming Z, Qiao D, et al. Morphological analysis of myocardial bridging leading to myocardial ischemia: Myocardial coronary coupling[J]. Front Bioeng Biotechnol, 2025, 13: 1559963.doi:10.3389/fbioe.2025.1559963.