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Coronary microcirculation

Karima Ait-Aissa, Joseph Hockenberry, David Gutterman, Aron Geurts, Andreas Beyer
OBJECTIVE: Flow mediated dilation (FMD) is the most physiological relevant form of endothelial-mediated vasodilation. Our laboratory has previously shown that telomerase, a ribo-nucleoprotein that counteracts telomere shortening, has a protective effect on endothelial function under conditions of oxidative stress in the human microcirculation. In the presence of coronary artery disease, decreased telomerase activity contributes to a shift in the mediator of FMD from atheroprotective nitric oxide (NO) to pro-inflammatory and atherogenic hydrogen peroxide (H2O2)...
September 2016: Journal of Hypertension
Wan Qin, Meredith A Roberts, Xiaoli Qi, Charles E Murry, Ying Zheng, Ruikang K Wang
In this study, we propose a novel implementation of optical coherence tomography-based angiography combined with ex vivo perfusion of fixed hearts to visualize coronary microvascular structure and function. The extracorporeal perfusion of Intralipid solution allows depth-resolved angiographic imaging, control of perfusion pressure, and high-resolution optical microangiography. The imaging technique offers new opportunities for microcirculation research in the heart, which has been challenging due to motion artifacts and the lack of independent control of pressure and flow...
October 7, 2016: Physics in Medicine and Biology
Edip Güvenç Çekiç, Özcan Başaran, Nesrin Filiz Başaran, Onur Elmas, Volkan Doğan, Gurbet Özge Mert, Kadir Uğur Mert, Ibrahim Altun, Fatih Akın, Murat Biteker
BACKGROUND AND AIM: Decreased vascular reactivity in atherosclerosis was previously shown. In our study, it was aimed to demonstrate the decreased vascular functions in both microvascular and macrovascular tissues and to estimate any correlation between them. METHODS: Twenty-five control outpatients with no coronary artery disease (CAD) history and 26 outpatients with CAD history were enrolled in the study. Local cutaneous post-occlusive reactive hyperemia (PORH) responses after three minutes of brachial occlusion with a pneumatic cuff were recorded noninvasively by a Perimed Periflux 5010 laser Doppler flow system...
September 28, 2016: Microvascular Research
T K Kim, K Nam, Y J Cho, J J Min, Y J Hong, K U Park, D M Hong, Y Jeon
The infusion of fluids to patients may affect tissue microcirculation and the endothelial glycocalyx. However, the effects of hydroxyethyl starch and crystalloid on endothelial glycocalyx degradation and microvascular reactivity have not been evaluated in detail. We hypothesised that hydroxyethyl starch may cause less endothelial glycocalyx degradation and better microvascular reactivity than that caused by crystalloid. We randomly allocated 120 patients undergoing off-pump coronary artery bypass graft surgery to receive up to 20 ml...
September 26, 2016: Anaesthesia
Karima Ait-Aissa, Joseph Hockenberry, David Gutterman, Aron Geurts, Andreas Beyer
OBJECTIVE: Flow mediated dilation (FMD) is the most physiological relevant form of endothelial-mediated vasodilation. Our laboratory has previously shown that telomerase, a ribo-nucleoprotein that counteracts telomere shortening, has a protective effect on endothelial function under conditions of oxidative stress in the human microcirculation. In the presence of coronary artery disease, decreased telomerase activity contributes to a shift in the mediator of FMD from atheroprotective nitric oxide (NO) to pro-inflammatory and atherogenic hydrogen peroxide (H2O2)...
September 2016: Journal of Hypertension
Man-Jong Lee, Sang-Don Park, Sung Woo Kwon, Seong-Ill Woo, Myung-Dong Lee, Sung-Hee Shin, Dae-Hyeok Kim, Jun Kwan, Keum-Soo Park
The neutrophil-to-lymphocyte ratio (NLR) has been proved as a reliable inflammatory marker for the atherosclerotic process and as a predictor for clinical outcomes in patients with various cardiovascular diseases. A recent study reported that elevated NLR is associated with impaired myocardial perfusion in patients with ST-segment elevation myocardial infarction (STEMI). We investigated whether NLR is associated with coronary microcirculation as assessed by the index of microcirculatory resistance (IMR) in patients with STEMI who had undergone primary percutaneous coronary intervention (PCI)...
August 13, 2016: American Journal of Cardiology
Chuanjian Lu, Yu-Qun Zeng, Huazhen Liu, Qingfeng Xie, Shengmei Xu, Kangsheng Tu, Changwei Dou, Zhenhua Dai
BACKGROUND: Achieving long-term cardiac allograft survival without continuous immunosuppression is highly desired in organ transplantation. Studies have shown that Salvia miltiorrhiza, an herb also known as danshen, improves microcirculation and is highly effective in treating coronary heart disease. Our objective is to determine whether tanshinol, an ingredient of danshen, improves cardiac allograft survival. METHODS: Fully vascularized heterotopic heart transplantation was performed using BALB/c mice as donors and C57BL/6 mice as recipients, which were then treated with tanshinol and rapamycin...
