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microvascular angina

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https://www.readbyqxmd.com/read/29627899/influence-of-visual-functional-mismatch-on-coronary-flow-profiles-after-percutaneous-coronary-intervention-a-propensity-score-matched-analysis
#1
Masahiro Hoshino, Taishi Yonetsu, Tadashi Murai, Yoshihisa Kanaji, Eisuke Usui, Masahiro Hada, Rikuta Hamaya, Yoshinori Kanno, Tetsumin Lee, Tsunekazu Kakuta
The aims of this study are to clarify whether discrepancies between angiographic and fractional flow reserve (FFR) measurements (visual-functional mismatch) influence coronary flow profiles after percutaneous coronary intervention. While current guidelines FFR-guided revascularization, clinical practice most commonly relies on angiographic evaluation, which may under- or over-estimate the functional relevance of the lesion. Our retrospective analysis involved 274 vessels from 264 patients with stable angina pectoris who underwent FFR, index of microvascular resistance, and coronary flow reserve (CFR) measurements before and after PCI...
April 7, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29538142/microvascular-angina-prevalence-pathophysiology-and-therapy
#2
Angelo Villano, Gaetano A Lanza, Filippo Crea
No abstract text is available yet for this article.
February 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29515047/exploring-deep-into-the-coronary-microcirculation-of-patients-with-microvascular-angina
#3
Masami Goto
No abstract text is available yet for this article.
March 8, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29495996/diagnosis-of-microvascular-angina-using-cardiac-magnetic-resonance
#4
Alexander Liu, Rohan S Wijesurendra, Joanna M Liu, John C Forfar, Keith M Channon, Michael Jerosch-Herold, Stefan K Piechnik, Stefan Neubauer, Rajesh K Kharbanda, Vanessa M Ferreira
BACKGROUND: In patients with angina and nonobstructive coronary artery disease (NOCAD), confirming symptoms due to coronary microvascular dysfunction (CMD) remains challenging. Cardiac magnetic resonance (CMR) assesses myocardial perfusion with high spatial resolution and is widely used for diagnosing obstructive coronary artery disease (CAD). OBJECTIVES: The goal of this study was to validate CMR for diagnosing microvascular angina in patients with NOCAD, compared with patients with obstructive CAD and correlated to the index of microcirculatory resistance (IMR) during invasive coronary angiography...
March 6, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29495995/gadolinium-free-cardiac-mr-stress-t1-mapping-to-distinguish-epicardial-from-microvascular-coronary-disease
#5
Alexander Liu, Rohan S Wijesurendra, Joanna M Liu, Andreas Greiser, Michael Jerosch-Herold, John C Forfar, Keith M Channon, Stefan K Piechnik, Stefan Neubauer, Rajesh K Kharbanda, Vanessa M Ferreira
BACKGROUND: Novel cardiac magnetic resonance (CMR) stress T1 mapping can detect ischemia and myocardial blood volume changes without contrast agents and may be a more comprehensive ischemia biomarker than myocardial blood flow. OBJECTIVES: This study describes the performance of the first prospective validation of stress T1 mapping against invasive coronary measurements for detecting obstructive epicardial coronary artery disease (CAD), defined by fractional flow reserve (FFR <0...
March 6, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29471856/quantitative-cardiovascular-magnetic-resonance-perfusion-imaging-identifies-reduced-flow-reserve-in-microvascular-coronary-artery-disease
#6
Benjamin Zorach, Peter W Shaw, Jamieson Bourque, Sujith Kuruvilla, Pelbreton C Balfour, Yang Yang, Roshin Mathew, Jonathan Pan, Jorge A Gonzalez, Angela M Taylor, Craig H Meyer, Frederick H Epstein, Christopher M Kramer, Michael Salerno
BACKGROUND: Preliminary semi-quantitative cardiovascular magnetic resonance (CMR) perfusion studies have demonstrated reduced myocardial perfusion reserve (MPR) in patients with angina and risk factors for microvascular disease (MVD), however fully quantitative CMR has not been studied. The purpose of this study is to evaluate whether fully quantitative CMR identifies reduced MPR in this population, and to investigate the relationship between epicardial atherosclerosis, left ventricular hypertrophy (LVH), extracellular volume (ECV), and perfusion...
February 22, 2018: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/29429637/coronary-microembolization-and-microvascular-dysfunction
#7
Gerd Heusch, Andreas Skyschally, Petra Kleinbongard
Plaque erosion, fissuring or rupture occurs spontaneously or during coronary interventions. At some residual blood flow, the atherothrombotic debris is washed into the coronary microcirculation, causing physical obstruction, vasoconstriction, inflammation and ultimately microinfarction. Coronary microembolization also contributes to microvascular obstruction in reperfused acute myocardial infarction. Patients with microvascular obstruction after reperfused myocardial infarction have worse prognosis. Cardioprotective strategies to avoid acute coronary microembolization and rescue myocardium from microvascular obstruction have not yet been established in clinical practice...
