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Peripheral Arterial Obstructive Disease

Carlos Branco, Gonçalo F Coutinho, Filipe Soares, Pedro E Antunes, Manuel J Antunes
BACKGROUND: Complete revascularization is the gold standard of coronary artery bypass grafting (CABG). However, the rationale for revascularization of all diseased vessels is questionable. We aimed at evaluating the impact of multiple versus single grafts in each diseased coronary territory in the long-term survival and incidence of major adverse cardiac and cerebrovascular events (MACCE). METHODS: From January/00 to November/15, 5.694 consecutive patients were submitted to isolated CABG, of whom 4...
January 2018: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Fehmi Kacmaz, Adnan Kaya, Muhammed Keskin, Serdar Keceoglu, Ibrahim Halil Algin, Bayram Yilmazkaya, Erdogan Ilkay
Objective Buerger's disease is one of the worst diseases causing peripheral artery occlusions (especially lower extremity) with increased morbidity and mortality. Endovascular treatment of the diseased arteries gains preference over bypass surgery nowadays. Here, we aimed to present the clinical outcomes of 16 consecutive Buerger's disease patients underwent extended endovascular recanalization which is a new technique to restore direct blood flow to at least one foot artery, with the performance of angioplasty for each tibial and foot artery obstructions...
October 10, 2018: Vascular
Todd H Wagner, Brack Hattler, Faisal G Bakaeen, Joseph F Collins, G Hossein Almassi, Jacquelyn A Quin, Frederick L Grover, Muath Bishawi, A Laurie W Shroyer
BACKGROUND: Coronary artery bypass surgery (CABG) is a common surgical treatment for ischemic heart disease. Little is known about the long-term costs of conducting the surgery on-pump or off-pump. METHODS: As part of the Randomized On/Off Bypass follow-up study, we followed 2,203 participants randomized to on-pump (n = 1,099) and off-pump (n = 1,104) CABG for 5 years using Department of Veterans Affairs and Medicare administrative data. We examined annual costs through 5 years, standardized to 2016 dollars, using multivariate regression models, controlling for site and baseline patient factors...
September 28, 2018: Annals of Thoracic Surgery
Yunzhe Wang, Cong-Lin Liu, Jes S Lindholt, Guo-Ping Shi, Jinying Zhang
OBJECTIVE/BACKGROUND: The development of an abdominal aortic aneurysm (AAA) involves extensive extracellular matrix remodelling, leading to aortic wall weakening. This process is mediated by proteases, including cysteinyl cathepsins. Cystatins are their endogenous inhibitors. This study tested whether plasma cystatin B levels in patients with AAA differed from those of healthy controls. METHODS: Plasma samples from patients with AAA and age matched controls were selected from the Viborg Vascular (VIVA) screening trial for AAA...
September 24, 2018: European Journal of Vascular and Endovascular Surgery
Demet Ozkaramanli Gur, Ozcan Gur, Savas Guzel, Aydin Akyuz, Selami Gurkan, Seref Alpsoy, Nisa Simge Gulec, Fatma Koc
AIM: Peripheral artery disease (PAD) is a manifestation of atherosclerosis with poor prognosis. It is generally complicated by vascular calcification, which is located either in the intima as patchy infiltrates; or circumferentially in the media, also known as medial arterial calcification (MAC). Obstructive PAD is reflected by low anklebrachial index (ABI ≤ 0.9), whereas MAC is revealed by high ABI (ABI >1.4). Considering the increase in cardiovascular mortality at both ends of the ABI spectrum, this study aimed to explore the underlying pathology through cytokines with established prognostic significance; namely pentraxin-3(PTX3), high sensitivity C-reactive protein (hsCRP), copeptin, soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), NT-proBNP, and neopterin...
