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Myocardial IschemiaIschemiaBrain IschemiaMyocardial Reperfusion InjuryMyocardiumCoronary CirculationCoronary DiseaseElectrocardiographyReperfusion InjuryExercise TestMyocardial InfarctionMyocardial ReperfusionHeartAngina PectorisCardiotonic AgentsIschemic Preconditioning, MyocardialHemodynamicsDogsElectrocardiography, AmbulatoryCoronary VesselsTime FactorsDisease Models, AnimalHeart RateCoronary AngiographyTomography, Emission-Computed, Single-PhotonMyocardial ContractionArrhythmias, CardiacReperfusionRats, Sprague-DawleyMyocardial Perfusion ImagingVentricular Function, LeftCreatine KinaseIschemic PreconditioningIschemic Attack, TransientRats, WistarWarm IschemiaDipyridamoleMyocardial StunningPerfusionBlood PressureThallium RadioisotopesAdenosineCoronary Artery DiseaseCollateral CirculationDobutamineMyocytes, CardiacSwineIntraoperative ComplicationsVasodilator AgentsChest PainEchocardiographyCold IschemiaEchocardiography, StressTroponin IRabbitsHeart VentriclesIschemic PostconditioningGerbillinaeSpinal Cord IschemiaVentricular FibrillationTroponin TAcute DiseaseMitochondria, HeartNitroglycerinAnesthesiaLactic AcidCoronary StenosisAngina, UnstableCardiovascular AgentsProspective StudiesSwine, MiniaturePredictive Value of TestsHeart Function TestsRandom AllocationNecrosisConstrictionAngina Pectoris, VariantCoronary Vessel AnomaliesNeuroprotective AgentsLactatesL-Lactate DehydrogenaseBiological MarkersVentricular Dysfunction, LeftInfarction, Middle Cerebral ArteryMice, Inbred C57BLPeroxidaseCoronary VasospasmAdenosine TriphosphateAdrenergic beta-AntagonistsCoronary Artery BypassApoptosisMicrovascular AnginaOxygen ConsumptionErgonovineDiltiazemRisk FactorsPhosphocreatineTechnetium Tc 99m SestamibiAngioplasty, Balloon, CoronarySensitivity and Specificity
InfarctionReperfusion injuryVentricularPresence of myocardial ischemiaDiagnosisNecrosisSuggest myocardialElevationResponse to myocardialComplicationsAlbuminPerfusionTroponinsHypoxiaBiomarkerArrhythmiasTroponin assaysClinicalCardiovascularAtrialAcute mesentericCardiogenic shockElectrocardiogram2018InjuryPathophysiologyDetectionBiomarkersIncreasesTherapeuticSevereAssaysPotassium channelsSystemicOxygenationAnginaHypertensionDetectHemodynamicBiochemicalProteinsChestCardiac outputMortality
Infarction39
  • Go to Myocardial Infarction and Complications of Myocardial Infarction for more complete information on these topics. (medscape.com)
  • Worldwide morbidity and mortality from acute myocardial infarction (AMI) and related heart failure remain high. (hindawi.com)
  • Among clinical emergency events, ST-segment elevation (STE) or the non-STE electrocardiogram diagnosis of acute myocardial infarction (AMI) is particularly common worldwide, with a staggering number of annual first episodes as well as recurrent ones [ 1 ]. (hindawi.com)
  • As previously discussed, the keys to achieving a good outcome in patients with cardiogenic shock are rapid diagnosis, prompt supportive therapy, and expeditious coronary artery revascularization in patients with myocardial ischemia and infarction. (medscape.com)
  • The diagnosis of acute myocardial infarction (MI) is aided by a variety of serum markers, which include creatine kinase (CK) and its subclasses, troponin, myoglobin, and LDH. (medscape.com)
  • The urgency of the problem to diagnose the acute ischemic disease including the acute myocardial infarction is obvious to every general practitioner. (medline.ru)
  • Objective: To assess if the combination of cardiac troponin (cTn) and Ischemia Modified Albumin (IMA) can be used for early exclusion of acute myocardial infarction (AMI). (westminster.ac.uk)
  • Patients with persistent ST segment elevation or acute Q wave myocardial infarction, and those with alternative diagnoses, exit from this guideline and should be managed appropriately. (bmj.com)
  • Patients with unstable angina or non-Q wave myocardial infarction should have their cardiac prognosis assessed by estimation of their risk of death or further cardiac events. (bmj.com)
  • Those patients with unstable angina or non-Q wave myocardial infarction whose condition has stabilised, but who are at high risk of death or further cardiac events , should be referred for coronary angiography. (bmj.com)
  • Ischemia can result in heart failure, myocardial infarction, and stroke. (hemarina.com)
  • The presence of the cardiospecific cardiac troponins (cTns) I (cTnI) and T (cTnT) alongside signs or symptoms of myocardial infarction (MI) are indicative of an acute MI. (ecrjournal.com)
  • According to the new definition of myocardial infarction (MI) issued by the European Society of Cardiology/American College of Cardiology (ESC/ACC) Committee for the Redefinition of Myocardial Infarction, acute MI has occurred when cardiac troponin (cTn) is present in the blood of a patient who also exhibits signs or symptoms of MI. (ecrjournal.com)
