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Cardiac microvascular disease

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https://www.readbyqxmd.com/read/28081214/cold-pressor-stress-cardiac-magnetic-resonance-myocardial-flow-reserve-is-not-useful-for-detection-of-coronary-endothelial-dysfunction-in-women-with-signs-and-symptoms-of-ischemia-and-no-obstructive-cad
#1
Sofy Landes, Sherwin Dela Cruz, Janet Wei, Ahmed AlBadri, Chrisandra Shufelt, Puja Mehta, Louise E Thomson, Marcio A Diniz, Xiao Zhang, John W Petersen, R David Anderson, Carl J Pepine, Daniel S Berman, C Noel Bairey Merz
BACKGROUND: Coronary endothelial function testing using acetylcholine is not routinely available, while non-pharmacological cold pressor testing (CPT) is considered an endothelial stressor. Noninvasive cardiac magnetic resonance imaging (CMRI) myocardial perfusion reserve index (MPRI) can detect coronary microvascular dysfunction (CMD). We evaluated if CPT stress CMRI MPRI could detect invasive coronary endothelial dysfunction. METHODS: Coronary reactivity testing was performed in 189 women with symptoms and signs of ischemic but no obstructive coronary artery disease as previously described plus CPT stress...
2017: PloS One
https://www.readbyqxmd.com/read/28075427/evaluation-of-sudomotor-function-in-adult-patients-with-long-lasting-type-1-diabetes
#2
Agnieszka Gandecka, Aleksandra Araszkiewicz, Stanisław Piłaciński, Bogna Wierusz-Wysocka, Dorota Zozulińska-Ziółkiewicz
INTRODUCTION    The function of sweat glands appears to be impaired in patients with diabetic complications.  OBJECTIVES    The aim of the study was to evaluate the sudomotor function in adult patients with type 1 diabetes (DM1) and healthy controls and its relationship with metabolic control and diabetic complications. PATIENTS AND METHODS    The study included 404 adult patients with DM 1 (194 women) aged 41 years (IQR: 32-51), disease duration 23 years (IQR: 18-31). Electrochemical skin conductance (ESC) was measured with SUDOSCAN+ on feet and hands in the study group and in the control group of 84 healthy volunteers...
January 10, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28060863/the-systematic-evaluation-of-identifying-the-infarct-related-artery-utilizing-cardiac-magnetic-resonance-in-patients-presenting-with-st-elevation-myocardial-infarction
#3
Carine E Hamo, Igor Klem, Sunil V Rao, Vincent Songco, Samer Najjar, Edward G Lakatta, Subha V Raman, Robert A Harrington, John F Heitner
BACKGROUND: Identification of the infarct-related artery (IRA) in patients with STEMI using coronary angiography (CA) is often based on the ECG and can be challenging in patients with severe multi-vessel disease. The current study aimed to determine how often percutaneous intervention (PCI) is performed in a coronary artery different from the artery supplying the territory of acute infarction on cardiac magnetic resonance imaging (CMR). METHODS: We evaluated 113 patients from the Reduction of infarct Expansion and Ventricular remodeling with Erythropoetin After Large myocardial infarction (REVEAL) trial, who underwent CMR within 4±2 days of revascularization...
2017: PloS One
https://www.readbyqxmd.com/read/28011232/cardiac-biomarkers-in-diabetes-mellitus-new-dawn-for-risk-stratification
#4
REVIEW
Alexander E Berezin
Type 2 diabetes mellitus (T2DM) remains a leading cause of cardiovascular (CV) events and diseases worldwide. The aim of the review is to summarize our knowledge regarding clinical implementation of the biomarker-based strategy of the CV risk assessment in T2DM patient population. There is large body of evidence regarding use of the cardiac biomarkers to risk stratification at higher CV risk individuals who belongs to general population and cohort with established CV disease. Although T2DM patients have higher incidence of macrovascular and microvascular CV complications than the general population, whether cardiac biomarkers would be effective to risk stratification of the T2DM is not fully understood...
