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coronary microvascular resistance

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https://www.readbyqxmd.com/read/28550173/experimental-cardiac-radiation-exposure-induces-ventricular-diastolic-dysfunction-with-preserved-ejection-fraction
#1
Hirofumi Saiki, Gilles Moulay, Adam J Guenzel, Weibin Liu, Teresa Decklever, Kelly Classic, Linh Pham, Horng H Chen, John C Burnett, Stephen J Russell, Margaret M Redfield
BACKGROUND: Breast cancer radiotherapy increases the risk of heart failure (HF) with preserved ejection fraction (HFpEF). Cardiomyocytes are highly radio-resistant but radiation specifically affects coronary microvascular endothelial cells with subsequent microvascular inflammation and rarefaction. The effects of radiation on left ventricular (LV) diastolic function are poorly characterized. We hypothesized that cardiac radiation exposure may result in diastolic dysfunction without reduced EF...
May 26, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28526024/protective-effect-on-the-coronary-microcirculation-of-patients-with-diabetes-by-clopidogrel-or-ticagrelor-predict-study-rationale-and-design-a-randomized-multicenter-clinical-trial-using-intracoronary-multimodal-physiology
#2
Enrico Cerrato, Alicia Quirós, Mauro Echavarría-Pinto, Hernan Mejia-Renteria, Andres Aldazabal, Nicola Ryan, Nieves Gonzalo, Pilar Jimenez-Quevedo, Luis Nombela-Franco, Pablo Salinas, Iván J Núñez-Gil, José Ramón Rumoroso, Antonio Fernández-Ortiz, Carlos Macaya, Javier Escaned
BACKGROUND: In diabetic patients a predisposed coronary microcirculation along with a higher risk of distal particulate embolization during primary percutaneous intervention (PCI) increases the risk of peri-procedural microcirculatory damage. However, new antiplatelet agents, in particular Ticagrelor, may protect the microcirculation through its adenosine-mediated vasodilatory effects. METHODS: PREDICT is an original, prospective, randomized, multicenter controlled study designed to investigate the protective effect of Ticagrelor on the microcirculation during PCI in patient with diabetes mellitus type 2 or pre-diabetic status...
May 19, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28521932/discordance-between-fractional-flow-reserve-and-coronary-flow-reserve-insights-from-intracoronary-imaging-and-physiological%C3%A2-assessment
#3
Sung Gyun Ahn, Jon Suh, Olivia Y Hung, Hee Su Lee, Yasir H Bouchi, Wenjie Zeng, Rounak Gandhi, Parham Eshtehardi, Bill D Gogas, Habib Samady
OBJECTIVES: The aim of this study was to investigate the epicardial and microvascular substrates associated with discordances between fractional flow reserve (FFR) and coronary flow reserve (CFR) values. BACKGROUND: Discordances between FFR and CFR remain poorly characterized. METHODS: FFR, hyperemic stenosis resistance (HSR), and intravascular ultrasound were performed as indexes of epicardial function and CFR and hyperemic microvascular resistance (HMR) as measures of microvascular function in 94 patients with moderate coronary stenosis...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28514327/postoperative-assessment-of-myocardial-function-and-microcirculation-in-patients-with-acute-coronary-syndrome-by-myocardial-contrast-echocardiography
#4
Li Jiang, Hong Yao, Zhao-Guang Liang
BACKGROUND Postoperative myocardial function and microcirculation of acute coronary syndrome (ACS) was assessed by myocardial contrast echocardiography (MCE). MATERIAL AND METHODS Eighty-nine ACS patients treated with percutaneous coronary intervention (PCI) were detected by MCE and two-dimensional ultrasonography before and a month later after PCI respectively. Their myocardial perfusion was evaluated by myocardial contrast score (MSC) and contrast score index (CSI); cross-sectional area of microvessel (A), average myocardial microvascular impairment (β), and myocardial blood flow (MBF) were analyzed by cardiac ultrasound quantitative analysis (CUSQ), and fractional flow reserve (FFR) change was observed...
May 17, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28506937/bivalirudin-infusion-to-reduce-ventricular-infarction-the-open-label-randomised-bivalirudin-infusion-for-ventricular-infarction-limitation-bival-study
#5
Robert Jan van Geuns, Georgios Sideris, Niels Van Royen, Rami El Mahmoud, Roberto Diletti, Claire Bal Dit Sollier, Jerome Garot, Nina W Van Der Hoeven, Bernardo Cortese, Li Ding, Ilknur Lechthaler, Efthymios N Deliargyris, Prodromos Anthopoulos, Ludovic Drouet
AIMS: The aim of the study was to investigate whether bivalirudin versus unfractionated heparin (UFH) reduces infarct size (IS) for primary percutaneous coronary intervention (PPCI) in large acute myocardial infarction (AMI). METHODS AND RESULTS: This multicentre open-label trial randomised 78 patients undergoing PPCI for large AMI to bivalirudin or UFH. The primary endpoint was IS, assessed by cardiac magnetic resonance (CMR) five days after PPCI. Secondary endpoints included index of microcirculatory resistance (IMR), CMR-assessed microvascular obstruction (MVO) and ejection fraction, and biomarkers for thrombin activity and cell injury...