  • The occurrence of myocardial infarction (MI) in men is expected earlier and with higher severity compared to age-matched women [ 1 ]. (biomedcentral.com)
  • Over a mean follow-up period of 8.44 years, 268 subjects developed a major cardiovascular event (composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and heart failure requiring hospitalization) and 220 subjects died. (limkinase-signal.com)
  • Here we report a case of acute mesenteric ischaemia complicated with acute anterior myocardial infarction. (rcpjournals.org)
  • AMAE often has a cardiac aetiology, for example mural thrombi after myocardial infarction (MI), atrial thrombi associated with mitral stenosis and atrial fibrillation. (rcpjournals.org)
  • When mesenteric ischaemia occurs in a patient with myocardial infarction, both the occlusive and non-occlusive types may contribute to the pathophysiologic process. (rcpjournals.org)
  • We report such a case, where AMI is complicated with bowel obstruction and delayed perforation in a patient with acute anterior myocardial infarction. (rcpjournals.org)
  • He had a medical history of atrial fibrillation and hypertension of 10 years' duration, and had had a myocardial infarction 4 years ago with stent placement in the left anterior descending (LAD) artery. (rcpjournals.org)
  • The dynamic change of troponin and wave of leads V1-5 indicated acute anterior intensive myocardial infarction. (rcpjournals.org)
  • Multidisciplinary team consultation concluded that NOMI and AMAT were both causes of bowel dysfunction, which should have recovered within a few days of the acute myocardial infarction, and the patient decided to continue with conservative treatment. (rcpjournals.org)
  • Cardiac enzymes are routinely used to risk stratify ED patients with acute chest pain when there is concern for an acute myocardial infarction (AMI) or acute coronary syndrome (ACS). (manualofmedicine.com)
  • The primary endpoint was to identify predictors for NCP presence and adverse CVEs (death, myocardial infarction, or cerebrovascular accident) within two years. (bvsalud.org)
  • Acute myocardial infarction (AMI) is a major cause of morbidity and mortality worldwide. (radcliffecardiology.com)
  • Myocardial infarction (MI), commonly called heart attack, remains a leading cause of mortality and morbidity worldwide, raising an urgent need for novel therapies. (debuglies.com)
  • This study investigated whether continuative use of antidepressants (ADs), considered as a proxy of a state of depression, prior to acute myocardial infarction (AMI) is associated with a higher mortality afterwards. (debuglies.com)
  • In high-income countries, acute myocardial infarction (AMI) is the CHD carrying the highest mortality and morbidity rates [ 1 , 2 , 3 , 4 ]. (debuglies.com)
  • Detailed data have shown a drop in the hospitalization rates for ST-segment elevation myocardial infarction (STEMI) and a rise in the proportion of hospital admissions for other forms (NSTEMI) in the past decade in both Europe and the United States [ 5 , 6 , 7 ]. (debuglies.com)
  • Patients with ST-segment elevated myocardial infarction (STEMI) may have different symptoms and signs of both severe angina pectoris and various complications. (iasp-pain.org)
  • Introduction The European Society of Cardiology has suggested an accelerated algorithm for ruling-in and ruling-out myocardial infarction (MI) with high-sensitive cardiac troponin (hs-cTn) measured at admission (0 hour) and after 1 hour (1 hour) as an alternative to standard measurements at 0 hour and 3 hours. (bmj.com)
  • Recently, European Society of Cardiology introduced an assay-specific 0 hour/1 hour algorithm measuring troponin at admission and 1 hour later for accelerated rule-in and rule-out of acute myocardial infarction. (bmj.com)
  • Moreover, it is unknown if myocardial infarction can be ruled out earlier than at 1 hour. (bmj.com)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. (nih.gov)
  • [6] Such a strategy may determine long-term risk and future therapy but cannot address the risk of acute perioperative myocardial infarction, which has a high mortality rate. (silverchair.com)
  • In a patient who presents with chest pain and possible myocardial infarction (MI), an abnormal value is that above the 99th percentile of the healthy population as a cutoff using an assay with acceptable precision. (medscape.com)
  • The result is a heart attack, known as a myocardial infarction. (medlineplus.gov)
  • Stroke and myocardial infarction are among the most common causes of mortality and disability in the world. (cdc.gov)
