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Coronary microcirculation

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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
#1
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/28514327/postoperative-assessment-of-myocardial-function-and-microcirculation-in-patients-with-acute-coronary-syndrome-by-myocardial-contrast-echocardiography
#2
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
#3
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
#4
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/28482008/the-microcirculation-a-key-player-in-obesity-associated-cardiovascular-disease
#5
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/28476516/effects-of-neuropeptide-y-on-coronary-artery-vasomotion-in-patients-with-microvascular-angina
#6
Giuseppe M C Rosano, Dimitris Tousoulis, Eugene McFadden, John Clarke, Graham J Davies, Juan Carlos Kaski
BACKGROUND: Patients with microvascular angina (exertional angina, positive exercise tests and normal coronary arteriograms) usually have a reduced coronary blood flow reserve. Neuropeptide Y (NPY) is a potent endogenous vasoconstrictor involved in modulation of coronary vasomotor tone and may play a role in microvascular angina. METHODS: We compared the effects of NPY (0.2-1.0pmol/kg, intracoronary) on the vasomotor response of proximal and distal segments of the coronary arteries in 7 patients with microvascular angina, 9 with chronic stable angina, and 9 control individuals...
March 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28432490/thallium-201-washout-rate-of-stress-myocardial-perfusion-imaging-as-a-predictor-of-mortality-in-diabetic-kidney-disease-patients-initiating-hemodialysis-an-observational-follow-up-study
#7
Toshihide Hayashi, Nobuhiko Joki, Yuri Tanaka, Masaki Iwasaki, Shun Kubo, Ai Matsukane, Yasunori Takahashi, Yoshihiko Imamura, Koichi Hirahata, Hiroki Hase
BACKGROUND: Thallium-201 washout rate of stress myocardial perfusion imaging (MPI) has been reported to correlate with coronary flow reserve which is a parameter of myocardial microcirculation. However, the evidence for its use in diabetic kidney disease (DKD) has been lacking, and the association between thallium-201 washout rate and adverse outcomes including death is unknown. Therefore, the present study was conducted to evaluate the predictive ability of thallium-201 washout rate for mortality in DKD patients initiating hemodialysis...
April 21, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28429664/alternative-causes-of-myocardial-ischemia-in-women-an-update-on-spontaneous-coronary-artery-dissection-vasospastic-angina-and-coronary-microvascular-dysfunction
#8
Bina Ahmed, Mark A Creager
Although coronary obstruction due to atherosclerosis is the most common cause of myocardial ischemia, a significant proportion of patients have myocardial ischemia in the absence of obstructive epicardial coronary artery disease (CAD). This finding is more common among women and alternative causes can mediate myocardial ischemia. Abnormalities in vascular structure, alterations in coronary vasomotion and dysfunction of the coronary microcirculation can all cause ischemia in the absence of obstructive CAD due to atherosclerosis...
April 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28413578/epicardial-fat-in-the-maintenance-of-cardiovascular-health
#9
Yang Wu, Aijun Zhang, Dale J Hamilton, Tuo Deng
Epicardial fat is a unique adipose tissue located between the myocardium and the visceral layer of pericardium. This tissue is characterized by highly active fatty acid metabolism and highly expressed thermogenic genes. Epicardial fat and the underlying myocardium share the same microcirculation, suggesting a close and strong interaction between these two structures. Under physiological conditions, epicardial fat protects and supports the heart to exert its normal function. Many clinical studies have shown significant associations between increased amounts of epicardial fat and coronary artery disease (CAD)...
January 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28410144/cardiotoxicity-in-oncology-and-coronary-microcirculation-future-challenges-in-theranostics
#10
Giovanni Peretto, Davide Lazzeroni, Carmem L Sartorio, Paolo G Camici
Many of the patients undergoing chemotherapy or radiotherapy for cancer are at increased risk of developing cardiovascular diseases. Recent evidence suggests that cardiac dysfunction and subsequent heart failure are mainly due to vascular toxicity rather than only to due to myocyte toxicity. However, not all of the vascular toxicity of cancer therapies can be explained by epicardial coronary artery disease. In fact, in the last decades, it has been found that myocardial ischemia may occur as a consequence of structural or functional dysfunction of the complex network of vessels, which cannot be seen by a coronary angiography: the coronary microcirculation...
