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  1. Attenuation of reactive gliosis does not affect infarct volume in neonatal hypoxic-ischemic brain injury in mice.

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    Katarina Järlestedt

    attenuation of reactive gliosis in the developing brain does not affect the hemisphere or infarct volume after HI, but increases the number of surviving newborn neurons.

  2. Diffusion tensor imaging correlates with lesion volume in cerebral hemisphere infarctions

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    Dastidar Prasun; Marchesotti Silvia; Jason Eeva; Rossi Maija E; Ollikainen Jyrki; Soimakallio Seppo

    2010-01-01

    Abstract Background Both a large lesion volume and abnormalities in diffusion tensor imaging are independently associated with a poor prognosis after cerebral infarctions. Therefore, we assume that they are associated. This study assessed the associations between lesion volumes and diffusion tensor imaging in patients with a right-sided cerebral infarction. Methods The lesion volumes of 33 patients (age 65.9 ± 8.7, 26 males and 7 females) were imaged using computed tomography (CT) in the acut...

  3. Mean platelet volume and the risk of periprocedural myocardial infarction in patients undergoing coronary angioplasty

    NARCIS (Netherlands)

    Verdoia, M.; Camaro, C.; Barbieri, L.; Schaffer, A.; Marino, P.; Bellomo, G.; Suryapranata, H.; Luca, G. De

    2013-01-01

    BACKGROUND: Periprocedural myocardial infarction (PMI) represents a relatively common complication of percutaneous coronary intervention (PCI). Mean platelet volume (MPV) has been proposed as a marker for platelet activation, as larger sized platelets have been associated with higher pro-thrombotic

  4. Factors Affecting in-Hospital Mortality of Acute Myocardial Infarction

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    M Salarifar

    2009-09-01

    Full Text Available "nBackground: Acute myocardial infarction (AMI is one of the most common causes of morbidity and mortality. Considering immense socioeconomic damages of growing AMI in developing countries we estimated prognostic value of major risk factors of AMI to predict probable In-hospital AMI mortality."nMethods: In a cohort survey from June 2004 to March 2006, 1798 patients hospitalized with proven AMI entered into two groups: Survived (patients discharged alive and Expired (patients expired during hospitalization due to AMI. We evaluated relationship of 17 risk factors including age, sex, smoking, opium usage, hypertension, diabetes mellitus (DM, dyslipidemia, Killip class, existence of Q wave, St segment elevation, bundle branch blocks (BBB, involved surface of heart, mean left ventricular ejection fraction (LVEF, mitral valve regurgitation (MR, and serum level of Troponin I and CKMB, with patients' survival and expiry by using chi square test, T test and multivariate logistic regression analysis. P value ≤ 0.05 was considered significant."nResults: There were 1629 (90.6% survived and 169 (9.4% expired patients. Factors significantly affected in-hospital mortality of AMI include: age (P< 0.001, femaleness (P< 0.001, smoking (P< 0.001, Killip class>II (P< 0.001, hy­per­tension (P= 0.036, DM (P< 0.001, bundle branch block (P< 0.001, Moderate to severe mitral regurgitation (P< 0.001, lower Mean LVEF (P< 0.001, and lower mean serum concentration of CKMB and Troponin I (P< 0.001. Mortality was significantly higher in anterolateral infarction."nConclusion: Mean age> 69.01 yr, femaleness, Killip class III & V, hypertension, DM, moderate to severe MR, anterolateral AMI, bundle branch block and higher serum concentration of CKMB & Troponin I are associated with higher In-hospital post-AMI mortality.

  5. Infarct volume predicts critical care needs in stroke patients treated with intravenous thrombolysis

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    Patients receiving intravenous thrombolysis with recombinant tissue plasminogen activator (IVT) for ischemic stroke are monitored in an intensive care unit (ICU) or a comparable unit capable of ICU interventions due to the high frequency of standardized neurological exams and vital sign checks. The present study evaluates quantitative infarct volume on early post-IVT MRI as a predictor of critical care needs and aims to identify patients who may not require resource intense monitoring. We identified 46 patients who underwent MRI within 6 h of IVT. Infarct volume was measured using semiautomated software. Logistic regression and receiver operating characteristics (ROC) analysis were used to determine factors associated with ICU needs. Infarct volume was an independent predictor of ICU need after adjusting for age, sex, race, systolic blood pressure, NIH Stroke Scale (NIHSS), and coronary artery disease (odds ratio 1.031 per cm3 increase in volume, 95 % confidence interval [CI] 1.004-1.058, p = 0.024). The ROC curve with infarct volume alone achieved an area under the curve (AUC) of 0.766 (95 % CI 0.605-0.927), while the AUC was 0.906 (95 % CI 0.814-0.998) after adjusting for race, systolic blood pressure, and NIHSS. Maximum Youden index calculations identified an optimal infarct volume cut point of 6.8 cm3 (sensitivity 75.0 %, specificity 76.7 %). Infarct volume greater than 3 cm3 predicted need for critical care interventions with 81.3 % sensitivity and 66.7 % specificity. Infarct volume may predict needs for ICU monitoring and interventions in stroke patients treated with IVT. (orig.)

  6. Infarct volume predicts critical care needs in stroke patients treated with intravenous thrombolysis

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    Faigle, Roland; Marsh, Elisabeth B.; Llinas, Rafael H.; Urrutia, Victor C. [Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, MD (United States); Wozniak, Amy W. [Johns Hopkins University, Department of Biostatistics, Bloomberg School of Public Health, Baltimore, MD (United States)

    2014-10-26

    Patients receiving intravenous thrombolysis with recombinant tissue plasminogen activator (IVT) for ischemic stroke are monitored in an intensive care unit (ICU) or a comparable unit capable of ICU interventions due to the high frequency of standardized neurological exams and vital sign checks. The present study evaluates quantitative infarct volume on early post-IVT MRI as a predictor of critical care needs and aims to identify patients who may not require resource intense monitoring. We identified 46 patients who underwent MRI within 6 h of IVT. Infarct volume was measured using semiautomated software. Logistic regression and receiver operating characteristics (ROC) analysis were used to determine factors associated with ICU needs. Infarct volume was an independent predictor of ICU need after adjusting for age, sex, race, systolic blood pressure, NIH Stroke Scale (NIHSS), and coronary artery disease (odds ratio 1.031 per cm{sup 3} increase in volume, 95 % confidence interval [CI] 1.004-1.058, p = 0.024). The ROC curve with infarct volume alone achieved an area under the curve (AUC) of 0.766 (95 % CI 0.605-0.927), while the AUC was 0.906 (95 % CI 0.814-0.998) after adjusting for race, systolic blood pressure, and NIHSS. Maximum Youden index calculations identified an optimal infarct volume cut point of 6.8 cm{sup 3} (sensitivity 75.0 %, specificity 76.7 %). Infarct volume greater than 3 cm{sup 3} predicted need for critical care interventions with 81.3 % sensitivity and 66.7 % specificity. Infarct volume may predict needs for ICU monitoring and interventions in stroke patients treated with IVT. (orig.)

  7. Influence of skeletal muscle satellite cells implanted into infarcted myocardium on remnant myocyte volumes

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    钟竑; 朱洪生; 卫洪超; 张臻

    2003-01-01

    Objective To study the effects of skeletal muscle satellite cells implanted into infarcted myocardium on the volume of remnant myocytes.Methods Thirty-six adult mongrel canines were divided randomly into implantation group and control group. In the implantation group, skeletal muscle satellite cells taken from the gluteus maximus muscles of the dogs were cultured, proliferated and labeled with 4', 6-diamidino-2-phenylindone (DAPI) in vitro. In both groups, a model of acute myocardial infarction was established in every dog. In the implantation group, each dog was injected with M199 solution containing autologous skeletal muscle satellite cells. The dogs in the control group received M199 solution without skeletal muscle satellite cells. The dogs of both groups were killed 2, 4 and 8 weeks after implantation (six dogs in a separate group each time). Both infarcted myocardium and normal myocytes distal from the infracted regions isolated were observed under optical and fluorescent microscope. Their volumes were determined using a confocal microscopy image analysis system and analyzed using SAS. A P<0.05 was considered significant.Results A portion of the implanted cells differentiated into muscle fiber with striations and were connected with intercalated discs. Cross-sectional area and cell volume were increased in normal myocardium. Hypertrophy of remnant myocytes in the infarcted site after skeletal muscle cell implantation was much more evident than in the control group. Cross-sectional area, cell area and cell volume differed significantly from those of the control group (P< 0.05). Hypertrophy of the cells occurred predominantly in terms of width and thickness, whereas cell length remained unchanged. Conclusion Skeletal muscle satellite cells implanted into infarct myocardium, could induce the hypertrophy of remnant myocyte cells in the infarcted site and could also aid in the recovery of the contractile force of the infarcted myocardium.

  8. CT angiography and CT perfusion improve prediction of infarct volume in patients with anterior circulation stroke

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    Seeters, Tom van; Schaaf, Irene C. van der; Dankbaar, Jan Willem; Horsch, Alexander D.; Niesten, Joris M.; Luitse, Merel J.A.; Mali, Willem P.T.M.; Velthuis, Birgitta K. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Biessels, Geert Jan; Kappelle, L.J. [University Medical Center Utrecht, Department of Neurology, Brain Center Rudolf Magnus, Utrecht (Netherlands); Majoie, Charles B.L.M. [Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Vos, Jan Albert [St. Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Schonewille, Wouter J. [St. Antonius Hospital, Department of Neurology, Nieuwegein (Netherlands); Walderveen, Marianne A.A. van [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Wermer, Marieke J.H. [Leiden University Medical Center, Department of Neurology, Leiden (Netherlands); Duijm, Lucien E.M. [Catharina Hospital, Department of Radiology, Eindhoven (Netherlands); Keizer, Koos [Catharina Hospital, Department of Neurology, Eindhoven (Netherlands); Bot, Joseph C.J. [VU University Medical Center, Department of Radiology, Amsterdam (Netherlands); Visser, Marieke C. [VU University Medical Center, Department of Neurology, Amsterdam (Netherlands); Lugt, Aad van der [Erasmus MC University Medical Center, Department of Radiology, Rotterdam (Netherlands); Dippel, Diederik W.J. [Erasmus MC University Medical Center, Department of Neurology, Rotterdam (Netherlands); Kesselring, F.O.H.W. [Rijnstate Hospital, Department of Radiology, Arnhem (Netherlands); Hofmeijer, Jeannette [Rijnstate Hospital, Department of Neurology, Arnhem (Netherlands); Lycklama a Nijeholt, Geert J. [Medical Center Haaglanden, Department of Radiology, The Hague (Netherlands); Boiten, Jelis [Medical Center Haaglanden, Department of Neurology, The Hague (Netherlands); Rooij, Willem Jan van [St. Elisabeth Hospital, Department of Radiology, Tilburg (Netherlands); Kort, Paul L.M. de [St. Elisabeth Hospital, Department of Neurology, Tilburg (Netherlands); Roos, Yvo B.W.E.M. [Academic Medical Center, Department of Neurology, Amsterdam (Netherlands); Meijer, Frederick J.A. [Radboud University Medical Center, Department of Radiology, Nijmegen (Netherlands); Pleiter, C.C. [St. Franciscus Hospital, Department of Radiology, Rotterdam (Netherlands); Graaf, Yolanda van der [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Collaboration: Dutch acute stroke study (DUST) investigators

    2016-04-15

    We investigated whether baseline CT angiography (CTA) and CT perfusion (CTP) in acute ischemic stroke could improve prediction of infarct presence and infarct volume on follow-up imaging. We analyzed 906 patients with suspected anterior circulation stroke from the prospective multicenter Dutch acute stroke study (DUST). All patients underwent baseline non-contrast CT, CTA, and CTP and follow-up non-contrast CT/MRI after 3 days. Multivariable regression models were developed including patient characteristics and non-contrast CT, and subsequently, CTA and CTP measures were added. The increase in area under the curve (AUC) and R{sup 2} was assessed to determine the additional value of CTA and CTP. At follow-up, 612 patients (67.5 %) had a detectable infarct on CT/MRI; median infarct volume was 14.8 mL (interquartile range (IQR) 2.8-69.6). Regarding infarct presence, the AUC of 0.82 (95 % confidence interval (CI) 0.79-0.85) for patient characteristics and non-contrast CT was improved with addition of CTA measures (AUC 0.85 (95 % CI 0.82-0.87); p < 0.001) and was even higher after addition of CTP measures (AUC 0.89 (95 % CI 0.87-0.91); p < 0.001) and combined CTA/CTP measures (AUC 0.89 (95 % CI 0.87-0.91); p < 0.001). For infarct volume, adding combined CTA/CTP measures (R{sup 2} = 0.58) was superior to patient characteristics and non-contrast CT alone (R{sup 2} = 0.44) and to addition of CTA alone (R{sup 2} = 0.55) or CTP alone (R{sup 2} = 0.54; all p < 0.001). In the acute stage, CTA and CTP have additional value over patient characteristics and non-contrast CT for predicting infarct presence and infarct volume on follow-up imaging. These findings could be applied for patient selection in future trials on ischemic stroke treatment. (orig.)

  9. CT angiography and CT perfusion improve prediction of infarct volume in patients with anterior circulation stroke

    International Nuclear Information System (INIS)

    We investigated whether baseline CT angiography (CTA) and CT perfusion (CTP) in acute ischemic stroke could improve prediction of infarct presence and infarct volume on follow-up imaging. We analyzed 906 patients with suspected anterior circulation stroke from the prospective multicenter Dutch acute stroke study (DUST). All patients underwent baseline non-contrast CT, CTA, and CTP and follow-up non-contrast CT/MRI after 3 days. Multivariable regression models were developed including patient characteristics and non-contrast CT, and subsequently, CTA and CTP measures were added. The increase in area under the curve (AUC) and R2 was assessed to determine the additional value of CTA and CTP. At follow-up, 612 patients (67.5 %) had a detectable infarct on CT/MRI; median infarct volume was 14.8 mL (interquartile range (IQR) 2.8-69.6). Regarding infarct presence, the AUC of 0.82 (95 % confidence interval (CI) 0.79-0.85) for patient characteristics and non-contrast CT was improved with addition of CTA measures (AUC 0.85 (95 % CI 0.82-0.87); p < 0.001) and was even higher after addition of CTP measures (AUC 0.89 (95 % CI 0.87-0.91); p < 0.001) and combined CTA/CTP measures (AUC 0.89 (95 % CI 0.87-0.91); p < 0.001). For infarct volume, adding combined CTA/CTP measures (R2 = 0.58) was superior to patient characteristics and non-contrast CT alone (R2 = 0.44) and to addition of CTA alone (R2 = 0.55) or CTP alone (R2 = 0.54; all p < 0.001). In the acute stage, CTA and CTP have additional value over patient characteristics and non-contrast CT for predicting infarct presence and infarct volume on follow-up imaging. These findings could be applied for patient selection in future trials on ischemic stroke treatment. (orig.)

  10. Does Preinterventional Flat-Panel Computer Tomography Pooled Blood Volume Mapping Predict Final Infarct Volume After Mechanical Thrombectomy in Acute Cerebral Artery Occlusion?

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    Wagner, Marlies, E-mail: marlies.wagner@kgu.de [Hospital of Goethe University, Institute of Neuroradiology (Germany); Kyriakou, Yiannis, E-mail: yiannis.kyriakou@siemens.com [Siemens AG, Health Care Sector (Germany); Mesnil de Rochemont, Richard du, E-mail: mesnil@em.uni-frankfurt.de [Hospital of Goethe University, Institute of Neuroradiology (Germany); Singer, Oliver C., E-mail: o.singer@em.uni-frankfurt.de [Hospital of Goethe University, Department of Neurology (Germany); Berkefeld, Joachim, E-mail: berkefeld@em.uni-frankfurt.de [Hospital of Goethe University, Institute of Neuroradiology (Germany)

    2013-08-01

    PurposeDecreased cerebral blood volume is known to be a predictor for final infarct volume in acute cerebral artery occlusion. To evaluate the predictability of final infarct volume in patients with acute occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA) and successful endovascular recanalization, pooled blood volume (PBV) was measured using flat-panel detector computed tomography (FPD CT).Materials and MethodsTwenty patients with acute unilateral occlusion of the MCA or distal ACI without demarcated infarction, as proven by CT at admission, and successful Thrombolysis in cerebral infarction score (TICI 2b or 3) endovascular thrombectomy were included. Cerebral PBV maps were acquired from each patient immediately before endovascular thrombectomy. Twenty-four hours after recanalization, each patient underwent multislice CT to visualize final infarct volume. Extent of the areas of decreased PBV was compared with the final infarct volume proven by follow-up CT the next day.ResultsIn 15 of 20 patients, areas of distinct PBV decrease corresponded to final infarct volume. In 5 patients, areas of decreased PBV overestimated final extension of ischemia probably due to inappropriate timing of data acquisition and misery perfusion.ConclusionPBV mapping using FPD CT is a promising tool to predict areas of irrecoverable brain parenchyma in acute thromboembolic stroke. Further validation is necessary before routine use for decision making for interventional thrombectomy.

  11. Diffusion tensor imaging correlates with lesion volume in cerebral hemisphere infarctions

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    Dastidar Prasun

    2010-09-01

    Full Text Available Abstract Background Both a large lesion volume and abnormalities in diffusion tensor imaging are independently associated with a poor prognosis after cerebral infarctions. Therefore, we assume that they are associated. This study assessed the associations between lesion volumes and diffusion tensor imaging in patients with a right-sided cerebral infarction. Methods The lesion volumes of 33 patients (age 65.9 ± 8.7, 26 males and 7 females were imaged using computed tomography (CT in the acute phase (within 3-4 hours and magnetic resonance imaging (MRI in the chronic phase (follow-up at 12 months, with a range of 8-27 months. The chronic-phase fractional anisotropy (FA and mean diffusivity (MD values were measured at the site of the infarct and selected white matter tracts. Neurological tests in both the acute and chronic phases, and DTI lateralization were assessed with the Wilcoxon signed-rank test. The effects of thrombolytic therapy (n = 10 were assessed with the Mann-Whitney U test. The correlations between the measured parameters were analysed with Spearman's rho correlation. Bonferroni post-hoc correction was used to compensate for the familywise error rate in multiple comparisons. Results Several MD values in the right hemisphere correlated positively and FA values negatively with the lesion volumes. These correlations included both lesion area and healthy tissue. The results of the mini-mental state examination and the National Institutes of Health Stroke Scale also correlated with the lesion volume. Conclusions A larger infarct volume is associated with more pronounced tissue modifications in the chronic stage as observed with the MD and FA alterations.

  12. THE INFLUENCE OF CEREBRAL INFARCT LOCATION AND VOLUME ON MOTOR AND FUNCTIONAL RECOVERY AFTER STROKE: A NARRATIVE REVIEW

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    Sivakumar.R

    2015-04-01

    Full Text Available Introduction: The knowledge on effect of location of infarct and volume of infarct on motor and functional outcomes is ambiguous due to variations in methodology and outcome measures used. This narrative review is aimed to summaries the studies on infarct location and volume related to motor and functional outcome, for a better understanding of the conclusions and limitation of the studies. Methodology: Literature search was done with key words of location of infarcts, size of infarct, motor recovery and functional recovery with Boolean term AND. Studies using outcome measures of multiple domain was not considered for inclusion. Results: 13 studies were identified in an extensive search without a time limit. Studies were categorized under location and volume with motor and functional recovery as variables. Majority of studies were done in isolation to any two variables, location outnumbered volume. The relationship with location and motor outcome was inconclusive, though two studies concluded that cortical infarcts had better scores than sub cortical. Volume was moderately associated with motor and functional recovery. Majority of the studies concluded a relationship between location and functional outcome, however the results are variable. Conclusion: Only few studies have analyzed the impact of infarct in different location and results were inconclusive. Outcome measures were summative in nature, not reflecting recovery in upper and lower extremities in isolation. The amount of recovery is analysed with initial deficits. We suggest more studies are required in this area to provide clarity.

  13. Clinical factors adversely affecting early outcome after brain infarction

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    Charles André

    1994-06-01

    Full Text Available PURPOSE AND METHODS: One-hundred-and-nine consecutive patients admitted during the acute phase of a CT-confirmed brain infarction (BI were studied. Putative adverse influence of demographic and stroke risk factors, previous medical history, clinical presentation, initial and follow-up neurological examination, initial general evaluation, laboratory findings, chest X-ray and electrocardiographic findings, treatment, and topography and etiology of the ischemic insult was analysed. The end-point for assessment was early death (within 30 days. Statistical analysis was performed with univariate analysis and multiple regression. RESULTS: The main adverse factors related to an increased death risk during the first 30 days were, in decreasing order of importance: coma 48-72 hours after admission; stroke occuring in already hospitalized patients; Babinski sign on admission; minor degrees of impairment of consciousness 48-72 hours after admission; stroke related to large artery atherothrombosis and to embolism; a history of early impairment of consciousness; cardiac failure on admission. In 53 lucid patients on admission, only a history of congestive heart failure (CHF was associated with a reduced survival rate. In 56 patients with impaired consciousness, the presence of a Babinski sign increased death risk, but the main factor predicting a high case-fatality rate was the persistence of consciousness disturbances after48-72 hours. CONCLUSIONS: The presence of impairment of consciousness, especially coma, 2-3 days after disease onset, and a history of CHF greatly increase the early case fatality rate in patients with acute BI presenting with or without consciousness disturbances at admission, respectively. The use of a prognostic algorythm considering these few variables seems to predict the approximate 30-day fatality rates.

  14. Moringa Oleifera Lam Mitigates Oxidative Damage and Brain Infarct Volume in Focal Cerebral Ischemia

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    Woranan Kirisattayakul

    2012-01-01

    Full Text Available Problem statement: At present, the therapeutic outcome of cerebral ischemia is still not in the satisfaction level. Therefore, the preventive strategy is considered. Based on the protective effect against oxidative damage of Moringa oleifera Lam. Leaves extract, we hypothesized that this plant extract might protect against cerebral ischemia, one of the challenge problems nowadays. In order to test this hypothesis, we aimed to determine the protective effect of M.oleifera leaves extract in animal model of focal cerebral ischemia induced by permanent occlusion of right middle cerebral artery. Approach: Male Wistar rats, weighing 300-350 g, were orally given the extract once daily at doses of 100, 200 and 400 mg kg-1 BW at a period of 2 weeks, then, they were permanently occluded the right Middle Cerebral Artery (MCAO. The animals were assessed the cerebral infarction volume and oxidative damage markers including MDA level and the activities of SOD, CAT and GSHPx enzymes at 24 h after occlusion. Results: Rats subjected to M.oleifera extract at all doses used in this study significantly decreased brain infarct volume both at cortical and subcortical structures in accompany with the elevation of SOD activity in both hippocampus and striatum while only the rats exposed to the extract at doses of 100 and 400 mg kg-1 BW showed the increased GSHPx activity in hippocampus. No the changes were observed. Therefore, our results demonstrates the potential benefit of M.oleifera leaves to decrease oxidative stress damage and brain infarct volume. Conclusion: This study is the first study to demonstrate the neuroprotective effect against focal cerebral ischemia of M.oleifera leaves. It suggests that M.oleifera may be served as natural resource for developing neuroprotectant against focal cerebral ischemia. However, the precise underlying mechanism and possible active ingredient are still required further study.

  15. Influence of mild hypothermia on vascular endothelial growth factor and infarct volume in brain tissues after cerebral ischemia in rats

    Institute of Scientific and Technical Information of China (English)

    Fei Ye; Gangming Xi; Biyong Qin; Shifeng Wang; Chengyan Li

    2006-01-01

    BACKGROUND: It has been demonstrated that mild hypothermia has obvious protective effect on both whole and local cerebral ischemia. However, the definite mechanism is still unclear for the brain protection of mild hypothermia on cerebral edema, inhibiting inflammatory reaction, stabilizing blood brain barrier, etc.OBJECTIVE: To investigate the effect of mild hypothermia on the expression of vascular endothelial growth factor and the infarct volume after cerebral ischemia in rats, and analyze the brain protective mechanism of mild hypothermia.DESIGN: A randomized grouping and controlled animal trial.SETTING: Department of Neurology, People's Hospital of Yunyang Medical College.MATERIALS: Twenty adult male SD rats of clean degree, weighing (250±30) g, were provided by the animal experimental center, School of Medicine, Wuhan University. The kits for SP immunohistochemistry were purchased from Beijing Zhongshan Golden Bridge Biotechnology Co., Ltd.METHODS: The experiments were carried out in the laboratory of Department of Neurology, Renmen Hospital of Wuhan University from May to July 2005. ① The 20 rats were divided randomly into normal temperature group (n =10) and mild hypothermia group (n =10). Models of permanent middle cerebral artery occlusion were established with modified nylon suture embolization. The rats were assessed with the Longa standards: O point for without nerve dysfunction; 1 for mild neurological deficit (fore claws could no extend completely); 2 for moderate neurological deficit (circling towards the affected side); 3 for severe neurological deficit (tilting towards the affected side); 4 for coma and unconscious; 1 -3 points represented that models were successfully established. The rats of the normal temperature group were fed at room temperature, and those in the mild hypothermia group were induced by hypothermia from 2 hours postoperatively, and the rectal temperature was kept at 34-35 ℃ for 72 hours. ② Measurement of infarct volume

  16. Initial study of 3D perfused blood volume imaging using 64-detector CT in hyperacute cerebral infarction

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    Objective: To evaluate the value of three dimensional CT whole brain perfused blood volume (3D-PBV) based on CTA row data in hyperacute cerebral infarction. Methods: 38 patients with stroke within 12 hours performed plain CT and CTA scans. 3D software Neuro PBV was applied to process the CTA row data and 3D-PBV of brain was obtained. MR examinations were performed within 2 hours after CT scans. The numbers of ischemic lesions on plain CT, 3D-PBV and MRI-DWI were recorded. The volumes of ischemic lesions on 3D-PBV and MR -DWI were measured. Results: In 38 patients, the number of infarct lesion detected by MRI-DWI, PBV, and plain CT was 45, 41, and 16 respectively. Kappa test showed a substantial agreement (κ=0.78) between 3D-PBV and MRI-DWI in detecting ischemic lesions. The detectability of plain CT showed fair or slight agreements to 3D-PBV and MR-DWI (κ=0.24, 0.18, respectively). The lesion volumes did not differ on 3D-PBV and MR-DWI (t=7.249, P>0.05). Conclusion: 3D-PBV combined with CTA can detect ischemic lesion and evaluate perfusion. It had important value in diagnosing hyperacute cerebral infarction. (authors)

  17. A study on cognitive impairment and gray matter volume abnormalities in silent cerebral infarction patients

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    Luo, Wei; Wei, Xiaofeng; Li, Mengxiong [The First Affiliated Hospital of Yangtze University, Biomedical Engineering Laboratory, Jingzhou, Hubei (China); Jiang, Xun [Renmin Hospital of Wuhan University, Biomedical Engineering Laboratory, Wuhan, Hubei (China); Li, Shanshan [JingZhou City Central Blood Bank, Jingzhou, Hubei (China)

    2015-08-15

    The relationship between silent cerebral infarction (SCI) and the integrity of cognitive function is unknown. We intended to investigate whether cognitive impairment is associated with gray matter volume (GMV) in the SCI patients. Sixty-two patients with SCI and 62 age- and gender-matched healthy controls (HC) were evaluated with P300 test, Montreal Cognitive Assessment (MoCA) test, Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HDRS). Whole brain high-resolution T1-weighted images were processed with SPM12b software and analyzed by voxel-based morphometry (VBM). Correlation analysis was performed between the GMV and the scores of MoCA Scale, P300 latency, P300 amplitude, HAMA, HDRS, age, and educational level. The brains of the SCI patients have a significant reduction in GMV in the left superior and inferior frontal gyrus, left superior temporal gyrus, right middle temporal gyrus, and bilateral hippocampus gyrus (p < 0.01, FDR correction). No significant increase of GMV was detected. The GMV of their frontal and temporal lobes is positively correlated with the score of MoCA scale and P300 amplitude (r ≥ 0.62, p < 0.01). The GMV of frontal, temporal, and hippocampus is negatively correlated with P300 latency (r ≤ -0.71, p < 0.05). No significant correlation between the GMV of abnormal brain regions and another two clinical characteristics was found. SCI patients have impaired cognitive function and reduced GMV compared to the HC subjects. The neuropathological basis of such cognitive deficits in SCI patients might be a reduced GMV. (orig.)

  18. 胰岛素对脑梗死小鼠梗死周围区血管直径和梗死体积的影响%Effects of insulin on vascular diameter of the peri -infarct region and infarct volume after cerebral infarction in mice

    Institute of Scientific and Technical Information of China (English)

    吴腾腾; 李明月; 邝亚晗; 裴中; 陶玉倩

    2016-01-01

    Objective To investigate the effects of insulin on vascular diameter of the peri -infarct region and infarct volume after cerebral infarction in mice. Methods Forty male C57/BL6j mice w ere randomly divided into a control group ( n = 5), a cerebral infarction group ( n = 15), a cerebral insulin resistance group (n = 5), and a cerebral insulin resistance infarction group ( n = 15). A model of cerebral infarction w as induced by the photochemical method. A model of cerebral insulin resistance w as induced by intracerebroventricular injection of streptozocin. Tw o -photon confocal microscope w as used to in vivo evaluate the changes of vascular diameter in the peri-infarct region at 20 min after insulin injection into the cerebelomedulary cistern. After modeling of cerebral infarction, artificial cerebrospinal fluid or insulin (10 ng/ml) w as immediately injected into the cerebelomedulary cistern, and the effect of insulin on cerebral infarct volume w as evaluated at 24 h after infarction. Results Insulin did not have significant effect on various types of cerebral vascular diameters in the normal control group, but it significantly contracted cerebral arteries ( -23.16% ±6.86% and -23.32% ±6.40%, respectively; al P <0.001) and penetrating arteries ( -15.20% ±5.51% and -16.40% ±4.27%, respectively; al P < 0.001) in the cerebral insulin resistance group and the cerebral insulin resistance infarction group, but it did not have any effect on the diameters of the cerebral veins. There w ere no significant differences in the vasoactive effects of insulin betw een the cerebral infarction group and the normal control group, as w el as betw een the cerebral insulin resistance group and the cerebral insulin resistance infarction group. Insulin significantly reduced the volume of cerebral infarction in the cerebral infarction group (9.0 ±1.0 mm3 vs.6.0 ±1.2 mm3; t = 4.294,P =0.002), and it did not have significant effect on the volume of cerebral infarction in the

  19. Comparison of quantitative estimation of intracerebral hemorrhage and infarct volumes after thromboembolism in an embolic stroke model

    DEFF Research Database (Denmark)

    Eriksen, Nina; Rasmussen, Rune Skovgaard; Overgaard, Karsten;

    2014-01-01

    measurements, the stereological method was the most efficient and advantageous. CONCLUSIONS: We found that stereology was the superior method for quantification of hemorrhagic volume, especially for rodent petechial bleeding, which is otherwise difficult to measure. Our results suggest the possibility of......BACKGROUND: Strokes have both ischemic and hemorrhagic components, but most studies of experimental stroke only address the ischemic component. This is likely because investigations of hemorrhagic transformation are hindered by the lack of methods based on unbiased principles for volume estimation....... AIMS: We evaluated different methods for estimating the volume of infarcts, hemorrhages, after embolic middle cerebral artery occlusion with or without thrombolysis. METHODS: An experimental thromboembolytic rat model was used in this study. The rats underwent surgery and were placed in two groups...

  20. Prediction of subacute infarct lesion volumes by processing apparent diffusion coefficient maps based on apparent diffusion coefficient cut-off values in patients with acute stroke

    Institute of Scientific and Technical Information of China (English)

    郭翔

    2014-01-01

    Objective To explore the feasibility of prediction of subacute infarct lesion volumes by processing ADC maps based on ADC cut-off values in patients with acute stroke.Methods MRI was performed in 20 patients with clinically diagnosed acute infarct less than 6 h after stroke onset.The MRI included a DWI and conventional MRI.The follow-up MR examinations of all the patients

  1. Relationship of infarct size and severity versus left ventricular ejection fraction and volumes obtained from {sup 99m}Tc-sestamibi gated single-photon emission computed tomography in patients treated with primary percutaneous coronary intervention

    Energy Technology Data Exchange (ETDEWEB)

    Sciagra, Roberto; Imperiale, Alessio; Comis, Giannetto; Pupi, Alberto [Nuclear Medicine Unit, Department of Clinical Physiopathology, University of Florence, Viale Morgagni 85, 50134, Florence (Italy); Antoniucci, David; Migliorini, Angela; Parodi, Guido [Division of Cardiology, Careggi Hospital, Florence (Italy)

    2004-07-01

    The current technique of choice for perfusion imaging is gated single-photon emission computed tomography (SPECT), which allows the simultaneous assessment of perfusion and left ventricular (LV) function. We examined the relationships of infarct size and severity with LV ejection fraction (EF) and volumes in 215 myocardial infarction patients treated with primary percutaneous coronary intervention within 6 h of symptom onset. Patients were studied with resting gated SPECT 1 month later. Infarct size was expressed as LV percent, and infarct severity as the lowest activity ratio within the defect. LVEF, end-diastolic (ED) and end-systolic (ES) volume indexes (Vi) were calculated with commercial software. There was a significant correlation between infarct size and LVEF (r=-0.68, P<0.00001), EDVi (r=0.53, P<0.00001), and ESVi (r=0.62, P<0.00001). Slightly lower correlations were demonstrated using infarct severity. LVEF and volumes were related to infarct location. A significantly higher correlation was observed between infarct size and LVEF in anterior than in non-anterior infarctions (r=-0.75 vs -0.60, P<0.05). In multivariate analysis, infarct size and infarct location were significant predictors of LVEF (R{sup 2}=0.50) and ESV (R{sup 2}=0.40). Infarct size and infarct severity were significant predictors of EDVi (R{sup 2}=0.29). Infarct size (and severity) and LVEF (and volumes) derived from a single gated SPECT study correlate closely. Infarct location influences this relationship, with anterior infarctions showing a lower LVEF than inferior or lateral ones of the same extent. (orig.)

  2. Fluid therapy in acute myocardial infarction: evaluation of predictors of volume responsiveness

    DEFF Research Database (Denmark)

    Snygg, J; Bech-Hanssen, O; Lönn, L;

    2008-01-01

    infarction by temporary coronary occlusion. Animals were instrumented to monitor central venous (CVP) and pulmonary artery occlusion (PAOP) pressures and arterial systolic variations (SPV) and PPV. Cardiac output (CO) was measured using the pulmonary artery catheter and by using the PiCCO monitor also giving...

  3. Chronic methamphetamine exposure prior to middle cerebral artery occlusion increases infarct volume and worsens cognitive injury in Male mice.

    Science.gov (United States)

    Zuloaga, Damian G; Wang, Jianming; Weber, Sydney; Mark, Gregory P; Murphy, Stephanie J; Raber, Jacob

    2016-08-01

    Emerging evidence indicates that methamphetamine (MA) abuse can impact cardiovascular disease. In humans, MA abuse is associated with an increased risk of stroke as well as an earlier age at which the stroke occurs. However, little is known about how chronic daily MA exposure can impact ischemic outcome in either humans or animal models. In the present study, mice were injected with MA (10 mg/kg, i.p.) or saline once daily for 10 consecutive days. Twenty-four hours after the final injection, mice were subjected to transient middle cerebral artery occlusion (tMCAO) for one hour followed by reperfusion. Mice were tested for novel object memory at 96 h post-reperfusion, just prior to removal of brains for quantification of infarct volume using 2,3,5-Triphenyltetrazolium Chloride (TTC) staining. Mice treated with MA prior to tMCAO showed decreased object memory recognition and increased infarct volume compared to saline-treated mice. These findings indicate that chronic MA exposure can worsen both cognitive and morphological outcomes following cerebral ischemia. PMID:27021292

  4. Osthole, a natural coumarin, improves neurobehavioral functions and reduces infarct volume and matrix metalloproteinase-9 activity after transient focal cerebral ischemia in rats.

    Science.gov (United States)

    Mao, Xuexuan; Yin, Wei; Liu, Mengfei; Ye, Minzhong; Liu, Peiqing; Liu, Jianxin; Lian, Qishen; Xu, Suowen; Pi, Rongbiao

    2011-04-18

    Previously we demonstrated that Osthole, a natural coumarin, protects against focal cerebral ischemia/reperfusion-induced injury in rats. In the present study, the effects of Osthole on neurobehavioral functions, infarct volume and matrix metalloproteinase-9 (MMP-9) in a rat 2h focal cerebral ischemia model were investigated. Osthole (100mg/kg per dose) was administrated intraperitoneally 30min before ischemic insult and immediately after reperfusion. Osthole treatment significantly reduced neurological deficit score and infarct volume by 38.5% and 33.8%, respectively, as compared with the untreated animals. Osthole reversed ischemia-reperfusion-induced increase in MMP-9 protein level/activity as evidenced by Western blotting and gelatin zymography. Taken together, these results for the first time demonstrate that Osthole reduces infarct volume, restores neurobehavioral functions and downregulates MMP-9 protein level/activity in ischemia/reperfused brain. PMID:21316348

  5. Influence of rotating magnetic field on cerebral infarction volume, cerebral edema and free radicals metabolism after cerebral ischemia/reperfusion injury in rats

    Institute of Scientific and Technical Information of China (English)

    Xiaohong Liu; Zhiqiang Zhang; Lixin Zhang

    2006-01-01

    BACKGROUND: It has shown that magnetic field can improve blood circulation, decrease blood viscosity, inhibit free radicals, affect Ca2+ flow in nerve cells, control inflammatory and immunological reaction, and accelerate nerve cell regeneration. In addition, protective effect of magnetic field, which acts as an iatrophysics, on ischemic brain tissues has been understood gradually.OBJECTIVE: To investigate the effects of rotating magnetic field (RMF) on volume of cerebral infarction,cerebral edema and metabolism of free radicals in rats after cerebral ischemia/reperfusion injury.DESIGN: Randomized controlled animal study.SETTING: Rehabilitation Center of disabled children, Liaoniang; Department of Rehabilitation, the Second Affiliated Hospital, China Medical University; Department of Rehabilitation Physiotherapy, the First Affiliated Hospital, China Medical University.MATERIALS: A total of 70 healthy Wistar rats aged 18-20 weeks of both genders were selected and randomly divided into 3 groups: sham operation group with 12 rats, control group with 20 rats and treatment group with 38 rats. The treatment group included 4 time points: immediate reperfusion with 6 ones, 6-hour reperfusion with 20 ones, 12-hour reperfusion with 6 ones and 18-hour reperfusion with 6 rats. Main instruments were detailed as follows: magnetic head of rotating magnetic device was 6 cm in diameter; magnetic induction intensity at the surface of magnetic head was 0.25 T in silence; the maximal magnetic induction intensity was 0.09 T at the phase of rotation; the average rotating speed was 2500 r per minute.METHODS: The experiment was carried out in the China Medical University in March 2003. Focal cerebral ischemic animal models were established with modified Longa's method. Operation was the same in the sham operation, but the thread was inserted as 10 mm. Neurologic impairment was assessed with 5-rating method to screen out cases. Those survivals with grade 1 and grade 2 after ischemia for 2

  6. INFARCT DETECTION IN BRAIN MRI USING IMPROVED SEGMENTATION ALGORITHM AND VOLUME VISUALIZATION

    OpenAIRE

    Praveen Kumar E; Sumithra M G; Sunil Kumar P

    2013-01-01

    In the present days, for the human body anatomical study and for the treatment planning medicalscience very much depend on the medical imaging technology and medical images. Specifically for thehuman brain, MRI widely prefers and using for the imaging. But by nature medical images are complex andnoisy.This leads to the necessity of processes that reduces difficulties in analysis and improves quality ofoutput.This paper discuss about an improved segmentation algorithm for infarct detection in ...

  7. Exercise preconditioning reduces ischemia reperfusion-induced focal cerebral infarct volume through up-regulating the expression of HIF-1α.

    Science.gov (United States)

    Wang, Lu; Deng, Wenqian; Yuan, Qiongjia; Yang, Huijun

    2015-03-01

    To study the effect and mechanism of exercise preconditioning on focal cerebral ischemia reperfusion induced cerebral infarction via rat model; Sixty Sprague Dawley rats were divided into three groups at random: ischemia reperfusion group (IR, n=24), sham group (sham, n=12) and exercise preconditioning group (EP, n=24). Group EP carried out moderate exercise preconditioning for 4 weeks (swimming with non-weight bearing, 60 minutes/day, 6 days/week), Rats in Group EP and IR were established cerebral ischemia reperfusion injury model by Zea Longa's thread method. The cerebral infarct volume in rat of different group was evaluated after 2%TTC staining, expression of HIF-1α in rats' brain was detected by real-time RT-PCR, immunohistochmeistry method and western blot. No cerebral infarction and significant expression of HIF-1α in Group sham. Compared with Group IR, there was smaller infarct volume and stronger HIF-1α expression in Group EP (Pexercise preconditioning reduces ischemia reperfusion induced focal cerebral infarct volume through up-regulating the expression of HIF-1α. PMID:25796156

  8. Influence of rotating magnetic field on cerebral infarction volume, cerebral edema and free radicals metabolism after cerebral ischemia/reperfusion injury in rats

    Institute of Scientific and Technical Information of China (English)

    Xiaohong Liu; Zhiqiang Zhang; Lixin Zhang

    2006-01-01

    BACKGROUND: It has shown that magnetic field can improve blood circulation, decrease blood viscosity, inhibit free radicals, affect Ca2+ flow in nerve cells, control inflammatory and immunological reaction, and accelerate nerve cell regeneration. In addition, protective effect of magnetic field, which acts as an iatrophysics, on ischemic brain tissues has been understood gradually.OBJECTIVE: To investigate the effects of rotating magnetic field (RMF) on volume of cerebral infarction,cerebral edema and metabolism of free radicals in rats after cerebral ischemia/reperfusion injury.DESIGN: Randomized controlled animal study.SETTING: Rehabilitation Center of disabled children, Liaoniang; Department of Rehabilitation, the Second Affiliated Hospital, China Medical University; Department of Rehabilitation Physiotherapy, the First Affiliated Hospital, China Medical University.MATERIALS: A total of 70 healthy Wistar rats aged 18-20 weeks of both genders were selected and randomly divided into 3 groups: sham operation group with 12 rats, control group with 20 rats and treatment group with 38 rats. The treatment group included 4 time points: immediate reperfusion with 6 ones, 6-hour reperfusion with 20 ones, 12-hour reperfusion with 6 ones and 18-hour reperfusion with 6 rats. Main instruments were detailed as follows: magnetic head of rotating magnetic device was 6 cm in diameter; magnetic induction intensity at the surface of magnetic head was 0.25 T in silence; the maximal magnetic induction intensity was 0.09 T at the phase of rotation; the average rotating speed was 2500 r per minute.METHODS: The experiment was carried out in the China Medical University in March 2003. Focal cerebral ischemic animal models were established with modified Longa's method. Operation was the same in the sham operation, but the thread was inserted as 10 mm. Neurologic impairment was assessed with 5-rating method to screen out cases. Those survivals with grade 1 and grade 2 after ischemia for 2

  9. Sequence variants affecting eosinophil numbers associate with asthma and myocardial infarction

    DEFF Research Database (Denmark)

    Gudbjartsson, Daniel F; Bjornsdottir, Unnur S; Halapi, Eva;

    2009-01-01

    in blood of 9,392 Icelanders. The most significant SNPs were studied further in 12,118 Europeans and 5,212 East Asians. SNPs at 2q12 (rs1420101), 2q13 (rs12619285), 3q21 (rs4857855), 5q31 (rs4143832) and 12q24 (rs3184504) reached genome-wide significance (P = 5.3 x 10(-14), 5.4 x 10(-10), 8.6 x 10(-17), 1.......2 x 10(-10) and 6.5 x 10(-19), respectively). A SNP at IL1RL1 associated with asthma (P = 5.5 x 10(-12)) in a collection of ten different populations (7,996 cases and 44,890 controls). SNPs at WDR36, IL33 and MYB that showed suggestive association with eosinophil counts were also associated...... with atopic asthma (P = 4.2 x 10(-6), 2.2 x 10(-5) and 2.4 x 10(-4), respectively). We also found that a nonsynonymous SNP at 12q24, in SH2B3, associated significantly (P = 8.6 x 10(-8)) with myocardial infarction in six different populations (6,650 cases and 40,621 controls)....

  10. How Reading Volume Affects Both Reading Fluency and Reading Achievement

    Science.gov (United States)

    Allington, Richard L.

    2014-01-01

    Long overlooked, reading volume is actually central to the development of reading proficiencies, especially in the development of fluent reading proficiency. Generally no one in schools monitors the actual volume of reading that children engage in. We know that the commonly used commercial core reading programs provide only material that requires…

  11. Melatonin Does Not Affect Oxidative/Inflammatory Biomarkers in a Closed-Chest Porcine Model of Acute Myocardial Infarction

    DEFF Research Database (Denmark)

    Halladin, Natalie L.; Ekelof, Sarah; Jensen, Svend Eggert;

    2014-01-01

    Aim: To test whether melatonin reduces oxidative and inflammatory biomarkers in a closed-chest porcine model of acute myocardial infarction. Materials and Methods: Twenty pigs were randomized to receive a total dosage of 200 mg (0.4 mg/ml) of melatonin, or placebo immediately prior to reperfusion...... or oxidative stress markers after experimental myocardial infarction compared to placebo....

  12. The time-of-day of myocardial infarction onset affects healing through oscillations in cardiac neutrophil recruitment

    OpenAIRE

    Schloss, M.J.; Horckmans, M; Nitz, K.; Duchene, J.; Drechsler, M.; Bidzhekov, K.; Scheiermann, C.; Weber, C.; O. Soehnlein; Steffens, S.

    2016-01-01

    Myocardial infarction (MI) is the leading cause of death in Western countries. Epidemiological studies show acute MI to be more prevalent in the morning and to be associated with a poorer outcome in terms of mortality and recovery. The mechanisms behind this association are not fully understood. Here, we report that circadian oscillations of neutrophil recruitment to the heart determine infarct size, healing, and cardiac function after MI Preferential cardiac neutrophil recruitment during the...

