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coronary microvascular resistance

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https://www.readbyqxmd.com/read/29424571/coronary-microvascular-dysfunction-in-patients-with-heart-failure-with-preserved-ejection-fraction
#1
Kathryn Dryer, Mark Gajjar, Nikhil Narang, Margaret Lee, Jonathan Paul, Atman P Shah, Sandeep Nathan, Javed Butler, Charles J Davidson, William F Fearon, Sanjiv J Shah, John Edward Abellera Blair
BACKGROUND: There are multiple proposed mechanisms for the pathophysiology of heart failure (HF) with preserved ejection fraction (HFpEF). We hypothesize that coronary microvascular dysfunction is common in these patients. METHODS AND RESULTS: In a prospective, observational study, patients undergoing cardiac catheterization with HFpEF (left ventricular (LV) ejection fraction {greater than or equal to} 50% and with clinical HF), were compared to similar patients without HFpEF...
February 9, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29419573/important-role-of-endothelial-caveolin-1-in-the-protective-role-of-endothelium-dependent-hyperpolarization-against-nitric-oxide-mediated-nitrative-stress-in-microcirculation-in-mice
#2
Hiroki Saito, Shigeo Godo, Saori Sato, Akiyo Ito, Yosuke Ikumi, Shuhei Tanaka, Tomoaki Ida, Shigemoto Fujii, Takaaki Akaike, Hiroaki Shimokawa
AIMS: Nitric oxide (NO) and endothelium-dependent hyperpolarization (EDH) play important roles in maintaining cardiovascular homeostasis. We have previously demonstrated that endothelial NO synthase (eNOS) plays diverse roles depending on vessel size, as a NO generating system in conduit arteries and an EDH-mediated system in resistance arteries, for which caveolin-1 (Cav-1) is involved. However, the physiological role of endothelial Cav-1 in microvessels remains to be elucidated. METHODS AND RESULTS: We newly generated endothelium-specific Cav-1-knockout (eCav-1-KO) mice...
February 2018: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29344840/design-and-rationale-for-comparison-between-ticagrelor-and-clopidogrel-on-microcirculation-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-pleio-trial
#3
Kyungil Park, Young-Rak Cho, Jong-Sung Park, Tae-Ho Park, Moo-Hyun Kim, Young-Dae Kim
It has been previously demonstrated that ticagrelor can reduce mortality compared to clopidogrel in acute coronary syndrome (ACS) patients. However, the mechanism for this mortality reduction remains uncertain. The objective of the present study is to assess the impact of chronic ticagrelor treatment on microvascular circulation. A total of 120 participants aged 20-85 years with clinical diagnosis of ACS will be randomized in a 1:1 fashion to the following two groups: ticagrelor 90 mg twice daily; clopidogrel 75 mg once daily...
January 17, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29336308/clinical-significance-of-concordance-or-discordance-between-fractional-flow-reserve-and-coronary-flow-reserve-for-coronary-physiological-indices-microvascular-resistance-and-prognosis-after-elective-percutaneous-coronary-intervention
#4
Eisuke Usui, Tadashi Murai, Yoshihisa Kanaji, Masahiro Hoshino, Masao Yamaguchi, Masahiro Hada, Rikuta Hamaya, Yoshinori Kanno, Tetsumin Lee, Taishi Yonetsu, Tsunekazu Kakuta
AIMS: We aimed to investigate the impact of concordance or discordance of fractional flow reserve (FFR) and coronary flow reserve (CFR) on coronary flow profiles and microvascular resistance after percutaneous coronary intervention (PCI), and the prognostic impact of the periprocedural physiological indices. METHODS AND RESULTS: Totally, 249 de novo physiologically significant coronary lesions from 231 patients who underwent FFR, CFR, and index of microcirculatory resistance (IMR) examinations before and after PCI were included...
January 16, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29317987/delineation-of-epicardial-stenosis-in-patients-with-microvascular-disease-using-pressure-drop-coefficient-a-pilot-outcome-study
#5
Ullhas Udaya Hebbar, Mohamed A Effat, Srikara V Peelukhana, Imran Arif, Rupak K Banerjee
AIM: To investigate the patient-outcomes of newly developed pressure drop coefficient (CDP) in diagnosing epicardial stenosis (ES) in the presence of concomitant microvascular disease (MVD). METHODS: Patients from our clinical trial were divided into two subgroups with: (1) cut-off of coronary flow reserve (CFR) < 2.0; and (2) diabetes. First, correlations were performed for both subgroups between CDP and hyperemic microvascular resistance (HMR), a diagnostic parameter for assessing the severity of MVD...
