Read by QxMD icon Read

microvascular angina

Theodor Baars, Philipp Kahlert, Albert Baars, Heike Preibsch, Tienush Rassaf, Gerd Heusch, Petra Kleinbongard
OBJECTIVE: Stent implantation into atherosclerotic coronary vessels induces the release of particulate debris and soluble vasoactive substances, which impair downstream microvascular function. Microvascular perfusion, however, is also determined by hemorheological parameters. We therefore analyzed now changes in erythrocyte (RBC) aggregation in coronary arterial blood during stent implantation. METHODS: Symptomatic male patients with stable angina pectoris and stenosis in their native right coronary artery (RCA) or saphenous vein graft on right coronary artery (SVG-RCA) were enrolled...
October 13, 2016: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
Hasan Basarir, Alan Brennan, Richard Jacques, Daniel Pollard, Katherine Stevens, Jennifer Freeman, Jerry Wales, Katherine Price
OBJECTIVES: Kids in Control OF Food (KICk-OFF) is a 5-day structured education program for 11- to 16-year-olds with type 1 diabetes mellitus (T1DM) who are using multiple daily insulin injections. This study evaluates the cost-effectiveness of the KICk-OFF education program compared with the usual care using data from the KICk-OFF trial. METHODS: The short-term within-trial analysis covers the 2-year postintervention period. Data on glycated hemoglobin (HbA1c), severe hypoglycemia, and diabetic ketoacidosis (DKA) were collected over a 2-year follow-up period...
October 10, 2016: International Journal of Technology Assessment in Health Care
Yuji Odaka, Jun Takahashi, Ryuji Tsuburaya, Kensuke Nishimiya, Kiyotaka Hao, Yasuharu Matsumoto, Kenta Ito, Yasuhiko Sakata, Satoshi Miyata, Daisuke Manita, Yuji Hirowatari, Hiroaki Shimokawa
AIMS: Although the importance of coronary microvascular dysfunction (CMD) has been emerging, reliable biomarkers for CMD remain to be developed. We examined the potential usefulness of plasma concentration of serotonin to diagnose CMD in patients with suspected angina and unobstructive coronary arteries. METHODS AND RESULTS: We enrolled 198 consecutive patients (M/F 116/82, 60.2 ± 13.3 years old) who underwent acetylcholine provocation test and measured plasma serotonin concentration...
October 2, 2016: European Heart Journal
Tomonori Akasaka, Daisuke Sueta, Yuichiro Arima, Noriaki Tabata, Seiji Takashio, Yasuhiro Izumiya, Eiichiro Yamamoto, Megumi Yamamuro, Kenichi Tsujita, Sunao Kojima, Koichi Kaikita, Ayami Kajiwara, Kazunori Morita, Kentaro Oniki, Junji Saruwatari, Kazuko Nakagawa, Yasuhiro Ogata, Kunihiko Matsui, Seiji Hokimoto
BACKGROUND: Categorization as a cytochrome P450 (CYP) 2C19 poor metabolizer (PM) is reported to be an independent risk factor for cardiovascular disease. Epoxyeicosatrienoic acids (EETs) are metabolites of arachidonic acid by CYP2C19 epoxygenases and anti-inflammatory properties, especially in microvascular tissues. We examined the impact of CYP2C19 polymorphisms and EETs on microvascular angina (MVA) caused by coronary microvascular dysfunction. METHODS AND RESULTS: We examined CYP2C19 genotypes in patients with MVA (n=71) and healthy subjects as control (n=71)...
September 23, 2016: American Journal of Physiology. Heart and Circulatory Physiology
Tracy K Paul, Kaartiga Sivanesan, Joshua Schulman-Marcus
The existence of sex differences in the epidemiology, presentation, diagnosis, and management of coronary artery disease (CAD) has been a subject of growing inquiry for the past several decades. The prevailing paradigm is that the prevalence of anatomically obstructive disease of the epicardial coronary arteries is less common in women than similarly aged men, while nonobstructive and microvascular ischemic disease is more prevalent in women. Although both "patterns" of coronary atherosclerosis are associated with angina and cardiovascular events, the dominant diagnostic and therapeutic tools used in cardiology have focused on the male-predominant pattern of anatomically obstructive epicardial CAD...
August 11, 2016: Trends in Cardiovascular Medicine
Peter Ong, Anastasios Athanasiadis, Udo Sechtem
Intracoronary acetylcholine provocation testing (ACH-test) is an established method for assessment of epicardial coronary artery spasm in the catheterization laboratory which was introduced more than 30 years ago. Due to the short half-life of acetylcholine it can only be applied directly into the coronary arteries. Several studies have demonstrated the safety and clinical usefulness of this test. However, acetylcholine testing is only rarely applied in the U.S. or Europe. Nevertheless, it has been shown that 62% of Caucasian patients with stable angina and unobstructed coronary arteries on coronary angiography suffer from coronary vasomotor disorders that can be diagnosed with acetylcholine testing...