  13. Intranasal delivery of transforming growth factor-beta1 in mice after stroke reduces infarct volume and increases neurogenesis in the subventricular zone

    Directory of Open Access Journals (Sweden)

    Xu Gelin

    2008-12-01

    Full Text Available Abstract Background The effect of neurotrophic factors in enhancing stroke-induced neurogenesis in the adult subventricular zone (SVZ is limited by their poor blood-brain barrier (BBB permeability. Intranasal administration is a noninvasive and valid method for delivery of neuropeptides into the brain, to bypass the BBB. We investigated the effect of treatment with intranasal transforming growth factor-β1 (TGF-β1 on neurogenesis in the adult mouse SVZ following focal ischemia. The modified Neurological Severity Scores (NSS test was used to evaluate neurological function, and infarct volumes were determined from hematoxylin-stained sections. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL labeling was performed at 7 days after middle cerebral artery occlusion (MCAO. Immunohistochemistry was used to detect bromodeoxyuridine (BrdU and neuron- or glia-specific markers for identifying neurogenesis in the SVZ at 7, 14, 21, 28 days after MCAO. Results Intranasal treatment of TGF-β1 shows significant improvement in neurological function and reduction of infarct volume compared with control animals. TGF-β1 treated mice had significantly less TUNEL-positive cells in the ipsilateral striatum than that in control groups. The number of BrdU-incorporated cells in the SVZ and striatum was significantly increased in the TGF-β1 treated group compared with control animals at each time point. In addition, numbers of BrdU- labeled cells coexpressed with the migrating neuroblast marker doublecortin (DCX and the mature neuronal marker neuronal nuclei (NeuN were significantly increased after intranasal delivery of TGF-β1, while only a few BrdU labeled cells co-stained with glial fibrillary acidic protein (GFAP. Conclusion Intranasal administration of TGF-β1 reduces infarct volume, improves functional recovery and enhances neurogenesis in mice after stroke. Intranasal TGF-β1 may have therapeutic potential for cerebrovascular

  14. Effects of transection of cervical sympathetic trunk on cerebral infarct volume and oxygen free radical levels in rats with focal cerebral ischemia/reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Liangzhi Xiong; Yongxia Shi; Feng Xiao; Qingxiu Wang

    2008-01-01

    BACKGROUND: Stellate ganglion block (SGB) plays a protective role on the brain, but the precise mechanism of action is not clear.OBJECTIVE: To simulate SGB by transection of the cervical sympathetic trunk (TCST) and to investigate the TCST effects on changes in cerebral infarct volume and oxygen free radical levels in rats with focal cerebral ischemia/reperfusion injury.DESIGN, TIME AND SETTING: A complete randomized control animal experiment was performed at the Institute of Neurological Diseases of Taihe Hospital, Yunyang Medical College from February to December 2005.MATERIALS: A total of 101 healthy Wistar rats, weighing 280-320g, of both genders, aged 17-18 weeks, were used in this study. 2,3,5-triphenyltetrazolium chloride (TTC) was purchased from Changsha Hongyuan Biological Company. Superoxide dismutase (SOD), malondialdehyde (MDA) and nitric oxide (NO) assay kits were provided by Nanjing Jiancheng Bioengineering Institute.METHODS: Rats were randomly divided into a TCST group, a model group and a sham operation group. Successful models were included in the final analysis, with at least 20 rats in each group. After TCST, rat models of focal cerebral ischemia/reperfusion injury were established in the TCST group by receiving middle cerebral artery occlusion (MCAO) by the intraluminal suture method for 2 hours, followed by 24 hours of reperfusion. Rat models of focal cerebral ischemia/reperfusion injury were made in the model group. Rats in the sham operation group underwent experimental procedures as for the model group, threading depth of 10mm, and middle cerebral artery was not ligated.MAIN OUTCOME MEASURES: Brain tissue sections of ten rats from each group were used to measure cerebral infarct volume by TTC staining. Brain tissue homogenate of another ten rats from each group was used to detect SOD activities, MDA contents and NO levels. Rat neurological function was assessed by neurobehavioral measures.RESULTS: Cerebral infarct volume was bigger in the

  15. The broad-spectrum cation channel blocker pinokalant (LOE 908 MS) reduces brain infarct volume in rats

    DEFF Research Database (Denmark)

    Christensen, Thomas; Wienrich, Marion; Ensinger, Helmut A;

    2005-01-01

    Activation of cation channels conducting Ca2+, Na+ and K+ is involved in the pathogenesis of infarction in experimental focal cerebral ischaemia. Pinokalant (LOE 908 MS) is a novel broad-spectrum inhibitor of several subtypes of such channels and has previously been shown to improve the metabolic...

  16. Preimplant factors affecting postimplant CT-determined prostate volume and the CT/TRUS volume ratio after transperineal interstitial prostate brachytherapy with 125I free seeds

    International Nuclear Information System (INIS)

    The aim was to identify preimplant factors affecting postimplant prostate volume and the increase in prostate volume after transperineal interstitial prostate brachytherapy with 125I free seeds. We reviewed the records of 180 patients who underwent prostate brachytherapy with 125I free seeds for clinical T1/T2 prostate cancer. Eighty-one (45%) of the 180 patients underwent neoadjuvant hormonal therapy. No patient received supplemental external beam radiotherapy. Postimplant computed tomography was undertaken, and postimplant dosimetric analysis was performed. Univariate and multivariate analyses were performed to identify preimplant factors affecting postimplant prostate volume by computed tomography and the increase in prostate volume after implantation. Preimplant prostate volume by transrectal ultrasound, serum prostate-specific antigen, number of needles, and number of seeds implanted were significantly correlated with postimplant prostate volume by computed tomography. The increase in prostate volume after implantation was significantly higher in patients with neoadjuvant hormonal therapy than in those without. Preimplant prostate volume by transrectal ultrasound, number of needles, and number of seeds implanted were significantly correlated with the increase in prostate volume after implantation. Stepwise multiple linear regression analysis showed that preimplant prostate volume by transrectal ultrasound and neoadjuvant hormonal therapy were significant independent factors affecting both postimplant prostate volume by computed tomography and the increase in prostate volume after implantation. The results of the present study show that preimplant prostate volume by transrectal ultrasound and neoadjuvant hormonal therapy are significant preimplant factors affecting both postimplant prostate volume by computed tomography and the increase in prostate volume after implantation

  17. Splenic infarction

    Science.gov (United States)

    Splenic infarction is the death of tissue (necrosis) in the spleen due to a blockage in blood flow. ... Common causes of splenic infarction include: Blood clots Blood diseases such as sickle cell anemia Infections such as endocarditis

  18. Troglitazone treatment increases bone marrow adipose tissue volume but does not affect trabecular bone volume in mice

    DEFF Research Database (Denmark)

    Erikstrup, Lise Tornvig; Mosekilde, Leif; Justesen, J;

    2001-01-01

    proliferator activated receptor-gamma (PPARgamma). Histomorphometric analysis of proximal tibia was performed in order to quantitate the amount of trabecular bone volume per total volume (BV/TV %), adipose tissue volume per total volume (AV/TV %), and hematopoietic marrow volume per total volume (HV...

  19. Variation in orbitofrontal cortex volume: relation to sex, emotion regulation and affect

    OpenAIRE

    Welborn, B. Locke; Papademetris, Xenophon; Reis, Deidre L.; Rajeevan, Nallakkandi; Bloise, Suzanne M.; Gray, Jeremy R.

    2009-01-01

    Sex differences in brain structure have been examined extensively but are not completely understood, especially in relation to possible functional correlates. Our two aims in this study were to investigate sex differences in brain structure, and to investigate a possible relation between orbitofrontal cortex subregions and affective individual differences. We used tensor-based morphometry to estimate local brain volume from MPRAGE images in 117 healthy right-handed adults (58 female), age 18–...

  20. Relationship between cerebral infarct volume and peripheral blood lymphocyte DNA damage%脑梗死体积与外周血淋巴细胞DNA损伤的关系

    Institute of Scientific and Technical Information of China (English)

    鲁文果; 姜丹; 范德义; 张苏明

    2012-01-01

    Objective To study the relationship between cerebral infarct volume and peripheral blood lymphocyte DNA damage. Methods Sixty acute cerebral infarction patients were divided into small, medium and large infarct groups according to the infarct votume , 20 cases in each group. The percentage of DNA in the tail of lymphoeytic nuclear was assessed by single-cell gel electrophoresis (comet assay) in infarct groups and 20 normal controls (IMC group) , and the results were compared. Results In the alkaline comet assay, the percentage of DNA in the tail of lymphocytic nuclear in infarction groups were significantly higher than NC group (all P <0. 01) ; which in small and medium infarct groups were significantly lower than large infarct group (all P < 0. 01 ). In the neutral comet assay, the percentage of DNA DNA in the tail of lymphocytic nuclear in medium and large infarct groups were significantly higher than NC group (all P < 0. 01) ; which in large infarct group was significantly higher than small and medium infarct groups (all P < 0. 01 ). Conclusion Infarct volume may reflect the degree of peripheral lymphocytes DNA damage.%目的 探讨脑梗死体积与外周血淋巴细胞DNA损伤的关系.方法 按梗死灶体积将60例急性脑梗死患者分为小、中和大梗死组,每组 20例.应用单细胞凝胶电泳(彗星实验)检测各脑梗死组和20名正常对照者(正常对照组)外周血淋巴细胞核尾部DNA的百分比,并进行比较.结果 碱性彗星试验中,各脑梗死组的淋巴细胞核尾部DNA百分比显著高于正常对照组(均P<0.01);小、中梗死组淋巴细胞核尾部DNA百分比显著低于大梗死组(均P<0.01).中性彗星试验巾,中梗死组和大梗死组的淋巴细胞核尾部DNA百分比显著高于正常对照组(均P<0.01);大梗死组明显高于小、中梗死组(均P<0.01).结论 脑梗死体积可能可以反映外周血淋巴细胞DNA损伤程度.

  1. Momentary affective states are associated with momentary volume, prospective trends and fluctuation of daily physical activity

    Directory of Open Access Journals (Sweden)

    Martina K. Kanning

    2016-05-01

    Full Text Available Several interventions aiming to enhance physical activity in everyday life showed mixed effects. Affective constructs are thought to potentially support health behavior change. However, little is known about within-subject associations between momentary affect and subsequent physical activity in everyday life. This study analyzed the extent to which three dimensions of affective states (valence, calmness, and energetic arousal were associated with different components of daily activity trajectories. Sixty-five undergraduates’ students (Age: M = 24.6; SD = 3.2; females: 57% participated in this study. Physical activity was assessed objectively through accelerometers during 24 hours. Affective states assessments were conducted randomly every 45min using an e-diary with a six-item mood scale that was especially designed for ambulatory assessment. We conducted three-level multi-level analyses to investigate the extent to which momentary affect accounted for momentary volume, prospective trends and stability vs. fluctuation of physical activity in everyday life. All three affect dimensions were significantly associated with momentary activity volumes and prospective trends over 45 minute periods. Physical activity didn’t fluctuate freely, but featured significant autocorrelation across repeated measurements, suggesting some stability of physical activity across 5-minute assessments. After adjusting for the autoregressive structure in physical activity assessments, only energetic arousal remained a significant predictor. Feeling energized and awake was associated with an increased momentary volume of activity and initially smaller but gradually growing decreases in subsequent activity within the subsequent 45 minutes. Although not related to trends in physical activity, higher valence predicted lower stability in physical activity across subsequent 45 minutes, suggesting more short-term fluctuations in daily activity the more participants reported

  2. Is kidney function affecting the management of myocardial infarction? A retrospective cohort study in patients with normal kidney function, chronic kidney disease stage III-V, and ESRD.

    Science.gov (United States)

    Saad, Marc; Karam, Boutros; Faddoul, Geovani; Douaihy, Youssef El; Yacoub, Harout; Baydoun, Hassan; Boumitri, Christine; Barakat, Iskandar; Saifan, Chadi; El-Charabaty, Elie; Sayegh, Suzanne El

    2016-01-01

    Patients with chronic kidney disease (CKD) are three times more likely to have myocardial infarction (MI) and suffer from increased morbidity and higher mortality. Traditional and unique risk factors are prevalent and constitute challenges for the standard of care. However, CKD patients have been largely excluded from clinical trials and little evidence is available to guide evidence-based treatment of coronary artery disease in patients with CKD. Our objective was to assess whether a difference exists in the management of MI (ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction) among patients with normal kidney function, CKD stage III-V, and end-stage renal disease (ESRD) patients. We conducted a retrospective cohort study on patients admitted to Staten Island University Hospital for the diagnosis of MI between January 2005 and December 2012. Patients were assigned to one of three groups according to their kidney function: Data collected on the medical management and the use of statins, platelet inhibitors, beta-blockers, and angiotensin converting enzyme inhibitors/angiotensin receptor blockers were compared among the three cohorts, as well as medical interventions including: catheterization and coronary artery bypass graft (CABG) when indicated. Chi-square test was used to compare the proportions between nominal variables. Binary logistic analysis was used in order to determine associations between treatment modalities and comorbidities, and to account for possible confounding factors. Three hundred and thirty-four patients (mean age 67.2±13.9 years) were included. In terms of management, medical treatment was not different among the three groups. However, cardiac catheterization was performed less in ESRD when compared with no CKD and CKD stage III-V (45.6% vs 74% and 93.9%) (PCardiac catheterization on the other hand carried the strongest association among all studied variables (Pstatistically different. Many

  3. Is kidney function affecting the management of myocardial infarction? A retrospective cohort study in patients with normal kidney function, chronic kidney disease stage III–V, and ESRD

    Directory of Open Access Journals (Sweden)

    Saad M

    2016-01-01

    between treatment modalities and comorbidities, and to account for possible confounding factors. Three hundred and thirty-four patients (mean age 67.2±13.9 years were included. In terms of management, medical treatment was not different among the three groups. However, cardiac catheterization was performed less in ESRD when compared with no CKD and CKD stage III–V (45.6% vs 74% and 93.9% (P<0.001. CABG was performed in comparable proportions in the three groups and CABG was not associated with the degree of CKD (P=0.078 in binary logistics regression. Cardiac catheterization on the other hand carried the strongest association among all studied variables (P<0.001. This association was maintained after adjusting for other comorbidities. The length of stay for the three cohorts (non-CKD, CKD stage III–V, and ESRD on hemodialysis was 16, 17, and 15 days, respectively and was not statistically different. Many observations have reported discrimination of care for patients with CKD considered suboptimal candidates for aggressive management of their cardiac disease. In our study, medical therapy was achieved at high percentage and was comparable among groups of different kidney function. However, kidney disease seems to affect the management of patients with acute MI; percutaneous coronary angiography is not uniformly performed in patients with CKD and ESRD when compared with patients with normal kidney function. Keywords: myocardial infarction, chronic kidney disease, end-stage renal disease

  4. Migrainous infarction

    DEFF Research Database (Denmark)

    Laurell, K; Artto, V; Bendtsen, L;

    2011-01-01

    Migrainous infarction (MI), i.e. an ischemic stroke developing during an attack of migraine with aura is rare and the knowledge of its clinical characteristics is limited. Previous case series using the International Classification of Headache Disorders (ICHD) included......Migrainous infarction (MI), i.e. an ischemic stroke developing during an attack of migraine with aura is rare and the knowledge of its clinical characteristics is limited. Previous case series using the International Classification of Headache Disorders (ICHD) included...

  5. Does amniotic fluid volume affect fetofetal transfusion in monochorionic twin pregnancies? Modelling two possible mechanisms

    Science.gov (United States)

    Umur, Asli; van Gemert, Martin J. C.; Ross, Michael G.

    2002-06-01

    Clinical evidence suggests that increased amniotic fluid volume due to polyhydramnios increases placental vascular resistance. We have sought to model the possible effects of an increased amniotic fluid volume on the net fetofetal transfusion in monochorionic twin pregnancies. We wanted to compare these effects with the results of previous simulations, which aimed to explain why the twin-twin transfusion syndrome (TTTS) placentas more often include bidirectional arteriovenous (AV) rather than AV plus arterioarterial (AA) anastomoses. We extended our mathematical model of TTTS by simulating two different mechanisms that increase the placental vascular resistance as a consequence of polyhydramnios. First, there is an increase in the placental capillary resistance and hence in deep AV and opposite AV (denoted as VA) resistances due to polyhydramnios. Second, there is an increase in the resistance of chorionic veins due to polyhydramnios, assuming that these veins act as Starling resistors. We then simulated the effects of polyhydramnios on different placental anastomotic patterns. The results were as follows. In the first mechanism (polyhydramnios affects AV-VA resistances), an increased amniotic fluid volume hardly affected bidirectional AV, but slightly decreased fetofetal transfusion in AV plus AA anastomoses. However, for these effects to change the natural development of the pregnancy, polyhydramnios needed to persist for approximately 4 weeks, and by comparing the effects of polyhydramnios with the effects of amnioreduction, amnioreduction was more beneficial for normalizing the donor amniotic fluid volume. Therefore, these beneficial effects due to polyhydramnios have no practical clinical significance. In the second mechanism (Starling resistor for chorionic veins), polyhydramnios slightly increased fetofetal transfusion and hence slightly increased TTTS severity in bidirectional AV and AV plus VV, but did not affect AV plus AA anastomoses. In conclusion, we

  6. Acute myocardial infarction does not affect functional characteristics of adipose-derived stem cells in rats, but reduces the number of stem cells in adipose tissue.

    Science.gov (United States)

    Naaijkens, B A; Krijnen, P A J; Meinster, E; ter Horst, E N; Vo, K; Musters, R J P; Kamp, O; Niessen, H W M; Juffermans, L J M; van Dijk, A

    2015-12-01

    In most pre-clinical animal studies investigating stem cell therapy in acute myocardial infarction (AMI), the administered stem cells are isolated from healthy donors. In clinical practice, however, patients who suffer from AMI will receive autologous cells, for example using adipose-derived stem cells (ASC). During AMI, inflammation is induced and we hypothesized that this might affect characteristics of ASC. To investigate this, ASC were isolated from rat adipose tissue 1 day (1D group, n = 5) or 7 days (7D group, n = 6) post-AMI, and were compared with ASC from healthy control rats (Control group, n = 6) and sham-operated rats (Sham 1D group, n = 5). We found that significantly fewer ASC were present 1 day post-AMI in the stromal vascular fraction (SVF), determined by a colony-forming-unit assay (p cells in SVF of the 1D group. When cultured, no differences were found in proliferation rate and cell size between the groups in the first three passages. Also, no difference in the differentiation capacity of ASC was found. In conclusion, it was shown that significantly fewer stem cells were present in the SVF 1 day post-AMI; however, the stem cells that were present showed no functional differences.

  7. Regulatory volume decrease in isolated nematocytes is affected by crude venom from the jellyfish Pelagia noctiluca

    Directory of Open Access Journals (Sweden)

    Rossana Morabito

    2014-11-01

    Full Text Available Crude venom from nematocysts of the Scyphozoan Pelagia noctiluca possesses hemolytic and cytotoxic power on cultured cells and elicits local and systemic inflammation reactions in vivo. The ability of regulating their volume after exposure to an anisosmotic solution is a fundamental feature common to cells from vertebrates and invertebrates, including Cnidarians. The aim of the present work i s to assay whether crude venom from Pelagia noctiluca may affect the regulatory volume decrease (RVD of nematocytes isolated from the Anthozoan Aiptasia mutabilis, here employed as a cell model. For this purpose, nematocytes were isolated by 605 mM NaSCN plus 0.01 mM Ca2+ application on acontia of Aiptasia mutabilis, while crude venom was obtained by sonication of a population of, respectively, 10, 25 and 50 nematocysts/µL (n/µL. Isolated nematocytes were pre-treated for 30 min with crude venom, submitted to hypotonic stress and their osmotic response and RVD were measured optically. Our results show that, after exposure to crude venom, nematocytes were morphologically intact, as shown by the Trypan blue exclusion test, but did not exhibit RVD. This effect was dose-dependent and reversed by the ionopho re gramicidin. The last observation suggests an inhibitory effect of venom on cell membrane ion transport mechanisms involved in RVD. Further studies are needed to verify this hypothesis and ascertain if a similar effect could be observed in human cells.

  8. Prognostic factors affecting the all-cause death and sudden cardiac death rates of post myocardial infarction patients with low left ventricular ejection fraction

    Institute of Scientific and Technical Information of China (English)

    DAI Shi-mo; ZHANG Shu; CHEN Ke-ping; HUA Wei; WANG Fang-zheng; CHEN Xin

    2009-01-01

    Background Post myocardial infarction (post-MI) patients with low left ventricular ejection fraction (LVEF) have been candidates for an implantable cardioverter-deflbrillator (ICD) since the Multicenter Automatic Defibrillator Implantation Trail II (MADIT II).However,due to the high costs of ICDs,widespread usage has not been accepted.Therefore,further risk stratification for post-MI patients with low LVEF may aid in the selection of patients that will benefit most from ICD treatment.Methods Four hundred and seventeen post-MI patients with low LVEF (≤35%) were enrolled in the study.All the patients received standard examination and proper treatment and were followed up to observe the all-cause death rate and sudden cardiac death (SCD) rate.Then COX proportional-hazards regression model was used to investigate the clinical factors which affect the all-cause death rate and SCD rate.Results Of 55 patients who died during (32±24) months of follow-up,37 (67%) died suddenly.After adjusting for baseline clinical characteristics,multivariate COX proportional-hazards regression model identified the following variables associated with death from all causes:New York Heart Association (NYHA) heart failure class ≥111 (Hazard ratio:2.361),LVEF ≤20% (Hazard ratio:2.514),sustained ventricular tachycardia (Hazard ratio:6.453),and age ≥70 years (Hazard ratio:3.116).The presence of sustained ventricular tachycardia (Hazard ratio:6.491) and age ≥70 years (Hazard ratio:2.694) were specifically associated with SCD.Conclusions In the post-MI patients with low LVEF,factors as LVEF ≤20%,age ≥70 years,presence of ventricular tachycardia,and NYHA heart failure class≥111 predict an adverse outcome.The presence of sustained ventricular tachycardia and age ≥70 years was associated with occurrence of SCD in these patients.

  9. Visual localisation in patients with occipital infarction.

    OpenAIRE

    Ross Russell, R W; Bharucha, N

    1984-01-01

    Visually directed pointing has been examined in a group of patients with occipital lobe infarction and in an age-matched control group. The visual field ipsilateral to the infarct showed normal localisation; there was no evidence that right sided infarction produced a bilateral disturbance. In quadrantanopia the spared quadrant on the affected side showed abnormal localisation in a few patients but this was not consistently associated with right or left sided defects. The majority of patients...

  10. C4b-binding protein is present in affected areas of myocardial infarction during the acute inflammatory phase and covers a larger area than C3.

    Directory of Open Access Journals (Sweden)

    Leendert A Trouw

    Full Text Available BACKGROUND: During myocardial infarction reduced blood flow in the heart muscle results in cell death. These dying/dead cells have been reported to bind several plasma proteins such as IgM and C-reactive protein (CRP. In the present study we investigated whether fluid-phase complement inhibitor C4b-binding protein (C4BP would also bind to the infarcted heart tissue. METHODS AND FINDINGS: Initial studies using immunohistochemistry on tissue arrays for several cardiovascular disorders indicated that C4BP can be found in heart tissue in several cardiac diseases but that it is most abundantly found in acute myocardial infarction (AMI. This condition was studied in more detail by analyzing the time window and extent of C4BP positivity. The binding of C4BP correlates to the same locations as C3b, a marker known to correlate to the patterns of IgM and CRP staining. Based on criteria that describe the time after infarction we were able to pinpoint that C4BP binding is a relatively early marker of tissue damage in myocardial infarction with a peak of binding between 12 hours and 5 days subsequent to AMI, the phase in which infiltration of neutrophilic granulocytes in the heart is the most extensive. CONCLUSIONS: C4BP, an important fluid-phase inhibitor of the classical and lectin pathway of complement activation binds to jeopardized cardiomyocytes early after AMI and co-localizes to other well known markers such as C3b.

  11. How do sock ply changes affect residual-limb fluid volume in people with transtibial amputation?

    Directory of Open Access Journals (Sweden)

    Joan E. Sanders, PhD

    2012-04-01

    Full Text Available The purpose of this research was to investigate the influence of sock addition and removal on residual-limb fluid volume in people using prosthetic limbs. We used bioimpedance analysis to measure residual-limb extracellular fluid volume on 28 transtibial amputee subjects during 30 min test sessions. Upon addition of a one-ply polyester sock, residual-limb fluid volume changes ranged from −4.0% to 0.8% (mean −0.9 +/− 1.3% of the initial limb fluid volume. Changes for sock removal ranged from −1.2% to 2.8% (mean 0.5 +/− 0.8%. Subjects who reduced in fluid volume with both addition and removal of a sock and subjects with high positive ratios between the fluid-volume loss upon sock addition and gain upon sock removal (high add/remove [AR] ratios tended to have arterial disease, were obese, and were smokers. Subjects with low positive AR ratios, subjects who increased in fluid volume both with sock addition and removal, and a single subject who increased in fluid volume with sock addition and decreased with sock removal tended to be nonsmokers and either individuals in good health without complications or individuals without arterial problems. Results are relevant for the anticipation of limb volume changes during prosthetic fitting and toward the design of adjustable-socket technologies.

  12. Volume and Nutritional Status Evaluated by Bioimpedance Affected by Body Positions

    Directory of Open Access Journals (Sweden)

    Ender HÜR

    2014-01-01

    Full Text Available OBJECTIVE: Body composition analysis is useful technique for assessing hydration, nutritional status and predicting clinical outcomes. Bioimpedance analysis (BIA is a cheap and noninvasive tool for monitoring body composition but needs some improvements regarding measurement methods. We aimed to fi nd out if body position has an effect on the BIA results. MATERIAL and METHODS: Personal characteristics including age, gender, height, weight and blood pressure were recorded. Hydration and nutritional status measured by body composition monitor in supine and standing positions consequently for each individual. RESULTS: Two hundred and one populations from various region in Turkey, 61% (n: 123 male, mean age was 46.3±12 years (18-76 of age, participated in this crossectional study. From supine to standing positions overhydration and extracellular water (ECW were increased from 0.04±1.08 and 17.69±2.92 to 0.46±1.05 L and 17.84±2.90 L while intracellular water (ICW decreased from 22.55±4.35 to 22.04±4.28 L signifi cantly. Systolic and diastolic blood pressures were 131.3±18.1 and 75.1±12 decreased to 127.0±16.0 and 72.2±9.0 mmHg in supine to standing positions (p> 0.05. CONCLUSION: Supine and standing positions could affect the volume parameters of BIA due to shift of ECW and ICW by gravity but nutritional parameters also changes signifi cantly. Protocols should be re evaluated in order to get more accurate results in bioimpedance measurements.

  13. Changes in membrane lipid composition of Mycoplasma capricolum affect the cell volume.

    OpenAIRE

    N. Romano; Shirvan, M H; Rottem, S.

    1986-01-01

    The cellular water volume of Mycoplasma capricolum was markedly increased by a decrease in the cholesterol-to-phospholipid molar ratio in the membrane. An increase in cell volume was also observed with the increase in the phospholipid cell membrane content obtained by the incorporation of exogenous phosphatidylcholine from the growth medium.

  14. How does adding and removing liquid from socket bladders affect residual-limb fluid volume?

    Directory of Open Access Journals (Sweden)

    Joan E. Sanders, PhD

    2013-08-01

    Full Text Available Adding and removing liquid from socket bladders is a means for people with limb loss to accommodate residual-limb volume change. We fit 19 people with transtibial amputation using their regular prosthetic socket with fluid bladders on the inside socket surface to undergo cycles of bladder liquid addition and removal. In each cycle, subjects sat, stood, and walked for 90 s with bladder liquid added, and then sat, stood, and walked for 90 s again with the bladder liquid removed. The amount of bladder liquid added was increased in each cycle. We used bioimpedance analysis to measure residual-limb fluid volume. Results showed that the preferred bladder liquid volume was 16.8 +/– 8.4 mL (mean +/– standard deviation, corresponding with 1.7% +/– 0.8% of the average socket volume between the bioimpedance voltage-sensing electrodes. Residual-limb fluid volume driven out of the residual limb when bladder liquid was added was typically not recovered upon subsequent bladder liquid removal. Of the 19 subjects, 15 experienced a gradual residual-limb fluid volume loss over the test session. Care should be taken when implementing adjustable socket technologies in people with limb loss. Reducing socket volume may accentuate residual-limb fluid volume loss.

  15. How does adding and removing liquid from socket bladders affect residual-limb fluid volume?

    Science.gov (United States)

    Sanders, Joan E; Cagle, John C; Harrison, Daniel S; Myers, Timothy R; Allyn, Kathryn J

    2013-01-01

    Adding and removing liquid from socket bladders is a means for people with limb loss to accommodate residual-limb volume change. We fit 19 people with transtibial amputation using their regular prosthetic socket with fluid bladders on the inside socket surface to undergo cycles of bladder liquid addition and removal. In each cycle, subjects sat, stood, and walked for 90 s with bladder liquid added, and then sat, stood, and walked for 90 s again with the bladder liquid removed. The amount of bladder liquid added was increased in each cycle. We used bioimpedance analysis to measure residual-limb fluid volume. Results showed that the preferred bladder liquid volume was 16.8 +/- 8.4 mL (mean +/- standard deviation), corresponding with 1.7% +/- 0.8% of the average socket volume between the bioimpedance voltage-sensing electrodes. Residual-limb fluid volume driven out of the residual limb when bladder liquid was added was typically not recovered upon subsequent bladder liquid removal. Of the 19 subjects, 15 experienced a gradual residual-limb fluid volume loss over the test session. Care should be taken when implementing adjustable socket technologies in people with limb loss. Reducing socket volume may accentuate residual-limb fluid volume loss.

  16. 29 CFR 779.267 - Fluctuations in annual gross volume affecting enterprise coverage and establishment exemptions.

    Science.gov (United States)

    2010-07-01

    ... (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR STATEMENTS OF GENERAL POLICY OR INTERPRETATION NOT... Employment to Which the Act May Apply; Enterprise Coverage Computing the Annual Volume § 779.267 Fluctuations... monetary provisions of the Act may reveal changes in the annual gross volume or other determinative...

  17. Correlative factors of cognitive impairment in patients with lacunar infarcts

    Institute of Scientific and Technical Information of China (English)

    Zhang Qiujuan; Yao Xiaoxin; Guo Youmin; Zhang Gejuan; Yang Junle

    2007-01-01

    Objective To study the relationships between cognitive impairment in patients with lacunar infarcts and quantitative CT measures and to determine the independent correlative factors of cognitive impairment. Methods Neuropsychological examination was conducted for 128 patients with acute lacunar infarct. Number, location, and volume of infarcts, cerebral atrophy index and severity of white matter lesions (WMLs) were measured and recorded. Results The number of lacunar infarcts in cognitive impairment (CI) group was significantly larger than that in cognitive normal (CN) group. Mean width of sulcus and sylvian fissure, index of frontal horn and ventricular-brain ratio (VBR) were significantly different in both groups. There were more patients with 3 grades or 4 grades WMLs in CI group (62%) than those in CN group (22%). The total volume of lacunar infarcts showed no statistically significant difference. Logistic regression analysis indicated that the number of lacunar infarcts in frontal subcortex and thalamus, the volume of infarcts in anterior periventricular white matter, width of cerebral sulcus and sylvian fissure were correlated with cognitive impairment respectively. Additionally, age and education were correlative factors of cognitive impairment in patients with lacunar infarct. Conclusion Correlative factors of cognitive impairment in patients with lacunar infarct are not merely one feature, but a combination of infarct features (number, location, and volume), cortical atrophy and host factors (age and education).

  18. SNPs identified as modulators of ECG traits in the general population do not markedly affect ECG traits during acute myocardial infarction nor ventricular fibrillation risk in this condition

    OpenAIRE

    Raha Pazoki; de Jong, Jonas S.S.G.; Marsman, Roos F; Nienke Bruinsma; Dekker, Lukas R. C.; Wilde, Arthur A. M.; Connie R Bezzina; Tanck, Michael W.T.

    2013-01-01

    BACKGROUND: Ventricular fibrillation (VF) in the setting of acute ST elevation myocardial infarction (STEMI) is a leading cause of mortality. Although the risk of VF has a genetic component, the underlying genetic factors are largely unknown. Since heart rate and ECG intervals of conduction and repolarization during acute STEMI differ between patients who do and patients who do not develop VF, we investigated whether SNPs known to modulate these ECG indices in the general population also impa...

  19. Multi-Infarct Dementia

    Science.gov (United States)

    ... Diversity Find People About NINDS NINDS Multi-Infarct Dementia Information Page Synonym(s): Dementia - Multi-Infarct Table of ... Additional resources from MedlinePlus What is Multi-Infarct Dementia? Multi-infarct dementia (MID) is a common cause ...

  20. Distinct associations of insula and cingulate volume with the cognitive and affective dimensions of alexithymia

    NARCIS (Netherlands)

    Goerlich-Dobre, Katharina Sophia; Bruce, Lori; Martens, Sander; Aleman, Andreas; Hooker, Christine I.

    2014-01-01

    Alexithymia ("no words for feelings") is a major risk factor for psychosomatic and psychiatric conditions characterized by affect dysregulation. The alexithymia personality construct comprises an affective dimension, the level of subjective emotional experience (emotionalizing and fantasizing), and

  1. Changes in extracellular muscle volume affect heart rate and blood pressure responses to static exercise

    Science.gov (United States)

    Baum, K.; Essfeld, D.; Stegemann, J.

    To investigate the effect of μg-induced peripheral extracellular fluid reductions on heart rate and blood pressure during isometric exercise, six healthy male subjects performed three calf ergometer test with different extracellular volumes of working muscles. In all tests, body positions during exercise were identical (supine with the knee joint flexed to 900). After a pre-exercise period of 25 min, during which calf volumes were manipulated, subjects had to counteract an external force of 180 N for 5 min. During the pre-exercise period three different protocols were applied. Test A: Subjects rested in the exercise position; test B: Body position was the same as in A but calf volume was increased by venous congestion (cuffs inflated to 80 mm Hg); test C: Calf volumes were decreased by a negative hydrostatic pressure (calves about 40 cm above heart level with the subjects supine). To clamp the changed calf volumes in tests B and C, cuffs were inflated to 300 mm Hg 5 min before the onset of exercise. This occlusion was maintained until termination of exercise. Compared to tests A and B, the reduced volume of test C led to significant increases in heart rate and blood pressure during exercise. Oxygen uptake did not exceed resting levels in B and C until cuffs were deflated, indicating that exclusively calf muscles contributed to the neurogenic peripheral drive. It is concluded that changes in extracellular muscle volume have to be taken into account when comparing heart rate and blood pressure during lg- and μg- exercise.

  2. Hospital variation in mortality after first acute myocardial infarction in Denmark from 1995 to 2002: lower short-term and 1-year mortality in high-volume and specialized hospitals

    DEFF Research Database (Denmark)

    Rasmussen, Søren; Zwisler, Ann-Dorthe O; Abildstrom, Steen Z;

    2005-01-01

    history. RESULTS: Tertiary cardiac care centers (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.67-0.96) and main regional hospitals (OR, 0.90; 95% CI, 0.80-0.99) had improved 28-day mortality compared with local hospitals. A 2-fold increase in annual total MI volume decreased 28-day mortality (OR......BACKGROUND: This study used linked data from the National Hospital Registry to determine the factors that contribute to differences between hospitals in all-cause mortality after first acute myocardial infarction (AMI) between 1995 and 2002. METHODS: The study included 64,321 patients...... with their first admission for AMI between 1995 and 2002 and surviving the day of admission. Multilevel logistic regression was used to determine the relationships between regional and hospital characteristics and 28-day and 365-day mortality after adjusting for individual characteristics, period, and medical...

  3. Affectivity

    OpenAIRE

    Stenner, Paul; Greco, Monica

    2013-01-01

    The concept of affectivity has assumed central importance in much recent scholarship, and many in the social sciences and humanities now talk of an ‘affective turn’. The concept of affectivity at play in this ‘turn’ remains, however, somewhat vague and slippery. Starting with Silvan Tomkins’ influential theory of affect, this paper will explore the relevance of the general assumptions (or ‘utmost abstractions’) that inform thinking about affectivity. The technological and instrumentalist char...

  4. How Data Volume Affects Spark Based Data Analytics on a Scale-up Server

    OpenAIRE

    Awan, Ahsan Javed; Brorsson, Mats; Vlassov, Vladimir; Ayguade, Eduard

    2015-01-01

    Sheer increase in volume of data over the last decade has triggered research in cluster computing frameworks that enable web enterprises to extract big insights from big data. While Apache Spark is gaining popularity for exhibiting superior scale-out performance on the commodity machines, the impact of data volume on the performance of Spark based data analytics in scale-up configuration is not well understood. We present a deep-dive analysis of Spark based applications on a large scale-up se...

  5. Echocardiographic predictors of early in-hospital heart failure during first ST-elevation acute myocardial infarction: does myocardial performance index and left atrial volume improve diagnosis over conventional parameters of left ventricular function?

    Directory of Open Access Journals (Sweden)

    Machado Cristiano V

    2011-06-01

    Full Text Available Abstract Background Left ventricular ejection fraction (LVEF has been considered a major determinant of early outcome in acute myocardial infarction (AMI. Myocardial performance index (MPI has been associated to early evolution in AMI in a heterogeneous population, including non ST-elevation or previous AMI. Left atrial volume has been related with late evolution after AMI. We evaluated the independent role of clinical and echocardiographic variables including LVEF, MPI and left atrial volume in predicting early in-hospital congestive heart failure (CHF specifically in patients with a first isolated ST-elevation AMI. Methods Echocardiography was performed within 30 hours of chest pain in 95 patients with a first ST-elevation AMI followed during the first week of hospitalization. Several clinical and echocardiographic variables were analyzed. CHF was defined as Killip class ≥ II. Multivariate regression analysis was used to select independent predictor of in-hospital CHF. Results Early in-hospital CHF occurred in 29 (31% of patients. LVEF ≤ 0.45 was the single independent and highly significant predictor of early CHF among other clinical and echocardiographic variables (odds ratio 17.0; [95% CI 4.1 - 70.8]; p Conclusion For patients with first, isolated ST-elevation AMI, LVEF assessed by echocardiography still constitutes a strong and accurate independent predictor of early in-hospital CHF, superior to isolated MPI and left atrial volume in this particular subset of patients.

  6. Does hyrax expansion therapy affect maxillary sinus volume? A cone-beam computed tomography report

    Energy Technology Data Exchange (ETDEWEB)

    Darsey, Drew M.; English, Jeryl D.; Ellis, Randy K.; Akyalcin, Sercan [School of Dentistry, University of Texas Health Science Center at Houston, Houston (United States); Kau, Chung H [School of Dentistry, University of Alabama at Birmingham, Birmingham (United States)

    2012-06-15

    The aim of this study was to investigate the initial effects of maxillary expansion therapy with Hyrax appliance and to evaluate the related changes in maxillary sinus volume. Thirty patients (20 females, 10 males; 13.8 years) requiring maxillary expansion therapy, as part of their comprehensive orthodontic treatment, were examined. Each patient had cone-beam computed tomography (CBCT) images taken before (T1) and after (T2) maxillary expansion therapy with a banded Hyrax appliance. Multiplanar slices were used to measure linear dimensions and palatal vault angle. Volumetric analysis was used to measure maxillary sinus volumes. Student t tests were used to compare the pre- and post-treatment measurements. Additionally, differences between two age groups were compared with Mann-Whitney U test. The level of significance was set at p=0.05. Comparison of pre-treatment to post-treatment variables revealed significant changes in the transverse dimension related to both maxillary skeletal and dental structures and palatal vault angle, resulting in a widened palatal vault (p<0.05). Hard palate showed no significant movement in the vertical and anteroposterior planes. Nasal cavity width increased on a mean value of 0.93 mm(SD=0.23, p<0.05). Maxillary sinus volume remained virtually stable. No significant age differences were observed in the sample. Hyrax expansion therapy did not have a significant impact on maxillary sinus volume.

  7. Does the Addition of Inert Gases at Constant Volume and Temperature Affect Chemical Equilibrium?

    Science.gov (United States)

    Paiva, Joao C. M.; Goncalves, Jorge; Fonseca, Susana

    2008-01-01

    In this article we examine three approaches, leading to different conclusions, for answering the question "Does the addition of inert gases at constant volume and temperature modify the state of equilibrium?" In the first approach, the answer is yes as a result of a common students' alternative conception; the second approach, valid only for ideal…

  8. Renal infarction complicating fibromuscular dysplasia.

    Science.gov (United States)

    Gavalas, M; Meisner, R; Labropoulos, N; Gasparis, A; Tassiopoulos, A

    2014-01-01

    Fibromuscular dysplasia (FMD) is a nonatherosclerotic, noninflammatory vascular disease that most commonly affects the renal and extracranial carotid arteries. We present 3 cases of renal infarction complicating renal artery FMD in 42-, 43-, and 46-year-old females and provide a comprehensive review of the literature on this topic. In our patients, oral anticoagulation therapy was used to treat all cases of infarction, and percutaneous angioplasty was used nonemergently in one case to treat refractory hypertension. All patients remained stable at 1-year follow-up. This is consistent with outcomes in previously published reports where conservative medical management was comparable to surgical and interventional therapies. Demographic differences may also exist in patients with renal infarction and FMD. A higher prevalence of males and a younger age at presentation have been found in these patients when compared to the general population with FMD.

  9. Comparison of blood volume pulse and skin conductance responses to mental and affective stimuli at different anatomical sites

    International Nuclear Information System (INIS)

    Measurements of blood volume pulse (BVP) and skin conductance are commonly used as indications of psychological arousal in affective computing and human–machine interfaces. To date, palmar surfaces remain the primary site for these measurements. Placement of sensors on palmar surfaces, however, is undesirable when recordings are fraught with motion and pressure artifacts. These artifacts are frequent when the human participant has involuntary movements as in hyperkinetic cerebral palsy. This motivates the use of alternative measurement sites. The present study examined the correlation between measurements of blood volume pulse and skin conductance obtained from three different sites on the body (fingers, toes and ear for BVP; fingers, toes and arch of the foot for skin conductance) in response to cognitive and affective stimuli. The results of this pilot study indicated significant inter-site correlation among signal features derived from different sites, with the exception of BVP amplitude, the number of electrodermal reactions and the slope of the electrodermal activity response. We attribute these differences in part to inter-site discrepancies in local skin conditions, such as skin temperature. Despite these differences, significant changes from baseline were present in the responses to the cognitive and affective stimuli at non-palmar sites, suggesting that these sites may provide viable signal measurements for use in affective computing and human–machine interface applications

  10. Comparison of blood volume pulse and skin conductance responses to mental and affective stimuli at different anatomical sites

    Science.gov (United States)

    Kushki, Azadeh; Fairley, Jillian; Merja, Satyam; King, Gillian

    2016-01-01

    Measurements of blood volume pulse (BVP) and skin conductance are commonly used as indications of psychological arousal in affective computing and human–machine interfaces. To date, palmar surfaces remain the primary site for these measurements. Placement of sensors on palmar surfaces, however, is undesirable when recordings are fraught with motion and pressure artifacts. These artifacts are frequent when the human participant has involuntary movements as in hyperkinetic cerebral palsy. This motivates the use of alternative measurement sites. The present study examined the correlation between measurements of blood volume pulse and skin conductance obtained from three different sites on the body (fingers, toes and ear for BVP; fingers, toes and arch of the foot for skin conductance) in response to cognitive and affective stimuli. The results of this pilot study indicated significant inter-site correlation among signal features derived from different sites, with the exception of BVP amplitude, the number of electrodermal reactions and the slope of the electrodermal activity response. We attribute these differences in part to inter-site discrepancies in local skin conditions, such as skin temperature. Despite these differences, significant changes from baseline were present in the responses to the cognitive and affective stimuli at non-palmar sites, suggesting that these sites may provide viable signal measurements for use in affective computing and human–machine interface applications. PMID:21849720

  11. Manufacturing lot affects polyethylene tibial insert volume, thickness, and surface geometry.

    Science.gov (United States)

    Teeter, Matthew G; Milner, Jaques S; MacDonald, Steven J; Naudie, Douglas D R

    2013-08-01

    To perform wear measurements on retrieved joint replacement implants, a reference geometry of the implant's original state is required. Since implants are rarely individually scanned before implantation, a different, new implant of the same kind and size is frequently used. However, due to manufacturing variability, errors may be introduced into these measurements, as the dimensions between the retrieved and reference components may not be exactly the same. The hypothesis of this study was that new polyethylene tibial inserts from different manufacturing lots would demonstrate greater variability than those from the same lot. In total, 12 new tibial inserts of the same model and size were obtained, 5 from the same lot and the remainder from different lots. The geometry of each tibial insert was obtained using microcomputed tomography. Measurements of tibial insert volume, thickness, and three-dimensional surface deviations were obtained and compared between tibial inserts from the same and different manufacturing lots. Greater variability was found for the tibial inserts from different manufacturing lots for all types of measurements, including a fourfold difference in volume variability (p manufacturing lots for use as the reference geometry.

  12. Classification of myocardial infarction

    DEFF Research Database (Denmark)

    Saaby, Lotte; Poulsen, Tina Svenstrup; Hosbond, Susanne Elisabeth;

    2013-01-01

    The classification of myocardial infarction into 5 types was introduced in 2007 as an important component of the universal definition. In contrast to the plaque rupture-related type 1 myocardial infarction, type 2 myocardial infarction is considered to be caused by an imbalance between demand...... and supply of oxygen in the myocardium. However, no specific criteria for type 2 myocardial infarction have been established....

  13. Orthogonal design to sift the optimal parameter of Neiguan acupuncture for cerebral infarction***

    Institute of Scientific and Technical Information of China (English)

    Yanan Zhang; Sha Yang; Xiaonong Fan; Shu Wang; Nina He; Lingxin Li; Ding Luo; Xuemin Shi

    2013-01-01

    The individual difference and non-repeatability in acupuncture have not only restricted the devel-opment of acupuncture, but have also affected the specificity of acupoints. The present study used instruments to control needle depth, lifting and thrusting frequency, and the duration of acupuncture. Effects of the quantified acupuncture were observed at Neiguan (PC6) with different stimulation parameters. A frequency of 1, 2, or 3 Hz and duration of 5, 60, or 180 seconds were used to observe cerebral blood flow and ratio of infarct volume recovery. Results showed that stimulation at Neiguan with a frequency of 1 Hz and long duration of 180 seconds or 2/3 Hz and long duration of 5/60 se-conds significantly increased cerebral blood flow and decreased the ratio of infarct volume. Interac-tions between frequency and duration play a critical role in quantified acupuncture therapy.

  14. Assessment of factors affecting shrub volume estimations using airborne discrete-return LiDAR data in Mediterranean areas

    OpenAIRE

    Estornell Cremades, Javier; Ruiz Fernández, Luis Ángel; Velázquez Martí, Borja; Hermosilla Gómez, Txomin

    2012-01-01

    Shrub vegetation is a key element of Mediterranean forest areas and it is necessary to develop tools that allow a precise knowledge of this vegetation. This study aims to predict shrub volume and analyze the factors affecting the accuracy of these estimations in small stands using airborne discrete-return LiDAR data. The study was performed over 83 circular stands with 0.5 m radius located in Chiva (Spain) mainly occupied by Quercus coccifera. The vegetation inside each area was clear cut, an...