December 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/29222132/invasive-assessment-of-the-coronary-microvasculature-the-index-of-microcirculatory-resistance
#6
REVIEW
William F Fearon, Yuhei Kobayashi
Traditionally, invasive coronary physiological assessment has focused on the epicardial coronary artery. More recently, appreciation of the importance of the coronary microvasculature in determining patient outcomes has grown. Several invasive modalities for interrogating microvascular function have been proposed. Angiographic techniques have been limited by their qualitative and subjective nature. Doppler wire-derived coronary flow reserve has been applied in research studies, but its clinical role has been limited by its lack of reproducibility, its lack of a clear normal value, and the fact that it is not specific for the microvasculature but interrogates the entire coronary circulation...
December 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29215470/invasive-assessment-of-microvascular-function-in-patients-with-valvular-heart-disease
#7
Takeshi Nishi, Hideki Kitahara, Saito Yuichi, Tomoko Nishi, Takashi Nakayama, Yoshihide Fujimoto, Goro Matsumiya, Yoshio Kobayashi
BACKGROUND: The aim of this study was to investigate microvascular function in patients with valvular heart disease (VHD), which causes chronic left ventricular volume and/or pressure overload, therefore change in coronary microvascular hemodynamics. PATIENTS AND METHODS: We prospectively enrolled 30 patients with VHD considered for surgery (10 aortic stenosis, 12 aortic regurgitation, and eight mitral regurgitation) and 30 controls. Intracoronary physiological assessments were performed in the unobstructed left anterior descending artery using a pressure-temperature sensor guidewire at rest and hyperemia...
December 5, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/29209950/spect-myocardial-ischemia-in-the-absence-of-obstructive-cad-contribution-of-the-invasive-assessment-of-microvascular-dysfunction
#8
Loïc Djaïleb, Laurent Riou, Nicolas Piliero, Adrien Carabelli, Estelle Vautrin, Alexis Broisat, Julien Leenhardt, Jacques Machecourt, Daniel Fagret, Gerald Vanzetto, Gilles Barone-Rochette, Catherine Ghezzi
Coronary microvascular dysfunction has recently emerged as a major independent prognostic factor and can be invasively assessed by coronary flow reserve (CFR) and the index of microvascular resistance (IMR). The incremental prognostic value of myocardial ischemia from SPECT myocardial perfusion imaging (MPI) over clinical characteristics, cardiac risk factors, and stress test data for the prediction of hard cardiac events (myocardial infarction and cardiac death) has been well demonstrated over the last two decades regardless of the absence or presence of epicardial CAD...
December 5, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29196345/mitoprotection-attenuates-myocardial-vascular-impairment-in-porcine-metabolic-syndrome
#9
Fang Yuan, Ahmad F Hedayat, Christopher M Ferguson, Amir Lerman, Lilach O Lerman, Alfonso Eirin
INTRODUCTION: The metabolic syndrome (MetS) leads to cardiac vascular injury, which may reflect in increased retention of endothelial progenitor cells (EPC). Coronary endothelial cell (EC) mitochondria partly regulate vascular function and structure. We hypothesized that chronic mitoprotection would preserve EC mitochondria and attenuate coronary vascular injury and dysfunction in swine MetS. METHODS: Pigs were studied after 16 weeks of diet-induced MetS, MetS treated for the last 4 weeks with the mitochondria-targeted peptide elamipretide (ELAM, 0...
December 1, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29192067/effect-of-myostatin-deletion-on-cardiac-and-microvascular-function
#10
Joshua T Butcher, M Irfan Ali, Merry W Ma, Cameron G McCarthy, Bianca N Islam, Lauren G Fox, James D Mintz, Sebastian Larion, David J Fulton, David W Stepp
The objective of this study is to test the hypothesis that increased muscle mass has positive effects on cardiovascular function. Specifically, we tested the hypothesis that increases in lean body mass caused by deletion of myostatin improves cardiac performance and vascular function. Echocardiography was used to quantify left ventricular function at baseline and after acute administration of propranolol and isoproterenol to assess β-adrenergic reactivity. Additionally, resistance vessels in several beds were removed, cannulated, pressurized to 60 mmHg and reactivity to vasoactive stimuli was assessed...
