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https://www.readbyqxmd.com/read/28654959/cardiovascular-testing-and-clinical-outcomes-in-emergency-department-patients-with-chest-pain
#1
Alexander T Sandhu, Paul A Heidenreich, Jay Bhattacharya, M Kate Bundorf
Importance: Noninvasive testing and coronary angiography are used to evaluate patients who present to the emergency department (ED) with chest pain, but their effects on outcomes are uncertain. Objective: To determine whether cardiovascular testing-noninvasive imaging or coronary angiography-is associated with changes in the rates of coronary revascularization or acute myocardial infarction (AMI) admission in patients who present to the ED with chest pain without initial findings of ischemia...
June 26, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28654919/a-clinical-score-for-predicting-atrial-fibrillation-in-patients-with-cryptogenic-stroke-or-transient-ischemic-attack
#2
Calvin Kwong, Albee Y Ling, Michael H Crawford, Susan X Zhao, Nigam H Shah
OBJECTIVES: Detection of atrial fibrillation (AF) in post-cryptogenic stroke (CS) or transient ischemic attack (TIA) patients carries important therapeutic implications. METHODS: To risk stratify CS/TIA patients for later development of AF, we conducted a retrospective cohort study using data from 1995 to 2015 in the Stanford Translational Research Integrated Database Environment (STRIDE). RESULTS: Of the 9,589 adult patients (age ≥40 years) with CS/TIA included, 482 (5%) patients developed AF post CS/TIA...
June 28, 2017: Cardiology
https://www.readbyqxmd.com/read/28654911/radial-artery-intima-media-thickness-regresses-after-secondary-prevention-interventions-in-patients-post-acute-coronary-syndrome-and-is-associated-with-cardiac-and-kidney-biomarkers
#3
Damilola D Adingupu, Helena U Westergren, Santosh Dahgam, Ann-Cathrine Jönsson-Rylander, Juuso Blomster, Per Albertsson, Elmir Omerovic, Sara Svedlund, Li-Ming Gan
BACKGROUND: Radial artery intima-media thickness (rIMT) measured by ultra-high-resolution ultrasound is associated with increased cardiovascular risk and predicts outcomes. We performed non-invasive high-resolution ultrasound of the radial artery to investigate vascular changes in subjects presenting with acute coronary syndrome (ACS) and who had undergone percutaneous coronary intervention (PCI). PURPOSE: In the present work, we aimed to follow rIMT change over time post-acute coronary syndrome as a tool to monitor potential response to intensified medical therapy...
June 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28654509/pi3ks-in-diabetic-cardiomyopathy
#4
Mingchuan Li, Alessandra Murabito, Alessandra Ghigo, Emilio Hirsch
Diabetic cardiomyopathy is a heart disease in diabetic patients, identified as ventricular dysfunction in the absence of coronary artery disease and hypertension. The molecular mechanisms underlying diabetic cardiomyopathy are still poorly understood. The protein and lipid kinase phosphoinositide 3-kinases (PI3Ks) have been suggested to regulate cardiac injury during diabetes. In this review, we will summarize the role of different PI3K isoforms and of their downstream signaling in the pathogenesis of diabetic cardiomyopathy, including the regulation of cardiac metabolism, contractility, hypertrophy, myocardial cell death and inflammation...
June 22, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28654385/3d-fusion-framework-for-infarction-and-angiogenesis-analysis-in-a-myocardial-infarct-minipig-model
#5
Xu Zhenzhen, Bo Tao, Yu Li, Jun Zhang, Xiaochao Qu, Feng Cao, Jimin Liang
The combination of different modality images can provide detailed and comprehensive information for the prognostic assessment and therapeutic strategy of patients with ischemic heart disease. In this study, a 3D fusion framework is designed to integrate coronary computed tomography (CT) angiography (CTA), 2-deoxy-2-[(18)F]fluoro-D-glucose ([(18)F]DG) positron emission tomography (PET)/CT, and [(68)Ga]-1,4,7-triazacyclononane-1,4,7-triacetic acid-(Arg-Gly-Asp)2 ([(68)Ga]-NOTA-PRGD2) PET/CT images of the myocardial infarction model in minipigs...