  15. Cell volume changes affect gluconeogenesis in the perfused liver of the catfish Clarias batrachus

    Indian Academy of Sciences (India)

    Carina Goswami; Shritapa Datta; Kuheli Biswas; Nirmalendu Saha

    2004-09-01

    In addition to lactate and pyruvate, some amino acids were found to serve as potential gluconeogenic substrates in the perfused liver of Clarias batrachus. Glutamate was found to be the most effective substrate, followed by lactate, pyruvate, serine, ornithine, proline, glutamine, glycine, and aspartate. Four gluconeogenic enzymes, namely phosphoenolpyruvate carboxykinase (PEPCK), pyruvate carboxylase (PC), fructose 1,6-bisphosphatase (FBPase) and glucose 6-phosphatase (G6Pase) could be detected mainly in liver and kidney, suggesting that the latter are the two major organs responsible for gluconeogenic activity in this fish. Hypo-osmotically induced cell swelling caused a significant decrease of gluconeogenic efflux accompanied with significant decrease of activities of PEPCK, FBPase and G6Pase enzymes in the perfused liver. Opposing effects were seen in response to hyper-osmotically induced cell shrinkage. These changes were partly blocked in the presence of cycloheximide, suggesting that the aniso-osmotic regulations of gluconeogenesis possibly occurs through an inverse regulation of enzyme proteins and/or a regulatory protein synthesis in this catfish. In conclusion, gluconeogenesis appears to play a vital role in C. batrachus in maintaining glucose homeostasis, which is influenced by cell volume changes possibly for proper energy supply under osmotic stress.

  16. Acute myocardial infarct imaging

    International Nuclear Information System (INIS)

    A brief review is presented of radiopharmaceuticals used for imaging acute myocardial infarction and instrumentation using the rectilinear scanner and the scintillation camera. Clinical experience indicates that myocardial imaging with /sup 99 m/Tc pyrophosphate is a useful adjunct to the electrocardiogram and serum enzyme activity in managing patients with myocardial infarction. The technique allows rapid diagnosis, accurate localization, and an estimate of the size of acute infarcts. It can also be used to document infarct extension and in association with myocardial perfusion imaging can help differentiate fresh from old myocardial infarction

  17. Evaluation of heart perfusion in patients with acute myocardial infarction using dynamic contrast-enhanced magnetic resonance imaging

    DEFF Research Database (Denmark)

    Nielsen, Gitte; Fritz-Hansen, Thomas; Dirks, Christina G;

    2004-01-01

    PURPOSE: To investigate the diagnostic ability of quantitative magnetic resonance imaging (MRI) heart perfusion in acute heart patients, a fast, multislice dynamic contrast-enhanced MRI sequence was applied to patients with acute myocardial infarction. MATERIALS AND METHODS: Seven patients...... with acute transmural myocardial infarction were studied using a Turbo-fast low angle shot (FLASH) MRI sequence to monitor the first pass of an extravascular contrast agent (CA), gadolinium diethylene triamine pentaacetic acid (Gd-DTPA). Quantitation of perfusion, expressed as Ki (mL/100 g/minute), in five...... acutely ill patients following acute myocardial infarction. The technique provides information on both the volume and severity of affected myocardial tissue, enabling the power of treatment regimes to be assessed objectively, and this approach should aid individual patient stratification and prognosis...

  18. Factors affecting the lung perfused blood volume in patients with intrapulmonary clots after anti-coagulation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Munemasa, E-mail: radokada@yamaguchi-u.ac.jp [Department of Radiology, Yamaguchi University Graduate School of Medicine 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Masuda, Yu [4th Grade of 6-year Medicine Doctor Program, Department of Medicine, Yamaguchi University Faculty of Medicine and Health Sciences 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Nakashima, Yoshiteru [Department of Radiology, Yamaguchi Grand Medical Center, Oosaki 77, Hofu, Yamaguchi 747-8511 (Japan); Nomura, Takafumi; Nakao, Sei [Department of Radiology, Yamaguchi University Graduate School of Medicine 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Suga, Kazuyoshi [Department of Radiology, St Hills Hospital, Imamurakita 3-7-18, Ube, Yamaguchi 755-0155 (Japan); Kido, Shoji [Computer-aided Diagnosis and Biomedical Imaging Research Biomedical Engineering, Applied Medical Engineering Science Graduate School of Medicine, Yamaguchi University, Tokiwadai 2-16-1, Ube, Yamaguchi 755-8611 (Japan); Matsunaga, Naofumi [Department of Radiology, Yamaguchi University Graduate School of Medicine 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan)

    2015-08-15

    Highlights: • Dual-energy CT can provide morphological and functional lung images in the same examination. • The subsequent dual-energy CT demonstrates the increased whole lung perfused blood volume (V{sub 120}) despite the residual intrapulmonary clots after treatment in one examination. • The increased whole lung perfusion (V{sub 120}) and a decreased low perfusion volume (V{sub 5}) result in the improvement in the low perfusion rate (%V{sub 5}) in the patients with acute pulmonary embolism after treatment. - Abstract: Objectives: Factors affecting the improvement in the lung perfused blood volume (LPBV) were evaluated based on the presence of intrapulmonary clots (IPCs) after anti-coagulation therapy using 64-slice dual-energy CT. Materials and methods: 96 patients exhibiting venous thromboembolism underwent initial and repeated LPBV examinations between December 2008 and July 2014. Fifteen patients were excluded due to pulmonary comorbidities, and a total of 81 patients were included in this study. Acute pulmonary embolism (PE) was diagnosed in 46 of the patients (56.7%). LPBV images were three-dimensionally reconstructed with two threshold ranges: 1–120 HU (V{sub 120}) and 1–5 HU (V{sub 5}), and the relative value of V{sub 5} per V{sub 120} expressed as %V{sub 5}. These values were subsequently compared with indicators of the severity of PE, such as the D-dimer level, heart rate and CT measurements. This study was approved by the local ethics committee. Results: In patients with IPCs, the D-dimer, V{sub 5} and %V{sub 5}values were significantly larger (p ≤ 0.01) in the initial LPBV, although these differences disappeared in subsequent LPBV after treatment. The right ventricular (RV) diameter, RV/left ventricular (RV/LV) diameter ratio and %V{sub 5} values were also significantly reduced, whereas the V{sub 5} value did not significantly decrease (p = 0.07), but V{sub 120} value significantly increased (p < 0.001) after treatment. However, in

  19. A systematic review: effect of angiotensin converting enzyme inhibition on left ventricular volumes and ejection fraction in patients with a myocardial infarction and in patients with left ventricular dysfunction

    DEFF Research Database (Denmark)

    Abdulla, Jawdat; Barlera, Simona; Latini, Roberto;

    2006-01-01

    BACKGROUND AND AIM: To summarize and quantify results of echocardiographic studies examining the effect of angiotensin converting enzyme (ACE) inhibition on left ventricular remodelling in patients with acute myocardial infarction (MI) and in patients with left ventricular systolic dysfunction...

  20. [Spinal cord infarction].

    Science.gov (United States)

    Naumann, N; Shariat, K; Ulmer, S; Stippich, C; Ahlhelm, F J

    2012-05-01

    Infarction of the spinal cord can cause a variety of symptoms and neurological deficits because of the complex vascular supply of the myelon. The most common leading symptom is distal paresis ranging from paraparesis to tetraplegia caused by arterial ischemia or infarction of the myelon. Venous infarction, however, cannot always be distinguished from arterial infarction based on the symptoms alone.Modern imaging techniques, such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA) assist in preoperative planning of aortic operations to reliably identify not only the most important vascular structure supplying the spinal cord, the artery of Adamkiewicz, but also other pathologies such as tumors or infectious disorders. In contrast to CT, MRI can reliably depict infarction of the spinal cord.

  1. Do Sustained Lung Inflations during Neonatal Resuscitation Affect Cerebral Blood Volume in Preterm Infants? A Randomized Controlled Pilot Study.

    Directory of Open Access Journals (Sweden)

    Bernhard Schwaberger

    Full Text Available Sustained lung inflations (SLI during neonatal resuscitation may promote alveolar recruitment in preterm infants. While most of the studies focus on respiratory outcome, the impact of SLI on the brain hasn't been investigated yet.Do SLI affect cerebral blood volume (CBV in preterm infants?Preterm infants of gestation 28 weeks 0 days to 33 weeks 6 days with requirement for respiratory support (RS were included in this randomized controlled pilot trial. Within the first 15 minutes after birth near-infrared spectroscopy (NIRS measurements using 'NIRO-200-NX' (Hamamatsu, Japan were performed to evaluate changes in CBV and cerebral tissue oxygenation. Two groups were compared based on RS: In SLI group RS was given by applying 1-3 SLI (30 cmH2O for 15 s continued by respiratory standard care. Control group received respiratory standard care only.40 infants (20 in each group with mean gestational age of 32 weeks one day (±2 days and birth weight of 1707 (±470 g were included. In the control group ΔCBV was significantly decreasing, whereas in SLI group ΔCBV showed similar values during the whole period of 15 minutes. Comparing both groups within the first 15 minutes ΔCBV showed a tendency toward different overall courses (p = 0.051.This is the first study demonstrating an impact of SLI on CBV. Further studies are warranted including reconfirmation of the present findings in infants with lower gestational age. Future investigations on SLI should not only focus on respiratory outcome but also on the consequences on the developing brain.German Clinical Trials Register DRKS00005161 https://drks-neu.uniklinik-freiburg.de/drks_web/setLocale_EN.do.

  2. Assessment of myocardial infarction by thallium emission computed tomography

    International Nuclear Information System (INIS)

    Ninety-one cases with MI (myocardial infarction) and 29 normal persons were examined by thallium ECT and the conventional planar imaging. Diagnostic performance and quantification of MI, and characterization of non-transmural MI were also investigated. In the detection of a perfusion defect, the ECT imaging showed significantly higher sensitivity (96%) than the planar imaging (77%) (p<0.001), especially in those with inferior wall MI (95% vs 73%, p<0.02) and nontransmural MI (82% vs 27%) (p<0.01). The specificity was the same in both techniques (90%), and therefore, higher overall accuracy was obtained by the ECT imaging (94%) than by the planar imaging (80%) (p<0.01). The receiver operating characteristic (ROC) curves were obtained from three independent observers for quantitative evaluation of observer detection performance. The ECT curves in each observer were situated in the upper left corner, indicating excellent diagnostic performance. Infarct size was estimated from the extent of the perfusion defect expressed as a percentage of the planar imaging (% defect) and as a volume of the infarcted myocardium (infarct volume). Those parameters were significantly correlated with peak CPK (r=0.80 and 0.94, respectively), and inversely correlated with left ventricular ejection fraction (r=-0.78 and -0.85, respectively). Thus, the infarct volume calculated from the ECT is considered to permit estimation of infarct size more accurately than % defect from the planar imaging. To characterize nontransmural MI, 11 cases with nontransmural MI were examined by ECT and the findings were compared with those of transmural MI. A perfusion defect was detected in nine of the 11 patients (82%). As compared to those with transmural MI, infarct volume was smaller and the residual activity in an infarct region was higher in cases with nontransmural MI

  3. MR imaging findings in diabetic muscle infarction.

    Science.gov (United States)

    Bajaj, Gitanjali; Nicholas, Richard; Pandey, Tarun; Montgomery, Corey; Jambhekar, Kedar; Ram, Roopa

    2014-10-01

    Diabetic muscle infarction is a rare, often unrecognized complication seen in patients with poorly controlled Diabetes Mellitus. The diagnosis is often missed and leads to unnecessary invasive investigations and inappropriate treatment. The patients usually present with unilateral thigh pain and swelling. MRI typically demonstrates diffuse swelling and increased T2 signal intensity within the affected muscles. The condition is self-limiting and is treated conservatively with bed rest and analgesics. Recurrences have been reported in the same or contralateral limb. We report a case of diabetic muscle infarction with spontaneous resolution of symptoms and imaging abnormality with recurrence on the contralateral side.

  4. Coronary-Heart-Disease-Associated Genetic Variant at the COL4A1/COL4A2 Locus Affects COL4A1/COL4A2 Expression, Vascular Cell Survival, Atherosclerotic Plaque Stability and Risk of Myocardial Infarction.

    Science.gov (United States)

    Yang, Wei; Ng, Fu Liang; Chan, Kenneth; Pu, Xiangyuan; Poston, Robin N; Ren, Meixia; An, Weiwei; Zhang, Ruoxin; Wu, Jingchun; Yan, Shunying; Situ, Haiteng; He, Xinjie; Chen, Yequn; Tan, Xuerui; Xiao, Qingzhong; Tucker, Arthur T; Caulfield, Mark J; Ye, Shu

    2016-07-01

    Genome-wide association studies have revealed an association between coronary heart disease (CHD) and genetic variation on chromosome 13q34, with the lead single nucleotide polymorphism rs4773144 residing in the COL4A2 gene in this genomic region. We investigated the functional effects of this genetic variant. Analyses of primary cultures of vascular smooth muscle cells (SMCs) and endothelial cells (ECs) from different individuals showed a difference between rs4773144 genotypes in COL4A2 and COL4A1 expression levels, being lowest in the G/G genotype, intermediate in A/G and highest in A/A. Chromatin immunoprecipitation followed by allelic imbalance assays of primary cultures of SMCs and ECs that were of the A/G genotype revealed that the G allele had lower transcriptional activity than the A allele. Electrophoretic mobility shift assays and luciferase reporter gene assays showed that a short DNA sequence encompassing the rs4773144 site interacted with a nuclear protein, with lower efficiency for the G allele, and that the G allele sequence had lower activity in driving reporter gene expression. Analyses of cultured SMCs from different individuals demonstrated that cells of the G/G genotype had higher apoptosis rates. Immunohistochemical and histological examinations of ex vivo atherosclerotic coronary arteries from different individuals disclosed that atherosclerotic plaques with the G/G genotype had lower collagen IV abundance and thinner fibrous cap, a hallmark of unstable, rupture-prone plaques. A study of a cohort of patients with angiographically documented coronary artery disease showed that patients of the G/G genotype had higher rates of myocardial infarction, a phenotype often caused by plaque rupture. These results indicate that the CHD-related genetic variant at the COL4A2 locus affects COL4A2/COL4A1 expression, SMC survival, and atherosclerotic plaque stability, providing a mechanistic explanation for the association between the genetic variant and CHD

  5. Depression after myocardial infarction.

    Science.gov (United States)

    Ziegelstein, R C

    2001-01-01

    Depression is an independent risk factor for increased postmyocardial infarction morbidity and mortality, even after controlling for the extent of coronary artery disease, infarct size, and the severity of left ventricular dysfunction. This risk factor takes on added significance when one considers that almost half of patients recovering from a myocardial infarction have major or minor depression and that major depression alone occurs in about one in five of these individuals. Despite the well-documented risk of depression, questions remain about the mechanism of the relationship between mood disturbance and adverse outcome. The link may be explained by an association with lower levels of social support, poor adherence to recommended medical therapy and lifestyle changes intended to reduce the risk of subsequent cardiac events, disturbances in autonomic tone, enhanced platelet activation and aggregation, and systemic immune activation. Unfortunately, questions about the pathophysiologic mechanism of depression in this setting are paralleled by uncertainties about the optimal treatment of depression for patients recovering from a myocardial infarction and by a lack of knowledge about whether treating depression lowers the associated increased mortality risk. Ongoing research studies will help to determine the benefits of psychosocial interventions and of antidepressant therapy for patients soon after myocardial infarction. Although the identification of depression as a risk factor may by itself be a reason to incorporate a comprehensive psychological evaluation into the routine care of patients with myocardial infarction, this practice should certainly become standard if studies show that treating depression reduces the increased mortality risk of these patients.

  6. Does left ventricular function improve with L-carnitine after acute myocardial infarction?

    Directory of Open Access Journals (Sweden)

    Iyer R

    1999-04-01

    Full Text Available A double blind randomized placebo controlled clinical trial was carried out to assess the efficacy and safety of L-carnitine in patients suffering from acute anterior wall myocardial infarction with respect to left ventricular function. Sixty patients (34 men, 26 women, mean age 56+11 yr. with acute anterior wall myocardial infarction were randomized to placebo and L-carnitine. All the patients were given intravenous L-carnitine / placebo in the dose of 6gm/day for the first seven days followed by oral L-carnitine / placebo 3 gm/day in three divided doses for a period of three months. Echocardiography was performed for regional wall motion abnormality, left ventricular end systolic volume (ESV, end diastolic volume (EDV and ejection fraction (EF on admission, after seven days and after three months of the infarction. Forty-four patients completed the study. There were three deaths, two in the placebo and one in the L-carnitine group (p>0.05. Thirteen patients were lost to follow up. Echo parameters in both groups were comparable (p>0.05. The duration of chest pain prior to initiation of the I.V. L-carnitine was 7.5 + 5.2 hrs in the L-carnitine group and 7 + 4 hrs in the placebo group (p>0.05. There was no statistical difference in the EF, ESV and EDV on admission, at discharge and after three months in the L-carnitine and the placebo groups (p>0.05. No significant adverse effects were noted. L-carnitine, though a safe drug, does not affect the left ventricular function in patients with myocardial infarction.

  7. Permanent ligation of the left anterior descending coronary artery in mice: a model of post-myocardial infarction remodelling and heart failure.

    Science.gov (United States)

    Muthuramu, Ilayaraja; Lox, Marleen; Jacobs, Frank; De Geest, Bart

    2014-12-02

    Heart failure is a syndrome in which the heart fails to pump blood at a rate commensurate with cellular oxygen requirements at rest or during stress. It is characterized by fluid retention, shortness of breath, and fatigue, in particular on exertion. Heart failure is a growing public health problem, the leading cause of hospitalization, and a major cause of mortality. Ischemic heart disease is the main cause of heart failure. Ventricular remodelling refers to changes in structure, size, and shape of the left ventricle. This architectural remodelling of the left ventricle is induced by injury (e.g., myocardial infarction), by pressure overload (e.g., systemic arterial hypertension or aortic stenosis), or by volume overload. Since ventricular remodelling affects wall stress, it has a profound impact on cardiac function and on the development of heart failure. A model of permanent ligation of the left anterior descending coronary artery in mice is used to investigate ventricular remodelling and cardiac function post-myocardial infarction. This model is fundamentally different in terms of objectives and pathophysiological relevance compared to the model of transient ligation of the left anterior descending coronary artery. In this latter model of ischemia/reperfusion injury, the initial extent of the infarct may be modulated by factors that affect myocardial salvage following reperfusion. In contrast, the infarct area at 24 hr after permanent ligation of the left anterior descending coronary artery is fixed. Cardiac function in this model will be affected by 1) the process of infarct expansion, infarct healing, and scar formation; and 2) the concomitant development of left ventricular dilatation, cardiac hypertrophy, and ventricular remodelling. Besides the model of permanent ligation of the left anterior descending coronary artery, the technique of invasive hemodynamic measurements in mice is presented in detail.

  8. Multiscale Characterization of Impact of Infarct Size on Myocardial Remodeling in an Ovine Infarct Model.

    Science.gov (United States)

    Zhang, Pei; Li, Tielou; Griffith, Bartley P; Wu, Zhongjun J

    2015-01-01

    The surviving myocardium initially compensates the loss of injured myocardium after myocardial infarction (MI) and gradually becomes progressively dysfunctional. There have been limited studies on the effect of infarct size on temporal and spatial alterations in the myocardium during progressive myocardial remodeling. MI with three infarct sizes, i.e. 15, 25 and 35% of the left ventricular (LV) wall, was created in an ovine infarction model. The progressive LV remodeling over a 12-week period was studied. Echocardiography, sonomicrometry, and histological and molecular analyses were carried out to evaluate cardiac function, regional tissue contractile function, structural remodeling and cardiomyocyte hypertrophy, and calcium handling proteins. Twelve weeks after MI, the 15, 25 and 35% MI groups had normalized LV end diastole volumes of 1.4 ± 0.2, 1.7 ± 0.3 and 2.0 ± 0.4 ml/kg, normalized end systole volumes of 1.0 ± 0.1, 1.0 ± 0.2 and 1.3 ± 0.3 ml/kg and LV ejection fractions of 43 ± 3, 42 ± 6 and 34 ± 4%, respectively. They all differed from the sham group (p strain), larger cardiomyocyte size and altered expression of calcium handing proteins in the adjacent myocardium compared to the remote counterpart from the infarct. A significant correlation was found between cardiomyocyte size and remodeling strain in the adjacent zone. A comparative analysis among the three MI groups showed that a larger infarct size (35 vs. 15% MI) was associated with larger remodeling strain, more serious impairment in the cellular structure and composition, and regional contractile function at regional tissue level and LV function at organ level.

  9. Role of infarction artery status in left ventricular remodeling after acute myocardial infarction.

    Science.gov (United States)

    Sanchis, J; Insa, L; Bodí, V; Egea, S; Monmeneu, J V; Chorro, F J; Llácer, A; López Merino, V

    1997-04-18

    The aim of this study was to evaluate the relation between the infarction artery status and left ventricular volumes, independently of regional ventricular dysfunction, at 4-6 weeks after a first myocardial infarction. The study group consisted of 100 patients, of whom 80 received thrombolytic treatment. Coronary and contrast left ventricular angiograms were performed at 36+/-5 days postinfarction. Left ventricular end-diastolic and end-systolic volumes were measured. The centerline chord motion method was used to calculate the extent of wall motion abnormality (percentage of chords with hypokinetic motion) and its severity (maximum units of S.D. below the normal wall motion reference). Minimum lumen diameter, patency and collateral flow in the infarction artery were also analyzed. Eight patients (group I) showed occlusion with poor collateral flow in the infarction artery, 22 patients (group II) occlusion with good collateral flow, 38 patients (group III) severe residual stenosis (minimum lumen diameter 1 mm). Patients from group I presented greater wall motion abnormality in terms of both extent (P=0.005) and severity (P=0.007), and greater end-diastolic (P=0.07) and end-systolic (P=0.0008) volumes; there were no differences among groups II, III and IV. By stepwise multivariate regression analysis, the extent of wall motion abnormality was the main determinant of end-diastolic (P=0.0001) and end-systolic (P=0.0001) volumes; occlusion with poor collateral flow was also a significant independent factor for end-systolic volume (P=0.03). Total occlusion (including both with and without collaterals) and the minimum lumen diameter did not correlate with end-diastolic and end-systolic volumes. We concluded that (A) the extent of regional dysfunction is the primary determinant of left ventricular volumes at 4-6 weeks postinfarction. (B) The status of the infarction artery is a weak predictor of end-diastolic volume, which is the best descriptor of ventricular remodeling

  10. Predictors and prognostic value of left atrial remodelling after acute myocardial infarction

    DEFF Research Database (Denmark)

    Kyhl, Kasper; Vejlstrup, Niels; Lønborg, Jacob;

    2015-01-01

    PURPOSE: Left atrial (LA) volume is a strong prognostic predictor in patients following ST-segment elevation myocardial infarction (STEMI). However, the change in LA volume over time (LA remodelling) following STEMI has been scarcely studied. We sought to identify predictors for LA remodelling...... remodelling. Kaplan-Meier and Log Rank analyses showed that patients in the highest tertiles of LAmin or LAmax remodelling are at higher risk (0.030 and p=0.018). CONCLUSIONS: After a myocardial infarction, LA remodelling reflects a parallel ventricular-atrial remodelling. Infarct size is a major determinant......, larger infarct size by CMR, higher peak troponin T, larger area at risk and adverse left ventricular (LV) remodelling. LA maximum volume (LAmax) remodelling was correlated to larger infarct size by CMR, higher peak troponin T, larger area at risk, larger LV mass, impaired LV function and adverse LV...

  11. Occipital lobe infarctions are different

    OpenAIRE

    Naess, Halvor; Waje-Andreassen, Ulrikke; Thomassen, Lars

    2007-01-01

    Objectives We hypothesized that occipital lobe infarctions differ from infarctions in other locations as to etiology, risk factors and prognosis among young adults. Methods Location, etiology, risk factors and long-term outcome were evaluated among all young adults 15–49 years suffering from cerebral infarction in Hordaland County, Norway between 1988 and 1997. Results The following variables were more frequent among patients with occipital lobe infarction compared with patients with infarcti...

  12. Heroin Abuse and Myocardial Infarction

    OpenAIRE

    Tatli, Ersan; Aktoz, Meryem

    2010-01-01

    Information concerning acute myocardial infarction after heroin usage is limited and the actual mechanism of heroin-induced myocardial infarction is not well known. Only one report has been described noting the association between usage heroin and acute myocardial infarction in a young man with normal coronary arteries. We also reported a patient with normal coronary arteries and acute myocardial infarction after heroin abuse. Eroin kullanımı sonrası akut miyokard inf...

  13. 大鼠局灶性脑缺血后神经功能评分与脑梗死体积相关性分析%Correlation between neurological deficits scores and infarct volume in focal cerebral ischemia in rats

    Institute of Scientific and Technical Information of China (English)

    王荣亮; 刘小蒙; 张营; 吉训明; 罗玉敏

    2013-01-01

    Objective To invesligale the correlation belween three scores of neurological deficits and infarcl volume of middle cerebral artery occlusion (MCAO) model in rats. Methods A total of 20 Sprague-Dawley (SD) rats were randomly divided into five groups. MCAO models were induced. At five different lime poinls (24 h, 3d, 7 d, 14 d and 30 d after reperfusion) , ihree grading melhods (Longa test, Forelimb Placing test and Ludmila Belayev test) were used to evaluate neurological funclions of rats. Then, the volume of infarction was calculated after laking the brain for HE slaining. The correlations belween neurological function scores and brain infarction volumes were analyzed by ANOVA and correlation. Results From 24 hours to 30 days after reperfusion, the scores of neurological deficits and the volume of infarction were decreased. There were significant differences in the scores of forelimb placing test and Ludmila Belayev test between 7 and 30 days after reperfusing (P 0. 05) . In terms of the correlation between the Ludmila Belayev score and infarction volume, there exists the obvious statistical significance at 3 (P <0. 01) and 30 days (P <0. 05) . Conclusion For the MCAO model of rats, the Ludmila Belayev test can be used to evaluate the extent of injury after cerebral infarction at 3 and 30 days after reperfusion.%目的 探讨大鼠大脑中动脉阻塞模型(middle cerebral artery occlusion,MCAO)的神经功能评分与脑梗死体积的相关性.方法 20只雄性Sprague-Dawley(SD)大鼠按随机数字表法分为5组,采用线栓法制作短暂性MCAO模型,于缺血再灌注后24 h、3 d、7 d、14 d、30 d进行三种神经功能评分(Longa 5分法、前肢踩空实验、Ludmila Belayev 12评分法),取脑组织后行HE染色.计算各组大鼠脑梗死体积相对百分比,采用方差分析及相关性分析统计结果.结果 缺血再灌注后24 h到30 d,三种神经功能评分均有降低,7 d组与30 d组的前肢踩空实验和Ludmila Belayev 12评分

  14. Long-term function in the remote region after myocardial infarction: importance of significant coronary stenoses in the non-infarct-related artery.

    OpenAIRE

    de Albuquerque, C. P.; Kalil-Filho, R; Gerstenblith, G.; Nakano, O.; Barbosa, V; G. Bellotti; Pileggi, F.; Tranchesi, B

    1994-01-01

    BACKGROUND--Left ventricular (LV) function is the most important determinant of outcome after a myocardial infarction. Global LV function after a myocardial infarction is affected not only by wall motion in the infarct zone but also by regional function in the contralateral territory. It was hypothesised that the presence of significant stenoses in coronary arteries supplying the contralateral territory might influence the ability of this region to compensate for damaged myocardium after a my...

  15. Infarct healing is a dynamic process following acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Pokorney Sean D

    2012-09-01

    Full Text Available Abstract Background The role of infarct size on left ventricular (LV remodeling in heart failure after an acute ST-segment elevation myocardial infarction (STEMI is well recognized. Infarct size, as determined by cardiovascular magnetic resonance (CMR, decreases over time. The amount, rate, and duration of infarct healing are unknown. Methods A total of 66 patients were prospectively enrolled after reperfusion for an acute STEMI. Patients underwent a CMR evaluation within 1 week, 4 months, and 14 months after STEMI. Results Mean infarct sizes for the 66 patients at baseline (acute necrosis, early follow-up (early scar, and late follow-up (late scar were 25 ± 17 g, 17 ± 12 g, and 15 ± 11 g, respectively. Patients were stratified in tertiles, based on infarct size, with the largest infarcts having the greatest absolute decrease in mass at early and late scar. The percent reduction of infarct mass was independent of initial infarct size. There was an 8 g or 32% decrease in infarct mass between acute necrosis and early scar (p  Conclusions Infarct healing is a continuous process after reperfusion for STEMI, with greatest reduction in infarct size in the first few months. The dynamic nature of infarct healing through the first year after STEMI indicates that decisions based on infarct size, and interventions to reduce infarct size, must take into consideration the time frame of measurement.

  16. Migraine Infarction. Case Report

    Directory of Open Access Journals (Sweden)

    Yoany Mesa Barrera

    2015-03-01

    Full Text Available Migraine is considered like a risk factor for ischemic ictus in adult young people. In spite of the criteria established for the treatment of the migraine infarct, they are not always fulfilled strictly, permitting certain flexibility in the aforementioned treatment. The case of a patient with a background of migraine with auras, who suffers an ischemic cerebral migraine infarct at the course of a migraine crisis, is presented. The ictus was manifested like an especial right hemiparesis of the female sex in fertile age. The prognosis is good with low risk of recurrence, with unstable disorders and dysarthria. The laboratories studies were normal and the cerebral infarct was detected in the magnetic resonance, at the half left cerebral artery's territory. The patient had favorable evolution without sequel.

  17. SDN-POA volume, sexual behavior, and partner preference of male rats affected by perinatal treatment with ATD

    NARCIS (Netherlands)

    E.J. Houtsmuller (Elisabeth Judith); T. Brand (Teus); F.H. de Jonge (F.); R.N.J.M.A. Joosten (R. N J M A); N.E. van de Poll (N.); A.K. Slob (Koos)

    1994-01-01

    textabstractThe present study investigated 1) the importance of the aromatization process during the perinatal period for the development of the sexually dimorphic nucleus in the preoptic area of the hypothalamus (SDN-POA) of male rats, and 2) the relationship between SDN-POA volume and parameters o

  18. No evidence of a threshold in traffic volume affecting road-kill mortality at a large spatio-temporal scale

    Energy Technology Data Exchange (ETDEWEB)

    Grilo, Clara, E-mail: clarabentesgrilo@gmail.com [Departamento de Biología de la Conservación, Estación Biológica de Doñana (EBD-CSIC), Calle Américo Vespucio s/n, E-41092 Sevilla (Spain); Centro Brasileiro de Estudos em Ecologia de Estradas, Departamento de Biologia, Universidade Federal de Lavras, Campus Universitário, 37200-000 Lavras, Minas Gerais (Brazil); Ferreira, Flavio Zanchetta; Revilla, Eloy [Departamento de Biología de la Conservación, Estación Biológica de Doñana (EBD-CSIC), Calle Américo Vespucio s/n, E-41092 Sevilla (Spain)

    2015-11-15

    Previous studies have found that the relationship between wildlife road mortality and traffic volume follows a threshold effect on low traffic volume roads. We aimed at evaluating the response of several species to increasing traffic intensity on highways over a large geographic area and temporal period. We used data of four terrestrial vertebrate species with different biological and ecological features known by their high road-kill rates: the barn owl (Tyto alba), hedgehog (Erinaceus europaeus), red fox (Vulpes vulpes) and European rabbit (Oryctolagus cuniculus). Additionally, we checked whether road-kill likelihood varies when traffic patterns depart from the average. We used annual average daily traffic (AADT) and road-kill records observed along 1000 km of highways in Portugal over seven consecutive years (2003–2009). We fitted candidate models using Generalized Linear Models with a binomial distribution through a sample unit of 1 km segments to describe the effect of traffic on the probability of finding at least one victim in each segment during the study. We also assigned for each road-kill record the traffic of that day and the AADT on that year to test for differences using Paired Student's t-test. Mortality risk declined significantly with traffic volume but varied among species: the probability of finding road-killed red foxes and rabbits occurs up to moderate traffic volumes (< 20,000 AADT) whereas barn owls and hedgehogs occurred up to higher traffic volumes (40,000 AADT). Perception of risk may explain differences in responses towards high traffic highway segments. Road-kill rates did not vary significantly when traffic intensity departed from the average. In summary, we did not find evidence of traffic thresholds for the analysed species and traffic intensities. We suggest mitigation measures to reduce mortality be applied in particular on low traffic roads (< 5000 AADT) while additional measures to reduce barrier effects should take into

  19. Effects of myocardial infarction on the distribution and transport of nutrients and oxygen in porcine myocardium.

    Science.gov (United States)

    Davis, Bryce H; Morimoto, Yoshihisa; Sample, Chris; Olbrich, Kevin; Leddy, Holly A; Guilak, Farshid; Taylor, Doris A

    2012-10-01

    One of the primary limitations of cell therapy for myocardial infarction is the low survival of transplanted cells, with a loss of up to 80% of cells within 3 days of delivery. The aims of this study were to investigate the distribution of nutrients and oxygen in infarcted myocardium and to quantify how macromolecular transport properties might affect cell survival. Transmural myocardial infarction was created by controlled cryoablation in pigs. At 30 days post-infarction, oxygen and metabolite levels were measured in the peripheral skeletal muscle, normal myocardium, the infarct border zone, and the infarct interior. The diffusion coefficients of fluorescein or FITC-labeled dextran (0.3-70 kD) were measured in these tissues using fluorescence recovery after photobleaching. The vascular density was measured via endogenous alkaline phosphatase staining. To examine the influence of these infarct conditions on cells therapeutically used in vivo, skeletal myoblast survival and differentiation were studied in vitro under the oxygen and glucose concentrations measured in the infarct tissue. Glucose and oxygen concentrations, along with vascular density were significantly reduced in infarct when compared to the uninjured myocardium and infarct border zone, although the degree of decrease differed. The diffusivity of molecules smaller than 40 kD was significantly higher in infarct center and border zone as compared to uninjured heart. Skeletal myoblast differentiation and survival were decreased stepwise from control to hypoxia, starvation, and ischemia conditions. Although oxygen, glucose, and vascular density were significantly reduced in infarcted myocardium, the rate of macromolecular diffusion was significantly increased, suggesting that diffusive transport may not be inhibited in infarct tissue, and thus the supply of nutrients to transplanted cells may be possible. in vitro studies mimicking infarct conditions suggest that increasing nutrients available to

  20. Assessment of the pharmacological effects of alprazolam on electroencephalography using connectivity indexes not affected by volume conduction

    OpenAIRE

    Joan Francesc Alonso; Jordi Riba

    2015-01-01

    Introduction Electroencephalographic analysis techniques have become a very useful tool to assess brain activity and interactions between cerebral regions, that is, the so-called cerebral connectivity analysis. The effects of some drugs have, so far, been studied using spectral analysis and, to a lesser extent, some linear and nonlinear connectivity techniques. New indexes have recently been designed based on assumptions that make them more robust against volume conduction effects that co...

  1. CT features of renal infarction

    Energy Technology Data Exchange (ETDEWEB)

    Suzer, Okan; Shirkhoda, Ali; Jafri, S. Zafar; Madrazo, Beatrice L.; Bis, Kostaki G.; Mastromatteo, James F

    2002-10-01

    Purpose: To demonstrate the different patterns of renal infarction to avoid pitfalls. To present 'flip-flop enhancement' pattern in renal infarction. Materials and methods: Retrospective review of a total of 41 renal infarction in 37 patients were done. These patients underwent initial CT and the diagnosis of renal infarction was confirmed with either follow up CT or at surgery. Results: Twenty-three patients had wedge-shaped focal infarcts, nine patients had global and five patients had multifocal infarcts of the kidneys. Cortical rim sign was seen predominantly with global infarcts. In five patients, a 'flip-flop enhancement' pattern was observed. In two patients, planned renal biopsies due to tumefactive renal lesions were cancelled because of 'flip-flop enhancement' pattern on follow up CTs. Conclusion: Although most of our cases were straightforward for the diagnosis of renal infarction, cases with tumefactive lesions and global infarctions without the well-known cortical rim sign were particularly challenging. We describe a new sign, flip-flop enhancement pattern, which we believe solidified the diagnosis of renal infarction in five of our cases. The authors recommend further investigations for association of flip-flop enhancement and renal infarction.

  2. Depression following myocardial infarction

    DEFF Research Database (Denmark)

    Larsen, Karen Kjær

    2013-01-01

    Myocardial infarction (MI) is a severe life event that is accompanied by an increased risk of depression. Mounting evidence suggests that post-MI depression is associated with adverse outcomes, but the underlying mechanisms of this association remain unclear, and no previous studies have examined...

  3. Computed tomography of splenic infarcts

    Energy Technology Data Exchange (ETDEWEB)

    Triller, J.; Bona, E.; Barbier, P.

    1985-04-01

    Splenic infarcts are represented by wedge-shaped, oval or linear areas. Haemorrhagic infarcts are characterised by being hyperdense. Disseminated infarction occurs predominantly in myeloproliferative diseases. During the early stages, the infarct appears as an ill-defined hypodense defect, with non-homogeneous contrast enhancement. During the acute and sub-acute stage, the density of the infarct is low and there is no contrast enhancement. During the chronic stage, its density increases and there is slight contrast enhancement. Complications following splenic infarcts, such as abscesses, bleeding and rupture can be demonstrated by CT with great accuracy. Problems in differential diagnosis may occur if there are atypical manifestations of the infarct, with respect to abscess or leukaemic infiltrations.

  4. Subject positioning in the BOD POD® only marginally affects measurement of body volume and estimation of percent body fat in young adult men.

    Directory of Open Access Journals (Sweden)

    Maarten W Peeters

    Full Text Available INTRODUCTION: The aim of the study was to evaluate whether subject positioning would affect the measurement of raw body volume, thoracic gas volume, corrected body volume and the resulting percent body fat as assessed by air displacement plethysmography (ADP. METHODS: Twenty-five young adult men (20.7±1.1 y, BMI = 22.5±1.4 kg/m(2 were measured using the BOD POD® system using a measured thoracic gas volume sitting in a 'forward bent' position and sitting up in a straight position in random order. RESULTS: Raw body volume was 58±124 ml (p<0.05 higher in the 'straight' position compared to the 'bent' position. The mean difference in measured thoracic gas volume (bent-straight = -71±211 ml was not statistically significant. Corrected body volume and percent body fat in the bent position consequently were on average 86±122 ml (p<0.05 and 0.5±0.7% (p<0.05 lower than in the straight position respectively. CONCLUSION: Although the differences reached statistical significance, absolute differences are rather small. Subject positioning should be viewed as a factor that may contribute to between-test variability and hence contribute to (inprecision in detecting small individual changes in body composition, rather than a potential source of systematic bias. It therefore may be advisable to pay attention to standardizing subject positioning when tracking small changes in PF are of interest. The cause of the differences is shown not to be related to changes in the volume of isothermal air in the lungs. It is hypothesized and calculated that the observed direction and magnitude of these differences may arise from the surface area artifact which does not take into account that a subject in the bent position exposes more skin to the air in the device therefore potentially creating a larger underestimation of the actual body volume due to the isothermal effect of air close to the skin.

  5. Relationship between infarct size and severity measured by gated SPECT and long-term left ventricular remodelling after acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Berti, Valentina; Sciagra, Roberto; Pupi, Alberto [University of Florence, Nuclear Medicine Unit, Department of Clinical Physiopathology, Florence (Italy); Acampa, Wanda; Ricci, Francesca; Gallicchio, Rosj; Cuocolo, Alberto [University Federico II and Institute of Biostructures and Bioimages of the National Council of Research, Department of Biomorphological and Functional Sciences, Naples (Italy); Cerisano, Giampaolo [Careggi Hospital, Division of Cardiology, Florence (Italy); Vigorito, Carlo [University Federico II, Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Cardiac Rehabilitation Unit, Naples (Italy)

    2011-06-15

    After acute myocardial infarction (AMI), left ventricular (LV) remodelling may occur despite successful reperfusion. This study aimed to investigate by gated single photon emission computed tomography (SPECT) the long-term evolution of myocardial perfusion and LV function after AMI and to identify the predictors of LV remodelling. Sixty-eight AMI patients successfully treated by primary percutaneous coronary intervention underwent {sup 99m}Tc-sestamibi gated SPECT at 1 month (baseline) and over 6-month follow-up after the acute event. LV remodelling was defined as 20% increase in LV end-diastolic volume at follow-up. At baseline, patients with remodelling (n = 14) showed larger (infarct size 29.3 {+-} 7.8%) and more transmural (infarct severity 0.28 {+-} 0.10) infarctions, and reduced LV ejection fraction (35.4 {+-} 5.6%), but similar LV volume indexes, compared to patients without remodelling (n = 54) (infarct size 20.8 {+-} 14.4%, p < 0.05, infarct severity 0.40 {+-} 0.11, p < 0.001, ejection fraction 44.5 {+-} 9.2, p < 0.001). At stepwise multivariate regression analysis, infarct severity showed the best predictive value for predicting LV remodelling (F = 5.54, p < 0.05). Using the thresholds identified by receiver-operating characteristic curve analysis, infarct size and severity detected patients with remodelling with 75% accuracy and 95% negative predictive value. Infarct resorption (defined as the defect size difference between follow-up and baseline) was comparable between patients with (-4.4 {+-} 8.4%) and without remodelling (-6.8 {+-} 9.4%) (p = NS). Perfusion parameters assessed by gated SPECT in the subacute phase after successfully treated AMI correlate with changes in functional parameters at long-term follow-up. Infarct severity is more effective than infarct size, but both are helpful for predicting LV remodelling. (orig.)

  6. Decompressive craniectomy for malignant middle cerebral artery infarction: Impact on mortality and functional outcome

    Directory of Open Access Journals (Sweden)

    Mohammed Azman Mohammad Raffiq

    2014-01-01

    Full Text Available Background: Malignant middle cerebral artery (MCA infarction is a devastating clinical entity affecting about 10% of stroke patients. Decompressive craniectomy has been found to reduce mortality rates and improve outcome in patients. Methods: A retrospective case review study was conducted to compare patients treated with medical therapy and decompressive surgery for malignant MCA infarction in Hospital Kuala Lumpur over a period of 5 years (from January 2007 to December 2012. A total of 125 patients were included in this study; 90 (72% patients were treated with surgery, while 35 (28% patients were treated with medical therapy. Outcome was assessed in terms of mortality rate at 30 days, Glasgow Outcome Score (GOS on discharge, and modified Rankin scale (mRS at 3 and 6 months. Results: Decompressive craniectomy resulted in a significant reduction in mortality rate at 30 days (P < 0.05 and favorable GOS outcome at discharge (P < 0.05. Good functional outcome based on mRS was seen in 48.9% of patients at 3 months and in 64.4% of patients at 6 months (P < 0.05. Factors associated with good outcome include infarct volume of less than 250 ml, midline shift of less than 10 mm, absence of additional vascular territory involvement, good preoperative Glasgow Coma Scale (GCS score, and early surgical intervention (within 24 h (P < 0.05. Age and dominant hemisphere infarction had no significant association with functional outcome. Conclusion: Decompressive craniectomy achieves good functional outcome in, young patients with good preoperative GCS score and favorable radiological findings treated with surgery within 24 h of ictus.

  7. Nd:YAG Laser Welding of Sheet Metal Assembly: Transformation Induced Volume Strain Affect on Elastoplastic Model

    Science.gov (United States)

    Seang, C.; David, A. K.; Ragneau, E.

    This study presents the effect of transformation induced volume strain on the thermo-elastoplastic model in the simulation of Nd: YAG laser welding process applied for thin sheet metal dual phases steel DP600. The metallurgical phase transformations during heating and during cooling are used as the thermal expansion dependent parameters. The effect of transformation induced volumetric strain was identified where the comparisons of the elastoplastic model with and without metallurgical effect are based on the global distribution of residual stresses such as the longitudinal residual stresses and the transverse residual stresses.

  8. Distribution of brain infarction in children with tuberculous meningitis and correlation with outcome score at 6 months

    Energy Technology Data Exchange (ETDEWEB)

    Andronikou, Savvas [University of Stellenbosch, Department of Radiology, Tygerberg Hospital, P.O. Box 19063, Tygerberg (South Africa); Wilmshurst, Jo; Hatherill, Mark [University of Cape Town, Pediatric Neurology, Red Cross Children' s Hospital, School of Child and Adolescent Health, Cape Town (South Africa); VanToorn, Ronald [University of Stellenbosch, Department of Pediatric Neurology, Tygerberg Hospital, Cape Town (South Africa)

    2006-12-15

    Prognostic indicators for tuberculous meningitis (TBM) offer realistic expectations for parents of affected children. Infarctions affecting the basal ganglia are associated with a poor outcome. To correlate the distribution of infarction in children with TBM on CT with an outcome score (OS). CT brain scans in children with TBM were retrospectively reviewed and the distribution of infarctions recorded. The degree of correlation with OS at 6 months was determined. There was a statistically significant association between all sites of infarction (P = 0.0001-0.001), other than hemispheric (P = 0.35), and outcome score. There was also a statistically significant association between all types of infarction (P = 0.0001-0.02), other than hemispheric (P = 0.05), and overall poor outcome. The odds ratio for poor outcome with bilateral basal ganglia and internal capsule infarction was 12. The odds ratio for poor outcome with 'any infarction' was 4.91 (CI 2.24-10.74), with 'bilateral infarctions' 8.50 (CI 2.49-28.59), with basal ganglia infarction 5.73 (CI 2.60-12.64), and for hemispheric infarction 2.30 (CI 1.00-5.28). Infarction is associated with a poor outcome unless purely hemispheric. MRI diffusion-weighted imaging was not part of this study, but is likely to play a central role in detecting infarctions not demonstrated by CT. (orig.)

  9. Learning, Adjustment and Stress Disorders: With Special Reference to Tsunami Affected Regions. Beitrage zur Padagogischen und Rehabilitationspsychologie. Volume 1

    Science.gov (United States)

    Witruk, Evelin, Ed.; Riha, David, Ed.; Teichert, Alexandra, Ed.; Haase, Norman, Ed.; Stueck, Marcus, Ed.

    2010-01-01

    This book contains selected contributions from the international workshop Learning, "Adjustment and Stress Disorders--with special reference to Tsunami affected Regions" organised by Evelin Witruk and the team of Educational and Rehabilitative Psychology at the University of Leipzig in January 2006. The book contains new results and the state of…

  10. Prognostic Importance of ST-Segment Resolution in Acute Myocardial Infarction

    OpenAIRE

    Eroğlu M et al.

    2011-01-01

    Some factors may affect prognosis and may be used to determine long term life duration after myocardial infarction. Hence, risk classification after myocardial infarction is of great importance. Coronary reperfusion following fibrinolytic therapy may be detected invasively and non-invasively in myocardial infarction with ST-segment elevation. ST-segment resolution, which is one of non-invasive reperfusion criteria, might be used to determine prognosis, since it reflects myocardial microcircul...