February 3, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29407076/the-prognostic-value-of-coronary-endothelial-and-microvascular-dysfunction-in-subjects-with-normal-or-non-obstructive-coronary-artery-disease-a-systematic-review-and-meta-analysis
#8
Philip Brainin, Daria Frestad, Eva Prescott
AIMS: Coronary vascular dysfunction is linked with poor cardiovascular prognosis in patients without obstructive coronary artery disease (CAD) but a critical appraisal of the literature is lacking. METHODS AND RESULTS: We performed a systematic review and meta-analysis to quantify the cardiovascular risk associated with endothelial dependent and non-endothelial dependent coronary vascular dysfunction in patients with normal or non-obstructive CAD (epicardial stenosis <50%)...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29333218/impact-of-mindfulness-based-stress-reduction-therapy-on-myocardial-function-and-endothelial-dysfunction-in-female-patients-with-microvascular-angina
#9
Bong Joon Kim, In Suk Cho, Kyoung Im Cho
Background: Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic, and psychiatric disorders. In this study, we investigate the impact of MBSR on left ventricular (LV) and endothelial function in female patients with microvascular angina. Methods: A total of 34 female patients (mean age 52.2 ± 13.8 years) diagnosed with microvascular angina underwent a MBSR program with anti-anginal medication for 8 weeks...
December 2017: Journal of Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/29315085/biopsy-confirmed-endothelial-cell-activation-in-patients-with-coronary-microvascular-dysfunction
#10
Hannes Lindemann, Ivana Petrovic, Stephan Hill, Anastasios Athanasiadis, Heiko Mahrholdt, Tim Schäufele, Karin Klingel, Udo Sechtem, Peter Ong
BACKGROUND: Patients with angina yet having unobstructed coronaries are found in ∼50% of cases undergoing invasive angiography. Coronary spasm and microvascular dysfunction can be responsible for the clinical presentation in ∼60% of cases. However, little is known about structural changes in the myocardium. The aim of this study was to describe findings in endomyocardial biopsies of symptomatic patients with unobstructed coronaries. PATIENTS AND METHODS: We retrospectively analyzed a cohort of 1416 consecutive patients who underwent endomyocardial biopsy sampling and coronary angiography between 2002 and 2016 for various clinical indications...
May 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29249430/prevalence-of-takayasu-arteritis-in-young-women-with-acute-ischemic-heart-disease
#11
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/29242099/downregulation-of-circulating-mots-c-levels-in-patients-with-coronary-endothelial-dysfunction
#12
Qing Qin, Silvia Delrio, Junxiang Wan, R Jay Widmer, Pinchas Cohen, Lilach O Lerman, Amir Lerman
BACKGROUND: MOTS-c is one of the newly identified mitochondrial-derived peptides which play a role in regulating metabolic homeostasis. The current study aimed to investigate whether circulating MOTS-c levels are also associated with endothelial dysfunction(ED) in patients without significant structural coronary lesions. METHODS: Forty patients undergoing coronary angiography and endothelial function testing for clinical indications of recurrent angina with no structural coronary lesions were included in the study...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29228159/patients-with-acute-myocardial-infarction-and-non-obstructive-coronary-arteries-safety-and-prognostic-relevance-of-invasive-coronary-provocative-tests
#13
Rocco A Montone, Giampaolo Niccoli, Francesco Fracassi, Michele Russo, Filippo Gurgoglione, Giulia Cammà, Gaetano A Lanza, Filippo Crea
Aims: Functional alterations of epicardial coronary arteries or coronary microcirculation represent a frequent cause of myocardial infarction and non-obstructive coronary arteries (MINOCA). We aimed at assessing the prognostic value of intracoronary provocative tests in patients presenting with MINOCA and in which other causes of MINOCA have been excluded. Methods and results: We prospectively evaluated patients with a diagnosis of MINOCA, excluding patients with aetiologies other than suspected coronary vasomotor abnormalities...
