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Myocardial ischaemia

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https://www.readbyqxmd.com/read/28801416/outcome-of-revascularisation-in-stable-coronary-artery-disease-without-ischaemia-a-danish-registry-based-follow-up-study
#1
Jane Angel Simonsen, Hans Mickley, Allan Johansen, Søren Hess, Anders Thomassen, Oke Gerke, Lisette O Jensen, Jesper Hallas, Werner Vach, Poul F Hoilund-Carlsen
OBJECTIVES: In stable coronary artery disease (CAD), coronary revascularisation may reduce mortality of patients with a certain amount of left ventricular myocardial ischaemia. However, revascularisation does not always follow the guidance suggested by ischaemia testing. We compared outcomes in patients without ischaemia who had either revascularisation or medical treatment. DESIGN AND POPULATION: Based on registries, 1327 consecutive patients with normal myocardial perfusion scintigraphy (MPS) and 278 with fixed perfusion defects were followed for a median of 6...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28800035/the-anti-malarial-drug-artesunate-attenuates-cardiac-injury-in-a-rodent-model-of-myocardial-infarction
#2
Areeg I Khan, Amar Kapoor, Jianmin Che, Lukas Martin, Mara Rogazzo, Thomas Mercier, Laurent Decosterd, Massimo Collino, Christoph Thiemermann
Ischaemic heart disease remains the leading cause of morbidity and mortality in the Western world. Artesunate is the WHO-recommended drug of choice for complicated malaria (with organ failure). The administration of high doses of artesunate is safe in healthy volunteers (up to 8 mg/kg i.v) and patients with severe malaria (2.4 mg/kg i.v). We investigated the effects of artesunate (1 mg/kg) or its active metabolite dihydroartemisinin (DHA; 0.1 mg/kg) in a model of transient myocardial ischaemia/reperfusion (I/R) and evaluated the mechanism of action of the observed cardioprotective effects of artesunate and DHA...
August 9, 2017: Shock
https://www.readbyqxmd.com/read/28790461/anti-colon-cancer-effect-of-caffeic-acid-p-nitro-phenethyl-ester-in-vitro-and-in-vivo-and-detection-of-its-metabolites
#3
Hao Tang, Xiaofang Yao, Cong Yao, Xiaoyan Zhao, Hua Zuo, Zhubo Li
Caffeic acid phenethyl ester (CAPE), extracted from propolis, was proven to inhibit colon cancer. Caffeic acid p-nitro-phenethyl ester (CAPE-pNO2), a derivative of CAPE, was determined to be an anti-platelet agent and a protector of myocardial ischaemia with more potent effects. In the present study, CAPE-pNO2 showed stronger cytotoxic activity than CAPE. We revealed interactions between CAPE-pNO2 and experimental cells. CAPE-pNO2 induced apoptosis in HT-29 cells by up-regulating P53, cleaved-caspase-3, Bax, P38 and CytoC; CAPE-pNO2 also up-regulated P21(Cip1) and P27(Kip1) and down-regulated CDK2 and c-Myc to promote cell cycle arrest in G0/G1...
August 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28782109/low-vs-high-haemoglobin-trigger-for-transfusion-in-vascular-surgery-protocol-for-a-randomised-trial
#4
A Møller, H B Nielsen, J Wetterslev, O B Pedersen, D Hellemann, S Shahidi
BACKGROUND: In patients with cardiovascular disease, guidelines for administration of red blood cells (RBC) are mainly based on studies outside the vascular surgical setting with the recommendation to use a haemoglobin (hb) trigger-level lower than by guidelines from The European Society for Vascular Surgery. Restricting RBC transfusion may affect blood O2 transport with a risk for development of tissue ischaemia and postoperative complications. METHODS: In a single-centre, open-label, assessor blinded trial, 58 vascular surgical patients (> 40 years of age) awaiting open surgery of the infrarenal aorta or infrainguinal arterial bypass surgery undergo a web-based randomisation to one of two groups: perioperative RBC transfusion triggered by hb < 8 g/dl or hb < 9...
