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Coronary microcirculation

Masami Goto
No abstract text is available yet for this article.
March 8, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Marcin Hellmann, Jakub Piotrowski, Lech Anisimowicz, Jean-Luc Cracowski
No abstract text is available yet for this article.
March 2, 2018: European Journal of Cardio-thoracic Surgery
Waldemar Elikowski, Małgorzata Małek-Elikowska, Stanisław Łazowski, Magdalena Zawodna, Natalia Fertała, Maciej Bryl
The associations between stress-induced takotsubo cardiomyopathy (TC) and cancer or its therapy have been studied with increasing interest in recent years. Different mechanisms of TC development in neoplastic disease are suggested, including a decreased threshold for stress stimuli or aggravated heart adrenoreceptors sensitivity. The action of cytokines and reactive oxygen species on the myocardium, on the epicardial arteries as well as on the coronary microcirculation is also taken into consideration. The authors describe a case of a 30-year-old male with lung cancer, after immunotherapy with checkpoint inhibitors followed by two lines of chemotherapy and after pericardial and pleural drainage...
February 23, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Gerard M London
Accelerated ageing is observed in patients with chronic kidney disease (CKD)/end-stage renal disease. Premature vascular aging and arterial stiffening are the most characteristic features of this "progeria" that is already observed in those with the early stages of CKD. Aortic stiffening is associated with high characteristic impedance, left ventricular hypertrophy, decreased coronary perfusion, and is a strong prognostic marker of mortality and cardiovascular morbidity. With aging, the arterial stiffening is more pronounced in the aorta and central arteries than in peripheral conduit arteries...
January 26, 2018: Blood Purification
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
Richard A Brown, Gregory Y H Lip, Chetan Varma, Eduard Shantsila
INTRODUCTION: Monocyte-platelet aggregates (MPAs) form when Mon1, Mon2 or Mon3 monocyte subsets adhere to platelets. They are pathophysiologically linked to coronary artery disease (CAD). However, their individual roles in the occurrence of diffuse CAD remain unknown. METHODS: Peripheral blood from 50 patients with diffuse CAD, 40 patients with focal CAD and 50 age-matched patients with normal coronary arteries was analysed by flow cytometry to quantify MPAs associated with individual monocyte subsets...
February 9, 2018: European Journal of Clinical Investigation
Hiroki Saito, Shigeo Godo, Saori Sato, Akiyo Ito, Yosuke Ikumi, Shuhei Tanaka, Tomoaki Ida, Shigemoto Fujii, Takaaki Akaike, Hiroaki Shimokawa
AIMS: Nitric oxide (NO) and endothelium-dependent hyperpolarization (EDH) play important roles in maintaining cardiovascular homeostasis. We have previously demonstrated that endothelial NO synthase (eNOS) plays diverse roles depending on vessel size, as a NO generating system in conduit arteries and an EDH-mediated system in resistance arteries, for which caveolin-1 (Cav-1) is involved. However, the physiological role of endothelial Cav-1 in microvessels remains to be elucidated. METHODS AND RESULTS: We newly generated endothelium-specific Cav-1-knockout (eCav-1-KO) mice...
February 2018: Journal of Cardiovascular Pharmacology
Ricardo Poveda-Jaramillo, Fabrizio Monaco, Alberto Zangrillo, Giovanni Landoni
β-Blockers are useful drugs in several clinical cardiologic scenarios. Their use in the perioperative period and in critically ill patients is increasing, but their effect on clinically relevant outcomes remains controversial. Long-acting β-blockers can have detrimental effects that are difficult to be counteracted in these settings. The authors describe the possible clinical uses of ultra-short-acting β-blockers (esmolol and landiolol) in the perioperative period and in critically ill patients because these drugs have the beneficial effects of β-blockers, but do not have the detrimental effects of long-acting agents...
November 23, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Kyungil Park, Young-Rak Cho, Jong-Sung Park, Tae-Ho Park, Moo-Hyun Kim, Young-Dae Kim
It has been previously demonstrated that ticagrelor can reduce mortality compared to clopidogrel in acute coronary syndrome (ACS) patients. However, the mechanism for this mortality reduction remains uncertain. The objective of the present study is to assess the impact of chronic ticagrelor treatment on microvascular circulation. A total of 120 participants aged 20-85 years with clinical diagnosis of ACS will be randomized in a 1:1 fashion to the following two groups: ticagrelor 90 mg twice daily; clopidogrel 75 mg once daily...
