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[PMID]:28453798
[Au] Autor:Malinska A; Podemska Z; Sujka-Kordowska P; Witkiewicz W; Nowicki M; Perek B; Witt M
[Ad] Endereço:Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland.
[Ti] Título:Caveolin 2: a facultative marker of unfavourable prognosis in long-term patency rate of internal thoracic artery grafts used in coronary artery bypass grafting. Preliminary report.
[So] Source:Interact Cardiovasc Thorac Surg;24(5):714-720, 2017 05 01.
[Is] ISSN:1569-9285
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Intimal hyperplasia leading to graft failure in patients undergoing coronary artery bypass grafting (CABG) is related to vascular smooth muscle cells (SMCs) proliferation. SMCs respond to a variety of mediators, the most important of which is platelet-derived growth factor (PDGF). The platelet-derived growth factor-induced cellular response has been shown to be mediated by caveolins. The aim of this study was to analyze CAV1-3 expression in internal thoracic artery (ITA) grafts used in CABG and correlate their expression with graft occlusion. METHODS: Six hundred patients undergoing CABG with the use of ITA grafts between 2008 and 2014 were enrolled into this prospective study. CAV1-3 expression in the ITA grafts was analyzed prior to graft transplantation into the coronary circulation via immunohistochemistry. Estimated caveolins expression pattern was then correlated with the occurrence of ITA graft failure observed within 24-months of surgery. RESULTS: Thirty-four patients developed ITA graft failure (subgroup A) and 566 study participants presented no adverse events (subgroup B). CAV1 and CAV3 expression levels in SMCs of the tunica media of the ITA grafts did not differ between the study subgroups and were not associated with the risk of graft failure. CAV2 was expressed within SMCs of the ITA grafts in 94.1% of the patients from subgroup A and 2.5% from subgroup B, and its expression was associated with ITA graft occlusion observed within 24-months after CABG. CONCLUSIONS: CAV2 expression in SMCs of the tunica media in autologous ITA transplants might indicate the risk of graft failure.
[Mh] Termos MeSH primário: Caveolina 2/metabolismo
Ponte de Artéria Coronária/métodos
Doença da Artéria Coronariana/cirurgia
Circulação Coronária/fisiologia
Vasos Coronários/metabolismo
Artéria Torácica Interna/transplante
[Mh] Termos MeSH secundário: Idoso
Biomarcadores/metabolismo
Doença da Artéria Coronariana/sangue
Doença da Artéria Coronariana/diagnóstico
Vasos Coronários/ultraestrutura
Feminino
Seguimentos
Seres Humanos
Imuno-Histoquímica
Masculino
Artéria Torácica Interna/metabolismo
Artéria Torácica Interna/ultraestrutura
Microscopia Eletrônica de Transmissão
Meia-Idade
Prognóstico
Estudos Prospectivos
Estudos Retrospectivos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Biomarkers); 0 (Caveolin 2)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/icvts/ivw411


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[PMID]:28468789
[Au] Autor:Bobi J; Solanes N; Fernández-Jiménez R; Galán-Arriola C; Dantas AP; Fernández-Friera L; Gálvez-Montón C; Rigol-Monzó E; Agüero J; Ramírez J; Roqué M; Bayés-Genís A; Sánchez-González J; García-Álvarez A; Sabaté M; Roura S; Ibáñez B; Rigol M
[Ad] Endereço:August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Institut de Malalties Cardiovasculars, Hospital Clínic de Barcelona, Universitat de Barcelona, Spain.
[Ti] Título:Intracoronary Administration of Allogeneic Adipose Tissue-Derived Mesenchymal Stem Cells Improves Myocardial Perfusion But Not Left Ventricle Function, in a Translational Model of Acute Myocardial Infarction.
[So] Source:J Am Heart Assoc;6(5), 2017 May 03.