September 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28762939/-a-new-insight-on-anti-ischemic-action-of-ivabradine-in-patients-with-stable-angina
#5
Zh D Kobalava, A A Shavarov, G K Kiyakbaev
Increase in heart rate triggers most ischemic episodes due to disbalance between myocardial oxygen delivery and consumption. Furthermore, increased heart rate is a modifiable risk factor in patients with chronic heart failure. Ivabradine reduces heart rate by selectively inhibiting the If current of sinoatrial node cells. Recent studies have shown that ivabradine may reduce myocardial ischaemia and its consequences not only through heart rate reduction, but also because of additional pleiotropic effects. This review summarizes last findings that demonstrate variety of ivabradine actions on coronary blood flow and left ventricular function in patients with ischemic heart disease...
March 2017: Kardiologiia
https://www.readbyqxmd.com/read/28759083/a-rare-cause-of-early-repolarisation-in-an-adolescent-boy-with-chest-pain-myocardial-bridging
#6
Murat Deveci, Kadir Babaoğlu, Özlem Kayabey
Early repolarisation is a common electrocardiographic (ECG) finding characterised by J-point and ST segment elevation ≥ 0.1 mV in two or more adjacent leads. The ECG pattern of early repolarisation is relatively common in asymptomatic subjects. Early repolarisation pattern may be seen in secondary conditions such as hypothermia, autonomic nervous system disturbances, cocaine abuse, hypercalcaemia and myocardial ischaemia. We present a case of an adolescent boy with chest pain and concurrent ST-segment elevation...
May 23, 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/28751537/management-of-kawasaki-disease-in-adults
#7
REVIEW
Kara J Denby, Daniel E Clark, Larry W Markham
Kawasaki disease is the most common childhood vasculitis in the USA and the most common cause of acquired cardiac disease in children in developed countries. Since the vast majority of Kawasaki disease initially presents at <5 years of age, many adult cardiologists are unfamiliar with the pathophysiology of this disease. This vasculitis has a predilection for coronary arteries with a high complication rate across the lifespan for those with medium to large coronary artery aneurysms. An inflammatory cascade produces endothelial dysfunction and damage to the vascular wall, leading to aneurysmal dilatation...
July 27, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28748611/apelin-induced-cardioprotection-against-ischemia-reperfusion-injury-roles-of-epidermal-growth-factor-and-src
#8
Anna Folino, Lisa Accomasso, Claudia Giachino, Pier Giorgio Montarolo, Gianni Losano, Pasquale Pagliaro, Raffaella Rastaldo
AIM: Apelin, the ligand of the G-protein-coupled-receptor (GPCR) APJ, exerts a postconditioning-like protection against ischemia-reperfusion injury through activation of PI3K-Akt-NO signalling. The pathway connecting APJ to PI3K is still unknown. Since other GPCR ligands act through transactivation of epidermal growth factor receptor (EGFR) via a matrix-metalloproteinase (MMP) or Src kinase, we investigated whether EGFR transactivation is involved in the following three features of apelin-induced cardioprotection: limitation of infarct size, suppression of contracture, and improvement of post-ischemic contractile recovery...
July 27, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28732815/2-year-outcomes-with-the-absorb-bioresorbable-scaffold-for-treatment-of-coronary-artery-disease-a-systematic-review-and-meta-analysis-of-seven-randomised-trials-with-an-individual-patient-data-substudy
#9
Ziad A Ali, Patrick W Serruys, Takeshi Kimura, Runlin Gao, Stephen G Ellis, Dean J Kereiakes, Yoshinobu Onuma, Charles Simonton, Zhen Zhang, Gregg W Stone
BACKGROUND: Bioresorbable vascular scaffolds (BVS) offer the potential to improve long-term outcomes of percutaneous coronary intervention after their complete bioresorption. Randomised trials have shown non-inferiority between BVS and metallic drug-eluting stents at 1 year in composite safety and effectiveness outcomes, although some increases in rates of target vessel-related myocardial infarction and device thrombosis were identified. Outcomes of BVS following the first year after implantation are unknown...
July 18, 2017: Lancet
https://www.readbyqxmd.com/read/28730895/incidence-treatment-strategies-and-outcomes-of-acute-coronary-syndrome-with-and-without-ongoing-myocardial-ischaemia-results-from-the-czech-3-registry
#10
Petr Tousek, Klara Staskova, Anna Mala, Martin Sluka, Alexandra Vodzinska, Radek Jancar, Denisa Maluskova, Jiri Jarkovsky, Petr Widimsky
BACKGROUND: Patients with acute coronary syndrome with signs of ongoing myocardial ischaemia at first medical contact should be indicated for immediate invasive treatment. AIM: To assess the incidence, treatment strategies and outcomes of acute coronary syndrome in a large unselected cohort of patients with respect to the signs of ongoing myocardial ischaemia. METHODS: The CZECH-3 registry included 1754 consecutive patients admitted for suspected acute coronary syndrome to 43 hospitals during a 2-month period in the autumn of 2015...
