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Coronary physiology

Bhavik N Modi, Kalpa De Silva, Ronak Rajani, Nick Curzen, Divaka Perera
Importance: Ischemia-guided revascularization is the cornerstone of contemporary management of coronary artery disease and has evolved from noninvasive functional evaluation to real-time assessment with invasive physiological indices during diagnostic catheterization. However, serial/diffuse disease is common, and revascularization decisions often need to be made about individual lesions within the same vessel. It is unclear whether current physiological techniques, such as fractional flow reserve, can be reliably used to discern the individual contribution of lesions within a serially diseased vessel with erroneous measurements, potentially leading to suboptimal revascularization decisions...
March 21, 2018: JAMA Cardiology
Morton J Kern, Arnold H Seto
No abstract text is available yet for this article.
March 21, 2018: JAMA Cardiology
Joo Myung Lee, Joon Hyung Doh, Chang Wook Nam, Eun Seok Shin, Bon Kwon Koo
The presence of myocardial ischemia is the most important prognostic factor in patients with coronary artery disease, and ischemia-directed revascularization has been a standard of care. Fractional flow reserve (FFR) is an invasive method used to detect the functionally significant epicardial coronary stenosis, and FFR-guided revascularization strategy has been proven to be superior to angiography-guided strategy. Recently, a hyperemia-free index, instantaneous wave free ratio (iFR), was developed and showed its non-inferiority for clinical outcomes compared with FFR-guided strategy...
March 2018: Korean Circulation Journal
Wieneke Dijk, Sophie Schutte, Edo O Aarts, Ignace M C Janssen, Lydia Afman, Sander Kersten
BACKGROUND: Elevated plasma triglycerides are increasingly viewed as a causal risk factor for coronary artery disease. One protein that raises plasma triglyceride levels and that has emerged as a modulator of coronary artery disease risk is angiopoietin-like 4 (ANGPTL4). ANGPTL4 raises plasma triglyceride levels by inhibiting lipoprotein lipase (LPL), the enzyme that catalyzes the hydrolysis of circulating triglycerides on the capillary endothelium. OBJECTIVE: The objective of the present study was to assess the association between ANGPTL4 and LPL in human adipose tissue, and to examine the influence of nutritional status on ANGPTL4 expression...
February 17, 2018: Journal of Clinical Lipidology
Takayuki Warisawa, Christopher M Cook, Yoshihiro J Akashi, Justin E Davies
It is well known that the apparent significant coronary stenosis on angiography sometimes does not cause significant ischemia, and vice versa. For this reason, decision-making based on coronary physiology is becoming more and more important. Fractional flow reserve (FFR), which has emerged as a useful tool to determine which lesions need revascularization in the catheterization laboratory, now has a class IA indication in the European Society of Cardiology guidelines. More recently, the instantaneous wave-free ratio, which is considered easier to use than FFR, has been graded as equivalent to FFR...
March 15, 2018: Revista Española de Cardiología
Yun-Kyeong Cho, Chang-Wook Nam
Multi-vessel coronary artery disease (MVD) frequently features ambiguous or intermediate lesions that may be both serial and complex, suggesting that multiple regions require revascularization. Percutaneous coronary intervention (PCI) is associated with various challenges such as appropriate identification of lesions that should be treated, the choice of an optimum revascularization method, and limitations of long-term outcomes. Optimal patient selection and careful targeting of lesions are key when planning treatment...
March 21, 2018: Korean Journal of Internal Medicine
Rebecca C Gosling, Paul D Morris, Daniel A Silva Soto, Patricia V Lawford, D Rodney Hose, Julian P Gunn
OBJECTIVES: This study sought to assess the ability of a novel virtual coronary intervention (VCI) tool based on invasive angiography to predict the patient's physiological response to stenting. BACKGROUND: Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) is associated with improved clinical and economic outcomes compared with angiographic guidance alone. Virtual (v)FFR can be calculated based upon a 3-dimensional (3D) reconstruction of the coronary anatomy from the angiogram, using computational fluid dynamics (CFD) modeling...
March 9, 2018: JACC. Cardiovascular Imaging
Yong Gyun Bae, Seung Tae Hwang, Huan Han, Sung Mok Kim, Hyung-Yoon Kim, Il Park, Joo Myung Lee, Young-June Moon, Jin-Ho Choi
Invasive procedure is a prerequisite for studying coronary physiology. We established the measurement of non-invasive physiological parameters including coronary blood flow (CBF), flow velocity, and microvascular resistance using coronary computed tomography angiography (CCTA). Vessel-specific CBF was derived from transluminal attenuation flow encoding (TAFE) and then tested using three separate datasets consisted of computational simulation, human perfusion CT, and human CCTA. TAFE-derived CBF correlated well with measured vessel-specific myocardial blood flow and CBF...
