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https://www.readbyqxmd.com/read/29429637/coronary-microembolization-and-microvascular-dysfunction
#1
Gerd Heusch, Andreas Skyschally, Petra Kleinbongard
Plaque erosion, fissuring or rupture occurs spontaneously or during coronary interventions. At some residual blood flow, the atherothrombotic debris is washed into the coronary microcirculation, causing physical obstruction, vasoconstriction, inflammation and ultimately microinfarction. Coronary microembolization also contributes to microvascular obstruction in reperfused acute myocardial infarction. Patients with microvascular obstruction after reperfused myocardial infarction have worse prognosis. Cardioprotective strategies to avoid acute coronary microembolization and rescue myocardium from microvascular obstruction have not yet been established in clinical practice...
February 3, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29417141/nonculprit-plaque-characteristics-in-patients-with-acute-coronary-syndrome-caused-by-plaque-erosion-vs-plaque-rupture-a-3-vessel-optical-coherence-tomography-study
#2
Tomoyo Sugiyama, Erika Yamamoto, Krzysztof Bryniarski, Lei Xing, Hang Lee, Mitsuaki Isobe, Peter Libby, Ik-Kyung Jang
Importance: Patients with culprit plaque rupture are known to have pancoronary plaque vulnerability. However, the characteristics of nonculprit plaques in patients with acute coronary syndromes caused by plaque erosion are unknown. Objective: To investigate the nonculprit plaque phenotype in patients with acute coronary syndrome according to culprit plaque pathology (erosion vs rupture) by 3-vessel optical coherence tomography imaging. Design, Setting, and Participants: In this observational cohort study, between August 2010 and May 2014, 82 patients with ACS who underwent preintervention optical coherence tomography imaging of all 3 major epicardial coronary arteries were enrolled at the Massachusetts General Hospital Optical Coherence Tomography Registry database...
February 7, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29406998/prophylactic-use-of-colchicine-in-preventing-radiation-induced-coronary-artery-disease
#3
T O'Herron, J Lafferty
Radiation therapy is one of the primary treatments in fighting breast cancer, one of the most common cancers in the US. One of the dose limiting factors of this therapy is radiation induced heart damage that results from mediastinal radiation. Recently statins, a medication typically used to lower cholesterol levels, have been suggested as a prophylactic treatment to potentially mitigate this process. Similarly, we hypothesized whether colchicine, an anti-inflammatory medication that is presently used in the treatment of gout and pericarditis, might be used to prevent coronary artery disease induced by radiation therapy...
February 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29401041/perivascular-epicardial-fat-stranding-at-coronary-ct-angiography-a-marker-of-acute-plaque-rupture-and-spontaneous-coronary-artery-dissection
#4
Sandeep Hedgire, Vinit Baliyan, Evan J Zucker, Daniel O Bittner, Pedro Staziaki, Richard A P Takx, Jan-Erik Scholtz, Nandini Meyersohn, Udo Hoffmann, Brian Ghoshhajra
Purpose To evaluate the frequency and implications of perivascular fat stranding on coronary computed tomography (CT) angiograms obtained for suspected acute coronary syndrome (ACS). Materials and Methods This retrospective registry study was approved by the institutional review board. The authors reviewed the medical records and images of 1403 consecutive patients (796 men, 607 women; mean age, 52.8 years) who underwent coronary CT angiography at the emergency department from February 2012 to March 2016. Fat attenuation, length and number of circumferential quadrants of the affected segment, and attenuation values in the unaffected epicardial and subcutaneous fat were measured...
February 5, 2018: Radiology
https://www.readbyqxmd.com/read/29361487/novel-approach-for-in%C3%A2-vivo-detection-of-vulnerable-coronary-plaques-using-molecular-3-t-cmr-imaging-with-an-albumin-binding-probe
#5
Leif-Christopher Engel, Ulf Landmesser, Kevin Gigengack, Thomas Wurster, Constantina Manes, Georg Girke, Milosz Jaguszewski, Carsten Skurk, David M Leistner, Alexander Lauten, Andreas Schuster, Bernd Hamm, Rene M Botnar, Marcus R Makowski, Boris Bigalke
OBJECTIVES: This study sought to investigate the potential of the noninvasive albumin-binding probe gadofosveset-enhanced cardiac magnetic resonance (GE-CMR) for detection of coronary plaques that can cause acute coronary syndromes (ACS). BACKGROUND: ACS are frequently caused by rupture or erosion of coronary plaques that initially do not cause hemodynamically significant stenosis and are therefore not detected by invasive x-ray coronary angiography (XCA). METHODS: A total of 25 patients with ACS or symptoms of stable coronary artery disease underwent GE-CMR, clinically indicated XCA, and optical coherence tomography (OCT) within 24 h...