  11. Multiorgan with renal infarction following treatment of cerebral infarction.

    Science.gov (United States)

    Kim, Ji Hee; Kang, Chung; Moon, Hyo Jeong; Joo, Min Cheol

    2013-08-01

    Acute renal infarction is a rare disease and it is often difficult to make a clinical diagnosis due to the non-specific clinical presentations and lack of the physicians' awarenesses. We experienced a case of a 72-year-old man who was diagnosed as multiorgan with renal infarction during the bridge therapy of cerebral infarction with atrial fibrillation. Computed tomogram (CT) with intravenous contrast of the abdomen and pelvis revealed left renal infarction with renal artery occlusion, multifocal splenic infarction, and ischemic colitis on rectum and sigmoid colon. The patient was treated with low molecular weight heparin for 10 days, his symptoms were improved and laboratory findings were normalized. Follow-up CT was performed on the 43th day, there were persisted left renal infarction with atrophic change shown and the splenic perfusion was improved.

  12. Inflammatory markers in ST-elevation acute myocardial infarction.

    Science.gov (United States)

    Seropian, Ignacio M; Sonnino, Chiara; Van Tassell, Benjamin W; Biasucci, Luigi M; Abbate, Antonio

    2016-08-01

    After acute myocardial infarction, ventricular remodeling is characterized by changes at the molecular, structural, geometrical and functional level that determine progression to heart failure. Inflammation plays a key role in wound healing and scar formation, affecting ventricular remodeling. Several, rather different, components of the inflammatory response were studied as biomarkers in ST-elevation acute myocardial infarction. Widely available and inexpensive tests, such as leukocyte count at admission, as well as more sophisticated immunoassays provide powerful predictors of adverse outcome in patients with ST-elevation acute myocardial infarction. We review the value of inflammatory markers in ST-elevation acute myocardial infarction and their association with ventricular remodeling, heart failure and sudden death. In conclusion, the use of these biomarkers may identify subjects at greater risk of adverse events and perhaps provide an insight into the mechanisms of disease progression.

  13. Complete versus culprit-only revascularization for ST-segment-elevation myocardial infarction and multivessel disease

    DEFF Research Database (Denmark)

    Bangalore, Sripal; Toklu, Bora; Wetterslev, Jørn

    2015-01-01

    increase in contrast volume use (mean difference 85.12 [70.41-83.00] ml) and procedure time (mean difference 16.42 [13.22-19.63] mins) with complete revascularization without increase in contrast-induced nephropathy. CONCLUSIONS: In patients with ST-segment-elevation myocardial infarction, immediate or...... infarction. Efficacy outcomes were major adverse cardiovascular events, as well as death, cardiovascular death, myocardial infarction, and repeat revascularization. Safety outcomes were contrast-induced nephropathy, contrast volume used, and procedure time. Five trials with 1165 patients fulfilled the...

  14. Hyperintense Acute Reperfusion Marker on FLAIR in Posterior Circulation Infarction.

    Directory of Open Access Journals (Sweden)

    Alex Förster

    Full Text Available In the present study, we aimed to investigate the frequency of blood brain barrier injury in posterior circulation infarction as demonstrated by the hyperintense acute reperfusion marker (HARM on fluid attenuated inversion recovery images (FLAIR.From a MRI report database we identified patients with posterior circulation infarction who underwent MRI, including perfusion-weighted images (PWI, within 12 hours after onset and follow-up MRI within 24 hours and analyzed diffusion-weighted images (DWI, PWI, FLAIR, and MR angiography (MRA. On FLAIR images, the presence of HARM was noted by using pre-specified criteria (focal enhancement in the subarachnoid space and/or the ventricles.Overall 16 patients (median age of patients 68.5 (IQR 55.5-82.75 years with posterior circulation infarction were included. Of these, 13 (81.3% demonstrated PCA occlusion, and 3 (18.7% patients BA occlusion on MRA. Initial DWI demonstrated ischemic lesions in the thalamus (68.8%, splenium (18.8%, hippocampus (75%, occipital lobe (81.3%, mesencephalon (18.8%, pons (18.8%, and cerebellum (50%. On follow-up MRA recanalization was noted in 10 (62.5% patients. On follow-up FLAIR images, HARM was observed in 8 (50% patients. In all of these, HARM was detected remote from the acute ischemic lesion. HARM was more frequently observed in patients with vessel recanalization (p = 0.04, minor infarction growth (p = 0.01, and smaller ischemic lesions on follow-up DWI (p = 0.05.HARM is a frequent finding in posterior circulation infarction and associated with vessel recanalization, minor infarction growth as well as smaller infarction volumes in the course. Neuroradiologists should be cognizant of the fact that HARM may be present on short interval follow-up FLAIR images in patients with acute ischemic infarction who initially underwent MRI and received intravenous gadolinium-based contrast agents.

  15. Atorvastatin therapy during the peri-infarct period attenuates left ventricular dysfunction and remodeling after myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Xian-Liang Tang

    Full Text Available Although statins impart a number of cardiovascular benefits, whether statin therapy during the peri-infarct period improves subsequent myocardial structure and function remains unclear. Thus, we evaluated the effects of atorvastatin on cardiac function, remodeling, fibrosis, and apoptosis after myocardial infarction (MI. Two groups of rats were subjected to permanent coronary occlusion. Group II (n = 14 received oral atorvastatin (10 mg/kg/d daily for 3 wk before and 4 wk after MI, while group I (n = 12 received equivalent doses of vehicle. Infarct size (Masson's trichrome-stained sections was similar in both groups. Compared with group I, echocardiographic left ventricular ejection fraction (LVEF and fractional area change (FAC were higher while LV end-diastolic volume (LVEDV and LV end-systolic and end-diastolic diameters (LVESD and LVEDD were lower in treated rats. Hemodynamically, atorvastatin-treated rats exhibited significantly higher dP/dt(max, end-systolic elastance (Ees, and preload recruitable stroke work (PRSW and lower LV end-diastolic pressure (LVEDP. Morphometrically, infarct wall thickness was greater in treated rats. The improvement of LV function by atorvastatin was associated with a decrease in hydroxyproline content and in the number of apoptotic cardiomyocyte nuclei. We conclude that atorvastatin therapy during the peri-infarct period significantly improves LV function and limits adverse LV remodeling following MI independent of a reduction in infarct size. These salubrious effects may be due in part to a decrease in myocardial fibrosis and apoptosis.

  16. Acute myocardial infarction.

    Science.gov (United States)

    Rischpler, Christoph

    2016-09-01

    Inflammatory processes after myocardial infarction have gained major interest in recent cardiovascular research. It is believed that not only the degree of cell recruitment to the heart plays a pivotal role in the quality of wound healing after myocardial infarction, but also the balance between different types or even subtypes of cells. It is also this balance which is thought to control key processes in tissue repair, such as apoptosis and neoangiogenesis. In this paper, we aim to review imaging strategies (with a special focus on nuclear molecular imaging strategies) that target cells and processes involved in postischemic inflammation and that have a high potential to be translated into clinic or that are already being used and evaluated in humans. PMID:27225319

  17. Acute Myocardial Infarction 19922001

    OpenAIRE

    Robert Schmitz

    2005-01-01

    Heart disease is the leading cause of hospitalization and death in the United States among persons age 65 and older. Acute myocardial infarction (AMI), more commonly known as heart attack, accounted for more than 321,000 hospitalizations among Medicare beneficiaries in 2001. This report presents trends in AMI hospitalization, readmission, and mortality rates from 1992 through 2001 among Medicare fee-for-service beneficiaries across various demographic groups.

  18. Occipital lobe infarctions are different

    OpenAIRE

    Halvor Naess; Ulrikke Waje-Andreassen; Lars Thomassen

    2007-01-01

    Halvor Naess, Ulrikke Waje-Andreassen, Lars ThomassenDepartment of Neurology, Haukeland University Hospital, University of Bergen, N-5021 Bergen, NorwayObjectives: We hypothesized that occipital lobe infarctions differ from infarctions in other locations as to etiology, risk factors and prognosis among young adults.Methods: Location, etiology, risk factors and long-term outcome were evaluated among all young adults 15–49 years suffering from cerebral infarction in Hordaland County, Norw...

  19. Hawaii Integrated Energy Assessment. Volume V. Rules, regulations, permits and policies affecting the development of alternate energy sources in Hawaii

    Energy Technology Data Exchange (ETDEWEB)

    1980-01-01

    A comprehensive presentaton of the major permits, regulations, rules, and controls which are likely to affect the development of alternate energy sources in Hawaii is presented. An overview of the permit process, showing the major categories and types of permits and controls for energy alternatives is presented. This is followed by a brief resume of current and projected changes designed to streamline the permit process. The permits, laws, regulations, and controls that are applicable to the development of energy alternatives in Hawaii are described. The alternate energy technologies affected, a description of the permit or control, and the requirements for conformance are presented for each applicable permit. Federal, state, and county permits and controls are covered. The individual energy technologies being considered as alternatives to the State's present dependence on imported fossil fuels are emphasized. The alternate energy sources covered are bioconversion, geothermal, ocean thermal, wind, solar (direct), and solid waste. For each energy alternative, the significant permits are summarized with a brief explanation of why they may be necessary. The framework of policy development at each of the levels of government with respect to the alternate energy sources is covered.

  20. Occipital lobe infarctions are different

    Directory of Open Access Journals (Sweden)

    Halvor Naess

    2007-09-01

    Full Text Available Halvor Naess, Ulrikke Waje-Andreassen, Lars ThomassenDepartment of Neurology, Haukeland University Hospital, University of Bergen, N-5021 Bergen, NorwayObjectives: We hypothesized that occipital lobe infarctions differ from infarctions in other locations as to etiology, risk factors and prognosis among young adults.Methods: Location, etiology, risk factors and long-term outcome were evaluated among all young adults 15–49 years suffering from cerebral infarction in Hordaland County, Norway between 1988 and 1997.Results: The following variables were more frequent among patients with occipital lobe infarction compared with patients with infarctions located elsewhere: younger age (P < 0.001, female sex (P = 0.016, prothrombotic state (P = 0.005 and lack of hypertension (P = 0.001. There was no difference as to long-term mortality or recurrence of cerebral infarction. Conclusion: Occipital lobe infarctions differ from infarctions in other locations among young adults. This may have important etiologic and therapeutical implications that need further studies.Keywords: cerebral infarction, occipital lobe, young adults

  1. Small intestinal ischemia and infarction

    Science.gov (United States)

    Intestinal necrosis; Ischemic bowel - small intestine; Dead bowel - small intestine; Dead gut - small intestine; Infarcted bowel - small intestine; Atherosclerosis - small intestine; Hardening of the arteries - small intestine

  2. Electrocardiogram changes in acute cerebral infarction patients

    Institute of Scientific and Technical Information of China (English)

    Jing Fang; Weihong Yan

    2006-01-01

    opposite T wave of infarction group compared with control group (P > 0.05). PR and QTc [(0.167±0.010), (0.383±0.029) s] in infarction group were longer than those in control group [(0.159±0.008), (0.361 ±0.022) s, t = 1 .982, 2.363, P< 0.05,0.01]. ST changes cases were 77% (44/57), which was more than those in control group [46% (23/50), x2 = 11.072, P < 0.01]. ② Comparison of infarction in two hemispheres. HR, PR interval, QRS time, cases with opposite T wave and ST changes showed no differences (P > 0.05), and QTc interval in right hemisphere infarction was longer than left one [(0.391 ±0.054), (0.380±0.034) s, t=1.673, P < 0.05]. ③ ECG changes in different infarction locations. HR, PR interval, QTc interval, QRS time, cases with opposite T wave and ST changes showed no statistically significantly differences (P> 0.05). ④ ECG changes in different infarction sizes. HR, PR interval, QRS time showed no differences (P> 0.05). QTc interval in large size group was longer than the others [(0.399±0.044),(0.388±0.073), (0.378±0.124) s, F= 3.19, P < 0.05]. Cases with opposite T wave and ST changes in large size group were 80% (8/10), 100% (10/10), which were higher than those in medium size group [46% (6/13), 69% (9/13)]and small size group [44% (15/34), 35% (12/34), χ2 = 8.495, 10.538, P < 0.05, 0.01].CONCLUSrON: ① PR interval and QTc interval prolonged in cerebral infarction patients. Furthermore, QTc interval was more obvious in large size infarction group and right hemisphere infarction group. ② Infarction location did not affect the changes of ECG.

  3. What drives progressive motor deficits in patients with acute pontine infarction?

    Directory of Open Access Journals (Sweden)

    Jue-bao Li

    2015-01-01

    Full Text Available Progressive motor deficits are relatively common in acute pontine infarction and frequently associated with increased functional disability. However, the factors that affect the progression of clinical motor weakness are largely unknown. Previous studies have suggested that pontine infarctions are caused mainly by basilar artery stenosis and penetrating artery disease. Recently, lower pons lesions in patients with acute pontine infarctions have been reported to be related to progressive motor deficits, and ensuing that damage to the corticospinal tracts may be responsible for the worsening of neurological symptoms. Here, we review studies on motor weakness progression in pontine infarction and discuss the mechanisms that may underlie the neurologic worsening.

  4. what drives progressive motor deifcits in patients with acute pontine infarction?

    Institute of Scientific and Technical Information of China (English)

    Jue-bao Li; Rui-dong Cheng; Liang Zhou; Wan-shun Wen; Gen-ying Zhu; Liang Tian; Xiang-ming Ye

    2015-01-01

    Progressive motor deficits are relatively common in acute pontine infarction and frequently associated with increased functional disability. However, the factors that affect the progression of clinical motor weakness are largely unknown. Previous studies have suggested that pontine infarctions are caused mainly by basilar artery stenosis and penetrating artery disease. Recently, lower pons lesions in patients with acute pontine infarctions have been reported to be related to progressive motor deifcits, and ensuing that damage to the corticospinal tracts may be respon-sible for the worsening of neurological symptoms. Here, we review studies on motor weakness progression in pontine infarction and discuss the mechanisms that may underlie the neurologic worsening.

  5. Omental infarction in the postpartum period: a case report and a review of the literature

    Directory of Open Access Journals (Sweden)

    Izbicki Jakob R

    2010-11-01

    Full Text Available Abstract Introduction Omental infarction is a rare and often misdiagnosed clinical event with unspecific symptoms. It affects predominantly young and middle aged women. Case presentation This is a case report of a 26-year-old Caucasian woman with spontaneous omental infarction two weeks after normal vaginal delivery. Conclusion Omental infarction is a differential diagnosis in the postpartum acute abdomen. As some cases of omental infarction, which are caused by torsion, can be adequately diagnosed via computed tomography, a conservative treatment strategy for patients without complications should be considered in order to avoid any unnecessary surgical intervention.

  6. Myocardial infarction and cerebral infarction in a Danish suburban community

    DEFF Research Database (Denmark)

    Lyngborg, K; Marquardsen, J; Trautner, F;

    1985-01-01

    A comparison was made of 485 cases of cerebral infarction (CI), registered prospectively in Frederiksberg, Copenhagen, with 495 cases of myocardial infarction (AMI), recorded retrospectively in the same population. The overall annual incidence of AMI was 6.5 per 1,000 population for males, 3...

  7. LAD-Ligation: A Murine Model of Myocardial Infarction

    Science.gov (United States)

    Kolk, Mandy V.V.; Meyberg, Danja; Deuse, Tobias; Tang-Quan, Karis R.; Robbins, Robert C.; Reichenspurner, Hermann; Schrepfer, Sonja

    2009-01-01

    Research models of infarction and myocardial ischemia are essential to investigate the acute and chronic pathobiological and pathophysiological processes in myocardial ischemia and to develop and optimize future treatment. Two different methods of creating myocardial ischemia are performed in laboratory rodents. The first method is to create cryo infarction, a fast but inaccurate technique, where a cryo-pen is applied on the surface of the heart (1-3). Using this method the scientist can not guarantee that the cryo-scar leads to ischemia, also a vast myocardial injury is created that shows pathophysiological side effects that are not related to myocardial infarction. The second method is the permanent ligation of the left anterior descending artery (LAD). Here the LAD is ligated with one single stitch, forming an ischemia that can be seen almost immediately. By closing the LAD, no further blood flow is permitted in that area, while the surrounding myocardial tissue is nearly not affected. This surgical procedure imitates the pathobiological and pathophysiological aspects occurring in infarction-related myocardial ischemia. The method introduced in this video demonstrates the surgical procedure of a mouse infarction model by ligating the LAD. This model is convenient for pathobiological and pathophysiological as well as immunobiological studies on cardiac infarction. The shown technique provides high accuracy and correlates well with histological sections. PMID:19829290

  8. Multimodality imaging of pulmonary infarction

    Energy Technology Data Exchange (ETDEWEB)

    Bray, T.J.P., E-mail: timothyjpbray@gmail.com [Department of Radiology, Papworth Hospital NHS Foundation Trust, Ermine Street, Papworth Everard, Cambridge CB23 3RE (United Kingdom); Mortensen, K.H., E-mail: mortensen@doctors.org.uk [Department of Radiology, Papworth Hospital NHS Foundation Trust, Ermine Street, Papworth Everard, Cambridge CB23 3RE (United Kingdom); University Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 318, Cambridge CB2 0QQ (United Kingdom); Gopalan, D., E-mail: deepa.gopalan@btopenworld.com [Department of Radiology, Papworth Hospital NHS Foundation Trust, Ermine Street, Papworth Everard, Cambridge CB23 3RE (United Kingdom)

    2014-12-15

    Highlights: • A plethora of pulmonary and systemic disorders, often associated with grave outcomes, may cause pulmonary infarction. • A stereotypical infarct is a peripheral wedge shaped pleurally based opacity but imaging findings can be highly variable. • Multimodality imaging is key to diagnosing the presence, aetiology and complications of pulmonary infarction. • Multimodality imaging of pulmonary infarction together with any ancillary features often guide to early targeted treatment. • CT remains the principal imaging modality with MRI increasingly used alongside nuclear medicine studies and ultrasound. - Abstract: The impact of absent pulmonary arterial and venous flow on the pulmonary parenchyma depends on a host of factors. These include location of the occlusive insult, the speed at which the occlusion develops and the ability of the normal dual arterial supply to compensate through increased bronchial arterial flow. Pulmonary infarction occurs when oxygenation is cut off secondary to sudden occlusion with lack of recruitment of the dual supply arterial system. Thromboembolic disease is the commonest cause of such an insult but a whole range of disease processes intrinsic and extrinsic to the pulmonary arterial and venous lumen may also result in infarcts. Recognition of the presence of infarction can be challenging as imaging manifestations often differ from the classically described wedge shaped defect and a number of weighty causes need consideration. This review highlights aetiologies and imaging appearances of pulmonary infarction, utilising cases to illustrate the essential role of a multimodality imaging approach in order to arrive at the appropriate diagnosis.

  9. Multimodality imaging of pulmonary infarction

    International Nuclear Information System (INIS)

    Highlights: • A plethora of pulmonary and systemic disorders, often associated with grave outcomes, may cause pulmonary infarction. • A stereotypical infarct is a peripheral wedge shaped pleurally based opacity but imaging findings can be highly variable. • Multimodality imaging is key to diagnosing the presence, aetiology and complications of pulmonary infarction. • Multimodality imaging of pulmonary infarction together with any ancillary features often guide to early targeted treatment. • CT remains the principal imaging modality with MRI increasingly used alongside nuclear medicine studies and ultrasound. - Abstract: The impact of absent pulmonary arterial and venous flow on the pulmonary parenchyma depends on a host of factors. These include location of the occlusive insult, the speed at which the occlusion develops and the ability of the normal dual arterial supply to compensate through increased bronchial arterial flow. Pulmonary infarction occurs when oxygenation is cut off secondary to sudden occlusion with lack of recruitment of the dual supply arterial system. Thromboembolic disease is the commonest cause of such an insult but a whole range of disease processes intrinsic and extrinsic to the pulmonary arterial and venous lumen may also result in infarcts. Recognition of the presence of infarction can be challenging as imaging manifestations often differ from the classically described wedge shaped defect and a number of weighty causes need consideration. This review highlights aetiologies and imaging appearances of pulmonary infarction, utilising cases to illustrate the essential role of a multimodality imaging approach in order to arrive at the appropriate diagnosis

  10. Increased infarct wall thickness by a bio-inert material is insufficient to prevent negative left ventricular remodeling after myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Aboli A Rane

    Full Text Available BACKGROUND: Several injectable materials have been shown to preserve or improve cardiac function as well as prevent or slow left ventricular (LV remodeling post-myocardial infarction (MI. However, it is unclear as to whether it is the structural support or the bioactivity of these polymers that lead to beneficial effects. Herein, we examine how passive structural enhancement of the LV wall by an increase in wall thickness affects cardiac function post-MI using a bio-inert, non-degradable synthetic polymer in an effort to better understand the mechanisms by which injectable materials affect LV remodeling. METHODS AND RESULTS: Poly(ethylene glycol (PEG gels of storage modulus G' = 0.5±0.1 kPa were injected and polymerized in situ one week after total occlusion of the left coronary artery in female Sprague Dawley rats. The animals were imaged using magnetic resonance imaging (MRI at 7±1 day(s post-MI as a baseline and again post-injection 49±4 days after MI. Infarct wall thickness was statistically increased in PEG gel injected vs. control animals (p<0.01. However, animals in the polymer and control groups showed decreases in cardiac function in terms of end diastolic volume, end systolic volume and ejection fraction compared to baseline (p<0.01. The cellular response to injection was also similar in both groups. CONCLUSION: The results of this study demonstrate that passive structural reinforcement alone was insufficient to prevent post-MI remodeling, suggesting that bioactivity and/or cell infiltration due to degradation of injectable materials are likely playing a key role in the preservation of cardiac function, thus providing a deeper understanding of the influencing properties of biomaterials necessary to prevent post-MI negative remodeling.

  11. Affect of mood and cognitive function on motor function in patients with acute cerebral infarction%情绪和认知功能对早期脑梗死患者运动功能影响的研究

    Institute of Scientific and Technical Information of China (English)

    朱菊清; 冯子平; 杨旭东; 伯丹花; 陈世兵

    2015-01-01

    Objective:To analyze the relationship between motor dysfunction with cognitive function and mood among patients with a-cute cerebral infarction. Methods:Collected 78 cases patients with cerebral infarction, use upper limb function assessment table (DASH), 10m walking speed, Cognitive Assessment (MoCA), Self -Rating Anxiety Scale (SAS), Self -Rating Depression Scale ( SDS) to assess;comparison of patients with diffusion tensor imaging ( DTI) parameters:fractional anisotropy ( FA) values, and the ap-parent diffusion coefficient ( ADC) and FA index, ADC index, then correlation analysis and assessment of cognitive and emotional.Re-sults:DASH score and 10m walking speed had no correlation with MoCA, SAS, SDS scores (P>0.05);FA values in the ipsilateral and contralateral handers were negatively correlated (P<0.05) with SDS sorce.Conclusion:Cerebral infarction movement disorders might have no correlation with mood and cognitive function, while the infarct-induced defects in patients with neural networks should be associ-ated with emotions.%目的:研究脑梗死患者早期运动功能障碍与认知功能和情绪之间的关系。方法:收集自2011年5月~2014年5月于我院就诊的脑梗死患者78例,用上肢功能评定表( DASH)、10m步行速度、认知评估量表( MoCA)、焦虑自评量表( SAS)、抑郁自评量表( SDS)进行评定;比较患者弥散张量成像( DTI)相关参数:各向异性分数( FA)值、表观扩散系数( ADC)和FA指数、ADC指数,并与认知和情绪评估结果进行相关性分析。结果:DASH评分和10m步行速度与MoCA、SAS、SDS评分无相关性( P>0.05);患侧和健侧内囊后肢的FA值均与SDS评分呈负相关(P<0.05)。结论:脑梗死患者早期运动障碍与情绪和认知功能无相关性,而梗死灶所致的神经网络缺损则与情绪相关。

  12. Mild focal cerebral ischemia in the rat. The effect of local temperature on infarct size

    DEFF Research Database (Denmark)

    Hildebrandt-Eriksen, Elisabeth S; Christensen, Thomas; Diemer, Nils Henrik

    2002-01-01

    We aimed at investigating a new model of mild focal cerebral ischemia in rats with repeated, noninvasive magnetic resonance scanning combined with histology. Magnetic resonance imaging yielded information about infarct development enabling us to test the putative growth of the infarct over time....... The effect of local temperature at the occlusion site in this model was furthermore tested. Thirty-three Wistar rats were subjected to 30 min of simultaneous common carotid artery and distal middle cerebral artery occlusion or sham treatment. Animals were magnetic resonance-scanned repeatedly between day one...... smaller infarcts (14.4 +/- 10 mm3) than animals with normothermic local temperature (36.7 +/- 0.2 degrees C, 57.7 +/- 26.4 mm3). Infarct size was maximal on day 3 after ischemia but decreased as edema subsided. Infarct volumes from histology and magnetic resonance imaging correlated well. The model...

  13. Valsartan after myocardial infarction.

    Science.gov (United States)

    Güleç, Sadi

    2014-12-01

    One of the important problems of the patients undergoing acute myocardial infarction (MI) is early development of heart failure. It has been revealed in various studies that renin-angiotensin-aldosterone system (RAAS) has a significant role in this process. The studies conducted with angiotensin converting enzyme (ACE) inhibitors have resulted in decreased mortality rate. Another RAAS blocker which was discovered about ten years later than other ACE inhibitors in historical process is angiotensin receptor blockers (ARB) inhibiting the efficiency of angiotensin 2 by binding to angiotensin 1 receptor. Valsartan is one of the molecules of this group, which has higher number of large-scale randomized clinical studies. In this review, following presentation of a general overview on heart failure after acute MI, the efficiency of ARBs in this patient group will be discussed. This discussion will mostly emphasize the construction, outcomes and clinical importance of VALIANT (VALsartan In Acute myocardial iNfarcTion), which is the study on valsartan after acute MI heart failure. PMID:25604205

  14. No effect of ablation of surfactant protein-D on acute cerebral infarction in mice

    DEFF Research Database (Denmark)

    Lambertsen, Kate Lykke; Østergaard, Kamilla; Clausen, Bettina Hjelm;

    2014-01-01

    known to be involved in extrapulmonary modulation of inflammation in mice. We investigated whether SP-D affected cerebral ischemic infarction and ischemia-induced inflammatory responses in mice. METHODS: The effect of SP-D was studied by comparing the size of ischemic infarction and the inflammatory....... Changes in plasma SP-D and TNF were assessed by ELISA and proximity ligation assay, respectively. RESULTS: Infarct volumetric analysis showed that ablation of SP-D had no effect on ischemic infarction one and five days after induction of ischemia. Further, ablation of SP-D had no effect on the ischemia...... were comparable in SP-D KO and WT mice. CONCLUSIONS: SP-D synthesis in middle cerebral artery cells is consistent with SP-D conceivably leaking into the infarcted area and affecting local cytokine production. However, there was no SP-D synthesis in parenchymal brain cells and ablation of SP-D had...

  15. Reduced infarct size in neuroglobin-null mice after experimental stroke in vivo

    Directory of Open Access Journals (Sweden)

    Raida Zindy

    2012-08-01

    Full Text Available Abstract Background Neuroglobin is considered to be a novel important pharmacological target in combating stroke and neurodegenerative disorders, although the mechanism by which this protection is accomplished remains an enigma. We hypothesized that if neuroglobin is directly involved in neuroprotection, then permanent cerebral ischemia would lead to larger infarct volumes in neuroglobin-null mice than in wild-type mice. Methods Using neuroglobin-null mice, we estimated the infarct volume 24 hours after permanent middle cerebral artery occlusion using Cavalieri’s Principle, and compared the infarct volume in neuroglobin-null and wild-type mice. Neuroglobin antibody staining was used to examine neuroglobin expression in the infarct area of wild-type mice. Results Infarct volumes 24 hours after permanent middle cerebral artery occlusion were significantly smaller in neuroglobin-null mice than in wild-types (p  Conclusions Neuroglobin-deficiency resulted in reduced tissue infarction, suggesting that, at least at endogenous expression levels, neuroglobin in itself is non-protective against ischemic injury.

  16. Dihydroxyflavonol reduces post-infarction left ventricular remodeling by preventing myocyte apoptosis in the non-infarcted zone in goats

    Institute of Scientific and Technical Information of China (English)

    WANG Sheng; FEI Ke; XU Ya-wei; WANG Liang-xu; Chen Yan-qin

    2009-01-01

    Background Myocyte apoptosis is considered to be the major causative factor of left ventricular (LV) remodeling following myocardial infarction (MI). We previously reported that 3', 4'-dihydroxyflavonol (DiOHF), was able to suppress oxidative stress and preserve the expression of endothelial nitric oxide synthase during myocardial reperfusion injury, which may benefit the reduction of myocyte apoptosis. We therefore aimed to evaluate the potential actions of DiOHF against myocyte apoptosis and post-infarction LV remodeling in this study. Methods Following experimental MI, surgical instrumented goats were randomly assigned into vehicle and DiOHF (2 mg/kg; i.v., daily) groups to receive 4 weeks of reperfusion with corresponding treatments. LV pressure recordings and echocardiogram were performed at baseline, 2 and 4 weeks of reperfusion. Myocardial tissues were collected in the end to determine infarct size and apoptosis related assays. Results LV end-diastolic volume and diameter were significantly increased 4 weeks after MI in the vehicle group, accompanied by reduced posterior wall thickness, septal thickness and LV mass, whereas those changes were markedly prevented by DiOHF treatment. Similarly, significantly reduced infarct size was found in DiOHF group as compared to vehicle group, and DiOHF dramatically inhibited the increase in LV end-diastolic pressure and the reductions in ejection fraction, fraction shortening and dP/dtmax. Moreover, DiOHF treatment significantly reduced the extent of myocyte apoptosis detected by TUNEL assay, enhanced the protein expression of caspase-3, Fas, Bax and cytochrome c in the non-infarcted myocardium in comparison to vehicle. Conclusions Daily DiOHF treatment during the reperfusion period after MI in the ovine hearts markedly reduced the magnitude of post-infarction LV remodeling through the inhibition of myocyte apoptosis in the remote non-infarcted myocardium.

  17. MYOCARDIAL INFARCTION TYPE 2. MYTH OR REALITY?

    OpenAIRE

    V. V. Zhelnov; N. V. Dyatlov; L. I. Dvoretsky

    2016-01-01

    According to The Third Definition of Myocardial Infarction there are five types of myocardial infarction depending on pathogenesis. This review provides actual data about myocardial infarction type 2 mechanism including diagnosis management, epidemiological characteristic and patient prognosis. Previously published data shows discordant information about myocardial infarction type 2 frequency, treatment and diagnostic options. Our clinical observation illustrates these severities in diagnosis...

  18. Evaluation of multislice computed tomographic perfusion imaging and computed tomographic angiography on traumatic cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    XU Fang-hong; CHEN Wei-jian; YANG Yun-jun; DUAN Yu-xia; FU Feng-li

    2008-01-01

    Objective: To evaluate the application value of multislice computed tomographic perfusion imaging (MSCTPI) and multislice computed tomographic angiography (MSCTA) on traumatic cerebral infarction. Methods: MSCTA was performed on 10 patients who were initiailly diagnosed as traumatic cerebral infarction by normal conventional computed tomography (NCCT), among whom, 3 patients were examined by MSCTPI simultaneously. Reconstructed images of the intracranial artery were made with techniques of maximum intensity projection (MIP) and volume rendering (VR) from MSCTA scanning data. Then the graph of function of four parameters, regional cerebral blood flow (Rcbf), regional cerebral blood volume (Rcbv), mean transit time (MTT), and time to peak (TTP), acquired by the perfusing analysis software was obtained. Results: Among the 10 patients with traumatic cerebral infarction, 6 showed complex type on NCCT, which depicted abnormality on MSCTA, and 4 showed simple type on NCCT, which had negative results on MSCTA. Among the 4 patients with abnormal great vessels, 2 suffered from steno sis or occlusion of the middle cerebral artery, 1 from spasm of the anterior cerebral artery, and 1 from spasm of the vertebral-basal artery. The image of MSCTPI of 1 patient with massive cerebral infarction on the right cerebral hemisphere confirmed by CT was smaller than those of the other patients, which showed occlusion of the ipsilateral middle cerebral artery on MSCTA. Among the 6 patients whose MSCTA showed no abnormality, 4 showed simple infarction and 2 showed complex infarction. The infarction focus of 5 patients occurred in the basal ganglia and 1 in the splenium of corpus callosum. Among the 2 cases of small cerebral infarction volume on NCCT, one was normal, the other showed hypoperfusion on MSCTPI and was normal on MSCTA. Conclusion: The combination of MSCTPI and MSCTA is very useful for evaluating the change of intracranial artery in ischemic regions and assessing the cerebral

  19. DI-3-butylphthalide-enhanced hematopoietic stem cell transplantation and endogenous stem cell mobilization for the treatment of cerebral infarcts

    Institute of Scientific and Technical Information of China (English)

    Baoquan Lu; Xiaoming Shang; Yongqiu Li; Hongying Ma; Chunqin Liu; Jianmin Li; Yingqi Zhang; Shaoxin Yao

    2011-01-01

    Exogenous stem cell transplantation and endogenous stem cell mobilization are both effective for the treatment of acute cerebral infarction. The compound dl-3-butylphthalide is known to improve microcirculation and help brain cells at the infarct loci. This experiment aimed to investigate the effects of dl-3-butylphthalide intervention based on the transplantation of hematopoietic stem cells and mobilization of endogenous stem cells in a rat model of cerebral infarction, following middle cerebral artery occlusion. Results showed that neurological function was greatly improved and infarct volume was reduced in rats with cerebral infarction. Data also showed that dl-3-butylphthalide can promote hematopoietic stem cells to transform into vascular endothelial cells and neuronal-like cells, and also enhance the therapeutic effect on cerebral infarction by hematopoietic stem cell transplantation and endogenous stem cell mobilization.

  20. MRI evaluation of injectable hyaluronic acid-based hydrogel therapy to limit ventricular remodeling after myocardial infarction.

    Science.gov (United States)

    Dorsey, Shauna M; McGarvey, Jeremy R; Wang, Hua; Nikou, Amir; Arama, Leron; Koomalsingh, Kevin J; Kondo, Norihiro; Gorman, Joseph H; Pilla, James J; Gorman, Robert C; Wenk, Jonathan F; Burdick, Jason A

    2015-11-01

    Injectable biomaterials are an attractive therapy to attenuate left ventricular (LV) remodeling after myocardial infarction (MI). Although studies have shown that injectable hydrogels improve cardiac structure and function in vivo, temporal changes in infarct material properties after treatment have not been assessed. Emerging imaging and modeling techniques now allow for serial, non-invasive estimation of infarct material properties. Specifically, cine magnetic resonance imaging (MRI) assesses global LV structure and function, late-gadolinium enhancement (LGE) MRI enables visualization of infarcted tissue to quantify infarct expansion, and spatial modulation of magnetization (SPAMM) tagging provides passive wall motion assessment as a measure of tissue strain, which can all be used to evaluate infarct properties when combined with finite element (FE) models. In this work, we investigated the temporal effects of degradable hyaluronic acid (HA) hydrogels on global LV remodeling, infarct thinning and expansion, and infarct stiffness in a porcine infarct model for 12 weeks post-MI using MRI and FE modeling. Hydrogel treatment led to decreased LV volumes, improved ejection fraction, and increased wall thickness when compared to controls. FE model simulations demonstrated that hydrogel therapy increased infarct stiffness for 12 weeks post-MI. Thus, evaluation of myocardial tissue properties through MRI and FE modeling provides insight into the influence of injectable hydrogel therapies on myocardial structure and function post-MI.

  1. Observe the effect of vein thrombolytic therapy by the guide of 320 slices volume CT in the earliest period of cerebral infarction%320排容积CT指导下脑梗死超早期静脉溶栓的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张青山; 孙卫红; 黄颖; 李光超; 王涛; 魏涛; 曹伟; 赵宝忠

    2011-01-01

    Objective To observe the effect of vein thrombolytic therapy by the guide of 320 slices volume CT in the earliest period cerebral infarction. Methods Eleven patients with acute cerebral infarction ( ACI ) whose course <4.5 h were examined by the 320 slices volume CT. The vein thrombolytic therapy with ft-PA at the earliest period was applied by the guide of this test result. The scores of National Institutes of Health Stroke Scale (NIHSS) and modified Edinbergh-Scandinavia stroke scale(MESSS) were took before and after the treatment 24 h and 14 d,and the therapeutic effect were evaluated. Results There was no obvious responsibility focus of infarction in the 11 ACl patients by skull CT plain scan images. The CT angiography showed that the cerebral vessels in the reqine corresponding to the lesion were obvious rare. Seven cases had angiostenosis which corresponding to the infarction lesion. Four cases had vascular occlusion, including 2 cases had compensatory blood vessel formation. The CI perfusion showed the regional cerebral blood flow (rCBF) in the regine corresponding the clinical symptoms in 9 cases were descrsed. Regional cerebral blood volume (rCBV) in the regine corresponding the clinical symptoms were slight increased in 7 cases, decreased in 2 cases, and 2 cases had no change. MTT and TIP were obvious extension at 14 d after thrombolysis treatment. The NIHSS and MESSS scores after thrombolysis treatment 24 h and 14 d were significantly lower than before treatment ( all P < 0. O1 ). Six cases were basio-healing. Two cases were significant progressive. Two cases were progressive, and 1 case was no change. Conclusions 320 slices volume CT can reflect the perfusion condition of cerebral vessel and its tissue unit in the earliest period of cerebral infarction. And which can guide the thrombolytic therapy to save the damage brain tissue caused by ischemia.%目的 观察320排容积CT指导下脑梗死超早期静脉溶栓治疗的疗效.方法 对11

  2. Acute capsular infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kashihara, M.; Matsumoto, K.

    1985-05-01

    Sixty-three patients with lacunar-type of acute capsular infarction were treated in our service during the last 2 years. Their lesions were identified by computed tomography (CT) and classified into six types according to their locations: anterior, lateral, posterior, superior, inferior and multiple. The lesions were thought to be in the watershed areas of the regional arterial supplies, and the areas were considered to be prone to ischemia. The clinical course of each type showed characteristic features of ischemic strokes. In the majority of the patients with the lateral type, reversible ischemic neurological deficit (RIND) was seen as the predominant symptom, transient ischemic attack (TIA) was noted in the patients with the superior type, and major completed stroke was observed in those with posterior type.

  3. A prospective study found impaired left ventricular function predicted job retirement after acute myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, Finn E; Sørensen, Henrik T; Skagen, Knud

    2004-01-01

    OBJECTIVE: Impaired left ventricular function is associated with poor prognosis after acute myocardial infarction (MI). It might be hypothesized that impaired left ventricular function would also affect work outcome; however, no existing data address this hypothesis. This study examines whether...

  4. Time course of infarct healing and left ventricular remodelling in patients with reperfused ST segment elevation myocardial infarction using comprehensive magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ganame, Javier [University Hospitals Leuven, Cardiology Department, Leuven (Belgium); University Hospitals Leuven, Radiology Department, Leuven (Belgium); Messalli, Giancarlo; Dymarkowski, Steven; Abbasi, Kayvan; Bogaert, Jan [University Hospitals Leuven, Radiology Department, Leuven (Belgium); Masci, Pier Giorgio [University Hospitals Leuven, Radiology Department, Leuven (Belgium); MRI Unit, Monasterio Foundation, CNR, Pisa (Italy); Werf, Frans van de; Janssens, Stefan [University Hospitals Leuven, Cardiology Department, Leuven (Belgium)

    2011-04-15

    To describe the time course of myocardial infarct (MI) healing and left ventricular (LV) remodelling and to assess factors predicting LV remodelling using cardiac MRI. In 58 successfully reperfused MI patients, MRI was performed at baseline, 4 months (4M), and 1 year (1Y) post MI Infarct size decreased between baseline and 4M (p < 0.001), but not at 1Y; i.e. 18 {+-} 11%, 12 {+-} 8%, 11 {+-} 6% of LV mass respectively; this was associated with LV mass reduction. Infarct and adjacent wall thinning was found at 4M, whereas significant remote wall thinning was measured at 1Y. LV end-diastolic and end-systolic volumes significantly increased at 1Y, p < 0.05 at 1Y vs. baseline and vs. 4M; this was associated with increased LV sphericity index. No regional or global LV functional improvement was found at follow-up. Baseline infarct size was the strongest predictor of adverse LV remodelling. Infarct healing, with shrinkage of infarcted myocardium and wall thinning, occurs early post-MI as reflected by loss in LV mass and adjacent myocardial remodelling. Longer follow-up demonstrates ongoing remote myocardial and ventricular remodelling. Infarct size at baseline predicts long-term LV remodelling and represents an important parameter for tailoring future post-MI pharmacological therapies designed to prevent heart failure. (orig.)

  5. infarction in rats

    Directory of Open Access Journals (Sweden)

    Keyvan Yousefi

    2014-03-01

    Full Text Available Introduction: Nowadays, finding new therapeutic compounds from natural products for treatment and prevention of a variety of diseases including cardiovascular disorders is getting a great deal of attention. This approach would result in finding new drugs which are more effective and have fewer side effects than the conventional medicines. The present study was designed to investigate the anti-inflammatory effect of the methanolic extract of Marrubium vulgare, a popular traditional medicinal herb, on isoproterenol-induced myocardial infarction (MI in rat model. Methods: Male Wistar rats were assigned to 6 groups of control, sham, isoproterenol, and treatment with 10, 20, and 40 mg/kg/12h of the extract given orally concurrent with MI induction. A subcutaneous injection of isoproterenol (100 mg/kg/day for two consecutive days was used to induce MI. Then, histopathological changes and inflammatory markers were evaluated. Results: Isoproterenol injection increased inflammatory response, as shown by a significant increase in peripheral neutrophil count, myocardial myeloperoxidase (MPO activity and serum levels of creatinine kinase-MB (CK-MB and TNF-α (pM.vulgare extract serum CK-MB was subsided by 55.4%, 52.2% and 69%, respectively. Also treatment with the extract (40 mg/kg significantly reduced (p<0.001 MPO activity in MI group. The levels of TNF-α was also considerably declined in the serums of MI group (p<0.001. In addition, peripheral neutrophil count, was significantly lowered by all doses of the extract (p<0.001. Interstitial fibrosis significantly was attenuated in treated groups compared with control MI group.Conclusion:The results of study demonstrate that the M. vulgare extract has strong protective effects against isoproterenol-induced myocardial infarction and it seems possible that this protection is due to its anti-inflammatory effects.

  6. Myocardial damage size assessment in the zone of infarction for indicating rescue percutaneous coronary intervention

    OpenAIRE

    Baškot Branislav; Obradović Slobodan; Ristić-Angelkov Anđelka; Rusović Siniša; Orozović Vjekoslav; Gligić Branko; Marković Milić; Jung Robert

    2008-01-01

    Background. The most important predictors of subsequent patients outcome after acute myocardial infarction (AIM) are infarct size, left ventricular ejection fraction, left ventricular volumes and presence and extent of residual myocardial ischemia. All of these variables can be directly determined through scintigraphic approaches. The presence and extent of myocardial ischemia are strong predictors for fatal and nonfatal cardiac events and improve risk statification beyond the information gle...

  7. Cardiac magnetic resonance imaging parameters as surrogate endpoints in clinical trials of acute myocardial infarction

    OpenAIRE

    Gutberlet Matthias; Lurz Philipp; Fuernau Georg; de Waha Suzanne; Eitel Ingo; Desch Steffen; Schuler Gerhard; Thiele Holger

    2011-01-01

    Abstract Cardiac magnetic resonance (CMR) offers a variety of parameters potentially suited as surrogate endpoints in clinical trials of acute myocardial infarction such as infarct size, myocardial salvage, microvascular obstruction or left ventricular volumes and ejection fraction. The present article reviews each of these parameters with regard to the pathophysiological basis, practical aspects, validity, reliability and its relative value (strengths and limitations) as compared to competit...

  8. Moderate ischemic mitral regurgitation after postero-lateral myocardial infarction in sheep alters left ventricular shear but not normal strain in the infarct and infarct borderzone

    Science.gov (United States)

    Ge, Liang; Wu, Yife; Soleimani, Mehrdad; Khazalpour, Michael; Takaba, Kiyoaki; Tartibi, Mehrzad; Zhang, Zhihong; Acevedo-Bolton, Gabriel; Saloner, David A.; Wallace, Arthur W.; Mishra, Rakesh; Grossi, Eugene A.; Guccione, Julius M.; Ratcliffe, Mark B.

    2016-01-01

    Background Chronic ischemic mitral regurgitation (CIMR: MR) is associated with poor outcome. Left ventricular (LV) strain after postero-lateral myocardial infarction (MI) may drive LV remodeling. Although moderate CIMR has been previously shown to effect LV remodeling, the effect of CIMR on LV strain after postero-lateral MI remains unknown. We tested the hypothesis that moderate CIMR alters LV strain after postero-lateral MI. Methods/Results Postero-lateral MI was created in 10 sheep. Cardiac MRI with tags was performed 2 weeks before and 2, 8 and 16 weeks after MI. LV and right ventricular (RV) volumes were measured and regurgitant volume indexed to body surface area (BSA; RegurgVolume Index) calculated as the difference between LV and RV stroke volumes / BSA. Three-dimensional strain was calculated. Circumferential (Ecc)and longitudinal (Ell) strains were reduced in the infarct proper, MI borderzone (BZ) and remote myocardium 16 weeks after MI. In addition, radial circumferential (Erc) and radial longitudinal (Erl) shear strains were reduced in remote myocardium but increased in the infarct and BZ 16 weeks after MI. Of all strain components, however, only Erc was effected by RegurgVolume Index (p=0.0005). There was no statistically significant effect of RegurgVolume Index on Ecc, Ell, Erl, or circumferential longitudinal shear strain (Ecl). Conclusions Moderate CIMR alters radial circumferential shear strain after postero-lateral MI in the sheep. Further studies are needed to determine the effect of shear strain on myocyte hypertrophy and the effect of mitral repair on myocardial strain. PMID:26857634

  9. National registry of myocardial infarction

    OpenAIRE

    Amin Daemi; Mehdi Jafari

    2016-01-01

    The Registry of Myocardial Infarctions (MI Registry) is a national registry in Iran that collects and reports the data on myocardial infarctions. Its main advantage is that it covers the whole country and is mandatory for hospitals to register the MI cases in it. Then, the qualified individuals at the provincial and national levels can get intended reports and make appropriate decisions. Such reports, further to the policy makers and managers, can be very valuable for researchers. The regi...

  10. Watershed Cerebral Infarction in a Patient with Acute Renal Failure

    Directory of Open Access Journals (Sweden)

    Ruya Ozelsancak

    2016-02-01

    Full Text Available Acute renal failure can cause neurologic manifestations such as mood swings, impaired concentration, tremor, stupor, coma, asterixis, dysarthria. Those findings can also be a sign of cerebral infarct. Here, we report a case of watershed cerebral infarction in a 70-year-old female patient with acute renal failure secondary to contrast administration and use of angiotensin converting enzyme inhibitor. Patient was evaluated with magnetic resonance imaging because of dysarthria. Magnetic resonance imaging revealed milimmetric acute ischemic lesion in the frontal and parietal deep white matter region of both cerebral hemisphere which clearly demonstrated watershed cerebral infarction affecting internal border zone. Her renal function returned to normal levels on fifth day of admission (BUN 32 mg/dl, creatinine 1.36 mg/dl and she was discharged. Dysarthria continued for 20 days.

