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Cardiac microvascular disease

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https://www.readbyqxmd.com/read/29351959/diagnosis-and-significance-of-pulmonary-microvascular-disease-in-diabetes
#1
Timothy J Roberts, Andrew T Burns, Richard J MacIsaac, Andrew I MacIsaac, David L Prior, André La Gerche
OBJECTIVE: To determine whether pulmonary microvascular disease is detectable in subjects with diabetes and associated with diminished exercise capacity using a novel echocardiographic marker quantifying the pulmonary transit of agitated contrast bubbles (PTAC). RESEARCH DESIGN AND METHODS: Sixty participants (40 with diabetes and 20 control subjects) performed cardiopulmonary (maximal oxygen consumption [VO2peak]) and semisupine bicycle echocardiography exercise tests within a 1-week period...
January 19, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29348027/implications-of-underlying-mechanisms-for%C3%A2-the-recognition-and-management-of-diabetic-cardiomyopathy
#2
REVIEW
Thomas H Marwick, Rebecca Ritchie, Jonathan E Shaw, David Kaye
Heart failure is a complex clinical syndrome, the incidence and prevalence of which is increased in diabetes mellitus, pre-diabetes, and obesity. Although this may arise from underlying coronary artery disease, it often occurs in the absence of significant major epicardial coronary disease, and most commonly manifests as heart failure with preserved ejection fraction. Despite epidemiological evidence linking diabetes to heart failure incidence and outcome, the presence of a distinct primary "diabetic" cardiomyopathy has been difficult to prove, because the link between diabetes and heart failure is confounded by hypertension, microvascular dysfunction, and autonomic neuropathy...
January 23, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29325551/relationship-between-cardiac-microvascular-dysfunction-measured-with-82rubidium-pet-and-albuminuria-in-patients-with-diabetes-mellitus
#3
Louis Potier, Renata Chequer, Ronan Roussel, Kamel Mohammedi, Souad Sismail, Agnès Hartemann, Chloé Amouyal, Michel Marre, Dominique Le Guludec, Fabien Hyafil
BACKGROUND: Albuminuria is of one the strongest predictors of cardiovascular disease (CVD) in diabetes. Diabetes is associated with cardiac microvascular dysfunction (CMD), a powerful, independent prognostic factor for cardiac mortality. The aim of this study was to evaluate the relationship between CMD and microvascular complications in patients without known CVD. METHODS: In this monocentric study, myocardial flow reserve (MFR) was measured with cardiac 82Rubidium positron emission tomography (Rb-PET) in 311 patients referred to nuclear medicine department of Bichat University Hospital for screening of coronary artery disease from 2012 to 2014...
January 11, 2018: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29317987/delineation-of-epicardial-stenosis-in-patients-with-microvascular-disease-using-pressure-drop-coefficient-a-pilot-outcome-study
#4
Ullhas Udaya Hebbar, Mohamed A Effat, Srikara V Peelukhana, Imran Arif, Rupak K Banerjee
AIM: To investigate the patient-outcomes of newly developed pressure drop coefficient (CDP) in diagnosing epicardial stenosis (ES) in the presence of concomitant microvascular disease (MVD). METHODS: Patients from our clinical trial were divided into two subgroups with: (1) cut-off of coronary flow reserve (CFR) < 2.0; and (2) diabetes. First, correlations were performed for both subgroups between CDP and hyperemic microvascular resistance (HMR), a diagnostic parameter for assessing the severity of MVD...
December 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/29316137/have-we-really-demonstrated-the-cardiovascular-safety-of-antihyperglycemic-drugs-rethinking-the-concepts-of-macrovascular-and-microvascular-disease-in-type-2-diabetes
#5
REVIEW
Milton Packer
A primary goal of the treatment of type 2 mellitus is the prevention of morbidity and mortality due to cardiovascular disease. However, antihyperglycemic drugs have the capacity to cause deleterious effects on the circulation, a risk that is not adequately reflected by the endpoints selected for emphasis in large-scale clinical trials that are designed to evaluate cardiovascular safety. The primary endpoint of the large-scale studies mandated by regulatory authorities focuses only on 3-4 events that depict only a limited view of the circulatory system...
