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Microvascular disease of the heart

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https://www.readbyqxmd.com/read/28630913/an-innovative-biologic-system-for-photon-powered-myocardium-in-the-ischemic-heart
#1
Jeffrey E Cohen, Andrew B Goldstone, Michael J Paulsen, Yasuhiro Shudo, Amanda N Steele, Bryan B Edwards, Jay B Patel, John W MacArthur, Michael S Hopkins, Casey E Burnett, Kevin J Jaatinen, Akshara D Thakore, Justin M Farry, Vi N Truong, Alexandra T Bourdillon, Lyndsay M Stapleton, Anahita Eskandari, Alexander S Fairman, William Hiesinger, Tatiana V Esipova, William L Patrick, Keven Ji, Judith A Shizuru, Y Joseph Woo
Coronary artery disease is one of the most common causes of death and disability, afflicting more than 15 million Americans. Although pharmacological advances and revascularization techniques have decreased mortality, many survivors will eventually succumb to heart failure secondary to the residual microvascular perfusion deficit that remains after revascularization. We present a novel system that rescues the myocardium from acute ischemia, using photosynthesis through intramyocardial delivery of the cyanobacterium Synechococcus elongatus...
June 2017: Science Advances
https://www.readbyqxmd.com/read/28625511/lung-fluid-clearance-in-chronic-heart-failure-patients
#2
Dani-Louise Dixon, Carmine G De Pasquale, Mark D Lawrence, Elena Cavallaro, Vito Rubino, Andrew D Bersten
Chronic elevation of pulmonary microvascular pressure (Pmv) consistently leads to alveolocapillary barrier thickening and reduction in the filtration coefficient. In animal models of chronic heart failure (CHF) the lung remains dry despite hydrostatic forces. As fluid flux is bi-directional, it has been postulated that an increase in alveolar fluid clearance may facilitate the dry lung when Pmv is chronically elevated. In this study we aimed to examine alveolar fluid clearance in ambulatory patients with CHF secondary to left ventricular (LV) systolic dysfunction compared against non-CHF controls...
May 26, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28616394/new-method-of-sudomotor-function-measurement-to-detect-microvascular-disease-and-sweat-gland-nerve-or-unmyelinated-c-fiber-dysfunction-in-adults-with-retinopathy
#3
John E Lewis, Steven E Atlas, Ammar Rasul, Ashar Farooqi, Laura Lantigua, Oscar L Higuera, Andrea Fiallo, Lianette Laria, Renata Picciani, Ken Wals, Zohar Yehoshua, Armando Mendez, Janet Konefal, Sharon Goldberg, Judi Woolger
BACKGROUND: Diabetes-associated microvascular complications such as retinopathy and neuropathy often lead to end-organ and tissue damage. Impaired skin microcirculation often precedes the detection of other advanced diabetic complications. The ANS-1 system contains a redesigned sympathetic skin response (ANS-1 SSR) device that measures sudomotor function, a photoplethysmography sensor, and a blood pressure device to comprehensively assess cardiac autonomic neuropathy and endothelial dysfunction...
2017: Journal of Diabetes and Metabolic Disorders
https://www.readbyqxmd.com/read/28611075/identification-and-functional-characterization-of-hypoxia-induced-endoplasmic-reticulum-stress-regulating-lncrna-hyperlnc-in-pericytes
#4
Florian C Bischoff, Astrid Werner, David John, Jes-Niels Boeckel, Maria-Theodora Melissari, Phillip Grote, Simone F Glaser, Shemsi Demolli, Shizuka Uchida, Katharina M Michalik, Benjamin Meder, Hugo A Katus, Jan Haas, Wei Chen, Soni S Pullamsetti, Werner Seeger, Andreas M Zeiher, Stefanie Dimmeler, Christoph M Zehendner
Rationale: Pericytes are essential for vessel maturation and endothelial barrier function. Long non-coding RNAs (lncRNAs) regulate many cellular functions, but their role in pericyte biology remains unexplored. Objective: Here we investigate the effect of Hypoxia-Induced Endoplasmic Reticulum Stress Regulating lncRNA (HypERlnc, also known as ENSG00000262454) on pericyte function in vitro and its regulation in human heart failure and idiopathic pulmonary arterial hypertension. Methods and Results: RNA sequencing in human primary pericytes (hPCs) identified hypoxia regulated lncRNAs, including HypERlnc...