January 1, 2017: Molecular Imaging
https://www.readbyqxmd.com/read/28654382/imaging-of-myocardial-ischemia-reperfusion-injury-using-sodium-18-f-fluoride-positron-emission-tomography-computed-tomography-in-rats-and-humans
#6
Hongyoon Choi, Jeong Hee Han, Sue Yeon Lim, Inki Lee, Young-Seok Cho, Eun Ju Chun, Won Woo Lee
Positron emission tomography (PET)/computed tomography (CT) using sodium [(18)F]fluoride (Na[(18)F]F) has been proven to be a promising hot-spot imaging modality for myocardial infarction (MI). We investigated Na[(18)F]F uptake in ischemia-reperfusion injury (IRI) of rats and humans. Sodium [(18)F]fluoride PET/CT was performed in Sprague-Dawley rats that had IRI surgery, and it readily demonstrated prominent Na[(18)F]F uptake in the infarct area post-IRI. Sodium [(18)F]fluoride uptake was matched with negative 2,3,5-triphenyl-2 H-tetrazolium chloride staining results, accompanied by myocardial apoptosis and associated with positive calcium staining results...
January 1, 2017: Molecular Imaging
https://www.readbyqxmd.com/read/28654061/the-inverted-heart-model-for-interstitial-transudate-collection-from-the-isolated-rat-heart
#7
Kezhe Tan, Zhaoping Ding, Bodo Steckel, Sonja Hartwig, Stefan Lehr, Xiaoming Deng, Jürgen Schrader
The present protocol describes a unique approach that enables the collection of cardiac transudate (CT) from the isolated, saline-perfused rat heart. After isolation and retrograde perfusion of the heart according to the Langendorff technique, the heart is inverted into an upside-down position and is mechanically stabilized by a balloon catheter inserted into the left ventricle. Then, a thin latex cap - previously cast to match the average size of the rat heart - is placed over the epicardial surface. The outlet of the latex cap is connected to silicon tubing, with the distal opening 10 cm below the base level of the heart, creating slight suction...
June 20, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28653469/development-of-quality-metrics-for-ambulatory-pediatric-cardiology-chest-pain
#8
Jimmy C Lu, Manish Bansal, Sarina K Behera, Jeffrey R Boris, Brian Cardis, John S Hokanson, Bahram Kakavand, Roy Jedeikin
OBJECTIVE: As part of the American College of Cardiology Adult Congenital and Pediatric Cardiology Section effort to develop quality metrics (QMs) for ambulatory pediatric practice, the chest pain subcommittee aimed to develop QMs for evaluation of chest pain. DESIGN: A group of 8 pediatric cardiologists formulated candidate QMs in the areas of history, physical examination, and testing. Consensus candidate QMs were submitted to an expert panel for scoring by the RAND-UCLA modified Delphi process...
June 27, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28653465/introduction-to-anomalous-aortic-origin-of-a-coronary-artery
#9
Julie A Brothers
Anomalous aortic origin of a coronary artery (AAOCA) occurs when both coronary arteries arise from the same aortic sinus from a single ostium or two separate ostia. While most coronary anomalies are benign, the two most common subtypes that predispose to sudden cardiac death in the young are interarterial anomalous right coronary artery and interarterial anomalous left coronary artery. Practitioners face many challenges with AAOCA. Diagnosing patients may be difficult because children and adolescents are often asymptomatic and first presentation may be sudden death or sudden cardiac arrest...
June 27, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28653424/anesthetic-ointment-only-lidocaine-prilocaine-instead-of-injectable-local-lidocaine-in-trans-radial-catheterization-a-viable-no-needle-alternative
#10
George Latsios, Kostas Toutouzas, Alexios S Antonopoulos, Eleni Melidi, Andreas Synetos, Georgia Vogiatzi, Aggeliki Stasinopoulou, Kostas Tsioufis, Eleftherios Tsiamis, Dimitrios Tousoulis
OBJECTIVE: The aim of the present study was to assess the level of access site pain in patients undergoing transradial coronary catheterization by using topical application of an anesthetic ointment (lidocaine/prilocaine-AO) compared to standard local anesthesia (LA) by means of injectable lidocaine. METHODS: We prospectively studied 444 patients undergoing elective trans-radial coronary angiography. The quality of analgesia was assessed using a visual analogue scale (VAS) immediately after the puncture and 30 min after the removal of the sheath...