December 13, 2016: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28004395/myocardial-tissue-deformation-is-reduced-in-subjects-with-coronary-microvascular-dysfunction-but-not-rescued-by-treatment-with-ranolazine
#5
Michael D Nelson, Behzad Sharif, Jaime L Shaw, Galen Cook-Wiens, Janet Wei, Chrisandra Shufelt, Puja K Mehta, Louise E J Thomson, Daniel S Berman, Richard B Thompson, Eileen M Handberg, Carl J Pepine, Debiao Li, C Noel Bairey Merz
BACKGROUND: Patients with coronary microvascular dysfunction (CMD) often have diastolic dysfunction, representing an important therapeutic target. Ranolazine-a late sodium current inhibitor-improves diastolic function in animal models and subjects with obstructive coronary artery disease (CAD). HYPOTHESIS: We hypothesized that ranolazine would beneficially alter diastolic function in CMD. METHODS: To test this hypothesis, we performed retrospective tissue tracking analysis to evaluate systolic/diastolic strain, using cardiac magnetic resonance imaging cine images acquired in a recently completed, randomized, double-blind, placebo-controlled, crossover trial of short-term ranolazine in subjects with CMD and from 43 healthy reference controls...
December 22, 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/27976459/current-perspectives-in-coronary-microvascular-dysfunction
#6
Joy S Shome, Divaka Perera, Sven Plein, Amedeo Chiribiri
The coronary arterial system consists of large epicardial coronary arteries, pre-arterioles, and arterioles, which together closely regulate coronary blood flow. Structural, functional and extravascular abnormalities of the microcirculation lead to coronary microvascular dysfunction (CMD). CMD can present with symptoms suggestive of coronary artery disease (CAD), often in the absence of significant obstructive epicardial CAD. Conventional invasive angiography does not allow direct visualization of the microcirculation...
December 15, 2016: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/27931645/haemodynamic-coherence%C3%A2-%C3%A2-the-relevance-of-fluid-therapy
#7
REVIEW
Philip Arnemann, Laura Seidel, Christian Ertmer
The ultimate goal of fluid therapy is to improve the oxygenation of cells by improving the cardiac output, thus improving microcirculation by optimizing macrocirculation. This haemodynamic coherence is often altered in patients with haemorrhagic shock and sepsis. The loss of haemodynamic coherence is associated with adverse outcomes. It may be influenced by the mechanisms of the underlying disease and properties of different fluids used for resuscitation in these critically ill patients. Monitoring microcirculation and haemodynamic coherence may be an additional tool to predict the response to fluid administration...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27926994/microvessels-of-the-heart-formation-regeneration-and-dysfunction
#8
Ioakim Spyridopoulos, Helen M Arthur
This issue of Microcirculation focusses on the special topic of "microvessels of the heart" and contains five state-of-the-art reviews and one expert article that reflect current efforts to address the major gaps in our understanding of these key microvessels. In the adult heart, most attention until recently (especially among the clinical cardiology community) has been given to the main coronary arteries, which are the culprit vessels in patients with coronary artery disease, including its most serious manifestation, acute myocardial infarction (MI)...
December 7, 2016: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/27908971/13n-ammonia-pet-ct-detection-of-myocardial-perfusion-abnormalities-in-beagle-dogs-after-local-heart-irradiation
#9
Jianbo Song, Rui Yan, Zhifang Wu, Jianguo Li, Min Yan, Xinzhong Hao, Jianzhong Liu, Sijin Li
: To determine the potential value of (13)N-ammonia positron emission tomography (PET)/computed tomography (CT) myocardial perfusion imaging (MPI) for detection of myocardial perfusion changes at early stage induced by radiation damage. METHODS: Thirty-six Beagle dogs were randomly divided into the control (n = 18) or the irradiation groups (n = 18). The irradiation group underwent local irradiation to the left ventricular anterior cardiac wall with a single dose of 20 Gy, whereas the control group received sham irradiation...
