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Coronary slow flow

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https://www.readbyqxmd.com/read/28087172/endothelial-function-impairment-in-stemi-patients-with-out-of-hospital-cardiac-arrest-under-therapeutic-hypothermia-treatment
#1
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
#2
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
#3
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...
December 20, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28029214/long-term-outcomes-of-rotational-atherectomy-for-the-percutaneous-treatment-of-chronic-total-occlusions
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/27446339/thromboembolic-events-secondary-to-tirofiban-induced-thrombocytopenia-being-treated-with-thrombopoietin-a-case-report
#11
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
https://www.readbyqxmd.com/read/27412375/clinical-and-laboratory-predictors-of-coronary-slow-flow-in-coronary-angiography
#12
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...
January 2017: Perfusion
https://www.readbyqxmd.com/read/27378604/interventional-cardiology-where-real-life-and-science-do-not-necessarily-meet
#13
REVIEW
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
https://www.readbyqxmd.com/read/27364054/allograft-vasculopathy-the-achilles-heel-of-heart-transplantation
#14
REVIEW
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
https://www.readbyqxmd.com/read/27349023/the-relationship-between-interleukin-6-promotor-polymorphisms-and-slow-coronary-flow-phenomenon
#15
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
https://www.readbyqxmd.com/read/27343424/opium-addiction-as-an-independent-risk-factor-for-coronary-microvascular-dysfunction-a-case-control-study-of-250-consecutive-patients-with-slow-flow-angina
#16
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
https://www.readbyqxmd.com/read/27343175/is-dipyridamole-useful-in-improving-left-ventricular-systolic-and-diastolic-function-in-patients-with-coronary-slow-flow
#17
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
https://www.readbyqxmd.com/read/27326353/angiographic-enigma-a-single-coronary-artery-with-the-right-coronary-artery-originating-from-the-distal-left-circumflex-artery
#18
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
https://www.readbyqxmd.com/read/27315576/alternative-rota-flush-solution-for-patients-with-severe-coronary-artery-calcification-who-undergo-rotational-atherectomy
#19
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...
January 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27279756/double-trouble-in-a-patient-with-coronary-ectasia-bradycardia-with-angina-epiphenomenal-or-mechanistic-association
#20
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
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