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https://www.readbyqxmd.com/read/28296641/root-cause-analysis-of-deaths-in-st-segment-elevation-myocardial-infarctions-treated-with-primary-pci-what-can-we-do-better
#1
Fredy El Sakr, Mohamad Kenaan, Daniel Menees, Milan Seth, Hitinder S Gurm
OBJECTIVE: Recent data demonstrate that mortality of patients with ST-elevation myocardial infarction (STEMI) has not changed despite dramatic reduction in door-to-balloon times. Identifying potential areas in care that can be further optimized to decrease mortality remains a priority. METHODS: We performed a root cause analysis of all patients who died following primary percutaneous coronary intervention (PCI) during index hospitalization from 2008 to 2013 at the University of Michigan...
March 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28209739/myocardial-ischemic-tolerance-in-rats-subjected-to-endurance-exercise-training-during-adaptation-to-chronic-hypoxia
#2
Petra Alánová, Anna Chytilová, Jan Neckář, Jaroslav Hrdlička, Petra Míčová, Kristýna Holzerová, Markéta Hlaváčková, Kristýna Macháčková, František Papoušek, Jana Vašinová, Daniel Benák, Olga Nováková, František Kolář
Chronic hypoxia and exercise are natural stimuli that confer sustainable cardioprotection against ischemia/reperfusion (I/R) injury but it is unknown whether they can act in synergy to enhance ischemic resistance. Inflammatory response mediated by tumor necrosis factor-α (TNF-α) plays a role in the infarct size-limitation by continuous normobaric hypoxia (CNH) whereas exercise is associated with anti-inflammatory effects. This study was conducted to determine whether exercise training performed under conditions of CNH (12% O2) affects myocardial ischemic resistance with respect to inflammatory and redox status...
February 16, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28116675/anesthetic-considerations-for-patients-with-esophageal-achalasia-undergoing-peroral-endoscopic-myotomy-a-retrospective-case-series-review
#3
Benjamin Löser, Yuki B Werner, Mark A Punke, Bernd Saugel, Sebastian Haas, Daniel A Reuter, Oliver Mann, Anna Duprée, Guido Schachschal, Thomas Rösch, Martin Petzoldt
PURPOSE: Peroral endoscopic myotomy (POEM) is a novel technique for treating esophageal achalasia. During POEM, carbon dioxide (CO2) is insufflated to aid surgical dissection, but it may inadvertently track into surrounding tissues, causing systemic CO2 uptake and tension capnoperitoneum. This in turn may affect cardiorespiratory function. This study quantified these cardiorespiratory effects and treatment by hyperventilation and percutaneous abdominal needle decompression (PND). METHODS: One hundred and seventy-three consecutive patients who underwent POEM were included in this four-year retrospective study...
January 23, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28109967/subclavian-artery-disease-diagnosis-and-therapy
#4
REVIEW
Tisa Saha, Syed Yaseen Naqvi, Omar Abine Ayah, Daniel McCormick, Sheldon Goldberg
The diagnosis of brachiocephalic disease is often overlooked. Symptoms include arm claudication and vertebrobasilar insufficiency. In patients who have had the use of the internal mammary artery for coronary bypass surgery, the development of symptoms of myocardial ischemia should alert the clinician to the possibility of subclavian artery stenosis. Also, in patients who have had axillofemoral bypass, lower-extremity claudication may occur. Recognition involves physical examination and accurate noninvasive testing...
January 19, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28090786/inorganic-nitrite-modulates-mirna-signatures-in-acute-myocardial-in-vivo-ischemia-reperfusion
#5
Ulrike B Hendgen-Cotta, Daniel Messiha, Sonja Esfeld, René Deenen, Tienush Rassaf, Matthias Totzeck
Acute myocardial infarction is the leading cause of mortality in the industrialized world. While it is essential to attempt an early reperfusion of ischemic myocardial territories, reperfusion itself adds damage to the heart, the ischemia-reperfusion (I/R) injury. Particularly the injury resulting from the very first minutes of reperfusion remains incompletely understood. MicroRNAs (miRNAs) are dynamic regulators in I/R injury. Nitric oxide (•NO) signaling, in turn, interacts with miRNA signaling. Our previous investigations showed that •NO signaling in I/R could be modulated by nitrite...