July 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28725290/the-discovery-of-the-flammer-syndrome-a-historical-and-personal-perspective
#11
REVIEW
Josef Flammer, Katarzyna Konieczka
This review describes the clinical and basic research that led to the description of Flammer syndrome. It is narrated from a personal perspective. This research was initiated by the observation of an increased long-term fluctuation of visual fields in a subgroup of glaucoma patients. As these patients had strikingly cold hands, peripheral blood flow was tested with a capillary microscopy, and vasospastic syndrome (VS) was diagnosed. Further studies on these patients revealed frequently weakened autoregulation of ocular blood flow and increased flow resistivity in retroocular vessels...
June 2017: EPMA Journal
https://www.readbyqxmd.com/read/28705045/percutaneous-coronary-interventions-of-chronic-total-occlusions-a-review-of-clinical-indications-treatment-strategy-and-current-practice
#12
Johan Bennett, Peter Kayaert, Yoann Bataille, Jo Dens
Chronic total occlusions (CTOs) are commonly encountered in patients undergoing coronary angiography, but percutaneous coronary intervention (PCI) for CTO is currently infrequently performed owing to the perception of limited clinical benefit, high complexity and cost of intervention, and perceived risk of complications. Numerous observational studies have demonstrated that successful CTO revascularization is associated with better cardiovascular outcomes and enhanced quality of life (QOL). However, in the absence of randomized trials, its prognostic benefit remains debated...
July 14, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28703036/an-unusual-presentation-of-ischaemic-mitral-regurgitation-as-p2-prolapse
#13
David S Thompson, Prakash P Punjabi
A 54-year-old gentleman presented with pulmonary oedema secondary to anterolateral papillary muscle (PPM) rupture and acute mitral regurgitation subsequent to myocardial ischaemia (MI). Angiography revealed complete occlusion of the first obtuse marginal (OM1) branch of the circumflex coronary artery and a 70% occlusion of the left anterior descending (LAD) coronary artery. Operatively, unusual anatomy was noted; an accessory head was attached superiorly to the anterior lateral PPM. This gave rise to chordae that were subsequently attached to the posterior second (P2) scallop...
July 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28702857/protein-kinase-c-and-cardiac-dysfunction-a-review
#14
REVIEW
Raphael M Singh, Emanuel Cummings, Constantinos Pantos, Jaipaul Singh
Heart failure (HF) is a physiological state in which cardiac output is insufficient to meet the needs of the body. It is a clinical syndrome characterized by impaired ability of the left ventricle to either fill or eject blood efficiently. HF is a disease of multiple aetiologies leading to progressive cardiac dysfunction and it is the leading cause of deaths in both developed and developing countries. HF is responsible for about 73,000 deaths in the UK each year. In the USA, HF affects 5.8 million people and 550,000 new cases are diagnosed annually...