January 12, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29330042/differences-in-the-ct-findings-between-vulnerable-plaque-and-culprit-lesions-in-acute-coronary-syndrome
#6
Eun Ju Chun, Jin Hee Han, Seung Min Yoo, Hwa Yeon Lee, In Sup Song, Charles S White
BACKGROUND: The CT finding of "vulnerable plaque" is widely regarded as similar to that of a culprit lesion in an acute coronary syndrome (ACS). However, this hypothesis may not be accurate, since "vulnerable plaques" may substantially change their morphology when they rupture to cause an ACS. METHODS: We retrospectively evaluated coronary CT angiography data sets of 25 patients with ACS who had vulnerable (n = 10) or culprit plaques (n = 15). We analyzed CT features including positive remodeling (PR), low attenuation plaque (LAP), the napkin ring sign (NRS), degree of stenosis (normal, <50%, 50-99%, 100%), and myocardial hypoperfusion in the left ventricle...
January 5, 2018: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29319263/simultaneous-plaque-rupture-in-two-coronary-arteries-presenting-as-acute-coronary-syndrome
#7
Satish Chirde
A 45 yrs male presented with angina. ECG showed transient CHB, T wave inversion in V3 to V6 and inferior leads. It was difficult to predict the culprit vessel based on ECG. Coronary angiography showed thrombotic lesions in LAD, LCX and OM which can potentially impact identification of culprit vessel and hence affect the management with primary PCI.
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29317313/the-role-of-fenton-reaction-in-ros-induced-toxicity-underlying-atherosclerosis-modeled-and-analyzed-using-a-petri-net-based-approach
#8
Dorota Formanowicz, Marcin Radom, Agnieszka Rybarczyk, Piotr Formanowicz
The superoxide-driven Fenton reaction plays an important role in the transformation of poorly reactive radicals into highly reactive ones. These highly reactive species (ROS), especially hydroxyl radicals can lead to many disturbances contributing to the endothelial dysfunction being a starting point for atherosclerosis. Although, iron has been identified as a possible culprit influencing formation of ROS, its significance in this process is still debatable. To better understand this phenomenon, the influence of blockade of Fenton reaction in a proposed Petri net-based model of the selected aspects of the iron ROS-induced toxicity in atherosclerosis has been evaluated...
January 6, 2018: Bio Systems
https://www.readbyqxmd.com/read/29301128/features-and-outcomes-of-patients-with-calcified-nodules-at-culprit-lesions-of-acute-coronary-syndrome-an-optical-coherence-tomography-study
#9
Nobuaki Kobayashi, Masamichi Takano, Masafumi Tsurumi, Yusaku Shibata, Suguru Nishigoori, Saori Uchiyama, Hirotake Okazaki, Akihiro Shirakabe, Yoshihiko Seino, Noritake Hata, Wataru Shimizu
OBJECTIVES: We sought to clarify clinical features and outcomes related to calcified nodules (CN) compared with plaque rupture (PR) and plaque erosion (PE) detected by optical coherence tomography (OCT) at the culprit lesions in patients with acute coronary syndrome (ACS). METHODS: Based on OCT findings for culprit lesion plaque morphologies, ACS patients with analyzable OCT images (n = 362) were classified as CN, PR, PE, and other. RESULTS: The prevalence of CN, PR, and PE was 6% (n = 21), 45% (n = 163), and 41% (n = 149), respectively...
January 5, 2018: Cardiology
https://www.readbyqxmd.com/read/29259501/left-circumflex-coronary-artery-as-the-culprit-vessel-in-st-segment-elevation-myocardial-infarction
#10
Diab Ghanim, Fabio Kusniec, Wadi Kinany, Dahud Qarawani, David Meerkin, Khaled Taha, Offer Amir, Shemy Carasso
The prevalence of the left circumflex coronary artery (LCx) as the culprit vessel in ST-segment-elevation myocardial infarction (STEMI) is reportedly lowest among that of the 3 main epicardial arteries, and has not been described for non-STEMI (NSTEMI) and stable angina pectoris. We sought to define the distribution of culprit arteries in these clinical presentations and suggest mechanisms for the differences. We reviewed 189 coronary angiograms of patients with STEMI, 203 with NSTEMI, and 548 with stable angina (n=940), and compared distributions of stenotic and culprit coronary arteries (lesions prompting intervention)...
