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 ...
Online ISSN: 1468-201X Print ISSN: 1355-6037. Copyright © 2021 BMJ Publishing Group Ltd & British Cardiovascular Society. All rights reserved.. ...
Background: HMG-CoA reductase inhibitors (statins) improve mortality in high-risk patients. Statins may have beneficial properties beyond its lipid-lowering potential, including inflammation reduction and atherosclerotic plaque stabilization. In this study, we examined whether statins can reduce perioperative myocardial ischemia and improve long-term outcome in patients undergoing major vascular surgery.. Methods: A total of 213 consecutive patients (mean age 68 ± 10 years, 79% male) underwent surgery for abdominal aortic aneurysms or lower extremity bypass grafting. Statins were prescribed in 55% of the patients and serial cholesterol levels were measured 3 months and 1 week prior to surgery. Myocardial ischemia was assessed by continuous 12-lead ECG monitoring, starting 1 day before surgery and continuing for 3 days after. Serial troponin T measurements were performed on day 1, 3 and 7 after surgery. During follow-up, mortality was noted.. Results: In this study cohort, 71 patients (33%) had ...
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
The main finding of this study is that ED seems to be strongly and independently associated with angiographically verified silent CAD in uncomplicated type 2 diabetic patients at relatively low risk for CAD. Indeed, the study population was represented by diabetic subjects without clinical conditions associated with CAD, such as history of artery revascularization, heart failure, uncontrolled hypertension, kidney disease, proteinuria, proliferative retinopathy or previous photocoagulation (used also to treat severe nonproliferative retinopathy and macular edema), previous stroke, or claudicatio intermittens.11,12. We found that about one third of patients with silent CAD showed ED, whereas among subjects without silent myocardial ischemia, the prevalence of ED was about 5%. In other words, the prevalence of ED seems to be quite 8-fold higher in patients with than in those without silent myocardial ischemia. In addition, it is interesting to observe that in uncomplicated diabetic patients at ...
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
There is increasing evidence that transient ischemia in humans can affect myocardial function in similar patterns to those described in experimental animal models. In dogs, demand ischemia triggers both stunning (reversible contractile dysfunction despite the return of normal myocardial perfusion) and ischemic preconditioning (protection against infarction caused by subsequent coronary occlusion) (1,2). In patients with angina, myocardial contractile function may remain depressed for up to 30 min after the completion of exercise, and this may represent stunning (3-5). Patients may also develop less anginal pain and electrocardiographic (ECG) evidence of ischemia during sequential exercise testing: the warm-up phenomenon (6). It is hypothesized that this may represent a form of ischemic preconditioning.. There are important differences of definition between the warm-up effect and ischemic preconditioning. The former involves protection against indirect markers of ischemia (chest pain and ECG ...
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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Several studies have documented that transplantation of bone marrow-derived cells (BMC) following acute myocardial infarction is associated with a reduction in infarct scar size and improvements in left ventricular function and perfusion. The available evidence in humans suggests that BMC transplantation is associated with improvements in physiologic and anatomic parameters in both acute myocardial infarction and chronic ischemic heart disease, above and beyond the conventional therapy. In particular, intracoronary application of BMC is proved to be safe and was associated with significant improvement in the left ventricular ejection fraction (LVEF) in patients with chronic heart failure.. In contrast to ischemic heart failure, the data on effects of BMC transplantation in patients with dilated cardiomyopathy are limited to pre-clinical studies. In a rat model of dilated cardiomyopathy, intramyocardial delivery of pluripotent mesenchymal cells improved LVEF, possibly through induction of ...
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 ...
A large population of patients suffering from advanced coronary artery disease and chronic myocardial ischemia cannot be adequately managed by a combination of antianginal medication and angioplasty or coronary artery bypass surgery. Therefore, therapeutic stimulation of vascular growth in the management of chronic myocardial ischemia seems to be a useful strategy in treating such patients. A number of recent clinical trials have examined the role of therapeutic administration of molecular regulators of blood vessel growth to promote vascular development to treat ischemic heart disease (1). The patients eligible for these therapeutic angiogenic trials often have underlying ischemic but viable hibernating myocardium, characterized by persistent myocardial dysfunction in the presence of resting hypoperfusion or chronic myocardial stunning due to repetitive episodes of stress-induced ischemia in myocardial regions with severely impaired coronary flow reserve. Fallavollita et al. (2) have ...
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. ...