[Is] ISSN:2047-9980
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Autologous adipose tissue-derived mesenchymal stem cells (ATMSCs) therapy is a promising strategy to improve post-myocardial infarction outcomes. In a porcine model of acute myocardial infarction, we studied the long-term effects and the mechanisms involved in allogeneic ATMSCs administration on myocardial performance. METHODS AND RESULTS: Thirty-eight pigs underwent 50 minutes of coronary occlusion; the study was completed in 33 pigs. After reperfusion, allogeneic ATMSCs or culture medium (vehicle) were intracoronarily administered. Follow-ups were performed at short (2 days after acute myocardial infarction vehicle-treated, n=10; ATMSCs-treated, n=9) or long term (60 days after acute myocardial infarction vehicle-treated, n=7; ATMSCs-treated, n=7). At short term, infarcted myocardium analysis showed reduced apoptosis in the ATMSCs-treated animals (48.6±6% versus 55.9±5.7% in vehicle; =0.017); enhancement of the reparative process with up-regulated vascular endothelial growth factor, granulocyte macrophage colony-stimulating factor, and stromal-derived factor-1α gene expression; and increased M2 macrophages (67.2±10% versus 54.7±10.2% in vehicle; =0.016). In long-term groups, increase in myocardial perfusion at the anterior infarct border was observed both on day-7 and day-60 cardiac magnetic resonance studies in ATMSCs-treated animals, compared to vehicle (87.9±28.7 versus 57.4±17.7 mL/min per gram at 7 days; =0.034 and 99±22.6 versus 43.3±14.7 22.6 mL/min per gram at 60 days; =0.0001, respectively). At day 60, higher vascular density was detected at the border zone in the ATMSCs-treated animals (118±18 versus 92.4±24.3 vessels/mm in vehicle; =0.045). Cardiac magnetic resonance-measured left ventricular ejection fraction of left ventricular volumes was not different between groups at any time point. CONCLUSIONS: In this porcine acute myocardial infarction model, allogeneic ATMSCs-based therapy was associated with increased cardioprotective and reparative mechanisms and with better cardiac magnetic resonance-measured perfusion. No effect on left ventricular volumes or ejection fraction was observed.
[Mh] Termos MeSH primário: Tecido Adiposo/citologia
Circulação Coronária
Transplante de Células-Tronco Mesenquimais/métodos
Células Mesenquimais Estromais
Infarto do Miocárdio/cirurgia
Disfunção Ventricular Esquerda/cirurgia
Função Ventricular Esquerda
[Mh] Termos MeSH secundário: Proteínas Angiogênicas/metabolismo
Animais
Células Cultivadas
Angiografia por Tomografia Computadorizada
Angiografia Coronária/métodos
Citocinas/metabolismo
Modelos Animais de Doenças
Proteínas de Fluorescência Verde/genética
Proteínas de Fluorescência Verde/metabolismo
Imagem por Ressonância Magnética
Masculino
Transplante de Células-Tronco Mesenquimais/efeitos adversos
Células Mesenquimais Estromais/metabolismo
Tomografia Computadorizada Multidetectores
Infarto do Miocárdio/diagnóstico por imagem
Infarto do Miocárdio/metabolismo
Infarto do Miocárdio/fisiopatologia
Miocárdio/metabolismo
Miocárdio/patologia
Neovascularização Fisiológica
Imagem de Perfusão/métodos
Recuperação de Função Fisiológica
Regeneração
Sus scrofa
Fatores de Tempo
Transfecção
Transplante Homólogo
Disfunção Ventricular Esquerda/diagnóstico por imagem
Disfunção Ventricular Esquerda/metabolismo
Disfunção Ventricular Esquerda/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiogenic Proteins); 0 (Cytokines); 147336-22-9 (Green Fluorescent Proteins)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE


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[PMID]:28465300
[Au] Autor:Pelletier-Galarneau M; Hunter CRRN; Ascah KJ; Beanlands RSB; Dwivedi G; deKemp RA; Chow BJW; Ruddy TD
[Ad] Endereço:Division of Nuclear Medicine, The Ottawa Hospital, Ottawa, Canada.