October 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/29247510/culprit-plaque-characteristics-in-women-vs-men-with-a-first-st-segment-elevation-myocardial-infarction-in-vivo-optical-coherence-tomography-insights
#11
Rong Sun, Liping Sun, Yandong Fu, Huimin Liu, Maoen Xu, Xuefeng Ren, Huai Yu, Hui Dong, Yang Liu, Yinchun Zhu, Jinwei Tian, Bo Yu
BACKGROUND: It is unclear whether more severe coronary atherosclerosis is a prerequisite to an initial acute coronary event in women vs men. HYPOTHESIS: Women may have more severe coronary atherosclerosis than men in patients with acute coronary event. METHODS: We used intravascular optical coherence tomography (OCT) to evaluate gender differences in culprit-plaque morphology in patients with a first ST-segment elevation myocardial infarction (STEMI)...
December 16, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/29212965/effects-of-ezetimibe-statin-combination-therapy-on-coronary-atherosclerosis-in-acute-coronary-syndrome
#12
Kiyoshi Hibi, Shinjo Sonoda, Masanori Kawasaki, Yutaka Otsuji, Toyoaki Murohara, Hideki Ishii, Katsuhiko Sato, Ryoji Koshida, Yukio Ozaki, Masataka Sata, Yoshihiro Morino, Tadashi Miyamoto, Tetsuya Amano, Satoshi Morita, Ken Kozuma, Kazuo Kimura, Hisayoshi Fujiwara
BACKGROUND: The results of previous clinical trials on the effects of ezetimibe-statin combination therapy on atherosclerosis are inconsistent, and the anti-atherosclerotic effect of ezetimibe remains controversial.Methods and Results:We conducted a prospective, randomized open-label study at 10 centers. One hundred and twenty-eight statin-naïve patients with acute coronary syndrome (ACS) undergoing intravascular ultrasound (IVUS)-guided percutaneous coronary intervention were randomized to receive either 2 mg/day pitavastatin plus 10 mg/day ezetimibe, or 2 mg/day pitavastatin...
December 7, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29190694/contrast-enhanced-magnetic-resonance-imaging-for-the-detection-of-ruptured-coronary-plaques-in-patients-with-acute-myocardial-infarction
#13
Christian H P Jansen, Divaka Perera, Andrea J Wiethoff, Alkystis Phinikaridou, Reza M Razavi, Aldo Rinaldi, Mike S Marber, Gerald F Greil, Eike Nagel, David Maintz, Simon Redwood, Rene M Botnar, Marcus R Makowski
PURPOSE: X-ray coronary angiography (XCA) is the current gold standard for the assessment of lumen encroaching coronary stenosis but XCA does not allow for early detection of rupture-prone vulnerable plaques, which are thought to be the precursor lesions of most acute myocardial infarctions (AMI) and sudden death. The aim of this study was to investigate the potential of delayed contrast-enhanced magnetic resonance coronary vessel wall imaging (CE-MRCVI) for the detection of culprit lesions in the coronary arteries...
2017: PloS One
https://www.readbyqxmd.com/read/29171212/plaque-characteristics-and-ruptured-plaque-location-according-to-lesion-geometry-in-culprit-lesions-of-st-segment-elevation-myocardial-infarction
#14
Ju Hyun Chung, Joo Myung Lee, Ae Young Her, Heeyoun Cho, Joon Hyung Doh, Chang Wook Nam, Hyung Il Kim, Bon Kwon Koo, Eun Seok Shin
BACKGROUND AND OBJECTIVES: The correlations between plaque characteristics and plaque rupture location according to segmental lesion analysis have not been well defined. The aim of this study was to assess those characteristics of ST-segment elevation myocardial infarction (STEMI) culprit lesions according to segmental lesion geometry using virtual histology intravascular ultrasound (VH-IVUS). METHODS: Sixty single discrete lesions found in the left anterior descending (LAD) coronary arteries of 60 patients with STEMI were included...
October 26, 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29148241/peri-procedural-myocardial-infarction-plaques-and-patients-at-risk
#15
EDITORIAL
James A Goldstein
Patients with acute coronary syndrome are at risk for peri-procedural myocardial infarction (PMI) Lipid-laden plaques with thinned disrupted fibrous caps are most prone to PMI PMI is associated with worse outcome over time, though whether such damaging events are causal or instead reflect patients prone to future instability from non-culprit vulnerable plaques requires further delineation.