  • After noncardiac etiology arrests and missing hospital outcomes were excluded from the analysis (n = 8,585), 31,689 OHCA events of presumed cardiac etiology (e.g., myocardial infarction or arrhythmia) that received resuscitation efforts in the prehospital setting were analyzed. (cdc.gov)
Reperfusion injury7
  • While effective early reperfusion of the criminal coronary artery after a confirmed AMI is the typical treatment at present, collateral myocardial ischemia-reperfusion injury (MIRI) and pertinent cardioprotection are still challenging to address and have inadequately understood mechanisms. (hindawi.com)
  • However, while myocardial reperfusion is well established, the process itself can trigger myocardial reperfusion injury by causing further cardiomyocyte death through multiple pathophysiological mechanisms [ 3 - 5 ]. (hindawi.com)
  • This coupled comorbidity of pathological ischemia and therapeutic reinjury of infarcted myocardium, namely, myocardial ischemia-reperfusion injury (MIRI), is particularly refractory to treatment [ 4 , 5 ]. (hindawi.com)
  • Conceptual diagram of the development and unknown mechanisms of myocardial ischemia-reperfusion injury. (hindawi.com)
  • Effects of monophosphoryl lipid A on myocardial ischemia/reperfusion injury in dogs. (doximity.com)
  • This intervention limits neurologic injury associated with brain ischemia during a cardiac arrest and reperfusion injury associated with resuscitation. (medscape.com)
  • but reperfusion may introduce additional harm to the tissue through a process known as ischemia/reperfusion injury. (cdc.gov)
Ventricular7
Presence of myocardial ischemia1
  • In ischemic heart disease, altered energetics are a highly sensitive indicator of the presence of myocardial ischemia, offering the prospect of a non invasive biochemical stress test for the heart. (ox.ac.uk)
Diagnosis8
  • Cardiac troponins T and I are widely used for the diagnosis of myocardial injury. (medscape.com)
  • It means that Troponin T lends itself most widely for a diagnosis uniting the advantages of the quick and slow markers with the acute myocardial ischemia. (medline.ru)
  • Recently, new cTnI and cTnT with increased sensitivity and precision have been introduced to improve the detection and diagnosis of acute MI, the newest of which, the Elecsys ® Troponin T highly sensitive assay, has demonstrated a particular advantage with high precision even in the 99th percentile. (ecrjournal.com)
  • The detection of elevated cTn levels alone is not sufficient for a diagnosis of acute MI, and requires an in-depth assessment of clinical presentation to determine the source and severity of myocardial damage. (ecrjournal.com)
  • Recent multicentre studies have shown that novel, more sensitive and more precise cTn assays improve the early diagnosis of AMI. (radcliffecardiology.com)
  • Once the diagnosis of carbon monoxide poisoning is confirmed by arterial blood gas analysis for carboxyhemoglobin, electrocardiogram and cardiac biomarkers should be ordered to rule out myocardial ischemia as a sequelae of carbon monoxide poisoning. (infectiousdiseaseadvisor.com)
  • In fact, qualitative assessment of the aortic valve from the parasternal long and short axis views has been shown to be 75% sensitive and 93% specific for the diagnosis of severe AS among trained emergency medicine providers. (emra.org)
  • Diagnosis The normal heart beats in a regular, coordinated way because electrical impulses generated and spread by myocytes with unique electrical properties trigger a sequence of organized myocardial. (merckmanuals.com)
Necrosis3
  • As these proteins are not typically found in the sera of healthy individuals, any concentration of cTns exceeding the 99th percentile is interpreted as myocardial necrosis. (ecrjournal.com)
  • 1 As cTn is not present or is at only very low concentrations in the serum of healthy individuals, a serum concentration above the 99th percentile in a healthy reference population has been accepted as abnormal and, therefore, indicative of myocardial necrosis. (ecrjournal.com)
  • For PCI in patients with normal baseline troponin values, elevations of cardiac biomarkers above the 99th percentile upper reference limit indicate periprocedural myocardial necrosis. (medscape.com)
Suggest myocardial1
Elevation2
  • For example, patients with elevated troponin levels but negative CK-MB values who were formerly diagnosed with unstable angina or minor myocardial injury are now reclassified as non-ST-segment elevation MI (NSTEMI), even in the absence of diagnostic electrocardiographic (ECG) changes. (medscape.com)
  • Troponin elevation in the absence of clinical evidence of ischemia should prompt a search for other causes of cardiac damage, such as myocarditis. (medscape.com)
