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Left main coronary

Marty D Spranger, Jasdeep Kaur, Javier A Sala-Mercado, Abhinav C Krishnan, Rania Abu-Hamdah, Alberto Alvarez, Tiago M Machado, Robert A Augustyniak, Donal S O'Leary
Increases in myocardial oxygen consumption during exercise mainly occur via increases in coronary blood flow (CBF) as cardiac oxygen extraction is high even at rest. However, sympathetic coronary constrictor tone can limit increases in CBF. Increased sympathetic nerve activity (SNA) during exercise is, in part, a function of muscle metaboreflex activation (MMA). As SNA is heightened even at rest in subjects with hypertension (HTN), we tested whether HTN causes exaggerated coronary vasoconstriction during mild treadmill exercise with MMA (elicited by reducing hindlimb blood flow by ~60%) thereby limiting increases in CBF and ventricular performance...
October 21, 2016: American Journal of Physiology. Heart and Circulatory Physiology
Zhaoyang Hu, Sheng Hu, Shuai Yang, Mou Chen, Ping Zhang, Jin Liu, Geoffrey W Abbott
BACKGROUND: Preconditioning stimuli conducted in remote organs can protect the heart against subsequent ischemic injury, but effects on arrhythmogenesis and sudden cardiac death (SCD) are unclear. Here, we investigated the effect of remote liver ischemia preconditioning (RLIPC) on ischemia/reperfusion (I/R)-induced cardiac arrhythmia and sudden cardiac death (SCD) in vivo, and determined the potential role of ERK/GSK-3βsignaling. METHODS/RESULTS: Male Sprague Dawley rats were randomized to sham-operated, control, or RLIPC groups...
2016: PloS One
Daniel Verdini, Daniel Vargas, Anderson Kuo, Brian Ghoshhajra, Phillip Kim, Horacio Murillo, Jacobo Kirsch, Michael Lane, Carlos Restrepo
PURPOSE: Coronary-pulmonary arterial fistulas (CPAFs) are rare coronary artery anomalies that have been described only in limited case reports. This study aims to evaluate the clinical presentation and imaging findings of CPAFs collected from 6 participating medical centers along with CPAFs reported in the literature, to discern any general trends present in CPAFs. MATERIALS AND METHODS: A total of 25 cases of CPAF diagnosed by coronary computed tomography angiography were collected across 6 participating institutions...
November 2016: Journal of Thoracic Imaging
Bo Xu, Björn Redfors, Yuejin Yang, Shubin Qiao, Yongjian Wu, Jilin Chen, Haibo Liu, Jue Chen, Liang Xu, Yanyan Zhao, Changdong Guan, Runlin Gao, Philippe Généreux
OBJECTIVES: The aim of this study was to assess the impact of operator experience on prognosis after left main coronary artery (LM) percutaneous coronary intervention (PCI). BACKGROUND: LM PCI can be technically challenging and potentially risky considering the amount of supplied myocardium. METHODS: Consecutive patients who underwent unprotected LM PCI at a single institution were included and compared according to whether the primary operator was an experienced, high-volume LM operator (defined as an operator who performed at least 15 LM PCIs per year for at least 3 consecutive years) or not...
October 24, 2016: JACC. Cardiovascular Interventions
Elaheh Malakan Rad, Iran Malekzadeh, Vahid Ziaee, Raheleh Rajabi, Zohreh Shahabi
BACKGROUND: Kawasaki disease (KD) is the most common cause of acquired myocardial infarction in children. Coronary artery involvement is the most serious feature of this vasculitis syndrome. Timely diagnosis of coronary artery involvement is of utmost importance since it can prevent long-term morbidity and mortality. The current methods for the diagnosis of coronary artery dilation in KD are inconsistent and are also not capable of detecting all the abnormal coronary arteries or the so-called occult dilations present...
August 2016: Iranian Journal of Pediatrics
Daniele Iaccarino, Filippo Placentino, Alessandra Reggi, Stefano Tondi
No abstract text is available yet for this article.
December 2016: Minerva Cardioangiologica
T S Liu, B T Chen, R Dong, Y Li, Y Zhao, K Hua
Objective: To discuss the clinical safety and efficacy about off-pump coronary artery bypass grafting (OPCABG) in octogenarians. Methods: From June 2005 to July 2014, 252 patients (male 208, female 44, with a mean age of 81.7 years old) underwent OPCABG in Beijing Anzhen Hospital who were aged 80 years or older were enrolled. Results: Eight (3.2%) patients were diagnosed as single vessel coronary artery disease (CAD), 29 cases (11.5%) were diagnosed as bifurcation vessel CAD, and 215 cases (85.3%) were multivessel CAD...