December 2017: Physiological Reports
https://www.readbyqxmd.com/read/29169759/abnormal-coronary-vasoreactivity-in-transient-left-ventricular-apical-ballooning-tako-tsubo-syndrome
#11
Edoardo Verna, Stefano Provasoli, Sergio Ghiringhelli, Fabrizio Morandi, Jorge Salerno-Uriarte
BACKGROUND: The exact etiology and pathophysiologic mechanisms of tako-tsubo syndrome (TTS) remain controversial. OBJECTIVE: To further evaluate the abnormal coronary vasoreactivity and its possible anatomical substrate in TTS. METHODS: We studied 47 patients (46 women; age 67±12years) who underwent diagnostic cardiac catheterization and evaluation of coronary vasoreactivity by sequential acetylcholine (Ach), nitroglycerine and adenosine testing with angiographic and intracoronary pressure-Doppler flow monitoring...
January 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29154426/microvascular-dysfunction-and-cardiac-fibrosis-in-heart-failure-with-preserved-ejection-fraction-a-case-report
#12
Nikhil Narang, Diego Medvedofsky, Kathryn Dryer, Sanjiv J Shah, Charles J Davidson, Amit R Patel, John E A Blair
We report the case of a 55-year-old woman with heart failure with preserved ejection fraction (HFpEF), who presented with hypertensive urgency and pulmonary oedema. The patient was medically optimized and underwent cardiac catheterization revealing pulmonary hypertension, elevated pulmonary capillary wedge pressure, normal cardiac index, and non-obstructive coronary disease. Invasive evaluation of coronary flow revealed blunted coronary flow reserve and increased index of microvascular resistance. Cardiac magnetic resonance imaging demonstrated reduced global myocardial perfusion and diffuse interstitial fibrosis...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29146670/three-vessel-assessment-of-coronary-microvascular-dysfunction-in-patients-with-clinical-suspicion-of-ischemia-prospective-observational-study-with-the-index-of-microcirculatory-resistance
#13
Yuhei Kobayashi, Joo Myung Lee, William F Fearon, Jang Hoon Lee, Takeshi Nishi, Dong-Hyun Choi, Frederik M Zimmermann, Ji-Hyun Jung, Hyun-Jung Lee, Joon-Hyung Doh, Chang-Wook Nam, Eun-Seok Shin, Bon-Kwon Koo
BACKGROUND: Difficulty directly visualizing the coronary microvasculature as opposed to the epicardial coronary artery makes its assessment challenging. The goal of this study is to measure the index of microcirculatory resistance (IMR) in all 3 major coronary vessels to identify the clinical and angiographic predictors of an abnormal IMR. METHODS AND RESULTS: Ninety-three patients who underwent coronary physiological assessment in all 3 major coronary vessels were prospectively enrolled (59...
November 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29132649/doppler-versus-thermodilution-derived-coronary-microvascular-resistance-to-predict-coronary-microvascular-dysfunction-in-patients-with-acute-myocardial-infarction-or-stable-angina-pectoris
#14
Rupert P Williams, Guus A de Waard, Kalpa De Silva, Matthew Lumley, Kaleab Asrress, Satpal Arri, Howard Ellis, Awais Mir, Brian Clapp, Amedeo Chiribiri, Sven Plein, Paul F Teunissen, Maurits R Hollander, Michael Marber, Simon Redwood, Niels van Royen, Divaka Perera
Coronary microvascular resistance is increasingly measured as a predictor of clinical outcomes, but there is no accepted gold-standard measurement. We compared the diagnostic accuracy of 2 invasive indices of microvascular resistance, Doppler-derived hyperemic microvascular resistance (hMR) and thermodilution-derived index of microcirculatory resistance (IMR), at predicting microvascular dysfunction. A total of 54 patients (61 ± 10 years) who underwent cardiac catheterization for stable coronary artery disease (n = 10) or acute myocardial infarction (n = 44) had simultaneous intracoronary pressure, Doppler flow velocity and thermodilution flow data acquired from 74 unobstructed vessels, at rest and during hyperemia...
October 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29113999/index-of-microcirculatory-resistance-at-the-time-of-primary-percutaneous-coronary-intervention-predicts-early-cardiac-complications-insights-from-the-oxami-oxford-study-in-acute-myocardial-infarction-cohort
#15
Gregor Fahrni, Mathias Wolfrum, Giovanni Luigi De Maria, Florim Cuculi, Sam Dawkins, Mohammad Alkhalil, Niket Patel, John C Forfar, Bernard D Prendergast, Robin P Choudhury, Keith M Channon, Adrian P Banning, Rajesh K Kharbanda
BACKGROUND: Early risk stratification after primary percutaneous coronary intervention (PPCI) for ST-segment-elevation myocardial infarction is currently challenging. Identification of a low-risk group may improve triage of patients to alternative clinical pathways and support early hospital discharge. Our aim was to assess whether the index of microcirculatory resistance (IMR) at the time of PPCI can identify patients at low risk of early major cardiac complications and to compare its performance against guideline-recommended risk scores...