  11. PCA Infarction With Its Cognitive Findings: More Than Hemianopia

    Directory of Open Access Journals (Sweden)

    Zehra Bozdoğan

    2013-12-01

    Full Text Available Posterior cerebral artery infarctions constitute 5-10 % of all ischemic strokes.In this case report, a 62 year-old man presenting with right hemiparesia and dysarthria is going to be discussed. The patient had acute onset- demential symptoms and difficulty in reading, and acute infarction in the territory of left posterior cerebral artery was detected in cranial magnetic resonance imaging. The patient who had acute ischemic lesions in left parahippocampus, splenium of corpus callosum, left fusiform gyrus and left thalamus was evaluated with detailed neuropsychological tests. Cognitive deficits severe enough to affect daily living were detected. Pure alexia, anterograde amnesia and anomia, being often neglected manifestations of unilateral posterior cerebral artery infarction, are going to be reviewed with corresponding radiological findings.

  12. Repair of swine infarcted myocardium with 5-azacytidine intramyocardial injection

    International Nuclear Information System (INIS)

    Objective: To study swine infarcted myocardium repairment after 5-azacytidine intramyocardial injection. Methods: Twenty young swines were divided into the treatment and control group randomly. The acute myocardial infarction (AMI)models were made by ligating the left anterior descending (LAD) as previously described. After 3 weeks, 1 ml 5-azacytidine in 1 mg/ml concentration was intramyocardium injected into infarcted and border regions in the treatment group (n=10). In the control group (n=10), the same volume of cell culture medium was injected into infarcted myocardial tissue through intramyocardium. Positron emission tomography (PET) was examined at 3rd weeks and 7th weeks. After 7 weeks, the animals were killed, the specimens were harvested for triphenyltetrazolium chloride (TTC) and HE staining, electron microscopical studies and immunohistochemical examination for β muscle heavy chain (β-MHC), cardiac troponin I (cTn I) and connexin43 (Cx43). Results: PET demonstrated that radioactivity in the left ventricular free wall and apex became thick in the animals in the treatment group at 7th week compared with the animals in the control group. The infarcted area stained with TTC method and its percentage had significant difference between the treatment and the control group[(4.06 ± 0.29) cm2 vs (5.41 ± 0.28) cm2; (16.34 ± 0.89)% vs(21.23 ± 1.02)%, P<0.001]. New island and striated muscles were found in the treatment group at the site of injection. Actin were filaments with transmission electron microscopy found but not intercalated discs in the new muscle cells; these cells were positive with cellular immunohistochemical stain on β-MHC, cTnI and Cx43. There were symmetrical fibrous scar tissue with negative immunohistochemical result in the infarcted area in the control group. Conclusion: 5-azacytidine intramyocardial injection could repair swine myocardium injury. (authors)

  13. The clinic discuss of prognosis and treatment or brainstem infarction combined coma

    Institute of Scientific and Technical Information of China (English)

    Niu Junying; Wanglei; YinShimin; Zheng Yishan; Shijie Qu; Zhanfen

    2000-01-01

    Objective Discuss the relationship between the position, bound of brainstem infarction and .consciousness clog,determinan the prognosis and curative effect. Background and Methods Total brainstem infarction 14 patients,9 male and 5 female,43 to 80 years old.all patients had been checked by CT or MRI,brainstem foliun scanning 6 cases,checked by MRI 8 canes micbrain infarction 2 cases,pon infarction 5 cases,medulla infasction 7 cases the midbrain infarction were rise rapid,inmediately coma,the mydrasis in defect side,opposite body mucsle tension heighten.then both lower limbs straight,both pathology sign masculine.the two cases are all alive .tocked-in syndrom has appeared in 1 case of pon infarction ,and died of combined illness 1 year later. 1 case defect affect centrum of breath and hearlbeat, coma,breath rhythm malajustment,breath stop.threr were no consciousness clog in the other 3 cases ,vertigo,force head position to trouble side, nystagmus, trouble side face hypalgesia,and all cureed .2 cases of medulla infarction appeared quactriplegia ,swallow hardness,anarthriad and so on, 5 others were hemi Watlenberg syndrom,all wcre cured. Results and Discussion coma or no in brainstem infaciton was related with position.it is reparted that midbrain infarction coma was 7.6 persent of brainstem infarction. consciousness clog is distinctness which defect position in midbrain lateral-back, pon ventro defect, not involved ARAS ,lwas locked-in synxdom. brainstem infarction combined combined with freedom breath clog,in medulla was 16.1percent,midorain was 1 1.6 percent, pons ws 83.96 percent the prognosis was.all right in lightly brainsterm infarction, lf involved in both medulla, ventro pon,the prognosis was bad, and lose quadriplegia. CT brainstern foliun scanning would enhanced scanning lay, and helpful for chech up the pathological chanoes of brainstem.

  14. Comparing Cognitive and Somatic Symptoms of Depression in Myocardial Infarction Patients and Depressed Patients in Primary and Mental Health Care

    NARCIS (Netherlands)

    Groenewold, Nynke A.; Doornbos, Bennard; Zuidersma, Marij; Vogelzangs, Nicole; Penninx, Brenda W. J. H.; Aleman, Andre; de Jonge, Peter

    2013-01-01

    Depression in myocardial infarction patients is often a first episode with a late age of onset. Two studies that compared depressed myocardial infarction patients to psychiatric patients found similar levels of somatic symptoms, and one study reported lower levels of cognitive/affective symptoms in

  15. CT findings in hemorrhagic infarction

    International Nuclear Information System (INIS)

    7 cases of hemorrhagic infarction in which a high-density area in a low-density area were revealed on follow-up CT scan are reported. Symptomatically, 4 cases were completed strokes, while 3 cases were RIND. Recanalization of the occluded vessel was seen in all 5 cases on which follow-up angiography was performed. Hemorrhagic infarction was recognized between the 6th and 21st day after onset. CT scan revealed various patterns of hemorrhagic infarction - massive hematoma, watershed hemorrhage, diffuse petechial hemorrhage, etc. Clinical prognoses of these cases were provided in two groups. 3 cases whose clinical symptoms deteriorated at the time of hemorrhage died. On the other hand, 4 cases whose clinical symptoms were stationary, but who nevertheless had hemorrhagic infarction, had good or excellent prognoses. Hemorrhagic infarction of the former group took place during the acute stage of cerebral ischemia(6-8th day after onset), but that of the latter group took place during the subacute stage of cerebral ischemia (12-21st day after onset). Contrast enhancement was seen in all the cases except for one case of the acute stage. Contrast enhancement in the acute stage was recognized in 2 cases on the 4th day after onset. (author)

  16. Protective Effects of Overexpression of bcl-xl Gene on Local Cerebral Infarction in Transgenic Mice Undergoing Permanent Occlusion of Middle Cerebral Artery

    Institute of Scientific and Technical Information of China (English)

    Furong WANG; Yongsheng JIANG; Suming ZHANG; Wenwu XIAO; Suiqiang ZHU

    2008-01-01

    In order to investigate the protective effects of the overexpression of bcl-xl gene on local cerebral infarction in the transgenic mice subject to permanent occlusion of middle cerebral artery, the models of bcl-xl transgenic mice were established and subjected to cerebral infarction by intralu- minal occlusion of the middle cerebral artery. The infarct volume and the neurological scores were observed and comparison between the wild type mice and the transgenic mice was made. It was found that the infarct volume and the neurological scores in the transgenic mice were significantly decreased as compared with those in the wild type mice. It was suggested that the overexpression of bcl-xl gene in transgenic mice could reduce the infarct volume and improve the neurological function of the mice.

  17. Myocardial infarction in children: Two interesting cases

    Directory of Open Access Journals (Sweden)

    Suryawanshi Suresh

    2011-01-01

    Full Text Available Myocardial infarction in children is extremely rare and can have various etiologies. The following two case reports highlight rare but important causes of myocardial infarction in children.

  18. Quantitative assessment of the infarct size with the unfolded map method of sup 201 Tl myocardial SPECT in patient with acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kubota, Masahiro (Sapporo Medical Coll. (Japan))

    1992-03-01

    The unfolded map method of {sup 201}Tl single photon emission computed tomography (SPECT) was evaluated as to the ability to quantify and the clinical reliability in estimation of infarct size. The following results were obtained from basic experiments using a thoracic phantom. The defect area estimated by the unfolded map method was well correlated with the real defect area, in spite of overestimation of the defect area, when the defect area was determined by an isocount method (below 80% of maximum count) (y=1.941 + 2.292x, r=0.971). The defect volume estimated by short-axis images of {sup 201}Tl SPECT was closely correlated with real defect volume in spite of overestimation of defect volume (y=0.762 + 2.156x, r=0.982). When the defect area was estimated by division of the defect volume by the mean myocardial compartment thickness, it was closely correlated with real defect area (y=0.946 + 1.232x, r=0.990). When the volume was calculated from the summation of voxels in the regions districted by isocount threshold level at each section of the {sup 99m}Tc SPECT, the optimal isocount threshold level (percentage to maximum count) was 55%. Then, the clinical reliability of the unfolded map method as infarct sizing was evaluated in 26 patients with acute myocardial infarction by comparing it with enzymatic method, Bull's eye method, and {sup 99m}Tc pyrophosphate (PYP) SPECT method. In 14 first attack patients without right ventricular infarction, infarct area (IA) of the unfolded map method correlated most closely with the accumulated creatine kinase MB isoenzyme release (CK-MBr) (r=0.897), compared with the extent score (ES) (r=0.853) and the severity score (SS) (r=0.871) of Bull's eye method and the infarct volume (IV) (r=0.595) of {sup 99m}Tc PYP SPECT. In conclusion, although the unfolded map method of {sup 201}Tl SPECT has the tendency for overestimating infarct size, it is accurate and clinically reliable in estimating infarct size. (author).

  19. Effects of Bradykinin B2 Receptor Blockade on Infarct Size and Hemodynamics after Myocardial Infarction in Enalapril-treated Rats

    Institute of Scientific and Technical Information of China (English)

    Haizhu Zhang; Changcong Cui; Kexin Du; Jian Liu

    2008-01-01

    Objectives To study the effects of bradykinin (BK) B2 receptor blockade on infarct size and hemodynamics after myocardial infarction (MI) in rats with angiotensin-converting enzyme (ACE) inhibition therapy.Methods MI was produced by ligating the left coronary artery.The effects of enalapril(500μg/kg·day),enalapril(500μg/kg·day) with BK B2 receptor antagonist Hoe-140(500μg/kg·day),angiotensin Ⅱ(Ang Ⅱ) type 1(AT1) receptor antagonist losartan (3 mg/kg·day) on infarct size,left ventricular systolic pressure(LVSP),cardiac output index (CI) and stroke volume index (SVI) were observed in rats after MI.Treatments were started on the 2nd day after MI and continued for another 6 weeks.Results Enalapril reduced infarct size and improved CI and SVI compared with the untreated MI group (P<0.05 ),and these effects of enalapril were significantly blunted by concomitant treatment with Hoe-140 (P<0.05).Losartan was less effective than enalapril.LVSP were unchanged in the three treatment groups.Conclusions BK can reduce infract size and improve hemodynamics in rats following MI.The cardioprotective effects of ACEI partly result from the action of BK exerted through the B2 receptor.

  20. [Myocardial infarction caused by exertion].

    Science.gov (United States)

    Bernard, F; Weber, S

    1997-01-01

    Myocardial infarction is the main cause of sudden death during physical exercise, particularly in subjects over 40 and may even occur in high-performance young athletes. Sports and physical activity have a beneficial effect in preventing cardiovascular diseases, but certain rules of prudence must be followed to avoid the risk of a severe coronary event. Myocardial infarction always occurs in particularly susceptible subjects with several risk factors, predominantly smoking, hypercholesterolemia, family history of atherosclerosis. Dietary factors, either before, during or after the exercise, are always found. Distribution of coronary lesions differs with age. Before 40 years, the coronary network is normal in 40% of the cases. The infarction is partially explained by platelet hyperaggregahility and coronary spasms at exercise or in the post-exercise period.

  1. Coffee component 3-caffeoylquinic acid increases antioxidant capacity but not polyphenol content in experimental cerebral infarction.

    Science.gov (United States)

    Ruiz-Crespo, Silvia; Trejo-Gabriel-Galan, Jose M; Cavia-Saiz, Monica; Muñiz, Pilar

    2012-05-01

    Although coffee has antioxidant capacity, it is not known which of its bioactive compounds is responsible for it, nor has it been analyzed in experimental cerebral infarction. We studied the effect one of its compounds, 3-caffeoylquinic acid (3-CQA), at doses of 4, 25 and 100 μg on plasma antioxidant capacity and plasma polyphenol content, measuring the differences before and after inducing a cerebral infarction in an experimental rat model. We compared them with 3-caffeoylquinic-free controls. The increase in total antioxidant capacity was only higher than in controls in 3-CQA treated animals with the highest dose. This increase in antioxidant capacity was not due to an increase in polyphenols. No differences between the experimental and control group were found regarding polyphenol content and cerebral infarction volume. In conclusion, this increase in antioxidant capacity in the group that received the highest dose of 3-CQA was not able to reduce experimental cerebral infarction.

  2. Diffusion tensor imaging detects Wallerian degeneration of the corticospinal tract early after cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Ruiman Xie; Min Fang; Linjiang Zhou; Shanghua Fan; Jianying Liu; Hongbo Quan; Man Luo; Dongying Qiu

    2012-01-01

    To investigate the feasibility and time window of early detection of Wallerian degeneration in the corticospinal tract after middle cerebral artery infarction, 23 patients were assessed using magnetic resonance diffusion tensor imaging at 3.0T within 14 days after the infarction. The fractional anisotropy values of the affected corticospinal tract began to decrease at 3 days after onset and decreased in all cases at 7 days. The diffusion coefficient remained unchanged. Experimental findings indicate that diffusion tensor imaging can detect the changes associated with Wallerian degeneration of the corticospinal tract as early as 3 days after cerebral infarction.

  3. Prognostic Importance of ST-Segment Resolution in Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Eroğlu M et al.

    2011-02-01

    Full Text Available Some factors may affect prognosis and may be used to determine long term life duration after myocardial infarction. Hence, risk classification after myocardial infarction is of great importance. Coronary reperfusion following fibrinolytic therapy may be detected invasively and non-invasively in myocardial infarction with ST-segment elevation. ST-segment resolution, which is one of non-invasive reperfusion criteria, might be used to determine prognosis, since it reflects myocardial microcirculatory circulation better, and it is an easy, simple, and inexpensive parameter used in clinical practice. In the present study, we evaluated the prognostic importance of ST-segment resolution degree.

  4. Physical Activitiea Associted with Angina Pectoris Before Myocardial Infarction and the Onset of Myocardial Infarction

    OpenAIRE

    Matsuda, Masako

    1984-01-01

    One hundred and ninety-seven patients with a history of myocardeal infarction were interviewed to evaluate the incidence of angina pectoris and the physical activity precipitating angina before myocardial infarction, and the mode of physical activity at the onset of myocardial infarction. Ninety-ewo patients had no angina before infarction, whereas 105 did, In 105 patients, 58 had a chronic stable angina without a change of pattern of angina before infarction, while 22 noticed worsening of th...

  5. 高压氧治疗脑梗死疗效观察%Observation of therapeutic effect of hyperbaric oxygen on cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    马维艳; 杨丽

    2002-01-01

    Background:Hypoxia and ischemia resulting from cerebral infarction can further cause a series of pathological changes such as hydrocephallus.Drug therapy can improve cerebral blood circulation and enhance flow volume and decrease infarction area.If hyperbaric oxygen is added,pathophysiological changes such as ischemia and hypoxia can be improved and normal metabolism of brain cells be restored.

  6. Intravenous Followed by X-ray Fused with MRI-Guided Transendocardial Mesenchymal Stem Cell Injection Improves Contractility Reserve in a Swine Model of Myocardial Infarction

    Science.gov (United States)

    Schmuck, Eric G.; Koch, Jill M.; Hacker, Timothy A.; Hatt, Charles R.; Tomkowiak, Michael T.; Vigen, Karl K.; Hendren, Nicholas; Leitzke, Cathlyn; Zhao, Ying-qi; Li, Zhanhai; Centanni, John M.; Hei, Derek J.; Schwahn, Denise; Kim, Jaehyup; Hematti, Peiman

    2016-01-01

    The aim of this study is to determine the effects of early intravenous (IV) infusion later followed by transendocardial (TE) injection of allogeneic mesenchymal stem cells (MSCs) following myocardial infarction (MI). Twenty-four swine underwent balloon occlusion reperfusion MI and were randomized into 4 groups: IV MSC (or placebo) infusion (post-MI day 2) and TE MSC (or placebo) injection targeting the infarct border with 2D X-ray fluoroscopy fused to 3D magnetic resonance (XFM) co-registration (post-MI day 14). Continuous ECG recording, MRI, and invasive pressure-volume analyses were performed. IV MSC plus TE MSC treated group was superior to other groups for contractility reserve (p=0.02) and freedom from VT (p=0.03) but had more lymphocytic foci localized to the peri-infarct region (p= 0.002). No differences were observed in post-MI remodeling parameters. IV followed by XFM targeted TE MSC therapy improves contractility reserve and suppresses VT but does not affect post-MI remodeling and may cause an immune response. PMID:26374144

  7. [Fibrinolysis in acute myocardial infarct].

    Science.gov (United States)

    Bleifeld, W

    1987-10-24

    Fibrinolysis has opened up a new avenue in the treatment of acute myocardial infarction (AMI). In principle, the rate of reperfusion depends on the type of compound used, the mode of administration and the time between onset of symptoms and the beginning of treatment. With intracoronary streptokinase the reperfusion rate is of the order of 85%. Intravenous urokinase administered as a bolus results in a reopening rate of 50-60%; a similar rate of reperfusion is achieved with rt-PA as infusion, while i.v. streptokinase produces about 50% reopened coronary vessels. The final infarct size is decreased in 70% of patients if fibrinolysis is initiated within 2.5 hours after the onset of symptoms and followed by reopening of the occluded vessel. This results in a lowering of in-hospital mortality, which in various studies is of the order of 45-60%.- Bearing in mind the contraindications, fibrinolysis should be initiated within 3 hours. Hemodynamic improvement by a decrease of infarct size may also be achieved beyond 3 hours in large anterior myocardial infarctions and in posterior infarctions with cardiogenic shock. Early initiation of thrombolysis is of major importance in improving left ventricular function and lowering mortality following acute myocardial infarction. Therefore, prehospital thrombolytic therapy should be considered. - In the postinfarction phase coronary angiography is indicated in patients with angina at rest, stable angina of ECG signs of ischemia. In this situation transfer to a specialized cardiology division for possible percutaneous transluminal angioplasty is indicated. - Reocclusion after successful thrombolysis occurs in 20-30%, and it is therefore important to avoid reinfarction to improve the long term prognosis after AMI.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3321420

  8. Solar activity and myocardial infarction.

    Science.gov (United States)

    Szczeklik, E; Mergentaler, J; Kotlarek-Haus, S; Kuliszkiewicz-Janus, M; Kucharczyk, J; Janus, W

    1983-01-01

    The correlation between the incidence of myocardial infarction, sudden cardiac death, the solar activity and geomagnetism in the period 1969-1976 was studied, basing on Wrocław hospitals material registered according to WHO standards; sudden death was assumed when a person died within 24 hours after the onset of the disease. The highest number of infarctions and sudden deaths was detected for 1975, which coincided with the lowest solar activity, and the lowest one for the years 1969-1970 coinciding with the highest solar activity. Such an inverse, statistically significant correlation was not found to exist between the studied biological phenomena and geomagnetism. PMID:6851574

  9. Hospital variation in mortality after first acute myocardial infarction in Denmark from 1995 to 2002: lower short-term and 1-year mortality in high-volume and specialized hospitals

    DEFF Research Database (Denmark)

    Rasmussen, Søren; Zwisler, Ann-Dorthe O; Abildstrom, Steen Z;

    2005-01-01

    history. RESULTS: Tertiary cardiac care centers (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.67-0.96) and main regional hospitals (OR, 0.90; 95% CI, 0.80-0.99) had improved 28-day mortality compared with local hospitals. A 2-fold increase in annual total MI volume decreased 28-day mortality (OR...... with their first admission for AMI between 1995 and 2002 and surviving the day of admission. Multilevel logistic regression was used to determine the relationships between regional and hospital characteristics and 28-day and 365-day mortality after adjusting for individual characteristics, period, and medical......, 0.91; 95% CI, 0.87-0.94) and 365-day mortality (OR, 0.95; 95% CI, 0.91-0.98). Differences between hospitals were more substantial for short-term mortality, such that patients were about twice as likely to die within 28 days in hospitals with the worst performance versus those with the best...

  10. Effects of angiotensin-converting enzyme inhibition and bradykinin peptides in rats with myocardial infarction

    OpenAIRE

    Qu, Zhe; Xu, Hongxin; Tian, Yihao

    2015-01-01

    Background and objective: Angiotensin-converting enzyme (ACE) inhibitors have been reported to decrease myocardial remodeling and faciliate cardiac function improvement in the setting myocardial infarction by affecting bradykinin. The purpose of this study was to evaluate the combination effects of perindopril and bradykinin (BK) in rats with myocardial infarction. Methods: Wistar Rats underwent to left anterior descending (LAD) coronary artery ligation were allocated into MI group (n = 6); P...

  11. Acute myocardial infarction: Can it be a complication of acute organophosphorus compound poisoning?

    OpenAIRE

    Joshi, P.; P Manoria; Joseph, D., T.; Z Gandhi

    2013-01-01

    Organophosphorus compounds are used as pesticides and represent a common cause of poisoning in developing countries including India due to their widespread availability and use. Toxicity due to these agents can affect many organs including heart. Here, we report a case of acute organophosphorus poisoning (parathion), followed by acute myocardial infarction; documented by clinical features, electrocardiographic changes, and elevated cardiac enzymes. Myocardial infarction has been rarely report...

  12. Renal infarction secondary to ketamine abuse.

    Science.gov (United States)

    Chen, Chin-Li; Chen, Jin-Li; Cha, Tai-Lung; Wu, Sheng-Tang; Tang, Shou-Hung; Tsao, Chih-Wei; Meng, En

    2013-07-01

    Renal infarction is an uncommon condition that resulted from inadequate perfusion of the kidney and is easily missed diagnosed due to its nonspecific clinical presentations. Major risk factors for renal infarction are atrial fibrillation, previous embolism, and ischemic and valvular heart disease. Progressive decrease in renal function or even death can occur if renal infarction is not diagnosed accurately and promptly. Ketamine abuse may cause variable urinary tract injury. However, renal infarction caused by ketamine abuse has never been reported. To our knowledge, this is the first documented case of renal infarction following nasal insufflation of ketamine.

  13. Association between baseline peri-infarct magnetic resonance spectroscopy and regional white matter atrophy after stroke

    Energy Technology Data Exchange (ETDEWEB)

    Yassi, Nawaf; Campbell, Bruce C.V.; Davis, Stephen M.; Bivard, Andrew [Melbourne Brain Centre rate at The Royal Melbourne Hospital, Departments of Medicine and Neurology, Parkville, Victoria (Australia); Moffat, Bradford A.; Steward, Christopher; Desmond, Patricia M. [The University of Melbourne, Department of Radiology, The Royal Melbourne Hospital, Parkville (Australia); Churilov, Leonid; Donnan, Geoffrey A. [The University of Melbourne, Florey Institute of Neuroscience and Mental Health, Parkville (Australia); Parsons, Mark W. [University of Newcastle and Hunter Medical Research Institute, Priority Research Centre for Translational Neuroscience and Mental Health, Newcastle (Australia)

    2016-01-15

    Cerebral atrophy after stroke is associated with poor functional outcome. The prediction and prevention of post-stroke brain atrophy could therefore represent a target for neurorestorative therapies. We investigated the associations between peri-infarct metabolite concentrations measured by quantitative MRS and brain volume change in the infarct hemisphere after stroke. Twenty patients with ischemic stroke were enrolled. Patients underwent 3T-MRI within 1 week of onset, and at 1 and 3 months. At the baseline scan, an MRS voxel was placed manually in the peri-infarct area and another in the corresponding contralateral region. Volumetric analysis of T1 images was performed using two automated processing packages. Changes in gray and white matter volume were assessed as percentage change between 1 and 3 months. Mean concentrations (institutional units) of N-acetylaspartic acid (NAA) (6.1 vs 7.0, p = 0.039), total creatine (Cr+PCr) (5.4 vs 5.8, p = 0.043), and inositol (4.5 vs 5.0, p = 0.014), were significantly lower in the peri-infarct region compared with the contralateral hemisphere. There was a significant correlation between baseline peri-infarct NAA and white matter volume change in the infarct hemisphere between 1 and 3 months, with lower NAA being associated with subsequent white matter atrophy (Spearman's rho = 0.66, p = 0.010). The baseline concentration of Cr+PCr was also significantly correlated with white matter atrophy in the infarct hemisphere (Spearman's rho = 0.59, p = 0.027). Both of these associations were significant after adjustment for the false discovery rate and were validated using the secondary volumetric method. MRS may be useful in the prediction of white matter atrophy post-stroke and in the testing of novel neurorestorative therapies. (orig.)

  14. Spousal Adjustment to Myocardial Infarction.

    Science.gov (United States)

    Ziglar, Elisa J.

    This paper reviews the literature on the stresses and coping strategies of spouses of patients with myocardial infarction (MI). It attempts to identify specific problem areas of adjustment for the spouse and to explore the effects of spousal adjustment on patient recovery. Chapter one provides an overview of the importance in examining the…

  15. Neonatal Myocardial Infarction or Myocarditis?

    NARCIS (Netherlands)

    de Vetten, Leanne; Bergman, Klasien A.; Elzenga, Nynke J.; van Melle, Joost P.; Timmer, Albertus; Bartelds, Beatrijs

    2011-01-01

    We report a 29 week-gestation preterm infant who presented during his second week of life with cardiogenic shock. Clinical presentation and first diagnostics suggested myocardial infarction, but echocardiographic features during follow-up pointed to a diagnosis of enteroviral myocarditis. The child

  16. Acute inferior myocardial infarction with right ventricular infarction is more prone to develop cardiogenic shock.

    Science.gov (United States)

    Bari, M A; Roy, A K; Islam, M Z; Aditya, G; Bhuiyan, A S

    2015-01-01

    Cardiogenic shock is rare in isolated acute inferior myocardial infarction but there is relationship of cardiogenic shock with inferior myocardial infarction if associated with right ventricular infarction. A prospective study was carried out to see the association of cardiogenic shock with inferior myocardial infarction if associated with right ventricular infarction. This study was conducted from January 2011 to November 2011. A total of 100 cases were selected as study population which was taken from the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Among them 50 were in Group A and 50 were in Group B. Group A was the patients of acute myocardial infarction with right ventricular infarction. Group B was the patients of acute myocardial infarction without right ventricular infarction. It revealed that 9(18%) in Group A and 3(6%) in Group B developed cardiogenic shock which is statistically significant (pcardiogenic shock.

  17. Comparison between primary angioplasty and thrombolytic therapy on erectile dysfunction after acute ST elevation myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Ramazan Akdemir; Ekrem Yeter; (O)zlem Karakurt; Salih Orcan; Nihat Karakoyunlu; Mustafa Mucahit Balci; Levent Sa(g)nak; Hamit Ersoy; Mehmet Bulent Vatan; Harun Kilic

    2012-01-01

    Acute ST elevation myocarclial infarction has high mortality and morbidity rates.The majority of patients with this condition face erectile dysfunction in addition to other health problems,In this study,we aimed to investigate the effects of two different reperfusion strategies,primary angioplasty and thrombolytic therapy,on the prevalence of erectile dysfunction after acute myocardial infarction.Of the 71 patients matching the selection criteria,45 were treated with primary coronary angioplasty with stenting,and 26 were treated with thrombolytic agents.Erectile function was evaluated using the International Index of Erectile Function in the hospital to characterize each patient's sexual function before the acute myocardial infarction and 6 months after the event.The time required to restore blood flow to the artery affected by the infarct was found to be associated with the occurrence of erectile dysfunction after acute myocardial infarction.The increase in the prevalence of erectile dysfunction after acute myocardial infarction was 44.4% in the angioplasty group and 76.9% in the thrombolytic therapy group (P=0.008).In conclusion,this study has shown that reducing the time of reperfusion decreases the erectile dysfunction prevalence,and primary angioplasty is superior to thrombolytic therapy for decreasing the prevalence of erectile dysfunction after acute myocardial infarction.

  18. The Relationship among N-Terminal Pro-B-Type Natriuretic Peptide, High-Sensitivity C-Reactive Protein and Infarct Size in Patients with Acute ST-Elevation Myocardial Infarction

    OpenAIRE

    Sim, Doo Sun; Ahn, Youngkeun; Kim, Yun-Hyeon; Seon, Hyun Ju; Park, Keun Ho; Yoon, Hyun Ju; Yoon, Nam Sik; Kim, Kye Hun; Hong, Young Joon; Park, Hyung Wook; Kim, Ju Han; Jeong, Myung Ho; Cho, Jeong Gwan; Park, Jong Chun

    2015-01-01

    Background and Objectives We sought to investigate the relationship between levels of high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) and the infarct size and left ventricular (LV) volume after acute myocardial infarction (MI). Subjects and Methods Eighty-six patients with acute ST-elevation MI underwent delayed enhancement multidetector computed tomography immediately after they underwent percutaneous coronary intervention to determine t...

  19. Ventricular-arterial uncoupling in heart failure with preserved ejection fraction after myocardial infarction in dogs - invasive versus echocardiographic evaluation

    OpenAIRE

    Bartunek Jozef; Metens Thierry; Thoma Philippe; Mahmoudabady Maryam; Hadad Ielham; Touihri Karim; El Oumeiri Bachar; Mathieu Myrielle; Heyndrickx Guy R; Brimioulle Serge; Naeije Robert; Mc Entee Kathleen

    2010-01-01

    Abstract Background Heart failure with preserved left ventricular ejection fraction and abnormal diastolic function is commonly observed after recovery from an acute myocardial infarction. The aim of this study was to investigate the physiopathology of heart failure with preserved ejection fraction in a model of healed myocardial infarction in dogs. Methods Echocardiography, levels of neurohormones and conductance catheter measurements of left ventricular pressure-volume relationships were ob...

  20. Cyclosporin variably and inconsistently reduces infarct size in experimental models of reperfused myocardial infarction: a systematic review and meta-analysis.

    Science.gov (United States)

    Lim, W Y; Messow, C M; Berry, C

    2012-04-01

    Cyclosporin is an immunosuppressant that has recently been proposed as a treatment to prevent reperfusion injury in acute myocardial infarction (MI). We aimed to determine the overall efficacy of cyclosporin in experimental studies of acute reperfused MI. We conducted a systematic review and stratified meta-analysis of published studies describing the efficacy of cyclosporin in experimental models of acute reperfused MI. We included all in vivo publications of cyclosporin where infarct size was measured. A literature search identified 29 potential studies of which 20 fulfilled the eligibility criteria. In these studies (involving four species of animals), cyclosporin reduced myocardial infarct size by a standardized mean (95% confidence interval) difference of -1.60 (-2.17, -1.03) compared with controls. Cyclosporin failed to demonstrate a convincing benefit in studies involving pigs. Despite this observation, the overall efficacy of cyclosporin did not differ across species (P= 0.358). The dose of cyclosporin given did not affect final infarct size (P= 0.203). Funnel plots of these data suggested heterogeneity among the studies. Cyclosporin had variable effects on infarct size compared with placebo. Cyclosporin had no effect on myocardial infarct size in swine, raising a question over the potential cardioprotective effects of cyclosporin in man.

  1. Metabolic Changes in Rats with Photochemically Induced Cerebral Infarction and the Effects of Batroxobin: A Study by Magnetic Resonance Imaging, 1H- and 31P- Magnetic Resonance Spectroscopy

    Institute of Scientific and Technical Information of China (English)

    管兴志; 吴卫平; 匡培根; 匡培梓; 高杨; 管林初; 李丽云; 毛希安; 刘买利

    2001-01-01

    Metabolic changes in rats with photochemically induced cerebral infarction and the effects of batroxobin were investigated 1, 3, 5 and 7 days after infarction by means of magnetic resonance imaging (MRI), 1H- and 31P- magnetic resonance spectroscopy (MRS). A region of T2 hyperintensity was observed in left temporal neocortex in infarction group and batroxobin group 1, 3, 5 and 7 days after infarction. The volume of the region gradually decreased from 1 day to 7 days after infarction. The ratio of NAA/Cho+Cr in the region of T2 hyperintensity in the infarction group was significantly lower than that in the corresponding region in the sham-operated group 3, 5 and 7 days after infarction respectively (P<0.05). Lac appeared in the region of T2 hyperintensity in the infarction group 1, 3, 5 and 7 days after infarction, but it was not observed in the corresponding region in sham-operated group at all time points. Compared with the sham-operated group, the ratios of bATP/PME+PDE and PCr/PME+PDE of the whole brain in the infarction group were significantly lower 1, 3 and 5 days after infarction respectively (P<0.05), and the ratio of bATP/PCr also was significantly lower 1 day after infarction (P<0.05). Batroxobin significantly decreased the volume of the region of T2 hyperintensity 1 and 3 days after infarction (P<0.05), significantly increased the ratio of NAA/Cho+Cr in the region 5 and 7 days after infarction (P<0.05), significantly decreased the ratios of Lac/Cho+Cr and Lac/NAA in the region 5 and 7 days after infarction (P<0.05), and significantly increased the ratios of bATP/PME+PDE and bATP/PCr in the whole brain 1 day after infarction (P<0.05). The results indicated that the infracted region had severe edema, increased Lac and apparent neuronal dysfunction and death, and energy metabolism of the whole brain decreased after focal infarction, and that batroxobin effectively ameliorated the above-mentioned abnormal changes.

  2. Dysrhythmias Induced by Streptokinase Infusion in Patients with Acute Myocardial Infarction Admitted to Cardiac Care Units in the Northwest of Iran

    OpenAIRE

    Parizad Razieh; Mousavi Shabestari Mitra; Lak Dizaji Sima; Sehati Maliheh

    2014-01-01

    Objective: Currently, the most common cause of death in the world is cardiovascular disease, particularly myocardial infarction. Myocardial infarction is caused by reducing or cutting off the blood supply to the heart muscle due to obstruction caused by the presence of plaque or thrombus. The first step for the treatment of acute myocardial infarction is using thrombolytic drugs. By the analysis of plaque and removing the blockage, the blood flows to the affected area again....

  3. Myocardial damage size assessment in the zone of infarction for indicating rescue percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Baškot Branislav

    2008-01-01

    Full Text Available Background. The most important predictors of subsequent patients outcome after acute myocardial infarction (AIM are infarct size, left ventricular ejection fraction, left ventricular volumes and presence and extent of residual myocardial ischemia. All of these variables can be directly determined through scintigraphic approaches. The presence and extent of myocardial ischemia are strong predictors for fatal and nonfatal cardiac events and improve risk statification beyond the information gleaned from clinical variables. Case report. We presented a case of 66-years-old male with myocardial infarction of anteroseptal localization. Myocardial perfusion imaging (MPI detected a large zone of residual ischemia (culprit lesion within infarction zone. It has an important role in risk stratification after myocardial infarction, and indicates subsequent therapeutic decision making, in this case rescue percutaneous coronary intervention (PCI. After PCI we followed the therapy effect by MPI, and we found practically normal perfusion with minimal zone of defect perfusion in the apex. Conclusion. Myocardial perfusion imaging has an important role in the initial evaluation and risk stratification of patients surviving myocardial infarction. It also plays a major role in guiding subsequent therapeutic decision making, and in monitoring the benefits of these therapeutic measures.

  4. Neural Mechanisms and Delayed Gastric Emptying of Liquid Induced Through Acute Myocardial Infarction in Rats

    International Nuclear Information System (INIS)

    In pathological situations, such as acute myocardial infarction, disorders of motility of the proximal gut can trigger symptoms like nausea and vomiting. Acute myocardial infarction delays gastric emptying (GE) of liquid in rats. Investigate the involvement of the vagus nerve, α 1-adrenoceptors, central nervous system GABAB receptors and also participation of paraventricular nucleus (PVN) of the hypothalamus in GE and gastric compliance (GC) in infarcted rats. Wistar rats, N = 8-15 in each group, were divided as INF group and sham (SH) group and subdivided. The infarction was performed through ligation of the left anterior descending coronary artery. GC was estimated with pressure-volume curves. Vagotomy was performed by sectioning the dorsal and ventral branches. To verify the action of GABAB receptors, baclofen was injected via icv (intracerebroventricular). Intravenous prazosin was used to produce chemical sympathectomy. The lesion in the PVN of the hypothalamus was performed using a 1mA/10s electrical current and GE was determined by measuring the percentage of gastric retention (% GR) of a saline meal. No significant differences were observed regarding GC between groups; vagotomy significantly reduced % GR in INF group; icv treatment with baclofen significantly reduced %GR. GABAB receptors were not conclusively involved in delaying GE; intravenous treatment with prazosin significantly reduced GR% in INF group. PVN lesion abolished the effect of myocardial infarction on GE. Gastric emptying of liquids induced through acute myocardial infarction in rats showed the involvement of the vagus nerve, alpha1- adrenergic receptors and PVN

  5. Hemorrhagic transformation in ischemic posterior infarction by magnetic resonance imaging (MRI)

    International Nuclear Information System (INIS)

    Purpose: To describe the incidence, time course, and clinical correlates of hemorrhagic transformation (HT) of ischemic stroke in the posterior cerebral artery territory. Methods: Within 42 months 48 patients with 52 occipital lobe infarctions were examined by T1- and T2-weighted MR imaging. The extent and distribution of secondary hemorrhage were analysed at different intervals after stroke. Volume of ischemic and hemorrhagic infarction was measured planimetrically. Results: HT was observed in 71% of the infarcts between the 5th day and up to 1 year after stroke. HT was most frequently (88%) observed in the 2nd and 3rd month. HT was present in 55% of small infarcts (3), in 88% of medium size (10-50 cm3), and in all large (>50 cm3) infarcts. In 92% HT presented with petechial bleedings within the cortex (64%) or less frequently (28%) in subcortical structures. The latter types of HT showed no progression and did not increase the clinical deficits. Space-occupying bleedings occurred in only two large defects. Conclusions: In ischemic posterior infarction, HT can frequently be detected within the first three months after stroke and is predominantly of the petechial type and seems not to be relevant with regard to clinical deficits. (orig.)

  6. Changes in the electro-physical properties of MCT epitaxial films affected by a plasma volume discharge induced by an avalanche beam in atmospheric-pressure air

    Science.gov (United States)

    Grigoryev, D. V.; Voitsekhovskii, A. V.; Lozovoy, K. A.; Tarasenko, V. F.; Shulepov, M. A.

    2015-11-01

    In this paper the influence of the plasma volume discharge of nanosecond duration formed in a non-uniform electric field at atmospheric pressure on samples of epitaxial films HgCdTe (MCT) films are discussed. The experimental data show that the action of pulses of nanosecond volume discharge in air at atmospheric pressure leads to changes in the electrophysical properties of MCT epitaxial films due to formation of a near-surface high- conductivity layer of the n-type conduction. The preliminary results show that it is possible to use such actions in the development of technologies for the controlled change of the properties of MCT.

  7. Alien hand syndrome following corpus callosum infarction: A case report and review of the literature

    Science.gov (United States)

    Gao, Xiaoyu; Li, Bing; Chu, Wenzheng; Sun, Xuwen; Sun, Chunjuan

    2016-01-01

    Alien hand syndrome (AHS) is characterized by involuntary and autonomous activity of the affected limbs, and consists of the frontal, callosal and posterior AHS variants. The callosal subtype, resulting from damage to the corpus callosum, frequently features intermanual conflict. However, infarction of the corpus callosum is rare due to abundant blood supply. The present study reported a case of AHS (callosal subtype, in the right hand) caused by callosal infarction. Infarction of the left corpus callosum was confirmed with magnetic resonance imaging. In addition, magnetic resonance angiography and digital subtraction angiography examinations revealed multiple lesions in the feeding arteries. Subsequent to antiplatelet therapy for 2 weeks following admission, the patient gradually recovered. Furthermore, the current study reviewed 31 previously reported cases of AHS following callosal infarction in the literature. PMID:27698701

  8. Alien hand syndrome following corpus callosum infarction: A case report and review of the literature

    Science.gov (United States)

    Gao, Xiaoyu; Li, Bing; Chu, Wenzheng; Sun, Xuwen; Sun, Chunjuan

    2016-01-01

    Alien hand syndrome (AHS) is characterized by involuntary and autonomous activity of the affected limbs, and consists of the frontal, callosal and posterior AHS variants. The callosal subtype, resulting from damage to the corpus callosum, frequently features intermanual conflict. However, infarction of the corpus callosum is rare due to abundant blood supply. The present study reported a case of AHS (callosal subtype, in the right hand) caused by callosal infarction. Infarction of the left corpus callosum was confirmed with magnetic resonance imaging. In addition, magnetic resonance angiography and digital subtraction angiography examinations revealed multiple lesions in the feeding arteries. Subsequent to antiplatelet therapy for 2 weeks following admission, the patient gradually recovered. Furthermore, the current study reviewed 31 previously reported cases of AHS following callosal infarction in the literature.

  9. Myocardial infarction and stem cells

    Directory of Open Access Journals (Sweden)

    K Ananda Krishna

    2011-01-01

    Full Text Available Permanent loss of cardiomyocytes and scar tissue formation after myocardial infarction (MI results in an irreversible damage to the cardiac function. Cardiac repair (replacement, restoration, and regeneration is, therefore, essential to restore function of the heart following MI. Existing therapies lower early mortality rates, prevent additional damage to the heart muscle, and reduce the risk of further heart attacks. However, there is need for treatment to improve the infarcted area by replacing the damaged cells after MI. Thus, the cardiac tissue regeneration with the application of stem cells may be an effective therapeutic option. Recently, interest is more inclined toward myocardial regeneration with the application of stem cells. However, the potential benefits and the ability to improve cardiac function with the stem cell-based therapy need to be further addressed. In this review, we focus on the clinical applications of stem cells in the cardiac repair.

  10. Mortality rate in type 2 myocardial infarction

    DEFF Research Database (Denmark)

    Saaby, Lotte; Poulsen, Tina Svenstrup; Diederichsen, Axel Cosmus Pyndt;

    2014-01-01

    BACKGROUND: The classification of myocardial infarction into 5 types was introduced in 2007. The prognostic impact of this universal definition, with particular focus on type 2 myocardial infarction, has not been studied prospectively in unselected hospital patients. METHODS: During a 1-year period......, all hospitalized patients having cardiac troponin I measured were considered. The diagnosis of a myocardial infarction was according to the universal definition, and specified criteria were used in the classification of type 2 myocardial infarction. Follow-up was at least 1 year, with mortality...... as the end point. RESULTS: A total of 3762 consecutive patients were studied, of whom 488 (13%) had a myocardial infarction. In 119 patients a type 2 myocardial infarction was diagnosed. After a median of 2.1 years (interquartile range, 1.6-2.5 years), 150 patients had died, with a mortality rate of 49% (58...

  11. Myocardial infarction and subsequent pregnancy

    Directory of Open Access Journals (Sweden)

    Tedoldi Citânia Lúcia

    2000-01-01

    Full Text Available We report the case of a 40-year-old woman with 2 previous myocardial infarctions, revascularization surgery, and an ongoing pregnancy complicated with preeclampsia and fetal hypoxia. Her follow-up performed by a multidisciplinary team made possible the birth through cesarean section of a premature infant of the female sex with a very low birth weight, but without severe respiratory distress of the hyaline membrane disease type. Three months after the delivery, mother and daughter were healthy.

  12. Enteroviruses in Acute Myocardial Infarction

    OpenAIRE

    A Gholoobi; MS Nabavinia; T Mohamadpoor; MS Alavi; Z Meshkat

    2012-01-01

    Background: Human enteroviruses (EVs) may have a role as a possible risk factor in the pathogenesis of MI. The aim of this study was to evaluate the presence of enterovirus genomic RNA in peripheral blood samples of patients with acute myocardial infarction (MI). Methods: We investigated the presence of enterovirus genomic RNA in the peripheral blood of 115 patients with acute MI hospitalized in the Coronary Care Unit of Imam Reza and Ghaem University Hospitals (Mashhad, Iran) by RT-PCR using...

  13. Clinical studies on cerebral infarction

    International Nuclear Information System (INIS)

    Hemorrhagic infarction (HI) is termed as the infarction in which a large part of the necrotic tissue is stippled with small hemorrhage. The pathogenetic mechanism of this disease still remains controversial. Cerebral infarction has long been divided into two subtypes-thrombosis and embolism-according to the pathogenetic mechanisms. Clinical studies were carried out in 31 cases of HI with cerebral thrombosis. CT findings of these cases were classified into five groups according to both size of low density area which indicates regions of infarction and distribution of arterial supply. The low density area of Type I-Type III were observed in the area of the middle cerebral artery. That of Type IV was observed in the area of the internal capsule and basal ganglia. That of Type V was observed in the area of the posterior cerebral artery. CT reveals two patterns of HI -pattern A and pattern B-. The CT finding of pattern A is appearance of high density area in the low density area. The CT finding of pattern B is appearance of iso density area in the low density area. rCBF was measured by 133Xe inhalation technique in 21 patients with CT type I, II and III. Thereafter, with regard to the various findings in CT, the clinical findings and CBF findings, a comparative study was carried out on these ten groups. From the results of present studies, it is concluded that sequential changes of CBF in cases with pattern A are different from those with pattern B, and that CBF measurement does not permit an estimation of a patient's chance for functionary recovery after a stroke in acute and subacute stage but permits estimation of functional outcome in chronic stage. (J.P.N.)

  14. SERUM MAGNESIUM IN ACUTE MYOCARDIAL INFARCTION

    OpenAIRE

    Nambakam Tanuja; Girish P

    2015-01-01

    BACKGROUND: In myocardial infarction, there occurs functional deficit of available magnesium due to trapping of free magnesium in adipocytes. Magnesium has been implicated in the pathogenesis of acute myocardial infarction and its complications. Magnesium ions are considered essential for the maintenance of functional integrity of myocardium. The serum magnesium concentration was found to have g reat significance in acute myocardial infarction. The present study was un...