November 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29131800/qualitative-and-quantitative-evaluation-of-dynamic-changes-in-non-culprit-coronary-atherosclerotic-lesion-morphology-a-longitudinal-oct-study
#16
Bu-Chun Zhang, Antonios Karanasos, Muthukaruppan Gnanadesigan, Johannes N van der Sijde, Nienke van Ditzhuijzen, Karen T Witberg, Jurgen Ligthart, Roberto Diletti, Robert-Jan van Geuns, Jouke Dijkstra, Felix Zijlstra, Gijs van Soest, Evelyn Regar
AIMS: There is limited in vivo evidence regarding the temporal evolution of non-culprit coronary plaque morphology. We evaluated changes in non-culprit plaque morphology over time by optical coherence tomography (OCT). METHODS AND RESULTS:  72 patients with 257 non-culprit segments with serial OCT studies were analyzed. Non-culprit 5mm-long coronary segments from the same imaged region were matched between baseline and follow-up. OCT plaque characterization including automated attenuation analysis was performed and changes over a median follow-up of 6...
November 14, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29064537/in-stent-restenosis-prone-coronary-plaque-composition-a-retrospective-virtual-histology-intravascular-ultrasound-study
#17
Duck-Jun Seo, Yong-Kyun Kim, Young-Hoon Seo, In-Geol Song, Ki-Hong Kim, Taek-Geun Kwon, Hyun-Woong Park, Jang-Ho Bae
BACKGROUND: The mechanism of in-stent restenosis (ISR) is multifactorial, which includes biological, mechanical and technical factors. This study hypothesized that increased inflammatory reaction, which is known to be an important atherosclerotic process, at a culprit lesion may lead to higher restenosis rates. METHODS: The study population consisted of 241 patients who had undergone percutaneous coronary intervention with virtual histology-intravascular ultrasound (VH-IVUS) and a 9-month follow-up coronary angiography...
October 24, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/29047360/comparison-of-circulating-dendritic-cell-and-monocyte-subsets-at-different-stages-of-atherosclerosis-insights-from-optical-coherence-tomography
#18
Jianhui Zhuang, Yang Han, Dachun Xu, Guofu Zhu, Shekhar Singh, Luoman Chen, Mengyun Zhu, Wei Chen, Yawei Xu, Xiankai Li
BACKGROUND: While specific patterns of circulating dendritic cells (DCs) and monocytes are associated with the incidence of coronary artery disease, the characterization of circulating DC and monocyte subsets in patients with different stages of atherosclerosis remains unclear. METHODS: Forty-eight patients with unstable angina pectoris (UAP) diagnosed by angiography were enrolled. Likewise, 31 patients with ST-segment elevation myocardial infarction (STEMI) were enrolled and confirmed with the presence of thrombosis by angiography...
October 18, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28943494/association-between-coronary-atherosclerosis-progression-and-in-stent-neoatherosclerosis-in-patients-with-st-elevation-myocardial-infarction-at-5-years-follow-up
#19
Giulia Paoletti, Josep Gomez-Lara, Salvatore Brugaletta, Marcos Ñato, Rafael Romaguera, Gerard Roura, José-Luis Ferreiro, Luis Teruel, Montserrat Gracida, Luis Ortega-Paz, Joan-Antoni Gomez-Hospital, Manel Sabate, Angel Cequier
AIMS: To investigate the association between in-stent neoatherosclerosis (NA) and atherosclerosis progression (AP) in non-culprit segments in patients with ST-elevation myocardial infarction at 5 years. METHODS AND RESULTS: Sixty-two out of 169 consecutive patients included in the EXAMINATION study underwent optical coherence tomography (OCT) at 5 years. NA plaques were observed in 13 (21.0%), signal-rich bands (SRB) in 22 (35.5%) and AP in 11 (17.7%). NA plaques were more frequently observed in patients treated with two stents (53...
September 26, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28941357/microrna-in-alzheimer-s-disease-revisited-implications-for-major-neuropathological-mechanisms
#20
Reihaneh Dehghani, Farzaneh Rahmani, Nima Rezaei
Pathology of Alzheimer's disease (AD) goes far beyond neurotoxicity resulting from extracellular deposition of amyloid β (Aβ) plaques. Aberrant cleavage of amyloid precursor protein and accumulation of Aβ in the form of the plaque or neurofibrillary tangles are the known primary culprits of AD pathogenesis and target for various regulatory mechanisms. Hyper-phosphorylation of tau, a major component of neurofibrillary tangles, precipitates its aggregation and prevents its clearance. Lipid particles, apolipoproteins and lipoprotein receptors can act in favor or against Aβ and tau accumulation by altering neural membrane characteristics or dynamics of transport across the blood-brain barrier...
September 23, 2017: Reviews in the Neurosciences
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