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https://www.readbyqxmd.com/read/27910053/cardiac-gene-delivery-in-large-animal-models-antegrade-techniques
#1
Shin Watanabe, Lauren Leonardson, Roger J Hajjar, Kiyotake Ishikawa
Percutaneous antegrade coronary injection is among the least invasive cardiac selective gene delivery methods. However, transduction efficiency is quite low with a simple bolus antegrade injection. In order to improve the transduction efficiency using antegrade delivery, several additional approaches have been proposed.In this chapter, we briefly discuss important elements associated with intracoronary delivery methods and present protocols for three different catheter-based antegrade delivery techniques in a preclinical large animal model...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27910052/a-needleless-liquid-jet-injection-delivery-approach-for-cardiac-gene-therapy
#2
Anthony S Fargnoli, Michael G Katz, Charles R Bridges
Fundamentally, cardiac gene therapy clinical trials have demonstrated that route efficiency is paramount in achieving maximum myocardial expression within safety limits. Gene transfer phenomena are largely influenced by physical transport principles (i.e., pressure, residence time, dispersion trafficking, mechanical resistance) that are independent of therapeutic characteristics. An alternative to intracoronary infusion methods, in an effort to improve efficiency in terms of cardiac specificity, is direct myocardial delivery via surgical injection...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27910047/lipidoid-mrna-nanoparticles-for-myocardial-delivery-in-rodents
#3
Irene C Turnbull, Ahmed A Eltoukhy, Daniel G Anderson, Kevin D Costa
An area of active research in the field of cardiac gene therapy aims to achieve high transfection efficiency without eliciting immune or inflammatory reactions. Nanomedicine offers an attractive alternative to traditional viral delivery vehicles because nanoparticle technology can enable safer and more controlled delivery of therapeutic agents. Here we describe the use of lipidoid nanoparticles for delivery of modified mRNA (modRNA) to the myocardium in vivo, with a focus on rodent models that represent a first step toward preclinical studies...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27904523/the-role-of-near-infrared-spectroscopy-in-the-detection-of-vulnerable-atherosclerotic-plaques
#4
Martin Horvath, Petr Hajek, Cyril Stechovsky, Jakub Honek, Miloslav Spacek, Josef Veselka
Coronary artery disease is the leading cause of mortality worldwide. Most acute coronary syndromes are caused by a rupture of a vulnerable atherosclerotic plaque which can be characterized by a lipid-rich necrotic core with an overlying thin fibrous cap. Many vulnerable plaques can cause angiographically mild stenoses due to positive remodelling, which is why the extent of coronary artery disease may be seriously underestimated. In recent years, we have witnessed a paradigm shift in interventional cardiology...
December 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27904032/coronary-microvascular-dysfunction%C3%A3-epidemiology-pathogenesis-prognosis-diagnosis-risk-factors-and-therapy
#5
Cheng Chen, Janet Wei, Ahmed AlBadri, Parham Zarrini, C Noel Bairey Merz
Angina has traditionally been thought to be caused by obstructive coronary artery disease (CAD). However, a substantial number of patients with angina are found to not have obstructive CAD when undergoing coronary angiography. A significant proportion of these patients have coronary microvascular dysfunction (CMD), characterized by heightened sensitivity to vasoconstrictor stimuli and limited microvascular vasodilator capacity. With the advent of non-invasive and invasive techniques, the coronary microvasculature has been more extensively studied in the past 2 decades...
November 29, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27904031/variant-aldehyde-dehydrogenase-2-aldh2-2-in-east-asians-interactively-exacerbates-tobacco-smoking-risk-for-coronary-spasm%C3%A3-possible-role-of-reactive-aldehydes
#6
Yuji Mizuno, Seiji Hokimoto, Eisaku Harada, Kenji Kinoshita, Michihiro Yoshimura, Hirofumi Yasue
BACKGROUND: Coronary spastic angina (CSA) is common among East Asians and tobacco smoking (TS) is an established risk factor for CSA. Aldehyde dehydrogenase 2 (ALDH2) plays a key role in removing reactive toxic aldehydes and a deficient variant ALDH2 genotype (ALDH2*2) is prevalent among East Asians. We examined the interaction between TS andALDH2*2as a risk factor for CSA to better understand the disease pathogenesis.Methods and Results:The study subjects comprised 410 patients (258 men, 152 women; mean age, 66...
