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Coronary physiology

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https://www.readbyqxmd.com/read/28929388/fiber-reinforced-computational-model-of-the-aortic-root-incorporating-thoracic-aorta-and-coronary-structures
#1
Hossein Mohammadi, Raymond Cartier, Rosaire Mongrain
Cardiovascular diseases are still the leading causes of death in the developed world. The decline in the mortality associated with circulatory system diseases is accredited to development of new diagnostic and prognostic tools. It is well known that there is an inter relationship between the aortic valve impairment and pathologies of the aorta and coronary vessels. However, due to the limitations of the current tools, the possible link is not fully elucidated. Following our previous model of the aortic root including the coronaries, in this study, we have further developed the global aspect of the model by incorporating the anatomical structure of the thoracic aorta...
September 19, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28929246/a-numerical-study-of-the-hemodynamic-effect-of-the-aortic-valve-on-coronary-flow
#2
Shaily Wald, Alex Liberzon, Idit Avrahami
During diastole, coronary perfusion depends on the pressure drop between the myocardial tissue and the coronary origin located at the aortic root. This pressure difference is influenced by the flow field near the closing valve leaflets. Clinical evidence is conclusive that patients with severe aortic stenosis (AS) suffer from diastolic dysfunction during hyperemia, but show increased coronary blood flow (CBF) during rest. Transcatheter aortic valve implantation (TAVI) was shown to decrease rest CBF along with its main purpose of improving the aortic flow and reducing the risk of heart failure...
September 19, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28928613/clarifying-the-anatomy-and-physiology-of-totally-anomalous-systemic-venous-connection
#3
REVIEW
Saurabh Kumar Gupta, Rajnish Juneja, Robert H Anderson, Gurpreet S Gulati, Velayoudam Devagorou
The description of totally anomalous systemic venous connection is limited to case reports. In this review, we seek to clarify anatomic, physiologic, and hemodynamic aspects of this extremely rare anomaly. We also present findings of two patients in whom connection of all the systemic veins was anomalous. In the first patient, with usual atrial arrangement, all systemic veins, including the coronary sinus, were connected anomalously to the morphologically left atrium. Limited left-to-right shunt across an atrial septal defect provided the only source of blood flow to the lungs...
September 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28922543/in-vitro-and-in-vivo-degradation-of-microfiber-bioresorbable-coronary-scaffold
#4
Chi-Hung Huang, Sheng-Yang Lee, Sonida Horng, Louis-Georges Guy, Ting-Bin Yu
The degradation of Mirage Bioresorbable Microfiber Scaffold was evaluated in vitro and in vivo. The degradation in polymer molecular weight (MW), strut morphology, and integrity was accessed using gel permeation chromatography (GPC), X-ray micro-computed tomography (micro-CT) evaluation. To simulate the physiological degradation in vitro, scaffolds were deployed in silicone mock vessels connected to a peristaltic pumping system, which pumps 37°C phosphate-buffered saline (PBS, pH 7.4) at a constant rate. At various time points (30D, 60D, 90D, 180D, 270D, and 360D), the MW of microfibers decreased to 57...
September 18, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/28922188/new-insights-into-the-role-of-glycosylation-in-lipoprotein-metabolism
#5
Marjolein A W van den Boogert, Daniel J Rader, Adriaan G Holleboom
PURPOSE OF REVIEW: Human genetics has provided new insights into the role of protein glycosylation in regulating lipoprotein metabolism. Here we review these new developments and discuss the biological insights they provide. RECENT FINDINGS: Case descriptions of patients with congenital defects in N-glycosylation (CDG-I) frequently describe a distinct hypocholesterolemia in these rare multisystem clinical syndromes. Two novel CDGs with disturbed Golgi homeostasis and trafficking defects result in mixed glycosylation disorders, hepatic steatosis and hypercholesterolemia...