January 2017: Free Radical Research
https://www.readbyqxmd.com/read/28081214/cold-pressor-stress-cardiac-magnetic-resonance-myocardial-flow-reserve-is-not-useful-for-detection-of-coronary-endothelial-dysfunction-in-women-with-signs-and-symptoms-of-ischemia-and-no-obstructive-cad
#6
Sofy Landes, Sherwin Dela Cruz, Janet Wei, Ahmed AlBadri, Chrisandra Shufelt, Puja Mehta, Louise E Thomson, Marcio A Diniz, Xiao Zhang, John W Petersen, R David Anderson, Carl J Pepine, Daniel S Berman, C Noel Bairey Merz
BACKGROUND: Coronary endothelial function testing using acetylcholine is not routinely available, while non-pharmacological cold pressor testing (CPT) is considered an endothelial stressor. Noninvasive cardiac magnetic resonance imaging (CMRI) myocardial perfusion reserve index (MPRI) can detect coronary microvascular dysfunction (CMD). We evaluated if CPT stress CMRI MPRI could detect invasive coronary endothelial dysfunction. METHODS: Coronary reactivity testing was performed in 189 women with symptoms and signs of ischemic but no obstructive coronary artery disease as previously described plus CPT stress...
2017: PloS One
https://www.readbyqxmd.com/read/28025263/quantitative-plaque-features-from-coronary-computed-tomography-angiography-to-identify-regional-ischemia-by-myocardial-perfusion-imaging
#7
Mariana Diaz-Zamudio, Tobias A Fuchs, Piotr Slomka, Yuka Otaki, Reza Arsanjani, Heidi Gransar, Guido Germano, Daniel S Berman, Philipp A Kaufmann, Damini Dey
AIMS: We aimed to investigate whether quantitative plaque features measured from coronary CT angiography (CCTA) predict ischemia by myocardial perfusion SPECT imaging (MPI). METHODS AND RESULTS: Hundred and eighty-four consecutive patients (63% males) with suspected-coronary artery disease, undergoing hybrid CCTA, and attenuation corrected solid state (99m)Tc stress/rest MPI and single vessel ischemia were considered. Quantitative analysis of CCTA derived non-calcified plaque (NCP), low-density NCP [< 30 Hounsfield Units (HU)] (LDNCP), calcified and total plaque burdens (%, normalized to vessel volume), maximum diameter stenosis and contrast density difference (CD, maximum difference in HU/lumen area within lesion)...
December 26, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/27993119/pathophysiology-of-myocardial-infarction-and-acute-management-strategies
#8
Daniel Petrovič, Miha Tibaut, Dušan Mekiš
Yearly, 13,2% of all deaths are attributable to coronary artery disease (CAD), which with 7.4 million deaths makes CAD leading cause of death in the world. In this review we discuss current knowledge in pathophysiology of atherosclerosis with its progression to stable CAD and its destabilization and complication with thrombus formation - myocardial infarction (MI). Next, we describe mechanisms of myocardial cell death in MI, ischemia-reperfusion injury, left-ventricular remodeling and complications of MI. Furthermore, we add acute management strategies concentrating on medical therapy, decision on reperfusion strategy, timing and cardiac protection by ischemic preconditioning, postconditioning and remote ischemic conditioning...
December 15, 2016: Cardiovascular & Hematological Agents in Medicinal Chemistry
https://www.readbyqxmd.com/read/27940009/no-protection-of-heart-kidneys-and-brain-by-remote-ischemic-preconditioning-before-transfemoral-transcatheter-aortic-valve-implantation-interim-analysis-of-a-randomized-single-blinded-placebo-controlled-single-center-trial
#9
Philipp Kahlert, Heike Annelie Hildebrandt, Polykarpos Christos Patsalis, Fadi Al-Rashid, Rolf Alexander Jánosi, Felix Nensa, Thomas Wilfried Schlosser, Marc Schlamann, Daniel Wendt, Matthias Thielmann, Eva Kottenberg, Ulrich Frey, Markus Neuhäuser, Michael Forsting, Heinz Günther Jakob, Tienush Rassaf, Jürgen Peters, Gerd Heusch, Petra Kleinbongard
BACKGROUND: Remote ischemic preconditioning (RIPC) reduces myocardial injury and improves clinical outcome in patients undergoing coronary revascularization, but only in the absence of propofol-anesthesia. We investigated whether RIPC provides protection of heart, kidneys and brain and improves outcome in patients undergoing transfemoral transcatheter aortic valve implantation (TF-TAVI). METHODS: Patients undergoing TF-TAVI were randomized to receive RIPC (3cycles of 5min left upper arm ischemia and 5min reperfusion) or placebo...