November 29, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27899850/evaluation-of-short-and-long-term-efficacy-of-combined-intracoronary-administration-of-high-dose-adenosine-and-tirofiban-during-primary-percutaneous-coronary-intervention
#7
Yanbing Li, Qiang Li, Feiou Li, Min Zong, Guobin Miao, Xinchun Yang, Zichuan Tong, Jianjun Zhang
BACKGROUND: To assess the influence of combined intracoronary application of high-dose adenosine and tirofiban in primary percutaneous coronary intervention (PCI) on clinical events and cardiac function. METHODS: Our study evaluated consecutive patients with acute ST-segment elevation myocardial infarction undergoing primary PCI, who were randomly divided into adenosine group (n = 130) and control group (n = 128). Combined with thrombus aspiration and then intracoronary tirofiban, the adenosine group received intracoronary adenosine (2 mg) through the aspiration catheter 2 times...
November 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27898505/clinical-role-of-post-angioplasty-hyperemic-microvascular-resistances-in-chronic-ischemic-left-ventricular-dysfunction
#8
Riccardo Gorla, Edoardo Verna, Simone Scotti, Sergio Ghiringhelli, Laura Zoli, Stefano Provasoli, Silvana Garancini, Roberto De Ponti, Jorge A Salerno-Uriarte
AIMS: To investigate the impact of hyperemic microvascular resistances (HMRs) on myocardial perfusion and contractility after percutaneous coronary intervention (PCI) in chronic ischemic left ventricular dysfunction (CILVD). METHODS: The current retrospective study included 48 patients with CILVD of the left anterior descending territory undergoing HMRs assessment before and after PCI with a dual-sensor intracoronary pressure-flow wire. The severity of resting myocardial underperfusion and contractile dysfunction of the left anterior descending territory was scored as summed rest score (SRS-T) by single photon emission tomography, wall motion score index (WMSI-T) and left ventricular ejection fraction (LVEF) by transthoracic echocardiography before PCI and after 3 months...
November 24, 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/27894949/intravascular-hemodynamics-and-coronary-artery-disease-new-insights-and-clinical-implications
#9
REVIEW
Marina Zaromytidou, Gerasimos Siasos, Ahmet U Coskun, Michelle Lucier, Antonios P Antoniadis, Michail I Papafaklis, Konstantinos C Koskinas, Yannis Andreou, Charles L Feldman, Peter H Stone
Understanding of the pathophysiological mechanisms is the cornerstone of preventive and treatment strategies in the battle against coronary artery disease. Hyperlipidemia, arterial hypertension, smoking and diabetes, are established risk factors affecting coronary vasculature. However, the focal formation of atherosclerotic lesions in certain arterial regions underscores that local factors are implicated in the initiation and progression of atherosclerosis. Introduction of novel imaging modalities and technological advances offered new insights and acknowledged intravascular hemodynamics, and particularly flow-derived endothelial shear stress as a critical factor in the natural history of coronary artery disease...
November 25, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/27891513/clinic-predictive-factors-for-insufficient-myocardial-reperfusion-in-st-segment-elevation-myocardial-infarction-patients-treated-with-selective-aspiration-thrombectomy-during-primary-percutaneous-coronary-intervention
#10
Jinfan Tian, Yue Liu, Xiantao Song, Min Zhang, Feng Xu, Fei Yuan, Shuzheng Lyu
Background. Insufficient data are available on the potential benefit of selective aspiration and clinical predictors for no-reflow in STEMI patients undergoing primary percutaneous coronary intervention (PPCI) adjunct with aspiration thrombectomy. Objective. The aim of our study was to investigate clinical predictors for insufficient reperfusion in patients with high thrombus burden treated with PPCI and manual aspiration thrombectomy. Methods. From January 2011 till December 2015, 277 STEMI patients undergoing manual aspiration thrombectomy and PPCI were selected and 202 patients with a Thrombolysis in Myocardial Infarction (TIMI) thrombus grade 4~5 were eventually involved in our study...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27881555/recurrent-hospitalization-among-patients-with-atrial-fibrillation-undergoing-intracoronary-stenting-treated-with-2-treatment-strategies-of-rivaroxaban-or-a-dose-adjusted-oral-vitamin-k-antagonist-treatment-strategy
#11
C Michael Gibson, Duane S Pinto, Gerald Chi, Douglas Arbetter, Megan Yee, Roxana Mehran, Christoph Bode, Jonathan Halperin, Freek W A Verheugt, Peter Wildgoose, Paul Burton, Martin van Eickels, Serge Korjian, Yazan Daaboul, Purva Jain, Gregory Y H Lip, Marc Cohen, Eric D Peterson, Keith A A Fox
BACKGROUND: -Patients with atrial fibrillation who undergo intracoronary stenting traditionally are treated with a vitamin K antagonist (VKA) plus dual antiplatelet therapy (DAPT), yet this treatment leads to high risks of bleeding. We hypothesized that a regimen of rivaroxaban plus a P2Y12 inhibitor monotherapy or rivaroxaban plus DAPT could reduce bleeding and thereby have a favorable impact on all-cause mortality and the need for rehospitalization. METHODS: -Stented subjects with nonvalvular atrial fibrillation (n=2124) were randomized 1:1:1 to administration of reduced-dose rivaroxaban 15 mg daily plus a P2Y12 inhibitor for 12 months (group 1); rivaroxaban 2...
