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Coronary slow flow

Q Wu, B Yang
Objective: To investigate the correlation between epicardial adipose thickness and slow flow of non-obstructive coronary artery. Methods: Clinical data of patients with coronary angiography examination evidenced stenosis<50% in our department from May 2014 to May 2015 were retrospectively analyzed.According to the level of TIMI in angiography, patients were divided into slow blood flow group (TIMI Ⅰ-Ⅱ, n=16) and normal blood flow group (TIMI Ⅲ, n=127). All epicardial adipose thickness was determined by echocardiography and data of biochemical data (fibrinogen, whole blood viscosity at high shear rate, erythrocyte aggregation index, platelet count, and platelet aggregation rate) were also analyzed...
November 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
Ali Hosseinsabet, Shima Yarmohamadi, Sima Narimani, Nazanin Amini-Farshidmehr
OBJECTIVE: Coronary slow-flow phenomenon (CSFP) is described as protracted passage of angiographic contrast agent to the distal portion of the epicardial coronary arteries in the absence of stenosis. Few studies have addressed the effects of this condition on right ventricular (RV) dysfunction. The present objective was to assess RV function in CSFP via 2-dimensional speckle-tracking echocardiography (2DSTE). METHODS: A total of 29 patients with CSFP and 29 participants with normal coronary flow were compared regarding RV systolic and diastolic functions...
September 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Haoyin Zhou, Peng Sun, Seongmin Ha, Devon Lundine, Guanglei Xiong
Image-based simulation of blood flow using computational fluid dynamics has been shown to play an important role in the diagnosis of ischemic coronary artery disease. Accurate extraction of complex coronary artery structures in a watertight geometry is a prerequisite, but manual segmentation is both tedious and subjective. Several semi- and fully automated coronary artery extraction approaches have been developed but have faced several challenges. Conventional voxel-based methods allow for watertight segmentation but are slow and difficult to incorporate expert knowledge...
October 2016: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
Lu Gao, Zhenhua Cao, Hong Zhang
BACKGROUND No/slow reflow gives rise to serious complications in STEMI patients undergoing PCI, and can lead to worse outcomes. Several measures are used to prevent no/slow reflow, including thrombus removal processes and intensive use of anticoagulant agents. Our study was designed to evaluate the efficacy and safety of thrombectomy and intracoronary administration of GPIIb/IIIa inhibitors in STEMI patients undergoing PPCI. MATERIAL AND METHODS We randomly assigned 240 STEMI patients into 3 groups. Before PPCI, patients in group A received thrombectomy and intracoronary administration of tirofiban...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Kenichi Sakakura, Hiroshi Funayama, Yousuke Taniguchi, Yoshimasa Tsurumaki, Kei Yamamoto, Mitsunari Matsumoto, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
OBJECTIVES: The purpose of this randomized trial was to compare the incidence of slow flow between low-speed and high-speed rotational atherectomy (RA) of calcified coronary lesions. BACKGROUND: Preclinical studies suggest that slow flow is less frequently observed with low-speed than high-speed RA because of less platelet aggregation with low-speed RA. METHODS: This was a prospective, randomized, single center study. A total of 100 patients with calcified coronary lesions were enrolled and randomly assigned in a 1:1 ratio to low-speed (140,000 rpm) or high-speed (190,000 rpm) RA...
July 25, 2016: Catheterization and Cardiovascular Interventions
Yanhua Li, Qiang Xu, Xinhong Guo
A 68-year-old man presented with acute coronary syndrome (ACS). The glycoprotein/IIb/IIIa receptor antagonist tirofiban was administered to the patient to treat a right coronary artery slow flow detected during percutaneous coronary intervention. The patient developed very severe thrombocytopenia 8 h after tirofiban infusion with no signs of bleeding. Antiplatelet medication was discontinued immediately, methylprednisolone was administered and platelets were transfused. Thrombopoietin (TPO) was also applied to the patient as recommended by a hematology consultant...
August 2016: Experimental and Therapeutic Medicine
Samad Ghaffari, Arezou Tajlil, Naser Aslanabadi, Ahmad Separham, Bahram Sohrabi, Gholamreza Saeidi, Leili Pourafkari
BACKGROUND: The coronary slow-flow phenomenon (CSFP) is a multifactorial angiographic finding with no established pathogenesis. OBJECTIVE: To investigate the role of clinical profile and laboratory findings in patients with CSFP. METHODS: We prospectively recruited 69 patients with angiographically diagnosed CSFP and compared them with 88 patients with normal coronary flow. Demographic information, comorbidities and laboratory analysis, including complete blood count with differential, lipid profile and serum biochemical analysis, were documented and compared in univariate and multivariate analyses...