September 15, 2017: Current Opinion in Lipidology
https://www.readbyqxmd.com/read/28921447/structure-pharmacology-and-roles-in-physiology-of-the-p2y12-receptor
#6
Ivar von Kügelgen
P2Y receptors are G-protein-coupled receptors (GPCRs) for extracellular nucleotides. The platelet ADP-receptor which has been denominated P2Y12 receptor is an important target in pharmacotherapy. The receptor couples to Gαi2 mediating an inhibition of cyclic AMP accumulation and additional downstream events including the activation of phosphatidylinositol-3-kinase and Rap1b proteins. The nucleoside analogue ticagrelor and active metabolites of the thienopyridine compounds ticlopidine, clopidogrel and prasugrel block P2Y12 receptors and, thereby, inhibit ADP-induced platelet aggregation...
September 12, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28920099/fast-virtual-fractional-flow-reserve-based%C3%A2-upon-steady-state-computational-fluid-dynamics-analysis-results-from-the-virtu-fast-study
#7
Paul D Morris, Daniel Alejandro Silva Soto, Jeroen F A Feher, Dan Rafiroiu, Angela Lungu, Susheel Varma, Patricia V Lawford, D Rodney Hose, Julian P Gunn
Fractional flow reserve (FFR)-guided percutaneous intervention is superior to standard assessment but remains underused. The authors have developed a novel "pseudotransient" analysis protocol for computing virtual fractional flow reserve (vFFR) based upon angiographic images and steady-state computational fluid dynamics. This protocol generates vFFR results in 189 s (cf >24 h for transient analysis) using a desktop PC, with <1% error relative to that of full-transient computational fluid dynamics analysis...
August 2017: JACC. Basic to Translational Science
https://www.readbyqxmd.com/read/28919601/relationship-between-echocardiographic-epicardial-adipose-tissue-eat-thickness-and-angiographically-detected-coronary-artery-disease
#8
G R Bhuiyan, G C Roy, M A Siddique, M Rahman, K Ahmed, F Nahar
Epicardial adipose tissue (EAT) is a particular form of visceral adipose tissue deposited around the heart and there is growing evidence about the physiological and metabolic importance of EAT, especially in the association of cardiovascular risk profiles and the pathogenesis of atherosclerotic coronary artery disease. This observational, cross sectional study was done to determine the relationship between echocardiographic epicardial adipose tissue (EAT) thickness and coronary artery disease (CAD). Total 123 patients with established or suspected coronary artery disease admitted for coronary angiogram in the department of Cardiology of Bangabandhu Sheikh Mujib Medical University (BSMMU) from November 2010 to the end of April 2011 were included in this study...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28917684/role-of-low-endothelial-shear-stress-and-plaque-characteristics-in-the-prediction-of-nonculprit-major-adverse-cardiac-events-the-prospect-study
#9
Peter H Stone, Akiko Maehara, Ahmet Umit Coskun, Charles C Maynard, Marina Zaromitydou, Gerasimos Siasos, Ioannis Andreou, Dimitris Fotiadis, Kostas Stefanou, Michail Papafaklis, Lampros Michalis, Alexandra J Lansky, Gary S Mintz, Patrick W Serruys, Charles L Feldman, Gregg W Stone
OBJECTIVES: This study sought to determine whether low endothelial shear stress (ESS) adds independent prognostication for future major adverse cardiac events (MACE) in coronary lesions in patients with high-risk acute coronary syndrome (ACS) from the United States and Europe. BACKGROUND: Low ESS is a proinflammatory, proatherogenic stimulus associated with coronary plaque development, progression, and destabilization in human-like animal models and in humans. Previous natural history studies including baseline ESS characterization investigated low-risk patients...
September 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28916602/validation-study-of-image-based-fractional-flow-reserve-during-coronary-angiography
#10
Mariano Pellicano, Ifat Lavi, Bernard De Bruyne, Hana Vaknin-Assa, Abid Assali, Orna Valtzer, Yonit Lotringer, Giora Weisz, Yaron Almagor, Panagiotis Xaplanteris, Ajay J Kirtane, Pablo Codner, Martin B Leon, Ran Kornowski
BACKGROUND: Fractional flow reserve (FFR), an index of the hemodynamic severity of coronary stenoses, is derived from invasive measurements and requires a pressure-monitoring guidewire and hyperemic stimulus. Angiography-derived FFR measurements (FFRangio) may have several advantages. The aim of this study is to assess the diagnostic performance and interobserver reproducibility of FFRangio in patients with stable coronary artery disease. METHODS AND RESULTS: FFRangio is a computational method based on rapid flow analysis for the assessment of FFR...