June 13, 2017: Circulation Research
https://www.readbyqxmd.com/read/28606344/empa-reg-outcome-the-endocrinologist-s-point-of-view
#5
Leigh Perreault
For many years, it was widely accepted that control of plasma lipids and blood pressure could lower macrovascular risk in patients with type 2 diabetes mellitus (T2DM), whereas the benefits of lowering plasma glucose were largely limited to improvements in microvascular complications. The Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients-Removing Excess Glucose (EMPA-REG OUTCOME) study demonstrated for the first time that a glucose-lowering agent, the sodium glucose cotransporter 2 (SGLT2) inhibitor empagliflozin, could reduce major adverse cardiovascular events, cardiovascular mortality, hospitalization for heart failure, and overall mortality when given in addition to standard care in patients with T2DM at high cardiovascular risk...
July 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28598888/long-term-diabetes-complications-after-pancreas-transplantation
#6
Trond Jenssen, Anders Hartmann, Kåre I Birkeland
PURPOSE OF REVIEW: The intention of this study is to summarize present knowledge about adverse effects of hyperglycemia in diabetes, and in this context review more recent data concerning the effects of pancreas transplantation on a wide range of diabetic complications. RECENT FINDINGS: Effective blood glucose control by insulin delays progression of microvascular complications and probably improves survival in type 1 diabetes. A successful pancreas transplantation combined with a kidney graft has recently been found to prevent diabetic kidney lesions, and registry data support improved long-term patient survival...
June 8, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28585034/myocardial-perfusion-imaging-in-women-for-the-evaluation-of-stable-ischemic-heart-disease-state-of-the-evidence-and-clinical-recommendations
#7
Viviany R Taqueti, Sharmila Dorbala, David Wolinsky, Brian Abbott, Gary V Heller, Timothy M Bateman, Jennifer H Mieres, Lawrence M Phillips, Nanette K Wenger, Leslee J Shaw
This document from the American Society of Nuclear Cardiology represents an updated consensus statement on the evidence base of stress myocardial perfusion imaging (MPI), emphasizing new developments in single-photon emission tomography (SPECT) and positron emission tomography (PET) in the clinical evaluation of women presenting with symptoms of stable ischemic heart disease (SIHD). The clinical evaluation of symptomatic women is challenging due to their varying clinical presentation, clinical risk factor burden, high degree of comorbidity, and increased risk of major ischemic heart disease events...
June 5, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28577279/role-of-pet-to-evaluate-coronary-microvascular-dysfunction-in-non-ischemic-cardiomyopathies
#8
REVIEW
Paco E Bravo, Marcelo F Di Carli, Sharmila Dorbala
Coronary microvascular dysfunction (CMD) can result from structural and functional abnormalities at the intramural and small coronary vessel level affecting coronary blood flow autoregulation and consequently leading to impaired coronary flow reserve. CMD often co-exists with epicardial coronary artery disease but is also commonly seen in patients with various forms of heart disease, including dilated, hypertrophic, and infiltrative cardiomyopathies. CMD can go unnoticed without any symptoms, or manifest as angina, and/or dyspnea, and contribute to the development of heart failure, and even sudden death especially when co-existing with myocardial fibrosis...
June 3, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28574039/-peripheral-perfusion-in-cad-patients-with-various-stage-chronic-heart-failure-undergoing-coronary-artery-bypass-grafting
#9
O V Kamenskaia, A S Klinkova, D V Khabarov
Using the orthostatic test, we examined peripheral perfusion by means of laser Doppler flowmetry (LDF) and transcutaneous oximetry in a total of 104 patients presenting with coronary artery disease and functional class II-IV chronic heart failure (CHF) prior to coronary artery bypass grafting (CABG) and in the remote terms thereafter. Volumetric velocity of the microcirculatory blood flow (MCB) of the lower limbs was measured by means of LDF in perfusion units; partial oxygen pressure (TcPO2, mmHg) was registered by means of transcutaneous oximetry...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28573765/design-and-baseline-characteristics-of-participants-in-the-researching-cardiovascular-events-with-a-weekly-incretin-in-diabetes-rewind-trial-of-dulaglutide-s-cardiovascular-effects
#10
Hertzel C Gerstein, Helen M Colhoun, Gilles R Dagenais, Rafael Diaz, Mark Lakshmanan, Prem Pais, Jeffrey Probstfield, Matthew C Riddle, Lars Rydén, Denis Xavier, Charles Messan Atisso, Alvaro Avezum, Jan Basile, Namsik Chung, Ignacio Conget, William C Cushman, Edward Franek, Nicolae Hancu, Markolf Hanefeld, Shaun Holt, Petr Jansky, Matyas Keltai, Fernando Lanas, Lawrence A Leiter, Patricio Lopez-Jaramillo, Ernesto German Cardona Munoz, Valdis Pirags, Nana Pogosova, Peter J Raubenheimer, Jonathan Shaw, Wayne H-H Sheu, Theodora Temelkova-Kurktschiev
BACKGROUND: Dulaglutide, a synthetic once-weekly, injectable human glucagon-like peptide 1 (GLP1) analogue lowers blood glucose, body weight, appetite, and blood pressure. Its effect on cardiovascular outcomes is unknown. METHODS: People with type 2 diabetes, aged 50 or older, a HbA1c ≤9.5%, and either a previous cardiovascular (CV) event, evidence of CV disease or ≥ 2 CV risk factors were randomly allocated to a weekly subcutaneous injection of either dulaglutide (1...