September 27, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Marina Pieri, Alessandro Belletti, Fabrizio Monaco, Antonio Pisano, Mario Musu, Veronica Dalessandro, Giacomo Monti, Gabriele Finco, Alberto Zangrillo, Giovanni Landoni
BACKGROUND: In patients undergoing cardiac surgery, a reduced preoperative left ventricular ejection fraction (LVEF) is common and is associated with a worse outcome. Available outcome data for these patients address specific surgical procedures, mainly coronary artery bypass graft (CABG). Aim of our study was to investigate perioperative outcome of surgery on patients with low pre-operative LVEF undergoing a broad range of cardiac surgical procedures. METHODS: Data from patients with pre-operative LVEF ≤40 % undergoing cardiac surgery at a university hospital were reviewed and analyzed...
October 18, 2016: BMC Anesthesiology
Damiano Regazzoli, Manuela Giglio, Francesca Besana, Pier Pasquale Leone, Akihito Tanaka, Marco Bruno Ancona, Antonio Mangieri, Matteo Montorfano, Francesco Giannini, Giuseppe De Angelis, Antonio Colombo, Azeem Latib
Congenital coronary-pulmonary fistulas are uncommon coronary anomalies. We present a case of a 63-year-old woman with a tortuous fistula between the proximal left anterior descending and main pulmonary artery which was effectively closed using an AMPLATZER Vascular Plug IV.
October 2, 2016: International Journal of Cardiology
Takayuki Warisawa, Toru Naganuma, Sunao Nakamura
We report a case of percutaneous coronary intervention in a bifurcation lesion involving left circumflex (LCx) artery and 2 major posterolateral (PL) arteries. The target LCx had diffuse long and severely calcified lesion with the acute takeoff angle from the left main. Despite adequate lesion preparation with rotational atherectomy and balloon angioplasty, the stent was not deliverable, even with deep intubation of 7Fr-guiding catheter. Conventional use of guiding extension catheter (GEC) would have required removal of a wire from at least one PL because of the device interference in the GEC...
October 18, 2016: Cardiovascular Intervention and Therapeutics
Dae Young Hyun, Myung Ho Jeong, Doo Sun Sim, Yun Ah Jeong, Kyung Hoon Cho, Min Chul Kim, Hyun Kuk Kim, Hae Chang Jeong, Keun Ho Park, Young Joon Hong, Jun Han Kim, Youngkeun Ahn, Jung Chaee Kang
Background/Aims: This study appraised the long term clinical outcomes of patients treated with percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease. There are limited data regarding long-term clinical outcomes after PCI for ULMCA disease. Methods: From 2001 to 2011, a total of 448 patients who underwent PCI for ULMCA disease and had 2-year clinical follow-up, were analyzed. The study patients were divided into two groups: group I (stable angina pectoris [SAP], n = 60, 48 men, 62 ± 10 years) and group II (acute coronary syndrome [ACS], n = 388, 291 men, 64 ± 10 years)...
October 18, 2016: Korean Journal of Internal Medicine
Rohit Bhoil, Shikha Sood, Sabina Bhoil, Anshul Chamail, R G Sood
Left coronary artery compression syndrome is an uncommon entity and characterized by compression of the LMCA in-between the aorta and an enlarged main pulmonary arterial trunk. It is usually associated with a congenital cardiac defect. Cardiac 64-slice MDCT provides a non-invasive and an accurate method for assessing the degree of dynamic LMCA compression throughout the cardiac cycle, its angulation relative to the left sinus of Valsalva and depiction of pulmonary pathology, making it a valuable tool in the workup of patients suspected of left coronary artery compression...
October 18, 2016: Acute Cardiac Care
Fatih Sen, Ozcan Ozeke, Ozgur Kirbas, Cengiz Burak, Habibe Kafes, Bahar Tekin Tak, Umran Ozdamar, Kadir Ocak, Serkan Topaloglu, Dursun Aras
Prediction of left main coronary artery (LMCA) or equivalent disease is important with regard to selecting the appropriate treatment strategy. The classical electrocardiographic pattern of LMCA disease includes ST elevation (STE) in lead aVR in the presence of extensive ST depression (most prominent in leads I, II, and V4-6) with the STE in aVR≥V1. Patients with these findings may potentially require early coronary angiography and coronary bypass surgery; therefore selected patients with these findings on exercise testing might benefit from more urgent or expedited angiography...