[Ti] Título:Randomized Trial Comparing the Effects of Ticagrelor Versus Clopidogrel on Myocardial Perfusion in Patients With Coronary Artery Disease.
[So] Source:J Am Heart Assoc;6(5), 2017 May 02.
[Is] ISSN:2047-9980
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Ticagrelor is a P2Y receptor inhibitor used in acute coronary syndromes to reduce platelet activity and to decrease thrombus formation. Ticagrelor is associated with a reduction in mortality incremental to that observed with clopidogrel, potentially related to its non-antiplatelet effects. Evidence from animal models indicates that ticagrelor potentiates adenosine-induced myocardial blood flow (MBF) increases. We investigated MBF at rest and during adenosine-induced hyperemia in patients with stable coronary artery disease treated with ticagrelor versus clopidogrel. METHODS AND RESULTS: This randomized double-blinded crossover study included 22 patients who received therapeutic interventions of ticagrelor 90 mg orally twice a day for 10 days and clopidogrel 75 mg orally once a day for 10 days, with a washout period of at least 10 days between the treatments. Global and regional MBF and myocardial flow reserve were measured using rubidium 82 positron emission tomography/computed tomography at baseline and during intermediate- and high-dose adenosine. Global MBF was significantly greater with ticagrelor versus clopidogrel (1.28±0.55 versus 1.13±0.47 mL/min per gram, =0.002) at intermediate-dose adenosine and not different at baseline (0.65±0.19 versus 0.60±0.15 mL/min per gram, =0.084) and at high-dose adenosine (1.64±0.40 versus 1.61±0.19 mL/min per gram, =0.53). In regions with impaired myocardial flow reserve (<2.5), MBF was greater with ticagrelor compared with clopidogrel during intermediate and high doses of adenosine ( <0.0001), whereas the differences were not significant at baseline. CONCLUSIONS: Ticagrelor potentiates global and regional adenosine-induced MBF increases in patients with stable coronary artery disease. This effect may contribute to the incremental mortality benefit compared with clopidogrel. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01894789.
[Mh] Termos MeSH primário: Adenosina/análogos & derivados
Doença da Artéria Coronariana/tratamento farmacológico
Circulação Coronária/efeitos dos fármacos
Vasos Coronários/efeitos dos fármacos
Inibidores da Agregação de Plaquetas/administração & dosagem
Ticlopidina/análogos & derivados
[Mh] Termos MeSH secundário: Adenosina/administração & dosagem
Adenosina/efeitos adversos
Administração Oral
Idoso
Doença da Artéria Coronariana/diagnóstico por imagem
Doença da Artéria Coronariana/fisiopatologia
Vasos Coronários/diagnóstico por imagem
Vasos Coronários/fisiopatologia
Estudos Cross-Over
Método Duplo-Cego
Esquema de Medicação
Feminino
Seres Humanos
Masculino
Meia-Idade
Imagem de Perfusão do Miocárdio/métodos
Ontário
Inibidores da Agregação de Plaquetas/efeitos adversos
Tomografia Computadorizada com Tomografia por Emissão de Pósitrons
Valor Preditivo dos Testes
Compostos Radiofarmacêuticos/administração & dosagem
Radioisótopos de Rubídio/administração & dosagem
Ticlopidina/administração & dosagem
Ticlopidina/efeitos adversos
Fatores de Tempo
Resultado do Tratamento
Vasodilatadores/administração & dosagem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Platelet Aggregation Inhibitors); 0 (Radiopharmaceuticals); 0 (Rubidium Radioisotopes); 0 (Vasodilator Agents); A74586SNO7 (clopidogrel); GLH0314RVC (Ticagrelor); K72T3FS567 (Adenosine); OM90ZUW7M1 (Ticlopidine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


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[PMID]:29384863
[Au] Autor:Cai X; Zhang S; Deng D; Li H; Guan X; Fang J; Zhou Q
[Ad] Endereço:Medical Imaging Center, First Affiliated Hospital of Jinan University.