January 5, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29305560/heart-failure-with-preserved-ejection-fraction-controversies-challenges-and-future-directions
#6
REVIEW
Rosita Zakeri, Martin R Cowie
Heart failure with preserved ejection fraction (HFpEF) comprises almost half of the population burden of HF. Because HFpEF likely includes a range of cardiac and non-cardiac abnormalities, typically in elderly patients, obtaining an accurate diagnosis may be challenging, not least due to the existence of multiple HFpEF mimics and a newly identified subset of patients with HFpEF and normal plasma natriuretic peptide concentrations. The lack of effective treatment for these patients represents a major unmet clinical need...
January 5, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29286050/nonalcoholic-fatty-liver-disease-and-chronic-vascular-complications-of-diabetes-mellitus
#7
REVIEW
Giovanni Targher, Amedeo Lonardo, Christopher D Byrne
Nonalcoholic fatty liver disease (NAFLD) and diabetes mellitus are common diseases that often coexist and might act synergistically to increase the risk of hepatic and extra-hepatic clinical outcomes. NAFLD affects up to 70-80% of patients with type 2 diabetes mellitus and up to 30-40% of adults with type 1 diabetes mellitus. The coexistence of NAFLD and diabetes mellitus increases the risk of developing not only the more severe forms of NAFLD but also chronic vascular complications of diabetes mellitus. Indeed, substantial evidence links NAFLD with an increased risk of developing cardiovascular disease and other cardiac and arrhythmic complications in patients with type 1 diabetes mellitus or type 2 diabetes mellitus...
December 29, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/29280281/the-impact-of-exercise-frequency-upon-microvascular-endothelium-function-and-oxidative-stress-among-patients-with-coronary-artery-disease
#8
Juliana P Borges, Alessandro R Nascimento, Gabriella O Lopes, Daniel J M Medeiros-Lima, Marina P Coelho, Pablo M C Nascimento, Daniel A Kopiler, Cristiane Matsuura, Mauro Felippe F Mediano, Eduardo Tibirica
PURPOSE: This study compared the effects of low and high weekly exercise frequencies on microvascular endothelium function and oxidative stress among patients with coronary artery disease. METHODS: Thirty-four male patients completed a 6-month cardiac rehabilitation programme, from which 23 performed exercise with a high frequency (HF) and 11 with a low frequency (LF). Systemic microvascular blood flow, maximal aerobic capacity, blood lipids, oxidative stress and anthropometric data were assessed prior to and after the cardiac rehabilitation programme...
December 27, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/29249430/prevalence-of-takayasu-arteritis-in-young-women-with-acute-ischemic-heart-disease
#9
Giulio Cavalli, Alessandro Tomelleri, Davide Di Napoli, Elena Baldissera, Lorenzo Dagna
OBJECTIVES: Takayasu arteritis (TA), a systemic vasculitis typically occurring in female patients aged ≤40, can affect coronary arteries and cause ischemic heart disease (IHD). In this study, we investigated the prevalence of TA in young women presenting with IHD in the Emergency Department. METHODS: We evaluated hospital records of 158,860 consecutive female patients aged <40, who accessed the Emergency Department of our institution over 8 consecutive years (2007-2015)...
February 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29246770/a-longitudinal-cohort-study-of-aspirin-use-and-progression-of-emphysema-like-lung-on-ct-the-mesa-lung-study
#10
Carrie P Aaron, Joseph E Schwartz, Eric A Hoffman, Elsa Angelini, John H M Austin, Mary Cushman, David R Jacobs, Joel D Kaufman, Andrew Laine, Lewis J Smith, Jie Yang, Karol E Watson, Russell P Tracy, R Graham Barr
BACKGROUND: Platelet activation reduces pulmonary microvascular blood flow and contributes to inflammation, which have been implicated in the pathogenesis of chronic obstructive pulmonary disease and emphysema. We hypothesized that regular use of aspirin, a platelet-inhibitor, would be associated with slower progression of emphysema-like lung on computed tomography (CT) and slower decline in lung function. METHODS: The Multi-Ethnic Study of Atherosclerosis (MESA) enrolled participants 45-84 years old without clinical cardiovascular disease in 2000-02...