March 16, 2018: Scientific Reports
David S Olshan, Daniel J Rader
The angiopoietin-like proteins are a family of proteins that share structural similarities to the angiopoietins. These proteins have been described to play a key role in the regulation of a myriad of physiologic processes, including serving as essential modulators of lipid and glucose metabolism. Angiopoietin-like protein 4 (ANGPTL4) is a key regulator of lipoprotein lipase, and its modulation has been shown to significantly impact the body's processing and distribution of triglycerides and cholesterol. Although more research remains to elucidate the full range of mechanisms through which ANGPTL4 affects triglyceride and cholesterol homeostasis, current research has associated decreased ANGPTL4 function with a beneficial effect on lipid parameters and overall cardiovascular disease risk, opening the possibility of ANGPTL4 as a new therapeutic target for the treatment of cardiovascular disease...
February 2, 2018: Journal of Clinical Lipidology
S Arques
Cardiovascular diseases are the leading cause of death worldwide. Conceptually, endothelial dysfunction, inflammatory status and oxidative stress are at the forefront in the onset and development of most cardiovascular diseases, particularly coronary artery disease and heart failure. Serum albumin, the most abundant plasma protein, has many physiological properties, including anti-inflammatory, antioxidant and antiplatelet aggregation activity. It also plays an essential role in the fluid exchange across the capillary membrane...
March 12, 2018: Annales de Cardiologie et D'angéiologie
Cédric Garcia, Nicolas Montée, Julien Faccini, Jennifer Series, Olivier Meilhac, Anne-Valérie Cantero, Pauline Le Faouder, Meyer Elbaz, Bernard Payrastre, Cécile Vindis
BACKGROUND: While high-density lipoproteins (HDL) have anti-thrombotic effects by reducing platelet activation, the relationship between HDL levels and the risk of acute coronary syndrome (ACS) is unclear since HDL particles are heterogeneous in composition and biological properties OBJECTIVE: We characterized the effects of HDL2 and HDL3 subclasses from ACS patients and non-coronary artery disease (CAD) subjects on platelet activation. METHODS: We measured platelet aggregation and ex vivo thrombus formation, analyzed signaling pathways by flow cytometry and performed a targeted lipidomics analysis on HDL subclasses RESULTS: Analysis of human platelet aggregation in suspension, adhesion on von Willebrand factor and thrombus formation on collagen under arterial shear demonstrated that HDL2 subclass from ACS patients had a higher antiplatelet potency compared to ACS HDL3 particles and HDL subclasses from non-CAD subjects...
March 15, 2018: Journal of Thrombosis and Haemostasis: JTH
Elie Fiogbé, Rafaela Ferreira, Márcio Antônio Gonçalves Sindorf, Silvia Aparecida Tavares, Keiti Passoni de Souza, Marcelo de Castro Cesar, Charles Ricardo Lopes, Marlene Aparecida Moreno
BACKGROUND AND PURPOSE: It is important to assess the effectiveness and efficiency of water-based training programs in order to prescribe it as an alternative in cardiac rehabilitation for patients who have coronary artery disease (CAD). In these patients, autonomic dysfunction is an important physiological change strongly associated with adverse outcomes, morbidity, and mortality. Given that the beneficial effects of physical training in CAD patients have been traditionally evidenced with programs involving land-based aerobic exercises, this study aims to evaluate the effects of water aerobic exercise training (WAET) on the autonomic modulation of heart rate (HR) and body composition, in the rehabilitation of CAD patients...
March 14, 2018: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
Sarah Soo-Hoo, Samantha Nemeth, Onur Baser, Michael Argenziano, Paul Kurlansky
Objective: To explore the impact of racial and ethnic diversity on the performance of cardiac surgical risk models, the Chinese SinoSCORE was compared with the Society of Thoracic Surgeons (STS) risk model in a diverse American population. Methods: The SinoSCORE risk model was applied to 13 969 consecutive coronary artery bypass surgery patients from twelve American institutions. SinoSCORE risk factors were entered into a logistic regression to create a 'derived' SinoSCORE whose performance was compared with that of the STS risk model...