[Ti] Título:Myocardial perfusion at rest in uncomplicated type 2 diabetes patients without coronary artery disease evaluated by 320-multidetector computed tomography: A pilot study.
[So] Source:Medicine (Baltimore);97(5):e9762, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Using computed tomography myocardial perfusion imaging (CTP) to investigate resting myocardial perfusion alterations in uncomplicated type 2 diabetes mellitus (T2DM) patients without obstructive coronary artery disease (CAD).A total of 34 participants with 544 myocardial segments were included prospectively: 17 uncomplicated T2DM patients with no significant coronary artery stenosis on coronary computed tomography angiography and 17 healthy controls. Myocardial perfusion was evaluated by transmural perfusion ratio (TPR). Parameters of cardiac structure and function were measured for cardiac comprehensive assessment. Analyses included descriptive statistics and group comparisons.TPR of segments 5, 7, 9, 10 to 14 were significantly reduced in T2DM group compared with controls (P < .05). When 16 myocardial segments were localized into different areas according to the wall orientations, axial levels of left ventricle and coronary artery territories, respectively, TPR of each area in T2DM group were significantly lower than those in the control group (P < .05). No significant differences were found in cardiac anatomy and function analyses between 2 groups.In uncomplicated T2DM patients without obstructive CAD, myocardial perfusion impairments were present and may develop prior to cardiac morphological and functional abnormalities, which can be early detected by CTP.
[Mh] Termos MeSH primário: Circulação Coronária/fisiologia
Diabetes Mellitus Tipo 2/diagnóstico por imagem
Diabetes Mellitus Tipo 2/fisiopatologia
[Mh] Termos MeSH secundário: Estudos de Casos e Controles
Diabetes Mellitus Tipo 2/complicações
Feminino
Seres Humanos
Masculino
Meia-Idade
Tomografia Computadorizada Multidetectores
Imagem de Perfusão do Miocárdio
Projetos Piloto
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009762


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[PMID]:29279526
[Au] Autor:Ji Q; Xia L; Shi Y; Ma R; Shen J; Lai H; Ding W; Wang C
[Ad] Endereço:Department of Cardiovascular Surgery, Zhongshan Hospital Fudan University.
[Ti] Título:In Situ Skeletonized Right Internal Mammary Artery Bypass Grafting to Left Anterior Descending Artery.
[So] Source:Int Heart J;59(1):35-42, 2018 Jan 27.
[Is] ISSN:1349-3299
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:This study aimed to evaluate the feasibility and the mid-term efficacy of an in situ skeletonized right internal mammary artery (IMA) bypass grafting to a left anterior descending artery (LAD), and to determine risk factors for IMA graft failure in a single-center study.From January 2012 to December 2015, 189 patients (173 males, 50.6 ± 6.0 years old) undergoing first isolated coronary artery bypass grafting surgery with the in situ skeletonized right IMA grafting to the LAD were included in this study. Baseline characteristics, peroperative data, and follow-up outcomes were investigated and analyzed.The length of the in situ skeletonized right IMA grafts was 18.6 ± 1.2 cm (17.0-22.0 cm). Intraoperative graft flow of the in situ skeletonized right IMA grafting to LAD was 42 ± 9 mL/minute (18-72 mL/minute) associated with measured pulsatility index of 0.8-4.3. In-hospital mortality was 0.5%. Postoperative morbidity included acute myocardial infarction (0.5%), stroke (0.5%), and deep sternal wound infections (1.1%). The mid-term survival was 97.2% and the incidence of repeat revascularization was 0.6%. The patency rate of the in situ skeletonized right IMA grafting to the LAD was 97.1% by computed tomography angiography examination during the follow-up period of 23.2 ± 9.7 months. Additionally, logistic regression analysis showed that intraoperative graft flow had an independent influence on the risk of the mid-term right IMA graft failure.The strategy of the in situ skeletonized right IMA grafting to the LAD is feasible and effective. Intraoperative graft flow was an independent risk factor for the mid-term right IMA graft failure.