  15. Molecular Imaging of Healing After Myocardial Infarction

    OpenAIRE

    Naresh, Nivedita K; Ben-Mordechai, Tamar; Leor, Jonathan; Epstein, Frederick H

    2011-01-01

    The progression from acute myocardial infarction (MI) to heart failure continues to be a major cause of morbidity and mortality. Potential new therapies for improved infarct healing such as stem cells, gene therapy, and tissue engineering are being investigated. Noninvasive imaging plays a central role in the evaluation of MI and infarct healing, both clinically and in preclinical research. Traditionally, imaging has been used to assess cardiac structure, function, perfusion, and viability. H...

  16. Right ventricle infarction and its characteristics

    OpenAIRE

    Nozari Y

    1997-01-01

    Right ventricular (RV) infarction presents with clinical spectrum from a rather being, uncomplicated disorder to a serious event. A total of one hundred patients with inferior myocardial infarction (MI) retrospectively were studied to determine clinical significance and characteristics of RV infarction in our patients. Data and variables such as demographic features, chief-complain, clinical findings on arrival and during hospitalization, major risk factors, history of corpulmonale, and elect...

  17. Leukocytosis: a risk factor for myocardial infarction

    OpenAIRE

    Kotla SK

    2012-01-01

    Suman K KotlaDepartment of Internal Medicine, Memorial Medical Center, Johnstown, PA, USAAbstract: Myocardial infarction commonly results from atherosclerotic lesions in the coronary arteries. Approximately 5% of patients with acute myocardial infarction do not have atherosclerotic disease. In this case report, we present an unusual leukostatic complication in a patient with acute myeloblastic leukemia and extreme hyperleukocytosis who presented with an acute myocardial infarction that resolv...

  18. Motor recovery in a patient with an infarct in the medullary pyramid via the corticospinal tract passing through the small spared area within the infarcted medullary pyramid

    Institute of Scientific and Technical Information of China (English)

    Hyeok Gyu Kwon; Sung Ho Jang

    2011-01-01

    The present study reported a 58-year-old male patient who exhibited complete paralysis of the right extremities at stroke onset.Brain MR images showed an infarct in the left medullary pyramid and a small spared area on the medial side of the infarct.He gained the ability to extend the affected fingers against gravity and to dorsiflex the affected ankle without gravity at 3 months after stroke onset.Diffusion tensor imaging results showed that at 6 months after stroke onset,the corticospinal tract of the affected (left) hemisphere descended through the small spared area of the infarcted medullary pyramid.No motor-evoked potential was elicited from the affected (left) hemisphere at 2 weeks after stroke onset;however,motor-evoked potential was elicited at 6 months as shown by transcranial magnetic stimulation results.The motor function of the affected side of this patient appears to have been recovered via the corticospinal tract that passed through the small spared area within the infarcted medullary pyramid.

  19. Autologous bone marrow-derived progenitor cell transplantation for myocardial regeneration after acute infarction

    Directory of Open Access Journals (Sweden)

    Obradović Slobodan

    2004-01-01

    Full Text Available Background. Experimental and first clinical studies suggest that the transplantation of bone marrow derived, or circulating blood progenitor cells, may beneficially affect postinfarction remodelling processes after acute myocardial infarction. Aim. This pilot trial reports investigation of safety and feasibility of autologous bone marrow-derived progenitor cell therapy for faster regeneration of the myocardium after infarction. Methods and results. Four male patients (age range 47-68 years with the first extensive anterior, ST elevation, acute myocardial infarction (AMI, were treated by primary angioplasty. Bone marrow mononuclear cells were administered by intracoronary infusion 3-5 days after the infarction. Bone marrow was harvested by multiple aspirations from posterior cristae iliacae under general anesthesia, and under aseptic conditions. After that, cells were filtered through stainless steel mesh, centrifuged and resuspended in serum-free culture medium, and 3 hours later infused through the catheter into the infarct-related artery in 8 equal boluses of 20 ml. Myocardial viability in the infarcted area was confirmed by dobutamin stress echocardiography testing and single-photon emission computed tomography (SPECT 10-14 days after infarction. One patient had early stent thrombosis immediately before cell transplantation, and was treated successfully with second angioplasty. Single average ECG revealed one positive finding at discharge, and 24-hour Holter ECG showed only isolated ventricular ectopic beats during the follow-up period. Early findings in two patients showed significant improvement of left ventricular systolic function 3 months after the infarction. There were no major cardiac events after the transplantation during further follow-up period (30-120 days after infarction. Control SPECT for the detection of ischemia showed significant improvement in myocardial perfusion in two patients 4 months after the infarction

  20. Cerebellar infarct patterns: The SMART-Medea study

    Directory of Open Access Journals (Sweden)

    Laurens J.L. De Cocker, MD

    2015-01-01

    Conclusions: Small cerebellar infarcts proved to be much more common than larger infarcts, and preferentially involved the cortex. Small cortical infarcts predominantly involved the posterior lobes, showed sparing of subcortical white matter and occurred in characteristic topographic patterns.

  1. Stability of ischemic core volume during the initial hours of acute large vessel ischemic stroke in a subgroup of mechanically revascularized patients

    Energy Technology Data Exchange (ETDEWEB)

    Finitsis, Stephanos [Universitaetsklinikum Hamburg-Eppendorf, Neuroradiologie, Hamburg (Germany); Aristotle University of Thessaloniki, Neuroradiology Department, Ahepa Hospital, Thessaloniki (Greece); Kemmling, Andrea; Fiehler, Jens; Brekenfeld, Caspar [Universitaetsklinikum Hamburg-Eppendorf, Neuroradiologie, Hamburg (Germany); Havemeister, Stephanie; Thomalla, Goetz [Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik fuer Neurologie, Kopf- und Neurozentrum, Hamburg (Germany)

    2014-04-15

    This study aimed to relate growth of the infarct core with time to recanalization in patients receiving mechanical recanalization in whom the time of recanalization is known. We analyzed data from patients with anterior circulation acute ischemic stroke who underwent mechanical recanalization. Demographic and angiographic characteristics, initial apparent diffusion coefficient (ADC) infarct volume, time-to-peak defect volume, revascularization grade, 24-48 h nonenhanced computed tomography (CT) infarct volume, symptom onset to recanalization time, diffusion-weighted imaging to recanalization time, and discharge National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) scores were compared between minimal and substantial infarct growth groups. Substantial infarct growth was defined as an increase of infarct volume >10 cm{sup 3} assessed by subtracting initial ADC infarct core volume from infarct volume at 24-48 h CT. Of 25 patients, 9 had minimal infarct growth (median 0 cm{sup 3}, interquartile range (IQR) -3 to 5 cm{sup 3}) and 16 had substantial infarct growth (median 103 cm{sup 3}, IQR 48-132 cm{sup 3}). Patients with minimal infarct growth had a median time from symptom onset to recanalization of 329 min (IQR 314-412 min) and a median time from imaging to recanalization of 231 min (IQR 198-309 min). On univariate analysis, minimal infarct growth was related to male gender (p = 0.04), smaller initial ADC volume (p = 0.04), higher recanalization grade (p < 0.001), and lower discharge NIHSS (p = 0.04) and mRS grades (p = 0.04). There was no or minimal infarct core growth in at least one third of patients despite an exceptionally long median time from magnetic resonance imaging to recanalization of almost 4 h. (orig.)

  2. Microvascular obstruction after successful fibrinolytic therapy in acute myocardial infarction. Comparison of reteplase vs reteplase+abciximab: A cardiovascular magnetic resonance study

    Directory of Open Access Journals (Sweden)

    Tiziano Gherli

    2010-05-01

    Full Text Available Background. About one third of patients with TIMI 3 after reperfusion have evidence of microvascular obstruction (MO which represents an independent predictor of myocardial wall rupture. This explains all efforts made to prevent MO. Magnetic resonance imaging (MRI has proved to be particularly useful in detecting MO. The aim of this study was to evaluate with MRI if different fibrinolytic regimens in acute myocardial infarction display different effects on left ventricle (LV volumes and ejection fraction (EF, as well as on myocardial infarct size (MIsz and MO. Methods. Twenty male patients, mean age 58 years, affected by acute myocardial infarction, ten anterior and ten inferior, were treated with: full dose reteplase in ten, and half dose reteplase plus full dose abciximab (R+Abcx in the other ten patients. In the fourth day after hospital admission, MRI STIR T2 images were used to quantify MIsz, while 2dflash cineloops were used after the injection of gadolinium, to quantify LV volumes, EF and to detect MO. Results. LV EF was higher in R+Abcx 51±10 than in reteplase 41±8. MIsz was similar in both treatment groups: however a close relationship was present between MIsz and EF in the reteplase group indicating that the greater the MIsz the lower the EF. In R+Abcx this relationship was no longer present, suggesting a protective effect of the drug on microcirculation. In fact extensive MO was present in 25% of all cases, 80% of which in the reteplase group while only 20% in R+Abcx. Conclusion. R+Abcx prevents MO: compared to traditional fibrinolytic therapy it allows better LV function and most likely improved long term survival.

  3. Computational modeling of acute myocardial infarction.

    Science.gov (United States)

    Sáez, P; Kuhl, E

    2016-01-01

    Myocardial infarction, commonly known as heart attack, is caused by reduced blood supply and damages the heart muscle because of a lack of oxygen. Myocardial infarction initiates a cascade of biochemical and mechanical events. In the early stages, cardiomyocytes death, wall thinning, collagen degradation, and ventricular dilation are the immediate consequences of myocardial infarction. In the later stages, collagenous scar formation in the infarcted zone and hypertrophy of the non-infarcted zone are auto-regulatory mechanisms to partly correct for these events. Here we propose a computational model for the short-term adaptation after myocardial infarction using the continuum theory of multiplicative growth. Our model captures the effects of cell death initiating wall thinning, and collagen degradation initiating ventricular dilation. Our simulations agree well with clinical observations in early myocardial infarction. They represent a first step toward simulating the progression of myocardial infarction with the ultimate goal to predict the propensity toward heart failure as a function of infarct intensity, location, and size. PMID:26583449

  4. Systemic Atherosclerotic Inflammation Following Acute Myocardial Infarction: Myocardial Infarction Begets Myocardial Infarction

    OpenAIRE

    Joshi, Nikhil V; Toor, Iqbal; Shah, Anoop S V; Carruthers, Kathryn; Alex T. Vesey; Alam, Shirjel R; Sills, Andrew; Hoo, Teng Y; Melville, Adam J; Langlands, Sarah P; Jenkins, William S A; Uren, Neal G; Mills, Nicholas L.; Fletcher, Alison M; van Beek, Edwin J.R.

    2015-01-01

    BACKGROUND: Preclinical data suggest that an acute inflammatory response following myocardial infarction (MI) accelerates systemic atherosclerosis. Using combined positron emission and computed tomography, we investigated whether this phenomenon occurs in humans.METHODS AND RESULTS: Overall, 40 patients with MI and 40 with stable angina underwent thoracic 18F-fluorodeoxyglucose combined positron emission and computed tomography scan. Radiotracer uptake was measured in aortic atheroma and nonv...

  5. Modulators of Macrophage Polarization Influence Healing of the Infarcted Myocardium

    Directory of Open Access Journals (Sweden)

    Ellis N. ter Horst

    2015-12-01

    Full Text Available To diminish heart failure development after acute myocardial infarction (AMI, several preclinical studies have focused on influencing the inflammatory processes in the healing response post-AMI. The initial purpose of this healing response is to clear cell debris of the injured cardiac tissue and to eventually resolve inflammation and support scar tissue formation. This is a well-balanced reaction. However, excess inflammation can lead to infarct expansion, adverse ventricular remodeling and thereby propagate heart failure development. Different macrophage subtypes are centrally involved in both the promotion and resolution phase of inflammation. Modulation of macrophage subset polarization has been described to greatly affect the quality and outcome of healing after AMI. Therefore, it is of great interest to reveal the process of macrophage polarization to support the development of therapeutic targets. The current review summarizes (preclinical studies that demonstrate essential molecules involved in macrophage polarization that can be modulated and influence cardiac healing after AMI.

  6. Middle cerebral artery occlusion in presence of low perfusion pressure increases infarct size in rats

    DEFF Research Database (Denmark)

    Sillesen, H; Nedergaard, Majken; Schroeder, T;

    1988-01-01

    A model was set up in order to evaluate the importance of hemispheric perfusion pressure when the middle cerebral artery (MCA) is occluded in anaesthetized rats. In 6 animals the internal carotid artery (ICA) was occluded prior to ipsilateral MCA occlusion; in 17 animals the MCA only was occluded......; 6 animals underwent the same preparation, but the vessels were left unoccluded. Four days after surgery the infarct volume was measured with a computerized image analyser. The infarcted areas were significantly larger in the ICA + MCA occluded group compared with the MCA occluded group (p less than...... occurs, as compared to patients with no, or only minor, reduction in hemispheric perfusion pressure....

  7. Silent ST segment elevation myocardial infarction with multi-segmental renal infarction: an unusual presentation.

    Science.gov (United States)

    Chang, Hung-Yu; Yang, Yung-Nien

    2011-01-01

    A 36-year-old diabetic man came to our institution presenting with constant left flank pain. Left renal embolic infarction was found by abdominal computed tomography. Silent ST segment elevation myocardial infarction was noted on 12-lead electrocardiogram. Emergent coronary angiography revealed large thrombus burdens with complete occlusion at the left anterior descending artery ostium, which may be the embolic origin. Silent ST segment elevation myocardial infarction with acute flank pain and multiple segmental renal infarction is an unusual presentation. High vigilance may prevent delay of the "golden hour" to treat acute myocardial infarction.

  8. [Atrial filling fraction predicts left ventricular systolic function after myocardial infarction: pre-discharge echocardiographic evaluation].

    Science.gov (United States)

    Galderisi, M; Fakher, A; Petrocelli, A; Alfieri, A; Garofalo, M; de Divitiis, O

    1995-10-01

    Aim of the study was to examine the relation between Doppler-derived indices of left ventricular diastolic and systolic function early after myocardial infarction. Fifty-three patients (31 males, 22 females) recovering from acute myocardial infarction underwent predischarge Doppler echocardiographic examination. Patients with age > 70 years, previous myocardial infarction, more than mild mitral and aortic regurgitation, mitral and aortic stenosis were excluded. Twenty-two healthy subjects (13 males; 9 females) free of coronary risk factors were selected as the control group. Both end-diastolic and end-systolic volumes and ejection fraction were measured by two-dimensional echocardiography. Pulsed Doppler was used to evaluate mitral inflow and left ventricular outflow velocity patterns. The following indices were measured: peak velocity of early (E) and late (A) flows, ratio of E/A peak velocities, ratio of early to late time velocity integrals, atrial filling fraction (time velocity integral A / time velocity integral of flow during total diastole) and deceleration time of E wave for mitral inflow; peak and time-velocity integral for left ventricular outflow. Stroke volume and cardiac output were obtained by pulsed Doppler using the left ventricular outflow method. The two groups were comparable for age, with blood pressure (p volumes were significantly higher (both p volume and cardiac output (both p volumes, atrial filling fraction was an independent predictor of stroke volume, with a direct relation (beta coefficient = 0.53, p volume indicates the importance of atrial contribution to maintain an adequate systolic performance in patients with myocardial infarction. PMID:8819737

  9. Microvascular basis for growth of small infarcts following occlusion of single penetrating arterioles in mouse cortex.

    Science.gov (United States)

    Taylor, Zachary J; Hui, Edward S; Watson, Ashley N; Nie, Xingju; Deardorff, Rachael L; Jensen, Jens H; Helpern, Joseph A; Shih, Andy Y

    2016-08-01

    Small cerebral infarcts, i.e. microinfarcts, are common in the aging brain and linked to vascular cognitive impairment. However, little is known about the acute growth of these minute lesions and their effect on blood flow in surrounding tissues. We modeled microinfarcts in the mouse cortex by inducing photothrombotic clots in single penetrating arterioles. The resultant hemodynamic changes in tissues surrounding the occluded vessel were then studied using in vivo two-photon microscopy. We were able to generate a spectrum of infarct volumes by occluding arterioles that carried a range of blood fluxes. Those resulting from occlusion of high-flux penetrating arterioles (flux of 2 nL/s or higher) exhibited a radial outgrowth that encompassed unusually large tissue volumes. The gradual expansion of these infarcts was propagated by an evolving insufficiency in capillary flow that encroached on territories of neighboring penetrating arterioles, leading to the stagnation and recruitment of their perfusion domains into the final infarct volume. Our results suggest that local collapse of microvascular function contributes to tissue damage incurred by single penetrating arteriole occlusions in mice, and that a similar mechanism may add to pathophysiology induced by microinfarcts of the human brain. PMID:26661182

  10. Protein Synthesis Inhibition in the Peri-Infarct Cortex Slows Motor Recovery in Rats.

    Science.gov (United States)

    Schubring-Giese, Maximilian; Leemburg, Susan; Luft, Andreas Rüdiger; Hosp, Jonas Aurel

    2016-01-01

    Neuroplasticity and reorganization of brain motor networks are thought to enable recovery of motor function after ischemic stroke. Especially in the cortex surrounding the ischemic scar (i.e., peri-infarct cortex), evidence for lasting reorganization has been found at the level of neurons and networks. This reorganization depends on expression of specific genes and subsequent protein synthesis. To test the functional relevance of the peri-infarct cortex for recovery we assessed the effect of protein synthesis inhibition within this region after experimental stroke. Long-Evans rats were trained to perform a skilled-reaching task (SRT) until they reached plateau performance. A photothrombotic stroke was induced in the forelimb representation of the primary motor cortex (M1) contralateral to the trained paw. The SRT was re-trained after stroke while the protein synthesis inhibitor anisomycin (ANI) or saline were injected into the peri-infarct cortex through implanted cannulas. ANI injections reduced protein synthesis within the peri-infarct cortex by 69% and significantly impaired recovery of reaching performance through re-training. Improvement of motor performance within a single training session remained intact, while improvement between training sessions was impaired. ANI injections did not affect infarct size. Thus, protein synthesis inhibition within the peri-infarct cortex impairs recovery of motor deficits after ischemic stroke by interfering with consolidation of motor memory between training sessions but not short-term improvements within one session. PMID:27314672

  11. Protein Synthesis Inhibition in the Peri-Infarct Cortex Slows Motor Recovery in Rats

    Science.gov (United States)

    Schubring-Giese, Maximilian; Leemburg, Susan; Luft, Andreas Rüdiger; Hosp, Jonas Aurel

    2016-01-01

    Neuroplasticity and reorganization of brain motor networks are thought to enable recovery of motor function after ischemic stroke. Especially in the cortex surrounding the ischemic scar (i.e., peri-infarct cortex), evidence for lasting reorganization has been found at the level of neurons and networks. This reorganization depends on expression of specific genes and subsequent protein synthesis. To test the functional relevance of the peri-infarct cortex for recovery we assessed the effect of protein synthesis inhibition within this region after experimental stroke. Long-Evans rats were trained to perform a skilled-reaching task (SRT) until they reached plateau performance. A photothrombotic stroke was induced in the forelimb representation of the primary motor cortex (M1) contralateral to the trained paw. The SRT was re-trained after stroke while the protein synthesis inhibitor anisomycin (ANI) or saline were injected into the peri-infarct cortex through implanted cannulas. ANI injections reduced protein synthesis within the peri-infarct cortex by 69% and significantly impaired recovery of reaching performance through re-training. Improvement of motor performance within a single training session remained intact, while improvement between training sessions was impaired. ANI injections did not affect infarct size. Thus, protein synthesis inhibition within the peri-infarct cortex impairs recovery of motor deficits after ischemic stroke by interfering with consolidation of motor memory between training sessions but not short-term improvements within one session. PMID:27314672

  12. Acute Myocardial Infarction Due To Electrical Injury

    OpenAIRE

    Uzkeser M et al.

    2011-01-01

    Rhythm abnormalities (conduction defects, tachycardia, and arrhythmia)due to electric shock are common. Rarely, myocardial infarction may beseen in these patients. This situation is generally caused by coronaryartery vasospasm and direct myocardial damage. In this report, wepresent a rare case of myocardial infarction due to electric shock.

  13. Do episodes of anger trigger myocardial infarction?

    DEFF Research Database (Denmark)

    Möller, J; Hallqvist, J; Diderichsen, Finn;

    1999-01-01

    Our objectives were to study anger as a trigger of acute myocardial infarction (MI) and to explore potential effect modification by usual behavioral patterns related to hostility.......Our objectives were to study anger as a trigger of acute myocardial infarction (MI) and to explore potential effect modification by usual behavioral patterns related to hostility....

  14. [Contralateral hyperhidrosis secondary to the pontine infarct].

    Science.gov (United States)

    Rey, A; Martí-Vilalta, J L; Abellán, M T

    1996-04-01

    Unilateral hyperhydrosis due to a cerebral infarct is a clinical sign rarely described in the literature, the significance of which is unknown and may be due to a lesion of the crossed sympathetic inhibitory tract. We describe the case of a patient with contralateral hyperhydrosis due to a hemipontine infarct. PMID:8721928

  15. Primary coronary angioplasty in acute myocardial infarction.

    OpenAIRE

    Grech, E. D.; Ramsdale, D. R.

    1996-01-01

    It is well established that recanalisation of the infarct-related artery is of great benefit in the early hours after acute myocardial infarction. This can be achieved by the use of thrombolytic agents and/or by percutaneous transluminal coronary angioplasty (PTCA). This article reviews data on the role of primary PTCA and summarises current opinion on its use.

  16. Gastric infarction following gastric bypass surgery

    Science.gov (United States)

    Do, Patrick H; Kang, Young S; Cahill, Peter

    2016-01-01

    Gastric infarction is an extremely rare occurrence owing to the stomach’s extensive vascular supply. We report an unusual case of gastric infarction following gastric bypass surgery. We describe the imaging findings and discuss possible causes of this condition. PMID:27200168

  17. Effect of cocaine-amphetamine-regulated transcript peptide on the content of 4-hydroxy-2-noneral and infarct volume after cerebral ischenia/reperfusion in mice%可卡因-苯丙胺调节转录肽对脑缺血再灌注小鼠梗死体积和脑组织4-羟壬烯醛含量的影响

    Institute of Scientific and Technical Information of China (English)

    朱震寒; 沙杜鹃; 李启明; 李瑾; 韩勇; 顾双双; 张均

    2012-01-01

    Objective To investigate the effect of cocaine-amphetamine-regulated transcript peptide (CART) on the content of 4-hydroxy-2-noneral (HNE) and infarct volume after cerebral ischemia/reperfusion in mice.Methods A total of 96 healthy male mice were randomly divided into four groups:ischemia/reperfusion (n =27),CART (n =27),normal saline control (n =27) and sham operation (n =15) groups.A middle cerebral artery occlusion (MCAO) model was induced.Two hours after MCAO,CART 55-102 and equivalent normal saline were injected respectively via the tail veins of mice in the CART group and the normal saline control group,and then they were injected every other 24 hour.The neurological scores,infarct volume and the HNE content of lipid metabolism of oxidative stress were performed and detected respectively at 12,24,48 and 72hours after reperfusion.Results CART could significantly improve the neurological deficit scores (all P <0.05) and reduce infarct volume (all P<0.05) at different time points after ischemia/reperfusion.The content of HNE was upregulated (all P<0.05) at different points after referfusion.CART could significantly down-regulate the increased HNE levd in brain after ischemia (all P<0.05).Conclusions CART may protect ischemic brain injury in mice by inhibiting lipid peroxidation.%目的 探讨可卡因-苯丙胺调节转录肽(cocaine- and amphetamine-regulated transcript peptides,CART)对缺血再灌注小鼠梗死体积和脑组织4-羟壬烯醛(4-hydroxy-2 -noneral,HNE)含量的影响.方法 健康雄性小鼠随机分为缺血再灌注组(n=27)、CART组(n=27)、生理盐水对照组(n=27)和假手术组(n=15).建立大脑中动脉闭塞(middle cerebral artery occlusion,MCAO)模型,CART组和生理盐水对照组在MCAO2 h后分别经尾静脉注射给予CART55-102和同体积生理盐水,然后每隔24 h重复1次.在再灌注后12、24、48和72 h分别进行神经功能评分、梗死体积和脂质氧化应激

  18. Myocardial perfusion at fatal infarction

    DEFF Research Database (Denmark)

    Hvid-Jacobsen, K; Møller, J T; Kjøller, E;

    1992-01-01

    In a consecutive study of myocardial scintigraphy in acute ischemic syndrome, four patients had 99mTc-hexamibi injected intravenously before they developed fatal cardiogenic shock. Planar scintigraphy was performed after death. Slices of the hearts after autopsy were analyzed for scintigraphic......, where 83%-92% of the myocardium showed ischemia as defined by a 99mTc-hexamibi uptake below an arbitrary limit on half maximum uptake. Myocardial hypoperfusion might thus aggravate the functional impairment at myocardial infarction and lead to cardiogenic shock....

  19. Magnetic resonance perfusion imaging evaluation in perfusion abnormalities of the cerebellum after supratentorial unilateral hyperacute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Pan Liang; Yunjun Yang; Weijian Chen; Yuxia Duan; Hongqing Wang; Xiaotong Wang

    2012-01-01

    Magnetic resonance imaging (MRI) data of 10 patients with hyperacute cerebral infarction (≤ 6 hours) were retrospectively analyzed. Six patients exhibited perfusion defects on negative enhancement integral maps, four patients exhibited perfusion differences in pseudo-color on mean time to enhance maps, and three patients exhibited perfusion differences in pseudo-color on time to minimum maps. Dynamic susceptibility contrast-enhanced perfusion weighted imaging revealed a significant increase in region negative enhancement integral in the affected hemisphere of patients with cerebral infarction. The results suggest that dynamic susceptibility contrast-enhanced perfusion weighted imaging can clearly detect perfusion abnormalities in the cerebellum after unilateral hyperacute cerebral infarction.

  20. Which patient benefits from early angiotensin-converting enzyme inhibition after myocardial infarction? Results of one-year serial echocardiographic follow-up from the captopril and thrombolysis study (CATS)

    NARCIS (Netherlands)

    vanGilst, WH; Kingma, JH; Peels, KH; Dambrink, Jan Hendrik Everwijn

    1996-01-01

    Objectives. In this study we sought to investigate the effect of intervention with captopril within 6 h of the onset of myocardial infarction on left ventricular volume and clinical symptoms of heart failure in relation to infarct size during a 1-year follow-up period. Background. Remodeling of the

  1. Novel adjunctive treatments of myocardial infarction

    DEFF Research Database (Denmark)

    Schmidt, Michael Rahbek; Pryds, Kasper; Bøtker, Hans Erik

    2014-01-01

    Myocardial infarction is a major cause of death and disability worldwide and myocardial infarct size is a major determinant of prognosis. Early and successful restoration of myocardial reperfusion following an ischemic event is the most effective strategy to reduce final infarct size and improve...... by endovascular infusion of cold saline all reduce infarct size and may confer clinical benefit for patients admitted with acute myocardial infarcts. Equally promising, three follow-up studies of the effect of remote ischemic conditioning (RIC) show clinical prognostic benefit in patients undergoing coronary...... clinical outcome, but reperfusion may induce further myocardial damage itself. Development of adjunctive therapies to limit myocardial reperfusion injury beyond opening of the coronary artery gains increasing attention. A vast number of experimental studies have shown cardioprotective effects of ischemic...

  2. Sildenafil and diastolic dysfunction after acute myocardial infarction in patients with preserved ejection fraction

    DEFF Research Database (Denmark)

    Andersen, Mads J; Ersbøll, Mads; Axelsson, Anna;

    2013-01-01

    BACKGROUND: Diastolic dysfunction is frequently seen after myocardial infarction and is characterized by a disproportionate increase in filling pressure during exercise to maintain stroke volume. We hypothesized that sildenafil would reduce filling pressure during exercise in patients...... with diastolic dysfunction after myocardial infarction. METHODS AND RESULTS: Seventy patients with diastolic dysfunction and near normal left ventricular ejection fraction on echocardiography were randomly assigned sildenafil 40 mg thrice daily or matching placebo for 9 weeks. Before randomization and after 9...... in the placebo group. CONCLUSIONS: Sildenafil did not decrease filling pressure at rest or during exercise in post-myocardial infarction patients with diastolic dysfunction. However, there were effects on secondary end points, which require further studies....

  3. Huoxue Rongluo Tablet reduces matrix metalloproteinase-9 expression in infarcted brain tissue

    Institute of Scientific and Technical Information of China (English)

    Desheng Zhou; Mei Li; Hua Hu; Yao Chen; Yang Yang; Jie Zhong; Lijuan Liu

    2013-01-01

    Huoxue Rongluo Tablet was made of tal gastrodis tuber, dahurian angelica root, honeysuckle stem, grassleaf sweetflag rhizome, common flowering quince fruit, figwort root, red peony root and peach seed at a ratio of 3:2:6:2:3:3:3:3. Huoxue Rongluo Tablet is a wel-established and common pre-scription for the treatment of cerebral infarction. In this study, a rat model of cerebral ischemia was established and the animals were intragastrical y administered Huoxue Rongluo Tablet. This treat-ment reduced infarct volume, decreased matrix metal oproteinase-9 expression, and improved neurological function. Moreover, the effects of Huoxue Rongluo Tablet were better than those of buflomedil pyridoxal phosphate. These results indicate that Huoxue Rongluo Tablet is effective in treating cerebral infarction by regulating matrix metal oproteinase-9 protein expression.

  4. Preconditioning of stem cells for the treatment of myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    LU Hui-he; LI Yi-fei; SHENG Zheng-qiang; WANG Yi

    2012-01-01

    Objective Poor stem cell survival is one of the obstacles for cell regeneration therapy post myocardial infarction (MI) and responsible for unsatisfactory therapeutic effectiveness.Various approaches to improve the status of these cells and increase cell survival have become research foci.The following article is a mini-review on the utilization of cell preconditioning for stem cell survival.Date sources The data used in this review were mainly from the articles in Medline and PubMed published from 1990 to 2010.The search terms included "preconditioning,stem cell and myocardial infarction".Study selection Original articles and critical reviews selected were relevant to the review's theme.Results The harsh ischemic and inflammatory microenvironment in the infarcted myocardium offers a significant challenge to the transplanted donor stem cells.Survival of stem cells following transplantation is affected by many factors,such as limited blood supply,nutritional deficiency,hypoxia,oxidative stress,and inflammation.Preconditioning methods have potent cytoprotective effects,which enables cells to maintain a "standby state" through programmed initiation of cell survival pathways.Conclusions The findings suggest that cell preconditioning can be used as an effective anti-apoptotic strategy and enable cells to withstand and survive the harsh environment after transplantation.

  5. Assessment of the relationships between myocardial contractility and infarct tissue revealed by serial magnetic resonance imaging in patients with acute myocardial infarction.

    Science.gov (United States)

    McComb, Christie; Carrick, David; McClure, John D; Woodward, Rosemary; Radjenovic, Aleksandra; Foster, John E; Berry, Colin

    2015-08-01

    Imaging changes in left ventricular (LV) volumes during the cardiac cycle and LV ejection fraction do not provide information on regional contractility. Displacement ENcoding with Stimulated Echoes (DENSE) is a strain-encoded cardiac magnetic resonance (CMR) technique that measures strain directly. We investigated the relationships between strain revealed by DENSE and the presence and extent of infarction in patients with recent myocardial infarction (MI). 50 male subjects were invited to undergo serial CMR within 7 days of MI (baseline) and after 6 months (follow-up; n = 47). DENSE and late gadolinium enhancement (LGE) images were acquired to enable localised regional quantification of peak circumferential strain (Ecc) and the extent of infarction, respectively. We assessed: (1) receiver operating characteristic (ROC) analysis for the classification of LGE, (2) strain differences according to LGE status (remote, adjacent, infarcted) and (3) changes in strain revealed between baseline and follow-up. 300 and 258 myocardial segments were available for analysis at baseline and follow-up respectively. LGE was present in 130/300 (43%) and 97/258 (38%) segments, respectively. ROC analysis revealed moderately high values for peak Ecc at baseline [threshold 12.8%; area-under-curve (AUC) 0.88, sensitivity 84%, specificity 78%] and at follow-up (threshold 15.8%; AUC 0.76, sensitivity 85%, specificity 64%). Differences were observed between remote, adjacent and infarcted segments. Between baseline and follow-up, increases in peak Ecc were observed in infarcted segments (median difference of 5.6%) and in adjacent segments (1.5%). Peak Ecc at baseline was indicative of the change in LGE status between baseline and follow-up. Strain-encoded CMR with DENSE has the potential to provide clinically useful information on contractility and its recovery over time in patients with MI.

  6. Circadian influences on myocardial infarction.

    Science.gov (United States)

    Virag, Jitka A I; Lust, Robert M

    2014-01-01

    Components of circadian rhythm maintenance, or "clock genes," are endogenous entrainable oscillations of about 24 h that regulate biological processes and are found in the suprachaismatic nucleus (SCN) and many peripheral tissues, including the heart. They are influenced by external cues, or Zeitgebers, such as light and heat, and can influence such diverse phenomena as cytokine expression immune cells, metabolic activity of cardiac myocytes, and vasodilator regulation by vascular endothelial cells. While it is known that the central master clock in the SCN synchronizes peripheral physiologic rhythms, the mechanisms by which the information is transmitted are complex and may include hormonal, metabolic, and neuronal inputs. Whether circadian patterns are causally related to the observed periodicity of events, or whether they are simply epi-phenomena is not well established, but a few studies suggest that the circadian effects likely are real in their impact on myocardial infarct incidence. Cycle disturbances may be harbingers of predisposition and subsequent response to acute and chronic cardiac injury, and identifying the complex interactions of circadian rhythms and myocardial infarction may provide insights into possible preventative and therapeutic strategies for susceptible populations. PMID:25400588

  7. Does thrombolytic therapy harm or help in ST elevation myocardial infarction (STEMI) caused by the spontaneous coronary dissection?

    OpenAIRE

    Jović Zoran; Obradović Slobodan; Đenić Nemanja; Mladenović Zorica; Đurić Predrag; Spasić Marijan; Tavčiovski Dragan

    2015-01-01

    Introduction. Spontaneous coronary artery dissection (SCAD) is a very rare disease with poor prognosis. It mainly affects young women free of risk factors for coronary artery disease (CAD) and women during the peripartum period. The prognosis for myocardial infarction caused by SCAD is poor, management is often difficult and guidelines still missing. Case report. We presented a woman with acute myocardial infarction of anterior wall of the left ventricle, c...

  8. Data quality and practical challenges of thyroid volume assessment by ultrasound under field conditions - observer errors may affect prevalence estimates of goitre

    Directory of Open Access Journals (Sweden)

    Torheim Liv E

    2010-12-01

    Full Text Available Abstract Background The ultrasonographic estimation of thyroid size has been advocated as being more precise than palpation to diagnose goitre. However, ultrasound also requires technical proficiency. This study was conducted among Saharawi refugees, where goitre is highly prevalent. The objectives were to assess the overall data quality of ultrasound measurements of thyroid volume (Tvol, including the intra- and inter-observer agreement, under field conditions, and to describe some of the practical challenges encountered. Methods In 2007 a cross-sectional study of 419 children (6-14 years old and 405 women (15-45 years old was performed on a population of Saharawi refugees with prevalent goitre, who reside in the Algerian desert. Tvol was measured by two trained fieldworkers using portable ultrasound equipment (examiner 1 measured 406 individuals, and examiner 2, 418 individuals. Intra- and inter-observer agreement was estimated in 12 children selected from the study population but not part of the main study. In the main study, an observer error was found in one examiner whose ultrasound images were corrected by linear regression after printing and remeasuring a sample of 272 images. Results The intra-observer agreement in Tvol was higher in examiner 1, with an intraclass correlation coefficient (ICC of 0.97 (95% CI: 0.91, 0.99 compared to 0.86 (95% CI: 0.60, 0.96 in examiner 2. The ICC for inter-observer agreement in Tvol was 0.38 (95% CI: -0.20, 0.77. Linear regression coefficients indicated a significant scaling bias in the original measurements of the AP and ML diameter and a systematic underestimation of Tvol (a product of AP, ML, CC and a constant. The agreement between re-measured and original Tvol measured by ICC (95% CI was 0.76 (0.71, 0.81. The agreement between re-measured and corrected Tvol measured by ICC (95% CI was 0.97 (0.96, 0.97. Conclusions An important challenge when using ultrasound to assess thyroid volume under field

  9. Automatic Detection and Quantification of Acute Cerebral Infarct by Fuzzy Clustering and Histographic Characterization on Diffusion Weighted MR Imaging and Apparent Diffusion Coefficient Map

    Directory of Open Access Journals (Sweden)

    Jang-Zern Tsai

    2014-01-01

    Full Text Available Determination of the volumes of acute cerebral infarct in the magnetic resonance imaging harbors prognostic values. However, semiautomatic method of segmentation is time-consuming and with high interrater variability. Using diffusion weighted imaging and apparent diffusion coefficient map from patients with acute infarction in 10 days, we aimed to develop a fully automatic algorithm to measure infarct volume. It includes an unsupervised classification with fuzzy C-means clustering determination of the histographic distribution, defining self-adjusted intensity thresholds. The proposed method attained high agreement with the semiautomatic method, with similarity index 89.9 ± 6.5%, in detecting cerebral infarct lesions from 22 acute stroke patients. We demonstrated the accuracy of the proposed computer-assisted prompt segmentation method, which appeared promising to replace the laborious, time-consuming, and operator-dependent semiautomatic segmentation.

  10. Therapeutic Hypothermia for Cardioprotection in Acute Myocardial Infarction

    OpenAIRE

    Kang, In Sook; Fumiaki, Ikeno; Pyun, Wook Bum

    2016-01-01

    Mild therapeutic hypothermia of 32–35℃ improved neurologic outcomes in outside hospital cardiac arrest survivor. Furthermore, in experimental studies on infarcted model and pilot studies on conscious patients with acute myocardial infarction, therapeutic hypothermia successfully reduced infarct size and microvascular resistance. Therefore, mild therapeutic hypothermia has received an attention as a promising solution for reduction of infarction size after acute myocardial infarction which are...

  11. Segmental Renal Infarction due to Blunt Trauma.

    Science.gov (United States)

    Alevizopoulos, Aristeidis; Hamilton, Lauren; Stratu, Natalia; Rix, Gerald

    2016-05-01

    Segmental renal infarction is a rare situation which has been reported so far in the form of case reports. It's caused usually by cardiac conditions, such as atrial fibrillation, and systemic diseases (e.g. systemic lupus erythematous). We are presenting a case of a 31 year old healthy male, who sustained a left segmental renal infarction, following a motorbike accident. We report his presentation, management and outcome. We also review the literature in search of the optimal diagnostic and treatment pathway. To our knowledge, this is the first report of segmental renal infarction due to blunt trauma.

  12. Study of the factors affecting the karst volume assessment in the Dead Sea sinkhole problem using microgravity field analysis and 3-D modeling

    Directory of Open Access Journals (Sweden)

    L. V. Eppelbaum

    2008-11-01

    Full Text Available Thousands of sinkholes have appeared in the Dead Sea (DS coastal area in Israel and Jordan during two last decades. The sinkhole development is recently associated with the buried evaporation karst at the depth of 25–50 m from earth's surface caused by the drop of the DS level at the rate of 0.8–1.0 m/yr. Drop in the Dead Sea level has changed hydrogeological conditions in the subsurface and caused surface to collapse. The pre-existing cavern was detected using microgravity mapping in the Nahal Hever South site where seven sinkholes of 1–2 m diameter had been opened. About 5000 gravity stations were observed in the area of 200×200 m2 by the use of Scintrex CG-3M AutoGrav gravimeter. Besides the conventional set of corrections applied in microgravity investigations, a correction for a strong gravity horizontal gradient (DS Transform Zone negative gravity anomaly influence was inserted. As a result, residual gravity anomaly of –(0.08÷0.14 mGal was revealed. The gravity field analysis was supported by resistivity measurements. We applied the Emigma 7.8 gravity software to create the 3-D physical-geological models of the sinkholes development area. The modeling was confirmed by application of the GSFC program developed especially for 3-D combined gravity-magnetic modeling in complicated environments. Computed numerous gravity models verified an effective applicability of the microgravity technology for detection of karst cavities and estimation of their physical-geological parameters. A volume of the karst was approximately estimated as 35 000 m3. The visual analysis of large sinkhole clusters have been forming at the microgravity anomaly site, confirmed the results of microgravity mapping and 3-D modeling.

  13. Toxocariasis: A Rare Cause of Multiple Cerebral Infarction.

    Science.gov (United States)

    Kwon, Hyun Hee

    2015-06-01

    Toxocariasis is a parasitic infection caused by the roundworms Toxocara canis or Toxocara cati, mostly due to accidental ingestion of embryonated eggs. Clinical manifestations vary and are classified as visceral larva migrans or ocular larva migrans according to the organs affected. Central nervous system involvement is an unusual complication. Here, we report a case of multiple cerebral infarction and concurrent multi-organ involvement due to T. canis infestation of a previous healthy 39-year-old male who was admitted for right leg weakness. After treatment with albendazole, the patient's clinical and laboratory results improved markedly. PMID:26157596

  14. Determination of the Role of Oxygen in Suspected Acute Myocardial Infarction by Biomarkers

    Science.gov (United States)

    2016-01-25

    Acute Myocardial Infarction (AMI); Acute Coronary Syndrome (ACS); ST Elevation (STEMI) Myocardial Infarction; Ischemic Reperfusion Injury; Non-ST Elevation (NSTEMI) Myocardial Infarction; Angina, Unstable

  15. Statins reduce new-onset atrial fibrillation in a first-time myocardial infarction population

    DEFF Research Database (Denmark)

    Bang, Casper N; Gislason, Gunnar H; Greve, Anders M;

    2014-01-01

    AIM: To evaluate the effect of statins on reducing new-onset atrial fibrillation (AF) in a large real-world post-myocardial infarction (MI) population. Subsequently, to test if different statin doses, various types and compliance affected the incidence of new-onset AF post MI. METHODS: All patien...

  16. Myocardial infarction and nocturnal hypoxaemia

    Directory of Open Access Journals (Sweden)

    Penčić Biljana

    2007-01-01

    Full Text Available Introduction: There is an increased risk of cardiovascular morbidity and mortality in patients with nocturnal intermittent hypoxaemia. Objecive. The aim of this study was to evalute the influence of nocturnal hypoxaemia on ventricular arrhythmias and myocardial ischaemia in patients with myocardial infarction (MI. Method. We studied 77 patients (55.8±7.9 years with MI free of complications, chronic pulmonary diseases, abnormal awake blood gases tension. All patients underwent overnight pulse oximetry and 24-hour electrocardiography. Patients were divided into two groups according to nocturnal hypoxaemia. Total number of ventricular premature complex (VPC; maximal VPC/h; incidence of VPC Lown class>2 and occurrence of ST-segment depression were analyzed for nocturnal (10 PM to 6 AM, daytime (6 AM to 22 PM periods and for the entire 24 hours. Results. Both groups were similar in age, gender, standard risk factors, myocardial infarction size and did not differ in VPC during the analyzed periods. The number of nocturnal maximal VPC/h was insignificantly greater in group 1 (with hypoxaemia compared to group 2 (without hypoxaemia, (p=0.084. Maximal VPC/h did not differ significantly either for daytime or for 24 hours among the groups. Nocturnal VPC Lown>2 were significantly more frequent in group 1 (25% vs 0%, p=0.002. The incidence of VPC Lown>2 was similar during the daytime, and during 24 hrs in both groups. Occurrence of ST-segment depression did not differ between groups 1 and 2. Conclusion. Nocturnal hypoxaemia was associated with complex nocturnal ventricular arrhythmias in patients with MI. .

  17. Noninvasive MR characterization of structural and functional components of reperfused infarct

    Energy Technology Data Exchange (ETDEWEB)

    Saeed, Maythem; Martin, Alastair J.; Saloner, David; Loi Do; Wilson, Mark (Dept. of Radiology and Biomedical Imaging, Univ. of California San Francisco, San Francisco, CA (United States)), e-mail: Maythem.Saeed@radiology.ucsf.edu

    2010-12-15

    Background: Left ventricular (LV) remodeling is a highly complex phenomenon that starts soon after infarction and progresses to extensive regional and global architectural changes over time. Purpose: To noninvasively comprehensively characterize transient (edema, hemorrhage, microvascular obstruction (MO)) and persistent structural (infarct size) components of reperfused infarct up to 10 weeks and to determine their relation to LV function. Material and Methods: Farm pigs were used for the study. Under fluoroscopy the left anterior descending (LAD) coronary artery was occluded for 90 min. MR imaging was performed at 3 days (n=14 pigs), 5 weeks (n=10), and 10 weeks (n=6) after reperfusion. The following MR imaging sequences were used: (i) cine; (ii) T2-weighted turbo spin echo; (iii) T2-weighted turbo spin echo; (iv) tagged; (v) phase-contrast velocity-encoded; (vi) first-pass perfusion; and (vii) delayed contrast-enhanced (DE-MR imaging). After imaging, animals were euthanized at 3 days (n=4), 5 weeks (n=4), and 10 weeks (n=6) and hearts were stained with triphenyltetrazolium chloride to define acute, subacute, and scar infarct and interstitial hemorrhage. Results: T2, T2, and DE-MR imaging demonstrated transient interstitial edema, interstitial hemorrhage, and MO, respectively. MO was observed in 85% of animals and 60% of these showed hemorrhages. Cine, tagged, and phase-contrast velocity-encoded images documented the persistent impairment in 3D strain of infarcted segments, which on first-pass perfusion showed persistent perfusion deficit. MR imaging demonstrated the progressive increase in LV volumes and decreased ejection fraction over time. The changes in LV between 5 and 10 weeks were not related to the presence of interstitial edema, interstitial hemorrhage, MO or increase in infarct size. Conclusion: The various MR sequences described in this study allowed the demonstration of transient and persistent components of reperfused infarct. The progressive

  18. Acute myocardial infarction in a 28 year man with familial hypercholesterolemia

    Directory of Open Access Journals (Sweden)

    Ahmed Al Montasir

    2012-01-01

    Full Text Available Familial hypercholesterolemia is a single gene disorder. It has autosomal dominant pattern of inheritance. We report a 28-year-old man who presented with acute myocardial infarction. He had xanthomas and an elevated serum low density lipoprotein cholesterol (LDL-C. His only sibling, 32-year-old brother have similar cutaneous lesions and lipid profile. His mother and maternal uncle died at a young age due to myocardial infarction. This report is to emphasize the need to clinically recognize xanthomas and its familial inheritance with elevated LDL-C, premature atherosclerosis. Early diagnosis and early initiation of treatment will save the affected individual and the other family members.