Looking for online definition of demand-induced ischemia in the Medical Dictionary? demand-induced ischemia explanation free. What is demand-induced ischemia? Meaning of demand-induced ischemia medical term. What does demand-induced ischemia mean?
Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease. Circulation. 2019 [Epub ahead of print] PMID: 30879355 pubmed.ncbi.nlm.nih.gov/30879355/. Boden WE. Angina pectoris and stable ischemic heart disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 62. 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: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2014;130(19):1749-1767.PMID: 25070666 pubmed.ncbi.nlm.nih.gov/25070666/. Marks AR. Cardiac and circulatory function. In: Goldman ...
OBJECTIVES--To assess the relationship between haematocrit and risk of major ischaemic heart disease events. DESIGN--Prospective study of a cohort of men followed up for 9.5 years. SETTING--General practices in 24 towns in England, Wales, and Scotland (British Regional Heart Study). SUBJECTS--Altogether 7735 men aged 40-59 years at screening, who were selected at random from one general practice in each of 24 towns, were studied. MAIN OUTCOME MEASURES--Fatal and nonfatal ischaemic heart disease events. RESULTS--Risk of major ischaemic heart disease events was significantly increased at haematocrit levels of , or = 46.0%. Men with raised haematocrit (, or = 46.0%) showed a 30% increase in relative risk (RR) of major ischaemic heart disease events (RR = 1.32; 95% confidence intervals (CI) 1.10,1.57, p , 0.01) compared with those with values below 46.0%, even after adjustment for age, social class, smoking, body mass index, physical activity, blood cholesterol, lung function (FEV1), and ...
TY - JOUR. T1 - Model of right ventricular failure after global myocardial ischemia and mechanical left ventricular support. AU - Shuman, Todd A.. AU - Palazzo, Robert S.. AU - Jaquiss, Robert B.D.. AU - Harper, Baron D.. AU - Barzilai, Benico. AU - Cox, James Lewis. AU - Kouchoukos, Nicholas T.. AU - Wareing, Thomas H.. PY - 1991/7/1. Y1 - 1991/7/1. N2 - Postcardiotomy right ventricular (RV) failure after institution of mechanical left ventricular (LV) support is poorly understood. Using a canine model supported by cardiopulmonary bypass (CPB), the animals underwent 30 min of aortic clamping or no ischemia and were weaned to an LV assist device (LVAD). Echocardiographic measurements of LV and RV cavity size off support allowed calculation of percentage change in cavity area (fractional shortening). There were no differences at baseline. After 2 hrs on LVAD, there were significant differences between ischemic and control groups in both LV (38 ± 12 vs. 61 ± 6) and RV (15 ± 3 vs. 55 ± 12). The ...
Background: During myocardial ischemia, hypoxia-inducible factors are stabilized and provide protection from ischemia and reperfusion injury. Recent studies show that myocyte-specific hypoxia-inducible factor 2A promotes myocardial ischemia tolerance through induction of epidermal growth factor, amphiregulin. Here, the authors hypothesized that hypoxia-inducible factor 2A may enhance epidermal growth factor receptor 1 (ERBB1) expression in the myocardium that could interface between growth factors and its effect on providing tolerance to ischemia and reperfusion injury. Methods: Human myocardial tissues were obtained from ischemic heart disease patients and normal control patients to compare ERBB1 expression. Myocyte-specific Hif2a or ErbB1 knockout mice were generated to observe the effect of Hif2a knockdown in regulating ERBB1 expression and to examine the role of ERBB1 during myocardial ischemia and reperfusion injury. Results: Initial studies of myocardial tissues from patients with ischemic ...
Introduction. Multiple clinical methods for detecting myocardial ischemia are utilised in the hospital setting each day, but there is uncertainty about their diagnostic accuracy. In the operating room, multiple methods may be employed, while in the CCU advanced electrophysiological (ECG) techniques for myocardial ischemia detection, and in particular, ST segment analysis, are common. Vectorcardiography (VCG) is one form of ECG.. Several conditions other than ischemia may cause marked ST changes, which can impair the process of diagnosis of clinical ischemia. Elevated HR is one of these factors, which is studied here. The hypotheses were about concordance of different methods to detect ischemia, and relation of ECG ST levels to HR with and without myocardial ischemia.. Methods. Study I. Anesthetised vascular surgical patients with coronary artery disease were studied during the start of anesthesia and surgery: ECG, hemodynamic, mechanical, and metabolic parameters were measured and categorised as ...
