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Microvascular disease of the heart

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https://www.readbyqxmd.com/read/27855624/the-women-s-heart-insights-into-new-potential-targeted-therapy
#1
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
#2
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/27817854/functional-impairment-of-precerebral-arteries-in-huntington-disease
#3
Jan Kobal, Ksenija Cankar, Janja Pretnar, Marjan Zaletel, Lucijan Kobal, Natasa Teran, Ziva Melik
BACKGROUND: Cardiovascular pathology of Huntington disease (HD) appears to be complex; while microvascular dysfunction seems to appear early, deaths from cardiomyopathy and stroke might occur in the late phase of HD. METHODS: Our study evaluated global risk factors for coronary heart disease (CHD), structure and function of precerebral arteries in 41 HD subjects and 41 matched controls. HD subjects were divided into groups by the United Huntington disease rating scale (presymptomatic-PHD, early-EHD, midstage-MHD and late-LHD)...
October 23, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27812962/implications-of-the-empa-reg-trial-for-clinical-care-and-research
#4
REVIEW
Angeliki M Stamatouli, Silvio E Inzucchi
EMPA-REG OUTCOME was a multicenter, randomized placebo-controlled trial that examined the effect of empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor in addition to standard of care in patients with type 2 diabetes and established cardiovascular (CV) disease. The primary goal was to assess CV safety, as mandated by the US Food and Drug Administration since 2008 for all new glucose-lowering agents. Secondary goals were to examine the effects of empagliflozin on microvascular outcomes and, in particular, kidney disease...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27809867/coronary-microvascular-function-and-myocardial-fibrosis-in-women-with-angina-pectoris-and-no-obstructive-coronary-artery-disease-the-ipower-study
#5
Naja Dam Mygind, Marie Mide Michelsen, Adam Pena, Abbas Ali Qayyum, Daria Frestad, Thomas Emil Christensen, Adam Ali Ghotbi, Nynne Dose, Rebekka Faber, Niels Vejlstrup, Philip Hasbak, Andreas Kjaer, Eva Prescott, Jens Kastrup
BACKGROUND: Even in absence of obstructive coronary artery disease women with angina pectoris have a poor prognosis possibly due to coronary microvascular disease. Coronary microvascular disease can be assessed by transthoracic Doppler echocardiography measuring coronary flow velocity reserve (CFVR) and by positron emission tomography measuring myocardial blood flow reserve (MBFR). Diffuse myocardial fibrosis can be assessed by cardiovascular magnetic resonance (CMR) T1 mapping. We hypothesized that coronary microvascular disease is associated with diffuse myocardial fibrosis...
November 4, 2016: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/27803933/endothelial-microparticles-act-as-novel-diagnostic-and-therapeutic-biomarkers-of-diabetes-and-its-complications-a-literature-review
#6
REVIEW
Fan Deng, Shuang Wang, Liangqing Zhang
Diabetes mellitus- (DM-) related vascular diseases attract increased attention due to their high morbidity and mortality. The incidence of obesity, atherosclerosis, coronary heart disease, hypertension, and dyslipidemia is significantly higher in DM patients, with an earlier onset and faster progression compared with non-DM patients. DM-related vascular diseases including macrovascular and microvascular complications are characterized by endothelial dysfunction. Therefore, a better understanding of the etiology and mechanisms of endothelial dysfunction is important for the diagnosis and treatment of DM...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27793103/the-sphinx-s-riddle-cardiovascular-involvement-in-autoimmune-rheumatic-disease
#7
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/27789769/effect-of-sodium-nitrite-on-local-control-of-contracting-skeletal-muscle-microvascular-oxygen-pressure-in-healthy-rats
#8
Trenton D Colburn, Scott K Ferguson, Clark T Holdsworth, Jesse C Craig, Timothy I Musch, David C Poole
Exercise intolerance characteristic of diseases such as chronic heart failure (CHF) and diabetes is associated with reduced nitric oxide (NO) bioavailability from nitric oxide synthase (NOS), resulting in an impaired microvascular O2 driving pressure (PO2mv; O2 delivery / O2 utilization) and metabolic control. Infusions of the potent NO donor sodium nitroprusside augment NO bioavailability, yet decrease mean arterial pressure (MAP) thereby reducing its potential efficacy for patient populations. To eliminate or reduce hypotensive sequelae, NO2(-) was superfused onto the spinotrapezius muscle...