June 26, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28653394/ranolazine-reduces-repolarization-heterogeneity-in%C3%A2-symptomatic-patients-with-diabetes-and-non-flow-limiting-coronary-artery-stenosis
#11
Ederson Evaristo, Fernando G Stocco, Nishant R Shah, Michael K Cheezum, Jon Hainer, Courtney Foster, Bruce D Nearing, Marcelo Di Carli, Richard L Verrier
BACKGROUND: Experimental evidence suggests that ranolazine decreases susceptibility to ischemia-induced arrhythmias independent of effects on coronary artery blood flow. OBJECTIVE: In symptomatic diabetic patients with non-flow-limiting coronary artery stenosis with diffuse atherosclerosis and/or microvascular dysfunction, we explored whether ranolazine reduces T-wave heterogeneity (TWH), an electrocardiographic (ECG) marker of arrhythmogenic repolarization abnormalities shown to predict sudden cardiac death...
June 27, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28653340/aortic-perfusion-score-for-pulmonary-atresia-with-intact-ventricular-septum-an-antegrade-coronary-perfusion-scoring-system-that-is-predictive-of-need-for-transplant-and-mortality
#12
Rohit S Loomba, Andrew N Pelech
BACKGROUND: Pulmonary atresia with intact ventricular septum is a unique congenital malformation of the heart in which patients may undergo single-, two- or 1½- ventricle repair. Size of the tricuspid valve annulus, morphology of the right ventricle and presence of ventriculocoronary connections can all impact the selection of appropriate palliative strategy. We developed the aortic perfusion score, a novel scoring system based on anterograde coronary perfusion with the aim of being able to identify patients at risk for death or transplant...
June 27, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28653314/fractional-flow-reserve-based-therapy-in-patients-presenting-with-acute-coronary-syndrome-current-data-and-everyday-practice
#13
Grzegorz Zuk, Dariusz Ciecwierz, Natalia Cwalina, Marcin Gruchala, Florim Cuculi
Fractional flow reserve (FFR) is an evidence-based diagnostic tool of physiological significance of coronary artery stenosis in patients with stable coronary artery disease (CAD). Due to microvascular dysfunction in acute coronary syndrome (ACS), information obtained from FFR assessment could be less reliable and, thus, its clinical role remains controversial. Indeed, results of currently published studies are essentially discrepant. Only a few randomized clinical trials have been performed showing the efficacy of FFR-guided percutaneous coronary intervention (PCI) in ACS...
June 27, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28653312/link-of-renal-microcirculatory-dysfunction-to-increased-coronary-microcirculatory-resistance-in-hypertensive-patients
#14
Cong Lin, Pu Zhang, Yangjing Xue, Yinqing Huang, Kangting Ji
BACKGROUND: This study investigated the correlation between renal microcirculation and coronary microcirculation in hypertensive patients. METHODS: Participants consisted of 231 consecutive candidates who were referred to the Second Affiliated Hospital of Wenzhou Medical University from March 2014 to May 2016 for elective coronary angiography due to suspected myocardial ischemia. All participants were evaluated for the index of microvascular resistance (IMR), coronary flow reserve (CFR), and fractional flow reserve (FFR) using a pressure wire...
June 27, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28653131/novel-risk-stratification-assays-for-acute-coronary-syndrome
#15
REVIEW
Haitham M Ahmed, Stanley L Hazen
PURPOSE OF REVIEW: Since identification of aspartate aminotransferase as the first cardiac biomarker in the 1950s, there have been a number of new markers used for myocardial damage detection over the decades. There have also been several generations of troponin assays, each with progressively increasing sensitivity for troponin detection. Accordingly, the "standard of care" for myocardial damage detection continues to change. The purpose of this paper is to review the clinical utility, biological mechanisms, and predictive value of these various biomarkers in contemporary clinical studies...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28652956/a-case-of-transient-st-elevation-and-polymorphic-tachycardia-without-angina-diagnosed-by-holter-monitoring
#16
Ali Farooq, Fahad Alqahtani, Almoutassim Trabulsi, Akram Kawsara, Mohamad Alkhouli
We report the case of 52-year-old female with recurrent episodes of palpitations and dizziness. Holter monitoring revealed transient ST elevations followed by episodes of polymorphic ventricular tachycardia associated with episodes of palpitations and dizziness. Coronary angiography revealed mildly irregular right coronary artery with 90% stenosis. The patient underwent percutaneous coronary intervention with successful placement of a stent to the mid-right coronary artery. The patient has been followed closely over a period of 12 months...
