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Coronary slow flow

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https://www.readbyqxmd.com/read/28324943/overcoming-spatio-temporal-limitations-using-dynamically-scaled-in-vitro-pc-mri-a-flow-field-comparison-to-true-scale-computer-simulations-of-idealized-stented-and-patient-specific-left-main-bifurcations
#1
Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan
The majority of patients with angina or heart failure have coronary artery disease. Left main bifurcations are particularly susceptible to pathological narrowing. Flow is a major factor of atheroma development, but limitations in imaging technology such as spatio-temporal resolution, signal-to-noise ratio (SNRv), and imaging artefacts prevent in vivo investigations. Computational fluid dynamics (CFD) modelling is a common numerical approach to study flow, but it requires a cautious and rigorous application for meaningful results...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28322100/could-neutrophil-lymphocyte-ratio-be-an-indicator-of-coronary-artery-disease-coronary-artery-ectasia-and-coronary-slow-flow
#2
Mücahid Yılmaz, Hasan Korkmaz, Mehmet Nail Bilen, Ökkeş Uku, Ertuğrul Kurtoğlu
Objective To determine whether neutrophil/lymphocyte ratio (NLR) differed between patients with isolated coronary artery disease (CAD), isolated coronary artery ectasia (CAE), coronary slow flow and normal coronary anatomy. Methods Patients who underwent coronary angiography were consecutively enrolled into one of four groups: CAD, coronary slow flow, CAE and normal coronary anatomy. Results The CAD ( n = 40), coronary slow flow ( n = 40), and CAE ( n = 40) groups had similar NLRs (2.51 ± 0...
December 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/28314673/can-we-perform-rotational-atherectomy-in-patients-with-severe-aortic-stenosis-substudy-from-the-ocean-tavi-registry
#3
Toru Naganuma, Hiroyoshi Kawamoto, Kensuke Takagi, Hiroto Yabushita, Satoru Mitomo, Yusuke Watanabe, Shinichi Shirai, Motoharu Araki, Norio Tada, Futoshi Yamanaka, Masanori Yamamoto, Hirokazu Onishi, Sunao Nakamura, Akihiro Higashimori, Minoru Tabata, Kazuki Mizutani, Hiroshi Ueno, Kentaro Hayashida
PURPOSE: The aim of this study was to report the safety of coronary rotational atherectomy (RA) in patients with severe aortic stenosis (AS). RA in the clinical setting seems challenging because coronary slow flow leads to hemodynamic instability. METHODS: Between October 2013 and May 2016, 1401 patients in the Optimized transCathEter vAlvular iNtervention (OCEAN) registry in Japan underwent transcatheter aortic valve implantation (TAVI). The primary study endpoint was procedural success, defined as residual stenosis <20% with final Thrombolysis in Myocardial Infarction flow 3...
February 28, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28255104/-single-operator-technique-for-advancing-the-orbital-atherectomy-device
#4
Michael S Lee, Heajung Nguyen, Daniel Philipson, Richard A Shlofmitz
OBJECTIVE: We assessed the feasibility and safety of the "single-operator" technique in which the operator autonomously advanced the orbital atherectomy (OA) device while maintaining wire position. BACKGROUND: Severe coronary artery calcification (CAC) increases the complexity of percutaneous coronary intervention (PCI), and is associated with lower procedural success rates and higher rates of adverse outcomes, including death, myocardial infarction, target-vessel revascularization, and stent thrombosis...
March 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28235809/management-and-outcome-of-patients-with-acute-coronary-syndrome-caused-by-plaque-rupture-versus-plaque-erosion-an%C3%A2-intravascular-optical-coherence-tomography-study
#5
Sining Hu, Yinchun Zhu, Yingying Zhang, Jiannan Dai, Lulu Li, Harold Dauerman, Tsunenari Soeda, Zhao Wang, Hang Lee, Chao Wang, Chunyang Zhe, Yan Wang, Gonghui Zheng, Shaosong Zhang, Haibo Jia, Bo Yu, Ik-Kyung Jang
BACKGROUND: Plaque rupture and erosion are the 2 most common mechanisms for acute coronary syndromes. However, the outcome of these 2 distinct pathologies in patients with acute coronary syndromes has never been studied. METHODS AND RESULTS: We retrospectively studied 141 patients with acute coronary syndromes who underwent optical coherence tomography (OCT) imaging of the culprit lesion prior to stenting from the Massachusetts General Hospital OCT Registry. Management (stent versus no stent), poststent OCT findings, and outcomes were compared...
