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Coronary microcirculation

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https://www.readbyqxmd.com/read/28721646/non-invasive-measures-of-coronary-microcirculation-taking-the-long-road-to-the-clinic
#1
EDITORIAL
Kieran S Chung, Patricia K Nguyen
Although coronary microvascular disease is now a well-recognized entity that is associated with significant morbidity and mortality, current non-invasive strategies cannot differentiate between coronary microvascular disease (CMD) and obstructive epicardial stenosis. While the evaluation of intramyocardial blood volume as a surrogate measure for microvascular health may have limited sensitivity in early-stage disease, this strategy does enable the diagnosis of CMD in the presence of concurrent epicardial disease, bringing us one step further toward improving the management of this disease...
July 18, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28721151/moderate-dose-atorvastatin-improves-arterial-endothelial-function-in-patients-with-angina-pectoris-and-normal-coronary-angiogram-a-pilot-study
#2
Amela Kabaklić, Zlatko Fras
INTRODUCTION: Endothelial dysfunction could contribute to the pathophysiology of angina pectoris (AP) in patients with normal coronary angiograms. Besides lipid-lowering effects, statins exert pleiotropic effects including improving endothelial function. MATERIAL AND METHODS: Our double-blind study included 58 patients with AP, noninvasively confirmed myocardial ischemia and a normal coronary angiogram. The effect of once-daily 20 mg atorvastatin (A) was compared with placebo (P) for 6 months...
June 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28700893/coronary-microvascular-disease-as-an-early-culprit-in-the-pathophysiology-of-diabetes-and-metabolic-syndrome
#3
REVIEW
Hicham Labazi, Aaron J Trask
Metabolic syndrome (MetS) is a group of cardio-metabolic risk factors that includes obesity, insulin resistance, hypertension, and dyslipidemia; these are also a combination of independent coronary artery disease (CAD) risk factors. Alarmingly, the prevalence of MetS risk factors are increasing and a leading cause for mortality. In the vasculature, complications from MetS and type 2 diabetes (T2D) can be divided into microvascular (retinopathy and nephropathy) and macrovascular (cardiovascular diseases and erectile dysfunction)...
July 9, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28667102/adiponectin-improves-coronary-no-reflow-injury-by-protecting-endothelium-in-rats-with-type-2-diabetes-mellitus
#4
Xue Han, Ye Wu, Xin Liu, Lu Ma, Tingting Lv, Qi Sun, Wenli Xu, Suli Zhang, Ke Wang, Wen Wang, Xinliang Ma, Huirong Liu
To determine the effect of adiponectin on the coronary no-reflow (NR) injury in rats with Type 2 Diabetes Mellitus (T2DM), 80 male SD rats were fed with high-sugar and high-fat diet to build T2DM model. Rats received vehicle or Adiponectin (APN) in the last week and then were subjected to myocardial ischemia reperfusion (MI/R) injury. Endothelium dependent vasorelaxation of thoracic aorta was significantly decreased and serum levels of endothelin-1 (ET-1), intercellular cell adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) were obviously increased in T2DM rats compared with that in the rats without T2DM...
June 30, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/28653312/link-of-renal-microcirculatory-dysfunction-to-increased-coronary-microcirculatory-resistance-in-hypertensive-patients
#5
Cong Lin, Pu Zhang, Yangjing Xue, Yinqing Huang, Kangting Ji
BACKGROUND: This study investigated the correlation between renal microcirculation and coronary microcirculation in hypertensive patients. METHODS: Participants consisted of 231 consecutive candidates who were referred to the Second Affiliated Hospital of Wenzhou Medical University from March 2014 to May 2016 for elective coronary angiography due to suspected myocardial ischemia. All participants were evaluated for the index of microvascular resistance (IMR), coronary flow reserve (CFR), and fractional flow reserve (FFR) using a pressure wire...