February 2018: Journal of Cardiovascular Translational Research
Lulu Sun, Zilong Wang, Tongda Xu, Defeng Pan, Li Liang, Ji Hao, Xiaoping Wang, Dongye Li
OBJECTIVE: The aim of this study was to evaluate the value of real-time myocardial contrast echocardiography (RT-MCE) for detecting coronary microcirculation (CM) function in coronary artery disease (CAD) patients. METHODS: Sixty-five consecutive patients were divided into CAD (n=52) and no-CAD (n=13) groups using coronary angiography (CAG). All patients underwent RT-MCE at rest and CAG within 1 week after RT-MCE. The ventricular segments in CAD patients were divided semi-quantitatively into ischemic and non-ischemic myocardial groups based on RT-MCE images...
January 2018: Anatolian Journal of Cardiology
Daniel Grandmougin, Jean-Mathieu Casse, Antoine Chalon, Yun Luo, Aude Falanga, Vanessa Marie, Fréderique Groubatch-Joineau, Brice Mourer, Marie Grandmougin, David Grandmougin, Guillaume Gauchotte, Juan-Pablo Maureira, Nguyen Tran
BACKGROUND: Retrograde perfusion into the coronary sinus is used to deliver cardioplegia. We developed an in-vivo porcine beating-heart model of self-myocardial retroperfusion (SMR) using the venous route to supply myocardial oxygenation and sought to assess hemodynamic and cardiac responses triggered by SMR before and after a prolonged occlusion of the LAD. METHODS: A bypass-line between the ascending aorta and the coronary sinus was made to perform a selective retrograde perfusion of the great cardiac vein with oxygenated blood (SMR)...
January 9, 2018: Journal of Cardiovascular Surgery
Yingnan Bai, Xiaoyan Wang, Xin Deng, Hongyi Wu, Abdel Hamid Fathy, Yan Xi, Yunzeng Zou, Jie Cui, Junbo Ge
Percutaneous coronary intervention (PCI) and coronary-artery bypass grafting (CABG) are two major preferred reperfusion strategies to restore the ischemic-related artery patency, but PCI and CABG do not necessarily guarantee the recovery of post-procedure left ventricular (LV) dysfunction and release of symptoms. Moreover, there is no definitive effective way to enhance microcirculations. Theoretically, shock wave therapy (SWT) is an option. We report here a case of patient who received SWT. The patient's medical history was characterized by chest pain for 20 years, having received CABG 13 years ago...
December 2017: Journal of Thoracic Disease
Francisco A H Fonseca, Maria Cristina Izar, Ieda M L Maugeri, Otavio Berwanger, Lucas P Damiani, Ibraim M Pinto, Gilberto Szarf, Carolina N França, Henrique T Bianco, Flavio T Moreira, Adriano Caixeta, Claudia M R Alves, Aline Soriano Lopes, Aline Klassen, Marina F M Tavares, Henrique A Fonseca, Antonio C C Carvalho
BACKGROUND: Early reperfusion of the occluded coronary artery during acute myocardial infarction is considered crucial for reduction of infarcted mass and recovery of ventricular function. Effective microcirculation and the balance between protective and harmful lymphocytes may have roles in reperfusion injury and may affect final ventricular remodeling. METHODS/DESIGN: BATTLE-AMI is an open-label, randomized trial comparing the effects of four therapeutic strategies (rosuvastatin/ticagrelor, rosuvastatin/clopidogrel, simvastatin plus ezetimibe/ticagrelor, or simvastatin plus ezetimibe/clopidogrel) on infarcted mass and left ventricular ejection fraction (LVEF) (blinded endpoints) in patients with ST-segment elevation myocardial infarction submitted to fibrinolytic therapy before coronary angiogram (pharmacoinvasive strategy)...
December 19, 2017: Trials
Michael Wilk, Bettina G Zelger, Undine Hauser, Reinhard Höpfl, Bernhard Zelger
Erosive pustular dermatosis of the scalp (EPDS) is an inflammatory dermatosis of unknown etiology. Herein, we present a review of the disease and report our own clinical and histopathological experience in eleven patients. EPDS tends to spontaneously affect bald areas of the scalp in elderly individuals. A history of previous surgery at the same site - as observed in four of our patients - is common. Coronary artery disease, cerebrovascular insult, arterial hypertension, diabetes mellitus, and severe cases of cancer were frequent comorbidities...
