The Stable Ischemic Heart Disease (SIHD) GUIDELINES Pocket Card is endorsed by the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA). It is based on their latest guidelines. This practical quick-reference tool contains screening, risk assessment and diagnostic recommendations; multiple diagnostic and treatment tables and algorithms, drug and interventional therapy, patient education and follow-up recommendations. The Stable Ischemic Heart Disease GUIDELINES Pocket Cards provides all that is needed to make accurate clinical decisions at the point of care.. Whats Inside:. ...
Document is the second of the updated two-part criteria for coronary revascularization WASHINGTON (March 10, 2017) - The American College of Cardiology, along with several partnering organizations, today released updated appropriate use criteria for performing coronary revascularization in patients with stable ischemic heart disease.
The debate over the optimal management in stable ischemic heart disease has grown over the past decade with more evidence supporting a conservative medical therapy approach over an upfront invasive strategy with coronary revascularization. However, there remains significant practice variation in deciding when to pursue coronary revascularization.
Healio asked experts for their key takeaways from the ISCHEMIA and ISCHEMIA-CKD trials of invasive vs. conservative strategies in patients with stable ischemic heart disease.
To investigate the effects of age and disease on endogenous cardiac progenitor cells, we obtained right atrial and left ventricular epicardial biopsies from patients (n = 22) with chronic ischaemic heart disease and measured doubling time and surface marker expression in explant- and cardiosphere-derived cells (EDCs, CDCs). EDCs could be expanded from all atrial biopsy samples, but sufficient cells for cardiosphere culture were obtained from only 8 of 22 ventricular biopsies. EDCs from both atrium and ventricle contained a higher proportion of c-kit+ cells than CDCs, which contained few such cells. There was wide variation in expression of CD90 (atrial CDCs 5-92 % CD90+; ventricular CDCs 11-89 % CD90+), with atrial CDCs cultured from diabetic patients (n = 4) containing 1.6-fold more CD90+ cells than those from non-diabetic patients (n = 18). No effect of age or other co-morbidities was detected. Thus, CDCs from atrial biopsies may vary in their therapeutic potential.
This overview provides a guideline for the management of stable ischemic heart disease. It represents the work of a primary and secondary panel of participants from across Canada who achieved consensus on behalf of the Canadian Cardiovascular Society. The suggestions and recommendations are intended …
Background: The use of motivational interviewing (MI) for changing unhealthy behaviour of ischemic heart disease patients forces us to find methods for its effectiveness evaluation. One of the solutions could be the transtheoretical model (TTM). It is a stage-based theory of behaviour changes. Movement through the stages is hypothesized to be caused by the processes of change, decisional balance and temptation. The objective of this study is to find out how TTM can show health behaviour changes for ischemic heart disease patients. Methods: One to three MI sessions has been successfully applied for 12 cardiac patients during their rehabilitation treatment period. TTMs Readiness to Change Questionnaire was used to evaluate behaviour changes at the beginning and at the end of MI treatment. Findings: There were 7 patients at precontemplation, 5 at contemplation and none at action stages at the begining of MI sessions. Results showed that 5 patients stayed at contemplation stage but 4 patients moved ...
Treatment selection for stable ischemic heart disease patients remains a work in progress. The stable ischemic heart disease guidelines published in 2012 (1) address 2 pathways to progress from medical therapy only toward revascularization: unsatisfactorily controlled symptoms or high-risk features on the basis of noninvasive testing. For patients without compelling symptoms, the risk stratification by noninvasive ischemia testing provides the gateway to move beyond medical therapy only. The ongoing ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) trial (2) is using this measure in an attempt to identify a relatively high-risk group in whom revascularization may be beneficial. Much of the rationale for the trial springs from the failure of the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) trial (3) or the BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial (4) to show a ...
Our analysis of long-term exposure to the mass and constituents of PM2.5 and UF particles revealed several statistically significant associations with all-cause, cardiovascular, and IHD mortality. For PM2.5, high-sulfur content fuel combustion was associated with all three end points, and nitrates were associated with cardiovascular and IHD mortality. Several other constituents reached statistical significance with IHD mortality including PM2.5 mass, Cu, EC, and the SOAs, as well as the sources including gas- and diesel-fueled vehicles, meat cooking, and high-sulfur fuel combustion. Among the PM2.5 constituents, based on their associated IQRs, nitrate had the highest HR and provided the best fit of the data. For UFs, constituents such as SOA_ant, EC, and other metals exhibited statistically significant associations with IHD mortality, as did all of the mobile sources and high-sulfur fuel combustion. For both PM2.5 and UF particles, several constituents generated higher HRs based on their ...
The results of Bostick et al suggest that among postmenopausal women, the risk of dying of IHD may be reduced by consuming relatively high concentrations of calcium. This association seems plausible given the findings of previous research showing that higher consumption of calcium lowers blood cholesterol concentrations,1 may reduce blood pressure,2 and may prevent hypertension.. The strengths of this study are that it was prospective and included a large, well defined cohort derived from a general population. In addition, the validity of the nutritional questionnaire is impressive and well supported by published data. The limitations of the study are the many confounders related to the evaluation of the effects of vitamins and minerals on health or disease states. Data on possible confounders, such as sunlight exposure as a source of vitamin D, were not provided.. The findings suggest that there is no increase in IHD mortality as a result of increased calcium intake, provided the calcium does ...
TY - JOUR. T1 - Global myocardial ischemia in the newborn, juvenile, and adult isolated isovolumic rabbit heart. Age-related differences in systolic function, diastolic stiffness, coronary resistance, myocardial oxygen consumption, and extracellular pH. AU - Parrish, M. D.. AU - Payne, A.. AU - Fixler, David E. PY - 1987/1/1. Y1 - 1987/1/1. N2 - Controversy persists over the relative tolerance of the immature myocardium to global ischemia. Thus, we evaluated the physiologic effects of 30, 60, and 180 minutes of global ischemia in an isolated, isovolumic rabbit heart model, at 3 different ages: newborns (less than 1 week of age) (n = 36), juveniles (4 to 6 weeks old) (n = 36), and adults (5 to 7 months old) (n = 36). Following 30 and 60 minutes of ischemia, respectively, adults recovered 87 ± 4% (mean ± SEM) and 90 ± 7% of baseline systolic function, and juveniles recovered 91 ± 10% and 85 ± 8%. In contrast, newborns recovered only 27 ± 6% and 28 ± 4% of baseline systolic function (p , ...
Cardiac anatomy was defined by gated nuclear magnetic resonance (NMR) imaging at a magnetic field strength of 3.5 kGauss in eight normal subjects and 10 patients with chronic myocardial infarctions. Multisectional imaging was performed with the spin-echo technique and encompassed most of the left ventricle in an imaging time of 5 to 12 min. In all subjects internal cardiac structure was well delineated without the use of any type of contrast medium. The myocardial wall-blood interface was sharply defined, resulting in visualization of trabeculations, papillary muscle, and chordal structures in both ventricles. In patients with ischemic heart disease, the extent of postinfarctional wall thinning, aneurysms, and mural thrombi were depicted on NMR images. Images obtained with the second spin-echo (delay time = 56 msec) demonstrated high signal intensity in regions of the left ventricular chamber adjacent to the site of aneurysms or infarctions; this finding suggested stasis of blood in a region of ...