December 12, 2017: Chest
https://www.readbyqxmd.com/read/29244159/pre-clinical-model-of-severe-glutathione-peroxidase-3-deficiency-and-chronic-kidney-disease-results-in-coronary-artery-thrombosis-and-depressed-left-ventricular-function
#11
Paul Pang, Molly Abbott, Malyun Abdi, Quynh-Anh Fucci, Nikita Chauhan, Murti Mistri, Brandon Proctor, Matthew Chin, Bin Wang, Wenqing Yin, Tzong-Shi Lu, Arvin Halim, Kenneth Lim, Diane E Handy, Joseph Loscalzo, Andrew M Siedlecki
Background: Chronic kidney disease (CKD) patients have deficient levels of glutathione peroxidase-3 (GPx3). We hypothesized that GPx3 deficiency may lead to cardiovascular disease in the presence of chronic kidney disease due to an accumulation of reactive oxygen species and decreased microvascular perfusion of the myocardium. Methods: To isolate the exclusive effect of GPx3 deficiency in kidney disease-induced cardiac disease, we studied the GPx3 knockout mouse strain (GPx3-/-) in the setting of surgery-induced CKD...
December 13, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29241208/exosomes-from-mir-126-overexpressing-adscs-are-therapeutic-in-relieving-acute-myocardial-ischaemic-injury
#12
Qiancheng Luo, Dongfeng Guo, Guorong Liu, Guo Chen, Min Hang, Mingming Jin
BACKGROUND/AIMS: Recent studies have indicated that exosomes play an important role in adipose-derived stem cell (ADSC) transplant-mediated ischaemic heart disease therapy. However, the treatment effect is not obvious. The aim of this study is to investigate whether ADSC-derived exosomes enriched with microRNA (miR)-126 have a more protective effect on acute myocardial infarction (AMI). METHODS: Exosomes were characterized by transmission electron microscopy, and the exosome particles were further examined using nanoparticle tracking analyses...
December 12, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/29240905/coronary-autoregulation-and-assessment-of-stenosis-severity-without-pharmacological-vasodilation
#13
Guus A de Waard, Christopher M Cook, Niels van Royen, Justin E Davies
For identification of myocardial ischaemia by non-invasive imaging or invasive physiological assessment, administration of a vasodilating or positive inotropic agent is often considered indispensable to exhaust the cardiac compensation mechanisms. Indeed, microcirculatory dilatation is needed for assessment of myocardial perfusion or coronary blood flow. However, three different modalities exist that quantify myocardial ischaemia without recourse to pharmacological stress agents, using either myocardial contrast echocardiography, imaging of myocardial blood volume or invasive coronary pressure measurement with the instantaneous wave-free ratio (iFR)...
December 11, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29230571/correlation-of-left-ventricular-dyssynchrony-on-gated-myocardial-perfusion-spect-analysis-with-extent-of-late-gadolinium-enhancement-on-cardiac-magnetic-resonance-imaging-in-hypertrophic-cardiomyopathy
#14
Hideaki Yuki, Daisuke Utsunomiya, Shinya Shiraishi, Seiji Takashio, Fumi Sakamoto, Noriko Tsuda, Seitaro Oda, Masafumi Kidoh, Takeshi Nakaura, Kenichi Tsujita, Yasuyuki Yamashita
Myocardial perfusion-single-photon emission computed tomography (MP-SPECT) is used to evaluate microvascular dysfunction and coexisting coronary artery disease in patients with hypertrophic cardiomyopathy (HCM). Phase analysis in gated MP-SPECT can provide additional information on left ventricular (LV) dyssynchrony, while the extent of late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging is an important prognostic factor in patients with HCM. We, therefore, sought to investigate the relationship of dyssynchrony by phase analysis on gated MP-SPECT and LGE on CMR imaging in 22 patients with HCM who underwent both stress/rest-gated MP-SPECT and contrast-enhanced CMR imaging...
December 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29222132/invasive-assessment-of-the-coronary-microvasculature-the-index-of-microcirculatory-resistance
#15
REVIEW
William F Fearon, Yuhei Kobayashi
Traditionally, invasive coronary physiological assessment has focused on the epicardial coronary artery. More recently, appreciation of the importance of the coronary microvasculature in determining patient outcomes has grown. Several invasive modalities for interrogating microvascular function have been proposed. Angiographic techniques have been limited by their qualitative and subjective nature. Doppler wire-derived coronary flow reserve has been applied in research studies, but its clinical role has been limited by its lack of reproducibility, its lack of a clear normal value, and the fact that it is not specific for the microvasculature but interrogates the entire coronary circulation...
