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myocardial infarction with normal coronary artery

Basmah Safdar, Gail D'Onofrio, James Dziura, Raymond R Russell, Caitlin Johnson, Albert J Sinusas
AIMS: Coronary microvascular dysfunction (CMD) is common in patients with non-obstructive coronary arteries but has not been described in low-risk symptomatic patients. We therefore assessed the prevalence and characteristics of CMD in low to moderate risk patients with chest pain in an emergency department. METHODS AND RESULTS: We used three-dimensional Rb82 cardiac positron emission tomography/computed tomography to diagnose coronary artery disease (known or new regional defect, any coronary calcification) and CMD (low coronary flow reserve without coronary artery disease) in chest pain patients after being ruled out for acute myocardial infarction...
March 1, 2018: European Heart Journal. Acute Cardiovascular Care
Uma Mahesh R Avula, Jonathan J Hernandez, Masatoshi Yamazaki, Carmen R Valdivia, Antony Chu, Alvaro Rojas-Pena, Kuljeet Kaur, Roberto Ramos-Mondragón, Justus M Anumonwo, Stanley Nattel, Héctor H Valdivia, Jérôme Kalifa
BACKGROUND: The mechanisms underlying spontaneous atrial fibrillation (AF) associated with atrial ischemia/infarction are incompletely elucidated. Here, we investigate the mechanisms underlying spontaneous AF in an ovine model of left atrial myocardial infarction (LAMI). METHODS AND RESULTS: LAMI was created by ligating the atrial branch of the left anterior descending coronary artery. ECG loop recorders were implanted to monitor AF episodes. In 7 sheep, dantrolene-a ryanodine receptor blocker-was administered in vivo during the 8-day observation period (LAMI-D, 2...
March 2018: Circulation. Arrhythmia and Electrophysiology
Naser Ahmadi, Fereshteh Hajsadeghi, Vahid Nabavi, Garth Olango, Mohammed Molla, Matthew Budoff, Nutan Vaidya, Javier Quintana, Robert Pynoos, Peter Hauser, Rachel Yehuda
OBJECTIVE: Coronary-distensibility-index (CDI) impairments reflect endothelial-dependent process associated with vulnerable-plaque composition. This study investigates the relation of impaired-CDI with posttraumatic-stress-disorder (PTSD) and their predictive value for major-adverse-cardiovascular events (MACE). METHODS: This study involved 246 patients (age: 63±10 years, 12% women) with (n=50) and without (n=196) PTSD, who underwent computed-tomography angiography (CTA) to determine coronary artery disease (CAD) and CDI...
March 14, 2018: Psychosomatic Medicine
Sourabh Aggarwal, Feng Xie, Robin High, Gregory Pavlides, Thomas R Porter
BACKGROUND: Although microvascular flow abnormalities have been observed following epicardial recanalization in acute ST-segment elevation myocardial infarction (STEMI), the prevalence and severity of these abnormalities in the current era of rapid percutaneous coronary intervention (PCI) has not been evaluated. The objective of this study was to assess microvascular perfusion (MVP) following successful primary PCI in patients with STEMI and how it affects clinical outcome. METHODS: In this single-center, retrospective study, 170 patients who successfully underwent emergent PCI for STEMI were assessed using real-time myocardial contrast echocardiography using a continuous infusion of intravenous commercial microbubbles (3% Definity)...
March 7, 2018: Journal of the American Society of Echocardiography
Alexander Liu, Rohan S Wijesurendra, Joanna M Liu, John C Forfar, Keith M Channon, Michael Jerosch-Herold, Stefan K Piechnik, Stefan Neubauer, Rajesh K Kharbanda, Vanessa M Ferreira
BACKGROUND: In patients with angina and nonobstructive coronary artery disease (NOCAD), confirming symptoms due to coronary microvascular dysfunction (CMD) remains challenging. Cardiac magnetic resonance (CMR) assesses myocardial perfusion with high spatial resolution and is widely used for diagnosing obstructive coronary artery disease (CAD). OBJECTIVES: The goal of this study was to validate CMR for diagnosing microvascular angina in patients with NOCAD, compared with patients with obstructive CAD and correlated to the index of microcirculatory resistance (IMR) during invasive coronary angiography...