Coronary computed tomography angiography (CCTA) has recently emerged as a noninvasive method to image the coronary arteries. CCTA has a negative predictive value of nearly 100% for the detection of coronary artery disease (demonstrated in the trial known as ROMICAT). This approach has been investigated recently as a means of helping sort out which patients presenting to an emergency department with chest pain are safe to treat and then discharge as opposed to treat urgently and then admit. It is a huge challenge.. In a nonurgent setting, the guidelines state CCTA may be reasonable for patients with an intermediate pretest probability of SIHD who have at least moderate physical functioning or no disabling comorbidity. CCTA is reasonable for these same patients with an intermediate pretest probability of SIHD who a) have continued symptoms with prior normal test findings, or b) have inconclusive results from prior exercise or pharmacological stress testing, or c) are unable to undergo stress with ...
Assessment of improvement in LV function after cell therapy may be a more difficult task than simply assessing a change in overall LVEF. This may be particularly true in the setting of acute myocardial infarction where hyperdynamic contraction of remote regions may elevate LVEF. Quantified measures of LV segmental myocardial strain may allow for better recognition of these early and subtle improvements in myocardial function in the peri-infarct region following cell therapy. For example, early after reperfusion for acute myocardial infarction, there was no significant difference in the improvement in LVEF comparing patients treated with cells and controls (9). However, strain of infarcted segments improved significantly more in the cell-treated group. In another pilot study, 12 patients who received intramyocardial autologous cells during coronary artery bypass surgery were evaluated with echocardiography before and 1 year after injection (44). On average, longitudinal strain increased 40% in ...
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Primary physicians need to know more about the prognostic and therapeutic implications of silent (asymptomatic, painless) myocardial ischemia. There is growing concern that certain asymptomatic patients with coronary artery disease, who repeatedly have silent ischemia, may be at increased risk for a serious cardiac event. This concern is based on the large number of patients with coronary artery disease whose first clinical manifestation of that disease is sudden death or a myocardial infarction.. What is silent myocardial ischemia? Usually, we equate angina with myocardial ischemia, but the former is merely the subjective manifestation of the latter, and chest pain or ...
Question - What does Reversible Myocardial Ischaemia mean ?. Ask a Doctor about diagnosis, treatment and medication for Hypothyroidism, Ask a Cardiologist
We have previously shown that intracoronary delivery of recombinant adenoviruses encoding angiogenic proteins that contain signal peptides (fibroblast growth factor-4 and fibroblast growth factor-5) ameliorate myocardial ischemia. In the present paper, we test the hypothesis that the presence of the signal peptide is an important element in the favorable effects that transgene expression has on regional flow and function in an animal model of myocardial ischemia. We performed intracoronary delivery of two different recombinant adenoviruses encoding a fibroblast growth factor-2 variant, one with a signal peptide, FGF-2LI(+sp), and one without a signal peptide, FGF-2LI(-sp). In a model of stress-induced myocardial ischemia, intracoronary injection of these recombinants resulted in mRNA and protein expression of the transferred gene. Two weeks after gene transfer, regional abnormalities in stress-induced function and blood flow were improved after delivery of FGF-2LI containing the signal peptide. ...
Define Ischaemic heart disease. Ischaemic heart disease synonyms, Ischaemic heart disease pronunciation, Ischaemic heart disease translation, English dictionary definition of Ischaemic heart disease. n. Atherosclerosis of the coronary arteries, often leading to angina pectoris or heart attack, and associated with risk factors such as hypertension,...
In patients with an intermediate likelihood for the presence of coronary artery disease (CAD), most of todays guidelines require proof of myocardial ischemia before invasive angiography. Similarly, significant myocardial ischemia should be demonstrated before revascularization. The most recent European Society of Cardiology guidelines for patients with stable coronary artery disease leave the choice of the test to the practitioner on the basis of local expertise (1). The recently published multimodality appropriateness criteria for detection and risk assessment in stable ischemic heart disease have rated various imaging modalities on the basis of existing evidence, assuming they are equally available with appropriate quality and expertise, while suggesting to keep cost-effectiveness and value in mind when ordering such tests (2).. Direct comparisons between different imaging modalities are rare, as patients have to undergo both imaging modalities as well as an invasive reference standard to ...
Stress-induced myocardial ischemia is a common manifestation of heart ailment, and sympathetic activation is a vital precipitating and irritating think about such pressure- brought about ischemia. although, the advanced interaction among the sympathetic initiation of myocardial ischemia, ischemia-induced adjustments in sympathetic neurotransmission, in addition to alterations in adrenoceptor density and post-receptor sign transduction that can ensue in the course of ischemia continues to be incompletely understood. not just the activation of myocardial fJ- adrenoceptors, but additionally the activation of coronary IX-adrenoceptors can give a contribution to myocar- dial ischemia. despite the fact that, the function of fJ-adrenoceptor-mediated raises in contractility relative to middle cost within the initiation of ischemia isnt really transparent, and the importance of IX-adrenoceptor- mediated adjustments in coronary vasomotor tone, in addition to the in charge IX-adrenoceptor subtypes are ...
Ischaemic heart disease is the number one cause of death in the United States, and it is one of the leading reasons for admittance to hospitals. Also known as myocardial ischaemia, it is the condition of restricted blood flow to the heart. This is typically the result of other heart disease, including atherosclerosis.. CAUSES OF ISCHAEMIC HEART DISEASE. Ischaemic refers to a restriction in blood supply to any organ, and the cause of ischaemic heart disease is restricted blood flow to the heart. This is typically caused by atherosclerosis, or hardening of the arteries, in which plaque (cholesterol) attaches to the walls of the arteries and impedes blood flow. When the heart does not get enough blood, parts of it can die or become dysfunctional. When blood cannot flow to the heart, fresh oxygen cannot be supplied.. SIGNS AND SYMPTOMS OF ISCHAEMIC HEART DISEASE. Ischaemic heart disease is frequently known as the silent killer, as it affects fourteen million Americans every year, and three to ...
The major U.S. PM2.5 sources identified, their key tracer elements, and their mean nationwide PM2.5 impacts were: Soil (Ca, Si) 0.8 ug/m3; Metals (Pb, Zn) 0.2 ug/m3; Traffic (OC, EC, NO2) 4.6 ug/m3 ; Steel (Fe, Mn) , 0.1 ug/m3; Coal Combustion (As, Se) 1.1 ug/m3; Oil Combustion (V, Ni) 0.9 ug/m3; Salt (Na, Cl) 0.1 ug/m3; Biomass burning 1.3 ug/m3; Other Sulfates (S) 4.3 ug/m3; Other Nitrates (NO3 -) 0.6 ug/m3; and, Other Organic Carbon (OC) 0.5 ug/m3. While most industrial and fossil fuel combustion categories had relative risk (RR) estimates above 1.0 for IHD deaths, coal combustion and traffic emission-related particles were among the largest and strongest PM2.5-mortality associations.. ...