December 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29215470/invasive-assessment-of-microvascular-function-in-patients-with-valvular-heart-disease
#16
Takeshi Nishi, Hideki Kitahara, Saito Yuichi, Tomoko Nishi, Takashi Nakayama, Yoshihide Fujimoto, Goro Matsumiya, Yoshio Kobayashi
BACKGROUND: The aim of this study was to investigate microvascular function in patients with valvular heart disease (VHD), which causes chronic left ventricular volume and/or pressure overload, therefore change in coronary microvascular hemodynamics. PATIENTS AND METHODS: We prospectively enrolled 30 patients with VHD considered for surgery (10 aortic stenosis, 12 aortic regurgitation, and eight mitral regurgitation) and 30 controls. Intracoronary physiological assessments were performed in the unobstructed left anterior descending artery using a pressure-temperature sensor guidewire at rest and hyperemia...
December 5, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/29198139/evaluation-of-the-coronary-flow-by-the-coronary-clearance-time-in-patients-with-cardiac-syndrome-x
#17
Erkan Yildirim, Uygar Cagdas Yuksel, Murat Celik, Baris Bugan, Mutlu Gungor, Yalcin Gokoglan, Mustafa Koklu, Suat Gormel, Salim Yasar, Cem Barcin
Objective The vessels involved in the microcirculation are too small to be visualized by conventional angiography and no tools are currently available that can directly evaluate the coronary microcirculation. This study evaluated the coronary clearance frame count (CCFC) in patients with cardiac syndrome X (CSX). Methods The retrospective study enrolled patients with angina, who had a positive nuclear imaging test and normal coronary angiography; and a control group consisting of patients who underwent an angiogram to exclude coronary artery disease...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29189827/-coronary-microvascular-dysfunction-past-present-and-future-of-an-evolving-disease
#18
Vincenzo Sucato, Salvatore Evola, Giuseppina Novo, Nicolò Bellante, Giuseppe Andolina, Salvatore Novo
Coronary atherosclerosis is the main cause of myocardial ischemia. Nevertheless 10-30% of patients with angina has angiographically normal coronary arteries. In the last 30 years, several studies showed that in these patients the symptoms can be caused by dysfunction of the coronary microcirculation. Coronary microvascular dysfunction (CMVD) occurring in patients affected by specific cardiac or systemic diseases may be due to mechanisms of the underlying disease. On the other hand, in several patients affected by angina with angiographically normal coronary arteries, there is no specific disease, and CMVD only is responsible for the clinical picture...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29169759/abnormal-coronary-vasoreactivity-in-transient-left-ventricular-apical-ballooning-tako-tsubo-syndrome
#19
Edoardo Verna, Stefano Provasoli, Sergio Ghiringhelli, Fabrizio Morandi, Jorge Salerno-Uriarte
BACKGROUND: The exact etiology and pathophysiologic mechanisms of tako-tsubo syndrome (TTS) remain controversial. OBJECTIVE: To further evaluate the abnormal coronary vasoreactivity and its possible anatomical substrate in TTS. METHODS: We studied 47 patients (46 women; age 67±12years) who underwent diagnostic cardiac catheterization and evaluation of coronary vasoreactivity by sequential acetylcholine (Ach), nitroglycerine and adenosine testing with angiographic and intracoronary pressure-Doppler flow monitoring...
January 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29168920/a-case-report-of-open-craniofacial-sutures-a-novel-feature-of-systemic-sclerosis
#20
Patricia Gorecki, John Rout
Scleroderma is an uncommon connective-tissue disease, its key feature being excessive collagen deposition resulting in fibrosis of the skin and internal organs. There are different types that can vary in severity from localized scleroderma to systemic sclerosis. Various clinical and radiographic findings can be attributed to the disease, which arise due to the progressive nature of microvascular changes and collagen deposition. These include limited mouth opening, xerostomia, periodontal disease and cardiac and pulmonary disease...
November 23, 2017: Dento Maxillo Facial Radiology
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