December 1, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/27904032/coronary-microvascular-dysfunction%C3%A3-epidemiology-pathogenesis-prognosis-diagnosis-risk-factors-and-therapy
#10
Cheng Chen, Janet Wei, Ahmed AlBadri, Parham Zarrini, C Noel Bairey Merz
Angina has traditionally been thought to be caused by obstructive coronary artery disease (CAD). However, a substantial number of patients with angina are found to not have obstructive CAD when undergoing coronary angiography. A significant proportion of these patients have coronary microvascular dysfunction (CMD), characterized by heightened sensitivity to vasoconstrictor stimuli and limited microvascular vasodilator capacity. With the advent of non-invasive and invasive techniques, the coronary microvasculature has been more extensively studied in the past 2 decades...
December 22, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27855624/the-women-s-heart-insights-into-new-potential-targeted-therapy
#11
Daniele Gianfrilli, Ricardo Pofi, Tiziana Feola, Andrea Lenzi, Elisa Giannetta
Cardiovascular disease represents an increasing cause of death in women. The analysis of cardiovascular risk factors in women has not reached a consensus with respect to a specific and personalized treatment designed in pre-menopausal and post-menopausal phases. Clinically significant cardioprotective and antiremodeling effects were detected in animal and human study exploring chronic inhibition of Phosphodiesterase type 5 (PDE5). The relationship between heart, estrogens and PDE5 inhibitors (PDE5i) remains unclear...
November 18, 2016: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/27837397/from-arb-to-arni-in-cardiovascular-control
#12
REVIEW
Estrellita Uijl, Lodi C W Roksnoer, Ewout J Hoorn, A H Jan Danser
Coexistence of hypertension, diabetes mellitus and chronic kidney disease synergistically aggravates the risk of cardiovascular and renal morbidity and mortality. These high-risk, multi-morbid patient populations benefit less from currently available anti-hypertensive treatment. Simultaneous angiotensin II type 1 receptor blockade and neprilysin inhibition ('ARNI') with valsartan/sacubitril (LCZ696) might potentiate the beneficial effects of renin-angiotensin-aldosterone inhibition by reinforcing its endogenous counterbalance, the natriuretic peptide system...
December 2016: Current Hypertension Reports
https://www.readbyqxmd.com/read/27832796/antecedent-hypertension-and-myocardial-injury-in-patients-with-reperfused-st-elevation-myocardial-infarction
#13
Sebastian J Reinstadler, Thomas Stiermaier, Charlotte Eitel, Mohammed Saad, Bernhard Metzler, Suzanne de Waha, Georg Fuernau, Steffen Desch, Holger Thiele, Ingo Eitel
BACKGROUND: Antecedent hypertension is associated with poor outcome in patients with ST-elevation myocardial infarction (STEMI). Whether differences in myocardial salvage, infarct size and microvascular injury contribute to the adverse outcome is unknown. We investigated the association between antecedent hypertension and cardiovascular magnetic resonance (CMR) parameters of myocardial salvage and damage in a multicenter CMR substudy of the AIDA-STEMI trial (Abciximab Intracoronary versus intravenously Drug Application in ST-elevation myocardial infarction)...
November 11, 2016: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/27826336/the-association-between-whole-blood-viscosity-and-coronary-collateral-circulation-in-patients-with-chronic-total-occlusion
#14
Mehmet Serkan Cetin, Elif Hande Ozcan Cetin, Kevser Gülcihan Balcı, Selahattin Aydin, Emek Ediboglu, Muhammed Fatih Bayraktar, Mustafa Mücahit Balcı, Orhan Maden, Ahmet Temizhan, Sinan Aydogdu
BACKGROUND AND OBJECTIVES: Coronary collateral circulation (CCC) has been attributed as inborn bypass mechanisms supporting ischemic myocardium. Various factors have been postulated in CCC. Whole blood viscosity (WBV) has been an underappreciated entity despite close relationships between multiple cardiovascular diseases. WBV can be calculated with a validated equation from hematocrit and total plasma protein levels for a low and high shear rate. On the grounds, we aimed to evaluate the association between WBV and CCC in patients with chronic total occlusion...