TY - JOUR. T1 - Dose-response studies with idrapril in the rat heart during acute myocardial ischaemia and reperfusion. AU - Riva, Emma. AU - Traquandi, Cristina. PY - 1996/10/3. Y1 - 1996/10/3. N2 - We assessed the effects of idrapril, a novel angiotensin-converting enzyme inhibitor, and captopril in the isolated rat heart after ischaemia and reperfusion and measured angiotensin-converting enzyme activity in myocardial tissue. Hearts were perfused and subjected to global ischaemia and reperfusion. Idrapril (0.1, 1, 10, and 50 μg/ml), captopril (80 μg/ml) or vehicle were given before ischaemia and throughout reperfusion. Post-ischaemic recovery of coronary flow was significantly decreased with 50 μg/ml of idrapril (43 ± 9% compared to 64 ± 3% in controls) whereas heart rate was unaffected. Recovery of developed pressure and activity of cardiac angiotensin-converting enzyme were significantly reduced by idrapril in a dose-dependent manner. This study suggests that protection or lack of ...
BACKGROUND: Ischemic ventricular fibrillation in experimental models has been shown to progress through a series of stages. Progression of ischemic VF in the in vivo human heart has not been determined. METHODS AND RESULTS: We studied 10 patients undergoing cardiac surgery. Ventricular fibrillation was induced by burst pacing. After 30 seconds, global myocardial ischemia was induced by aortic cross-clamp and maintained for 2.5 minutes, followed by coronary reflow. Epicardial activity was sampled (1 kHz) with a sock that contained 256 unipolar contact electrodes. Dominant frequencies were calculated with a fast Fourier transform with a moving window. The locations of phase singularities and activation wavefronts were identified at 10-ms intervals. Preischemic (perfused) ventricular fibrillation was maintained by a disorganized mix of large and small wavefronts. During global myocardial ischemia, mean dominant frequencies decreased from 6.4 to 4.7 Hz at a rate of -0.011±0.002 Hz s(-1) (P|0.001) and then
Cardiovascular disease is the leading cause of death in women accounting for 1 in every 4 female deaths. Pathophysiology of ischemic heart disease in women includes epicardial coronary artery, endothelial dysfunction, coronary vasospasm, plaque erosion and spontaneous coronary artery dissection. Angina is the most common presentation of stable ischemic heart disease (SIHD) in women. Risk factors for SIHD include traditional risks such as older age, obesity (body mass index [BMI] ,25 kg/m2), smoking, hypertension, dyslipidemia, cerebrovascular and peripheral vascular disease, sedentary lifestyle, family history of premature coronary artery disease, metabolic syndrome and diabetes mellitus, and nontraditional risk factors, such as gestational diabetes, insulin resistance/polycystic ovarian disease, pregnancy-induced hypertension, pre-eclampsia, eclampsia, menopause, mental stress and autoimmune diseases ...
Introduction: Cardiovascular mortality has risen in the last few years and Ischemic Heart Disease (IHD) is one of the most common causes. Ischemia Reversal Program (IRP) kit uses a combination of Snehana (Centripetal oleation), Swedana (Thermal vasodilation) and Basti (Per rectal drug administration) for providing relief to IHD patients. This study was conducted to evaluate the efficacy of IRP in IHD patients. Methods: This retrospective study included data of patients having positive inducible ischemia by stress test with known history of hypertension (HTN) and had visited the Madhavbaug clinics. A minimum of 7 IRP sittings were needed for inclusion. Duke Treadmill score, VO2 max, systolic plus diastolic blood pressure (SBP, DBP) and details of conventional medications were noted on day 1 and on day 90 followed by comparison between these values. Results: 19 patients having mean age 59.26 ± 8.03 years were enrolled, with 78.9% being males. On day 90, none of the patients were at high risk by ...
Title:Dose-dependent Effects of Esmolol-epinephrine Combination Therapy in Myocardial Ischemia and Reperfusion Injury VOLUME: 25 ISSUE: 19. Author(s):Yoshimasa Oyama, Justin Blaskowsky and Tobias Eckle*. Affiliation:Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO 80045, Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO 80045, Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO 80045. Keywords:Epinephrine, esmolol, myocardial ischemia and reperfusion injury, troponin, TTC, blood pressure, heart rate.. Abstract:. Background: Animal studies on cardiac arrest found that a combination of epinephrine with esmolol attenuates post-resuscitation myocardial dysfunction. Based on these findings, we hypothesized that esmololepinephrine combination therapy would be superior to a reported cardioprotective esmolol therapy alone in a mouse model of myocardial ischemia and reperfusion (IR) injury. Methods: ...