September 25, 2018: Journal of Atherosclerosis and Thrombosis
Damian Hudziak, Adrianna M Nowak, Radosław Gocoł, Radosław Parma, Joanna Ciosek, Andrzej Ochała, Marek Deja, Wojciech Wojakowski
AIM OF STUDY: The aim of the study was to assess safety TAVI procedure through the common carotid artery in high-vascular-risk patients. METHODS: The approach was selected by a multidisciplinary (cardiologists and cardiac surgeons) heart team after analyzing preoperative coronary angiography, TTE and MSCT of the peripheral arteries. Patients with the following conditions were qualified to the transcarotid access: severe PAD (stenotic, heavily calcified), tortuous or small diameter < 6 mm iliofemoral arteries, descending and abdominal aortic disease...
September 13, 2018: Minerva Cardioangiologica
Karri T Utriainen, Juhani K Airaksinen, Olli J Polo, Harry Scheinin, Ruut M Laitio, Kari A Leino, Tero J Vahlberg, Tom A Kuusela, Timo T Laitio
OBJECTIVE: Obstructive sleep apnea (OSA) is common in peripheral arterial disease (PAD) and associates with high mortality after surgery. Since abnormal heart rate variability (HRV) is predictive of postoperative complications, we investigated the relations of HRV with PAD, OSA and major adverse cardiovascular and cerebrovascular events (MACCE). MATERIALS AND METHODS: Seventy-five patients (67±9 years) scheduled for sub-inguinal revascularization and 15 controls (63±6 years) underwent polysomnography and HRV analyses...
2018: PloS One
Hongbao Ma, Steven Lee, Yan Yang, Puneet Bedi, Shyan-Yih Chou
Tubulointerstitial fibrosis (TIF) is a hallmark of chronic kidney disease resulting from diverse etiologies and predicts severity and progression of the kidney disease. To investigate the pathogenesis of TIF, complete unilateral ureteral obstruction (UUO) is the most widely used animal model. However, UUO precludes evaluation of renal function. In the present study, we created a rat model of chronic partial ureteral obstruction (PUO), which allowed assessment of renal function at different intervals after obstruction...
August 23, 2018: Pathophysiology: the Official Journal of the International Society for Pathophysiology
Anouk W Vaes, Martijn A Spruit, Jan Theunis, Emiel F M Wouters, Patrick De Boever
BACKGROUND: Patients with COPD are frequently diagnosed with cardiovascular disease. Peripheral endothelial dysfunction is an underlying mechanism and can be used as an early marker of cardiovascular impairment. To date, little is known on the association between peripheral endothelial dysfunction, cardiovascular risk factors and measurements of exercise capacity in patients with COPD. Therefore, we aimed to determine the relation between endothelial function and patient characteristics, cardiovascular risk factors and (micro)vascular and functional performance in patient with CODP...
September 2018: Respiratory Medicine
Thomas J Ford, Paul Rocchiccioli, Richard Good, Margaret McEntegart, Hany Eteiba, Stuart Watkins, Aadil Shaukat, Mitchell Lindsay, Keith Robertson, Stuart Hood, Eric Yii, Novalia Sidik, Adam Harvey, Augusto C Montezano, Elisabeth Beattie, Laura Haddow, Keith G Oldroyd, Rhian M Touyz, Colin Berry
Aims: Coronary microvascular dysfunction and/or vasospasm are potential causes of ischaemia in patients with no obstructive coronary artery disease (INOCA). We tested the hypothesis that these patients also have functional abnormalities in peripheral small arteries. Methods and results: Patients were prospectively enrolled and categorised as having microvascular angina (MVA), vasospastic angina (VSA) or normal control based on invasive coronary artery function tests incorporating probes of endothelial and endothelial-independent function (acetylcholine and adenosine)...
August 27, 2018: European Heart Journal
Madalina Macrea, Sabrina Campbell, Thomas Martin, Kris Ann Oursler
BACKGROUND: Overlap syndrome (OS) describes the association of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) in a single individual. Subjects with OS have increased cardiovascular mortality which is presumed to be inflammation-mediated. As a clinical biomarker, an increased neutrophil count correlates with the severity of coronary artery stenosis. OBJECTIVES: As little is known about the role of neutrophils in the underlying inflammatory mechanisms in OS, we aimed to assess the percentage of peripheral neutrophils (PPN) in OS vs in COPD alone...