September 2016: Indian Heart Journal
S Thrudeep, George Geofi, George Rupesh, S Abdulkhadar
Acute coronary syndrome (ACS) and electrocardiography showing ST elevation in Lead aVR>V1 are considered specific for left main coronary artery lesion and also suggest extensive anterior wall myocardial infarction. In this backdrop, we are presenting an incidental observation of an association of ST elevation in lead aVR>V1 in isolated proximal left circumflex lesion in the setting of ACS, who later underwent successful primary percutaneous coronary intervention.
September 2016: Indian Heart Journal
P Vinodh Kumar, Asha Moorthy
A 38-year-old man presented with exertional angina of 1-year duration. Treadmill was strongly positive. Coronary angiogram revealed a significant phasic systolic compression of the left main and the proximal left circumflex artery. Echo and MRI revealed a subaortic left ventricle diverticulum causing compression of the coronary vessels. Before the planned surgery, the patient had sudden deterioration with cardiogenic shock and could not be saved.
September 2016: Indian Heart Journal
Amin Daoulah, Mohamed N Alama, Osama E Elkhateeb, Mushabab Al-Murayeh, Salem Al-Kaabi, Salem M Al-Faifi, Hind M Alosaimi, Amir Lotfi, Khalid S Asiri, Ahmed M Elimam, Ayman S Abougalambo, Waheed Murad, Mamdouh M Haddara, Ciaran M Dixon, Alawi A Alsheikh-Ali
OBJECTIVES: The aim of this study was to assess the association of widowhood with the severity and extent of coronary artery disease (CAD), and whether it is modified by sex or socioeconomic status. PATIENTS AND METHODS: A total of 1068 patients undergoing coronary angiography at five centers in Saudi Arabia and the United Arab Emirates were included in the study. CAD was defined as more than 70% lumen stenosis in a major epicardial vessel or more than 50% in the left main coronary artery...
October 4, 2016: Coronary Artery Disease
Yalcin Velibey, Tolga Sinan Guvenc, Ahmet Taha Alper
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
Tzu-Hsien Tsai, Cheng-I Cheng
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
Leonida Compostella, Nenad Lakusic, Nicola Russo, Tiziana Setzu, Caterina Compostella, Elia Vettore, Giambattista Isabella, Giuseppe Tarantini, Sabino Iliceto, Fabio Bellotto
BACKGROUND: Depressed heart rate variability (HRV) is usually considered a negative long-term prognostic factor after acute myocardial infarction. Anyway, most of the supporting research was conducted before the era of immediate reperfusion by percutaneous coronary intervention (PCI). Main aim of this study was to evaluate if HRV still retains prognostic significance in our era of immediate PCI. METHODS AND RESULTS: Two weeks after STEMI treated by primary PCI, time-domain HRV was assessed from 24-h Holter recordings in 186 patients: markedly depressed HRV (SDNN <70ms or <50ms) was present in 16% and in 5% of cases, respectively; patients with left ventricle ejection fraction (LVEF) <40% presented more often SDNN values in the lowest quartile...
September 23, 2016: International Journal of Cardiology
Dong Jia, Xiao-Ming Zhou, Gang Hou
To evaluate the feasibility and the efficacy of computed tomography pulmonary angiography (CTPA) in differentiating acute pulmonary embolism (PE) patients with or without right ventricular dysfunction and to evaluate the severity of right ventricular dysfunction in acute PE patients with CPTA. We retrospectively collected and measured the following parameters: right ventricular diameter by short axis in the axial plane (RVDaxial), left ventricular diameter by short axis in the axial plane (LVDaxial), right ventricular diameter by level on the reconstructed four-chamber views (RVD4-CH), left ventricular diameter by level on the reconstructed four-chamber views (LVD4-CH), main pulmonary artery diameter (MPAD), ascending aorta diameter (AOD), coronary sinus diameter (CSD), superior vena cava diameter (SVCD), inferior vena cava (IVC) reflux and interventricular septum deviation by CTPA, and we calculated the RVDaxial/LVDaxial, RVD4-CH/LVD4-CH and MPAD/AOD ratios in acute PE patients...
October 12, 2016: Journal of Thrombosis and Thrombolysis
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