March 6, 2018: Journal of the American College of Cardiology
Alexander Liu, Rohan S Wijesurendra, Joanna M Liu, Andreas Greiser, Michael Jerosch-Herold, John C Forfar, Keith M Channon, Stefan K Piechnik, Stefan Neubauer, Rajesh K Kharbanda, Vanessa M Ferreira
BACKGROUND: Novel cardiac magnetic resonance (CMR) stress T1 mapping can detect ischemia and myocardial blood volume changes without contrast agents and may be a more comprehensive ischemia biomarker than myocardial blood flow. OBJECTIVES: This study describes the performance of the first prospective validation of stress T1 mapping against invasive coronary measurements for detecting obstructive epicardial coronary artery disease (CAD), defined by fractional flow reserve (FFR <0...
March 6, 2018: Journal of the American College of Cardiology
C P Ma, X L Liu, Q S Wang, S P Nie
Objective: To develop and prospectively validate a risk score for acute chest pain patients with normal high-sensitivity troponin I (hs-TnI) levels and without obvious ST-segment deviation in China. Methods: Chest pain patients admitted to the emergency department of Beijing Anzhen Hospital from September 2014 to July 2015 were enrolled. Baseline characteristics of patients met inclusion criteria including normal hs-TnI levels and without obvious ST-segment deviation were included. The endpoint (major adverse cardiovascular events) was a composite of acute myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, and all-cause death within 3 months after initial presentation...
February 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Ludovic Melly, Giulia Cerino, Aurélien Frobert, Stéphane Cook, Marie-Noëlle Giraud, Thierry Carrel, Hendrik T Tevaearai Stahel, Friedrich Eckstein, Benoît Rondelet, Anna Marsano, Andrea Banfi
Vascular Endothelial Growth Factor (VEGF) can induce normal or aberrant angiogenesis depending on the amount secreted in the microenvironment around each cell. Towards a possible clinical translation, we developed a Fluorescence Activated Cell Sorting (FACS)-based technique to rapidly purify transduced progenitors that homogeneously express a desired specific VEGF level from heterogeneous primary populations. Here, we sought to induce safe and functional angiogenesis in ischaemic myocardium by cell-based expression of controlled VEGF levels...
February 25, 2018: Journal of Cellular and Molecular Medicine
Ayman Samman Tahhan, Pratik Sandesara, Salim S Hayek, Muhammad Hammadah, Ayman Alkhoder, Heval M Kelli, Matthew Topel, Wesley T O'Neal, Nima Ghasemzadeh, Yi-An Ko, Mohamad Mazen Gafeer, Naser Abdelhadi, Fahad Choudhary, Keyur Patel, Agim Beshiri, Gillian Murtagh, Jonathan Kim, Peter Wilson, Leslee Shaw, Viola Vaccarino, Stephen E Epstein, Laurence Sperling, Arshed A Quyyumi
BACKGROUND: The associations between high-sensitivity troponin I (hsTnI) levels and coronary artery disease (CAD) severity and progression remain unclear. We investigated whether there is an association between hsTnI and angiographic severity and progression of CAD and whether the predictive value of hsTnI level for incident cardiovascular outcomes is independent of CAD severity. METHODS AND RESULTS: In 3087 patients (aged 63±12 years, 64% men) undergoing cardiac catheterization without evidence of acute myocardial infarction, the severity of CAD was calculated by the number of major coronary arteries with ≥50% stenosis and the Gensini score...