June 1, 2017: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/28398674/melatonin-protects-cardiac-microvasculature-against-ischemia-reperfusion-injury-via-suppression-of-mitochondrial-fission-vdac1-hk2-mptp-mitophagy-axis
#11
Hao Zhou, Ying Zhang, Shunying Hu, Chen Shi, Pingjun Zhu, Qiang Ma, Qinhua Jin, Feng Cao, Feng Tian, Yundai Chen
The cardiac microvascular system, which is primarily composed of monolayer endothelial cells, is the site of blood supply and nutrient exchange to cardiomyocytes. However, microvascular ischemia/reperfusion injury (IRI) following percutaneous coronary intervention is a woefully neglected topic and few strategies are available to reverse such pathologies. Here, we studied the effects of melatonin on microcirculation IRI and elucidated the underlying mechanism. Melatonin markedly reduced infarcted area, improved cardiac function, restored blood flow and lower microcirculation perfusion defects...
April 11, 2017: Journal of Pineal Research
https://www.readbyqxmd.com/read/28327605/ginsenoside-rb1-protects-against-ischemia-reperfusion-induced-myocardial-injury-via-energy-metabolism-regulation-mediated-by-rhoa-signaling-pathway
#12
Yuan-Chen Cui, Chun-Shui Pan, Li Yan, Lin Li, Bai-He Hu, Xin Chang, Yu-Ying Liu, Jing-Yu Fan, Kai Sun, Quan -Li, Jing-Yan Han
Cardiac ischemia and reperfusion (I/R) injury remains a challenge for clinicians. Ginsenoside Rb1 (Rb1) has been reported to have the ability to attenuate I/R injury, but its effect on energy metabolism during cardiac I/R and the underlying mechanism remain unknown. In this study, we detected the effect of Rb1 on rat myocardial blood flow, myocardial infarct size, cardiac function, velocity of venule red blood cell, myocardial structure and apoptosis, energy metabolism and change in RhoA signaling pathway during cardiac I/R injury...
March 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28319406/effect-of-apelin-13-on-erythrocyte-deformability-during-ischaemia-reperfusion-injury-of-heart-in-diabetic-rats
#13
H Kartal, F M Comu, A Kucuk, Y Polat, A D Dursun, M Arslan
OBJECTIVES: Erythrocyte deformability and plasma viscosity are of crucial importance for the perfusion of tissues and organs. The aim of this study was to evaluate the effect of apelin-13 on erythrocyte deformability during IR heart injury in diabetic rats. METHODS: Eighteen Wistar Albino rats were included in the study after streptozotocin (55 mg/kg) treatment for four weeks of observation for diabetes existence. The animals were randomly assigned to one of five experimental groups...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/28289763/-gender-and-cardiovascular-diseases-why-we-need-gender-medicine
#14
V Regitz-Zagrosek
Gender medicine is concerned with the question of why diseases are expressed differently in the genders. It takes differences between men and women into account, which are often neglected by traditional medicine. Sex differences can also be found in cardiovascular diseases; therefore, risk factors for cardiovascular diseases have a different significance depending on the sex. Diabetic diseases tend to promote the occurrence of coronary heart disease (CHD) more strongly in women than in men. Myocardial infarctions affect women 10 years later than men and young women are often treated too late, possibly because myocardial infarction is consider to be a "male disease"...
March 13, 2017: Der Internist
https://www.readbyqxmd.com/read/28288978/mff-dependent-mitochondrial-fission-contributes-to-the-pathogenesis-of-cardiac-microvasculature-ischemia-reperfusion-injury-via-induction-of-mros-mediated-cardiolipin-oxidation-and-hk2-vdac1-disassociation-involved-mptp-opening
#15
Hao Zhou, Shunying Hu, Qinhua Jin, Chen Shi, Ying Zhang, Pingjun Zhu, Qiang Ma, Feng Tian, Yundai Chen
BACKGROUND: The cardiac microvascular system ischemia/reperfusion injury following percutaneous coronary intervention is a clinical thorny problem. This study explores the mechanisms by which ischemia/reperfusion injury induces cardiac microcirculation collapse. METHODS AND RESULTS: In wild-type mice, mitochondrial fission factor (Mff) expression increased in response to acute microvascular ischemia/reperfusion injury. Compared with wild-type mice, homozygous Mff-deficient (Mff(gt)) mice exhibited a smaller infarcted area, restored cardiac function, improved blood flow, and reduced microcirculation perfusion defects...