July 27, 2016: Journal of Heart and Lung Transplantation
Marcel van 't Veer, Julien Adjedj, Inge Wijnbergen, Gabor G Tóth, Marcel C M Rutten, Emanuele Barbato, Lokien X van Nunen, Nico H J Pijls, Bernard De Bruyne
AIMS: The aim of this study is to validate a novel monorail infusion catheter for thermodilution-based quantitative coronary flow measurements. METHODS AND RESULTS: Based on the principles of thermodilution, volumetric coronary flow can be determined from the flow rate of a continuous saline infusion, the temperature of saline when it enters the coronary artery, and the temperature of the blood mixed with the saline in the distal part of the coronary artery. In an in vitro set-up of the systemic and coronary circulation at body temperature, coronary flow values were varied from 50-300 ml/min in steps of 50 ml/min...
August 20, 2016: EuroIntervention
Zuhal Caliskan, Nursen Keles, Huseyin Savas Gokturk, Kamil Ozdil, Feyza Aksu, Oguzhan Ozturk, Resul Kahraman, Osman Kostek, Ahmet S Tekin, Gulsum Teke Ozgur, Mustafa Caliskan
BACKGROUND: Inflammatory bowel disease [IBD] includes a number of chronic relapsing diseases. In IBD intestinal microvascular endothelial cells are damaged by an abnormal immune response. Several studies have shown that IBD may cause increment in risk of developing atherosclerosis. IBD in activation was related to enhanced risks of worse cardiovascular [CV] outcome, on the other hand no risk increment was seen in remission comparing to control group in those studies. Coronary Flow Reserve [CFR] reflects coronary microvascular circulation...
November 15, 2016: International Journal of Cardiology
Takanori Miura, Jun Maruya, Jun Watanabe, Ryuta Sato, Takashi Hatakeyama, Keiichi Nishimaki
Cerebral involvement is rare in polyarteritis nodosa(PAN);furthermore, secondary intracranial hemorrhage due to cerebral aneurysm is extremely rare. We describe an unusual case of repeated subarachnoid hemorrhage(SAH)in a 64-year-old woman with a history of PAN. Initially, she developed severe headache(probable first SAH, day 0), and presented at our hospital with second severe headache with disturbed consciousness on day 6. Computed tomography(CT)revealed that SAH was mainly distributed in the right basal cistern and sylvian fissure(second SAH)...
August 2016: No Shinkei Geka. Neurological Surgery
Hernán David Mejía-Rentería, Iván J Núñez-Gil
Takotsubo cardiomyopathy is a syndrome mimicking an acute myocardial infarction in absence of obstructive epicardial coronary artery disease to explain the degree of the wall motion abnormalities. Typically more common in the elderly women, this condition is usually triggered by unexpected emotional or physical stress situations, and is associated with electrocardiogram abnormalities and slight elevation of cardiac biomarkers. The pathophysiological mechanism is not clear yet, but it is believed that a high circulating concentration of catecholamines causes an acute dysfunction of the coronary microcirculation and metabolism of cardiomyocytes, leading to a transient myocardial stunning...
July 26, 2016: World Journal of Cardiology
Simone Rivolo, Lucas Hadjilucas, Matthew Sinclair, Pepijn van Horssen, Jeroen Phm van den Wijngaard, Roman Wesolowski, Amedeo Chiribiri, Maria Siebes, Nicolas P Smith, Jack Lee
The branching pattern of the coronary vasculature is a key determinant of its function and plays a crucial role in shaping the pressure and velocity waveforms measured for clinical diagnosis. However, although multiple scaling laws have been proposed to characterize the branching pattern, the implications they have on wave propagation remains unassessed to date. To bridge this gap, we have developed a new theoretical framework by combining the mathematical formulation of scaling laws with the wave propagation theory in the pulsatile flow regime...
July 8, 2016: American Journal of Physiology. Heart and Circulatory Physiology
Maurits R Hollander, Guus A de Waard, Lara S F Konijnenberg, Rosalie M E Meijer-van Putten, Charissa E van den Brom, Nanne Paauw, Helga E de Vries, Peter M van de Ven, Jurjan Aman, Geerten P Van Nieuw-Amerongen, Peter L Hordijk, Hans W M Niessen, Anton J G Horrevoets, Niels Van Royen
BACKGROUND: Microvascular injury (MVI) after coronary ischemia-reperfusion is associated with high morbidity and mortality. Both ischemia and reperfusion are involved in MVI, but to what degree these phases contribute is unknown. Understanding the etiology is essential for the development of new potential therapies. METHODS AND FINDINGS: Rats were divided into 3 groups receiving either 30 minutes ischemia, 90 minutes ischemia or 30 minutes ischemia followed by 60 minutes reperfusion...