July 13, 2016: Perfusion
Bernhard Meier
Evidence-based diagnosis, decision-making, and therapy appear a must these days. Generating and publishing evidence is a tedious job according to ever new and tightened research practice regulations. Rules will never prevent the typical human behaviour from showing the new thing to be shinier and the old thing dustier than they really are. The medical community is solicited to concoct a meal that is gullible for patients, authorities, and third-party payers out of the available evidence (after applying some conversion factors correcting the common bias of the researchers), anticipation of what will be the evidence tomorrow, common sense, and digested experience...
July 7, 2016: European Heart Journal
Sharon Chih, Aun Yeong Chong, Lisa M Mielniczuk, Deepak L Bhatt, Rob S B Beanlands
Cardiac allograft vasculopathy (CAV) remains the Achilles' heel of long-term survival after heart transplantation. Almost one-third of patients develop CAV by 5 years post-transplant and 1 in 8 deaths beyond a year are due to CAV. Abnormal vascular fibroproliferation in CAV occurs as a result of coronary endothelial inflammation, injury, and dysfunction triggered by immune and nonimmune insults. Surveillance methods for CAV have significant limitations, particularly for detecting early disease. Areas of investigation include myocardial and coronary blood flow quantification, and intracoronary imaging to detect early changes in the vessel wall and high-risk plaques...
July 5, 2016: Journal of the American College of Cardiology
Chun-Ling Liu, Zong-Qian Xue, Shu-Ping Gao, Chu Chen, Xiao-Hu Chen, Min Pan, Zhen-Xing Wang
BACKGROUND: Several lines of evidence suggest that slow coronary flow (SCF) phenomenon seems to be an early form of atherosclerosis and low-grade inflammation plays a role in the development of SCF. Interleukin-6 (IL-6) is a pleiotropic cytokine, functions as a mediator of inflammatory response, and has both pro-inflammatory and anti-inflammatory properties. The aim of the present study is to investigate the relationship between IL-6 -634C/G polymorphism and SCF in Han Chinese. METHODS: 250 subjects who underwent coronary angiography and had normal coronary arteries of varying coronary flow rates without any atherosclerotic lesion were enrolled in this study...
2016: Clinical Laboratory
Ali Esmaeili Nadimi, Farah Pour Amiri, Mahmood Sheikh Fathollahi, Gholamhossien Hassanshahi, Zahra Ahmadi, Ahmad Reza Sayadi
BACKGROUND: Approximately 20% to 30% of patients who undergo coronary angiography for assessment of typical cardiac chest pain display microvascular coronary dysfunction (MCD). This study aimed to determine potential relationships between baseline clinical characteristics and likelihood of MCD diagnosis in a large group of patients with stable angina symptoms, positive exercise test and angiographic ally normal epicardial coronary arteries. MATERIAL AND METHODS: This cross-sectional study included 250 Iranian with documented evidence of cardiac ischemia on exercise testing, class I or II indication for coronary angiography, and either: (1) angiographically normal coronary arteries and diagnosis of MCD with slow-flow phenomenon, or (2) normal angiogram and no evidence of MCD...
September 15, 2016: International Journal of Cardiology
Arif Suner, Mustafa Cetin
BACKGROUND: Coronary slow flow (CSF) is an angiographic finding characterized by delayed opacification of epicardial coronary arteries without obstructive coronary disease. Previous studies have shown greater impairment of left ventricular (LV) systolic and diastolic function in patients with CSF. We aimed to examine the effect of dipyridamole on these functions. METHODS: Our study included 40 patients with CSF and 40 subjects with normal coronary arteries. Conventional echocardiography Doppler imaging (CDI) and tissue Doppler echocardiography imaging (TDI) were used to evaluate LV systolic and diastolic function before and 2 months after treatment with dipyridamole...
October 2016: Echocardiography
Satyajit Singh, Sanat Kumar Sahoo, Mahendra Prasad Tripathy, Giridhari Jena
An isolated single coronary artery (SCA) is a rare anomaly. A SCA originating from the left sinus of Valsalva is even rarer than one arising from the right. Most patients with a congenital coronary artery anomaly are asymptomatic. Herein, we report an extremely uncommon variant, where the right coronary artery arose from the distal segment of the left circumflex artery with slow coronary flow leading to myocardial ischemia.