The Caerphilly Prospective Ischaemic Heart Disease (IHD) Study is based on a sample of 2512 men aged 45-59 years when first seen. Nutrient intakes, estimated using a self-administered semi-quantitative food frequency questionnaire, are available for 2423 men (96 %). Amongst these, 148 major IHD events occurred during the first 5 years of follow-up. Associations were examined between these events and baseline diet. Incident IHD (new events) was negatively associated with total energy intake: men who went on to experience an IHD event had consumed 560 kJ (134 kcal)/d (6%) less at baseline than men who experienced no event (P = 0.01). The relative odds of an IHD event was 1.5 among men in the lowest fifth of energy intake, compared with 1.3,1.2,0.9 and 1.0 respectively for the other four fifths (P , 0.05). The difference in energy intake was reflected in lower intakes of every nutrient examined. When expressed as a percentage of total energy, mean intakes of men who experienced an IHD event were ...
The purpose of the ISCHEMIA trial is to determine the best management strategy for higher-risk patients with stable ischemic heart disease. This is a multicenter randomized controlled trial with a target enrollment of ~5000 patients with at least moderate ischemia on stress imaging. Patients will be assigned at random to a routine invasive strategy (INV) with cardiac catheterization (cath) followed by revascularization plus optimal medical therapy (OMT) or to a conservative strategy (CON) of OMT, with cath and revascularization reserved for those who fail OMT.. SPECIFIC AIMS. A. Primary Aim The primary aim of the ISCHEMIA trial is to determine whether an initial invasive strategy of cardiac catheterization followed by optimal revascularization, if feasible, in addition to OMT, will reduce the primary composite endpoint of cardiovascular death or nonfatal myocardial infarction in participants with SIHD and at least moderate ischemia over an average follow-up of approximately 4 years compared with ...
BACKGROUND:. Evidence supporting a routine invasive practice paradigm for patients with SIHD is outdated. In strategy trials conducted in the 1970s, coronary artery bypass grafting (CABG) improved survival as compared with no CABG in SIHD patients with high-risk anatomic features. The relevance of these studies today is speculative because contemporary secondary prevention-aspirin, beta-blockers, statins, ACE inhibitors, and lifestyle interventions-were used minimally if at all. Subsequent trials have compared percutaneous coronary intervention (PCI) with medical therapy, as PCI has replaced CABG as the dominant method of revascularization for SIHD. To date, PCI has not been shown to reduce death or myocardial infarction (MI) compared with medical therapy in SIHD patients.. COURAGE and BARI 2D, the two largest trials comparing coronary revascularization vs. medical therapy in SIHD patients, found that among patients selected on the basis of coronary anatomy after cardiac catheterization, an ...
Heart failure resulting from ischaemic heart disease is associated with a poor prognosis despite optimal medical treatment. Despite this, patients with ischaemic cardiomyopathy have been largely excluded from randomised trials of revascularisation in stable coronary artery disease. Revascularisation has multiple potential mechanisms of benefit, including the reversal of myocardial hibernation, suppression of ventricular arrhythmias and prevention of spontaneous myocardial infarction. Coronary artery bypass grafting is considered the first-line mode of revascularisation in these patients; however, evidence from the Surgical Treatment of Ischaemic Heart Failure (STICH) trial showed a reduction in mortality, though this only became apparent with extended follow-up due to an excess of early adverse events in the surgical arm. There is currently no randomised controlled trial evidence for percutaneous coronary intervention in patients with ischaemic cardiomyopathy; however, the REVIVED-BCIS2 trial ...
Our study sheds light on why patients with mental stress ischemia were more likely to experience AECG ischemia during daily life activities. The heightened resting hemodynamics and more exaggerated peak hemodynamic response to mental stress in patients who experience daily life ischemia suggest that they may be in a chronic state of increased sympathetic arousal, and more prone to an exaggerated sympathetic systemic response to mental or exercise stress as well. The HR at rest and in response to stress was lower in our patients with daily life ischemia compared with the patients without daily life ischemia, which may represent a reflex response to the chronically increased EF and SV. We found no correlation between the level of serum epinephrine or norepinephrine at rest or at peak stress and the presence or absence of daily life ischemia, but these may not be an adequate gauge of either a chronic or an acute state of arousal or associated vascular effects.. The strong association between the ...
Market Research Future published a study report on Myocardial Ischemia Market. This report studies the global market size, industry status and forecast,
Analysis of rotational myocardial motion has been reported to be a sensitive index of myocardial ischemia. In this study, circumferential and radial myocardial strain and displacement was monitored during angioplasty balloon-induced myocardial ischemia in 8 patients undergoing percutaneous coronary intervention. The circumferential and radial variables were measured simultaneously in parasternal short-axis view at the papillary muscle level using the recently introduced speckle tracking echocardiography technique that allows 2-dimensional, angle-independent, real-time evaluation of the myocardial motion (2-dimensional strain modality). Acute regional myocardial ischemia caused a significant reduction of circumferential (-35.6 +/- 23.1%) and radial (-27.1 +/- 23.2%) strain and displacement (-49.6 +/- 27.2% and -43.2 +/- 26.8%, respectively). Simultaneously, time to the respective peak systolic values became significantly prolonged, the circumferential ischemic response in temporal domain being ...
The guidelines described here specifically address the clinical syndrome of stable ischaemic heart disease (SIHD), which is defined by the presence of confirmed obstructive coronary artery disease without recent (,1 year) acute coronary syndrome or percutaneous intervention. [2] Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease. J Am Coll Cardiol. 2014;64:1929-1949. http://content.onlinejacc.org/article.aspx?articleid=1891717 http://www.ncbi.nlm.nih.gov/pubmed/25077860?tool=bestpractice.com This clinical syndrome includes patients with stable angina pain syndromes and patients with low-risk unstable angina. Angina is considered unstable if it occurs at rest, is new in onset, and is severe (occurs with walking 1 flight of stairs, or similar low level of exertion), or if it is increasing in severity or frequency requiring markedly less provocation in patients ...
TY - JOUR. T1 - Prevalence of silent myocardial ischaemia during exercise stress testing. Its relation to effort tolerance and myocardial perfusion abnormalities. AU - Fragasso, G.. AU - Sciammarella, M. G.. AU - Rossetti, E. E.. AU - Xuereb, R. G.. AU - Xuereb, M.. AU - Bonetti, F.. AU - Carandente, O. M.. AU - Margonato, A.. AU - Chierchia, S. L.. PY - 1992. Y1 - 1992. N2 - The number of underperfused myocardial segments, the extent of coronary artery disease and the severity of impairment of coronary flow reserve were compared in 147 consecutive patients exhibiting painful or painless ischaemic ST segment depression on exercise testing. Of 147 patients, only 61 (41%) experienced angina (group 1) whilst 86 (59%) did not (group 2). In the two groups coronary disease was comparable for both extent and distribution, and neither the location of transient perfusion defects nor their relation to areas of old myocardial necrosis appeared to influence the presence or absence of chest pain. However, ...