August 7, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Ana Alastruey-Izquierdo, Jacques Cadranel, Holger Flick, Cendrine Godet, Christophe Hennequin, Martin Hoenigl, Chris Kosmidis, Christoph Lange, Oxana Munteanu, Iain Page, Helmut J F Salzer
Chronic pulmonary aspergillosis (CPA) complicates conditions including tuberculosis, chronic obstructive pulmonary disease and sarcoidosis, and is associated with high morbidity and mortality. Surgical cure should be considered where feasible; however, many patients are unsuitable for surgery due to extensive disease or poor respiratory function. Azoles are the only oral drug with anti-Aspergillus activity and itraconazole and voriconazole are considered as first-line drugs. A randomized controlled trial demonstrated improvement or stability in three-quarters of patients given 6 months of itraconazole, but a quarter relapsed on stopping therapy...
2018: Respiration; International Review of Thoracic Diseases
Ryan L Hoiland, Suzana Mladinov, Otto F Barak, Christopher K Willie, Tanja Mijacika, Mike Stembridge, Zeljko Dujic, Philip N Ainslie
NEW FINDINGS: What is the central question of this study? How does oxygen therapy influence cerebral blood flow, cerebral oxygen delivery and neurovascular function in chronic obstructive pulmonary disease patients? What is the main finding and its importance? Oxygen therapy improves cerebral oxygen delivery and neurovascular function in chronic obstructive pulmonary disease patients. This improvement in cerebral oxygen delivery and neurovascular function might provide a physiological link between oxygen therapy and a reduced risk of cerebrovascular disease (e...
August 2018: Experimental Physiology
Natacha Angélica da Fonseca Miranda, Cássia da Luz Goulart, Audrey Borghi E Silva, Dannuey Machado Cardoso, Dulciane Nunes Paiva, Renata Trimer, Andréa Lúcia Gonçalves da Silva
Background: The pathophysiology of chronic obstructive pulmonary disease (COPD) is complex and understanding of it has been changing in recent years, with regard to its multisystemic manifestations, especially peripheral dysfunction and its influence on intolerance to exercise. Objectives: To evaluate the relationship between peripheral arterial occlusive disease (PAOD) and peripheral muscle strength and exercise capacity in COPD patients. Methods: We conducted a cross-sectional study of 35 patients with COPD who were evaluated with the Ankle-Brachial Index, handgrip strength test, 1 repetition maximum (1RM) of knee extensors and flexors, and distance covered in the incremental shuttle walking test (dISWT)...
October 2017: Jornal Vascular Brasileiro
O L Schjørring, A P Toft-Petersen, K H Kusk, P Mouncey, E E Sørensen, P Berezowicz, M H Bestle, H-H Bülow, H Bundgaard, S Christensen, S A Iversen, I Kirkeby-Garstad, K B Krarup, M Kruse, J H Laake, L Liboriussen, R L Laebel, M Okkonen, L M Poulsen, L Russell, F Sjövall, K Sunde, E Søreide, T Waldau, A R Walli, A Perner, J Wetterslev, B S Rasmussen
BACKGROUND: Oxygen is liberally administered in intensive care units (ICUs). Nevertheless, ICU doctors' preferences for supplementing oxygen are inadequately described. The aim was to identify ICU doctors' preferences for arterial oxygenation levels in mechanically ventilated adult ICU patients. METHODS: In April to August 2016, an online multiple-choice 17-part-questionnaire was distributed to 1080 ICU doctors in seven Northern European countries. Repeated reminder e-mails were sent...
June 21, 2018: Acta Anaesthesiologica Scandinavica
Shilpa Sharma, Puja K Mehta, Reza Arsanjani, Tara Sedlak, Zachary Hobel, Chrisandra Shufelt, Erika Jones, Paul Kligfield, David Mortara, Michael Laks, Márcio Diniz, C Noel Bairey Merz
BACKGROUND: The utility of exercise-induced ST-segment depression for diagnosing ischemic heart disease (IHD) in women is unclear. HYPOTHESIS: Based on evidence that IHD pathophysiology in women involves coronary vascular dysfunction, we hypothesized that coronary vascular dysfunction contributes to exercise electrocardiography (Ex-ECG) ST-depression in the absence of obstructive coronary artery disease, so-called false positive results. We tested our hypothesis in a pilot study evaluating the relationship between peripheral vascular endothelial function and Ex-ECG...