September 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28915434/neutralization-of-viral-infectivity-by-zebrafish-c-reactive-protein-isoforms
#11
Melissa Bello-Perez, Alberto Falco, Regla Medina-Gali, Patricia Pereiro, Jose Antonio Encinar, Beatriz Novoa, Luis Perez, Julio Coll
This work explores the unexpected in vivo and in vitro anti-viral functions of the seven c-reactive protein (crp1-7) genes of zebrafish (Danio rerio). First results showed heterogeneous crp1-7 transcript levels in healthy wild-type zebrafish tissues and organs and how those levels heterogeneously changed not only after bacterial but also after viral infections, including those in adaptive immunity-deficient rag1(-/-) mutants. As shown by microarray hybridization and proteomic techniques, crp2/CRP2 and crp5/CRP5 transcripts/proteins were among the most modulated during in vivo viral infection situations including the highest responses in the absence of adaptive immunity...
September 12, 2017: Molecular Immunology
https://www.readbyqxmd.com/read/28913725/exercise-and-competitive-sport-physiology-adaptations-and-uncertain-long-term-risks
#12
REVIEW
Patrick T Gleason, Jonathan H Kim
The benefits of regular and moderate exercise training on cardiovascular outcomes have been well established. In addition, strenuous exercise training leads to corollary cardiac structural and functional adaptations that are sport-specific and facilitate athletic performance. In this review, the normal physiologic and hemodynamic changes that occur during exercise and the subsequent differential exercise-induced cardiac remodeling patterns that develop will be discussed. Paradoxically, recent data have raised concern about the long-term impact of higher doses of physical activity and exercise on mortality and cardiovascular health outcomes...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28905113/influence-of-increased-heart-rate-and-aortic-pressure-on-resting-indices-of-functional-coronary-stenosis-severity
#13
Lorena Casadonte, Bart-Jan Verhoeff, Jan J Piek, Ed VanBavel, Jos A E Spaan, Maria Siebes
Baseline assessment of functional stenosis severity has been proposed as a practical alternative to hyperemic indices. However, intact autoregulation mechanisms may affect intracoronary hemodynamics. The aim of this study was to investigate the effect of changes in aortic pressure (Pa) and heart rate (HR) on baseline coronary hemodynamics and functional stenosis assessment. In 15 patients (55 ± 3% diameter stenosis) Pa, intracoronary pressure (Pd) and flow velocity were obtained at control, and during atrial pacing at 120 bpm, increased Pa (+30 mmHg) with intravenous phenylephrine (PE), and elevated Pa while pacing at sinus heart rate (PE + sHR)...
September 13, 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/28902523/functional-assessment-of-lesion-severity-without-using-the-pressure-wire-coronary-imaging-and-blood-flow-simulation
#14
Michail I Papafaklis, Michail C Mavrogiannis, Panagiotis K Siogkas, Lampros S Lakkas, Christos S Katsouras, Dimitrios I Fotiadis, Lampros K Michalis
Hemodynamic indices derived from measurements with the pressure wire (primarily fractional flow reserve [FFR]) have been established as a reliable tool for assessing coronary stenoses and improving clinical decision making. However, the use of the pressure wire constitutes a hurdle for the universal adoption of physiology-guided patient management. Technological advancements have enabled the large-scale application of blood flow simulation (computational fluid dynamics [CFD]) to medical imaging, thereby enabling the virtual assessment of coronary physiology...
September 19, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28899911/correlation-of-end-tidal-carbon-dioxide-amplitude-spectrum-area-and-coronary-perfusion-pressure-in-a-porcine-model-of-cardiac-arrest
#15
Nicolas Segal, Anja K Metzger, Johanna C Moore, Laura India, Michael C Lick, Paul S Berger, Wanchun Tang, David G Benditt, Keith G Lurie
Amplitude Spectrum Area (AMSA) values during ventricular fibrillation (VF) correlate with myocardial energy stores and predict defibrillation success. By contrast, end tidal CO2 (ETCO2) values provide a noninvasive assessment of coronary perfusion pressure and myocardial perfusion during cardiopulmonary resuscitation (CPR). Given the importance of the timing of defibrillation shock delivery on clinical outcome, we tested the hypothesis that AMSA and ETCO2 correlate with each other and can be used interchangably to correlate with myocardial perfusion in an animal laboratory preclinical, randomized, prospective investigation...