March 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27885445/limited-ventricular-preload-is-the-main-reason-for-reduced-stress-reserve-after-atrial-baffle-repair
#10
Andreas Eicken, Julia Michel, Alfred Hager, Daniel Tanase, Harald Kaemmerer, Julie Cleuziou, John Hess, Peter Ewert
The atrial baffle repair (ABR) significantly improved the fate of patients with transposition of the great arteries (TGA). However, these patients show impaired exercise tolerance and some present severe decline of systemic ventricular function. Intrinsic myocardial weakness, low heart rate response to exercise and diastolic filling impairment are discussed to be causative. Forty-nine long-term survivors with TGA (median age 23.7 year) after ABR were catheterized with measured oxygen consumption in four conditions (baseline, volume, atrial pacing, dobutamine) and the results were compared to 10 normal controls...
November 24, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27847563/randomized-controlled-trial-of-remote-ischemic-preconditioning-and-atrial-fibrillation-in-patients-undergoing-cardiac-surgery
#11
Amir S Lotfi, Hossein Eftekhari, Auras R Atreya, Ananth Kashikar, Senthil K Sivalingam, Miguel Giannoni, Paul Visintainer, Daniel Engelman
AIM: To study whether remote ischemic preconditioning (RIPC) has an impact on clinical outcomes, such as post-operative atrial fibrillation (POAF). METHODS: This was a prospective, single-center, single-blinded, randomized controlled study. One hundred and two patients were randomized to receive RIPC (3 cycles of 5 min ischemia and 5 min reperfusion in the upper arm after induction of anesthesia) or no RIPC (control). Primary outcome was POAF lasting for five minutes or longer during the first seven days after surgery...
October 26, 2016: World Journal of Cardiology
https://www.readbyqxmd.com/read/27832901/cmr-first-pass-perfusion-for-suspected-inducible-myocardial-ischemia
#12
REVIEW
Robert C Hendel, Matthias G Friedrich, Jeanette Schulz-Menger, Claudia Zemmrich, Frank Bengel, Daniel S Berman, Paolo G Camici, Scott D Flamm, Dominique Le Guludec, Raymond Kim, Massimo Lombardi, John Mahmarian, Udo Sechtem, Eike Nagel
Cardiovascular magnetic resonance (CMR) has evolved from a pioneering research tool to an established noninvasive imaging method for detecting inducible myocardial perfusion deficits. In this consensus document, experts of different imaging techniques summarize the existing body of evidence regarding CMR perfusion as a viable complement to other established noninvasive tools for the assessment of perfusion and discuss the advantages and pitfalls of the technique. A rapid, standardized CMR perfusion protocol is described, which is safe, clinically feasible, and cost-effective for centers with contemporary magnetic resonance equipment...
November 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27804072/long-term-prognostic-value-of-coronary-artery-calcium-scanning-coronary-computed-tomographic-angiography-and-stress-myocardial-perfusion-imaging-in-patients-with-suspected-coronary-artery-disease
#13
Carmela Nappi, Emanuele Nicolai, Stefania Daniele, Wanda Acampa, Valeria Gaudieri, Roberta Assante, Emilia Zampella, Sabrina Segreto, Massimo Imbriaco, Mario Petretta, Marco Salvatore, Alberto Cuocolo
BACKGROUND: We compared the long-term prognostic value of coronary artery calcium (CAC) scanning, coronary computed tomographic angiography (CCTA), and stress single-photon emission computed tomography myocardial perfusion imaging (MPI) in patients with suspected coronary artery disease (CAD). METHODS AND RESULTS: A total of 164 patients were studied. CAC score was measured according to the Agatston method and patients were categorized into 3 groups (0, 1-300, and >300)...