August 2018: Clinical Cardiology
Annamaria Iorio, Michele Senni, Giulia Barbati, Stephen J Greene, Stefano Poli, Elena Zambon, Concetta Di Nora, Giovanni Cioffi, Luigi Tarantini, Antonello Gavazzi, Gianfranco Sinagra, Andrea Di Lenarda
AIM: To assess adverse outcomes attributable to non-cardiac co-morbidities and to compare their effects by left ventricular ejection fraction (LVEF) group [LVEF <50% (heart failure with reduced ejection fraction, HFrEF), LVEF ≥50% (heart failure with preserved ejection fraction, HFpEF)] in a contemporary, unselected chronic heart failure population. METHODS AND RESULTS: This community-based cohort enrolled patients from October 2009 to December 2013. Adjusted hazard ratio (HR) and the population attributable fraction (PAF) were used to compare the contribution of 15 non-cardiac co-morbidities to adverse outcome...
September 2018: European Journal of Heart Failure
Cian P McCarthy, Nasrien E Ibrahim, Roland R J van Kimmenade, Hanna K Gaggin, Mandy L Simon, Parul Gandhi, Noreen Kelly, Shweta R Motiwala, Renata Mukai, Craig A Magaret, Grady Barnes, Rhonda F Rhyne, Joseph M Garasic, James L Januzzi
BACKGROUND: Peripheral arterial disease (PAD) is a global health problem that is frequently underdiagnosed and undertreated. Noninvasive tools to predict the presence and severity of PAD have limitations including inaccuracy, cost, or need for intravenous contrast and ionizing radiation. HYPOTHESIS: A clinical/biomarker score may offer an attractive alternative diagnostic method for PAD. METHODS: In a prospective cohort of 354 patients referred for diagnostic peripheral and/or coronary angiography, predictors of ≥50% stenosis in ≥1 peripheral vessel (carotid/subclavian, renal, or lower extremity arteries) were identified from >50 clinical variables and 109 biomarkers...
July 2018: Clinical Cardiology
Chang-Guo Wang, Chang Li, Wei Lei, Jun-Hong Jiang, Jian-An Huang, Da-Xiong Zeng
Introduction: Chronic hypoxia-induced pulmonary vascular remodeling is a feature of chronic obstructive pulmonary disease (COPD). Our previous reports indicate that neuron-derived orphan receptor 1 (NOR1) promoted pulmonary smooth muscle cell proliferation in vitro. But it remains unclear whether NOR1 participated into hypoxia-induced pulmonary vascular remodeling in COPD patients. Patients and methods: For this study, we collected peripheral lung tissues of 26 male COPD patients with or without hypoxemia...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Maciej Michał Kowalik, Romuald Lango, Piotr Siondalski, Magdalena Chmara, Maciej Brzeziński, Krzysztof Lewandowski, Dariusz Jagielak, Andrzej Klapkowski, Jan Rogowski
There is increasing evidence that genetic variability influences patients' early morbidity after cardiac surgery performed using cardiopulmonary bypass (CPB). The use of mortality as an outcome measure in cardiac surgical genetic association studies is rare. We publish the 30-day and 5-year survival analyses with focus on pre-, intra-, postoperative variables, biochemical parameters, and genetic variants in the INFLACOR (INFLAmmation in Cardiac OpeRations) cohort. In a prospectively recruited cohort of 518 adult Polish Caucasians, who underwent cardiac surgery in which CPB was used, the clinical data, biochemical parameters, IL-6, soluble ICAM-1, TNFα, soluble E-selectin, and 10 single nucleotide polymorphisms were evaluated for their association with 30-day and 5-year mortality...
2018: Acta Biochimica Polonica
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