2016: Journal of Visualized Experiments: JoVE
Matthew Lumley, Rupert Williams, Kaleab N Asrress, Satpal Arri, Natalia Briceno, Howard Ellis, Ronak Rajani, Maria Siebes, Jan J Piek, Brian Clapp, Simon R Redwood, Michael S Marber, John B Chambers, Divaka Perera
BACKGROUND: Severe aortic stenosis (AS) can manifest as exertional angina even in the presence of unobstructed coronary arteries. OBJECTIVES: The authors describe coronary physiological changes during exercise and hyperemia in the healthy heart and in patients with severe AS. METHODS: Simultaneous intracoronary pressure and flow velocity recordings were made in unobstructed coronary arteries of 22 patients with severe AS (mean effective orifice area 0...
August 16, 2016: Journal of the American College of Cardiology
Giacinta Guarini, Alda Huqi, Doralisa Morrone, Mario Marzilli
Despite continuous advances in myocardial revascularization procedures and intracoronary devices, patients with ischemic heart disease (IHD) still experience worse prognosis and poor quality of life (QoL). Indeed, chronic stable angina (CSA) is a common disease with a large burden on healthcare costs. Traditionally, CSA is interpreted as episodes of reversible myocardial ischemia related to the presence of stable coronary artery plaque causing myocardial demand/supply mismatch when myocardial oxygen consumption increases...
August 2016: Cardiovascular Drugs and Therapy
Seiji Hokimoto, Noriaki Tabata, Kenshi Yamanaga, Daisuke Sueta, Tomonori Akasaka, Kenichi Tsujita, Kenji Sakamoto, Eiichiro Yamamoto, Megumi Yamamuro, Yasuhiro Izumiya, Koichi Kaikita, Sunao Kojima, Kunihiko Matsui, Hisao Ogawa
BACKGROUND: The aim was to examine the prevalence and characteristics of epicardial vasomotor abnormality (EVA) and coronary microvascular dysfunction (CMD) including endothelium-dependent (EDCMD) or -independent (EICMD) in patients following a second-generation drug-eluting stent (second DES) implantation without in-stent restenosis. METHODS AND RESULTS: In 105 patients who underwent second DES implantation in the left anterior descending coronary artery (74 men; mean age, 67...
November 1, 2016: International Journal of Cardiology
Jeong-Eun Yi, Ho-Joong Youn
AIM: The role of elevated whole blood viscosity (WBV) in the pathogenesis of atherosclerosis is well known. We sought to investigate the gender differences in the association between WBV, coronary blood flow and tissue oxygen delivery index (TODI) in cardiac syndrome X (CSX). METHODS: Forty-six CSX patients and 14 healthy volunteers were enrolled. The coronary flow parameters were obtained with transthoracic Doppler echocardiography and WBV was measured (at high-shear and low-shear rates of 300s(-1) and 5s(-1), respectively) using a scanning capillary tube viscometer...
July 20, 2016: Perfusion
Petr A Sarapultsev, Alexey P Sarapultsev
In 2006, Takotsubo syndrome (TTC) was described as a distinct type of stress-induced cardiomyopathy (stress cardiomyopathy). However, when thinking about Takotsubo cardiomyopathy from the viewpoints of the AHA and ESC classifications, 2 possible problems may arise. The first potential problem is that a forecast of disease outcome is lacking in the ESC classification, whereas the AHA only states that 'outcome is favorable with appropriate medical therapy'. However, based on the literature data, one can make a general conclusion that occurrence of myocardial lesions in TTC (i...
October 15, 2016: International Journal of Cardiology
David A Halon, Mali Azencot, Ronen Rubinshtein, Barak Zafrir, Moshe Y Flugelman, Basil S Lewis
BACKGROUND: Type 2 diabetics are at increased risk for vascular events, but the value of further risk stratification for coronary heart disease (CHD) in asymptomatic subjects is unclear. We examined the added value of coronary computed tomography angiography over clinical risk scores (United Kingdom Prospective Diabetes Study), and coronary artery calcium in a population-based cohort of asymptomatic type 2 diabetics. METHODS AND RESULTS: Subjects (n=630) underwent baseline clinical assessment and computed tomography angiography (64-slice scanner)...
June 2016: Journal of the American Heart Association
Peter Ong, Anastasios Athanasiadis, Udo Sechtem
Treatment of angina pectoris associated with coronary microvascular dysfunction is challenging as the underlying mechanisms are often diverse and overlapping. Patients with type 1 coronary microvascular dysfunction (i.e. absence of epicardial coronary artery disease and myocardial disease) should receive strict control of their cardiovascular risk factors and thus receive statins and ACE-inhibitors in most cases. Antianginal medication consists of ß-blockers and/or calcium channel blockers. Second line drugs are ranolazine and nicorandil with limited evidence...