January 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Rocco A Montone, Giampaolo Niccoli, Francesco Fracassi, Michele Russo, Filippo Gurgoglione, Giulia Cammà, Gaetano A Lanza, Filippo Crea
Aims: Functional alterations of epicardial coronary arteries or coronary microcirculation represent a frequent cause of myocardial infarction and non-obstructive coronary arteries (MINOCA). We aimed at assessing the prognostic value of intracoronary provocative tests in patients presenting with MINOCA and in which other causes of MINOCA have been excluded. Methods and results: We prospectively evaluated patients with a diagnosis of MINOCA, excluding patients with aetiologies other than suspected coronary vasomotor abnormalities...
January 7, 2018: European Heart Journal
Erkan Yildirim, Uygar Cagdas Yuksel, Murat Celik, Baris Bugan, Mutlu Gungor, Yalcin Gokoglan, Mustafa Koklu, Suat Gormel, Salim Yasar, Cem Barcin
Objective The vessels involved in the microcirculation are too small to be visualized by conventional angiography and no tools are currently available that can directly evaluate the coronary microcirculation. This study evaluated the coronary clearance frame count (CCFC) in patients with cardiac syndrome X (CSX). Methods The retrospective study enrolled patients with angina, who had a positive nuclear imaging test and normal coronary angiography; and a control group consisting of patients who underwent an angiogram to exclude coronary artery disease...
January 1, 2017: Journal of International Medical Research
Joshua T Butcher, M Irfan Ali, Merry W Ma, Cameron G McCarthy, Bianca N Islam, Lauren G Fox, James D Mintz, Sebastian Larion, David J Fulton, David W Stepp
The objective of this study is to test the hypothesis that increased muscle mass has positive effects on cardiovascular function. Specifically, we tested the hypothesis that increases in lean body mass caused by deletion of myostatin improves cardiac performance and vascular function. Echocardiography was used to quantify left ventricular function at baseline and after acute administration of propranolol and isoproterenol to assess β -adrenergic reactivity. Additionally, resistance vessels in several beds were removed, cannulated, pressurized to 60 mmHg and reactivity to vasoactive stimuli was assessed...
December 2017: Physiological Reports
Mieke van den Heuvel, Oana Sorop, Nienke S van Ditzhuijzen, René de Vries, Richard W B van Duin, Ilona Peters, Janine E van Loon, Moniek P de Maat, Heleen M van Beusekom, Wim J van der Giessen, A H Jan Danser, Dirk J Duncker
BACKGROUND: We studied the effect of bioresorbable vascular scaffold (BVS) implantation on distal coronary endothelial function, in swine on a high fat diet without (HFD) or with diabetes (DM+HFD). METHODS: Five DM+HFD and five HFD swine underwent BVS implantation on top of coronary plaques, and were studied six months later. Conduit artery segments >5mm proximal and distal to the scaffold and corresponding segments of non-scaffolded coronary arteries, and segments of small arteries within the flow-territory of scaffolded and non-scaffolded arteries were harvested for in vitro vasoreactivity studies...
February 1, 2018: International Journal of Cardiology
Vincenzo Sucato, Salvatore Evola, Giuseppina Novo, Nicolò Bellante, Giuseppe Andolina, Salvatore Novo
Coronary atherosclerosis is the main cause of myocardial ischemia. Nevertheless 10-30% of patients with angina has angiographically normal coronary arteries. In the last 30 years, several studies showed that in these patients the symptoms can be caused by dysfunction of the coronary microcirculation. Coronary microvascular dysfunction (CMVD) occurring in patients affected by specific cardiac or systemic diseases may be due to mechanisms of the underlying disease. On the other hand, in several patients affected by angina with angiographically normal coronary arteries, there is no specific disease, and CMVD only is responsible for the clinical picture...
December 2017: Giornale Italiano di Cardiologia
Patricia P Wadowski, Martin Hülsmann, Christian Schörgenhofer, Irene M Lang, Raphael Wurm, Thomas Gremmel, Renate Koppensteiner, Barbara Steinlechner, Michael Schwameis, Bernd Jilma
BACKGROUND AND OBJECTIVE: Microcirculatory changes contribute to clinical symptoms and disease progression in chronic heart failure (CHF). A depression of coronary flow reserve is associated with a lower myocardial capillary density in biopsies. We hypothesized that changes in cardiac microcirculation might also be reflected by a systemic reduction in capillaries and visualized by sublingual videomicroscopy. The aim was to study in vivo capillary density and glycocalyx dimensions in patients with CHF vs healthy controls...
February 2018: European Journal of Clinical Investigation
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