May 16, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28501910/targeting-the-dominant-mechanism-of-coronary-microvascular-dysfunction-with-intracoronary-physiology-tests
#6
REVIEW
Hernán Mejía-Rentería, Nina van der Hoeven, Tim P van de Hoef, Julius Heemelaar, Nicola Ryan, Amir Lerman, Niels van Royen, Javier Escaned
The coronary microcirculation plays a key role in modulating blood supply to the myocardium. Several factors like myocardial oxygen demands, endothelial and neurogenic conditions determine its function. Although there is available evidence supporting microvascular dysfunction as an important cause of myocardial ischaemia, with both prognostic and symptomatic implications, its diagnosis and management in clinical practice is still relegated to a second plane. Both diagnostic and therapeutic approaches are hampered by the broadness of the concept of microvascular dysfunction, which fails addressing the plurality of mechanisms leading to dysfunction...
May 13, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28499911/aging-associated-metabolic-disorder-induces-nox2-activation-and-oxidative-damage-of-endothelial-function
#7
Lampson M Fan, Sarah Cahill-Smith, Li Geng, Junjie Du, Gavin Brooks, Jian-Mei Li
Oxidative stress attributable to the activation of a Nox2-containing NADPH oxidase is involved in the development of vascular diseases and in aging. However, the mechanism of Nox2 activation in normal aging remains unclear. In this study, we used age-matched wild-type (WT) and Nox2 knockout (KO) mice at 3-4 months (young); 11-12 months (middle-aged) and 21-22 months (aging) to investigate age-related metabolic disorders, Nox2 activation and endothelial dysfunction. Compared to young mice, middle-aged and aging WT mice had significant hyperglycaemia, hyperinsulinaemia, increased systemic oxidative stress and higher blood pressure...
May 10, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28482008/the-microcirculation-a-key-player-in-obesity-associated-cardiovascular-disease
#8
Oana Sorop, T Dylan Olver, Jens van de Wouw, Ilkka Heinonen, Richard W van Duin, Dirk J Duncker, Daphne Merkus
It is increasingly recognized that obesity is a risk factor for microvascular disease, i.e. results in structural and functional changes in the microvasculature. This review aims to describe how obesity impacts the microvasculature of visceral adipose tissue, skeletal muscle, heart, brain, kidneys and lungs. These changes involve endothelial dysfunction, which in turn impacts control of vascular tone, contributes to development of microvascular insulin resistance, alters secretion of paracrine factors like nitric oxide and endothelin, but also influences vascular structure and perivascular inflammation...
May 8, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28470563/effects-of-qishen-yiqi-dripping-pills-in-reducing-myocardial-injury-and-preserving-microvascular-function-in-patients-undergoing-elective-percutaneous-coronary-intervention-a-pilot-randomized-study
#9
Gui-Xin He, Jun Xie, Hao Jiang, Wei Tan, Biao Xu
OBJECTIVES: To evaluate the effect of treatment with Qishen Yiqi Dripping Pills (, QSYQ) on myocardial injury and myocardial microvascular function in patients undergoing elective percutaneous coronary intervention (PCI). METHODS: Eighty patients undergoing elective PCI were randomly assigned to QSYQ and control groups. The QSYQ group received QSYQ at a dosage of 0.5 g 3 times daily (3-7 days before PCI and then daily for 1 month) and regular medication, which comprised of aspirin, clopidogrel, statin, β-blocker, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker in the absence of contradiction...