November 2016: Korean Circulation Journal
https://www.readbyqxmd.com/read/27793103/the-sphinx-s-riddle-cardiovascular-involvement-in-autoimmune-rheumatic-disease
#15
REVIEW
Sophie Mavrogeni, George Markousis-Mavrogenis, Genovefa Kolovou
Factors leading to Cardiovascular Disease (CVD) in Autoimmune Rheumatic Diseases (ARD) include: a) atherosclerosis and macro-microvascular coronary artery disease b) pericardial, myocardial and vascular inflammation c) heart valve disease d) heart failure and e) pulmonary hypertension.Cardiology utilizes various non-invasive imaging modalities, such as rest/stress Electrocardiogram (ECG), echocardiography, nuclear imaging and more recently Cardiovascular Magnetic Resonance (CMR) to detect ischemic or inflammatory disease in ARD...
October 28, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27767984/the-optimum-hematocrit
#16
Walter H Reinhart
The hematocrit (Hct) determines the oxygen carrying capacity of blood, but also increases blood viscosity and thus flow resistance. From this dual role the concept of an optimum Hct for tissue oxygenation has been derived. Viscometric studies using the ratio Hct/blood viscosity at high shear rate showed an optimum Hct of 50-60% for red blood cell (RBC) suspensions in plasma. For the perfusion of an artificial microvascular network with 5-70μm channels the optimum Hct was 60-70% for high driving pressures. With lower shear rates or driving pressures the optimum Hct shifted towards lower values...
October 21, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27753846/ed-02-3-clinical-implications-of-central-hemodynamics-on-aortic-and-end-organ-diseases
#17
Junichiro Hashimoto
The central aorta constitutes the main trunk of the systemic arterial tree. It dilates passively with cardiac ejection during systole and then constricts with its recoil function during diastole, thereby regulating blood pressure and blood flow. The central pulsatile hemodynamics affects local hemodynamics within as well as downstream of the aorta (e.g., end organs).The aorta progressively stiffens and dilates with advancing age, and such age-dependent change is accelerated by hypertension. According to the law of Laplace, wall stress depends on the diameter and pressure of the blood vessel...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27747373/coronary-flow-reserve-in-patients-with-resistant-hypertension
#18
Sebastian Völz, Sara Svedlund, Bert Andersson, Gan Li-Ming, Bengt Rundqvist
Resistant hypertension is associated with increased risk for cardiovascular events. Coronary flow reserve (CFR) is impaired in patients with hypertension and an independent predictor of cardiac mortality. However, there are no published data on CFR in the subset of treatment-resistant hypertension. The aim of this study was to assess CFR in patients with resistant hypertension. Twenty-five consecutive patients with primary resistant hypertension, scheduled for renal denervation, 25 matched patients with controlled hypertension, and 25 healthy controls underwent transthoracic colour Doppler echocardiography at rest and during adenosine infusion...
October 17, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/27710895/cd200fc-attenuates-inflammatory-responses-and-maintains-barrier-function-by-suppressing-nf-%C3%AE%C2%BAb-pathway-in-cigarette-smoke-extract-induced-endothelial-cells
#19
Junwei Xu, Lu Lu, Jing Lu, Jihui Xia, Hongjin Lu, Lin Yang, Wensheng Xia, Shihai Shen
BACKGROUND: Recent evidence suggests that CD200 fusion protein (CD200Fc), a CD200R1 agonist may attenuate inflammatory responses in autoimmune diseases and neuro-degeneration. While, little is known about the function of CD200Fc in cigarette smoke extract (CSE)-induced mouse Cardiac Microvascular Endothelial Cells (mCMECs). The present study was designed to elucidate the effects of CD200Fc on CSE-induced vascular endothelial barrier (VEB) dysfunction and inflammatory responses, which is a highly clinically relevant model of smoking related cardiovascular diseases...
December 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/27708590/qt-interval-derived-measurements-in-patients-with-cardiac-syndrome-x-compared-to-coronary-artery-disease
#20
Mohamed F Lutfi
Previous studies assessing effect of ischemia on ventricular repolarization are mostly directed toward patients with coronary artery disease (CAD); however, similar reports on cardiac syndrome X (CSX) are scarce. Whether microvascular dysfunction of CSX and ischemia induced by CAD produce comparable effect on ventricular repolarization is unclear and deserve further studies. In the present study, ECG measures of ventricular repolarization were compared between CAD and CSX patients (40 subjects in each group)...
2016: Frontiers in Physiology
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