March 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28242607/invasive-assessment-of-the-coronary-microcirculation-in-reperfused-st-segment-elevation-myocardial-infarction-patients-where-do-we-stand
#16
Heerajnarain Bulluck, Nicolas Foin, Jack W Tan, Adrian F Low, Murat Sezer, Derek J Hausenloy
For patients presenting with an acute ST-segment-elevation myocardial infarction, the most effective therapy for reducing myocardial infarct size and preserving left ventricular systolic function is primary percutaneous coronary intervention (PPCI). However, mortality and morbidity remain significant. This is partly attributed to the development of microvascular obstruction, which occurs in around 50% of ST-segment-elevation myocardial infarction patients post-PPCI, and it is associated with adverse left ventricular remodeling and worse clinical outcomes...
March 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28191873/orbital-atherectomy-treatment-of-severely-calcified-coronary-lesions-in-patients-with-impaired-left-ventricular-ejection-fraction-one-year-outcomes-from-the-orbit-ii-study
#17
Michael S Lee, Brad J Martinsen, Richard Shlofmitz, Evan Shlofmitz, Arthur C Lee, Jeffrey Chambers
AIMS: Percutaneous coronary intervention (PCI) of severe coronary artery calcification (CAC) is challenging. The ORBIT II study demonstrated the safety and efficacy of orbital atherectomy (OA) in patients with severe CAC. Microparticulate liberated during OA may disturb coronary microcirculation. We evaluated OA treatment in patients with left ventricular systolic dysfunction. METHODS AND RESULTS: Patients were grouped by left ventricular ejection fraction (LVEF): 26-40% (n=33), 41-50% (n=90), and >50% (n=314)...
February 14, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28180196/serial-transthoracic-coronary-doppler-shows-complete-reversibility-of-microvascular-obstruction-pattern-at-one-month-after-reperfused-acute-myocardial-infarction
#18
Camelia Diana Ober, Mihai Claudiu Ober, Adrian Corneliu Iancu
"No reflow" phenomenon is a common complication with significant prognostic repercussions after reperfused acute myocardial infarction. Previous studies have shown the feasibility and prognostic significance of coronary microcirculation assessment by transthoracic Doppler of left anterior descending artery (LAD). The aim of the study was to evaluate the time course of the coronary microcirculation status after acute anterior myocardial infarction reperfused by primary angioplasty with stent on LAD. MATERIAL AND METHODS: Twenty-three patients underwent transthoracic echocardiography at 3 days (M0) and one month (M1) after reperfusion, with LAD flow analysis (peak systolic and diastolic velocities, diastolic deceleration time and systolic flow reversal)...
January 31, 2017: Medical Ultrasonography
https://www.readbyqxmd.com/read/28094311/evidence-of-microvascular-changes-in-the-retina-following-kawasaki-disease
#19
Katherine Y H Chen, David P Burgner, Tien Y Wong, Seang Mei Saw, Swee Chye Quek, Audrey Y C Pang, Seo Wei Leo, Inez B Wong, Diana Zannino, Nigel Curtis, Michael Cheung, Carol Y Cheung, Terence C W Lim
It is unclear whether all children with Kawasaki disease (KD) have increased later cardiovascular risk. The retinal microvasculature reflects changes in the microcirculation and is associated with traditional cardiovascular risk factors and events. The aim of this study was to investigate retinal microvascular parameters in two populations of patients with previous KD and control participants. We performed case-control studies of 116 (57 patients and 59 control participants) Australian and 156 (78 patients and 78 control participants) Singaporean individuals, at least two years since their acute illness...
January 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28028974/myocardial-ischaemia-coronary-atherosclerosis-and-pulmonary-pressure-elevation-in-antiphospholipid-syndrome-patients
#20
Agnieszka Padjas, Wojciech Płazak, Magdalena Celińska-Lowenhoff, Adam Mazurek, Carlo Perricone, Piotr Podolec, Jacek Musiał
BACKGROUND: Thrombotic events in antiphospholipid syndrome (APS) involve venous and arterial circulation with the possible involvement of coronary or pulmonary microcirculation. OBJECTIVES: To evaluate the influence of antiphospholipid antibodies (aPL) and on myocardial ischaemia assessed by single-photon emission computerized tomography (SPECT), coronary atherosclerosis assessed by multidetector computerized tomography (MDCT) and pulmonary pressure assessed by transthoracic echocardiography (TTE) in patients with primary antiphospholipid syndrome (PAPS)...
November 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
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