Introduction The cardiac localization of hydatid cyst (HC) is rare and little known. It is exceptionally primary and isolated. Myocardial ischemia remains an exceptional and unusual manifestation of this localization. We report the original observation of cardiac HC revealed by acute myocardial ischemia in a young subject. Observation A 35-year-old patient with no notable pathological history was admitted to our department via the emergency room for acute anterior chest pain. The somatic examination was without abnormalities as well as the baseline biological tests. The electrocardiogram demonstrated epicardial ischemia in the infero-lateral territory without other abnormalities. The cardiac troponin I was slightly elevated (32ng/l, N|19ng/l). Subsequent controls after 30min, 60min and 180min did not show significant variations. Subsequent investigations (CT, coro-CT, coronary angiography) led to the diagnosis of intramyocardial HC of the left ventricle, with no abnormalities of the coronary arteries.
We have evaluated an intracardiac technique for the study of the electrophysiological patterns of early or subendocardial ischaemia in man. Simultaneous recordings of the paced endocardial evoked response and monophasic action potentials were obtained during pacing stress testing in 10 patients with reversible myocardial ischaemia. Early patterns of change occurred in both these recordings in response to regional ischaemia. Abnormal rate corrected shortening of the local repolarisation time in the paced endocardial evoked response from the left ventricular ischaemic zone diverging from control non-ischaemic values by a mean of 10.6% was paralleled by decreases in the simultaneous paced monophasic action potentials duration. A differential delay in the local activation time and conduction was also documented by the paced endocardial evoked response and monophasic action potential electrodes. Non-ischaemic control zones showed no changes in the pattern of activation and repolarisation. Disparate ...
During the more than 15 years since the conduct of the COURAGE trial, the evaluation and management of coronary disease continued to evolve, and our assessment of the risk of transitioning from stable to unstable ischemic disease shifted from the importance of what has been termed hemodynamically significant stenoses, even as defined using fractional flow reserve (12), to total atherosclerotic burden, which can be assessed noninvasively with coronary calcium scoring (13, 14). At the same time, invasive and medical therapies for stable disease significantly improved with the use of drug-eluting stents, better antithrombotic regimens, and more aggressive lipid-lowering therapies and goals.. Thus, the stage was set then for the ISCHEMIA trial, addressing the same questions in the current era (2). Dr. Hochman and her collaborators studied, in stable patients with moderate or severe ischemia on a stress test, whether there was a benefit of performing coronary angiography and, if feasible, ...
TY - JOUR. T1 - Current perspectives therapeutic approach in patients with stable angina. AU - Lettino, Maddalena. AU - Falcone, Colomba. AU - Tavazzi, Luigi. PY - 2005/1. Y1 - 2005/1. N2 - Which therapeutic strategy among medical, interventional and surgical options should be preferred in patients with chronic stable ischemic heart disease is an important public health problem. The available scientific evidence does not help much to facilitate the choice among the three available strategies of medical treatment, percutaneous coronary intervention and coronary artery bypass grafting. In this area practice-based medicine overwhelms evidence-based medicine. However, existing findings are discussed. The present experience in diabetic patients is highlighted; in such patients surgery is generally recommended but the results obtained by percutaneous coronary intervention with the currently available tools are improving markedly. Pharmacological therapy is also improving, particularly in the ...
Introduction: Stem cell therapy is a new strategy for chronic ischemic heart disease in patients, however, no consensus exists on the most optimal delivery strategy.. Hypothesis: This randomized study was designed to assess cell delivery efficiency of intracoronary (IC), transendocardial (TE) and surgical delivery in a chronic pig model of ischemia-reperfusion injury.. Methods: Twenty-one animals underwent delivery of 107 autologous Indium-oxine labeled bone marrow-derived mesenchymal stem cells (MSC) 4 weeks after infarction and were randomized to 1 of 3 groups (n=7 each group): IC, TE using electromechanical mapping guidance (NOGA) or surgical delivery. Primary endpoint was defined as percentage (%) of injected dose per organ and assessed by in vivo gamma-emission counting.. Results: No significant difference in hemodynamics was observed. Troponin and intracoronary flow (Thrombolysis in Myocardial Infarction score) did not differ between the percutaneous groups. Blinded endpoint analysis ...
The clinical trial was stopped early because of clear differences in the rates of hospitalization (4 percent for stents against 13 percent for medical therapy). FAME 2 showed that the strategy of treating stable ischemic heart disease with FFR-guided coronary stenting reduces the combination of death, MI and urgent revascularization as compared with strategy of medical therapy alone, Mavromatis says. This benefit was specifically due to the reduced need of urgent revascularization due to acute coronary syndrome, a dramatic event for our patients.. Some cardiologists have criticized the FAME 2 study, noting that the benefits of stenting didnt come in terms of reducing hard events (deaths and heart attacks).. It is important to recognize that less symptoms of angina and less chance of hospitalization are tremendous benefits that our patients really appreciate, Mavromatis says. I think FFR will play a bigger role in evaluating and treating coronary artery disease, as it can direct ...
F. Appreciate the competing modalities for detection of chronic ischemic heart disease including myocardial perfusion scintigraphy, stress echo, stress MRI, cardiac CT, exercise ECG and PET. Be able to enlist advantages and disadvantages of each ...
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The word is finally in from the massive multicenter, international ISCHEMIA trial: For patients with severe but stable ischemic heart disease, invasive treatment with PCI or bypass surgery offers no benefit above optimal medical therapy alone ...
TUESDAY, March 31, 2020 (HealthDay News) -- Folks with clogged arteries do as well with medication and lifestyle changes as they do after undergoing invasive procedures to reopen their blood vessels, a major new clinical trial reports.. Bypass surgery, balloon angioplasty and stenting are no better than drugs, eating right and exercising at reducing the risk of heart attack and death in people with stable ischemic heart disease, a condition where theres been no heart attack but the heart is under strain from clogged arteries, trial results show.. No matter how you look at it, theres no statistically significant difference overall, said study chair Dr. Judith Hochman, senior associate dean for clinical sciences at the NYU Grossman School of Medicine.. These results indicate that tens of thousands of elective procedures to reopen clogged arteries are performed on people whose health wont benefit from it, Hochman noted.. The best that can happen is people suffering daily or weekly chest pain ...
Invasive procedures such as bypass surgery and stenting-commonly used to treat blocked arteries-are no better at reducing the risk for heart attack and death in patients with stable ischemic heart disease than medication and lifestyle changes alone
Rates of PCI declined by a relative 10.5% from 2010 to 2017 (232.8 vs 260.2 per 100,000, PJAMA Cardiology.. The sole driver of that decline was a 34.4% drop in elective PCI (from 165.3 to 123.6 per 100,000), which largely occurred in the early part of the study period from 2010 to 2013.. That early shift likely reflected ongoing impact of the 2007 publication of the COURAGE trial, which emphasized the role of medical therapy in managing stable ischemic heart disease by showing that PCI had no outcome advantage.. Since 2013, those rates have stabilized, potentially owing to waning influence of the trial on clinical practice as well as an increasing population rate of patients with MI undergoing PCI, Yehs group noted.. Urgent PCI rates rose by a relative 15.0% over the entire study period (P. These patterns mirror what the data and guidelines tell us to do, so that is good to see, commented Deepak Bhatt, MD, MPH, of Brigham and Womens Hospital Heart & Vascular Center and Harvard Medical ...