February 21, 2018: Journal of the American Heart Association
G Demircan, O Kaplan, S B Ozdas
OBJECTIVE: In this study, we measured the level of autophagy enzyme in patients with coronary artery disease (CAD) and investigated whether the role of autophagy existed in the progress of coronary collateral and coronary total occlusion (TO). METHODS: Overall, 115 participants were included in this study. They were divided into the three groups: group 1: patients had chronic TO (n=49); group 2: patients had acute TO such as myocardial infarction (n=36); and group 3: participants were normal controls (n=30)...
2018: Bratislavské Lekárske Listy
Hu Zhai, Wenyi Dai, Yu Wang
This study investigated the protective effect of metoprolol on cardiomyocytes in rabbits with heart failure and its possible mechanism. Sixty New Zealand white rabbits were randomly divided into infarction group and non-infarction group, 30 in each group. Myocardial infarction was constructed by ligation of anterior descending branch of coronary artery. Coronary artery threading without ligation after thoracotomy was performed for rabbits in non-infarction group. After model construction, rabbits in each group were further divided into control group (n=15) and metoprolol group (n=15), and fed with normal diet and normal diet + metoprolol...
February 2018: Experimental and Therapeutic Medicine
Andreas Boening, Lena Assling-Simon, Martina Heep, Kerstin Boengler, Bernd Niemann, Philippe Grieshaber
BACKGROUND: In patients undergoing surgical myocardial revascularization for acute myocardial infarction, excellent myocardial protection can be achieved by blood cardioplegia. We investigated the influence of age on cardiac function, metabolism, and infarct size using Buckberg's blood cardioplegia (BCP). METHODS: The hearts of male Wistar rats ("adult", age 3 months, n = 8; "senile", age 24 months, n = 8) were excised and mounted on a blood-perfused isolated heart apparatus...
February 10, 2018: Experimental Gerontology
Safoora Pordel, Mahdi Sajedi Khanian, Mohammad Hossein Karimi, Hossein Nikoo, Mehrnoosh Doroudchi
BACKGROUND: IL-17A plays an important role in inflammatory responses in myocardial infarction (MI). IL-17A signals through its receptor, for which, Act1 (TRAF3IP2) functions as a key upstream adaptor in the pathway. AIM: To compare frequencies of functional polymorphisms of TRAF3IP2 (rs13210247, rs33980500) between patients with MI and healthy controls. METHODS: The selected SNPs were studied in 201 Iranian MI patients and 201 healthy blood donors from Fars Province by PCR-RFLP in association with clinicopathologic criteria of patients...
February 12, 2018: Journal of Clinical Laboratory Analysis
David F Miranda, Angie S Lobo, Brooks Walsh, Yader Sandoval, Stephen W Smith
The 12-lead electrocardiogram (ECG) remains the most immediately accessible and widely used initial diagnostic tool for guiding management in patients with suspected myocardial infarction (MI). Although the development of high-sensitivity cardiac troponin assays has improved the rule-in and rule-out and risk stratification of acute MI without ST elevation, the immediate management of the subset of acute MI with acute coronary occlusion depends on integrating clinical presentation and ECG findings. Careful interpretation of the ECG might yield subtle features suggestive of ischemia that might facilitate more rapid triage of patients with subtle acute coronary occlusion or, conversely, in identification of ST-elevation MI mimics (pseudo ST-elevation MI patterns)...
February 2018: Canadian Journal of Cardiology
Abdullah Haddad, Triston Smith, Aneel Bole, Moneal Shah, Mithun Chakravarthy
Kounis syndrome defined as the occurrence of acute coronary syndrome in the setting of allergic reaction due to mast cells activation and inflammatory mediators release that induces coronary vasospasm, plaque erosion, or even stent thrombosis. A 25-year-old postpartum female with asthma and recurrent episodes of chest pain was admitted with ST-segment elevation myocardial infarction in the setting of coronary artery spasms. The patient was started on calcium channel blockers and nitrite-based medication with no improvement...