2018: Heart Asia
Uma Mahesh R Avula, Jonathan J Hernandez, Masatoshi Yamazaki, Carmen R Valdivia, Antony Chu, Alvaro Rojas-Pena, Kuljeet Kaur, Roberto Ramos-Mondragón, Justus M Anumonwo, Stanley Nattel, Héctor H Valdivia, Jérôme Kalifa
BACKGROUND: The mechanisms underlying spontaneous atrial fibrillation (AF) associated with atrial ischemia/infarction are incompletely elucidated. Here, we investigate the mechanisms underlying spontaneous AF in an ovine model of left atrial myocardial infarction (LAMI). METHODS AND RESULTS: LAMI was created by ligating the atrial branch of the left anterior descending coronary artery. ECG loop recorders were implanted to monitor AF episodes. In 7 sheep, dantrolene-a ryanodine receptor blocker-was administered in vivo during the 8-day observation period (LAMI-D, 2...
March 2018: Circulation. Arrhythmia and Electrophysiology
Stuart J McCarter, David B Burkholder, James P Klaas, Christopher J Boes
Charles Edward Beevor (1854-1908) was a prominent English neurologist who served in a variety of positions at the National Hospital for the Paralysed and Epileptic, Queen Square, from 1883 until his sudden death due to coronary artery disease in 1908. Staunchly committed to the meticulous study of neuroanatomy and physiology and education of his fellow physicians, Beevor was an accomplished clinician-scientist. He is most well known for describing the Beevor sign (commonly known as "Beevor's sign"), which is the upward movement of the umbilicus with truncal flexion from a supine position, used to indicate a spinal cord lesion between the levels of T10 and T12...
March 13, 2018: Neurology
Wenguang Li
Strain energy-based constitutive laws with damage effect were proposed by using existing both uniaxial tensile test and tubular biaxial inflation test data on the human great saphenous vein (GSV) segments. These laws were applied into GSV coronary artery bypass grafts (CABG) by employing a thin-walled vessel model to evaluate their passive biomechanical performance under coronary artery physiological conditions at a fixed axial pre-stretch. At a peak systolic pressure in 100-150 mmHg, a 20-33% GSV diameter dilation was predicted with the law based on tubular biaxial inflation test data and agreed well with 25% dilation in clinical observation in comparison with as small as 2-4% dilation estimated with the law based on uniaxial tensile test data...
February 23, 2018: Journal of the Mechanical Behavior of Biomedical Materials
L Testa, A Latib, M Bollati, F Bedogni
Increasing evidence suggests that percutaneous coronary intervention with newer generation drug-eluting stents may be an acceptable alternative, or even preferred in selected cases to the surgical approach, in patients with left main disease. This review will discuss the anatomic factors, the clinical variables, and the procedural strategies to consider, including physiology assessment and imaging guidance, in order to optimize outcomes.
March 9, 2018: Catheterization and Cardiovascular Interventions
Amanda J LeBlanc, Natia Q Kelm, Monika George
Advancing age will affect every individual and its impact on cardiac health deserves significant attention. The age-related physiological changes occurring in the coronary vasculature, myocardium, and valves set the stage upon which cardiovascular disease can escalate in the elderly population. The overall focus of this review is to highlight new and noteworthy studies and to incorporate reviews related to cardiac senescence in the context of the current state of the field. Lastly, future directions in the field of cardiac aging and the development of novel therapeutics to treat pathophysiological conditions typically associated with advancing age will be discussed...
February 2018: Current Opinion in Physiology
So-Yeon Choi, In-Ho Chae, Gary S Mintz, Seung-Jea Tahk
No abstract text is available yet for this article.
March 12, 2018: JACC. Cardiovascular Interventions
Takayuki Niida, Tadashi Murai, Taishi Yonetsu, Yoshihisa Kanaji, Eisuke Usui, Junji Matsuda, Masahiro Hoshino, Makoto Araki, Masao Yamaguchi, Masahiro Hada, Sadamitsu Ichijyo, Rikuta Hamaya, Yoshinori Kanno, Mitsuaki Isobe, Tsunekazu Kakuta
OBJECTIVES: The aim of this study is to investigate the association between fractional flow reserve (FFR) values and change in coronary physiological indices after elective percutaneous coronary intervention (PCI). BACKGROUND: Decision making for revascularization when FFR is 0.75-0.80 is controversial. METHODS: A retrospective analysis was performed of 296 patients with stable angina pectoris who underwent physiological examinations before and after PCI...
March 8, 2018: Catheterization and Cardiovascular Interventions
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