October 27, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27767984/the-optimum-hematocrit
#9
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/27754865/central-hemodynamics-and-arterial-stiffness-in-systemic-sclerosis
#10
Elena Bartoloni, Giacomo Pucci, Francesca Cannarile, Francesca Battista, Alessia Alunno, Marco Giuliani, Giacomo Cafaro, Roberto Gerli, Giuseppe Schillaci
Although microvascular disease is a hallmark of systemic sclerosis (SSc), a higher prevalence of macrovascular disease and a poorer related prognosis have been reported in SSc than in the general population. The simultaneous assessment of prognostically relevant functional properties of larger and smaller arteries, and their effects on central hemodynamics, has never been performed in SSc using the state-of-the-art techniques. Thirty-four women with SSc (aged 61±15 years, disease duration 17±12 years, and blood pressure 123/70±18/11 mm Hg) and 34 healthy women individually matched by age and mean arterial pressure underwent the determination of carotid-femoral (aortic) and carotid-radial (upper limb) pulse wave velocity (a direct measure of arterial stiffness), aortic augmentation (a measure of the contribution of reflected wave to central pulse pressure), and aortobrachial pulse pressure amplification (brachial/aortic pulse pressure) through applanation tonometry (SphygmoCor)...
October 17, 2016: Hypertension
https://www.readbyqxmd.com/read/27753852/ed-04-4-retinal-arteriolar-structure-as-a-maker-of-vascular-health
#11
Tien Wong
The vasculature in the retina can be viewed directly and non-invasively in vivo, offers a unique perspective of the human microvasculature, and therefore the ability to understand early changes, processes, pathways and consequences of hypertension. In the past 15 years, advances in high resolution digital retinal photography and automated or semi-automated computer image software have been applied to measure and quantify a variety of retinal microvascular parameter, including retinal arteriolar and venular caliber, tortuosity, branching patterns and fractal dimensions...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27751310/a-rare-malady-with-a-rarer-complication
#12
Arun Gopi, Placid Sebastian, C D Ramakrishna
Isolated ventricular noncompaction (IVNC) is an unclassified cardiomyopathy characterized by prominent intraventricular trabeculations separated by deep intertrabecular recesses. Although microvascular dysfunction is known, myocardial infarction is rare and usually seen as a consequence of coincidental coronary artery disease. We report the case of a 19-year-old male patient who presented to us with symptoms and signs of heart failure. Echocardiography revealed IVNC with severe left ventricular dysfunction...
September 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27749939/quality-of-diabetes-care-in-germany-improved-from-2000-to-2007-to-2014-but-improvements-diminished-since-2007-evidence-from-the-population-based-kora-studies
#13
Michael Laxy, Gabriella Knoll, Michaela Schunk, Christa Meisinger, Cornelia Huth, Rolf Holle
OBJECTIVE: Little is known about the development of the quality of diabetes care in Germany. The aim of this study is to analyze time trends in patient self-management, physician-delivered care, medication, risk factor control, complications and quality of life from 2000 to 2014. METHODS: Analyses are based on data from individuals with type 2 diabetes of the population-based KORA S4 (1999-2001, n = 150), F4 (2006-2008, n = 203), FF4 (2013/14, n = 212) cohort study...
2016: PloS One
https://www.readbyqxmd.com/read/27747373/coronary-flow-reserve-in-patients-with-resistant-hypertension
#14
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/27718051/are-all-people-with-diabetes-and-cardiovascular-risk-factors-or-microvascular-complications-at-very-high-risk-findings-from-the-risk-and-prevention-study
#15
Irene Marzona, Fausto Avanzini, Giuseppe Lucisano, Mauro Tettamanti, Marta Baviera, Antonio Nicolucci, Maria Carla Roncaglioni
AIMS: To verify whether it is possible, in people with diabetes mellitus (DM) considered at very high cardiovascular (CV) risk, stratify this risk better and identify significant modifiable risk factor (including lifestyle habits) to help patients and clinicians improve CV prevention. METHODS: People with DM and microvascular diseases or one or more CV risk factors (hypertension, hyperlipidemia, smoking, poor dietary habits, overweight, physical inactivity) included in the Risk and Prevention study were selected...