January 2018: Avicenna Journal of Medicine
Pia Hedegaard Johnsen, Martin Berg Johansen, Svend Eggert Jensen
Ischaemic heart disease (IHD) is the leading cause of mortality in the Western world. Therefore, to focus on those at risk of having IHD while at the same time avoiding unnecessary patient concern, it is important to have diagnostic tools capable of refuting an IHD diagnosis. Within the past 30 years, myocardial perfusion imaging (MPI) has been used increasingly to detect myocardial perfusion defects. MPI is a safe and non-invasive method with a sensitivity and specificity of > 90%. The aim of this study was to evaluate the long-term prognostic outcome after a normal MPI...
February 2018: Danish Medical Journal
Shinya Yamada, Man-Cai Fong, Ya-Wen Hsiao, Shih-Lin Chang, Yung-Nan Tsai, Li-Wei Lo, Tze-Fan Chao, Yenn-Jiang Lin, Yu-Feng Hu, Fa-Po Chung, Jo-Nan Liao, Yao-Ting Chang, Hsing-Yuan Li, Satoshi Higa, Shih-Ann Chen
BACKGROUND: Myocardial infarction increases the risk of heart failure (HF) and atrial fibrillation. Renal denervation (RDN) might suppress the development of atrial remodeling. This study aimed to elucidate the molecular mechanism of RDN in the suppression of atrial fibrillation in a HF model after myocardial infarction. METHODS AND RESULTS: HF rabbits were created 4 weeks after coronary ligation. Rabbits were classified into 3 groups: normal control (n=10), HF (n=10), and HF-RDN (n=6)...
January 22, 2018: Journal of the American Heart Association
Sayna Matinrazm, Adetola Ladejobi, Deepak Kumar Pasupula, Awais Javed, Asad Durrani, Shahzad Ahmad, Muhammad Bilal Munir, Evan Adelstein, Sandeep K Jain, Samir Saba
BACKGROUND: Although elevated body mass index (BMI) is a risk factor for cardiac disease, patients with elevated BMI have better survival in the context of severe illness, a phenomenon termed the "obesity paradox." HYPOTHESIS: Higher BMI is associated with lower mortality in sudden cardiac arrest (SCA) survivors. METHODS: Data were collected on 1433 post-SCA patients, discharged alive from the hospitals of the University of Pittsburgh Medical Center between 2002 and 2012...
January 22, 2018: Clinical Cardiology
Halla Malik, Nadarajah Kangaharan, Ian Agahari
Background: Takotsubo cardiomyopathy (TC) is a condition of transient left ventricular dysfunction precipitated by acute physical or emotional stress. The pathogenesis of TC is not well understood, but it is known to predominantly affect postmenopausal women in the context of physical or emotional triggers. Aims: To describe a case of TC with an association to a never previously described work place stressor of bullying. Case Report: A 48-year-old female lawyer developed acute chest pain after experiencing significant emotional distress at a workplace meeting...
February 16, 2018: Occupational Medicine
Hiroshi Wakabayashi, Junichi Taki, Anri Inaki, Tomo Hiromasa, Koichi Okuda, Takayuki Shibutani, Kazuhiro Shiba, Seigo Kinuya
PURPOSE: Ultra-high resolution single-photon emission computed tomography (SPECT) system, using multiple pinhole collimators, has been applied to the imaging of small rodents. We aimed to compare the myocardial infarction (MI) area on quantitative perfusion single-photon emission computed tomography (QPS; Cedars-Sinai Medical Center, USA) with that on high-resolution autoradiography in rat model to determine the accuracy of perfusion defect measurement by QPS. PROCEDURES: After thoracotomy, rats (n = 9) had their left coronary arteries occluded and reperfused before injection with 185 MBq [99mTc] methoxyisobutylisonitrile ([99mTc]MIBI) for SPECT and autoradiography...
January 16, 2018: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
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