July 12, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28698323/performance-of-highly-sensitive-cardiac-troponin-t-assay-to-detect-ischaemia-at-pet-ct-in-low-risk-patients-with-acute-coronary-syndrome-a-prospective-observational-study
#15
Beata Morawiec, Stephane Fournier, Maxime Tapponnier, John O Prior, Pierre Monney, Vincent Dunet, Nathalie Lauriers, Frederique Recordon, Catalina Trana, Juan-Fernando Iglesias, Damian Kawecki, Olivier Boulat, Daniel Bardy, Sabine Lamsidri, Eric Eeckhout, Olivier Hugli, Olivier Muller
BACKGROUND: Highly sensitive troponin T (hs-TnT) assay has improved clinical decision-making for patients admitted with chest pain. However, this assay's performance in detecting myocardial ischaemia in a lowrisk population has been poorly documented. PURPOSE: To assess hs-TnT assay's performance to detect myocardial ischaemia at positron emission tomography/CT (PET-CT) in low-risk patients admitted with chest pain. METHODS: Patients admitted for chest pain with a nonconclusive ECG and negative standard cardiac troponin T results at admission and after 6 hours were prospectively enrolled...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28695353/cardioprotection-by-the-transfer-of-coronary-effluent-from-ischaemic-preconditioned-rat-hearts-identification-of-cardioprotective-humoral-factors
#16
Leonardo Maciel, Dahienne F de Oliveira, Giovani C Verissimo da Costa, Paulo M Bisch, Jose Hamilton Matheus Nascimento
Ischaemic preconditioning (IPC) provides myocardial resistance to ischaemia/reperfusion (I/R) injuries. The protection afforded by IPC is not limited to the target tissue but extends to remote tissues, suggesting a mechanism mediated by humoral factors. The aim of the present study was to identify the humoral factors that are responsible for the cardioprotection induced by the coronary effluent transferred from IPC to naïve hearts. Isolated rat hearts were submitted to IPC (three cycles of 5 min I/R) before 30-min global ischaemia and 60-min reperfusion...
September 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/28689986/quaternion-based-study-of-angular-velocity-of-the-cardiac-vector-during-myocardial-ischaemia
#17
Pablo Daniel Cruces, Pedro David Arini
BACKGROUND: Early detection of acute ischaemia through non-invasive methods remains a challenge in health research. Ischaemic condition caused by a decrease in the blood supply in a cardiac region induces hypoxia and metabolic abnormalities that contribute to the electrical instability of the heart and to the development of slow conduction in damaged tissue. METHODS: Herein, a percutaneous transluminal coronary angiography (PTCA) is considered as a model of supply ischaemia...
June 30, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28674630/a-specialty-specific-multimodality-educational-quality-improvement-initiative-to-deimplement-rarely-appropriate-myocardial-perfusion-imaging
#18
David E Winchester, Carsten Schmalfuss, Christian D Helfrich, Rebecca J Beyth
OBJECTIVE: Investigations of Appropriate Use Criteria (AUC) education have shown a mixed effect on changing provider behaviour. At our facility, rarely appropriate myocardial perfusion imaging (MPI) differs by specialty; awareness of AUC is low. Our objective is to investigate if specialty-specific, multimodality education could reduce rarely appropriate MPI. METHODS: We designed education focused on the rarely appropriate MPI ordered most often by each specialty...
2017: Open Heart
https://www.readbyqxmd.com/read/28674132/exploration-into-lipid-management-and-persistent-risk-in-patients-hospitalised-for-acute-coronary-syndrome-in-japan-explore-j-protocol-for-a-prospective-observational-study
#19
Masato Nakamura, Kiyoko Uno, Atsushi Hirayama, Junya Ako, Atsushi Nohara, Hidenori Arai, Mariko Harada-Shiba
INTRODUCTION: The present study is the largest registry study ever conducted in Japan exploring the prevalence of familial hypercholesterolaemia (FH) among patients with acute coronary syndrome (ACS). Our study aims to (1) evaluate the status of lipid management and the subsequent risk of major cardiovascular events following hospitalisation of Japanese patients with ACS in real-world clinical practice; (2) determine the proportion of Japanese patients with ACS who achieve the lipid management goal and have a reduction of event risks with strict lipid management (low-density lipoprotein-cholesterol <1...
July 2, 2017: BMJ Open
https://www.readbyqxmd.com/read/28667170/isolated-cardiac-sarcoidosis-masquerading-as-right-ventricular-outflow-tract-ventricular-tachycardia
#20
Auras R Atreya, Mitkumar Patel, Senthil K Sivalingam, Mathias L Stoenescu
A 67-year-old man with coronary artery disease (CAD) and left anterior descending artery (LAD) stent presented with symptomatic monomorphic ventricular tachycardia (VT) at a rate of 190 bpm requiring cardioversion. ECG showed left bundle branch block pattern and inferior axis, suggestive of a right ventricular outflow tract (RVOT) focus rather than left ventricular scar due to LAD territory myocardial infarction (MI). Echocardiography showed normal wall motion. Angiography revealed a patent mid-LAD stent. Cardiac MRI with delayed postcontrast sequence revealed several regions of hyperenhancement abnormality within the basal portion of the interventricular septum...
June 30, 2017: BMJ Case Reports
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