OBJECTIVE: To examine the associations of vegetarianism with risks of ischaemic heart disease and stroke. DESIGN: Prospective cohort study. SETTING: The EPIC-Oxford study, a cohort in the United Kingdom with a large proportion of non-meat eaters, recruited across the country between 1993 and 2001. PARTICIPANTS: 48 188 participants with no history of ischaemic heart disease, stroke, or angina (or cardiovascular disease) were classified into three distinct diet groups: meat eaters (participants who consumed meat, regardless of whether they consumed fish, dairy, or eggs; n=24 428), fish eaters (consumed fish but no meat; n=7506), and vegetarians including vegans (n=16 254), based on dietary information collected at baseline, and subsequently around 2010 (n=28 364). MAIN OUTCOME MEASURES: Incident cases of ischaemic heart disease and stroke (including ischaemic and haemorrhagic types) identified through record linkage until 2016. RESULTS: Over 18.1 years of follow-up, 2820 cases of ischaemic heart disease
The subject was a 65-year-old woman with chest pain. An electrocardiogram revealed T-wave-inversion in leads III, aVF, V1-V5. 99mTc-tetrofosmin myocardial SPECT showed mildly reduced uptake in the anteroseptal wall and the apex. These findings suggested acute myocardial ischemia. Coronary angiography did not show any stenotic lesions, but diffuse coronary ectasia was noted in three vessels. Coronary flow velocity was remarkably reduced on coronary angiography. Epicardial coronary spasm was not provoked by ergonovine loading test. Left ventriculography showed diffuse hypokinesis. 123I-BMIPP myocardial SPECT showed mildly reduced uptake in the anteroseptal wall and the apex on the early images. But 4-hour delayed images showed an increase of 8% in myocardial 123I-BMIPP uptake. We treated this patient with ticlopidine and nicorandil. After drug therapy her symptoms and left ventriculography improved. 123I-BMIPP myocardial SPECT findings on the early images improved, whereas delayed images showed a decrease
Clinical Topics: Anticoagulation Management, Arrhythmias and Clinical EP, Cardiac Surgery, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Prevention, Stable Ischemic Heart Disease, Atherosclerotic Disease (CAD/PAD), Anticoagulation Management and Atrial Fibrillation, Atrial Fibrillation/Supraventricular Arrhythmias, Aortic Surgery, Cardiac Surgery and Arrhythmias, Cardiac Surgery and Heart Failure, Cardiac Surgery and SIHD, Novel Agents, Statins, Acute Heart Failure, Heart Failure and Cardiac Biomarkers, Interventions and Coronary Artery Disease, Interventions and Imaging, Interventions and Vascular Medicine, Angiography, Nuclear Imaging, Diet, Hypertension, Smoking, Chronic Angina Keywords: ACC Publications, Cardiology Magazine, African Americans, Alcohol Drinking, Amoxicillin, Anemia, Angiography, Aneurysm, Dissecting, Anti-Bacterial Agents, Anticoagulants, Aortic Aneurysm, Arteries, Arthritis, Psoriatic, Atherosclerosis, Biological Markers, Atrial ...
BACKGROUND: Preconditioning might protect the myocardium against ischemia/reperfusion injury by reducing infarct size and preventing arrhythmias. Dexmedetomidine (DEX) is a highly selective alpha(2)-agonist used for sedoanalgesia in daily anesthetic practice. The cardioprotective effects of DEX on infarct size and on the incidence of arrhythmias observed after regional ischemia/reperfusion injury in vivo have not been reported. ...
Internal Medicine, State medical University, Tbilisi, Georgia. Abstract. It could be conjectured that the hemorheological disorders are involved in development of the ischemic heart disease. But this fact was so far insufficiently cleared up. The present studies were carried out in patients with various forms of chronic ischemic heart disease. We investigated the most significant factor of rheological disorders in the microcirculation, the erythrocyte aggregability, which a technique that provided us with the direct and quantitative data. Simultaneously we investigated in the some patients the tone of the resistance arteries of the hand with an original non-invasive technique. We found that the erythrocyte aggregability increased almost twice in the blood of investigated patients as compared to the healthy control group. The aggregability was positively correlated with severity of the disease. ...