February 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28226721/overcoming-spatio-temporal-limitations-using-dynamically-scaled-in-vitro-pc-mri-a-flow-field-comparison-to-true-scale-computer-simulations-of-idealized-stented-and-patient-specific-left-main-bifurcations
#6
Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan, Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan, Stuart Norris, Brett Cowan, Pau Medrano-Gracia, Kathleen Gilbert, Mark Webster, Alistair Young, Susann Beier, John Cater, John Ormiston
The majority of patients with angina or heart failure have coronary artery disease. Left main bifurcations are particularly susceptible to pathological narrowing. Flow is a major factor of atheroma development, but limitations in imaging technology such as spatio-temporal resolution, signal-to-noise ratio (SNRv), and imaging artefacts prevent in vivo investigations. Computational fluid dynamics (CFD) modelling is a common numerical approach to study flow, but it requires a cautious and rigorous application for meaningful results...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28180005/the-role-of-urotensin-ii-and-atherosclerotic-risk-factors-in-patients-with-slow-coronary-flow
#7
REVIEW
Ömer Şatıroğlu, Murtaza Emre Durakoğlugil, Mustafa Çetin, Yüksel Çiçek, Turan Erdoğan, Hakan Duman
BACKGROUND: Slow coronary flow (SCF) is an angiographic finding characterized with delayed opacification of epicardial coronary arteries without obstructive coronary disease. Urotensin II (UII) is an important vascular peptide, which has an important role in hypertension, coronary artery disease, and vascular remodeling in addition to potent vasoconstrictor effect. OBJECTIVES: We investigated UII levels, hypertension, and other atherosclerotic risk factors in patients with SCF, a variety of coronary artery disease...
December 2016: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28145873/incidence-of-bradycardia-and-outcomes-of-patients-who-underwent-orbital-atherectomy-without-a-temporary-pacemaker
#8
Michael S Lee, Heajung Nguyen, Richard Shlofmitz
OBJECTIVE: We analyzed the incidence of bradycardia and the safety of patients with severely calcified coronary lesions who underwent orbital atherectomy without the insertion of a temporary pacemaker. BACKGROUND: The presence of severely calcified coronary lesions can increase the complexity of percutaneous coronary intervention due to the difficulty in advancing and optimally expanding the stent. High-pressure inflations to predilate calcified lesions may cause angiographic complications like perforation and dissection...
February 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28121950/coronary-artery-ectasia-presenting-with-thrombus-embolization-and-acute-myocardial-infarction-a-case-report
#9
Yongle Li, Chengcheng Wu, Wennan Liu
RATIONALE: Coronary artery ectasia (CAE) is characterized by an abnormal dilatation of the coronary arteries. CAE is often associated with the presence of slow coronary flow and may lead to acute myocardial infarction (AMI), even without total occlusion. PATIENT CONCERNS AND DIAGNOSIS: We report a case of a 24-year-old male patient with CAE suffering from AMI. INTERVENTIONS: Percutaneous coronary intervention with aspiration thrombectomy failed to restore adequate blood flow...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28100342/-the-effect-on-myocardial-perfusion-and-clinical-outcome-of-intracoronary-nicorandil-injection-prior-to-percutaneous-coronary-intervention-in-st-segment-elevation-myocardial-infarction
#10
Z Q Wang, M X Chen, D L Liu, W X Zheng, X Z Cao, H Chen, M F Huang, Z R Luo
Objective: To investigate the effect of intracoronary administration of nicorandil prior to primary percutaneous coronary intervention (PPCI) on myocardial perfusion and short-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 158 patients with STEMI undergoing PPCI from January 2014 to December 2015 in Fuzhou General Hospital were enrolled consecutively in this prospective controlled randomized trial. Patients were assigned into three groups with random number table: the nicorandil group (patients received intracoronary administration of 6 mg nicorandil after guide wire or balloon successfully crossed the target lesion, n=53), the nitroglycerin group (patients received intracoronary administration of 300 μg nitroglycerin after after guide wire or balloon successfully crossed the target lesion, n=52) and the control group(patients received routine treatment, n=53)...
January 25, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28087172/endothelial-function-impairment-in-stemi-patients-with-out-of-hospital-cardiac-arrest-under-therapeutic-hypothermia-treatment
#11
Salvatore Brugaletta, Giancarla Scalone, Ana Paula Dantas, Luis Ortega-Paz, Manel Garabito, Mercè Roqué, Victoria Martin, Monica Masotti, Xavier Freixa, Manel Sabaté
BACKGROUND: Therapeutic hypothermia (HT) in out-of-hospital cardiac arrest STEMI patients aims to improve their neurological prognosis, but it has been associated with slow coronary flow and cardiac thrombotic events. We sought to serially assess endothelial function during the first 48h after admission in out-of-hospital cardiac arrest STEMI patients, under therapeutic hypothermia (HT). METHODS: From January 2015 to August 2015, eighteen consecutive out-of-hospital cardiac arrest STEMI patients eligible for primary PCI received HT at admission and were included in the study (HT group)...