An animal model of stress-induced regional myocardial ischemia was used to test the hypothesis that intracoronary delivery of an adenovirus encoding fibroblast growth factor Type 5 (FGF5) would result in improved blood flow, function and neovascularization in the ischemic region of the heart. These data indicated that this approach could be used safely and effectively in resolving regional myocardial ischemia in the ameroid model. Additional unpublished studies confirmed that a similar effect was achievable through use of other angiogenic transgenes, including FGF Type 4 (FGF4). The published studies using direct intracoronary delivery of adenovirus vectors to the heart is reviewed, with a focus on safety and efficacy. A multicenter Phase 1/Phase 2 clinical trial of intracoronary delivery of FGF4 in patients with angina pectoris was initiated under joint sponsorship of Collateral Therapeutics, Incorporated, Berlex Biosciences and Schering AG. Results of this trial are reviewed. The results of this
TY - JOUR. T1 - ICF Core Sets for chronic ischaemic heart disease. AU - Cieza, Alarcos. AU - Stucki, Armin. AU - Geyh, Szilvia. AU - Berteanu, Mihai. AU - Quittan, Michael. AU - Simon, Attila. AU - Kostanjsek, Nenad. AU - Stucki, Gerold. AU - Walsh, Nic. N1 - Copyright: Copyright 2019 Elsevier B.V., All rights reserved.. PY - 2004/7. Y1 - 2004/7. N2 - Objective: To report on the results of the consensus process integrating evidence from preliminary studies to develop the first version of a Comprehensive ICF Core Set, and a Brief ICF Core Set for chronic ischaemic heart disease. Methods: A formal decision-making and consensus process integrating evidence gathered from preliminary studies was followed. Preliminary studies included a Delphi exercise, a systematic review and an empirical data collection. After training in the ICF and based on these preliminary studies relevant ICF categories were identified in a formal consensus process by international experts from different backgrounds. Results: ...
Silent myocardial ischemia is a marker in patients with coronary artery disease identifying those at high risk for subsequent cardiac events. During provoked myocardial ischemia some patients with angina pectoris do not develop chest pain. Are there clinical, angiographic or electrocardiographic differences between patients with chest pain as compared with patients without chest pain during provoked myocardial ischemia? Coronary angioplasty is a well-established method for the treatment of coronary stenosis, but it is also an interesting model for the study of myocardial ischemia as a result of coronary occlusion. We monitored 114 patients with angina pectoris during coronary angioplasty with dynamic, computerized vectorcardiography. During inflation of the balloon 33 of 114 patients had silent ischemia. Patients with silent myocardial ischemia had similar reasons for terminating the preangioplasty exercise test and where on similar anti-ischemic drug regimes. Silent myocardial ischemia was
Aaron Nethercott, Mercer University College of Pharmacy Ischemic heart disease (IHD) accounted for almost 380,000 deaths in 2010. According to the 2012 American College of Cardiology Foundation/American Heart Association/American College of Cardiology/American Association for Thoracic Surgery/Preventive Cardiovascular Nurses Association/Society of Thoracic Surgeons guidelines for the diagnosis and management of patents with stable ischemic heart disease,…
BACKGROUND: Although anesthetics have some cardioprotective properties, these benefits are often counterbalanced by their negative inotropic effects. Xenon, on the other hand, does not influence myocardial contractility. Thus, xenon may be a superior treatment for the maintenance of global hemodynamics, especially during right ventricular ischemia, which is generally characterized by a high acute complication rate. METHODS: The effects of 70 vol% xenon and 0.9 vol% isoflurane on biventricular function were assessed in a porcine model (n=36) using the conductance catheter technique, and the expression of the type B natriuretic peptide (BNP) gene was measured. The animals underwent 90 min of right ventricular ischemia followed by 120 min of reperfusion. A barbiturate-anesthetized group was included as a control. RESULTS: Cardiac output was compromised in unprotected animals during ischemia by 33+/-18% and during reperfusion by 53+/-17%. This was mainly due to impaired contractility in the left ...
TY - JOUR. T1 - Pre-operative Diagnosis of Silent Coronary Ischaemia May Reduce Post-operative Death and Myocardial Infarction and Improve Survival of Patients Undergoing Lower Extremity Surgical Revascularisation. AU - Krievins, Dainis. AU - Zellans, Edgars. AU - Latkovskis, Gustavs. AU - Erglis, Andrejs. AU - Zvaigzne, Ligita. AU - Kumsars, Indulis. AU - Rumba, Roberts. AU - Stradins, Peteris. AU - Jegere, Sanda. AU - Zarins, Christopher K.. N1 - Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.. PY - 2020/9. Y1 - 2020/9. N2 - Objective: Patients undergoing peripheral vascular surgery have increased risk of death and myocardial infarction (MI), which may be due to unsuspected (silent) coronary ischaemia. The aim was to determine whether pre-operative diagnosis of silent ischaemia using coronary computed tomography (CT) derived fractional flow reserve (FFRCT) can facilitate multidisciplinary care to reduce post-operative death and MI, and improve survival. Methods: ...
Exercise may induce ventricular arrhythmias (VA) in patients with coronary artery disease. Exercise-induced VA can identify a subset of patients at higher risk of cardiac sudden death. The role of myocardial ischaemia and/or left ventricular disease in the appearance of VA during exercise is not completely understood. The incidence of VA during exercise-induced myocardial ischaemia was investigated in patients with suspected CAD or those undergoing a stress exercise test after a previous myocardial infarction (MI). Patients were divided in four groups. Group A, 836 patients without a previous MI showing exercise-induced myocardial ischaemia associated with ST-segment depression--group B, 72 patients without a previous MI and exercise-induced ST-segment elevation--group C, 50 patients survivors of a recent (1 month) MI and exercise-induced ST-segment depression--group D, 580 patients with an old MI (greater than 3 months) and a positive exercise test associated with ST-segment depression. ...
Table of Contents. Table of Contents 2. List of Tables 8. List of Figures 9. Introduction 10. Global Markets Direct Report Coverage 10. Coronary Artery Disease (CAD) (Ischemic Heart Disease) Overview 11. Therapeutics Development 12. Pipeline Products for Coronary Artery Disease (CAD) (Ischemic Heart Disease)-Overview 12. Pipeline Products for Coronary Artery Disease (CAD) (Ischemic Heart Disease)-Comparative Analysis 13. Coronary Artery Disease (CAD) (Ischemic Heart Disease)-Therapeutics under Development by Companies 14. Coronary Artery Disease (CAD) (Ischemic Heart Disease)-Therapeutics under Investigation by Universities/Institutes 17. Coronary Artery Disease (CAD) (Ischemic Heart Disease)-Pipeline Products Glance 18. Late Stage Products 18. Clinical Stage Products 19. Early Stage Products 20. Unknown Stage Products 21. Coronary Artery Disease (CAD) (Ischemic Heart Disease)-Products under Development by Companies 22. Coronary Artery Disease (CAD) (Ischemic Heart Disease)-Products under ...