January 7, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29222822/coronary-microvascular-dysfunction-and-myocardial-contractile-reserve-in-women-with-angina-and-no-obstructive-coronary-artery-disease
#14
Marie M Michelsen, Adam Pena, Naja D Mygind, Jan Bech, Ida Gustafsson, Jens Kastrup, Henrik S Hansen, Nis Høst, Peter R Hansen, Eva Prescott
BACKGROUND: Coronary microvascular dysfunction (CMD) is a potential cause of myocardial ischemia and may affect myocardial function at rest and during stress. We investigated whether CMD was associated with left ventricular diastolic and systolic function at rest and during pharmacologically induced hyperemic stress. METHODS: In a prospective cohort study, we included 963 women with angina, left ventricular ejection fraction (LVEF) >45%, and an invasive coronary angiogram without significant stenosis (<50%)...
February 2018: Echocardiography
https://www.readbyqxmd.com/read/29198139/evaluation-of-the-coronary-flow-by-the-coronary-clearance-time-in-patients-with-cardiac-syndrome-x
#15
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
#16
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/29132649/doppler-versus-thermodilution-derived-coronary-microvascular-resistance-to-predict-coronary-microvascular-dysfunction-in-patients-with-acute-myocardial-infarction-or-stable-angina-pectoris
#17
COMPARATIVE STUDY
Rupert P Williams, Guus A de Waard, Kalpa De Silva, Matthew Lumley, Kaleab Asrress, Satpal Arri, Howard Ellis, Awais Mir, Brian Clapp, Amedeo Chiribiri, Sven Plein, Paul F Teunissen, Maurits R Hollander, Michael Marber, Simon Redwood, Niels van Royen, Divaka Perera
Coronary microvascular resistance is increasingly measured as a predictor of clinical outcomes, but there is no accepted gold-standard measurement. We compared the diagnostic accuracy of 2 invasive indices of microvascular resistance, Doppler-derived hyperemic microvascular resistance (hMR) and thermodilution-derived index of microcirculatory resistance (IMR), at predicting microvascular dysfunction. A total of 54 patients (61 ± 10 years) who underwent cardiac catheterization for stable coronary artery disease (n = 10) or acute myocardial infarction (n = 44) had simultaneous intracoronary pressure, Doppler flow velocity and thermodilution flow data acquired from 74 unobstructed vessels, at rest and during hyperemia...
January 1, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29096805/sex-related-differences-in-vasomotor-function-in-patients-with-angina-and%C3%A2-unobstructed-coronary-arteries
#18
Ahmed Aziz, Henrik Steen Hansen, Udo Sechtem, Eva Prescott, Peter Ong
BACKGROUND: Coronary vasomotor dysfunction is an important mechanism for angina in patients with unobstructed coronary arteries. OBJECTIVES: The purpose of this study was to determine sex differences in the prevalence and clinical presentation of vasomotor dysfunction in a European population and to examine sex differences in the dose of acetylcholine leading to a positive acetylcholine provocation test (ACH test). METHODS: Between 2007 and 2014, we included 1,379 consecutive patients with stable angina, unobstructed coronaries and ACH test performed for epicardial vasospasm or coronary microvascular dysfunction (CMD) due to microvascular spasm...
November 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29046002/-optimal-diagnostics-and-therapy-for-microvascular-angina-pectoris
#19
Peter Ong, Udo Sechtem
Patients with microvascular angina are characterized by angina pectoris with proof of myocardial ischemia in the absence of any relevant epicardial stenosis and without myocardial disease (type 1 coronary microvascular dysfunction according to Crea and Camici). Structural and functional alterations of the coronary microvessels (diameter < 500 µm) are the reason for this phenomenon. Frequently such alterations are associated with cardiovascular risk factors. Patients with angina pectoris without epicardial stenoses represent for 10 - 50 % of all patients undergoing coronary angiography depending on the clinical presentation...
October 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29038224/effect-of-elective-percutaneous-coronary-intervention-on-hyperemic-absolute-coronary-blood-flow-volume-and-microvascular-resistance
#20
Yoshihisa Kanaji, Tadashi Murai, Taishi Yonetsu, Eisuke Usui, Makoto Araki, Junji Matsuda, Masahiro Hoshino, Masao Yamaguchi, Takayuki Niida, Masahiro Hada, Sadamitsu Ichijyo, Rikuta Hamaya, Yoshinori Kanno, Mitsuaki Isobe, Tsunekazu Kakuta
BACKGROUND: The hemodynamics involved in the relationship between absolute coronary blood flow (ABF) volume and myocardial resistance (MR) are complex, and the effect of percutaneous coronary intervention (PCI) on their changes remains unclear. The aim of this study was to investigate the differences in hyperemic ABF and MR before and after elective PCI using a thermodilution method. METHODS AND RESULTS: We investigated 28 vessels (right coronary artery, 9; left anterior descending coronary artery, 18; left circumflex coronary artery, 1) from 28 patients with stable angina pectoris undergoing elective PCI...
October 2017: Circulation. Cardiovascular Interventions
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