[Mh] Termos MeSH primário: Ponte de Artéria Coronária/métodos
Doença da Artéria Coronariana/cirurgia
Circulação Coronária
Vasos Coronários/cirurgia
Artéria Torácica Interna/transplante
Grau de Desobstrução Vascular
[Mh] Termos MeSH secundário: Adulto
Idoso
China/epidemiologia
Angiografia por Tomografia Computadorizada
Angiografia Coronária
Doença da Artéria Coronariana/diagnóstico
Doença da Artéria Coronariana/mortalidade
Vasos Coronários/diagnóstico por imagem
Vasos Coronários/fisiopatologia
Feminino
Seguimentos
Mortalidade Hospitalar/tendências
Seres Humanos
Masculino
Artéria Torácica Interna/diagnóstico por imagem
Artéria Torácica Interna/fisiopatologia
Meia-Idade
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1536/ihj.16-554


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[PMID]:28457603
[Au] Autor:Chiastra C; Gallo D; Tasso P; Iannaccone F; Migliavacca F; Wentzel JJ; Morbiducci U
[Ad] Endereço:Department of Cardiology, Biomedical Engineering, Erasmus MC, Rotterdam, The Netherlands; Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy.
[Ti] Título:Healthy and diseased coronary bifurcation geometries influence near-wall and intravascular flow: A computational exploration of the hemodynamic risk.
[So] Source:J Biomech;58:79-88, 2017 06 14.
[Is] ISSN:1873-2380
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Local hemodynamics has been identified as one main determinant in the onset and progression of atherosclerotic lesions at coronary bifurcations. Starting from the observation that atherosensitive hemodynamic conditions in arterial bifurcation are majorly determined by the underlying anatomy, the aim of the present study is to investigate how peculiar coronary bifurcation anatomical features influence near-wall and intravascular flow patterns. Different bifurcation angles and cardiac curvatures were varied in population-based, idealized models of both stenosed and unstenosed bifurcations, representing the left anterior descending (LAD) coronary artery with its diagonal branch. Local hemodynamics was analyzed in terms of helical flow and exposure to low/oscillatory shear stress by performing computational fluid dynamics simulations. Results show that bifurcation angle impacts lowly hemodynamics in both stenosed and unstenosed cases. Instead, curvature radius influences the generation and transport of helical flow structures, with smaller cardiac curvature radius associated to higher helicity intensity. Stenosed bifurcation models exhibit helicity intensity values one order of magnitude higher than the corresponding unstenosed cases. Cardiac curvature radius moderately affects near-wall hemodynamics of the stenosed cases, with smaller curvature radius leading to higher exposure to low shear stress and lower exposure to oscillatory shear stress. In conclusion, the proposed controlled benchmark allows investigating the effect of various geometrical features on local hemodynamics at the LAD/diagonal bifurcation, highlighting that cardiac curvature influences near wall and intravascular hemodynamics, while bifurcation angle has a minor effect.
[Mh] Termos MeSH primário: Vasos Coronários
Modelos Cardiovasculares
[Mh] Termos MeSH secundário: Circulação Coronária
Vasos Coronários/anatomia & histologia
Vasos Coronários/patologia
Vasos Coronários/fisiologia
Coração/anatomia & histologia
Hemodinâmica
Seres Humanos
Hidrodinâmica
Estresse Mecânico
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180120
[Lr] Data última revisão:
180120
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:28455632
[Au] Autor:Nanni S; Lovato L; Ghetti G; Vagnarelli F; Mineo G; Fattori R; Saia F; Marzocchi A; Marrozzini C; Zompatori M; Reggiani LB; Semprini F; Melandri G; Biagini E; Corsini A; Norscini G; Rapezzi C
[Ad] Endereço:Istituto di Cardiologia, Università di Bologna, Policlinico S.Orsola-Malpighi, Via G. Massarenti 9, 40138, Bologna, Italy. samuele.nanni@aosp.bo.it.