BACKGROUND: Clinical outcomes following coronary computed tomography-derived fractional flow reserve (FFRCT) testing in clinical practice are unknown.. OBJECTIVES: The study sought to assess real-world clinical outcomes following a diagnostic strategy including first-line coronary computed tomography angiography (CTA) with selective FFRCT testing.. METHODS: The study reviewed the results of 3,674 consecutive patients with stable chest pain evaluated with CTA and FFRCT testing to guide downstream management in patients with intermediate stenosis (30% to 70%). The composite endpoint (all-cause death, myocardial infarction, hospitalization for unstable angina, and unplanned revascularization) was determined in 4 patient groups: 1) CTA stenosis ,30%, optimal medical treatment (OMT), and no additional testing; 2) FFRCT ,0.80, OMT, no additional testing; 3) FFRCT ≤0.80, OMT, no additional testing; and 4) FFRCT ≤0.80, OMT, and referral to invasive coronary angiography. Patients were followed for a ...
Abstract: OBJECTIVES: The aim of this study was to assess the independent effect of high-density lipoprotein cholesterol (HDL-C) level on cardiovascular risk in patients with stable ischemic heart disease (SIHD) while on optimal medical therapy (OMT). BACKGROUND: While low HDL-C level is a powerful and independent predictor of cardiovascular risk, recent data suggest that this may not apply when low-density lipoprotein cholesterol (LDL-C) is reduced to optimal levels using intensive statin therapy. METHODS: We performed a post hoc analysis in 2,193 men and women with stable ischemic heart disease (SIHD) from the COURAGE trial. The primary outcome measure was the composite of death from any cause or nonfatal myocardial infarction (MI). The independent association between HDL-C levels measured after 6 months on optimal medical therapy (OMT) and the rate of cardiovascular events after 4 years was assessed. Similar analyses were performed separately in subjects with LDL-C levels below 70 mg/dL (1.8 ...
Abstract: OBJECTIVES: The aim of this study was to assess the independent effect of high-density lipoprotein cholesterol (HDL-C) level on cardiovascular risk in patients with stable ischemic heart disease (SIHD) while on optimal medical therapy (OMT). BACKGROUND: While low HDL-C level is a powerful and independent predictor of cardiovascular risk, recent data suggest that this may not apply when low-density lipoprotein cholesterol (LDL-C) is reduced to optimal levels using intensive statin therapy. METHODS: We performed a post hoc analysis in 2,193 men and women with stable ischemic heart disease (SIHD) from the COURAGE trial. The primary outcome measure was the composite of death from any cause or nonfatal myocardial infarction (MI). The independent association between HDL-C levels measured after 6 months on optimal medical therapy (OMT) and the rate of cardiovascular events after 4 years was assessed. Similar analyses were performed separately in subjects with LDL-C levels below 70 mg/dL (1.8 ...
The purpose of this study is to investigate the association between fine particulate matter and ischaemic heart disease. A literature search was conducted using six electronic databases (Embase, Scopus, PubMed, Google Scholar, Cochrane Library and Web of Science) and the University of Queenslands online library. A list of important sources was compiled and reviewed, and the ten best resources selected, based on their focus on Chinese cities and the administrative city of Hong Kong. The other criterion used to select the articles was that they must address and contain at least one outcome of the relationship between particulate matter and ischaemic heart disease. The result of the review indicates that both types of particulate matter (PM10 and PM2.5) have a strong association with ischaemic heart disease. Low and high concentrations of particulate matter have unhealthy effects on ischaemic heart disease mortality, morbidity, emergency visits and hospital admissions. Elderly subjects appear more ...
Introduction : Psychological characteristics of patients, depression, stress and anxiety are recognized as important confounding risk factors for ischemic heart disease. However, the impact of psychological characteristics on coronary ischemia and vice versa remain poorly understood. Aim:...
Coronary heart disease (CHD) is the leading cause of mortality and morbidity in the U.S. More women than men have died annually from ischemic heart disease (IHD) since 1984, and coronary artery disease (CAD) is the cause of over 250,000 deaths in women each year. The evaluation of IHD in women presents a unique and sometimes difficult challenge for clinicians, owing to the greater symptom burden, greater functional disability, and lower prevalence of obstructive coronary disease as compared to men. Objective evidence of ischemia, whether symptomatic or asymptomatic, identifies individuals with an adverse prognosis. The results of older trials largely defined the relative places of medical therapy and coronary surgery for the era in which they were conducted. A number of significant changes in selection of patients for surgery, in surgical methods, and in medical therapies have occurred. New pharmacologic and revascularization strategies are now available to relieve ischemia. However, the ...
Near-fatal neonatal coronary ischaemia associated with intermittent aortic regurgitation: successful surgical treatment - Volume 25 Special Issue - Maggie L. Likes, Norman H. Silverman, Erin L. Albers, Raylene Choy, Aarti Bhat, David M. McMullan
Despite a dramatic decline in mortality over the past three decades, coronary heart disease is the leading cause of death and disability in the U.S. Importantly, recent advances in the field of cardiovascular medicine have not led to significant declines in case fatality rates for women when compare …
The prevalence and characteristics of transient myocardial ischaemia were studied in 203 patients with recent acute myocardial infarction by both early (6.4 days) and late (38 days) ambulatory monitoring of the ST segment. Transient ST segment depres
Acute myocardial ischemia is implicated in many cases of fatal arrhythmias.1 2 The basis of ischemic arrhythmogenesis is alteration in the electrical properties of ventricular tissue, leading to changes in action potential conduction.3 4 Altered electrical properties are a result of the pathophysiological conditions of ischemia, which directly affect membrane ionic currents and intracellular and extracellular ionic concentrations.5 6 Therefore, there exist cause-and-effect relationships between ischemia modification of membrane currents and ionic concentrations and ischemia-related changes in action potential conduction. We investigated these cause-and-effect relationships to determine the ionic mechanisms of depressed conduction and development of conduction block during acute ischemia.. Our investigative tool is a theoretical multicellular fiber model that accounts for the major conditions of ischemia at the level of individual ionic currents and concentrations. The fiber is composed of LRd ...