June 27, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28643578/coronary-microvascular-dysfunction-in-diabetes-mellitus
#6
Aleksandar Kibel, Kristina Selthofer-Relatic, Ines Drenjancevic, Tatjana Bacun, Ivica Bosnjak, Dijana Kibel, Mario Gros
The significance, mechanisms and consequences of coronary microvascular dysfunction associated with diabetes mellitus are topics into which we have insufficient insight at this time. It is widely recognized that endothelial dysfunction that is caused by diabetes in various vascular beds contributes to a wide range of complications and exerts unfavorable effects on microcirculatory regulation. The coronary microcirculation is precisely regulated through a number of interconnected physiological processes with the purpose of matching local blood flow to myocardial metabolic demands...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28643215/relationship-between-instantaneous-wave-free-ratio-and-fractional-flow-reserve-in-patients-receiving-hemodialysis
#7
Yuta Morioka, Hiroyuki Arashi, Hisao Otsuki, Junichi Yamaguchi, Nobuhisa Hagiwara
Instantaneous wave-free ratio (iFR) is a vasodilator-free index and is reported to have a good correlation with fractional flow reserve (FFR). Hemodialysis patients exhibit left ventricular hypertrophy, reduced arterial compliance, and impaired microcirculation. Such a coronary flow condition in these patients may influence the relationship between iFR and FFR. This study assessed the impact of hemodialysis on the relationship between iFR and FFR. The study enrolled 196 patients with 265 stenoses who underwent assessment via iFR, FFR assessment, and right heart catheterization...
June 22, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28613418/differences-in-optic-nerve-head-microcirculation-between-evening-and-morning-in-patients-with-coronary-artery-disease
#8
Tomoaki Shiba, Mao Takahashi, Tadashi Matsumoto, Yuichi Hori
PURPOSE: To determine whether differences or variation of blood flow in the optic nerve head (ONH) are independent risk factors for coronary artery disease (CAD). METHODS: We studied 144 consecutive patients whose ocular blood flow in the ONH was measured in the evening and morning by laser speckle flowgraphy (LSFG). We analysed the mean blur rate (MBR) throughout the ONH (MBR-A) and in the tissue (MBR-T) and vessels (MBR-V) in the ONH. We also evaluated the MBR-T, -V and -A values obtained in the evening and morning and the variation (Δ) between evening and morning values in each group...
June 14, 2017: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/28574936/coronary-microcirculatory-dysfunction-in-human-cardiomyopathies-a-pathologic-and-pathophysiologic-review
#9
Kristina Selthofer-Relatic, Martina Mihalj, Aleksandar Kibel, Ana Stupin, Marko Stupin, Ivana Jukic, Akos Koller, Ines Drenjancevic
Cardiomyopathies are a heterogeneous group of diseases of the myocardium. The term cardiomyopathy involves a wide range of pathogenic mechanisms that affect the structural and functional states of cardiomyocytes, extravascular tissues, and coronary vasculature, including both epicardial coronary arteries and the microcirculation. In the developed phase, cardiomyopathies present with various clinical symptoms: dyspnea, chest pain, palpitations, swelling of the extremities, arrhythmias, and sudden cardiac death...
July 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28571183/effect-of-ranolazine-in-patients-with-chest-pain-and-normal-coronaries-a-hospital-based-study
#10
Swapan Saha, Tony Ete, Manish Kapoor, Pravin Kumar Jha, Rinchin Dorjee Megeji, Gaurav Kavi, Synrang Batngen Warjri, Animesh Mishra
INTRODUCTION: There is an important role of coronary microcirculation in the clinical presentation and prognosis of patients who have typical chest pain despite normal epicardial coronary arteries (microvascular angina). Treatment of these patients is empirical because of the incomplete knowledge of its cause. Limited data has shown that ranolazine reduces angina and improves exercise performance in such patients with frequent angina. AIM: To evaluate the effect of ranolazine in patients with chest pain and normal epicardial coronaries (micro-vascular angina)...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28534102/circulating-microaggregates-during-cardiac-surgery-precedes-postoperative-stroke
#11
Zühre Uz, Dan M J Milstein, Can Ince, Bastian A J M de Mol
Postoperative stroke and encephalopathy are potentially serious complications associated with coronary artery bypass grafting. In this case report a 78-year-old male patient receiving routine elective cardiac surgery presented with microaggregations in the sublingual microcirculation while on cardiopulmonary bypass that was undetected by routine intraoperative anticoagulation assessment. Microaggregates identified using video microscopy on his sublingual microcirculation during the procedure preceded a stroke postoperatively...
May 22, 2017: Journal of Thrombosis and Thrombolysis
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
REVIEW
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
#20
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
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