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No reflow

Alessandro Durante
Effective reperfusion of ischemic myocardium is the final aim of both pharmacological and mechanical reperfusive strategies in patients with ST-segment elevation myocardial infarction. More effective reperfusion is related to better prognosis. In contrast, ineffective reperfusion (no reflow) has been showed to be related to an increased rate of adverse events in the flow-up. Several techniques can be used to assess the effectiveness of reperfusion, and the evolved over the last decades according to the treatment methods but also to technological advancements...
March 13, 2018: Anatolian Journal of Cardiology
Hoyle L Whiteside, Supawat Ratanapo, Arun Nagabandi, Deepak Kapoor
INTRODUCTION: Elective insertion of a percutaneous circulatory assist device (PCAD) in high-risk patients is considered a reasonable adjunct to percutaneous coronary intervention (PCI). There is limited data examining the safety and efficacy of rotational atherectomy (RA) without hemodynamic support in patients with reduced left ventricular ejection fraction (LVEF). METHODS: We retrospectively identified 131 consecutive patients undergoing RA without elective PCAD over a three-year period...
February 9, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Petra Kleinbongard, Georgios Amanakis, Andreas Skyschally, Gerd Heusch
<u>Rationale:</u> Reduction of infarct size (IS) by remote ischemic per-conditioning (perRIC) is evident only after several hours reperfusion. <u>Objective:</u> To develop a potential real-time estimate of cardioprotection by perRIC we have analyzed the time course of ST-segment elevation. <u>Methods and Results:</u> Anesthetized open-chest pigs were subjected to 60 min coronary occlusion and 180 min reperfusion (placebo; PLA; n=19). perRIC (n=18; 4x5 min/5 min hindlimb occlusion/reperfusion) was induced 20 min after coronary occlusion...
February 21, 2018: Circulation Research
Jianjun Ren, Changfa Li, Yan Liu, Haitao Liu, Zhenming Dong
PURPOSE: To investigate the influence of dexmedetomidine on myocardial ischemia-reperfusion injury (IRI) in rabbits. METHODS: Twenty-four New Zealand white rabbits were randomly divided into two equal-sized groups: IRI group (group IR) and dexmedetomidine group (group D). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), left ventricular diastolic pressure (LVDP), +dp/dtmax, -dp/dtmax, and t-dp/dtmax were recorded and calculated at the following time points: before (T0) and after (T1) dexmedetomidine infusion, after 30-min ischemia (T2), and after 120-min reperfusion (T3)...
January 2018: Acta Cirúrgica Brasileira
Yosuke Negishi, Hideki Ishii, Susumu Suzuki, Toshijiro Aoki, Naoki Iwakawa, Hiroki Kojima, Kazuhiro Harada, Kenshi Hirayama, Takayuki Mitsuda, Takuya Sumi, Akihito Tanaka, Yasuhiro Ogawa, Katsuhiro Kawaguchi, Toyoaki Murohara
The usefulness of distal protection devices is still controversial. Moreover, there is no report on thrombus evaluation by using optical coherence tomography (OCT) for determining whether to use a distal protection device. The aim of the present study was to investigate the predictor of filter no-reflow (FNR) by using OCT in primary percutaneous coronary intervention (PCI) for ST-elevated acute myocardial infarction (STEMI).We performed preinterventional OCT in 25 patients with STEMI who were undergoing primary PCI with Filtrap...
December 2017: Medicine (Baltimore)
Mohammad Hashemi-Jazi, Sayed Mojtaba Hosseini, Ali Gholamrezaei
BACKGROUND: We investigated clinical and procedural factors associated with the no-reflow phenomenon following percutaneous coronary intervention (PCI) of the saphenous-vein grafts (SVG). METHODS: A cross-sectional study was done on patients who had undergone PCI of the SVG. Patients' medical documents were reviewed for demographic, clinical, laboratory, and procedural data. Slow/no-reflow was defined based on the thrombolysis in myocardial infarction (TIMI) grade (0 to 2)...
