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microvascular angina

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https://www.readbyqxmd.com/read/27907892/the-parallel-tales-of-microvascular-angina-and-heart-failure-with-preserved-ejection-fraction-a-paradigm-shift
#1
Filippo Crea, C Noel Bairey Merz, John F Beltrame, Juan Carlos Kaski, Hisao Ogawa, Peter Ong, Udo Sechtem, Hiroaki Shimokawa, Paolo G Camici
No abstract text is available yet for this article.
October 23, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27904032/coronary-microvascular-dysfunction%C3%A3-epidemiology-pathogenesis-prognosis-diagnosis-risk-factors-and-therapy
#2
Cheng Chen, Janet Wei, Ahmed AlBadri, Parham Zarrini, C Noel Bairey Merz
Angina has traditionally been thought to be caused by obstructive coronary artery disease (CAD). However, a substantial number of patients with angina are found to not have obstructive CAD when undergoing coronary angiography. A significant proportion of these patients have coronary microvascular dysfunction (CMD), characterized by heightened sensitivity to vasoconstrictor stimuli and limited microvascular vasodilator capacity. With the advent of non-invasive and invasive techniques, the coronary microvasculature has been more extensively studied in the past 2 decades...
November 29, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27870973/transthoracic-doppler-echocardiography-compared-with-positron-emission-tomography-for-assessment-of-coronary-microvascular-dysfunction-the-ipower-study
#3
Marie Mide Michelsen, Naja Dam Mygind, Adam Pena, Rasmus Huan Olsen, Thomas Emil Christensen, Adam Ali Ghotbi, Philip Hasbak, Andreas Kjaer, Ida Gustafsson, Peter Riis Hansen, Henrik Steen Hansen, Nis Høst, Jens Kastrup, Eva Prescott
BACKGROUND: Coronary microvascular function can be assessed by transthoracic Doppler echocardiography as a coronary flow velocity reserve (TTDE CFVR) and by positron emission tomography as a myocardial blood flow reserve (PET MBFR). PET MBFR is regarded the noninvasive reference standard for measuring coronary microvascular function but has limited availability. We compared TTDE CFVR with PET MBFR in women with angina pectoris and no obstructive coronary artery disease and assessed repeatability of TTDE CFVR...
November 7, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27848160/coronary-flow-reserve-and-relative-flow-reserve-measured-by-n-13-ammonia-pet-for-characterization-of-coronary-artery-disease
#4
Sang-Geon Cho, Ki Seong Park, Jahae Kim, Sae-Ryung Kang, Ho-Chun Song, Ju Han Kim, Jae Yeong Cho, Young Joon Hong, Zeenat Jabin, Hee Jeong Park, Geum-Cheol Jeong, Seong Young Kwon, Jin Chul Paeng, Hyeon Sik Kim, Jung-Joon Min, Ernest V Garcia, Henry Hee-Seung Bom
OBJECTIVE: We evaluated the relationships between coronary flow reserve (CFR) and relative flow reserve (RFR) measured by N-13 ammonia positron emission tomography (PET) for characterization of epicardial coronary artery disease (CAD). METHODS: Sixty-nine consecutive stable angina patients underwent N-13 ammonia PET, coronary computed tomography angiography (CCTA), and if necessary, invasive coronary angiography (CAG) within 2 weeks. Myocardial blood flow (MBF), CFR, RFR, and coronary vascular resistance of the reference arterial territory (CVRref) were measured by N-13 ammonia PET...
November 15, 2016: Annals of Nuclear Medicine
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/27736045/influence-of-stent-implantation-on-erythrocyte-aggregation-in-human-native-coronary-arteries-and-saphenous-vein-grafts
#6
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
https://www.readbyqxmd.com/read/27719689/cost-effectiveness-of-structured-education-in-children-with-type-1-diabetes-mellitus
#7
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...
January 2016: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/27694191/plasma-concentration-of-serotonin-is-a-novel-biomarker-for-coronary-microvascular-dysfunction-in-patients-with-suspected-angina-and-unobstructive-coronary-arteries
#8
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
https://www.readbyqxmd.com/read/27663770/association-of-cyp2c19-variants-and-epoxyeicosatrienoic-acids-on-patients-with-microvascular-angina
#9
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
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 association of CYP2C19 polymorphisms and EETs on microvascular angina (MVA) caused by coronary microvascular dysfunction. We examined CYP2C19 genotypes in patients with MVA (n = 71) and healthy subjects as control (n = 71)...
December 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27617797/sex-differences-in-nonobstructive-coronary-artery-disease-recent-insights-and-substantial-knowledge-gaps
#10
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
https://www.readbyqxmd.com/read/27583694/intracoronary-acetylcholine-provocation-testing-for-assessment-of-coronary-vasomotor-disorders
#11
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
https://www.readbyqxmd.com/read/27515327/coronary-physiology-during-exercise-and-vasodilation-in-the-healthy-heart-and-in-severe-aortic-stenosis
#12
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
https://www.readbyqxmd.com/read/27497930/pharmacological-agents-targeting-myocardial-metabolism-for-the-management-of-chronic-stable-angina-an-update
#13
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
https://www.readbyqxmd.com/read/27497093/prevalence-of-coronary-macro-and-micro-vascular-dysfunctions-after-drug-eluting-stent-implantation-without-in-stent-restenosis
#14
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
https://www.readbyqxmd.com/read/27440799/hemorheological-abnormalities-and-their-associations-with-coronary-blood-flow-in-patients-with-cardiac-syndrome-x-a-comparison-between-males-and-females
#15
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
https://www.readbyqxmd.com/read/27424315/stress-cardiomyopathy-is-it-limited-to-takotsubo-syndrome-problems-of-definition
#16
REVIEW
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
https://www.readbyqxmd.com/read/27412899/coronary-computed-tomography-ct-angiography-as-a-predictor-of-cardiac-and-noncardiac-vascular-events-in-asymptomatic-type-2-diabetics-a-7-year-population-based-cohort-study
#17
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
https://www.readbyqxmd.com/read/27358172/treatment-of-angina-pectoris-associated-with-coronary-microvascular-dysfunction
#18
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
https://www.readbyqxmd.com/read/27354848/women-and-chest-pain-recognizing-the-different-faces-of-angina-in-the-emergency-department
#19
REVIEW
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
https://www.readbyqxmd.com/read/27343424/opium-addiction-as-an-independent-risk-factor-for-coronary-microvascular-dysfunction-a-case-control-study-of-250-consecutive-patients-with-slow-flow-angina
#20
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
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