[Ti] Título:Utility of stress perfusion-cardiac magnetic resonance in follow-up of patients undergoing percutaneous coronary interventions of the left main coronary artery.
[So] Source:Int J Cardiovasc Imaging;33(10):1589-1597, 2017 Oct.
[Is] ISSN:1875-8312
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:To assess the accuracy of cardiac magnetic resonance (CMR) for the diagnosis of angiographic stenosis after percutaneous coronary intervention (PCI) of left main coronary artery (LMCA). Patients undergone in the last year PCI of unprotected LMCA and scheduled for conventional X-ray coronary angiography (CXA) were evaluated with stress perfusion CMR within 2 weeks before CXA. Main contraindications to CMR were exclusion criteria. Stress perfusion CMR was performed to follow a bolus of contrast Gadobutrol after 3 min of adenosine infusion. Between the 50 patients enrolled, only 1 did not finish the CMR protocol and 49 patients with median age 71 (65-75) years (38 male, 11 female) were analyzed. Between 784 coronary angiographic segments evaluated we found 75 stenosis or occlusions (prevalence 9.5%), but only 13 stenosis or occlusions in proximal segments (prevalence 6.6%). Patients with coronary stenosis (n = 12, 24%) showed a significantly (p = 0.002) higher prevalence of diabetes (7 of 12, 58%). At CMR examination, late gadolinium enhancement was present in 25 (51%), reversible perfusion defects in 12 (24%), and fixed perfusion defects in 6 subjects (12%). The only patient with LMCA restenosis resulted positive at perfusion CMR. The accuracy of stress perfusion CMR in diagnosis of coronary stenosis was higher when the analysis was performed only in proximal coronary arteries (95%, CI 86-99) compared to overall vessels (84%, CI 70-92). Stress perfusion CMR could strongly reduce the need for elective CXA in follow up of LMCA PCI and should be validated in further multicenter prospective studies.
[Mh] Termos MeSH primário: Adenosina/administração & dosagem
Doença da Artéria Coronariana/terapia
Circulação Coronária
Reestenose Coronária/diagnóstico por imagem
Estenose Coronária/terapia
Vasos Coronários/diagnóstico por imagem
Imagem Cinética por Ressonância Magnética/métodos
Imagem de Perfusão do Miocárdio/métodos
Intervenção Coronária Percutânea/efeitos adversos
Vasodilatadores/administração & dosagem
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Meios de Contraste/administração & dosagem
Angiografia Coronária
Doença da Artéria Coronariana/diagnóstico por imagem
Doença da Artéria Coronariana/fisiopatologia
Reestenose Coronária/etiologia
Reestenose Coronária/fisiopatologia
Estenose Coronária/diagnóstico por imagem
Estenose Coronária/fisiopatologia
Vasos Coronários/fisiopatologia
Estudos de Viabilidade
Feminino
Seguimentos
Seres Humanos
Interpretação de Imagem Assistida por Computador
Masculino
Meia-Idade
Compostos Organometálicos/administração & dosagem
Projetos Piloto
Valor Preditivo dos Testes
Estudos Prospectivos
Reprodutibilidade dos Testes
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contrast Media); 0 (Organometallic Compounds); 0 (Vasodilator Agents); 1BJ477IO2L (gadobutrol); K72T3FS567 (Adenosine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1007/s10554-017-1149-4


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[PMID]:28470330
[Au] Autor:Ajayi NO; Vanker EA; Satyapal KS
[Ad] Endereço:Department of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa.
[Ti] Título:The role of coronary artery collaterals in the preservation of left ventricular function: a study to address a long-standing controversy.
[So] Source:Cardiovasc J Afr;28(2):81-85, 2017 Mar/Apr.