September 2017: ARYA Atherosclerosis
Matheus A Costa, Ana E Paiva, Julia P Andreotti, Marcus V Cardoso, Carlos D Cardoso, Akiva Mintz, Alexander Birbrair
No-reflow phenomenon is defined as the reduced blood flow after myocardial ischemia. If prolonged it leads to profound damages in the myocardium. The lack of a detailed knowledge about the cells mediating no-reflow restricts the design of effective therapies. Recently, O'Farrell et al. (2017) by using state-of-the-art technologies, including high-resolution confocal imaging in combination with myocardial ischemia/reperfusion mouse model, reveal that pericytes contribute to the no-reflow phenomenon post-ischemia in the heart...
January 22, 2018: Journal of Molecular and Cellular Cardiology
Abdallah Almaghraby, Yehia Saleh, Basma Hammad, Mahmoud Abdelnaby, Haitham Badran
No abstract text is available yet for this article.
August 2017: Atherosclerosis
Metin Çağdaş, Süleyman Karakoyun, İbrahim Rencüzoğulları, Yavuz Karabağ, Mahmut Yesin, Yalçın Velibey, İnanç Artaç, Doğan İliş, Süleyman Çağan Efe, Onur Taşar, Halil İbrahim Tanboğa
OBJECTIVE: T-peak-T-end (TPE) interval, which represents the dispersion of repolarization, is defined as the interval between the peak and end of the T-wave, and is associated with increased malignant ventricular arrhythmia and sudden cardiac death (SCD) in patients with ST elevation myocardial infarction (STEMI). Although prolonged TPE interval is associated with poor short- and long-term outcomes, even in patients with STEMI treated with successful primary percutaneous coronary intervention (pPCI), clinical, angiographic, and laboratory parameters that affect TPE remain to be elucidated...
January 2018: Anatolian Journal of Cardiology
Shang-Jen Yu, James P Buerck, Edgar A O'Rear, Thomas L Whitsett
BACKGROUND: Reperfusion injury often occurs with therapeutic intervention addressing the arterial occlusions causing acute myocardial infarction and stroke. The no-reflow phenomenon has been ascribed to leukocyte plugging and blood vessel constriction in the microcirculation. OBJECTIVE: To assess possible red cell contributions to post thrombolytic no-reflow phenomenon. METHODS: Blood clots were formed by recalcifying 1 ml of citrated fresh human venous blood and then lysed by adding 1,000 units of streptokinase (SK) at several intervals within 1 hour...
January 11, 2018: Biorheology
Ahmed Nassar, Cristiano Quintini
No abstract text is available yet for this article.
January 11, 2018: Transplantation
Xiaowei Niu, Jingjing Zhang, Ming Bai, Yu Peng, Shaobo Sun, Zheng Zhang
BACKGROUND: Despite the restoration of epicardial flow after primary percutaneous coronary intervention (PPCI), myocardial reperfusion remains impaired in a significant proportion of patients. We performed a network meta-analysis to assess the effect of 7 intracoronary agents (adenosine, anisodamine, diltiazem, nicorandil, nitroprusside, urapidil, and verapamil) on the no-reflow phenomenon in patients with ST-elevation myocardial infarction (STEMI) undergoing PPCI. METHODS: Database searches were conducted to identify randomized controlled trials (RCTs) comparing the 7 agents with each other or with standard PPCI...
January 10, 2018: BMC Cardiovascular Disorders
Antonis S Manolis
BACKGROUND: Intracoronary thrombus in acute myocardial infarction (MI) confers higher rates of no-reflow with attendant adverse consequences. Earlier randomized-controlled-trials (RCTs) of routine thromboaspiration during percutaneous coronary intervention (PCI) indicated a clinical benefit, but more recent RCTs were negative. However, data of selective use of this adjunctive approach remain scarce. OBJECTIVE: The aim of this single-centre prospective study was to report the results of selective thromboaspiration during PCI in patients with intracoronary thrombi, and also to provide an extensive literature review on current status of thromboaspiration...
January 1, 2018: Current Vascular Pharmacology
Tejas Patel, Sanjay Shah, Rajiv Gulati, Tak Kwan, Mauricio G Cohen, Samir Pancholy
OBJECTIVE: Examining the efficacy and outcomes of intracoronary (IC) instillation of adenosine using a novel perforated balloon technique (PBT) to combat no-reflow phenomenon during percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). BACKGROUND: Occurrence of no-reflow during PCI is a serious adverse prognostic event and inability to re-establish better flow is associated with poor outcomes. Several pharmacological and non-pharmacological interventions have been used to treat this situation...