New research from Emory University is shedding light on a potential link between post-traumatic stress disorder (PTSD) and mental stress-induced myocardial ischemia in patients with stable coronary artery disease. The study, led by Viola Vaccarino, MD, PhD, of the department of epidemiology at Emory University Rollins School of Public Health, found that patients with stable coronary artery disease who survived a recent myocardial infarction (MI) and had PTSD were at a greater risk of developing myocardial ischemia than those who did not have PTSD.
Figure 5: Honokiol Ameliorates Myocardial Ischemia/Reperfusion Injury in Type 1 Diabetic Rats by Reducing Oxidative Stress and Apoptosis through Activating the SIRT1-Nrf2 Signaling Pathway
Introduction Myocardial ischemia can defined as a state of imbalance between myocardial oxygen supply and demand. This imbalance may be caused by a reduction of blood flow and oxygen supply secondary to increased coronary vascular tone, intracoronary platelet aggregation, thrombus formation, increase heart rate, or microvascular dysfunction [1]. Damage of cardiac cells occurs because of cutting blood flow to the heart and restoration it to myocytes in a state called ischemia reperfusion (I/R) injury [2]. Thus, reperfusion can cause further injury to the myocardium and act like a double--edged sword [3]. It is accepted that the production of reactive oxygen species (ROS) plays an important role in the development (I/R) injury in cardiac cell. (I/R) also have been found to induce myocytes necrosis and apoptosis that seem to be the prevalent modes of cell death during the ischemic period and the reperfusion [4]. Apoptosis is a regulated form of cell death that can potentially be a good approaches ...
There were no severe adverse events potentially related to blood pressure and no episodes of syncope reported in this study.Analysis of the safety database from controlled clinical trials showed no apparent difference in adverse reactions in patients taking VIAGRA with and without anti-hypertensive medication.In healthy male volunteers, there was no evidence of a clinically significant effect of azithromycin (500 mg daily for 3 days) on the systemic exposure of sildenafil or its major circulating metabolite.Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION).. In one small, open-label, uncontrolled, pilot study, eight patients with stable ischemic heart disease underwent Swan-Ganz catheterization.If you accidentally take too much VIAGRA, call your doctor or go to the nearest hospital emergency room right away.Find patient medical information for Viagra oral on WebMD including its uses, side effects and ...
Evolution of cardiovascular risk factors and ischemic heart disease in an elderly urban Romanian population over the course of 1 year Dana Pop, Alexandra DÄ dârlat, Mihnea Zdrenghea, Dumitru Tudor Zdrenghea, Adela Viviana Sitar-TaÄ ut Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania Background: Romania has some of the highest mortality figures in the world attributable to ischemic heart disease and stroke among both men and women. Objectives: To assess the changes in cardiovascular risk factors and ischemic heart disease in a group of subjects over 65 years of age during 1 year in an urban community of Romania. Materials and methods: We studied 515 subjects (264 women and 251 men) with a mean age of 73.41±6.44 years, followed up over the course of 1 year in order to determine the changes that occurred in cardiovascular risk factors and in the evolution of ischemic heart disease. At the beginning and after 1 year, we determined the following
To compare the prevalence of silent myocardial ischaemia associated with coronary artery disease in diabetic subjects with that in controls of similar age and sex. A controlled study in which subjects with positive findings on exercise electrocardiography, 24 hour electrocardiographic recording, or dynamic thallium scintigraphy (diabetics only) underwent coronary angiography. Academic medical centre; referral based cardiology clinic. 136 Diabetic subjects, of whom 72 (33 women, 39 men (mean age 46.0] were insulin dependent and 64 (19 women, 45 men (mean age 49.3] non-insulin dependent. 80 Controls matched for age and sex; all were clients of the Occupational Health Service of Oulu University Central Hospital or the State Occupational Health Service Station in Oulu in whom diabetes had been excluded by a glucose tolerance test. Any subject showing signs of myocardial ischaemia was referred for cardiac catheterization. Exercise electrocardiography and 24 hour electrocardiographic recording were ...
The present study confirms the results of our recent study19 that ischemia followed by reperfusion results in cardiac dysfunction in isolated perfused rat hearts, and the cardiac dysfunction is associated with an increase in total Ang II receptor expression in the myocardium immediately after ischemia/reperfusion. The marked increase in Ang II receptor expression could be accounted for in its entirety by an increase in AT1R expression, since AT2R expression was unchanged. In the present study, we also observed a marked increase in AT1R protein and mRNA expression in hearts exposed to ischemia/reperfusion. Although the beneficial effects of chemical blockade of AT1R have been previously shown,11 19 this is perhaps the first report on the salutary effect of AS-ODNs directed at AT1R mRNA on myocardial ischemia/reperfusion injury. AS-ODNs totally abolished the ischemia/reperfusion-induced increase in myocardial AT1R expression and protected against cardiac dysfunction induced by ischemia/reperfusion ...