June 1, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28571621/hemodynamic-catecholamine-vasomotor-and-vascular-responses-determinants-of-myocardial-ischemia-during-mental-stress
#11
Muhammad Hammadah, Ayman Alkhoder, Ibhar Al Mheid, Kobina Wilmot, Nino Isakadze, Naser Abdulhadi, Danielle Chou, Malik Obideen, Wesley T O'Neal, Samaah Sullivan, Ayman Samman Tahhan, Heval Mohamed Kelli, Ronnie Ramadan, Pratik Pimple, Pratik Sandesara, Amit J Shah, Laura Ward, Yi-An Ko, Yan Sun, Irina Uphoff, Brad Pearce, Ernest V Garcia, Michael Kutner, J Douglas Bremner, Fabio Esteves, David S Sheps, Paolo Raggi, Viola Vaccarino, Arshed A Quyyumi
AIMS: Mental stress-induced myocardial ischemia (MSIMI) in patients with coronary artery disease (CAD) is associated with adverse cardiovascular outcomes. We aim to assess hemodynamic, neuro-hormonal, endothelial, vasomotor and vascular predictors of MSIMI. METHODS AND RESULTS: We subjected 660 patients with stable CAD to 99mTc sestamibi myocardial perfusion imaging at rest, with mental (speech task) and with conventional (exercise/pharmacological) stress. Endothelium-dependent flow-mediated dilation (FMD), microvascular reactivity [reactive hyperemia index (RHI)] and arterial stiffness [pulse wave velocity (PWV)] were measured at rest and 30-min after mental stress...
May 25, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28559496/magnetic-resonance-imaging-of-cardiovascular-function-and-the-brain-is-dementia-a-cardiovascular-driven-disease
#12
REVIEW
Albert de Roos, Jeroen van der Grond, Gary Mitchell, Jos Westenberg
The proximal aorta acts as a coupling device between heart and brain perfusion, modulating the amount of pressure and flow pulsatility transmitted into the cerebral microcirculation. Stiffening of the proximal aorta is strongly associated with age and hypertension. The detrimental effects of aortic stiffening may result in brain damage as well as heart failure. The resulting cerebral small vessel disease and heart failure may contribute to early cognitive decline and (vascular) dementia. This pathophysiological sequence of events underscores the role of cardiovascular disease as a contributory mechanism in causing cognitive decline and dementia and potentially may provide a starting point for prevention and treatment...
May 30, 2017: Circulation
https://www.readbyqxmd.com/read/28553592/study-of-neutrophil-lymphocyte-ratio-as-novel-marker-for-diabetic-nephropathy-in-type-2-diabetes
#13
Sagar Ashokrao Khandare, Sachin Chittawar, Nitin Nahar, T N Dubey, Zahraan Qureshi
INTRODUCTION: Diabetic nephropathy (DN) is a microvascular complication of diabetes. DN is clinically manifested as an increase in urine albumin excretion. Total white blood cell count is a crude but sensitive indicator of inflammation and studied in many cardiac and noncardiac diseases as an inflammatory marker such as acute myocardial infarction, stroke, and heart failure. In this study, the association of neutrophil-lymphocyte ratio (NLR) with DN is studied. PATIENTS AND METHODS: It is an observational cross-sectional study...
May 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28540214/coronary-microvascular-dysfunction-in-women-with-nonobstructive-ischemic-heart-disease-as-assessed-by-positron-emission-tomography
#14
REVIEW
Roxana Campisi, Fernando D Marengo
Traditional approaches for risk assessment of ischemic heart disease (IHD) are based on the physiological consequences of an epicardial coronary stenosis. Of note, normal coronary arteries or nonobstructive coronary artery disease (CAD) is a common finding in women with signs and symptoms of ischemia. Therefore, assessment of risk based on a coronary stenosis approach may fail in women. Positron emission tomography (PET) quantifies absolute myocardial blood flow (MBF) which may help to elucidate other mechanisms involved such as endothelial dysfunction and alterations in the smooth muscle cell relaxation responsible for IHD in women...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28535803/blood-metabolomic-fingerprint-is-distinct-in-healthy-coronary-and-in-stenosing-or-microvascular-ischemic-heart-disease
#15
Martino Deidda, Cristina Piras, Christian Cadeddu Dessalvi, Damiana Congia, Emanuela Locci, Federica Ascedu, Gianfranco De Candia, Mauro Cadeddu, Giorgio Lai, Raimondo Pirisi, Luigi Atzori, Giuseppe Mercuro
BACKGROUND: The endothelium is a key variable in the pathogenesis of atherosclerosis and its complications, particularly coronary artery disease (CAD). Current evidence suggests that the endothelial status can be regarded as an integrated index of individual atherogenic and anti-atherogenic properties, and that the interaction between circulating factors and the arterial wall might be critical for atherogenesis. In organism-level investigations, a functional view is provided by metabolomics, the study of the metabolic profile of small molecules...