[Is] ISSN:1680-0745
[Cp] País de publicação:South Africa
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The functional significance of coronary artery collateral (CAC) vasculature in humans has been debated for decades and this has been compounded by the lack of a standard, systematic, objective method of grading and documenting CAC flow in man. CACs serve as alternative conduits for blood in obstructive coronary artery disease. This study aimed to evaluate the impact of CACs on left ventricular function in the presence of total coronary arterial occlusion. METHODS: The study group included the coronary angiographic records of 97 patients (mean age: 59 ± 8 years). CACs were graded from 0-3 based on the collateral connection between the donor and recipient arteries. Left ventricular function was computed from the ventriculogram and expressed as ejection fraction (EF). RESULTS: The mean EF of the patients with grades 0, 1, 2 and 3 CACs were calculated as 50.4, 47, 60.5 and 70%, respectively. A significant difference was recorded in the mean EF calculated for the different CAC grades (p = 0.001). There was a significant positive correlation (p < 0.001; r = 0.478) between the mean EF and the CAC grades. CONCLUSION: The patients with better coronary collateral grades had a higher mean EF. Therefore, as the grade of CACs increased, there was an improvement in their ability to preserve left ventricular function.
[Mh] Termos MeSH primário: Circulação Colateral
Circulação Coronária
Oclusão Coronária/fisiopatologia
Vasos Coronários/fisiopatologia
Volume Sistólico
Função Ventricular Esquerda
[Mh] Termos MeSH secundário: Idoso
Angiografia Coronária
Oclusão Coronária/diagnóstico por imagem
Vasos Coronários/diagnóstico por imagem
Feminino
Seres Humanos
Masculino
Meia-Idade
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171218
[Lr] Data última revisão:
171218
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.5830/CVJA-2016-054


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[PMID]:29079664
[Au] Autor:Ghafoori E; Kholmovski EG; Thomas S; Silvernagel J; Angel N; Hu N; Dosdall DJ; MacLeod R; Ranjan R
[Ad] Endereço:From the Department of Bioengineering (E.G., J.S., N.A., D.J.D., R.M., R.R.), Cardiovascular Medicine (E.G., J.S., N.A., R.R.), UCAIR, Department of Radiology and Imaging Sciences (E.G.K.), Department of Medicine (S.T., N.H., R.R.), and Department of Surgery (D.J.D.), University of Utah, Salt Lake C
[Ti] Título:Characterization of Gadolinium Contrast Enhancement of Radiofrequency Ablation Lesions in Predicting Edema and Chronic Lesion Size.
[So] Source:Circ Arrhythm Electrophysiol;10(11), 2017 Nov.
[Is] ISSN:1941-3084
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Magnetic resonance imaging (MRI) has been used to acutely visualize radiofrequency ablation lesions, but its accuracy in predicting chronic lesion size is unknown. The main goal of this study was to characterize different areas of enhancement in late gadolinium enhancement MRI done immediately after ablation to predict acute edema and chronic lesion size. METHODS AND RESULTS: In a canine model (n=10), ventricular radiofrequency lesions were created using ThermoCool SmartTouch (Biosense Webster) catheter. All animals underwent MRI (late gadolinium enhancement and T2-weighted edema imaging) immediately after ablation and after 1, 2, 4, and 8 weeks. Edema, microvascular obstruction, and enhanced volumes were identified in MRI and normalized to chronic histological volume. Immediately after contrast administration, the microvascular obstruction region was 3.2±1.1 times larger than the chronic lesion volume in acute MRI. Even 60 minutes after contrast administration, edema was 8.7±3.31 times and the enhanced area 6.14±2.74 times the chronic lesion volume. Exponential fit to the microvascular obstruction volume was found to be the best predictor of chronic lesion volume at 26.14 minutes (95% prediction interval, 24.35-28.11 minutes) after contrast injection. The edema volume in late gadolinium enhancement correlated well with edema volume in T2-weighted MRI with an of 0.99. CONCLUSION: Microvascular obstruction region on acute late gadolinium enhancement images acquired 26.1 minutes after contrast administration can accurately predict the chronic lesion volume. We also show that T1-weighted MRI images acquired immediately after contrast injection accurately shows edema resulting from radiofrequency ablation.