1 The effects of verapamil (0.15/kg) and fendiline (3 mg/kg) were studied in anaesthetized, thoracotomised dogs with a critical constriction of the left anterior descending coronary artery, paced in excess of the initial rate by 60-70 beats/min. Epicardial ST-segment elevation and changes in lactate uptake were used to assess the severity of myocardial ischaemia. 2 Both drugs prevented the ST-segment elevation and the reduced lactate uptake that resulted from atrial pacing. 3 The anti-ischaemic effect of fendiline is mainly due to its negative chronotropic action, whereas that of verapamil is due in part to bradycardia and in part to the reduced preload and afterload. In addition, both agents increase coronary flow to the ischaemic area and thus improve the myocardial oxygen supply/oxygen requirement ratio.
OBJECTIVE--To compare the prevalence of silent myocardial ischaemia associated with coronary artery disease in diabetic subjects with that in controls of similar age and sex. DESIGN--A controlled study in which subjects with positive findings on exercise electrocardiography, 24 hour electrocardiographic recording, or dynamic thallium scintigraphy (diabetics only) underwent coronary angiography. SETTING--Academic medical centre; referral based cardiology clinic. SUBJECTS--136 Diabetic subjects, of whom 72 (33 women, 39 men (mean age 46.0] were insulin dependent and 64 (19 women, 45 men (mean age 49.3] non-insulin dependent. 80 Controls matched for age and sex; all were clients of the Occupational Health Service of Oulu University Central Hospital or the State Occupational Health Service Station in Oulu in whom diabetes had been excluded by a glucose tolerance test. INTERVENTIONS--Any subject showing signs of myocardial ischaemia was referred for cardiac catheterization. MAIN OUTCOME ...
Objective: To assess the effects of traditional Chinese medicine YiQiFuMai on cardiac function during the progression of ischemic heart failure. Methods: Rabbits were divided into sham, heart failure, and YiQiFuMai groups. The ischemic heart failure model was established in New Zealand white rabbits, which were intraperitoneally injected with YiQiFuMai injection and 0.9% sodium chloride after the operation. After six weeks, cardiac function was examined by ultrasound; serum BNP levels were measured by ELISA; p-AKT, eNOS, ICAM-1 and VEGF levels were evaluated by real-time PCR and Western-Blot; pathological changes of the myocardial tissue were observed by H&E staining; CD31 expression in tissue samples was analyzed by immunohistochemistry. The ultrastructure and microcirculation of myocardial tissue specimens from the three groups were assessed by transmission electron microscopy. Results: YiQiFuMai decreased serum BNP levels, and increased LVEF and reduced LVEDD at 6 weeks postoperatively. In addition,
Most guidelines recommend a systematic screening of asymptomatic high risk patients with diabetes for silent ischemia, but the clinical benefit of this strategy has not been demonstrated compared with the simple control of cardiovascular risk factors. We sought to determine whether referring asymptomatic diabetic patients for screening of silent ischemia decreases the risk of cardiovascular events compared with usual care. DYNAMIT was a prospective, randomized, open, blinded end-point multicenter trial run between 2000 and 2005, with a 3.5 year mean follow-up in ambulatory care in 45 French hospitals. The study included 631 male and female with diabetes aged 63.9 ± 5.1 years, with no evidence of coronary artery disease and at least 2 additional cardiovascular risk factors, receiving appropriate medical treatment. The patients were randomized centrally to either screening for silent ischemia using a bicycle exercise test or Dipyridamole Single Photon Emission Computed Tomography (N = 316), or follow-up
Weve investigated the consequences of hypoxia and myocardial ischemia/reperfusion for the framework and function of cytochrome oxidase (CcO). immunoprecipitated CcO complicated. Most oddly enough, both H89 and MPI put into the perfusion moderate dramatically decreased the ischemia/reperfusion problems for the myocardial cells. Our results directed to a thrilling chance for using CcO activity modulators for managing myocardial damage connected with ischemia and oxidative tension circumstances. 404950-80-7 Cytochrome oxidase (CcO)3 may be the terminal oxidase from the mitochondrial 404950-80-7 electron transportation string, whose activity is normally modulated in response to O2 stress and the task load from the tissues (1-6). This rate-limiting enzyme can be an essential site of legislation of mitochondrial respiration and oxidative phosphorylation (7). In the 404950-80-7 SCA12 fungus, changed CcO activity in response to aerobic and anaerobic circumstances is from the differential appearance of ...