May 23, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28528579/phosphodiesterase-type-5-inhibition-may-reduce-diastolic-function-in-women-with-ischemia-but-no-obstructive-coronary-artery-disease
#16
Michael D Nelson, Puja K Mehta, Janet Wei, Behzad Sharif, Louise E J Thomson, Daniel Berman, Debiao Li, C Noel Bairey Merz
BACKGROUND: Ischemia, in the absence of obstructive coronary artery disease, is prevalent in women, and associated with increased risk for major cardiovascular events. Coronary microvascular dysfunction is prevalent in these patients, and associated with impaired diastolic function. Despite our general understanding, however, optimal treatment of this cohort remains elusive. METHODS: To address this knowledge gap, we performed an open-label treatment trial to assess whether phosphodiesterase type 5 inhibition improves coronary microvascular perfusion and diastolic function in women with signs and symptoms of ischemia but no evidence of obstructive coronary artery disease...
May 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28526185/empa-reg-outcome-the-endocrinologist-s-point-of-view
#17
Leigh Perreault
For many years, it was widely accepted that control of plasma lipids and blood pressure could lower macrovascular risk in patients with type 2 diabetes mellitus (T2DM), whereas the benefits of lowering plasma glucose were largely limited to improvements in microvascular complications. The Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients-Removing Excess Glucose (EMPA-REG OUTCOME) study demonstrated for the first time that a glucose-lowering agent, the sodium glucose cotransporter 2 (SGLT2) inhibitor empagliflozin, could reduce major adverse cardiovascular events, cardiovascular mortality, hospitalization for heart failure, and overall mortality when given in addition to standard care in patients with T2DM at high cardiovascular risk...
June 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28512159/employing-extracellular-volume-cardiovascular-magnetic-resonance-measures-of-myocardial-fibrosis-to-foster-novel-therapeutics
#18
REVIEW
Erik B Schelbert, Hani N Sabbah, Javed Butler, Mihai Gheorghiade
Quantifying myocardial fibrosis (MF) with myocardial extracellular volume measures acquired during cardiovascular magnetic resonance promises to transform clinical care by advancing pathophysiologic understanding and fostering novel therapeutics. Extracellular volume quantifies MF by measuring the extracellular compartment depicted by the myocardial uptake of contrast relative to plasma. MF is a key domain of dysfunctional but viable myocardium among others (eg, microvascular dysfunction and cardiomyocyte/mitochondrial dysfunction)...
June 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28482008/the-microcirculation-a-key-player-in-obesity-associated-cardiovascular-disease
#19
Oana Sorop, T Dylan Olver, Jens van de Wouw, Ilkka Heinonen, Richard W van Duin, Dirk J Duncker, Daphne Merkus
It is increasingly recognized that obesity is a risk factor for microvascular disease, i.e. results in structural and functional changes in the microvasculature. This review aims to describe how obesity impacts the microvasculature of visceral adipose tissue, skeletal muscle, heart, brain, kidneys and lungs. These changes involve endothelial dysfunction, which in turn impacts control of vascular tone, contributes to development of microvascular insulin resistance, alters secretion of paracrine factors like nitric oxide and endothelin, but also influences vascular structure and perivascular inflammation...
May 8, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28473471/are-targeted-therapies-for-diabetic-cardiomyopathy-on-the-horizon
#20
REVIEW
Mitchel Tate, David J Grieve, Rebecca H Ritchie
Diabetes increases the risk of heart failure approximately 2.5-fold, independent of coronary artery disease and other comorbidities. This process, termed diabetic cardiomyopathy, is characterized by initial impairment of left ventricular (LV) relaxation followed by LV contractile dysfunction. Post-mortem examination reveals that human diastolic dysfunction is closely associated with LV damage, including cardiomyocyte hypertrophy, apoptosis and fibrosis, with impaired coronary microvascular perfusion. The pathophysiological mechanisms underpinning the characteristic features of diabetic cardiomyopathy remain poorly understood, although multiple factors including altered lipid metabolism, mitochondrial dysfunction, oxidative stress, endoplasmic reticulum (ER) stress, inflammation, as well as epigenetic changes, are implicated...
May 1, 2017: Clinical Science (1979-)
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