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Myocardial bridging does not predict sudden death in children with hypertrophic cardiomyopathy but is associated with more severe cardiac disease

Saidi A. Mohiddin, MB, ChB, MRCP^*, David Begley, MB, ChB, MRCP^*, Joanna Shih, PhD and Lameh Fananapazir, MD, FRCP^*

^* Section of Electrophysiology and Inherited Heart Diseases, Cardiology Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA

View larger version (95K): [in a new window]   Figure 1 Figure illustrating coronary angiograms in three children with hypertrophic cardiomyopathy. Diastolic frames are on the left and systolic frames on the right. Panel A = 6-year-old male with mid-left anterior descending artery (LAD) bridging and compression of its intramyocardial branches. Panel B = 13-year-old female with bridging of proximal posterior descending branch of the right coronary artery with complete compression of its septal branches. Panel C = Complete compression of septal branches of the LAD. This child had bridging of an obtuse marginal branch. Large arrows indicate sites of bridging of epicardial arteries and small arrows indicate compression of septal branches.

View larger version (21K): [in a new window]   Figure 2 Figure showing interventricular septal wall thickness (panel A), ratio of septum:posterior wall thickness (panel B), and left ventricle outflow gradient at cardiac catheterization (panel C) in children with and without bridging of epicardial coronary arteries or compression of septal branches, and in children with and without myocardial perfusion abnormalities. Thallium (–ve), normal myocardial perfusion; thallium (+ve), abnormal myocardial perfusion.

View larger version (17K): [in a new window]   Figure 3 Figure showing survival rates in children with and without bridging. Cardiac death was defined as death or cardiac arrest. The number of children at different age intervals is indicated at the bottom of each panel.