Myocardial Ischemia/Reperfusion (MI/R) injury is a clinical phenomenon including myocardial structural damage, dysfunction and disorders of metabolism..
Echocardiography with its multiple modalities plays a central role in the evaluation of patients with known or suspected coronary artery disease, starting from the differential diagnosis of the patient presenting with acute chest pain. In the patient presenting with acute myocardial infarction (raised troponins) whether it is with ST-segment elevation or without, echocardiography is the first imaging modality used in order to ascertain the presence and extent of LV dysfunction and the presence of complications. In the absence of myocardial infarction (negative troponins), echocardiography will play an important diagnostic role in identifying the presence of reversible myocardial ischaemia. Stress echocardiography in many institutions is now the preferred stress modality associated with imaging as it is cost-effective and does not use ionizing radiation. Finally, echocardiography plays a pivotal role in the assessment of myocardial viability since the presence and extent of viable myocardium may ...
Left ventricular dysfunction is a major determinant of outcome in coronary artery disease.1 However, not all dyssynergic areas are irreversibly damaged after infarction, as left ventricular dysfunction may be caused by myocardial stunning2 or by chronic reduction of blood flow,3 and the segments involved may show improved function after restoration of blood flow.4 Preservation of metabolism despite reduced function is the cornerstone of viable myocardium, but ultrastructural changes have been documented in viable tissue, including loss of sarcoplasmic reticulum, small scattered mitochondria, and glycogen deposition.5 These changes suggest a reduction in aerobic metabolism, but glucose uptake and utilisation are preserved and indeed have been used as a diagnostic marker of viability.6. Because of co-morbidity, myocardial revascularisation may be difficult to achieve in many patients with left ventricular dysfunction and viable myocardium. In these situations, medical treatment to improve left ...
The study by the Medical Research Council is the first to suggest that a combined antithrombotic regimen is useful in the primary prevention of death caused by IHD. Treatment with warfarin alone or warfarin and aspirin was associated with reduced IHD mortality compared with aspirin alone, which only reduced nonfatal events. The results of aspirin therapy are consistent with a meta-analysis of studies on primary prevention with aspirin in patients at relatively low risk (1). Although this study defines the potential value of antithrombotic therapy in the primary prevention of IHD, several factors should be considered before using the combination of warfarin and aspirin. First, the data were mostly collected at a time when aggressive control of cholesterol levels was not widely done. It is difficult to determine the extent to which optimal management of hypertension and hypercholesterolemia would affect the results of this trial. Second, the identification of appropriate high-risk patients for ...
Exercise-induced left ventricular regional wall motion abnormalities among patients with coronary artery disease indicate myocardial ischemia due to significant coronary artery narrowing. Recovery of such stress-induced wall motion abnormalities is thought to occur within minutes after the termination of exercise. However, in some patients, persistent contractile dysfunction has been observed up to 90 minutes into recovery. Whether persistent regional wall motion abnormalities after exercise are due to stunned myocardium (prolonged but reversible postischemic dysfunction despite restoration of blood flow) or persistent ischemia due to coronary vasoconstriction (prolonged postischemic dysfunction due to persistent reduction of regional blood flow) is not well established. It is possible that persistent but reversible left ventricular dysfunction post-exercise may represent persistent reduction in regional blood flow and/or altered regional metabolic state.. In this protocol, we intend to ...
Experimental and clinical studies have demonstrated that myocardial ischemia induces activation of various components of the renin-angiotensin system (RAS), including angiotensinogen, renin, angiotensin-converting enzyme (ACE), angiotensins, and angi
In systemic hypertension, depressed left ventricular midwall shortening predicts an adverse outcome and is associated with increased left ventricular relative wall thickness, which has been proposed as an independent predictor of cardiovascular risk and reduced coronary reserve. This study was designed to investigate whether depressed midwall shortening is associated with more critical impairment of coronary function and with exercise-induced myocardial ischemia. Sixty untreated hypertensive patients without coronary artery stenosis and 20 normotensive volunteers underwent exercise ECG testing, standard and transesophageal echocardiography to assess the occurrence of exercise-induced myocardial ischemia, left ventricular mass, geometry, and midwall shortening, and coronary vasodilator capacity. Compared with hypertensive patients with normal midwall shortening, those with depressed function (n=15) had higher minimum coronary resistance (1.19 0.27 versus 1.39 0.20 mm Hg/cm per second, ...