November 14, 2016: Circulation
https://www.readbyqxmd.com/read/27873500/impact-of-diltiazem-alone-versus-diltiazem-with-nitrate-on-five-year-clinical-outcomes-in-patients-with-significant-coronary-artery-spasm
#12
Taeshik Park, Ji Young Park, Seung Woon Rha, Hong Seog Seo, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Sang Ho Park, Eun Jin Park, Jah Yeon Choi, Sung Hun Park, Jae Joong Lee, Sunki Lee, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu Park, Dong Joo Oh
PURPOSE: Calcium channel blockers diltiazem and nitrate have been used as selective coronary vasodilators for patients with significant coronary artery spasm (CAS). However, no study has compared the efficacy of diltiazem alone versus diltiazem with nitrate for long-term clinical outcomes in patients with CAS. MATERIALS AND METHODS: A total of 2741 consecutive patients without significant coronary artery disease with positive CAS by acetylcholine (Ach) provocation test between November 2004 and May 2014 were enrolled...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27873006/feasibility-of-omitting-provocation-test-with-50%C3%A2-%C3%AE-g-of-acetylcholine-in-left-coronary-artery
#13
Yuichi Saito, Hideki Kitahara, Toshihiro Shoji, Satoshi Tokimasa, Takashi Nakayama, Kazumasa Sugimoto, Yoshihide Fujimoto, Yoshio Kobayashi
According to the Japanese Circulation Society guideline of vasospastic angina, incremental doses of acetylcholine (ACh) are prescribed for coronary spasm provocation: 20 and 50 μg for the right coronary artery (RCA), and 20, 50 and 100 μg for the left coronary artery (LCA). However, provocation by low doses of ACh in patients with low vasoreactivity may be less needed, and the requirement of 50 μg of ACh for the LCA in these patients has not been evaluated. In the present study, patients who underwent ACh provocation test for both the RCA and LCA were included...
November 21, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27853102/cardiac-safety-profile-of-sildenafil-chronotropic-inotropic-and-coronary-vasodilator-effects-in-the-canine-isolated-blood-perfused-heart-preparations
#14
Nur Jaharat Lubna, Yuji Nakamura, Xin Cao, Takeshi Wada, Hiroko Izumi-Nakaseko, Kentaro Ando, Atsushi Sugiyama
Sildenafil is a phosphodiesterase type-5 inhibitor. We evaluated the effects of sildenafil on the sinoatrial rate, developed tension of the papillary muscle and coronary blood flow by using the canine isolated, blood-perfused sinoatrial node and papillary muscle preparations. The former preparation had a regular automaticity rate of 106 ± 1 beats/min (n = 4), whereas the latter showed a developed tension of 22 ± 4 mN (n = 4) and a coronary blood flow of 3.9 ± 0.1 mL/min (n = 4). Intracoronary injection of 10, 30 and 100 µg of sildenafil, which would provide about 20 to 200 times higher plasma drug concentrations than its therapeutic level, increased the automaticity rate by 4, 12 and 22%, the developed tension by 19, 55 and 118% and the coronary blood flow by 42, 95 and 142%, respectively...
2016: Journal of Toxicological Sciences
https://www.readbyqxmd.com/read/27844422/intracoronary-eptifibatide-during-primary-percutaneous-coronary-intervention-in-early-versus-late-presenters-with-st-segment-elevation-myocardial-infarction-a-randomized-trial
#15
Ayman Elbadawi, Gerald Gasioch, Islam Y Elgendy, Ahmed N Mahmoud, Le Dung Ha, Haitham Al Ashry, Hend Shahin, Mohamed A Hamza, Ahmed S Abuzaid, Marwan Saad
INTRODUCTION: The role of intracoronary (IC) eptifibatide in primary percutaneous coronary intervention (PPCI) for ST segment elevation myocardial infarction (STEMI) and whether time of patient presentation affects this role are unclear. We sought to evaluate the benefit of IC eptifibatide use during primary PCI in early STEMI presenters compared to late STEMI presenters. METHODS: We included 70 patients who presented with STEMI and were eligible for PPCI. On the basis of symptom-to-door time, patients were classified into two arms: early (<3 h, n = 34) vs late (≥3 h, n = 36) presenters...