May 3, 2017: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/28454806/assessing-micro-vascular-resistances-via-imr-to-predict-outcome-in-stemi-patients-with-multivessel-disease-undergoing-primary-pci-amicro-rationale-and-design-of-a-prospective-multicenter-clinical-trial
#10
Massimo Fineschi, Edoardo Verna, Giuseppe Mezzapelle, Davide Bartolini, Giovanni Turiano, Antonio Manari, Katia Lucarelli, Lucia Uguccioni, Alessandra Repetto, Giuseppe Tarantini
BACKGROUND: In STEMI patients treated with primary percutaneous coronary angioplasty (PPCI) the evaluation of coronary microcirculatory resistance index (IMR) predict the extent of microvascular damage and left ventricular (LV) remodeling. However, the impact of IMR on the clinical outcome after PPCI in patients with multivessel disease (MVD) remains unsettled. AIM: We designed a prospective multicenter controlled clinical trial to evaluate the prognostic value of IMR in terms of clinical outcome and left ventricular remodeling in STEMI patients with MVD undergoing PPCI...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28448601/determinants-of-coronary-flow-reserve-in-non-diabetic-patients-with-chest-pain-without-myocardial-perfusion-defects
#11
Helena U Westergren, Erik Michaëlsson, Juuso I Blomster, Tasso Miliotis, Sara Svedlund, Li-Ming Gan
BACKGROUND: Microvascular dysfunction could be responsible for chest pain in patients without myocardial perfusion defects. We evaluated microvascular function using ultrasound-assessed coronary flow reserve (CFR) in patients with chest pain and normal myocardial perfusion scintigram. Secondly, we investigated association between cardiovascular parameters and decreased CFR in a sex specific manner. METHODS: A total of 202 (128 women) non-diabetic patients with chest pain and suspected myocardial ischemia, but without myocardial perfusion defects on myocardial perfusion scintigram, were enrolled and underwent CFR examination and blood sampling...
2017: PloS One
https://www.readbyqxmd.com/read/28399917/metformin-and-sulodexide-restore-cardiac-microvascular-perfusion-capacity-in-diet-induced-obese-rats
#12
Judith van Haare, M Eline Kooi, Jurgen W G E van Teeffelen, Hans Vink, Jos Slenter, Hanneke Cobelens, Gustav J Strijkers, Dennis Koehn, Mark J Post, Marc van Bilsen
BACKGROUND: Disturbances in coronary microcirculatory function, such as the endothelial glycocalyx, are early hallmarks in the development of obesity and insulin resistance. Accordingly, in the present study myocardial microcirculatory perfusion during rest and stress was assessed following metformin or sulodexide therapy in a rat model of diet-induced obesity. Additionally, the effect of degradation of the glycocalyx on myocardial perfusion was assessed in chow-fed rats. METHODS: Rats were fed a high fat diet (HFD) for 8 weeks and were divided into a group without therapy, and groups that received the anti-diabetic drug metformin or the glycocalyx-stabilizing drug sulodexide in their drinking water during the last 4 weeks of the feeding period...
April 11, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28266345/arterial-stiffness-and-cognitive-function
#13
Laure Joly
Arterial stiffness is an independent predictor of morbidity (infarction, fatal stroke) and cardiovascular mortality, especially in elderly, hypertensive patients with pre-terminal renal insufficiency and in coronary disease patients. The gold standard of its measurement is the pulse wave velocity assessment. The important increase in arterial stiffness that occurs during midlife is associated with the occurrence of severe cardiovascular and cerebrovascular events and also cognitive decline. The causal relationship between stiffening of the arterial tree and cognitive disorders has not yet been clearly established, however, many studies show a relationship between higher levels of aortic stiffness and poorer performance on cognitive memory tests...
March 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28218606/microvascular-dysfunction-following-st-elevation-myocardial-infarction-and-its-recovery-over-time-is-associated-with-short-and-long-term-cardiac-function
#14
Mariëlla E C J Hassell, Matthijs Bax, Martijn A van Lavieren, Robin Nijveldt, Alexander Hirsch, Lourens Robbers, Koen M Marques, Jan G P Tijssen, Felix Zijlstra, Albert C van Rossum, Ronak Delewi, Jan J Piek
AIMS: It is unclear whether microvascular dysfunction following ST-elevation myocardial infarction (STEMI) is prognostic for long-term left ventricular function (LVF). and whether recovery of the microvasculature status is associated with LVF improvement. METHODS AND RESULTS: In 62 patients, Coronary Flow Reserve (CFR) and Hyperemic Microvascular Resistance Index (HMRI) in the infarct related artery (IRA) was assessed by intracoronary Doppler flow measurements within 1 week and at 4 months...
February 21, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28191874/instantaneous-wave-free-ratio-to-guide-coronary-revascularization-physiological-framework-validation-and-differences-with-fractional-flow-reserve
#15
Guus A de Waard, Carlo Di Mario, Amir Lerman, Patrick W Serruys, Niels van Royen
Determining the optimal treatment strategy for revascularization of coronary artery stenosis involves the use of fractional flow reserve (FFR). To improve the low clinical uptake of physiological lesion assessment to guide revascularization, the instantaneous wave-free period (iFR) was proposed as a simpler alternative to FFR that does not require adenosine administration. iFR is calculated as the ratio of blood pressure distal and proximal to a coronary artery stenosis during the diastolic wave- free period...