January 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28063138/are-biventricular-systolic-functions-impaired-in-patient-with-coronoray-slow-flow-a-prospective-study-with-three-dimensional-speckle-tracking
#12
Tuğba Kemaloğlu Öz, Mehmet Eren, Işıl Atasoy, Tayfun Gürol, Özer Soylu, Bahadır Dağdeviren
The newly developed three dimensional speckle-tracking echocardiography (3D-STE) technology provides quick and comprehensive quantitative assessment of biventricular myocardial dynamics. The impact of coronary slow flow phenomenon (CSFP) on biventricular functions has not been comprehensively evaluated using this new technology. Therefore, the aim of this study was to evaluate the effects of CSFP on biventricular systolic functions using 3D-STE. Forty patients with CSFP and otherwise normal coronary arteries (NCAs) and 40 age- and sex-matched controls with normal coronary angiograms (CAGs) were prospectively enrolled...
January 6, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28057364/deferred-versus-conventional-stent-implantation-in-patients-with-acute-st-segment-elevation-myocardial-infarction-an-updated-meta-analysis-of-10-studies
#13
Joo Myung Lee, Tae-Min Rhee, Haseong Chang, Chul Ahn, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Joo-Yong Hahn
BACKGROUND: We sought to evaluate safety and efficacy of the deferred stenting versus immediate stent implantation of infarct-related arteries in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS: A meta-analysis using random-effects models were conducted. The primary outcome, major adverse cardiac events (MACE), was a composite of all-cause mortality, myocardial infarction (MI), any unplanned target vessel revascularization (TVR), and hospitalization due to cardiac cause...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28029214/long-term-outcomes-of-rotational-atherectomy-for-the-percutaneous-treatment-of-chronic-total-occlusions
#14
Lorenzo Azzalini, Rustem Dautov, Soledad Ojeda, Antonio Serra, Susanna Benincasa, Barbara Bellini, Francesco Giannini, Jorge Chavarría, Livia L Gheorghe, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
OBJECTIVES: To study the long-term outcomes of rotational atherectomy (RA) for chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND: There is little evidence on the incidence, procedural results and long-term outcomes of RA for CTO PCI. METHODS: This registry included data from consecutive patients undergoing CTO PCI at four specialized centers. Major adverse cardiac events (MACE: cardiac death, target-vessel myocardial infarction and ischemia-driven target-vessel revascularization) on follow-up were the primary endpoint...
December 28, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27989961/role-of-mineralocorticoid-receptor-activation-in-cardiac-diastolic-dysfunction
#15
REVIEW
Guanghong Jia, Yan Jia, James R Sowers
The prevalence of cardiac diastolic dysfunction and heart failure with preserved ejection, a major cause of morbidity and mortality in the western world, is increasing due, in part, to increases in obesity and type 2 diabetes. Characteristics of cardiac diastolic dysfunction include increased myocardial stiffness and impaired left ventricular (LV) relaxation that is characterized by prolonged isovolumic LV relaxation and slow LV filling. Obesity, insulin resistance and type 2 diabetes, especially in females promote activation of mineralocorticoid receptor (MR) signaling with resultant increases in oxidative stress, maladaptive immune responses, inflammation, and impairment of coronary blood flow and cardiac interstitial fibrosis...
October 28, 2016: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/27903394/-correlation-between-epicardial-adipose-tissue-thickness-and-slow-flow-of-non-obstructive-coronary-artery
#16
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
https://www.readbyqxmd.com/read/27665327/right-ventricular-function-in-coronary-slow-flow-a-two-dimensional-speckle-tracking-echocardiographic-study
#17
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
https://www.readbyqxmd.com/read/27490317/watertight-modeling-and-segmentation-of-bifurcated-coronary-arteries-for-blood-flow-simulation-using-ct-imaging
#18
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
https://www.readbyqxmd.com/read/27475844/efficacy-and-safety-of-thrombectomy-combined-with-intracoronary-administration-of-tirofiban-in-st-segment-elevation-myocardial-infarction-stemi
#19
RANDOMIZED CONTROLLED TRIAL
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...
July 31, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27453426/the-incidence-of-slow-flow-after-rotational-atherectomy-of-calcified-coronary-arteries-a-randomized-study-of-low-speed-versus-high-speed
#20
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
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