  19. Coronary artery calcium scoring in myocardial infarction

    International Nuclear Information System (INIS)

    Background. The aim of this study was to evaluate coronary artery calcium scoring and the assessment of the risk factors in patients with myocardial infarction (MI). Methods. During the period of three years, 27 patients with MI were analyzed. The average age of patients was 66.1 years (46 to 81). Coronary arteries calcium was evaluated by multi row detector computed tomography (MTDC) Somatom Volume Zoom Siemens, and, retrospectively by ECG gating data acquisition. Semi automated calcium quantification to calculate Agatston calcium score (CS) was performed with 4 x 2.5 mm collimation, using 130 ml of contrast medium, injected with an automatic injector, with the flow rate of 4 ml/sec. The delay time was determined empirically. At the same time several risk factors were evaluated. Results. Out of 27 patients with MI, 3 (11.1%) patients had low CS (10- 100), 5 (18.5%) moderate CS (101- 499), and 19 (70.4%) patients high CS (>500). Of risk factors, smoking was confirmed in 17 (63.0%), high blood pressure (HTA) in 10 (57.0%), diabetes mellitus in 7 (25.9%), positive family history in 5 (18.5%), pathological lipids in 5 (18.5%), alcohol abuse in 4 (1.8%) patients. Six (22.2%) patients had symptoms of angina pectoris. Conclusions. The research showed high correlation of MI and high CS (>500). Smoking, HTA, diabetes mellitus, positive family history and hypercholesterolemia are significant risk factors. Symptoms are relatively poor in large number of patients. (author)

  20. [Stem cell perspectives in myocardial infarctions].

    Science.gov (United States)

    Aceves, José Luis; Archundia, Abel; Díaz, Guillermo; Páez, Araceli; Masso, Felipe; Alvarado, Martha; López, Manuel; Aceves, Rocío; Ixcamparij, Carlos; Puente, Adriana; Vilchis, Rafael; Montaño, Luis Felipe

    2005-01-01

    Myocardial infarction is the leading cause of congestive heart failure and death in industrializated countries. The cellular cardiomyoplasty has emerged as an alternative treatment in the regeneration of infarted myocardial tissue. In animals' models, different cellular lines such as cardiomyocites, skeletal myoblasts, embryonic stem cells and adult mesenchymal stem cells have been used, resulting in an improvement in ventricular function and decrease in amount of infarcted tissue. The first three cells lines have disvantages as they are allogenics and are difficult to obtain. The adult mesenchymal stem cells are autologous and can be obtained throught the aspiration of bone marrow or from peripherical circulation, after stimulating with cytokines (G-CSF). The implantation in humans with recent and old myocardial infarction have shown improvements similar to those shown in animal models. These findings encourage the continued investigation in the mechanism of cellular differentiation and implantation methods in infarcted myocardial tissue.

  1. Locations of cerebral infarctions in tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Hsieh, F.Y.; Chia, L.G. (Section of Neurology, Taichung Veterans General Hospital (Taiwan)); Shen, W.C. (Section of Neuroradiology, Taichung Veterans General Hospital (Taiwan))

    1992-06-01

    The locations of cerebral infarctions were studied in 14 patients with tuberculous meningitis (TBM) and 173 patients with noninflammatory ischemic stroke (IS). In patients with TBM, 75% of infarctions occurred in the 'TB zone' supplied by medial striate and thalamoperforating arteries; only 11% occurred in the 'IS zone' supplied by lateral striate, anterior choroidal and thalamogeniculate arteries. In patients with IS, 29% of infarctions occurred in the IS zone, 29% in the subcortical white matter, and 24% in (or involving) the cerebral cortex. Only 11% occurred in the TB zone. Bilaterally symmetrical infarctions of the TB zone were common with TBM (71%) but rare with IS (5%). (orig.).

  2. Ambulatory ST segment monitoring after myocardial infarction

    DEFF Research Database (Denmark)

    Mickley, H

    1994-01-01

    The prevalence of transient myocardial ischaemia after myocardial infarction seems to be lower than in other subgroups with coronary artery disease. In postinfarction patients, however, a greater proportion of ischaemic episodes are silent. At present there is substantial evidence that transient...... ischaemia provides prognostic information in different subsets of patients with previous myocardial infarction, but there is considerable disagreement about how this is expressed in terms of cardiac events. Small patient numbers, patient selection, and different timing of ambulatory monitoring are proposed...... be that it can be performed early after infarction at the time of maximum risk. Secondly, it can be performed in most patients after infarction, including those recognised as being at high risk who are unable to perform an exercise stress test....

  3. Aggravation of brain infarction through an increase in acrolein production and a decrease in glutathione with aging.

    Science.gov (United States)

    Uemura, Takeshi; Watanabe, Kenta; Ishibashi, Misaki; Saiki, Ryotaro; Kuni, Kyoshiro; Nishimura, Kazuhiro; Toida, Toshihiko; Kashiwagi, Keiko; Igarashi, Kazuei

    2016-04-29

    We previously reported that tissue damage during brain infarction was mainly caused by inactivation of proteins by acrolein. This time, it was tested why brain infarction increases in parallel with aging. A mouse model of photochemically induced thrombosis (PIT) was studied using 2, 6, and 12 month-old female C57BL/6 mice. The size of brain infarction in the mouse PIT model increased with aging. The volume of brain infarction in 12 month-old mice was approximately 2-fold larger than that in 2 month-old mice. The larger brain infarction in 12 month-old mice was due to an increase in acrolein based on an increase in the activity of spermine oxidase, together with a decrease in glutathione (GSH), a major acrolein-detoxifying compound in cells, based on the decrease in one of the subunits of glutathione biosynthesizing enzymes, γ-glutamylcysteine ligase modifier subunit, with aging. The results indicate that aggravation of brain infarction with aging was mainly due to the increase in acrolein production and the decrease in GSH in brain.

  4. Periventricular hyperintensity lesions and dementia in multiple cerebral infarction

    International Nuclear Information System (INIS)

    To examine the relationship between the presence of periventricular hyperintensity (PVH), as shown on MR-T2 weighted images, and both ischemia and dementia, regional cerebral blood flow (rCBF), oxygen extraction fraction (OEF), cerebral metabolic rate of oxygen (CMRO2), and cerebral blood volume (CBV) were determined by positron emission computed tomography using the 15O and 11CO inhalation technique. Thirty-three patients with subcortical cerebral infarction were classified according to the presence of PVH: the PVH (+) group with severe PVH (n=17) and the PVH (-) group without PVH (n=16). In the PVH (+) group of patients with no association of dementia and the PVH (-) group, both decreased rCBF and increased OEF were significantly observed in the frontal cingulate gyrus and PVH area, when compared with the normal controls. In the PVH (+) group of dementia patients, on the other hand, rCBF was significantly decreased in the PVH lesion and each cortical region; and CMRO2 was significantly decreased and OEF was increased in the PVH lesion and all cortical regions, especially the frontal cingulate gyrus. Moreover, the PVH(+) group had a significantly decreased rCBF and rCBF/CBV ratio in PVH lesion. These results showed that 'compensated hypoperfusion' existed in PVH lesion and cortical regions, especially the frontal cingulate gyrus, in multiple infarction patients without dementia and that 'ischemic hypoperfusion' was observed when associated with dementia. These changes, which seemed to be caused by cerebroarteriosclerosis, not only preceded the occurrence of mental deterioration, but also still persisted after dementia had occurred. PVH also reflected severe ischemic changes of the brain in multiple cerebral infarction, irrespective of the association of dementia. (N.K.)

  5. Secondary Prevention in Acute Myocardial Infarction

    OpenAIRE

    IRMAK, Yrd.Doç.Dr. Zöhre; FESCİ, Doç.Dr. Hatice

    2005-01-01

    Recent studies on patients who had an acute myocardial infarction have shown that risk factors are decreased, atherosclerosis regressed, and re-infarction and mortality rates are reduced as a result of drug therapy in combination with the changes in the lifestyle. This treatment called as secondary prevention, requires a behavioral change in the lifestyle that includes stopping smoking, making healthy food choices, and increasing physical activity. Risk factors related with lifestyle, wh...

  6. Acute myocardial infarction following a hornet sting

    OpenAIRE

    Cvetković-Matić Danica; Ašanin Milika; Matić Dragan; Ivanović Branislava; Simić Dragan; Kalezić Nevena; Stojanov Vesna

    2009-01-01

    Background. The occurrence of an acute myocardial infarction following a hornet sting has been very rarely reported in the previous literature. Pathogenetic mechanisms include direct action of the venom components on the coronary endothelium and allergic reaction with mediators released from mast cells. The anaphylactic reaction and venom components can produce acute coronary artery thrombosis. Case report. We reported a 45-year-old man with acute myocardial infarction after a hornet sting in...

  7. Headache: A Symptom of Acute Myocardial Infarction

    OpenAIRE

    Yasmine Elgharably; Cesar Iliescu; Stefano Sdringola; Syed Wamique Yusuf

    2013-01-01

    ABSTRACT:We present a case of 55 year old man, with myocardial infarction and coronary thrombosis, whose initial presentation was with severe headache and review the literature.INTRODUCTION:Coronary ischemia typically presents with retrosternal pain that radiates to left arm (1). present atypically in various forms like indigestion (2), otalgia (3), facial pain (4) and syncope (5). Headache as the sole presentation of myocardial infarction (MI) is rare; however it has been reported previously...

  8. A collagen α2(I) mutation impairs healing after experimental myocardial infarction.

    Science.gov (United States)

    Hofmann, Ulrich; Bonz, Andreas; Frantz, Stefan; Hu, Kai; Waller, Christiane; Roemer, Katrin; Wolf, Jürgen; Gattenlöhner, Stefan; Bauersachs, Johann; Ertl, Georg

    2012-01-01

    Collagen breakdown and de novo synthesis are important processes during early wound healing after myocardial infarction (MI). We tested the hypothesis that collagen I, the main constituent of the extracellular matrix, affects wound healing after MI. The osteogenesis imperfecta mouse (OIM), lacking procollagen-α2(I) expression, represents a model of the type III form of the disease in humans. Homozygous (OIM/OIM), heterozygous (OIM/WT), and wild-type (WT/WT) mice were subjected to a permanent myocardial infarction protocol or sham surgery. Baseline functional and geometrical parameters determined by echocardiography did not differ between genotypes. After MI but not after sham surgery, OIM/OIM animals exhibited significantly increased mortality, due to early ventricular rupture between day 3 and 7. Echocardiography at day 1 demonstrated increased left ventricular dilation in OIM/OIM animals. Less collagen I mRNA within the infarct area was found in OIM/OIM animals. At 2 days after MI, MMP-9 expression in the infarct border zone was higher in OIM/OIM than in WT/WT animals. Increased granulocyte infiltration into the infarct border zone occurred in OIM/OIM animals. Neither granulocyte depletion nor MMP inhibition reduced mortality in OIM/OIM animals. In this murine model, deficiency of collagen I leads to a myocardial wound-healing defect. Both structural alterations within pre-existing collagen matrix and impaired collagen de novo expression contribute to a high rate of early myocardial rupture after MI.

  9. Postmyocardial Infarct Remodeling and Heart Failure: Potential Contributions from Pro- and Antiaging Factors

    Directory of Open Access Journals (Sweden)

    Halliday A. Idikio

    2011-01-01

    Full Text Available Myocardial infarction and adverse postinfarct remodeling in older persons lead to poor outcome and need greater understanding of the contributions of age-related factors on abnormal cardiac function and management. In this perspective, how normal aging processes could contribute to the events of post-myocardial infarction and remodeling is reviewed. Post-myocardial infarction and remodeling involve cardiomechanical factors and neurohormonal response. Many factors prevent or accelerate aging including immunosenescence, recruitment and regeneration of stem cells, telomere shortening, oxidative damage, antiaging hormones klotho and melatonin, nutrition, and Sirtiun protein family, and these factors could affect post-MI remodeling and heart failure. Interest in stem cell repair of myocardial infarcts to mitigate post-MI remodeling needs more information on aging of stem cells, and potential effects on stem cell use in infarct repair. Integrating genomics and proteomics methods may help find clinically novel therapy in the management of post-MI remodeling and heart failure in aged individuals.

  10. Neural Mechanisms and Delayed Gastric Emptying of Liquid Induced Through Acute Myocardial Infarction in Rats

    Directory of Open Access Journals (Sweden)

    Wilson Ranu Ramirez Nunez

    2015-02-01

    Full Text Available Background: In pathological situations, such as acute myocardial infarction, disorders of motility of the proximal gut can trigger symptoms like nausea and vomiting. Acute myocardial infarction delays gastric emptying (GE of liquid in rats. Objective: Investigate the involvement of the vagus nerve, α 1-adrenoceptors, central nervous system GABAB receptors and also participation of paraventricular nucleus (PVN of the hypothalamus in GE and gastric compliance (GC in infarcted rats. Methods: Wistar rats, N = 8-15 in each group, were divided as INF group and sham (SH group and subdivided. The infarction was performed through ligation of the left anterior descending coronary artery. GC was estimated with pressure-volume curves. Vagotomy was performed by sectioning the dorsal and ventral branches. To verify the action of GABAB receptors, baclofen was injected via icv (intracerebroventricular. Intravenous prazosin was used to produce chemical sympathectomy. The lesion in the PVN of the hypothalamus was performed using a 1mA/10s electrical current and GE was determined by measuring the percentage of gastric retention (% GR of a saline meal. Results: No significant differences were observed regarding GC between groups; vagotomy significantly reduced % GR in INF group; icv treatment with baclofen significantly reduced %GR. GABAB receptors were not conclusively involved in delaying GE; intravenous treatment with prazosin significantly reduced GR% in INF group. PVN lesion abolished the effect of myocardial infarction on GE. Conclusion: Gastric emptying of liquids induced through acute myocardial infarction in rats showed the involvement of the vagus nerve, alpha1- adrenergic receptors and PVN.

  11. Neural Mechanisms and Delayed Gastric Emptying of Liquid Induced Through Acute Myocardial Infarction in Rats

    Energy Technology Data Exchange (ETDEWEB)

    Nunez, Wilson Ranu Ramirez; Ozaki, Michiko Regina; Vinagre, Adriana Mendes; Collares, Edgard Ferro; Almeida, Eros Antonio de, E-mail: erosaa@cardiol.br [Universidade Estadual de Campinas, Campinas, SP (Brazil)

    2015-02-15

    In pathological situations, such as acute myocardial infarction, disorders of motility of the proximal gut can trigger symptoms like nausea and vomiting. Acute myocardial infarction delays gastric emptying (GE) of liquid in rats. Investigate the involvement of the vagus nerve, α 1-adrenoceptors, central nervous system GABA{sub B} receptors and also participation of paraventricular nucleus (PVN) of the hypothalamus in GE and gastric compliance (GC) in infarcted rats. Wistar rats, N = 8-15 in each group, were divided as INF group and sham (SH) group and subdivided. The infarction was performed through ligation of the left anterior descending coronary artery. GC was estimated with pressure-volume curves. Vagotomy was performed by sectioning the dorsal and ventral branches. To verify the action of GABA{sub B} receptors, baclofen was injected via icv (intracerebroventricular). Intravenous prazosin was used to produce chemical sympathectomy. The lesion in the PVN of the hypothalamus was performed using a 1mA/10s electrical current and GE was determined by measuring the percentage of gastric retention (% GR) of a saline meal. No significant differences were observed regarding GC between groups; vagotomy significantly reduced % GR in INF group; icv treatment with baclofen significantly reduced %GR. GABA{sub B} receptors were not conclusively involved in delaying GE; intravenous treatment with prazosin significantly reduced GR% in INF group. PVN lesion abolished the effect of myocardial infarction on GE. Gastric emptying of liquids induced through acute myocardial infarction in rats showed the involvement of the vagus nerve, alpha1- adrenergic receptors and PVN.

  12. Selective homocysteine lowering gene transfer improves infarct healing, attenuates remodelling, and enhances diastolic function after myocardial infarction in mice.

    Directory of Open Access Journals (Sweden)

    Ilayaraja Muthuramu

    Full Text Available BACKGROUND AND AIMS: Homocysteine levels predict heart failure incidence in prospective epidemiological studies and correlate with severity of heart failure in cross-sectional surveys. The objective of this study was to evaluate whether a selective homocysteine lowering intervention beneficially affects cardiac remodelling and cardiac function after myocardial infarction (MI in a murine model of combined hypercholesterolemia and hyperhomocysteinemia. METHODOLOGY AND PRINCIPAL FINDINGS: A selective homocysteine lowering gene transfer strategy was evaluated in female C57BL/6 low density lipoprotein receptor (Ldlr⁻/⁻ cystathionine-ß-synthase (Cbs⁺/⁻ deficient mice fed a hyperhomocysteinemic and high saturated fat/high cholesterol diet using an E1E3E4-deleted hepatocyte-specific adenoviral vector expressing Cbs (AdCBS. MI was induced by permanent ligation of the left anterior descending coronary artery 14 days after saline injection or gene transfer. AdCBS gene transfer resulted in a persistent more than 5-fold (p<0.01 decrease of plasma homocysteine levels and significantly improved endothelial progenitor cell function. Selective homocysteine lowering enhanced infarct healing as indicated by a 21% (p<0.01 reduction of infarct length at day 28 after MI and by an increased number of capillaries and increased collagen content in the infarct zone. Adverse remodelling was attenuated in AdCBS MI mice as evidenced by a 29% (p<0.05 reduction of left ventricular cavity area at day 28, by an increased capillary density in the remote myocardium, and by reduced interstitial collagen. The peak rate of isovolumetric relaxation was increased by 19% (p<0.05 and the time constant of left ventricular relaxation was reduced by 21% (p<0.05 in AdCBS MI mice compared to control MI mice, indicating improved diastolic function. CONCLUSION/SIGNIFICANCE: Selective homocysteine lowering gene transfer improves infarct healing, attenuates remodelling, and

  13. Questing for circadian dependence in ST-segment-elevation acute myocardial infarction: A multicentric and multiethnic study

    KAUST Repository

    Ammirati, Enrico

    2013-05-09

    Rationale: Four monocentric studies reported that circadian rhythms can affect left ventricular infarct size after ST-segment-elevation acute myocardial infarction (STEMI). Objective: To further validate the circadian dependence of infarct size after STEMI in a multicentric and multiethnic population. Methods and Results: We analyzed a prospective cohort of subjects with first STEMI from the First Acute Myocardial Infarction study that enrolled 1099 patients (ischemic time <6 hours) in Italy, Scotland, and China. We confirmed a circadian variation of STEMI incidence with an increased morning incidence (from 6:00 am till noon). We investigated the presence of circadian dependence of infarct size plotting the peak creatine kinase against time onset of ischemia. In addition, we studied the patients from the 3 countries separately, including 624 Italians; all patients were treated with percutaneous coronary intervention. We adopted several levels of analysis with different inclusion criteria consistent with previous studies. In all the analyses, we did not find a clear-cut circadian dependence of infarct size after STEMI. Conclusions: Although the circadian dependence of infarct size supported by previous studies poses an intriguing hypothesis, we were unable to converge toward their conclusions in a multicentric and multiethnic setting. Parameters that vary as a function of latitude could potentially obscure the circadian variations observed in monocentric studies. We believe that, to assess whether circadian rhythms can affect the infarct size, future study design should not only include larger samples but also aim to untangle the molecular time-dynamic mechanisms underlying such a relation. © 2013 American Heart Association, Inc.

  14. Preconditioning cortical lesions reduce the incidence of peri-infarct depolarizations during focal ischemia in the Spontaneously Hypertensive Rat: interaction with prior anesthesia and the impact of hyperglycemia.

    Science.gov (United States)

    Zhao, Liang; Nowak, Thaddeus S

    2015-07-01

    The relationship between peri-infarct depolarizations (PIDs) and infarction was investigated in a model of preconditioning by cortical freeze lesions (cryogenic lesions, CL) in the Spontaneously Hypertensive Rat. Small (chloralose during perfusion imaging. As an additional methodological concern, blood glucose was frequently elevated at the time of the second surgery, reflecting buprenorphine-induced pica and other undefined mechanisms. Even modest hyperglycemia (>10 mmol/L) reduced PID incidence. In normoglycemic animals CL preconditioning reduced PID number by 50%, demonstrating associated effects on PID incidence, penumbral perfusion, and infarct progression. Hyperglycemia suppressed PIDs without affecting the relationship between CBF and infarction. This suggests that the primary effect of preconditioning is to improve penumbral perfusion, which in turn impacts PID incidence and infarct size. PMID:25757750

  15. Effects of renal sympathetic denervation on post-myocardial infarction cardiac remodeling in rats.

    Directory of Open Access Journals (Sweden)

    Jialu Hu

    Full Text Available OBJECTIVE: To investigate the therapeutic effects of renal denervation (RD on post- myocardial infarction (MI cardiac remodeling in rats, the most optimal time for intervention and the sustainability of these effects. METHODS: One hundred SPF male Wistar rats were randomly assigned to N group (Normal, n=10, MI group(MI, n=20,RD group (RD, n=10, RD3+MI (MI three days after RD, n=20, MI1+RD (RD one day after MI, n=20, MI7+RD (RD seven days after MI, n=20. MI was produced through thoracotomic ligation of the anterior descending artery. RD was performed through laparotomic stripping of the renal arteriovenous adventitial sympathetic nerve. Left ventricular function, hemodynamics, plasma BNP, urine volume, urine sodium excretion and other indicators were measured four weeks after MI. RESULTS: (1 The left ventricular function of the MI group significantly declined (EF<40%, plasma BNP was elevated, urine output was significantly reduced, and 24-hour urine sodium excretion was significantly reduced. (2 Denervation can be achieved by surgically stripping the arteriovenous adventitia, approximately 3 mm from the abdominal aorta. (3 In rats with RD3+MI, MI1+RD and MI7+RD, compared with MI rats respectively, the LVEF was significantly improved (75 ± 8.4%,69 ± 3.8%,73 ± 5.5%, hemodynamic indicators were significantly improved, plasma BNP was significantly decreased, and the urine output was significantly increased (21.3 ± 5 ml,23.8 ± 5.4 ml,25.2 ± 8.7 ml. However, the urinary sodium excretion also increased but without significant difference. CONCLUSIONS: RD has preventive and therapeutic effects on post-MI cardiac remodeling.These effects can be sustained for at least four weeks, but there were no significant differences between denervation procedures performed at different times in the course of illness. Cardiac function, hemodynamics, urine volume and urine sodium excretion in normal rats were not affected by RD.

  16. Application of radionuclide infarct scintigraphy to diagnose perioperative myocardial infarction following revascularization

    International Nuclear Information System (INIS)

    To evaluate the application of radionuclide infarct scintigraphy to diagnose myocardial infarction after revascularization, we obtained postoperative technetium 99m pyrophosphate myocardial scintigrams, serial electrocardiograms and CPK-MB isoenzymes in ten control and 51 revascularized patients. All control patients had negative electrocardiograms and scintigrams, but eight had positive isoenzymes. Eight revascularized patients had positive electrocardiograms, images and enzymes and two had positive scintigrams and enzymes with negative electrocardiograms. Thirty-four patients with negative electrocardiograms and scintigrams had positive isoenzymes; in only seven patients were all tests negative. Our data suggest radionuclide infarct scintigraphy is a useful adjunct to the electrocardiogram in diagnosing perioperative infarction. The frequent presence of CPK-MB in postoperative patients without other evidence of infarction suggests that further studies are required to identify all factors responsible for its release

  17. Acute myocardial infarction. Clinical application of technetium 99m stannous pyrophosphates infarct scintigraphy

    International Nuclear Information System (INIS)

    Acute myocardial infarction is being recognized as a spectrum of clinical subsets. This appreciation has been brought about to a large degree by the development of several new tools that can be applied clinically to aid in evaluation of patients with acute infarction, and in some cases to provide short- and long-term prognostic information. In the realm of noninvasive methods, several tests utilizing radiopharmaceuticals and scintillation cameras have emerged and are rapidly becoming reliable diagnostic parameters in patients with coronary disease and infarction. Technetium-99m (stannous) pyrophosphate (TcPYP) scintigraphy, one of the first of these techniques to find clinical use, has been shown to be an accurate indicator of acute transmural myocardial infarction and provides added sensitivity and specificity to the diagnosis. Increased diagnostic accuracy, the dimension of visible localization, and the potential for infarct sizing promise physicians better understanding of a patient's clinical presentation and a more rational approach to management

  18. Plasma level of neuron specific enolase in patients with acute cerebral infarction: A case-control study

    Institute of Scientific and Technical Information of China (English)

    Guoping Tian; Yang Zhang; Weiping Cheng

    2009-01-01

    BACKGROUND: The plasma level of neuron specific enolase (NSE) can be used to diagnose and evaluate neuronal injury and predict early prognosis.OBJECTIVE: To observe the dynamic changes in plasma levels of NSE in patients with acute cerebral infarction, and to investigate its correlations with disease severity and prognosis.DESIGN, TIME AND SETTING: This non-randomized, concurrent case-control experiment was performed at the Department of Neurology, First Hospital Affiliated to Heilongjiang University of Traditional Chinese Medicine between May and July 2007.PARTICIPANTS: Eighteen patients with acute cerebral infarction, who received treatment at the Department of Neurology, First Hospital Affiliated to Heilongjiang University of Traditional Chinese Medicine between May and July 2007, were recruited into the patient group. An additional 10 healthy individuals, who received health examinations simultaneously, were included as controls.METHODS: Following admission (within 3 days) and at days 6, 12, and 30 subsequent to acute cerebral infarction attack, 3 mL venous blood was taken from each patient before the morning meal to determine the plasma level of NSE by enzyme-labeled immunosorbent assay. One-time blood extraction was performed in each healthy subject during the health examination for the same purpose as in patients. At 6 and 30 days following acute cerebral infarction attack, CT examination was performed for calculation of cerebral infarction volume according to the Tada formula. Following admission and at 30 days of disease invasion, all patients were scored by the National Institutes of Health Stroke Scale (NIHSS, 13 items).MAIN OUTCOME MEASURES: Comparison of NSE plasma level between acute cerebral infarction patients and healthy individuals; correlations of NSE plasma level in acute cerebral infarction patients with cerebral infarction volume, NIHSS score, and prognosis.RESULTS: Following admission and at days 6 and 12 of disease invasion, the plasma level

  19. Medial reorganization of motor function in corona radiata following middle cerebral artery infarction A case report

    Institute of Scientific and Technical Information of China (English)

    Sung Ho Jang

    2009-01-01

    Peri-lesional reorganization is one of the motor recovery mechanisms following stroke. A 23-year-old female who presented with complete paralysis of the right extremities at the onset of infarct in the left middle cerebral artery territory was included. She slowly recovered some function, and could extend the affected knee with resistance after 9 months. Diffusion tensor tractography, functional MRI, and transcranial magnetic stimulation testing were performed at 7 years after onset. Results showed that diffusion tensor tractography of the affected (left) hemisphere passed through the medial corona radiata at, or around, the wall of the lateral ventricle. The contralateral primary sensorimotor cortex was activated during affected knee movements. The motor-evoked potential, which was obtained from the affected leg, exhibited corticospinal tract characteristics. Results indicated that motor function of the affected leg recovered via the corticospinal tract, which descended through the corona radiata medial to the infarct. The motor function of the affected leg was reorganized to the medial corona radiata following infarct to the middle cerebral artery territory.

  20. Acupuncture and Medicated Oxygen Therapy for Multiple Infarctional Dementia

    Institute of Scientific and Technical Information of China (English)

    HOU An-le; WANG Lei; BO Yuan; XIAO Yuan-chun

    2003-01-01

    Purpose To observe the clinical efficacy of acupuncture and medicated oxygen therapy in the treatment of multiple infarctional dementia(MID). Methods 150 cases of MID were randomized into three groups: group A in which 50 cases were treated by acupuncture and medicated oxygen, group B in which 50 cases were treated by acupuncture and inhaled oxygen and group C in which 50 cases were simply treated by acupuncture. Results The clinical effects were obviously better in group A than those in group B and group C ( P < 0.05, P < 0.01 ). Conclusion Chinese medicine together with oxygen and acupuncture can improve brain blood circulation, activate brain cells, increase the volume of brain blood flow and its blood supply, and enhance the clinical effects.

  1. Hepatic infarction following abdominal interventional procedures.

    Directory of Open Access Journals (Sweden)

    Fujiwara H

    2004-04-01

    Full Text Available To clarify the incidence, background, and progress of hepatic infarction following interventional procedures, cases of hepatic infarction following interventional procedures at our department during the last decade were identified by reviewing the clinical records of 1982 abdominal angiography and interventional procedures and records of abdominal CT. Nine episodes (0.5% in 8 patients were identified as hepatic infarction following an interventional procedure. Five episodes were preceded by embolization of the hepatic or celiac artery at emergency angiography for postoperative bleeding with hemorrhagic shock. Three episodes followed the elected interventional procedure for hepatocellular carcinoma, and the remaining episode occurred after 12 months of chemoinfusion through an indwelling catheter in the hepatic artery and portal vein. Hepatic arterial occlusion in all episodes and portal venous flow abnormality in 5 episodes were observed on angiography. Four patients whose liver function was initially impaired died of hepatic infarction, although the extent of the disease on CT did not appear to be related to the mortality. Multiple risk factors, including arterial insufficiency, were observed in each patient. The incidence of hepatic infarction following interventional procedures in this series was low but sometimes fatal, and occurred most frequently in emergency embolization in hemorrhagic shock.

  2. Postoperative omental infarction following colonic resection

    Energy Technology Data Exchange (ETDEWEB)

    Kerr, S.F., E-mail: skerr44@doctors.org.uk [Department of Radiology, Leeds General Infirmary, Leeds (United Kingdom); Hyland, R.; Rowbotham, E.; Chalmers, A.G. [Department of Radiology, Leeds General Infirmary, Leeds (United Kingdom)

    2012-02-15

    Aim: To illustrate the computed tomography (CT) appearances and natural history of postoperative omental infarction following colonic resection and to highlight the important clinical implications of this radiological diagnosis. Materials and methods: Over a 3 year period, 15 patients with a history of colonic resection were identified as having a CT diagnosis of postoperative omental infarction. Relevant clinical and pathological data were retrospectively collected from the institution's electronic patient records system and all relevant imaging was reviewed, including serial CT images in 10 patients. Results: A diagnosis of postoperative omental infarction was made in symptomatic and asymptomatic patients who had undergone open or laparoscopic colonic resection for benign or malignant disease. CT appearances ranged from diffuse omental stranding to discrete masses, which typically appeared within weeks of surgery and could persist for years. In four (36%) of the patients with colorectal cancer, the CT appearances raised concern for recurrent malignancy, but percutaneous biopsy and/or serial CT allowed a confident diagnosis of omental infarction to be made. Although most cases were self-limiting, three (20%) cases were complicated by secondary infection and required radiological or surgical intervention. Conclusion: Postoperative omental infarction is an under-recognized complication of colonic resection. It has the potential to mimic recurrent malignancy and may require radiological or surgical intervention for secondary infection.

  3. Postoperative omental infarction following colonic resection

    International Nuclear Information System (INIS)

    Aim: To illustrate the computed tomography (CT) appearances and natural history of postoperative omental infarction following colonic resection and to highlight the important clinical implications of this radiological diagnosis. Materials and methods: Over a 3 year period, 15 patients with a history of colonic resection were identified as having a CT diagnosis of postoperative omental infarction. Relevant clinical and pathological data were retrospectively collected from the institution’s electronic patient records system and all relevant imaging was reviewed, including serial CT images in 10 patients. Results: A diagnosis of postoperative omental infarction was made in symptomatic and asymptomatic patients who had undergone open or laparoscopic colonic resection for benign or malignant disease. CT appearances ranged from diffuse omental stranding to discrete masses, which typically appeared within weeks of surgery and could persist for years. In four (36%) of the patients with colorectal cancer, the CT appearances raised concern for recurrent malignancy, but percutaneous biopsy and/or serial CT allowed a confident diagnosis of omental infarction to be made. Although most cases were self-limiting, three (20%) cases were complicated by secondary infection and required radiological or surgical intervention. Conclusion: Postoperative omental infarction is an under-recognized complication of colonic resection. It has the potential to mimic recurrent malignancy and may require radiological or surgical intervention for secondary infection.

  4. Thrombolytic therapy in acute myocardial infarction.

    Science.gov (United States)

    Woo, K S; White, H D

    1994-07-01

    Thrombolytic therapy has revolutionized the treatment of acute myocardial infarction by reducing mortality and preserving left ventricular function. It is relatively safe and cost-effective. However, it is currently underused in most countries. Patients in whom thrombolysis is indicated include those with ST elevation on the electrocardiogram or bundle branch block pattern who present within 12 hours of myocardial infarction; the indications should be widened to include the elderly, patients who have undergone nontraumatic cardiopulmonary resuscitation, and women during menstruation. The risk-benefit ratio should be assessed for the individual patient. Prehospital thrombolytic treatment has been shown to be feasible with the support of well-trained staff and resuscitation equipment, and may be cost-effective in communities with time delays before hospitalization greater than 1 hour. The most important strategy is to shorten the "door to needle" time in hospital. The importance of full infarct-related artery flow (Thrombolysis in Myocardial Infarction [TIMI] grade 3 flow) for preservation of ventricular function and survival has been documented in the second Thrombolysis Trial of Eminase in Acute Myocardial Infarction (TEAM 2) and the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) studies. Aspirin and heparin are beneficial adjunctive regimens to thrombolytic therapy but optimal epicardial reperfusion is achieved in only about half of patients. Improved thrombolytic, adjunctive antiplatelet, and antithrombotic regimens are required to achieve early full reperfusion, which is crucial to improve survival and quality of life. PMID:7919592

  5. Association of blood transfusion with increased mortality in myocardial infarction

    DEFF Research Database (Denmark)

    Chatterjee, Saurav; Wetterslev, Jørn; Sharma, Abhishek;

    2013-01-01

    The benefit of blood transfusion in patients with myocardial infarction is controversial, and a possibility of harm exists.......The benefit of blood transfusion in patients with myocardial infarction is controversial, and a possibility of harm exists....

  6. Circulating NOS3 modulates left ventricular remodeling following reperfused myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Simone Gorressen

    Full Text Available Nitric oxide (NO is constitutively produced and released from the endothelium and several blood cell types by the isoform 3 of the NO synthase (NOS3. We have shown that NO protects against myocardial ischemia/reperfusion (I/R injury and that depletion of circulating NOS3 increases within 24 h of ischemia/reperfusion the size of myocardial infarction (MI in chimeric mice devoid of circulating NOS3. In the current study we hypothesized that circulating NOS3 also affects remodeling of the left ventricle following reperfused MI.To analyze the role of circulating NOS3 we transplanted bone marrow of NOS3-/- and wild type (WT mice into WT mice, producing chimerae expressing NOS3 only in vascular endothelium (BC-/EC+ or in both, blood cells and vascular endothelium (BC+/EC+. Both groups underwent 60 min of coronary occlusion in a closed-chest model of reperfused MI. During the 3 weeks post MI, structural and functional LV remodeling was serially assessed (24 h, 4 d, 1 w, 2 w and 3 w by echocardiography. At 72 hours post MI, gene expression of several extracellular matrix (ECM modifying molecules was determined by quantitative RT-PCR analysis. At 3 weeks post MI, hemodynamics were obtained by pressure catheter, scar size and collagen content were quantified post mortem by Gomori's One-step trichrome staining.Three weeks post MI, LV end-systolic (53.2±5.9 μl; ***p≤0.001; n = 5 and end-diastolic volumes (82.7±5.6 μl; *p<0.05; n = 5 were significantly increased in BC-/EC+, along with decreased LV developed pressure (67.5±1.8 mm Hg; n = 18; ***p≤0.001 and increased scar size/left ventricle (19.5±1.5%; n = 13; **p≤0.01 compared to BC+/EC+ (ESV: 35.6±2.2 μl; EDV: 69.1±2.6 μl n = 8; LVDP: 83.2±3.2 mm Hg; n = 24; scar size/LV13.8±0.7%; n = 16. Myocardial scar of BC-/EC+ was characterized by increased total collagen content (20.2±0.8%; n = 13; ***p≤0.001 compared to BC+/EC+ (15.9±0.5; n = 16, and increased collagen type I and III subtypes

  7. Polyhydroxylated fullerene nanoparticles attenuate brain infarction and oxidative stress in rat model of ischemic stroke

    Science.gov (United States)

    Vani, Javad Rasouli; Mohammadi, Mohammad Taghi; Foroshani, Mahsa Sarami; Jafari, Mahvash

    2016-01-01

    Oxidative stress is the common underlying mechanism of damage in ischemic stroke. Therefore, we aimed to evaluate the possible protective effects of polyhydroxylated fullerene derivatives on brain infarction and oxidative/nitrosative stress in a rat model of ischemic stroke. The experiment was performed by four groups of rats (each; n=12); Sham, Control ischemia, and ischemic treatment groups (Pretreatment and Posttreatment). Brain ischemia was induced by 90 min middle cerebral artery occlusion (MCAO) followed by 24 hours reperfusion. Rats received fullerene nanoparticles at dose of 1 mg/kg 30 min before MCAO and immediately after beginning of reperfusion. Infarct volume, contents of malondialdehyde (MDA), glutathione (GSH) and nitrate as well as superoxide dismutase (SOD) activity were assessed 24 hours after termination of MCAO. Brain infarct volume was 310 ± 21 mm3 in control group. Administration of fullerene nanoparticles before and after MCAO significantly decreased the infarct volume by 53 % (145 ± 45 mm3) and 81 % (59 ± 13 mm3), respectively. Ischemia also enhanced MDA and nitrate contents of ischemic hemispheres by 45 % and 25 % , respectively. Fullerene nanoparticles considerably reduced the MDA and nitrate contents of ischemic hemispheres before MCAO by 58 % and 17 % , respectively, and after MCAO by 38 % and 21 % , respectively. Induction of MCAO significantly decreased GSH content (19 % ) and SOD activity (52 % ) of ischemic hemispheres, whereas fullerene nanoparticles increased the GSH content and SOD activity of ischemic hemispheres by 19 % and 52 % before MCAO, respectively, and 21 % and 55 % after MCAO, respectively. Our findings indicate that fullerene nanoparticles, as a potent scavenger of free radicals, protect the brain cells against ischemia/reperfusion injury and inhibit brain oxidative/nitrosative damage.

  8. Neoinnervation and neovascularization of acellular pericardial-derived scaffolds in myocardial infarcts.

    Science.gov (United States)

    Gálvez-Montón, Carolina; Fernandez-Figueras, M Teresa; Martí, Mercè; Soler-Botija, Carolina; Roura, Santiago; Perea-Gil, Isaac; Prat-Vidal, Cristina; Llucià-Valldeperas, Aida; Raya, Ángel; Bayes-Genis, Antoni

    2015-01-01

    Engineered bioimplants for cardiac repair require functional vascularization and innervation for proper integration with the surrounding myocardium. The aim of this work was to study nerve sprouting and neovascularization in an acellular pericardial-derived scaffold used as a myocardial bioimplant. To this end, 17 swine were submitted to a myocardial infarction followed by implantation of a decellularized human pericardial-derived scaffold. After 30 days, animals were sacrificed and hearts were analyzed with hematoxylin/eosin and Masson's and Gallego's modified trichrome staining. Immunohistochemistry was carried out to detect nerve fibers within the cardiac bioimplant by using βIII tubulin and S100 labeling. Isolectin B4, smooth muscle actin, CD31, von Willebrand factor, cardiac troponin I, and elastin antibodies were used to study scaffold vascularization. Transmission electron microscopy was performed to confirm the presence of vascular and nervous ultrastructures. Left ventricular ejection fraction (LVEF), cardiac output (CO), stroke volume, end-diastolic volume, end-systolic volume, end-diastolic wall mass, and infarct size were assessed by using magnetic resonance imaging (MRI). Newly formed nerve fibers composed of several amyelinated axons as the afferent nerve endings of the heart were identified by immunohistochemistry. Additionally, neovessel formation occurred spontaneously as small and large isolectin B4-positive blood vessels within the scaffold. In summary, this study demonstrates for the first time the neoformation of vessels and nerves in cell-free cardiac scaffolds applied over infarcted tissue. Moreover, MRI analysis showed a significant improvement in LVEF (P = 0.03) and CO (P = 0.01) and a 43 % decrease in infarct size (P = 0.007). PMID:26205795

  9. Renal infarction in patients presenting with suspected renal colic *

    OpenAIRE

    Seetho, Ian W.; Bungay, Peter M.; Taal, Maarten W.; Fluck, Richard J.; Leung, Janson C. H.

    2009-01-01

    Acute renal infarction is a serious medical emergency. The diagnosis is often delayed or missed as it is not common. Hence, the exact incidence of acute renal infarction is not known. Failure to consider renal infarction in the initial differential diagnosis results in a delay in diagnosis and treatment, which in turn leads to permanent loss of renal function. We present two cases of acute kidney infarction that were initially treated as renal colic. In addition, we present a third case when ...

  10. Regional Mechanics Determine Collagen Fiber Structure in Healing Myocardial Infarcts

    OpenAIRE

    Fomovsky, Gregory M.; Rouillard, Andrew D.; Holmes, Jeffrey W.

    2012-01-01

    Following myocardial infarction, the mechanical properties of the healing infarct are an important determinant of heart function and the risk of progression to heart failure. In particular, mechanical anisotropy (having different mechanical properties in different directions) in the healing infarct can preserve pump function of the heart. Based on reports of different collagen structures and mechanical properties in various animal models, we hypothesized that differences in infarct size, shap...

  11. Viable Myocardium Impact on Left Ventricular Function after Late Revascularization of Infarct-related Artery in Acute Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    Ma Likun; Yu Hua; Huang Xiangyang; Feng Kefu; Han Xiaoping; Ye Qi

    2006-01-01

    Objectives The long-term benefit of late reperfusion of infarct-related artery (IRA) after acute myocardial infarction (AMI) is controversial, and the benefit mechanisms remain uncertain. Low dose dobutamine stress echocardiography (LDSE) can identify viable myocardium and predict improvement of wall motion after revascularization. Methods Sixtynine patients with first AMI who did not received early reperfusion therapy were studied by LDSE at 5 to 10 days after AMI. Wall motion abnormality and left ventricular size were measured at the same time.Successful PCI were done in all patients at 10 to 21 days after AMI onset. Patients were divided in two groups based on the presence or absence of viable myocardium. Echocardiography was repeated six months later. Results There were 157 motion abnormality segments. 89 segments (57%) were viable during LDSE. 26 patients (38%) with viability and 43(62%) without. In viable group, left ventricular ejection fraction (LVEF) was increased (P<0.05),and left ventricular end systolic volume index (LVESVI) and wall motion score (WMS) were decreased (P<0.05 and P<0.01) significantly at 6 months compared with baseline. But in patients without viability, LVEF was decreased (P<0.01), and LVESVI and left ventricular end diastolic volume index (LVEDVI) were increased (P<0.05) significantly after 6 months, and the WMS did not changed (P>0.05). LVEF increased (P<0.05) and WMS decreased (P<0.05) on LDSE during acute phase in patients with viability, but they were not changed in the nonviable group. Conclusions Late revascularization of IRA in patients with presence of viable myocardium after AMI is associated with long-term preservation left ventricular function and less ventricular remodeling.Improvement of left ventricular systolic function on LDSE indicates late phase recovery of left ventricular function after late revascularization.

  12. Quality indicators for acute myocardial infarction

    DEFF Research Database (Denmark)

    Schiele, Francois; Gale, Chris P; Bonnefoy, Eric;

    2016-01-01

    infarction (AMI), but no such indicators exist in Europe. In this context, the European Society of Cardiology (ESC) Acute Cardiovascular Care Association (ACCA) has reflected on the measurement of quality of care in the context of AMI (ST segment elevation myocardial infarction (STEMI) and non-ST segment...... be estimated solely on the basis of patients' clinical outcomes. Thus, measuring the process of care through quality indicators (QIs) has become a widely used practice in this context. Other professional societies have published QIs for the evaluation of quality of care in the context of acute myocardial...... elevation myocardial infarction (NSTEMI)) and created a set of QIs, with a view to developing programmes to improve quality of care for the management of AMI across Europe. We present here the list of QIs defined by the ACCA, with explanations of the methodology used, scientific justification and reasons...

  13. Acute myocardial infarction in a young patient

    International Nuclear Information System (INIS)

    Myocardial infarction (MI) is considered to be the disease of the fifth and sixth decade as seen in the West but an earlier age incidence is not infrequently encountered in the South Asian population. However, occurrence of MI in the teen-age still remains a rare happening. We are reporting a case of a teenager, who suffered a myocardial infarction with cardiogenic shock and pulmonary edema on two separate occasions with ECG and biochemical evidence of myocardial infarction. An exercise stress test done in between the two episodes was negative at a workload of 13.5 METs. A coronary angiogram done after the second event revealed normal coronary arteries and a preserved left ventricular systolic and segmental function. Except for low HDL (high density lipoprotein) and mildly raised homocysteine levels, the patient did not have other conventional or novel risk factors for coronary artery disease. (author)

  14. Transient myocardial ischemia after myocardial infarction

    DEFF Research Database (Denmark)

    Mickley, H

    1995-01-01

    Ambulatory ST-segment monitoring is a relatively new device in the evaluation of myocardial ischemia. The method is unique in allowing us to continuously examine the patient over an extended period of time in a changing environmental milieu. In survivors of acute myocardial infarction...... the prevalence of ambulatory or transient myocardial ischemia is lower than in patients with chronic, stable coronary artery disease. A greater proportion of ischemic episodes, however, are silent than in other subgroups with ischemic heart disease. Early after the infarction, transient myocardial ischemia...... exhibits a circadian variation with a peak activity occurring in the late evening hours. Patients with non-Q wave infarction have more transient myocardial ischemia, whereas thrombolytic therapy seems to result in less residual ischemia. Exercise testing is more sensitive than ambulatory monitoring...

  15. Exosomes and cardiac repair after myocardial infarction.

    Science.gov (United States)

    Sahoo, Susmita; Losordo, Douglas W

    2014-01-17

    Myocardial infarction is a leading cause of death among all cardiovascular diseases. The analysis of molecular mechanisms by which the ischemic myocardium initiates repair and remodeling indicates that secreted soluble factors are key players in communication to local and distant tissues, such as bone marrow. Recently, actively secreted membrane vesicles, including exosomes, are being recognized as new candidates with important roles in intercellular and tissue-level communication. In this review, we critically examine the emerging role of exosomes in local and distant microcommunication mechanisms after myocardial infarction. A comprehensive understanding of the role of exosomes in cardiac repair after myocardial infarction could bridge a major gap in knowledge of the repair mechanism after myocardial injury.

  16. Treatment with the gap junction modifier rotigaptide (ZP123) reduces infarct size in rats with chronic myocardial infarction

    DEFF Research Database (Denmark)

    Haugan, Ketil; Marcussen, Niels; Kjølbye, Anne Louise;

    2006-01-01

    Treatment with non-selective drugs (eg, long-chain alcohols, halothane) that reduce gap junction intercellular communication (GJIC) is associated with reduced infarct size after myocardial infarction (MI). Therefore, it has been suggested that gap junction intercellular communication stimulating ...