February 14, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28169057/invasive-assessment-of-coronary-flow-reserve-impairment-in-severe-aortic-stenosis-and-ecochadiographic-correlations
#16
Alejandro Gutiérrez-Barrios, Sergio Gamaza-Chulián, Antonio Agarrado-Luna, Dolores Ruiz-Fernández, G Calle-Pérez, E Marante-Fuertes, R Zayas-Rueda, Miguel Alba-Sánchez, Jesús Oneto-Otero, R Vázquez-Garcia
OBJECTIVES AND BACKGROUND: Patients with aortic stenosis (AS) may have impaired coronary flow reserve (CFR) despite angiographically normal coronary arteries. This is the first report of invasive thermodilution-derived CFR and IMR in patients with AS and their associations with echocardiographic parameters for AS assessment. METHODS: Thirty-six consecutive severe AS patients and ten patients without AS underwent prospectively cardiac catheterization and coronary physiological parameters were determined in the left anterior descending (LAD)...
June 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28134124/the-impact-of-microvascular-resistance-on-the-discordance-between-anatomical-and-functional-evaluations-of-intermediate-coronary-disease
#17
Kyoung-Woo Seo, Hong-Seok Lim, Myeong-Ho Yoon, Seung-Jea Tahk, So-Yeon Choi, Byoung-Joo Choi, Hyoung-Mo Yang, Joon-Han Shin, Gyo-Seung Hwang, Jin-Sun Park, XiongJie Jin
AIMS: In intermediate coronary artery disease, discordance between anatomical and functional assessments persists and the diagnostic accuracy of an anatomical evaluation is not satisfactory for determining functional significance. We evaluated the impact of microvascular resistance on 'anatomical-functional discordance'. METHODS AND RESULTS: In 97 intermediate coronary lesions of 83 patients, minimum lumen area (MLA), fractional flow reserve (FFR), ∆(Pd/Pa-FFR), and hyperaemic microvascular resistance index (hMVRI) were measured using intravascular ultrasound and intracoronary dual pressure and Doppler sensor-tipped guidewire...
January 31, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28132957/risk-of-heart-failure-with-preserved-ejection-fraction-in-older-women-after-contemporary-radiotherapy-for-breast-cancer
#18
Hirofumi Saiki, Ivy A Petersen, Christopher G Scott, Kent R Bailey, Shannon M Dunlay, Randi R Finley, Kathryn J Ruddy, Elizabeth Yan, Margaret M Redfield
BACKGROUND: Cardiomyocytes are resistant to radiation. However, cardiac radiation exposure causes coronary microvascular endothelial inflammation, a perturbation implicated in the pathogenesis of heart failure (HF) and particularly HF with preserved ejection fraction (HFpEF). Radiotherapy for breast cancer results in variable cardiac radiation exposure and may increase the risk of HF. METHODS: We conducted a population-based case-control study of incident HF in 170 female residents of Olmsted County, Minnesota (59 cases and 111 controls), who underwent contemporary (1998-2013) radiotherapy for breast cancer with computed tomography-assisted radiotherapy planning...
April 11, 2017: Circulation
https://www.readbyqxmd.com/read/28130064/cardiovascular-consequences-of-metabolic-syndrome
#19
REVIEW
Johnathan D Tune, Adam G Goodwill, Daniel J Sassoon, Kieren J Mather
The metabolic syndrome (MetS) is defined as the concurrence of obesity-associated cardiovascular risk factors including abdominal obesity, impaired glucose tolerance, hypertriglyceridemia, decreased HDL cholesterol, and/or hypertension. Earlier conceptualizations of the MetS focused on insulin resistance as a core feature, and it is clearly coincident with the above list of features. Each component of the MetS is an independent risk factor for cardiovascular disease and the combination of these risk factors elevates rates and severity of cardiovascular disease, related to a spectrum of cardiovascular conditions including microvascular dysfunction, coronary atherosclerosis and calcification, cardiac dysfunction, myocardial infarction, and heart failure...
May 2017: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/28007742/invasive-minimal-microvascular-resistance-is-a-new-index-to-assess-microcirculatory-function-independent-of-obstructive-coronary-artery-disease
#20
Guus A de Waard, Sukhjinder S Nijjer, Martijn A van Lavieren, Nina W van der Hoeven, Ricardo Petraco, Tim P van de Hoef, Mauro Echavarría-Pinto, Sayan Sen, Peter M van de Ven, Paul Knaapen, Javier Escaned, Jan J Piek, Justin E Davies, Niels van Royen
BACKGROUND: Coronary microcirculatory dysfunction portends a poor cardiovascular outcome. Invasive assessment of microcirculatory dysfunction by coronary flow reserve (CFR) and hyperemic microvascular resistance (HMR) is affected by coronary artery disease (CAD). In this study we propose minimal microvascular resistance (mMR) as a new measure of microcirculatory dysfunction and aim to determine whether mMR is influenced by CAD. METHODS AND RESULTS: We obtained 482 simultaneous measurements of intracoronary Doppler flow velocity and pressure...
December 22, 2016: Journal of the American Heart Association
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