November 1, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27791999/comparison-of-hemorheological-changes-in-patients-after-acute-coronary-events-intervention-and-ambulatory-rehabilitation
#14
Andras Toth, Barbara Sandor, Zsolt Marton, Gabor Kesmarky, Eszter Szabados, Daniel Kehl, Istvan Juricskay, Laszlo Czopf, Kalman Toth
During the past decades, our group have investigated the hemorheological parameters (HPs) of more than 1,000 patients with various forms of ischemic heart disease (IHD). Our data indicate that HPs are altered in patients with IHD and the extent of the alterations is in good correlation with the clinical severity of the disease. Our findings have also proven that HPs play a critical role in the pathogenesis of myocardial ischemia.The lack of regular exercise is an important cardiovascular risk factor. Regular physical activity - as part of the cardiovascular rehabilitation training program (CRP) - is recommended for the treatment of IHD and the prevention of first or further cardiovascular events...
2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27783337/the-new-frontier-of-cardiac-computed-tomography-angiography-fractional-flow-reserve-and-stress-myocardial-perfusion
#15
REVIEW
Gianluca Pontone, Giuseppe Muscogiuri, Daniele Andreini, Andrea I Guaricci, Marco Guglielmo, Saima Mushtaq, Andrea Baggiano, Edoardo Conte, Virginia Beltrama, Andrea Annoni, Alberto Formenti, Elisabetta Mancini, Mark G Rabbat, Mauro Pepi
The increased number of patients with coronary artery disease (CAD) in developed countries is of great clinical relevance and involves a large burden of the healthcare system. The management of these patients is focused on relieving symptoms and improving clinical outcomes. Therefore the ideal test would provide the correct diagnosis and actionable information. To this aim, several non-invasive functional imaging modalities are usually used as gatekeeper to invasive coronary angiography (ICA), but their diagnostic yield remains low with limited accuracy when compared to obstructive CAD at the time of ICA or invasive fractional flow reserve (FFR)...
December 2016: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27743118/from-basic-mechanisms-to-clinical-applications-in-heart-protection-new-players-in-cardiovascular-diseases-and-cardiac-theranostics-meeting-report-from-the-third-international-symposium-on-new-frontiers-in-cardiovascular-research
#16
REVIEW
Hector A Cabrera-Fuentes, Julian Aragones, Jürgen Bernhagen, Andreas Boening, William A Boisvert, Hans E Bøtker, Heerajnarain Bulluck, Stuart Cook, Fabio Di Lisa, Felix B Engel, Bernd Engelmann, Fulvia Ferrazzi, Péter Ferdinandy, Alan Fong, Ingrid Fleming, Erich Gnaiger, Sauri Hernández-Reséndiz, Siavash Beikoghli Kalkhoran, Moo Hyun Kim, Sandrine Lecour, Elisa A Liehn, Michael S Marber, Manuel Mayr, Tetsuji Miura, Sang-Bing Ong, Karlheinz Peter, Daniel Sedding, Manvendra K Singh, M Saadeh Suleiman, Hans J Schnittler, Rainer Schulz, Winston Shim, Daniel Tello, Carl-Wilhelm Vogel, Malcolm Walker, Qilong Oscar Yang Li, Derek M Yellon, Derek J Hausenloy, Klaus T Preissner
In this meeting report, particularly addressing the topic of protection of the cardiovascular system from ischemia/reperfusion injury, highlights are presented that relate to conditioning strategies of the heart with respect to molecular mechanisms and outcome in patients' cohorts, the influence of co-morbidities and medications, as well as the contribution of innate immune reactions in cardioprotection. Moreover, developmental or systems biology approaches bear great potential in systematically uncovering unexpected components involved in ischemia-reperfusion injury or heart regeneration...