October 7, 2016: Acta Diabetologica
https://www.readbyqxmd.com/read/27708615/reduced-venous-compliance-in-young-women-with-type-1-diabetes%C3%A2-further-aggravated-by-prolonged-elevated-levels-of-hba1c
#16
Marcus Lindenberger
BACKGROUND: Young patients with diabetes present with reduced compensatory responses to hypovolemic stress. Less compliant veins could be a contributing factor, since roughly two-thirds of the blood volume resides in the venous system as a blood reservoir, adjusting proper venous inflow to the heart. The aim of this study was to measure venous compliance and lower limb blood pooling during hypovolemic stress, and to correlate them to indices of diabetes severity and glucose control. METHODS: Fifteen young women with type 1 diabetes (DW) and 18 healthy age-matched women (C) were subjected to lower body negative pressure (LBNP) (11-44 mmHg), creating hypovolemic stress...
2016: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/27708590/qt-interval-derived-measurements-in-patients-with-cardiac-syndrome-x-compared-to-coronary-artery-disease
#17
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
https://www.readbyqxmd.com/read/27708281/the-fractal-heart-embracing-mathematics-in-the-cardiology-clinic
#18
REVIEW
Gabriella Captur, Audrey L Karperien, Alun D Hughes, Darrel P Francis, James C Moon
For clinicians grappling with quantifying the complex spatial and temporal patterns of cardiac structure and function (such as myocardial trabeculae, coronary microvascular anatomy, tissue perfusion, myocyte histology, electrical conduction, heart rate, and blood-pressure variability), fractal analysis is a powerful, but still underused, mathematical tool. In this Perspectives article, we explain some fundamental principles of fractal geometry and place it in a familiar medical setting. We summarize studies in the cardiovascular sciences in which fractal methods have successfully been used to investigate disease mechanisms, and suggest potential future clinical roles in cardiac imaging and time series measurements...
October 6, 2016: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/27679583/absence-of-peripheral-pulses-and-risk-of-major-vascular-outcomes-in-patients-with-type-2-diabetes
#19
Kamel Mohammedi, Mark Woodward, Sophia Zoungas, Qiang Li, Stephen Harrap, Anushka Patel, Michel Marre, John Chalmers
OBJECTIVE: The burden of vascular diseases remains substantial in patients with type 2 diabetes, requiring identification of further risk markers. We tested the absence of dorsalis pedis and posterior tibial pulses as predictors of major macrovascular and microvascular events, death, and cognitive decline in this population. RESEARCH DESIGN AND METHODS: Data were derived from 11,120 patients with type 2 diabetes in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled Evaluation (ADVANCE) study...
December 2016: Diabetes Care
https://www.readbyqxmd.com/read/27678264/prediabetes-and-type-2-diabetes-are-associated-with-generalized-microvascular-dysfunction-the-maastricht-study
#20
Ben M Sörensen, Alfons J H M Houben, Tos T J M Berendschot, Jan S A G Schouten, Abraham A Kroon, Carla J H van der Kallen, Ronald M A Henry, Annemarie Koster, Simone J S Sep, Pieter C Dagnelie, Nicolaas C Schaper, Miranda T Schram, Coen D A Stehouwer
BACKGROUND: -Type 2 diabetes (T2DM) is associated with an increased risk of cardiovascular disease (CVD). This can be partly explained by large artery dysfunction, which already occurs in prediabetes ('ticking clock hypothesis'). Whether a similar phenomenon also applies to microvascular dysfunction is not known. We therefore tested the hypothesis that microvascular dysfunction is already present in prediabetes and is more severe in T2DM. To do so, we investigated the associations of prediabetes, T2DM, and measures of hyperglycemia with microvascular function measured as flicker light-induced retinal arteriolar dilation and heat-induced skin hyperemia...
September 27, 2016: Circulation
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