August 2016: Cardiovascular Drugs and Therapy
Basmah Safdar, Gail D'Onofrio
Emergency departments (ED) in the United States see over eight million cases of chest pain annually. While a cardinal symptom of acute coronary syndrome (ACS), multiple emergent and non-emergent causes can attribute to chest pain. This case-based perspective describes the different sex-specific causes of angina seen in ED patients. Once coronary artery disease (CAD) is ruled out with standard protocols, microvascular dysfunction is perhaps the most prevalent but under-diagnosed cause of non-CAD related angina in ED patients...
June 2016: Yale Journal of Biology and Medicine
Ali Esmaeili Nadimi, Farah Pour Amiri, Mahmood Sheikh Fathollahi, Gholamhossien Hassanshahi, Zahra Ahmadi, Ahmad Reza Sayadi
BACKGROUND: Approximately 20% to 30% of patients who undergo coronary angiography for assessment of typical cardiac chest pain display microvascular coronary dysfunction (MCD). This study aimed to determine potential relationships between baseline clinical characteristics and likelihood of MCD diagnosis in a large group of patients with stable angina symptoms, positive exercise test and angiographic ally normal epicardial coronary arteries. MATERIAL AND METHODS: This cross-sectional study included 250 Iranian with documented evidence of cardiac ischemia on exercise testing, class I or II indication for coronary angiography, and either: (1) angiographically normal coronary arteries and diagnosis of MCD with slow-flow phenomenon, or (2) normal angiogram and no evidence of MCD...
September 15, 2016: International Journal of Cardiology
Tadashi Murai, Tetsumin Lee, Yoshihisa Kanaji, Junji Matsuda, Eisuke Usui, Makoto Araki, Takayuki Niida, Keiichi Hishikari, Sadamitsu Ichijyo, Rikuta Hamaya, Taishi Yonetsu, Mitsuaki Isobe, Tsunekazu Kakuta
This study investigates whether hyperemic microvascular resistance (MR) is influenced by elective percutaneous coronary intervention (PCI) by using the index of microcirculatory resistance (IMR). Seventy-one consecutive patients with stable angina pectoris undergoing elective PCI were prospectively studied. The IMR was measured before and after PCI and at the 10-mo follow-up. The IMR significantly decreased until follow-up; the pre-PCI, post-PCI, and follow-up IMRs had a median of 19.8 (interquartile range, 14...
September 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
P Ong, U Sechtem
Just as in epicardial coronary stenosis, coronary microvascular dysfunction (CMD) also leads to an imbalance of myocardial oxygen supply and demand. The dysfunction is located at the level of the coronary microcirculation with vessel diameters < 500 µm and structural as well as functional alterations have been described. The underlying mechanisms are diverse, frequently overlap and are still incompletely understood. Among others, conditions such as chronic inflammation, estrogen deficiency and a genetic familial predisposition have been reported...
June 2016: Herz
Gaetano A Lanza, Giulia Careri, Alessandra Stazi, Angelo Villano, Antonio De Vita, Cristina Aurigemma, Filippo Crea
BACKGROUND: Because approximately 10% of patients with no-ST-segment elevation acute coronary syndrome (NSTE-ACS) show no obstructive coronary artery disease (NOCAD) on angiography, we assessed the spectrum of diagnoses and the predictors of outcome of these patients. METHODS AND RESULTS: We studied 178 patients admitted to a coronary care unit with an initial diagnosis of NSTE-ACS, based on clinical, ECG and laboratory data, but found to have NOCAD. The final diagnosis in these patients was heterogeneous; true NSTE-ACS (ie, coronary thrombosis on an unstable plaque) was ascertained in 1 patient (0...
June 24, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Tadashi Murai, Yoshihisa Kanaji, Taishi Yonetsu, Tetsumin Lee, Junji Matsuda, Eisuke Usui, Makoto Araki, Takayuki Niida, Mitsuaki Isobe, Tsunekazu Kakuta
BACKGROUND: Epicardial focal coronary artery stenosis, diffuse coronary disease, and microvascular resistance (MR) may limit coronary flow. The purpose of percutaneous coronary intervention (PCI) is to increase coronary flow by targeting epicardial lesions. After PCI, MR might change and affect coronary flow. We investigated whether PCI influences MR using the index of microcirculatory resistance (IMR) and if pre-PCI fractional flow reserve (FFR) or MR predicts the post-PCI change in hyperaemic coronary flow...
May 24, 2016: Catheterization and Cardiovascular Interventions
Juuso I Blomster, Sara Svedlund, Helena U Westergren, Li-Ming Gan
BACKGROUND: Decreased coronary flow reserve (CFR) is associated with increased risk of adverse cardiovascular events. We sought to investigate how CFR from left anterior descending (LAD) coronary artery reflects clinical markers of cardiac function. METHODS: We enrolled 400 patients referred for myocardium perfusion scintigraphy due to chest pain at Sahlgrenska University Hospital in Gothenburg, Sweden. Transthoracic echocardiography including adenosine-assisted CFR in LAD was performed at a separate occasion...
August 15, 2016: International Journal of Cardiology
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"