[Mh] Termos MeSH primário: Ablação por Cateter/efeitos adversos
Cicatriz/diagnóstico por imagem
Meios de Contraste/administração & dosagem
Edema Cardíaco/diagnóstico por imagem
Ventrículos do Coração/cirurgia
Imagem por Ressonância Magnética
Meglumina/análogos & derivados
Compostos Organometálicos/administração & dosagem
[Mh] Termos MeSH secundário: Animais
Biópsia
Cicatriz/etiologia
Cicatriz/patologia
Circulação Coronária
Cães
Edema Cardíaco/etiologia
Edema Cardíaco/patologia
Ventrículos do Coração/diagnóstico por imagem
Ventrículos do Coração/patologia
Meglumina/administração & dosagem
Microcirculação
Modelos Animais
Valor Preditivo dos Testes
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contrast Media); 0 (Organometallic Compounds); 15G12L5X8K (gadobenic acid); 6HG8UB2MUY (Meglumine)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171121
[Lr] Data última revisão:
171121
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171029
[St] Status:MEDLINE


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[PMID]:29050557
[Au] Autor:Kobayashi Y; Johnson NP; Zimmermann FM; Witt N; Berry C; Jeremias A; Koo BK; Esposito G; Rioufol G; Park SJ; Nishi T; Choi DH; Oldroyd KG; Barbato E; Pijls NHJ; De Bruyne B; Fearon WF; CONTRAST Study Investigators
[Ad] Endereço:Stanford University School of Medicine, Stanford, California; Stanford Cardiovascular Institute, Stanford, California.
[Ti] Título:Agreement of the Resting Distal to Aortic Coronary Pressure With the Instantaneous Wave-Free Ratio.
[So] Source:J Am Coll Cardiol;70(17):2105-2113, 2017 Oct 24.
[Is] ISSN:1558-3597
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Recently, 2 randomized controlled trials showed that the instantaneous wave-free ratio (iFR), a resting coronary physiological index, is noninferior to fractional flow reserve for guiding revascularization. The resting distal to aortic coronary pressure (P /P ) measured at rest is another adenosine-free index widely available in the cardiac catheterization laboratory; however, little is known about the agreement of P /P using iFR as a reference standard. OBJECTIVES: The goal of this study was to investigate the agreement of P /P with iFR. METHODS: A total of 763 patients were prospectively enrolled from 12 institutions. iFR and P /P were measured under resting conditions. Using iFR ≤0.89 as a reference standard, the agreement of P /P and its best cutoff value were assessed. RESULTS: According to the independent core laboratory analysis, iFR and P /P were analyzable in 627 and 733 patients (82.2% vs. 96.1%; p < 0.001), respectively. The median iFR and P /P were 0.90 (interquartile range: 0.85 to 0.94) and 0.92 (interquartile range: 0.88 to 0.95), and the 2 indices were highly correlated (R = 0.93; p < 0.001; iFR = 1.31 * P /P -0.31). According to the receiver-operating characteristic curve analysis, P /P showed excellent agreement (area under the curve: 0.98; 95% confidence interval: 0.97 to 0.99; p < 0.001) with a best cutoff value of P /P ≤0.91. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 93.0%, 91.4%, 94.4%, 93.3%, and 92.7%, respectively. These results were similar in patients with acute coronary syndrome and stable angina. CONCLUSIONS: P /P was analyzable in a significantly higher number of patients than iFR. P /P showed excellent agreement with iFR, suggesting that it could be applied clinically in a similar fashion. (Can Contrast Injection Better Approximate FFR Compared to Pure Resting Physiology? [CONTRAST]; NCT02184117).
[Mh] Termos MeSH primário: Pressão Sanguínea/fisiologia
Vasos Coronários/fisiologia
[Mh] Termos MeSH secundário: Idoso
Determinação da Pressão Arterial/métodos
Circulação Coronária/fisiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Padrões de Referência
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171027
[Lr] Data última revisão:
171027
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171021
[St] Status:MEDLINE



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