November 7, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29095792/important-role-of-endothelial-caveolin-1-in-the-protective-role-of-edh-against-no-mediated-nitrative-stress-in-microcirculation-in-mice
#16
Hiroki Saito, Shigeo Godo, Saori Sato, Akiyo Ito, Yosuke Ikumi, Shuhei Tanaka, Tomoaki Ida, Shigemoto Fujii, Takaaki Akaike, Hiroaki Shimokawa
AIMS: Nitric oxide (NO) and endothelium-dependent hyperpolarization (EDH) play important roles in maintaining cardiovascular homeostasis. We have previously demonstrated that endothelial NO synthase (eNOS) plays diverse roles depending on vessel size, as a NO generating system in conduit arteries and an EDH-mediated system in resistance arteries, for which caveolin-1(Cav-1) is involved. However, the physiological role of endothelial Cav-1 in microvessels remains to be elucidated. METHODS AND RESULTS: We newly generated endothelium-specific Cav-1-knockout (eCav-1-KO) mice...
October 27, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29069202/association-of-inflammation-and-endothelial-dysfunction-with-coronary-microvascular-resistance-in-patients-with-cardiac-syndrome-x
#17
Ming Long, Zhibin Huang, Xiaodong Zhuang, Zena Huang, Yue Guo, Xinxue Liao, Chufan Luo
BACKGROUND: Although a proportion of CSX patients have impaired brachial artery flow-mediated dilatation (FMD) in response to hyperemia, suggesting that endothelial dysfunction in these patients may be systemic and not just confined to the coronary circulation; the underlying mechanisms triggering endothelial dysfunction in these patients are still incompletely understood. OBJECTIVES: To assess the association of the index of Microcirculatory Resistance (IMR) with endothelial dysfunction and inflammation in patients with CSX...
November 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29042091/effects-of-renal-denervation-on-coronary-flow-reserve-and-forearm-dilation-capacity-in-patients-with-treatment-resistant-hypertension-a-randomized-double-blinded-sham-controlled-clinical-trial
#18
Morten Engholm, Jannik B Bertelsen, Ole N Mathiassen, Hans E Bøtker, Henrik Vase, Christian D Peters, Jesper N Bech, Niels H Buus, Anne P Schroeder, Hans Rickers, Klavs W Hansen, Per L Poulsen, Anne Kaltoft, Kent L Christensen
BACKGROUND: Microvascular impairment is well documented in hypertension. We investigated the effect of renal sympathetic denervation (RDN) on cardiac and peripheral microvasculature in patients with treatment-resistant essential hypertension (TRH). METHODS: A randomized, single centre, double-blinded, sham-controlled clinical trial. Fifty-eight patients with TRH (ambulatory systolic BP (ASBP) ≥ 145mmHg) despite stable treatment were randomized to RDN or SHAM. RDN was performed with the unipolar Medtronic Flex catheter...
October 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29038227/quantification-of-absolute-coronary-blood-flow-and-microvascular-resistance
#19
EDITORIAL
Brahim Harbaoui, Olivier Muller
No abstract text is available yet for this article.
October 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29038224/effect-of-elective-percutaneous-coronary-intervention-on-hyperemic-absolute-coronary-blood-flow-volume-and-microvascular-resistance
#20
Yoshihisa Kanaji, Tadashi Murai, Taishi Yonetsu, Eisuke Usui, Makoto Araki, Junji Matsuda, Masahiro Hoshino, Masao Yamaguchi, Takayuki Niida, Masahiro Hada, Sadamitsu Ichijyo, Rikuta Hamaya, Yoshinori Kanno, Mitsuaki Isobe, Tsunekazu Kakuta
BACKGROUND: The hemodynamics involved in the relationship between absolute coronary blood flow (ABF) volume and myocardial resistance (MR) are complex, and the effect of percutaneous coronary intervention (PCI) on their changes remains unclear. The aim of this study was to investigate the differences in hyperemic ABF and MR before and after elective PCI using a thermodilution method. METHODS AND RESULTS: We investigated 28 vessels (right coronary artery, 9; left anterior descending coronary artery, 18; left circumflex coronary artery, 1) from 28 patients with stable angina pectoris undergoing elective PCI...
October 2017: Circulation. Cardiovascular Interventions
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