September 2017: Physiological Reports
https://www.readbyqxmd.com/read/28893911/molecular-and-functional-characterization-of-the-endothelial-atp-sensitive-potassium-channel
#16
Qadeer Aziz, Yiwen Li, Naomi Anderson, Leona Ojake, Elena Tsisanova, Andrew Tinker
ATP-sensitive potassium (KATP) channels are widely expressed in the cardiovascular system where they regulate a range of biological activities by linking cellular metabolism with membrane excitability. KATP channels in vascular smooth muscle have a well-defined role in regulating vascular tone. KATP channels are also thought to be expressed in vascular endothelial cells (ECs), but their presence and function in this context is less clear. As a result, we aimed to investigate the molecular composition and physiological role of endothelial KATP channels...
September 11, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28893450/emergency-medicine-evaluation-and-management-of-the-end-stage-renal-disease-patient
#17
REVIEW
Brit Long, Alex Koyfman, Courtney M Lee
BACKGROUND: End stage renal disease (ESRD) is increasing in the U.S., and these patients demonstrate greater all-cause mortality, cardiovascular events, and hospitalization rates when compared to those with normal renal function. These patients may experience significant complications associated with loss of renal function and dialysis. OBJECTIVE: This review evaluates complications of ESRD including cardiopulmonary, neurologic, infectious disease, vascular, and access site complications, as well as medication use in this population...
September 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28889147/acute-coronary-syndrome-risk-prediction-of-rapid-emergency-medicine-scoring-system-in-acute-chest-pain-an-observational-study-of-patients-presenting-with-chest-pain-in-the-emergency-department-in-central-saudi-arabia
#18
Tahir Mehmood, Mohammad S Al Shehrani, Muhammad Ahmad
To assess the diagnostic validity of the rapid emergency medical score (REMS) for the risk stratification of acute coronary syndrome (ACS) from non-cardiogenic chest pain. Methods: An observational cross-sectional study was carried out among patients presenting with chest pain to the Emergency Department of Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia, for 6 months from January to June 2016. All patients, included through non-probability convenience sampling, were assessed using standard protocols for the physiological parameters of the REMS, and ACS was confirmed through electrocardiography, cardiac enzyme testing, and angiography (if needed)...
September 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28888873/comparison-of-regadenoson-and-nitroprusside-to-adenosine-for-measurement-of-fractional-flow-reserve-a-systematic-review-and-meta-analysis
#19
Justin Z Lee, Nirmal Singh, Iwan Nyotowidjojo, Carol Howe, See-Wei Low, Thach Nguyen, Duane Pinto, Gautam Kumar, Kwan S Lee
BACKGROUND: FFR is useful in defining the physiological significance of intermediate coronary stenosis and requires induction of maximal hyperemia and measurement of pressure proximal and distal to the stenosis. Hyperemia normally is induced by either IV or IC adenosine, a medication associated with short-term side effects. IV regadenoson and IC nitroprusside have been suggested as viable alternatives. This meta-analysis aims to identify all studies comparing use of intravenous (IV) regadenoson or intracoronary (IC) nitroprusside with IV adenosine to determine differences related to the agent utilized for assessment of fractional flow reserve (FFR)...
July 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28882237/the-evolving-future-of-instantaneous%C3%A2-wave-free-ratio-and-fractional-flow%C3%A2-reserve
#20
REVIEW
Matthias Götberg, Christopher M Cook, Sayan Sen, Sukhjinder Nijjer, Javier Escaned, Justin E Davies
In this review, the authors reflect upon the role of coronary physiology in the modern management of coronary artery disease. They critically appraise the scientific background of the instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR), from early experimental studies to validation studies against indexes of ischemia, to clinical trials assessing outcome. At this important juncture for the field, the authors make predictions for the future of physiological stenosis assessment, outlining developments for both iFR and FFR in new clinical domains beyond the confines of stable angina...
September 12, 2017: Journal of the American College of Cardiology
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