GLP-1 also showed cardioprotective effects (i.e., infarct size reduction and ejection fraction improvement) in experimental models of myocardial ischemia-reperfusion injury by suppressing caspase-3 activation and preventing apoptosis of cardiomyocytes [[50], [51]]. Of note, such a cardioprotection was previously reported to be mediated by both GLP-1R-dependent and GLP-1R-independent mechanisms [78]. More importantly, GLP-1 has been reported to improve ejection fraction of left ventricle and to prevent its ischemic dysfunction in patients with acute myocardial infarction [79] and coronary artery disease (CAD) [53], respectively. Besides its beneficial effects in CAD, GLP-1 might improve heart failure by increasing glucose uptake and, therefore, left ventricular function, as suggested by both animal [80] and human [[81], [82]] studies. DPP-4 inhibition resulted in similar cardioprotective effects in preclinical models [[83], [84]]. Regarding cerebrovascular function, GLP-1 attenuated cerebral ...
Perioperative ischemia particularly in its NSTEMI aspect is a leading cause of morbidity and mortality and it continues to affect a large population. As the patient population is growing older as a result of technological advancements and sicker it is expected for perioperative ischemic episodes to continue. Such episodes not only affect the outcomes of surgical procedures and the patients quality of life but also translate into enormous associated costs. It is therefore a trifold need to increase awareness and knowledge of it. ...
Coronary artery aneurysms are the dilation of the coronary arteries that supply the heart tissue with blood and nutrients. The dilation exceeds 1.5 times the normal artery size. Complications can occur if these aneurysms rupture. Here is the latest research on coronary artery aneurysms. ...
TY - JOUR. T1 - Relation of baseline examination results to death from ischemic heart disease, cerebro-vascular disease and sudden death. AU - Matsumoto, K.. AU - Ohta, T.. AU - Iwatsuka, T.. AU - Hashimoto, S.. AU - Fukutomi, K.. PY - 1991/6. Y1 - 1991/6. N2 - The relation of variables obtained from a baseline examination to death from ischemic heart disease (IHD), cerebro-vascular disease (CVD) and sudden death (SUD) was analyzed in a case-control study. From questionnaire survey of approximately 180,000 subjects who underwent baseline health examinations in 1971-1986 at Aichi prefectural center of health care, 148 deaths were selected for this study. The number of cases on IHD, CVD and SUD was 36, 60, and 52, respectively. Mean age of cases was 54.8 years old and the mean follow up interval between baseline examination and death was 3.7 years. Four controls matched according to year of baseline examination, age and sex were chosen arbitrarily for each case, and odds ratios for the three ...
Evidence-based guidelines for treating CSX are still lacking. This due partly to the lack of a clear understanding of the pathophysiology of the syndrome and partly to the lack of sufficiently powered randomised controlled trials conducted in these patients. Traditionally, the prognosis of patients with CSX was considered to be benign. However, the Womens Ischaemia Syndrome Evaluation (WISE) study showed that women with persistent chest pain had twice the rate of composite cardiovascular events, including non-fatal myocardial infarction, stroke, congestive heart failure, and cardiovascular deaths, compared with those without [13].. A comprehensive prevention program includes recommendations on lifestyle modification (diet, exercise, body weight reduction, quitting smoking, behavioural and psychosocial issues) that may positively improve endothelial function and microvascular dysfunction. In particular, reduction of body weight in postmenopausal women with hypertension and microvascular angina ...
TY - JOUR. T1 - Scar size and characteristics assessed by CMR predict ventricular arrhythmias in ischaemic cardiomyopathy: comparison of previously validated models. AU - de Haan, S.. AU - Meijers, T.A.. AU - Knaapen, P.. AU - Beek, A.M.. AU - van Rossum, A.C.. AU - Allaart, C.P.. PY - 2011. Y1 - 2011. U2 - 10.1136/heartjnl-2011-300060. DO - 10.1136/heartjnl-2011-300060. M3 - Article. C2 - 21917670. VL - 97. SP - 1951. EP - 1956. JO - Heart. JF - Heart. SN - 1355-6037. IS - 23. ER - ...