TY - JOUR. T1 - Bioenergetic effect of liposomal coenzyme Q10 on myocardial ischemia reperfusion injury. AU - Niibori, Koki. AU - Wroblewski, Krzystof P.. AU - Yokoyama, Hitoshi. AU - Crestanello, Juan A.. AU - Whitman, Glenn J.R.. PY - 1999/1/1. Y1 - 1999/1/1. N2 - The antioxidant and bioenergetic effects of CoQ10 are well known but its clinical utility is limited by the requirement for enteral administration. A newly developed liposomal CoQ10 (CoQ) is water soluble and capable of intravenous administration. The purpose of this study is to determine the mechanism by which acute administration CoQ protects myocardium from reperfusion (Rp) injury. Rats were pretreated with CoQ 10 mg/kg i.v. 30 min prior to the experiment. Control rats were pretreated with liposome only. Hearts were excised and subjected to equilibration, 25 min of normothermic ischemia and 40 min of Rp on a Langendorff apparatus. At end Rp, CoQ hearts recovered 74 ± 5% of their DP vs. 50 ± 9% in control (p , 0.05). Aerobic ...
TY - JOUR. T1 - Verapamil in a new model of severe local myocardial ischaemia due to combined coronary occlusion and stenosis. AU - Végh, A.. AU - Szekeres, L.. AU - Udvary, Éva. PY - 1987/11/24. Y1 - 1987/11/24. N2 - The effect of verapamil was studied in a new canine model of local myocardial ischaemia. In this model in addition to the critical constriction of the left circumflex coronary artery, the left anterior descending branch was suddenly occluded. Experiments were performed in the anaesthetized, thoracotomized and artificially respired dog. The model represents a severe form of myocardial ischaemia and mimics the clinical situation in which usually more than one coronary artery is involved in the stenotic process. Verapamil (0.15 mg kg -1 i.v.) moderated the extent of the ischaemic changes (indicated by the ST segment elevation in the epicardial and endocardial ECG) as well as their consequences e.g. the incidence and severity of early postocclusion and reperfusion arrhythmias. This ...
Purpose: To estimate the cost-effectiveness of diagnostic pathways for assessing patients with ischaemic cardiomyopathy to identify patients with viable myocardium with a view to revascularisation Method: A decision analytic model was developed to estimate the cost-effectiveness of diagnostic strategies for assessing patients with ischaemic cardiomyopathy. The different diagnostic pathways were applied to a hypothetical cohort of patients with ischaemic cardiomyopathy and the probability of successful identification of viable myocardium and non-viable myocardium was determined by the accuracy of the diagnostic pathway. It was assumed that patients diagnosed with viable myocardium would be managed promptly by revascularisation and that the patients diagnosed with non-viable myocardium would be on medical therapy. The model assigned each patient a risk of death and rehospitalisation depending upon whether they are truly viable and whether they had revascularisation or not. Each patient then ...
New comprehensive guidelines for the diagnosis and treatment of stable ischemic heart disease have been released by the American College of Cardiology (ACC)/American Heart Association (AHA) Task Force on Practice Guidelines, along with the American College of Physicians (ACP), American Association for Thoracic Surgery (AATS), Preventive Cardiovascular Nurses Association (PCNA), Society for Cardiovascular Angiography and…. Click here to continue reading…. ...
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Angina is the clinical manifestation of myocardial ischemia and is most often due to coronary stenosis. The management of stable ischemic heart disease requires treatment aimed at both symptom relief and reduction of cardiovascular morbidity and mortality related to atherosclerosis. Risk-factor modification and medical therapy to prevent acute ischemic events and disease progression should be initiated after diagnosis. Patients with symptoms refractory to medical therapy, high-risk stress test results, or anatomic findings have an indication for coronary revascularization.
Background: Incident anxiety and depression are associated separately with cardiac events and mortality in patients after acute coronary syndromes, but the influence of persistent comorbid depression and anxiety on mortality remains unknown. The purpose of this study was to determine the prevalence of comorbid persistent depressive and anxious symptoms in individuals with ischemic heart disease and to evaluate effects on mortality. Methods: Prospective, longitudinal cohort design in the context of a randomized trial to decrease patient delay in seeking treatment for ischemic heart symptoms (PROMOTION trial) was used, with twelve-month follow-up of 2325 individuals with stable ischemic heart disease. Participants were assessed on enrollment and at 3 months using the Multiple Adjective Affect Checklist and the Brief Symptom Inventory for depressive and anxious symptoms, respectively. Results: At 3 months, 608 individuals (61.7%) reported persistent symptoms of depression, anxiety, or both. Three ...
Left ventricular energy model predicts adverse events in women with suspected myocardial ischemia: results from the NHLBI-sponsored womens ischemia syndrome evaluation (WISE) study
My research group conducts bench to bedside translational studies directed at advancing our mechanistic understanding of cardiac pathophysiology as well as developing new diagnostic and therapeutic approaches for the management of patients with chronic ischemic heart disease. Our ongoing areas of preclinical investigation apply proteomic approaches to identify intrinsic adaptive responses of the heart to ischemia and studies examining the ability of intracoronary stem cell therapies to stimulate endogenous cardiomyocyte proliferation and improve heart function. We are particularly interested in understanding how elevations in heart filling pressures and reversible ischemia lead to cardiomyocyte cell death and heart dysfunction. We also conduct basic and patient-oriented research to understand how chronic ischemia modifies the cellular composition and sympathetic innervation of the heart to help develop new approaches to identify patients at risk of sudden cardiac arrest from ventricular ...
Clinical Topics: Arrhythmias and Clinical EP, Cardiac Surgery, Diabetes and Cardiometabolic Disease, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Prevention, Stable Ischemic Heart Disease, Atherosclerotic Disease (CAD/PAD), Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Aortic Surgery, Cardiac Surgery and Arrhythmias, Cardiac Surgery and Heart Failure, Cardiac Surgery and SIHD, Acute Heart Failure, Heart Failure and Cardiac Biomarkers, Interventions and Coronary Artery Disease, Interventions and Imaging, Interventions and Vascular Medicine, Computed Tomography, Echocardiography/Ultrasound, Nuclear Imaging, Chronic Angina Keywords: EaglesEyeView, Angina, Stable, Aortic Aneurysm, Abdominal, Atrial Fibrillation, Bariatric Surgery, Body Mass Index, Cardiac Surgical Procedures, Constriction, Pathologic, Coronary Artery Bypass, Coronary Artery Disease, Cost-Benefit Analysis, ...
Click here to view ISCHEMIA-CKD study results. The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches-Chronic Kidney Disease trial (ISCHEMIA-CKD) is an international comparative effectiveness study to determine the best way to manage stable ischemic heart disease (SIHD) in patients with advanced chronic kidney disease (eGFR ,30 or on dialysis). Prior trials of strategy trials of revascularization versus medical therapy alone for SIHD have routinely excluded patients with CKD or enrolled a small proportion of such patients. As such, the evidence from randomized trials to drive decision making in this cohort is weak at best.. This is a multicenter clinical trial which has randomized 777 participants with advanced CKD with moderate to severe ischemia on stress testing. Participants were randomly assigned to a routine invasive strategy (INV) with cardiac catheterization (cath) followed by revascularization (if feasible) plus optimal medical therapy (OMT) or ...