November 2016: Basic Research in Cardiology
https://www.readbyqxmd.com/read/27716131/rationale-and-design-of-the-credence-trial-computed-tomographic-evaluation-of-atherosclerotic-determinants-of-myocardial-ischemia
#17
Asim Rizvi, Bríain Ó Hartaigh, Paul Knaapen, Jonathon Leipsic, Leslee J Shaw, Daniele Andreini, Gianluca Pontone, Subha Raman, Muhammad Akram Khan, Michael Ridner, Faisal Nabi, Alessia Gimelli, James Jang, Jason Cole, Ryo Nakazato, Christopher Zarins, Donghee Han, Ji Hyun Lee, Jackie Szymonifika, Millie J Gomez, Quynh A Truong, Hyuk-Jae Chang, Fay Y Lin, James K Min
BACKGROUND: Coronary computed tomography angiography (CCTA) allows for non-invasive assessment of obstructive coronary artery disease (CAD) beyond measures of stenosis severity alone. This assessment includes atherosclerotic plaque characteristics (APCs) and calculation of fractional flow reserve (FFR) from CCTA (FFRCT). Similarly, stress imaging by myocardial perfusion scintigraphy (MPS) provides vital information. To date, the diagnostic performance of integrated CCTA assessment versus integrated MPS assessment for diagnosis of vessel-specific ischemia remains underexplored...
October 6, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27715344/pharmacokinetics-and-pharmacodynamics-of-ticagrelor-in-the-treatment-of-cardiac-ischemia
#18
REVIEW
Gian Marco Rosa, Daniele Bianco, Alberto Valbusa, Laura Massobrio, Francesco Chiarella, Claudio Brunelli
After acute coronary syndromes (ACS), the so-called dual antiplatelet therapy (DAPT), which usually consists of low-dose of aspirin in combination with a thienopyridine (clopidogrel, prasugrel) or with a cyclopentyltriazolopyrimidine (ticagrelor), reduces the risk of ischemic events. Ticagrelor, un particular, is an effective drug as it isn' a prodrug, doesn't require metabolic activation and demonstrates a rapid onset and faster offset of action. Areas covered: This article evaluates the pharmacokinetics, efficacy, safety and tolerability of ticagrelor during DAPT after ACS and its potential use beyond the canonical twelve months after PCI...
December 2016: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/27714469/ambulatory-24-h-ecg-monitoring-and-cardiovascular-autonomic-assessment-for-the-screening-of-silent-myocardial-ischemia-in-elderly-type-2-diabetic-hypertensive-patients
#19
Daniele Bosone, Roberto Fogari, Matteo Cotta Ramusino, Natascia Ghiotto, Elena Guaschino, Annalisa Zoppi, Angela D'Angelo, Alfredo Costa
The aim of the study was to evaluate the usefulness of Holter monitoring for the detection of silent myocardial ischemia (SMI) in elderly type 2 diabetic patients with hypertension and the possible relationship between SMI and cardiovascular autonomic neuropathy (CAN). Two hundred and forty-three asymptomatic outpatients, aged 65-75 years, with type 2 diabetes and essential hypertension underwent 24-h ECG monitoring and 5 tests for the evaluation of both parasympathetic (heart rate variability, response to breath deeping, and Valsalva manoeuvre) and sympathetic (cold pressor test and orthostatic hypotension test) autonomic function...
October 6, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27536731/heart-resident-ccr2-macrophages-promote-neutrophil-extravasation-through-tlr9-myd88-cxcl5-signaling
#20
Wenjun Li, Hsi-Min Hsiao, Ryuji Higashikubo, Brian T Saunders, Ankit Bharat, Daniel R Goldstein, Alexander S Krupnick, Andrew E Gelman, Kory J Lavine, Daniel Kreisel
It is well established that maladaptive innate immune responses to sterile tissue injury represent a fundamental mechanism of disease pathogenesis. In the context of cardiac ischemia reperfusion injury, neutrophils enter inflamed heart tissue, where they play an important role in potentiating tissue damage and contributing to contractile dysfunction. The precise mechanisms that govern how neutrophils are recruited to and enter the injured heart are incompletely understood. Using a model of cardiac transplant-mediated ischemia reperfusion injury and intravital 2-photon imaging of beating mouse hearts, we determined that tissue-resident CCR2(+) monocyte-derived macrophages are essential mediators of neutrophil recruitment into ischemic myocardial tissue...
August 4, 2016: JCI Insight
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