2016: PloS One
Takashi Koyama, Masahito Munakata, Takashi Akima, Toshimi Kageyama, Masaru Shibata, Kazunori Moritani, Hideaki Kanki, Shiro Ishikawa, Hideo Mitamura
BACKGROUND: Reperfusion injury offsets the beneficial effects of reperfusion therapy for ST-segment elevation myocardial infarction (STEMI). In our previous reports, postconditioning with lactate-enriched blood (PCLeB) induced excellent microcirculation recovery and less inflammation in STEMI patients. This study aimed to determine the in-hospital outcomes of STEMI patients treated using PCLeB. METHODS: Fifty-five consecutive STEMI patients were treated using PCLeB (Age 66...
October 1, 2016: International Journal of Cardiology
Helen Triantafyllidi, Agis Grafakos, Ignatios Ikonomidis, George Pavlidis, Paraskevi Trivilou, Antonis Schoinas, John Lekakis
An association between androgenic alopecia (AGA), coronary artery disease, and hypertension has been reported in previous epidemiological studies. The authors evaluated the relationship of target organ damage caused by hypertension with AGA in 101 newly diagnosed and untreated hypertension men with mild to moderate AGA (AGAm ), severe AGA (AGAs ), and non-AGA. Pulse wave velocity (PWV), office and 24-hour pulse pressure (PP), carotid intima-media thickness (IMT), left ventricular hypertrophy (LVH), coronary flow reserve (CFRd), and AGA severity by Hamilton-Norwood scale were estimated...
July 1, 2016: Journal of Clinical Hypertension
Marc Moritz Berger, Franziska Macholz, Peter Schmidt, Ragnar Huhn
For decades the administration of oxygen has been a corner stone in the treatment of various medical emergencies, e.g. acute myocardial infarction. Several arguments support the perioperative use of high oxygen concentrations (>80%) for the prevention of surgical site infections. However, effects of oxygen include an increase in systemic vascular resistance, a reduction in heart rate and stroke volume and thus an impairment of the microcirculation, e.g. in the coronary and cerebral vasculature. Adequately powered, prospective, randomized, blinded outcome studies on the effects of hyperoxia in anesthesia and intensive care medicine are scarce...
June 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Sonnet S Jonker, Lowell Davis, Divya Soman, J Todd Belcik, Brian P Davidson, Tamara M Atkinson, Adrienne Wilburn, Samantha Louey, George D Giraud, Jonathan R Lindner
Fetal anemia causes cardiac adaptations that have immediate and life-long repercussions on heart function and health. It is known that resting and maximal coronary conductance both increase during chronic fetal anemia, but the coronary microvascular changes responsible for the adaptive response are unknown. Until recently, technical limitations have prevented quantifying functional capillary-level adaptations in the in vivo fetal heart. Our objective was to characterize functional microvascular adaptations in chronically anemic fetal sheep...
June 13, 2016: Journal of Physiology
Mustafa Bulut, Nursen Keles, Zuhal Caliskan, Osman Kostek, Feyza Aksu, Kamil Ozdil, Mustafa Akcakoyun, Kenan Demircioglu, Yusuf Yilmaz, Mehmet Kanbay, Mustafa Caliskan
BACKGROUND AND AIMS: Systemic amyloid A protein (AA) amyloidosis may occur as a complication of many chronic inflammatory disorders. Patients receiving inadequate anti-inflammatory and immunosuppressive therapies have an increased risk of developing systemic AA amyloidosis. Inflammation plays a role in all stages and the thrombotic complications of atherosclerosis. In the absence of epicardial coronary stenosis, coronary flow reserve (CFR) reflects coronary microvascular dysfunction. In the present study, we hypothesized that amyloid advanced subclinical inflammation in chronic inflammatory diseases (CID) patients may further affect coronary microcirculation...
August 2016: Atherosclerosis
Mehmet Ozulku, Mustafa Caliskan, Tonguc Saba, Feyza Aksu, Ozgur Ciftci, Hakan Gullu, Aytekin Guven, Osman Kostek, Ozge Telci Caklili, Sait Aslamaci, Haldun Muderrisoglu
BACKGROUND: Although several clinical trials have compared surgical outcomes between off-pump and on-pump coronary artery bypass grafting (CABG), whether there is a difference in the early- and medium-term postoperative coronary microvascular functions is not fully understood. We compared short- and medium-term coronary microvascular function after off-pump and on-pump CABG. METHODS: A prospective study of patients undergoing off-pump and on-pump CABG. Eighty-two patients scheduled for CABG were recruited: 38 underwent off-pump surgery and 44 on-pump surgery...
March 19, 2016: Heart, Lung & Circulation
P Ong, U Sechtem
Just as in epicardial coronary stenosis, coronary microvascular dysfunction (CMD) also leads to an imbalance of myocardial oxygen supply and demand. The dysfunction is located at the level of the coronary microcirculation with vessel diameters < 500 µm and structural as well as functional alterations have been described. The underlying mechanisms are diverse, frequently overlap and are still incompletely understood. Among others, conditions such as chronic inflammation, estrogen deficiency and a genetic familial predisposition have been reported...
June 2016: Herz
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