The purpose of the ISCHEMIA-CKD trial is to determine the best management strategy for patients with stable ischemic heart disease (SIHD), at least moderate ischemia and advanced chronic kidney disease (CKD; estimated glomerular filtration rate [eGFR] ,30 or on dialysis). This is a multicenter randomized controlled trial with a target randomization of ~1000 patients with advanced CKD and at least moderate ischemia on stress testing. Participants will be assigned at random to a routine invasive strategy (INV) with cardiac catheterization (cath) followed by revascularization plus optimal medical therapy (OMT) or to a conservative strategy (CON) of OMT, with cath and revascularization reserved for those who fail OMT. The trial is designed to run seamlessly in parallel to the main ISCHEMIA trial as a companion ancillary trial. SPECIFIC AIMS A. Primary Aim. The primary aim of the ISCHEMIA-CKD trial is to determine whether an invasive strategy of routine early catheterization followed by optimal ...
GROSS: CARDIOVASCULAR: HEART: Chronic Ischemia: Gross focal myocardial scars and hyperemia chronic ischemic heart disease same as slide 89 but close-up - 00000090.jpg
Heme Oxygenase-1 Induction Improves Cardiac Function following Myocardial Ischemia by Reducing Oxidative Stress. . Biblioteca virtual para leer y descargar libros, documentos, trabajos y tesis universitarias en PDF. Material universiario, documentación y tareas realizadas por universitarios en nuestra biblioteca. Para descargar gratis y para leer online.
TY - JOUR. T1 - Characterization of energy metabolism and blood flow distribution in myocardial ischemia in hemorrhagic shock. AU - Miyazaki, Koji. AU - Hori, Shingo. AU - Inoue, Sohshin. AU - Adachi, Takeshi. AU - Bessho, Motoaki. AU - Kuwahira, Ichiro. AU - Mori, Hidezo. AU - Nakazawa, Hiroe. AU - Aikawa, Naoki. AU - Ogawa, Satoshi. PY - 1997. Y1 - 1997. N2 - To characterize the mechanisms for myocardial ischemia induced by hemorrhagic shock, 29 dogs were subjected to hemorrhage at a mean aortic pressure (MAoP) of 30-60 mmHg. After 10 min of hemorrhage, the beating hearts were rapidly cross sectioned and freeze clamped to visualize the two- dimensional distribution of myocardial ischemia with NADH fluorescence (NADH- F) in 22 dogs. NADH-F was developed at an MAoP of 40 mmHg or less and involved both the subendocardial half and the subepicardial half of the left ventricle [34 ± 14 vs. 20 ± 14% (P , 0.05) and 65 ± 16 vs. 52 ± 15% (not significant) of the cross-sectional area of the left ...
TY - JOUR. T1 - Release of tissue-specific proteins into coronary perfusate as a model for biomarker discovery in myocardial ischemia/reperfusion injury. AU - Cordwell, Stuart J.. AU - Edwards, Alistair V G. AU - Liddy, Kiersten A.. AU - Moshkanbaryans, Lia. AU - Solis, Nestor. AU - Parker, Benjamin L.. AU - Yong, Andy S C. AU - Wong, Clement. AU - Kritharides, Leonard. AU - Hambly, Brett D.. AU - White, Melanie Y.. PY - 2012/4/6. Y1 - 2012/4/6. N2 - Diagnosis of acute coronary syndromes is based on protein biomarkers, such as the cardiac troponins (cTnI/cTnT) and creatine kinase (CK-MB) that are released into the circulation. Biomarker discovery is focused on identifying very low abundance tissue-derived analytes from within albumin-rich plasma, in which the wide dynamic range of the native protein complement hinders classical proteomic investigations. We employed an ex vivo rabbit model of myocardial ischemia/reperfusion (I/R) injury using Langendorff buffer perfusion. Nonrecirculating ...
Adult, Aged, Aged; 80 and over, Case-Control Studies, Denmark/epidemiology, Female, Genetic Predisposition to Disease, Genotype, Humans, Male, Middle Aged, Mutation; Missense, Myocardial Ischemia/epidemiology/*genetics, Odds Ratio, Prospective Studies, Risk, Superoxide Dismutase/*genetics ...
Get this from a library! The role of clopidogrel in the secondary prevention of recurrent ischemic vascular events after acute myocardial ischemia : a critical appraisal of the CURE Trial. [Michel Boucher, B Pharm.; Canadian Coordinating Office for Health Technology Assessment.;]
Research comparing sex differences in the effects of antipsychotic medications on acute ischemic heart disease (IHD) is limited and the findings ambiguous. This study aimed to investigate these associations within a primary care setting. Hong Kong public general outpatient electronic records of patients aged 45+ during 2007-2010 were extracted, with the last consultation date as the baseline for a 4-year follow-up period to observe acute IHD hospitalizations (2011-2014). Antipsychotic use was defined as any prescription over the previous 12 months from a list of 16 antipsychotics, while acute IHD was defined by ICD-9: 410.00-411.89. Both sex-specific and sex-combined (both sexes) mixed-effects Cox models (random intercept across 74 clinics) were implemented to examine the association and test the interaction between antipsychotics and sex. Among 1,043,236 included patients, 17,780 (1.7%) were prescribed antipsychotics, and 8342 (0.8%) developed IHD. In sex-specific analyses, antipsychotic prescription
Objective-To examine the relation between resting heart rate and new major ischaemic heart disease events in middle aged men with and without pre-existing ischaemic heart disease. Design-Prospective study of a cohort of men with eight years follow up for cardiovascular morbidity and mortality for all men. Setting-General practices in 24 British...
Background: Mental stress-induced myocardial ischemia (MSIMI) is associated with increased risk of adverse cardiovascular outcomes, yet the underlying mechanisms are not well understood. We measured the inflammatory response to acute laboratory mental stress in patients with coronary artery disease (CAD) and its association with MSIMI. We hypothesized that patients with MSIMI would have a higher inflammatory response to mental stress in comparison to those without ischemia. Methods: Patients with stable CAD underwent 99mTc sestamibi myocardial perfusion imaging during mental stress testing using a public speaking stressor. MSIMI was determined as impaired myocardial perfusion using a 17-segment model. Inflammatory markers including interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), matrix metallopeptidase 9 (MMP-9) and high-sensitivity C reactive protein (hsCRP) were measured at rest and 90 min after mental stress. Results were validated in an independent sample of 228 ...
Introduction: The pathophysiology of ischemia involves the cellular effect of myocardial ischemia, reactive oxygen species, and reactive inflammatory enzymes. Left atrial (LA) ischemia has been shown to have several mechanisms through which it can lead to abnormalities in left ventricular filling in early diastole and thus reduces LA passive functional reserve. In this review, we evaluated the physiological mechanisms of LA during myocardial ischemia, as previously demonstrated in experimental and clinical studies.Methods: Several databases were searched in order to find related articles. The outcome of interest included LA function measurements (measurement of LA volume) during ischemia. By applying a standardized protocol, reviewers independently extracted and assessed the studies.Results: The literature review indicated 50 publications, among which 15 studies were eligible for analysis. Assessment of LA dimension and function is essential for clinical evaluation and prognostic purposes. ...