May 25, 2017: Curēus
https://www.readbyqxmd.com/read/28652952/fibromuscular-dysplasia-with-spontaneous-coronary-artery-disease-presenting-as-acute-myocardial-infarction
#17
Ali Farooq, Waseem Amjad, Ata Ur Rahim Bajwa, Hassaan Yasin, Rizwan Ali, Muhammad Pervaiz
A 40-year-old female presented to a rural hospital with crushing substernal chest pain. An initial electrocardiogram showed ST elevation in lead II and aVF with elevated troponin I. She was immediately transferred to a tertiary care hospital. An emergent coronary angiogram did not show any significant coronary artery disease. On the second day, the patient experienced recurrence of severe chest pain with ST elevations in leads I, aVL, V5-V6, ST depressions in V1-V3, T-wave inversion over V2-V5. The troponin I level increased to > 40 ng/ml (normal 0...
May 23, 2017: Curēus
https://www.readbyqxmd.com/read/28652799/direct-oral-anticoagulants-in-patients-with-chronic-kidney-disease-patient-selection-and-special-considerations
#18
REVIEW
Jens Lutz, Kerstin Jurk, Helmut Schinzel
Many patients with chronic kidney disease (CKD) receive anticoagulation or antiplatelet therapy due to atrial fibrillation, coronary artery disease, thromboembolic disease, or peripheral artery disease. The treatment usually includes vitamin K antagonists (VKAs) and/or platelet aggregation inhibitors. The direct oral anticoagulants (DOAC) inhibiting factor Xa or thrombin represent an alternative for VKAs. In patients with acute and chronic kidney disease, caution is warranted, as DOACs can accumulate as they are partly eliminated by the kidneys...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28652743/zinc-oxide-nanoparticle-induced-atherosclerotic-alterations-in-vitro-and-in-vivo
#19
Zhen Yan, Wenjun Wang, Yongjun Wu, Wei Wang, Bing Li, Ning Liang, Weidong Wu
Engineered zinc oxide nanoparticles (ZnO-NPs) are currently being produced in high tonnage. Exposure to ZnO-NPs presents potential risks to cardiovascular system. Thus far, the toxicological effects of ZnO-NPs on cardiovascular system have not been well characterized. In this study, human coronary artery endothelial cells (HCAECs) were exposed to ZnO-NPs directly or indirectly using a transwell coculture system with human alveolar epithelial cell line A549 to mimic the lung/circulation interaction. It was shown that levels of proinflammatory mediators (interleukin-8 [IL-8] and tumor necrosis factor-α [TNF-α]) and biomarkers of atherosclerogenesis (heme oxygenase-1 [HO-1] and platelet endothelial cell adhesion molecules-1 [PECAM-1]) in the supernatants of culture media were significantly increased...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28652679/contrast-induced-thrombocytopenia-following-percutaneous-coronary-intervention
#20
Roberto Muniz Ferreira, João Mansur Filho, Paolo Blanco Villela, Juliano Carvalho Gomes de Almeida, Pedro Paulo Nogueres Sampaio, Felipe Neves de Albuquerque, Wolmar Pulcheri, Cláudio Buarque Benchimol
Contrast-induced thrombocytopenia is a rare complication distinguished by acute and severe platelet consumption, with spontaneous recovery within days. We describe a case of acute thrombocytopenia 6 hours after coronary angioplasty in a patient with a negative antiplatelet factor 4 test. The count reached 1 × 10(3)/µL, but improved spontaneously to 210 × 10(3)/µL after 8 days. In conclusion, physicians should be aware of this complication, particularly when dual antiplatelet therapy is being considered...
July 2017: Journal of the Saudi Heart Association
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