July 2015: Heart Views: the Official Journal of the Gulf Heart Association
Michael S Lee, Moo-Hyun Kim, Seung-Woon Rha
: We assessed the feasibility and safety of a rota-flush solution with 10,000 U of unfractionated heparin in 1 L of normal saline in patients who underwent rotational atherectomy. BACKGROUND: Rotational atherectomy with the Rotablator (Boston Scientific) rotational atherectomy system is an effective way to modify severely calcified plaque. Potential complications include coronary spasm and slow-flow/no-flow. A pressured rota-flush solution is infused into the device to lubricate the drive shaft to minimize the risk of these complications as well as facilitate delivery of the device...
June 15, 2016: Journal of Invasive Cardiology
Vanessa Rameh, Antoine Kossaify
Coronary artery ectasia is a rare angiographical finding, and it accounts for less than 5% of all coronary angiograms. We report a case of a 55-year-old male patient who presented with fatigue and exertional chest pain. Paraclinical tests revealed cardiac ischemia and sinus node dysfunction, as well as coronary artery ectasia without significant coronary stenosis. Factors involved in cardiac ischemia in this context comprise slow flow, poor collateral circulation, microcirculatory dysfunction, lack of adequate exertional coronary vasodilatation, and endothelial dysfunction...
2016: Clinical Medicine Insights. Case Reports
Sung Ha Mun, Dong Ai An, Hyun Jung Choi, Tae Hee Kim, Jung Woo Pin, Dong Chan Ko
Coronary air embolism is a rare event. We report a case in which an acute myocardial infarction occurred in the region supplied by the right coronary artery after the removal of a double-lumen hemodialysis catheter. Emergent coronary angiography revealed air bubbles obstructing the mid-segment of the right coronary artery with slow flow phenomenon distally. The patient expired due to myocardial infarction.
June 2016: Korean Journal of Anesthesiology
Mustafa Çetin, Emrullah Kiziltunc, Özgül Uçar Elalmış, Zehra Güven Çetin, Muhammed Bora Demirçelik, Hülya Çiçekçioğlu, Alparslan Kurtul, Selçuk Özkan, Candan Mansuroğlu Avan, Ender Örnek, Feridun Vasfi Ulusoy
BACKGROUND: Increased microvascular resistance due to chronic inflammation is assumed to be one of the mechanisms associated with coronary slow flow (CSF). Previous studies have shown that the platelet-to-lymphocyte ratio (PLR) and the neutrophil-lymphocyte ratio (NLR) are markers of inflammation for various diseases. In this study we aimed to evaluate the relationship between CSF and PLR-NLR. METHODS: Seventy-eight patients with CSF and 50 patients with normal coronary flow were enrolled into this study...
May 2016: Acta Cardiologica Sinica
Fedor Simko, Tomas Baka, Ludovit Paulis, Russel J Reiter
Elevated heart rate is a risk factor for cardiovascular and all-cause mortalities in the general population and various cardiovascular pathologies. Insufficient heart rate decline during the night, that is, nondipping heart rate, also increases cardiovascular risk. Abnormal heart rate reflects an autonomic nervous system imbalance in terms of relative dominance of sympathetic tone. There are only a few prospective studies concerning the effect of heart rate reduction in coronary heart disease and heart failure...
September 2016: Journal of Pineal Research
Lixia Yang, Lihua Mu, Linhui Sun, Feng Qi, Ruiwei Guo
BACKGROUND: The no/slow reflow phenomenon during primary percutaneous coronary intervention (PPCI) causes the destruction of the coronary microcirculation and further myocardial damage. Some studies have shown that intracoronary nitroprusside infusion is a safe and effective method for managing the no/slow reflow phenomenon. However, it is uncertain whether the injection of nitroprusside at a specific time point during PPCI can most effectively prevent no-reflow. In this study, we investigated the effect of the timing of an intracoronary nitroprusside injection on flow recovery during PPCI in patients with ST elevation acute myocardial infarction (STEMI)...
June 1, 2016: Minerva Cardioangiologica
Gregory Dendramis, Claudia Paleologo, Davide Piraino, Pasquale Assennato
Coronary artery ectasia (CAE) often represents a coronary angiography finding casually detected or following the occurrence of an acute coronary syndrome. The pathogenetic role of cocaine abuse in the genesis of CAE is still little known and very few data are available in literature. We describe a case of a 31-year-old male cocaine user admitted to our department for typical acute chest pain. Coronary angiography showed diffuse coronary ectasia with slow flows and without hemodynamically significant stenosis...
May 26, 2016: World Journal of Cardiology
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