Response to myocardial2
  • Several studies have been conducted on rodents to gain morphological, functional and molecular insights into sex-related differences in response to myocardial ischemic insults. (biomedcentral.com)
  • Troponins are released in response to myocardial injury regardless of cause. (medscape.com)
Complications3
  • OPCABG avoid CPB to the human body's internal environment disrupt a series of complications, compared with the pump coronary artery bypass grafting (conventional CABG, CCABG), OPCABG also reduce the body's inflammatory response, and significantly reduce oxygen free radical production and myocardial injury [ 2 - 4 ]. (biomedres.info)
  • The lack of serious complications and the high sensitivity to detect inducible ischemia in this patient population provide the basis for further evaluation of the safety and diagnostic value of dobutamine stress echocardiography during general anesthesia in larger studies of patients at risk for coronary artery disease undergoing noncardiac surgery. (silverchair.com)
  • Here we review the current literature on scutellarin to provide a comprehensive understanding of the pharmacological activity, mechanism of action, toxicity, and therapeutic potential of scutellarin for the treatment of ischemia, diabetic complications, and other chronic diseases. (cdc.gov)
Albumin1
Perfusion2
  • The clinical evaluation of ischaemia is problematic in HCM as baseline electrocardiographic abnormalities are frequent and thallium-201 perfusion abnormalities correlate poorly with anginal symptoms. (nih.gov)
  • The intestinal mucosa has a high metabolic rate and, accordingly, a high blood flow requirement (normally receiving 20 to 25% of cardiac output), making it very sensitive to the effects of decreased perfusion. (msdmanuals.com)
Troponins3
  • Since their introduction into clinical practice, the use of "highly sensitive" troponins has remained controversial. (manualofmedicine.com)
  • The current literature does not support the use of "highly sensitive" troponins as a single modality to exclude or diagnose AMI. (manualofmedicine.com)
  • Troponins are generally undetectable in healthy patients, although this may eventually change as more sensitive assays become available. (medscape.com)
Hypoxia3
  • Hypoxia provokes potassium efflux from cardiac muscles cells via the activation of ATP-sensitive potassium channels (KATP). (wikipedia.org)
  • The pathophysiological nature of MIRI is the short-term disturbance of myocardial energy and metabolism caused by reflow after ischemia and hypoxia in the coronary artery and the dynamic changes in apoptosis and the prosurvival signaling pathways in response to related injury factors. (hindawi.com)
  • Hypoxia inducible factor-1 (HIF-1) is an oxygen-sensitive transcriptional regulator that regulates more than 70 downstream target genes, including vascular endothelial growth factor, erythropoietin, glucose transporter and so on ( 5 ). (spandidos-publications.com)
Biomarker1
Arrhythmias1
  • Role of ATP-sensitive K+ channel current in ischemic arrhythmias. (wikipedia.org)
Troponin assays4
  • These changes were instituted following the introduction of increasingly sensitive and precise troponin assays. (medscape.com)
  • In 2009, "highly sensitive" troponin assays became available. (manualofmedicine.com)
  • These "highly sensitive" troponin assays have a higher analytic sensitivity compared with traditional assays. (manualofmedicine.com)
  • Several countries have not yet implemented the algorithm because it has only been validated in few patient cohorts and for certain high-sensitive cardiac troponin assays. (bmj.com)
Clinical5
  • The needleless approach provides millions of patients with potential myocardial ischemic diseases a minimum risk solution for examining their coronary circulation without the potential harm from the standard clinical exams. (cedars-sinai.edu)
  • The role of myocardial ischaemia in the pathophysiology of the disease remains to be determined but coronary sinus pH monitoring provides a method for quantifying and prospectively assessing its effects on clinical presentation and prognosis. (nih.gov)
  • Acute mesenteric ischaemia is divided into different clinical entities which are usually considered separately. (rcpjournals.org)
  • The clinical picture suggested that non-occlusive mesenteric ischaemia and acute mesenteric arterial thrombosis were both present in this case. (rcpjournals.org)
  • Phosphodiesterase inhibitors (PDIs) have important vascular and myocardial protective effects and thus have shown therapeutic usefulness in the clinical settings for treatment of patients with heart failure, pulmonary hypertension, and coronary artery disease. (biomedjournal.com)
Cardiovascular1