December 27, 2017: Catheterization and Cardiovascular Interventions
V A Kuznetsov, I S Bessonov, I P Zyrianov, T I Zyrianova, S S Sapozhnikov, Y V Potolinskaya
AIM: To study was to assess in-hospital outcomes of direct coronary stenting (DS) compared with stenting after predilation (PD) in patients with ST-elevation myocardial infarction (STEMI). MATERIAL AND METHODS: Data were collected from all patients (n=1103) with STEMI subjected to primary PCI in Tyumen cardiology center from 2006 to 2014. The clinical and angiographic characteristics, in-hospital outcomes, as well as predictors of no-reflow phenomenon were analyzed...
November 2017: Kardiologiia
Crochan John O'Sullivan, Daniela Groza, Franz R Eberli
Left ventricular pseudoaneurysm is a rare mechanical complication of acute myocardial infarction. In the present case, an 80-year-old man presenting with a subacute non-ST segment elevation myocardial infarction was found to have an occluded second obtuse marginal branch of the left circumflex coronary artery. Following the implantation of two drug-eluting stents, the patient developed no-reflow phenomenon. Coronary angiography 6 weeks later revealed persistence of the no-reflow phenomenon. During the left ventriculogram, a massive pseudoaneurysm was diagnosed and the patient successfully underwent emergency surgery...
December 14, 2017: BMJ Case Reports
Qiang Su, Lang Li, Jinmin Zhao, Yuhan Sun, Huafeng Yang
Coronary microembolization (CME) is a common complication of percutaneous coronary intervention (PCI) for acute coronary syndrome. It leads to myocardial apoptosis and cardiac dysfunction. Nicorandil pretreatment can prevent PCI-related myocardial injury and reduce the incidence of no- or slow-reflow phenomena. This cardioprotective effect is probably attributable to the suppression of CME-induced cardiomyocyte apoptosis, but the specific mechanisms have not been clarified. We aimed to investigate the protective effects of nicorandil pretreatment on CME-induced myocardial injury and clarify the underlying mechanisms...
November 21, 2017: Oncotarget
Z-W Tao, X-W Ma, N-N Liu, N-L Tian, X-F Gao, P-X Xiao
OBJECTIVE: To explore the effect of spontaneous reperfusion (SR) on three-dimensional myocardial strain in patients with acute anterior myocardial infarction by three-dimensional speckle tracking imaging (3D-STI) technology. PATIENTS AND METHODS: Patients diagnosed with acute anterior myocardial infarction during 2013 to 2016 were consecutively selected and divided into SR group and non-spontaneous reperfusion (Non-SR) group based on whether there was SR. Patients in both groups received direct percutaneous coronary intervention (PCI) in time window...
December 2017: European Review for Medical and Pharmacological Sciences
Ghasem Soltani, Saeed Jahanbakhsh, Mohammad Abbasi Tashnizi, Mehdi Fathi, Shahram Amini, Nahid Zirak, Shima Sheybani
Background: Arrhythmia occurring during and after surgery is one of the major complications in open-heart surgery. Dexmedetomidine is an intravenous alpha-2 agonist and very specific short-acting drug to protect the various organs against ischemic injuries and blood reflow. However, the effect of dexmedetomidine for preventing intraoperative heart arrhythmias has not been recognized. Objective: This study aimed to determine the effect of dexmedetomidine on the incidence rate of heart arrhythmias and anesthetic required in off-pump coronary artery bypass surgery...
October 2017: Electronic Physician
Xian-Tao Wang, Xiao-Dan Wu, Yuan-Xi Lu, Yu-Han Sun, Han-Hua Zhu, Jia-Bao Liang, Wen-Kai He, Zhi-Yu Zeng, Lang Li
BACKGROUND/AIMS: Coronary microembolization (CME) can lead to no-reflow or slow reflow, which is one of the important reasons for loss of clinical benefit from myocardial reperfusion therapy. MicroRNAs and autophagy are heavily implicated in the occurrence and development of almost all cardiovascular diseases. Therefore, the present study was designed to investigate the role of miR-30e-3p and autophagy in CME-induced myocardial injury rat model. METHODS: Sixty rats were randomly divided into six groups: sham, CME 1h,3h,6h,9h, and 12h (n = 10 per group)...
December 11, 2017: Cellular Physiology and Biochemistry
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