November 14, 2016: Cardiology and Therapy
https://www.readbyqxmd.com/read/27843802/coronary-ectasia-in-a-man-on-breast-cancer-therapy-presenting-with-acute-coronary-syndrome
#16
Dana C Johnson, Luay Rifai, Parag V Patel
Limited data exist on the association between breast cancer treatments and coronary artery disease anatomy, particularly in males. We describe an unusual case of diffuse coronary ectasia in a man with breast cancer presenting with acute coronary syndrome (ACS). A 66-year-old man with breast cancer on paclitaxel, tamoxifen, and carboplatin chemotherapy regimen, presents with new onset chest pain. Electrocardiogram reveals anterolateral ST-segment depressions and elevated troponin I level. Emergent angiography revealed grossly ectatic coronary arteries with a total thrombotic occlusion of the mid right coronary artery...
October 2016: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/27836374/inflammatory-cell-content-of-coronary-thrombi-is-dependent-on-thrombus-age-in-patients-with-st-elevation-myocardial-infarction
#17
Wessel W Fuijkschot, Wouter E Groothuizen, Yolande Appelman, Teodora Radonic, Niels van Royen, Maarten A H van Leeuwen, Paul A J Krijnen, Allard C van der Wal, Yvo M Smulders, Hans W M Niessen
BACKGROUND: ST-elevation myocardial infarction (STEMI) is typically caused by an occlusive coronary thrombus. The process of intracoronary thrombus formation is poorly understood. It is known that inflammatory cells play a role in the formation and resolution of venous thrombi, however their role in coronary thrombosis is not clear. We therefore analyzed inflammatory cells in thrombi derived from patients with STEMI in relation to histologically classified thrombus age. METHODS: Thrombus aspirates of 113 patients treated with primary percutaneous coronary intervention were prospectively collected and classified (fresh, lytic, or organized) based on hematoxylin and eosin staining...
November 8, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27832796/antecedent-hypertension-and-myocardial-injury-in-patients-with-reperfused-st-elevation-myocardial-infarction
#18
Sebastian J Reinstadler, Thomas Stiermaier, Charlotte Eitel, Mohammed Saad, Bernhard Metzler, Suzanne de Waha, Georg Fuernau, Steffen Desch, Holger Thiele, Ingo Eitel
BACKGROUND: Antecedent hypertension is associated with poor outcome in patients with ST-elevation myocardial infarction (STEMI). Whether differences in myocardial salvage, infarct size and microvascular injury contribute to the adverse outcome is unknown. We investigated the association between antecedent hypertension and cardiovascular magnetic resonance (CMR) parameters of myocardial salvage and damage in a multicenter CMR substudy of the AIDA-STEMI trial (Abciximab Intracoronary versus intravenously Drug Application in ST-elevation myocardial infarction)...
November 11, 2016: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/27830336/optical-coherence-tomography-influence-of-contrast-concentration-on-image-quality-and-diagnostic-confidence
#19
Florian Blachutzik, Stephan Achenbach, Holger Nef, Christian Hamm, Oliver Dörr, Niklas Boeder, Mohamed Marwan, Monique Tröbs, Reinhard Schneider, Jens Röther, Christian Schlundt
OCT requires intracoronary injection of contrast agent to remove blood from the coronary lumen during data acquisition, which is a possible limitation of this method. Aim of this study was to analyze the influence of iodine concentration on image quality and diagnostic certainty of optical coherence tomography (OCT). OCT sequences acquired using contrast agent with a reduced concentration of 150 mg iodine/ml and a standard concentration of 350 mg iodine/ml were analyzed. Cross-sectional images with a spacing of 10 mm were evaluated regarding image quality and diagnostic confidence...
November 9, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27821823/-new-intracoronary-shunt-cannula-in-off-pump-coronary-artery-bypass-grafting
#20
Masaki Tabuchi, Ryo Harada, Akitatsu Yamashita, Seiichi Funamoto, Kazutoshi Tachibana, Yasuko Miyaki, Nobuyuki Takagi, Shinya Terada, Daisuke Toritsuka, Akihiko Yamauchi, Tetsuya Higami
In off-pump coronary artery bypass grafting(OPCAB), a bloodless operative field has great influence on the quality of anastomosis. In addition, maintenance of distal coronary flow during anastomosis stabilizes hemodynamics. We introduced a new intracoronary shunt cannula, Mini Shunt Pro (MSP). MSP adopts the step-tip, which allows easy insertion and reduces the risk of intimal injury. The distal and proximal sides of the tips of MSP are 0.25 mm different in diameter, which improves its fitness to the coronary artery and enhances a bloodless operative field...
November 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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