  • As such, new drugs that would complement reperfusion by providing neural and cardiovascular protection and by targeting multiple abnormalities in ischemia are receiving increased attention. (cdc.gov)
Atrial1
  • Since changes in [K(+)](o) modulate membrane currents involved in sino-atrial node pacemaking, in particular the voltage-sensitive hyperpolarization-activated current (I(f)), we investigated whether raised [K(+)](o) (from 4 mM to 8 or 12 mM) could directly affect the heart rate response to cardiac sympathetic nerve stimulation (SNS). (ox.ac.uk)
Acute mesenteric1
  • Acute mesenteric ischemia is interruption of intestinal blood flow by embolism, thrombosis, or a low-flow state. (msdmanuals.com)
Cardiogenic shock1
  • both contribute to a self-perpetuating cycle of ischemia and cardiogenic shock (see Figure). (emra.org)
Electrocardiogram1
  • Before ischemia, acute troglitazone treatment had no effect on LV function, electrocardiogram, or substrate utilization. (diabetesjournals.org)
20181
  • Recognizing that cardiac troponin measurements may be elevated in disease states not primarily related to myocardial ischemia, a fourth universal definition of acute MI was developed by the American College of Cardiology (ACC), European Society of Cardiology (ESC), American Hospital Association (AHA), and World Health Federation (WHF) in 2018. (medscape.com)
Injury2
  • A positive "highly sensitive" troponin should be considered a marker of myocardial injury, but not necessarily diagnostic of an AMI. (manualofmedicine.com)
  • When measured with older generation assays, elevated troponin levels can be detected 6-12 hours after onset of myocardial injury, peaking at about 24 hours, followed by a gradual decline over several days (up to 2 weeks). (medscape.com)
Pathophysiology1
Detection2
  • The team has developed cutting-edge MRI technologies, which include a needleless method for myocardial ischemia detection named cardiac fMRI (cfMRI). (cedars-sinai.edu)
  • Coronary sinus pH measurement using a catheter mounted pH electrode is a validated sensitive technique for the detection of myocardial ischaemia. (nih.gov)
Biomarkers1
  • The combination of rising usage of sensitive MI biomarkers and precise imaging techniques, including electrocardiograph (ECG), computed tomography, and cardiac magnetic resonance imaging, made the new MI criteria necessary. (iasp-pain.org)
Increases1
  • Vasopressin, on the other hand, increases coronary blood flow and myocardial oxygen availability. (medscape.com)
Therapeutic1
  • pH Sensitive Drug Delivery Systems (PSDDS) are gaining importance as these systems deliver the drug at specific time as per the pathophysiological need of the disease, resulting in improved patient therapeutic efficacy and compliance. (scialert.net)
Severe1
Assays1
  • The newest generation of cTnT assays has recently been launched on the market as the Elecsys ® Troponin T highly sensitive (TnT-hs) assay (Roche Diagnostics), and has the potential to address both of these concerns. (ecrjournal.com)
Potassium channels4
Systemic1
  • Ischemia disrupts the mucosal barrier, allowing release of bacteria, toxins, and vasoactive mediators, which in turn leads to myocardial depression, systemic inflammatory response syndrome Sepsis and Septic Shock , multisystem organ failure, and death. (msdmanuals.com)
Oxygenation1
  • cfMRI utilizes oxygenation-sensitive MRI signal and controlled coronary artery stimulations to detect impaired coronary artery function without ionizing radiation, exogenous contrast agents and pharmacological stress agents. (cedars-sinai.edu)
Angina1
  • Angina pectoris is caused by myocardial ischemia in the main expression of pain in the chest or adjoining area, which is usually a result of exertion and related to myocardial function disorder. (iasp-pain.org)
Hypertension1
  • For example, up to 25% of all the acute myocardial infarctions do not cause any changes in ECG and from 20 to 30% of them do not display any aching attack, especially with older people as well as those suffering from diabetes and hypertension. (medline.ru)
Detect2
Hemodynamic2
Biochemical1
  • 1├óÔé¼ÔÇ£3 cTns, structural proteins unique to the heart, are sensitive and specific biochemical markers of myocardial damage. (radcliffecardiology.com)
Proteins1
  • FFPE tissue slides were scanned and analyzed digitally, while myocardial proteins were quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS) using isobaric labeling. (biomedcentral.com)
Chest1
  • This study provides further evidence that chest pain in patients with HCM is caused by myocardial ischaemia. (nih.gov)
Cardiac output1
  • This leaves the left ventricle uniquely susceptible to ischemia, which reduces cardiac output and promotes further ischemia. (emra.org)
Mortality1