  17. Clinical significance of urine ferritin in patients with cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    周慧

    2013-01-01

    Objective To find an indicator in urine to assist diagnosis of cerebral infarction,we investigated the changes of urine ferritin in patients with cerebral infarction.Methods Collected serum from 30 healthy volunteers and 53 patients with cerebral infarction (CI) ,with ratio ofmales to females

  18. Association of stroke and myocardial infarction in children.

    Science.gov (United States)

    Nakashima, M; Takashima, S; Hashimoto, K; Shiraishi, M

    1982-02-01

    A 9-year-old boy with cerebrovascular accident (CVA) and old myocardial infarction with mural thrombi is reported. The cause of the myocardial infarction was congenital coronary artery fistula originating from the left coronary artery and emptying into the right atrium. Although a common cause of strokes in adults, myocardial infarction has infrequently been reported as the source of emboli in children.

  19. Association of splenic and renal infarctions in acute abdominal emergencies

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Stefania E-mail: stefromano@libero.it; Scaglione, Mariano; Gatta, Gianluca; Lombardo, Patrizia; Stavolo, Ciro; Romano, Luigia; Grassi, Roberto

    2004-04-01

    Introduction: Splenic and renal infarctions are usually related to vascular disease or haematologic abnormalities. Their association is infrequent and rarely observed in trauma. In this study, we analyze our data to look at the occurrence of renal and splenic infarctions based on CT findings in a period of 4 years. Materials and Methods: We retrospectively reviewed the imaging findings of 84 patients admitted to our Department of Diagnostic Imaging from June 1998 to December 2002, who underwent emergency abdominal spiral CT examination and in whom there was evidence of splenic and/or renal infarction. Results: We found 40 cases of splenic infarction and 54 cases of renal infarction, associated in 10 patients. In 26 patients, there was also evidence of intestinal infarction. A traumatic origin was found in 19 cases; non-traumatic causes were found in 65 patients. Association between renal and splenic infarction in the same patient was related to trauma in two cases. Conclusions: Although renal and splenic infarctions are a common manifestation of cardiac thromboembolism, other systemic pathologies, infections or trauma may lead to this occurrence. Renal infarction may be clinically and/or surgically managed with success in most cases. There are potential complications in splenic infarction, such as development of pseudocysts, abscesses, hemorrhage, subcapsular haematoma or splenic rupture; splenectomy in these cases may be necessary. Some patients with splenic and/or renal infarction may be clinically asymptomatic. The high accuracy of CT examination is needed to allow a correct evaluation of infarcted organs.

  20. RAMIPRIL IN THERAPY OF PATIENTS AFTER MYOCARDIAL INFARCTION

    OpenAIRE

    I. V. Szirov; E. V. Malichenko

    2015-01-01

    Angiotensin converting enzyme inhibitors are the first line medicine for the treatment of the most of cardiovascular diseases. There is no class-effect for these drugs in myocardial infarction therapy. Moreover in myocardial infarction angiotensin converting enzyme inhibitors have significant intra-group differences. Ramipril is the one of the most studied drug of this group recommended for patients after acute myocardial infarction.

  1. Prevalence and extent of infarct and microvascular obstruction following different reperfusion therapies in ST-elevation myocardial infarction

    OpenAIRE

    Khan, Jamal N; Razvi, Naveed; Nazir, Sheraz A; Singh, Anvesha; Masca, Nicholas GD; Gershlick, Anthony H.; Squire, Iain; McCann, Gerry P.

    2014-01-01

    Background Microvascular obstruction (MVO) describes suboptimal tissue perfusion despite restoration of infarct-related artery flow. There are scarce data on Infarct Size (IS) and MVO in relation to the mode and timing of reperfusion. We sought to characterise the prevalence and extent of microvascular injury and IS using Cardiovascular magnetic resonance (CMR), in relation to the mode of reperfusion following acute ST-Elevation Myocardial Infarction (STEMI). Methods CMR infarct characteristi...

  2. [Segmental testicular infarction in sickle cell anemia].

    Science.gov (United States)

    Mueller, F E

    2014-05-01

    Vascular occlusions are the clinical indicators of sickle cell disease and in urology they can lead to papillary necrosis, renal infarction or priapism. Segmental testicular infarction in patients with sickle cell disease is a rare event and only a few cases have been reported. We present a 25-year-old man with right testicular pain increasing over 3 days and sickle cell disease. Ultrasound of the right scrotum presented an inhomogeneous, mainly hypoechegenic mass with a hyperechogenic margin and no sign of blood flow. A partial orchiectomy was performed with total enucleation of the lesion, which was histologically diagnosed as benign hemorrhagic necrotic testicular tissue.

  3. Does heavy physical exertion trigger myocardial infarction?

    DEFF Research Database (Denmark)

    Hallqvist, J; Möller, J; Ahlbom, A;

    2000-01-01

    To study possible triggering of first events of acute myocardial infarction by heavy physical exertion, the authors conducted a case-crossover analysis (1993-1994) within a population-based case-referent study in Stockholm County, Sweden (the Stockholm Heart Epidemiology Program). Interviews were...... carried out with 699 myocardial infarction patients after onset of the disease. These cases represented 47 percent of all cases in the study base, and 70 percent of all nonfatal cases. The relative risk from vigorous exertion was 6.1 (95% confidence interval: 4.2, 9.0). The rate difference was 1.5 per...

  4. Anterograde and Retrograde Amnesia following Bitemporal Infarction

    Directory of Open Access Journals (Sweden)

    A. Schnider

    1994-01-01

    Full Text Available A patient suffered very severe anterograde and retrograde amnesia following infarction of both medial temporal lobes (hippocampus and adjacent cortex and the left inferior temporo-occipital area. The temporal stem and the amygdala were intact; these structures do not appear to be critical for new learning in humans. Extension of the left-sided infarct into the inferior temporo-occipital lobe, an area critically involved in visual processing, appears to be responsible for our patient's loss of remote memories.

  5. Acute myopericarditis masquerading as acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Wen Tian; Zixin Zhang; Xiaojuan Bai; Dingyin Zeng; Guoxian Qi

    2008-01-01

    Patients with abrupt onset of chest pain, ischemic ECG abnormalities and elevated levels of cardiac markers could be given a diagnosis of acute myocardial infarction. However, some other diseases should be taken into consideration in this clinical setting when coronary arteries are proven to be normal. Here we report a case of acute myopericarditis with clinical presentation of myocardial infarction and normal coronary anatomy. The Herpes Simplex Virus Ⅱ was considered as the organism causing myopericarditis and the patient was recovered by the treatment with valacicloavir. A precise diagnosis is a prerequisite of successful treatment and favorable prognosis.

  6. Idiopathic renal infarction in a previously healthy active duty soldier.

    Science.gov (United States)

    Eickhoff, Christa; Mei, Jian M; Martinez, Jorge; Little, Dustin

    2014-02-01

    Renal infarction (RI) is rare, and usually occurs in patients with associated comorbidities. The majority of reported cases have presented with laboratory abnormalities, most notably leukocytosis and elevated lactate dehydrogenase (LDH). A 50-year-old active duty white male nonsmoker without medical history presented with flank pain. Urinalysis, complete blood count, LDH, and serum creatinine were normal. Contrast-enhanced computed tomography of the abdomen and pelvis showed a right-sided RI. The patient was admitted to the hospital and anticoagulated. Laboratory values remained normal, and a comprehensive workup failed to reveal an etiology for his RI. RI is rare, and affected patients often present with symptoms similar to more common conditions such as lumbago or nephrolithiasis. Elevated LDH may be a clue to the diagnosis, but unlike 92% of the reviewed cases, our patient presented with a normal value. This case suggests that clinicians should consider RI in patients with persistent symptoms for whom more common causes of flank pain have been excluded; including in nonsmoking patients without apparent risk factors for infarction who present with a normal LDH and no leukocytosis.

  7. Effects of Tribuli Saponins on Left Ventricular Remodeling after Acute Myocardial Infarction in Rats with Hyperlipidemia

    Institute of Scientific and Technical Information of China (English)

    GUO Yan; YIN Hui-jun; SHI Da-zhuo; CHEN Ke-ji

    2005-01-01

    Objective: To observe the effect of Tribuli saponins (TS) on left ventricularremodeling after acute myocardial infarction(AMI) in rats with hyperlipemia. Methods: A composite model of myocardial infarction and hyperlipemia was established and treated with TS to observe its effect on cardiac structure and function by echocardiography. Results: (1) Cardiac function: As compared with the model group, the fractional shortening (FS) and ejection fraction (EF) got increased, and the left ventricular end diastolic volume (LVEDV) and systolic volume (LVESV) got lower in the groups treated with high dose TS and simvastatin ( P<0.05 or P<0.01 ), but difference between the two treated groups was insignificant. (2) Cardiac structure: As compared with the model group, the left ventricular dimension end diastole (LVDd) and systole (LVDs) in the groups treated with high dose TS and simvastatin got lower ( P<0.05 or P<0.01 ). No treatment showed any effect on the thickness of ventricular wall. (3)Ventricular weight index: Both high dose TS and simvastatin could decrease the left ventricular weight index (LVWI) ( P<0.05). Conclusion: TS could attenuate the left ventricular remodeling after acute myocardial infarction to certain extent, and improve cardiac function in the early phase after AMI, thus playing an important role in controlling morbidity and mortality of cardiac events and long-term prognosis.

  8. Electrocardiographic localization of infarct related coronary artery in acute ST elevation myocardial infarction

    OpenAIRE

    C.S. Thejanandan Reddy; D Rajasekhar; Vanajakshamma, V.

    2013-01-01

    The electrocardiogram (ECG) remains a crucial tool in the identification and management of acute myocardial infarction (MI). A detailed analysis of patterns of ST-segment elevation may influence decisions regarding the use of reperfusion therapy. The early and accurate identification of the infarct-related artery on the ECG can help predict the amount of myocardium at risk and guide decisions regarding the urgency of revascularization. The specificity of the ECG in acute MI is lim...

  9. Malignant Hemispheric Cerebral Infarction Associated with Idiopathic Systemic Capillary Leak Syndrome

    Directory of Open Access Journals (Sweden)

    Kei Miyata

    2013-10-01

    Full Text Available Idiopathic systemic capillary leak syndrome (ISCLS is a rare condition that is characterized by unexplained episodic capillary hyperpermeability due to a shift of fluid and protein from the intravascular to the interstitial space. This results in diffuse general swelling, fetal hypovolemic shock, hypoalbuminemia, and hemoconcentration. Although ISCLS rarely induces cerebral infarction, we experienced a patient who deteriorated and was comatose as a result of massive cerebral infarction associated with ISCLS. In this case, severe hypotensive shock, general edema, hemiparesis, and aphasia appeared after serious antecedent gastrointestinal symptoms. Progressive life-threatening ischemic cerebral edema required decompressive hemicraniectomy. The patient experienced another episode of severe hypotension and limb edema that resulted in multiple extremity compartment syndrome. Treatment entailed forearm and calf fasciotomies. Cerebral edema in the ischemic brain progresses rapidly in patients suffering from ISCLS. Strict control of fluid volume resuscitation and aggressive diuretic therapy may be needed during the post-leak phase of fluid remobilization.

  10. [Hemodynamics after prindolol and digitalis in acute myocardial infarction (author's transl)].

    Science.gov (United States)

    Bachour, G; Bender, F; Hochrein, H

    1976-03-01

    In 20 patients with acute myocardial infarction hemodynamic controls were performed after digitalisation and following i.v. injection of 0,4 mg of Prindolol. Circulatory changes were most pronounced 5-15 min after Prindolol injection and consisted of decrease in heart rate of 7%, mean arterial blood pressure of 6%, cardiac output of 10,5%, stroke volume index of 5,1% and left ventricular work of 18%. An increase of pulmonary wedge pressure of 17%, pulmonary pressure of 9%, mean right atrial pressure of 16% and peripheral arterial resistance of 6% were calculated. In 5 cases a favourable effect on extrasystoles and in 2 cases on sinus tachycardia were observed. Not infrequently, during the initial phase of acute myocardial infarction, a hyperadrenergic state may be noted. Prindolol may be indicated, when circulatory changes or arrhythmias are suspect to be the result of this hyperadrenergic stimulation. A simultaneous digitalisation may inhibit a more intensive cardiodepression. PMID:57564

  11. Comparison of stroke infarction between CT perfusion and diffusion weighted imaging: preliminary results

    Science.gov (United States)

    Abd. Rahni, Ashrani Aizzuddin; Arka, Israna Hossain; Chellappan, Kalaivani; Mukari, Shahizon Azura; Law, Zhe Kang; Sahathevan, Ramesh

    2016-03-01

    In this paper we present preliminary results of comparison of automatic segmentations of the infarct core, between that obtained from CT perfusion (based on time to peak parameter) and diffusion weighted imaging (DWI). For each patient, the two imaging volumes were automatically co-registered to a common frame of reference based on an acquired CT angiography image. The accuracy of image registration is measured by the overlap of the segmented brain from both images (CT perfusion and DWI), measured within their common field of view. Due to the limitations of the study, DWI was acquired as a follow up scan up to a week after initial CT based imaging. However, we found significant overlap of the segmented brain (Jaccard indices of approximately 0.8) and the percentage of infarcted brain tissue from the two modalities were still fairly highly correlated (correlation coefficient of approximately 0.9). The results are promising with more data needed in future for clinical inference.

  12. SPECT analysis of recent cerebral infarction

    DEFF Research Database (Denmark)

    Raynaud, C; Rancurel, G; Tzourio, N;

    1989-01-01

    We measured regional cerebral blood flow and [123I]iodoamphetamine (IMP) uptake in 16 patients with unilateral brain infarcts during the subacute period (Day 3 to Day 50) and again after 3 months. Our results show that the central and peripheral areas described earlier in the chronic period were...

  13. Unilateral adrenal hemorrhagic infarction in essential thrombocythemia.

    Science.gov (United States)

    Burnet, G; Lambert, M; Annet, L; Lefebvre, C

    2015-12-01

    Adrenal hemorrhage is a rare disease associated with various conditions. We report a case of a 68-year-old woman with abdominal and back pain. The diagnostic work-up showed a left adrenal gland infarction associated with essential thrombocythemia. Treatment consisted in painkillers and treating the underlying condition in order to prevent further thrombotic events.

  14. Pseudoxanthoma elasticum presenting with myocardial infarction.

    OpenAIRE

    Slade, A K; John, R.M.; Swanton, R H

    1990-01-01

    A 31 year old man presented with an anterior myocardial infarction. He had a history of recurrent gastrointestinal bleeding of obscure cause since childhood and peripheral vascular disease. A clinical diagnosis of the type 1 dominant form of pseudoxanthoma elasticum was supported by histological data from skin biopsy.

  15. Ondine′s curse after brainstem infarction

    OpenAIRE

    Pedroso Jose; Baiense Robson; Scalzaretto Ana; Neto Pedro; Teixeira de Gois Aecio; Ferraz Maria

    2009-01-01

    This report describes a rare case of acquired Ondine′s curse. The patient developed central sleep apnea syndrome named Ondine′s curse after a brainstem infarction. Lesions involving the descending medullocervical pathways that subserve automatic breathing can result in this syndrome.

  16. CORRELATION BETWEEN FIBRINOGEN LEVEL AND CEREBRAL INFARCTION

    Institute of Scientific and Technical Information of China (English)

    Yi-cheng Zhu; Li-ying Cui; Bao-lai Hua; Jia-qi Pan

    2006-01-01

    Objective To investigate the correlation between plasma fibrinogen level and cerebral infarction (CI) as well as the difference of fibrinogen among subtypes of CI.Methods A case-controlled study was conducted with 131 cases of CI and 148 controls. Plasma fibrinogen levels were detected by the Clauss method.Results High fibrinogen level (3.09±0.94 g/L) was correlated with CI (OR=2.47, 95% CI:1.51-4.04,P<0.005) at the onset stage of the disease. Persistent high fibrinogen level (3.14±0.81 g/L) at 6-month after stroke onset was detected and correlated with CI (OR=4.34, 95% CI: 1.80-10. 51,P=0.001). Higher fibrinogen level was correlated with total anterior circulation infarction (TACI), partial anterior circulation infarction (PACI), and posterior circulation infarction (POCI) (OR = 4.008, P<0.001). Higher fibrinogen level was correlated with extracranial atherosclerosis (OR=3.220, P<0.05), but not with intracranial atherosclerosis.Conclusion Fibrinogen level may be a risk factor of CI and probably correlates with subtypes of CI and distributions of atherosclerosis.

  17. Aeromedical transport after acute myocardial infarction

    DEFF Research Database (Denmark)

    Seidelin, Jakob B; Bruun, Niels Eske; Nielsen, Henrik

    2009-01-01

    BACKGROUND: No guidelines exist for the planning of aeromedical repatriation after acute myocardial infarction (AMI). In 2004, we employed a risk evaluation-based decision-making system for repatriation of patients after AMI. The objective was to evaluate the safety of transports during 2005...

  18. THROMBOLYTIC THERAPY OF ACUTE MYOCARDIAL INFARCTION

    OpenAIRE

    D. P. Sementsov

    2015-01-01

    Importance of thrombolytic therapy for restoration of coronary blood flow in acute myocardial infarction is emphasized. Indications and contraindications, advantages and disadvantages for thrombolysis therapy are discussed. The ways of different thrombolytics implementation, efficacy criteria and possible side effects are also presented.

  19. Acute Thrombo-embolic Renal Infarction

    Directory of Open Access Journals (Sweden)

    Haijiang Zhou

    2016-07-01

    Full Text Available A 65-year-old woman was admitted for acute onset of right lower abdominal pain. She was taking anticoagulant medication regularly for rheumatic valvular disease and atrial fibrillation. Physical examination revealed no obvious abdominal or flank tenderness. Right thrombo-embolic renal infarction was diagnosed after performing computed tomography angiography (CTA.

  20. Acute Thrombo-embolic Renal Infarction.

    Science.gov (United States)

    Zhou, Haijiang; Yan, Yong; Li, Chunsheng; Guo, Shubin

    2016-07-01

    A 65-year-old woman was admitted for acute onset of right lower abdominal pain. She was taking anticoagulant medication regularly for rheumatic valvular disease and atrial fibrillation. Physical examination revealed no obvious abdominal or flank tenderness. Right thrombo-embolic renal infarction was diagnosed after performing computed tomography angiography (CTA).

  1. A rare cause of small bowel infarction

    OpenAIRE

    Lim, L.; Collier, K; Harland, R; Temperley, D

    2011-01-01

    We report a rare case of small bowel infarction due to superior mesenteric artery occlusion secondary to cardiac tumour embolism. To our knowledge, this has not been previously reported in the literature. This case highlights a rare case and reviews current knowledge on the subject.

  2. Unrecognised myocardial infarction in patients with schizophrenia

    DEFF Research Database (Denmark)

    Nielsen, Jimmi; Juel, Jacob; Al Zuhairi, Karam Sadoon Majeed;

    2015-01-01

    OBJECTIVE: Schizophrenia is associated with a reduction of the lifespan by 20 years, with type II diabetes and cardiovascular disease contributing the most to the increased mortality. Unrecognised or silent myocardial infarction (MI) occurs in ~30% of the population, but the rates of unrecognised...

  3. Relation between job strain and myocardial infarction

    DEFF Research Database (Denmark)

    Netterstrøm, B; Nielsen, F E; Kristensen, T S;

    1999-01-01

    OBJECTIVES: To study the influence of different job related and socioeconomic factors for development of myocardial infarction (MI). METHOD: The study was a case-control study of 76 male wage earners who had been admitted to hospital with MI. As a control group 176 male wage earners not admitted...

  4. Right ventricle infarction and its characteristics

    Directory of Open Access Journals (Sweden)

    Nozari Y

    1997-07-01

    Full Text Available Right ventricular (RV infarction presents with clinical spectrum from a rather being, uncomplicated disorder to a serious event. A total of one hundred patients with inferior myocardial infarction (MI retrospectively were studied to determine clinical significance and characteristics of RV infarction in our patients. Data and variables such as demographic features, chief-complain, clinical findings on arrival and during hospitalization, major risk factors, history of corpulmonale, and electrocardiogram were assessed. The mean age was 55±7.4. 16% had RV infarction. 69% were male and 31% female. Silent or atypical presentation was observed in 25%. 36% of men and all of women had previous history of angina pectoris (p=<0.05. In the course of acute inferior MI the frequency of various kinds of complication were higher among patients with RV MI. Early identification can lead to appropriate management and it might contribute to the prevention of some subsequent serious complication. However diagnosis of this condition requires a high degree of suspicion and the early recording of electrocardiagram through right precordial leads

  5. Silent Infarcts with Sickle Cell Anemia

    OpenAIRE

    J Gordon Millichap

    2002-01-01

    The effect of transfusion therapy on the risk for new silent infarct or stroke in children with sickle cell anemia and abnormal transcranial Doppler (TCD) ultrasonography was determined at the University of Miami, FL, and other centers in the STOP trial (Stroke Prevention in Sickle Cell Anemia).

  6. THROMBOLYTIC THERAPY OF ACUTE MYOCARDIAL INFARCTION

    Directory of Open Access Journals (Sweden)

    D. P. Sementsov

    2015-12-01

    Full Text Available Importance of thrombolytic therapy for restoration of coronary blood flow in acute myocardial infarction is emphasized. Indications and contraindications, advantages and disadvantages for thrombolysis therapy are discussed. The ways of different thrombolytics implementation, efficacy criteria and possible side effects are also presented.

  7. Cerebral Blood Volume ASPECTS Is the Best Predictor of Clinical Outcome in Acute Ischemic Stroke: A Retrospective, Combined Semi-Quantitative and Quantitative Assessment.

    Directory of Open Access Journals (Sweden)

    Marina Padroni

    Full Text Available The capability of CT perfusion (CTP Alberta Stroke Program Early CT Score (ASPECTS to predict outcome and identify ischemia severity in acute ischemic stroke (AIS patients is still questioned.62 patients with AIS were imaged within 8 hours of symptom onset by non-contrast CT, CT angiography and CTP scans at admission and 24 hours. CTP ASPECTS was calculated on the affected hemisphere using cerebral blood flow (CBF, cerebral blood volume (CBV and mean transit time (MTT maps by subtracting 1 point for any abnormalities visually detected or measured within multiple cortical circular regions of interest according to previously established thresholds. MTT-CBV ASPECTS was considered as CTP ASPECTS mismatch. Hemorrhagic transformation (HT, recanalization status and reperfusion grade at 24 hours, final infarct volume at 7 days and modified Rankin scale (mRS at 3 months after onset were recorded.Semi-quantitative and quantitative CTP ASPECTS were highly correlated (p<0.00001. CBF, CBV and MTT ASPECTS were higher in patients with no HT and mRS ≤ 2 and inversely associated with final infarct volume and mRS (p values: from p<0.05 to p<0.00001. CTP ASPECTS mismatch was slightly associated with radiological and clinical outcomes (p values: from p<0.05 to p<0.02 only if evaluated quantitatively. A CBV ASPECTS of 9 was the optimal semi-quantitative value for predicting outcome.Our findings suggest that visual inspection of CTP ASPECTS recognizes infarct and ischemic absolute values. Semi-quantitative CBV ASPECTS, but not CTP ASPECTS mismatch, represents a strong prognostic indicator, implying that core extent is the main determinant of outcome, irrespective of penumbra size.

  8. Magnetic resonance diffusion tensor imaging following major ozonated autohemotherapy for treatment of acute cerebral infarction.

    Science.gov (United States)

    Wu, Xiao-Na; Zhang, Tao; Wang, Jun; Liu, Xiao-Yan; Li, Zhen-Sheng; Xiang, Wei; Du, Wei-Qing; Yang, Hong-Jun; Xiong, Tie-Gen; Deng, Wen-Ting; Peng, Kai-Run; Pan, Su-Yue

    2016-07-01

    Major ozonated autohemotherapy has been shown to promote recovery of upper limb motor function in patients with acute cerebral infarction, but whether major ozonated autohemotherapy affects remote injury remains poorly understood. Here, we assumed that major ozonated autohemotherapy contributes to recovery of clinical function, possibly by reducing remote injury after acute cerebral infarction. Sixty acute cerebral infarction patients aged 30-80 years were equally and randomly allocated to ozone treatment and control groups. Patients in the ozone treatment group received medical treatment and major ozonated autohemotherapy (47 mg/L, 100 mL ozone) for 10 ± 2 days. Patients in the control group received medical treatment only. National Institutes of Health Stroke Scale score, modified Rankin scale score, and reduced degree of fractional anisotropy values of brain magnetic resonance diffusion tensor imaging were remarkably decreased, brain function improved, clinical efficiency significantly increased, and no obvious adverse reactions detected in the ozone treatment group compared with the control group. These findings suggest that major ozonated autohemotherapy promotes recovery of neurological function in acute cerebral infarction patients by reducing remote injury, and additionally, exhibits high safety. PMID:27630695

  9. Aortic dissection or renal infarction: Multislice computed tomographic angiography can tell

    Directory of Open Access Journals (Sweden)

    Stojanović Miloš

    2012-01-01

    Full Text Available Introduction. Acute renal infarction as a consequence of renal artery occlusion often goes unrecognized, mostly due to the non-specific clinical features. A quick diagnosis, ideally within three hours of presentation, is a key to renal function recovery. Case Outline. A 62-year-old male patient was admitted with a sudden abdominal pain, right flank pain and nausea. He had a diastolic hypertension at admission and his previous medical history showed atrial fibrillation. Initial clinical diagnosis was aortic dissection. Laboratory findings included elevated lactate dehydrogenase (LDH and serum creatinine levels. There were no signs of aortic dissection or aneurismatic lesions registered during a multislice computed tomographic (MSCT angiography. However, MSCT angiography demonstrated left “upper” renal artery thrombosis and renal infarction - avascular area of the upper two thirds of the left kidney sharply demarcated from the surrounding parenchyma. Both kidneys excreted the contrast. Anticoagulant therapy was initiated, along with antiarrythmic and antihypertensive medications. The follow-up by computed tomography was performed after nine weeks, and it showed a partial revascularization of the previously affected area. Conclusion. Concomitant presence of flank/abdominal pain, an increased risk for thromboembolism and an elevated LDH suggested a possibility of renal infarction. MSCT angiography is a non-invasive and accurate method in the diagnosis of renal artery occlusion and the resulting renal infarction.

  10. [Antithrombotic therapy after myocardial infarction: arguments for the use of acetylsalicylic acid and coumarin derivatives].

    Science.gov (United States)

    Waskowsky, W M; Brouwer, A; Verheugt, F W A

    2005-01-01

    Patients who survived myocardial infarction and who are being treated with the current optimal therapy (antithrombotics, statins and beta-blockers), have a 10-20% chance of death, re-infarction and stroke within in the first year. A possible explanation for this could be an increased activation and generation ofthrombin for at least 6 months following the cardiovascular event preceding preventative therapy. Acetylsalicylic acid and clopidogrel do not affect activation by thrombin of the platelet aggregation and the clotting cascade. The additional use of cumarin derivatives could therefore reduce the chance of recurring thrombotic events, and subsequently improve prognosis. Since the nineteen-nineties several randomised trials have been conducted to study the clinical relevance ofcumarin derivatives both with and without acetylsalicylic acid, in patients who had had a myocardial infarction. The conclusions of these studies were not unambiguous. If the international normalized ratio (INR) was kept > 2 for a long period, by means of frequent check-ups and effective dosage adjustment, the chance of death, recurrent myocardial infarction or stroke was 30-50% lower than when acetylsalicylic acid only was used. The risk of bleeding was raised by 2-4 times, but there were no life-threatening episodes of bleeding. In view of the recent development of anticoagulant agents, for which monitoring seems to be becoming unnecessary, identification of patients who would benefit most from a combined antithrombotic strategy is warranted. PMID:15688836

  11. Inhibition of Cathepsin B Alleviates Secondary Degeneration in Ipsilateral Thalamus After Focal Cerebral Infarction in Adult Rats.

    Science.gov (United States)

    Zuo, Xialin; Hou, Qinghua; Jin, Jizi; Zhan, Lixuan; Li, Xinyu; Sun, Weiwen; Lin, Kunqin; Xu, En

    2016-09-01

    Secondary degeneration in areas beyond ischemic foci can inhibit poststroke recovery. The cysteine protease Cathepsin B (CathB) regulates cell death and intracellular protein catabolism. To investigate the roles of CathB in the development of secondary degeneration in the ventroposterior nucleus (VPN) of the ipsilateral thalamus after focal cerebral infarction, infarct volumes, immunohistochemistry and immunofluorescence, and Western blotting analyses were conducted in a distal middle cerebral artery occlusion (dMCAO) stroke model in adult rats. We observed marked neuron loss and gliosis in the ipsilateral thalamus after dMCAO, and the expression of CathB and cleaved caspase-3 in the VPN was significantly upregulated; glial cells were the major source of CathB. Although it had no effect on infarct volume, delayed intracerebroventricular treatment with the membrane-permeable CathB inhibitor CA-074Me suppressed the expression of CathB and cleaved caspase-3 in ipsilateral VPN and accordingly alleviated the secondary degeneration. These data indicate that CathB mediates a novel mechanism of secondary degeneration in the VPN of the ipsilateral thalamus after focal cortical infarction and suggest that CathB might be a therapeutic target for the prevention of secondary degeneration in patients after stroke.

  12. Direct cardiac injection of G-CSF mobilized bone-marrow stem-cells improves ventricular function in old myocardial infarction.

    Science.gov (United States)

    Archundia, Abel; Aceves, José Luis; López-Hernández, Manuel; Alvarado, Martha; Rodriguez, Emma; Díaz Quiroz, Guillermo; Páez, Araceli; Rojas, Felipe Masso; Montaño, Luis Felipe

    2005-12-01

    Autologous transplant of bone marrow stem cells (BMSC), although extremely useful after acute myocardial events, has not been evaluated in patients with old (>one-year-old) myocardial infarction. Our aim was to determine if CD34(+)-enriched peripheral-blood cells, obtained by apheresis, injected directly into the severely damaged myocardium of five patients with old myocardial infarction could restore depressed myocardial function. We found that 28 weeks after revascularization and peri-infarction injection of the enriched CD34(+) peripheral mononuclear cells, ventricular hemodynamic parameters that included left ventricular ejection fraction, left ventricular diastolic volume, ventricular systolic volume and left ventricular diastolic diameter approximated normal values and there was no restenosis; two patients have been followed for >52 weeks and their parameters are within normal values. In conclusion, intramyocardial injection of easily obtained CD34(+) enriched peripheral blood cells represent an encouraging procedure for patients with severely scarred and dysfunctional myocardium.

  13. 曲美他嗪改善移植微环境对心肌梗死大鼠左心功能的影响%The cardiac functional affection by trimetazidine administration plus bone marrow stem cells transplanting in rats after myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    徐红新; 田毅浩; 江洪; 蒋学俊; 周青; 郭瑞强

    2009-01-01

    目的 采用超声心动图评价曲美他嗪改善移植微环境对心肌梗死大鼠心脏形态及左心功能的影响.方法 40只Wistar大鼠随机分成4组,对照组开胸不结扎,心肌梗死组心肌内注射无血清培养基;干细胞移植组注射骨髓干细胞;干细胞移植+曲美他嗪组注射骨髓干细胞,同时给予曲美他嗪灌胃.移植后4周测量4组实验动物的心脏形态和左心功能.结果 移植组大鼠左室腔内径明显小于心肌梗死组,左室收缩压明显高于心肌梗死组,而舒张末期压则显著降低,左室收缩功能等各项指标亦有明显改善,干细胞移植+曲美他嗪组大鼠上述指标改善更为显著.结论 骨髓干细胞移植可防止心肌梗死后左室腔扩大,有效改善左功能,同时给予曲美他嗪治疗可进一步提高疗效.%Objective To observe the rat cardiac size and cardiac function changes before and after trimetazidine administration plus bone-marrow stem cells transplanting through echocardiography.Methods Forty wistar rats were divided into the following 4 groups randomly:control group (T),myocardial infarction group (Ⅱ),bone marrow stem calls transplantation group (Ⅲ),and bone marrow stem cells transplantation plus trimetazidine administration group(Ⅳ).The rats' left anterior coronary artery in group Ⅱ,Ⅲ and Ⅳwas ligated to produce myocardial infarction model,then bone-marrow stem cells were injected around the infarcted area into the later two groups.Furthermore,rats in group Ⅳ were administrated with trimetazidine.The size and systolic function of the hearts were measured 4 weeks after transplantation.The left ventricular systolic pressure(LVSP) and the end-diastolic pressure(LVEDP) were also measured at the end of experiment.Results The left ventricular diameter of rats in group Ⅲ and Ⅳ was smaller than that in group Ⅱ,and the ventricular systolic function increased,LVSP increased and LVEDP decreased statistically in group Ⅲ and

  14. Factors influencing prehospital delay for patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Shujuan CHENG; Lufen GUO; Juyuan LIU; Xiaoling ZHU; Hongbing YAN

    2007-01-01

    Objective To investigate the influencing factors for prehospital delay in patients with acute myocardial infarction (AMI).Methods A total of 807 consecutive patients with AMI who presented to the emergency department of Beijing Anzhen Hospital were analyzed. The influence of several potential risk factors on the prehospital delay time (PDT) was evaluated by comparing patients admitted more than 2 hours after onset of chese pain with those admitted within 2 hours after onset. Results Among 807 patients, 402 came to the hospital within 2 hours while the others arrived at the hospital after 2 hours. The median PDT was 130 min. Among the potential variables, advanced age, history of diabetes mellitus, occurrence of symptom at night and use of emergency medical service significantly affected PDT by multivariate analysis. Conclusion Interventions aimed at reducing the prehospital delay in AMI should primarily focus on the awareness of the risk and help-seeking behavior of patients.

  15. Management of Acute Myocardial Infarction and its Effect on Women's Health (Female Versus Male)

    OpenAIRE

    Elnaz Asghari; Mohammad Reza Taban Sadeghi; Razieh Parizad; Nasrin Mohammasdi jhale

    2014-01-01

    Objectives: Acute Myocardial Infarction (AMI) has traditionally been considered a disease affecting mostly men, yet women are increasingly at risk due to the obesity and diabetes. This study used archival data on hospital discharges from the cardiac care unit (CCU) to examine the AMI risk factors and its management among female patients' presentations at emergency rooms (ER) ended at CCU with a concurrent diagnosis of AMI and to compare the results with men of the same diagnosis. Materials...

  16. Strategies to improve outcome in patients with ST elevation myocardial infarction treated with primary PCI

    OpenAIRE

    Tödt, Tim

    2012-01-01

    Background: ST elevation myocardial infarction (STEMI) caused by a ruptured atherosclerotic plaque with overlying thrombosis leads to ischemia and progressively to the death of the myocardial cells supplied by the affected coronary artery. Rapid reperfusion with primary Percutaneous Coronary Intervention (PCI) in an experienced centre is the preferred therapy for these patients. The aim of the research program on which this thesis is based was to study the effect of antiplatelet therapy with ...

  17. Spontaneous gastric ulcer perforation and acute spleen infarction caused by invasive gastric and splenic mucormycosis

    Directory of Open Access Journals (Sweden)

    Mushira Abdulaziz Enani

    2014-01-01

    Full Text Available Mucormycosis is a rare life-threatening fungal infection mostly affecting immunocompromised hosts. The main categories of human disease with the Mucorales are sinusitis/rhinocerebral, pulmonary, cutaneous/subcutaneous, gastrointestinal and disseminated disease. Other disease states occur with a much lower frequency and include cystitis, vaginitis; external otitis and allergic disease. We report a diabetic patient with comorbidities, who developed gastric perforation clinically indistinguishable from perforated peptic ulcer due to invasive gastric mucormycosis complicated by spleen infarction.

  18. Spontaneous gastric ulcer perforation and acute spleen infarction caused by invasive gastric and splenic mucormycosis.

    Science.gov (United States)

    Enani, Mushira Abdulaziz; Alharthi, Bandar N; Dewanjee, Nancy; Bhat, Nadeem A; Fagih, Mosa

    2014-07-01

    Mucormycosis is a rare life-threatening fungal infection mostly affecting immunocompromised hosts. The main categories of human disease with the Mucorales are sinusitis/rhinocerebral, pulmonary, cutaneous/subcutaneous, gastrointestinal and disseminated disease. Other disease states occur with a much lower frequency and include cystitis, vaginitis; external otitis and allergic disease. We report a diabetic patient with comorbidities, who developed gastric perforation clinically indistinguishable from perforated peptic ulcer due to invasive gastric mucormycosis complicated by spleen infarction.

  19. Estimation of Subjective Stress in Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Chockalingam A

    2003-01-01

    Full Text Available BACKGROUND and AIMS: Mental stress is considered to be a precipitating factor in acute coronary events. We aimed to assess the association of subjective or 'perceived' mental stress with the occurrence of acute coronary events. SETTINGS AND DESIGN: Prospective case-control survey was carried out in a referral teaching hospital. subjects & METHODS: Consecutive patients with acute myocardial infarction and ST elevation on electrocardiogram who were admitted to the Coronary Care Unit of a referral teaching hospital were enrolled in the study as cases. Controls were unmatched and were enrolled from amongst patients with coronary artery disease who did not have recent acute coronary events. Subjective Stress Functional Classification (SS-FC for the preceding 2-4 weeks was assessed and assigned four grades from I to IV as follows: I - baseline, II - more than usual but not affecting daily routine, III - significantly high stress affecting daily routine and IV - worst stress in life. STATISTICAL ANALYSIS: Proportions of different characteristics were compared using chi-square test with Yates continuity correction. Student's unpaired t test was applied for mean age. 'p' value of < 0.05 was considered statistically significant. RESULTS: SS-FC could be reliably (99% and easily assessed. Eighty (53% of the total 150 patients with acute MI reported 'high' levels of stress (stress class III and IV. This is in contrast to only 30 (20% of 150 healthy controls reporting high stress for the same period (p value < 0.001. CONCLUSION: Patients with acute myocardial infarction report a higher subjective mental stress during 2 to 4 weeks preceding the acute coronary event.

  20. MicroRNA miR-1 is up-regulated in remote myocardium in patients with myocardial infarction.

    Science.gov (United States)

    Bostjancic, E; Zidar, N; Stajner, D; Glavac, D

    2010-01-01

    MicroRNAs are small regulatory RNA molecules that mediate regulation of gene expression, thus affecting a variety of physiological, developmental and pathological conditions. They are believed to be new promising therapeutic targets. In recent studies two muscle-specific microRNAs were discovered to contribute to heart diseases and development: miR-1 and miR-133, but there is little data on their expression patterns in human myocardial infarction. We performed simultaneous expression analysis of miR-1, miR-133a, miR-133b in samples of infarcted tissue and remote myocardium from twenty- four patients with acute myocardial infarction. MicroRNA expression was analysed using quantitative real-time PCR and compared to the expression patterns in myocardium of eight healthy adults who died in accidents. We found ~3.8-fold miR-1 up-regulation in remote myocardium when compared to infarcted tissue or healthy adult hearts. As miR-1 has been shown in animal models and clinical studies to contribute to arrhythmogenesis by regulating pacemaker channel genes, our finding of miR-1 up-regulation in patients with myocardial infarction indicates that it might be responsible for the higher risk for arrhythmias in these patients. In addition, miR-133a/b down-regulation in infarcted tissue and remote myocardium was observed, indicating miR-133a/b involvement in the heart response to myocardial infarction. We conclude that miR-1 and miR-133 seem to be important regulators of heart adaptation after ischaemic stress.

  1. Allograftic bone marrow-derived mesenchymal stem cells transplanted into heart infarcted model of rabbit to renovate infarcted heart

    Institute of Scientific and Technical Information of China (English)

    王建安; 李长岭; 樊友启; 何红; 孙勇

    2004-01-01

    Objective: To investigate the directed transplantation of allograftic bone marrow-derived mesenchymal stem cells (MSCs) in myocardial infarcted (MI) model rabbits. Materials and Methods: Rabbits were divided into 3 groups, heart infarcted model with MSCs transplanted treatment (MSCs group, n=12), heart infarcted model with PBS injection (control group, n=20), sham operation with PBS injection (sham group, n=17). MSCs labelled by BrdUrd were injected into the MI area of the MSCs group. The same volume of PBS was injected into the MI area of the control group and sham group. The mortality, LVIDd, LVIDs and LVEF of the two groups were compared 4 weeks later. Tropomyosin inhibitory component (Tn Ⅰ) and BrdUrd immunohistochemistry identified the engrafted cells 4 weeks after transplantation. Result: The mortality of the MSCs group was 16.7% (2/12), and remarkably lower than the control group's mortality [35% (7/20) (P<0.05)]. Among the animals that survived for 4 weeks, the LVIDd and LVIDs of the MSCs group after operation were 1.17±0.21cm and 0.74±0.13cm, and remarkably lower than those of the model group, which were 1.64±0.14cm and 1.19±0.12cm (P<0.05); the LVEF of the MSCs group after operation was 63±6%, and remarkably higher than that of the model group, which was 53±6% (P<0.05). Among the 10 cases of animals that survived for 4 weeks in the MSCs group, in 8 cases (80%), the transplanted cells survived in the non MI, MI region and its periphery, and even farther away; part of them differentiated into cardiomyocytes; in 7 cases (70%), the transplanted cells participated in the formation of blood vessel tissue in the MI region. Conclusion: Transplanted allograftic MSCs can survive and differentiate into cardiomyocytes, form the blood vessels in the MI region. MSCs transplantation could improve the heart function after MI.

  2. Allograftic bone marrow-derived mesenchymal stem cells transplanted into heart infarcted model of rabbit to renovate infarcted heart

    Institute of Scientific and Technical Information of China (English)

    王建安; 李长岭; 樊友启; 何红; 孙勇

    2004-01-01

    Objective: To investigate the directed transplantation of allograftic bone marrow-derived mesenchymal stem cells (MSCs) in myocardial infarcted (MI) model rabbits. Materials and Methods: Rabbits were divided into 3 groups, heart infarcted model with MSCs transplanted treatment (MSCs group, n=12), heart infarcted model with PBS injection (control group, n=20), sham operation with PBS injection (sham group, n=l 7). MSCs labelled by BrdUrd were injected into the MI area of the MSCs group. The same volume of PBS was injected into the MI area of the control group and sham group. The mortality, LVIDd, LVIDs and LVEF Of the two groups were compared 4 weeks later. Tropomyosin inhibitory component (Tn I) and BrdUrd immunohistochemistry identified the engrafted cells 4 weeks after transplantation. Result: The mortality of the MSCs group was 16.7% (2/12), and remarkably lower than the control group's mortality [35% (7/20) (P<0.05)].Among the animals that survived for 4 weeks, the LVIDd and LVIDs of the MSCs group after operation were 1.17±0.21 cm and 0.74±0.13 cm, and remarkably lower than those of the model group, which were 1.64±0.14 cm and 1.19±0.12 cm (P<0.05); the LVEF of the MSCs group after operation was 63±6%, and remarkably higher than that of the model group,which was 53±6% (P<0.05). Among the 10 cases of animals that survived for 4 weeks in the MSCs group, in 8 cases (80%),the transplanted cells survived in the non MI, MI region and its periphery, and even farther away; part of them differentiated into cardiomyocytes; in 7 cases (70%), the transplanted cells participated in the formation of blood vessel tissue in the MI region. Conclusion: Transplanted allograftic MSCs can survive and differentiate into cardiomyocytes, form the blood vessels in the MI region. MSCs transplantation could improve the heart function after MI.

  3. Nanog expression in heart tissues induced by acute myocardial infarction.

    Science.gov (United States)

    Luo, Huanhuan; Li, Qiong; Pramanik, Jogen; Luo, Jiankai; Guo, Zhikun

    2014-10-01

    Nanog is a potential stem cell marker and is considered a regeneration factor during tissue repair. In the present study, we investigated expression patterns of nanog in the rat heart after acute myocardial infarction by semi-quantitative RT-PCR, immunohistochemistry and Western blot analyses. Our results show that nanog at both mRNA and protein levels is positively expressed in myocardial cells, fibroblasts and small round cells in different myocardial zones at different stages after myocardial infarction, showing a spatio-temporal and dynamic change. After myocardial infarction, the nanog expression in fibroblasts and small round cells in the infarcted zone (IZ) is much stronger than that in the margin zone (MZ) and remote infarcted zone (RIZ). From day 7 after myocardial infarction, the fibroblasts and small cells strongly expressed nanog protein in the IZ, and a few myocardial cells in the MZ and the RIZ and the numbers of nanog-positive fibroblasts and small cells reached the highest peak at 21 days after myocardial infarction, but in this period the number of nanog-positive myocardial cells decreased gradually. At 28 days after myocardial infarction, the numbers of all nanog-positive cells decreased into a low level. Therefore, our data suggest that all myocardial cells, fibroblasts and small round cells are involved in myocardial reconstruction after cardiac infarction. The nanog-positive myocardial cells may respond to early myocardial repair, and the nanog-positive fibroblasts and small round cells are the main source for myocardial reconstruction after cardiac infarction.

  4. Enlarged perivascular spaces and lacunar infarction Cerebral magnetic resonance evaluation

    Institute of Scientific and Technical Information of China (English)

    Weihong Yan; Jing Fang; Cuijuan Zhou

    2008-01-01

    BACKGROUND:Previous studies have demonstrated that enlarged perivascular spaces(EPVS)arg a result of microvaseular disease.To date,there age few reports about the relationship between EPVS and lacunar infarction.OBJECTIVE:To investigate whether EPVS is associated with lacunar infarction on the basis of cerebral magnetic resonance(MR)examination,clinical symptoms and signs,and past medical history of patients.DESIGN,TIME AND SETTING:Case contrast analysis was performed at the Department of Neurology,Shanghai Ninth People's Hospital from January 2007 to January 2008.PARTICIPANTS:Sixty-eight patients with lacunar infarction were admired to the Department of Neurology of Shanghai Ninth People's Hospital,including 37 cases with first-ever infarction,and 31 with infarction recurrence.In addition,53 healthy people were selected as controls.METHODS:All participants underwent past medical history investigation,nervous system examination.and cranial MR.The subjects were assessed using the JMW rating scale to identify the EPVS grade.MAIN OUTCOME MEASURES:EPVS scores of patients and controls;risk factors for cerebral vascular disease in patients with first-ever or recurrence of lacunar infarction.RESULTS:The EPVS grade from lacunar infarction patients was significantly higher than of the control group(P<0.05).The EPVS grade in patients with recurring lacunar infarction was significantly higher than in patients with first-ever infarction(P<0.05).In addition,hypertension incidence in patients with recurring lacunar infarction was significantly higher than in patients wim first-ever infarction (P<0.05).CONCLUSION:Results indicate that EPVS is related to the incidence of lacunar infarction.Earlier screening of EPVS.and the evaluation of EPVS severity,is of great importance to control the risk factors for cerebral vascular disease and to prevent lacunar infarction.

  5. [Prehospital thrombolytic therapy in acute myocardial infarction].

    Science.gov (United States)

    Carlsson, J; Schuster, H P; Tebbe, U

    1997-10-01

    The extent of myocardial damage occurring during acute myocardial infarction is time dependent, and there is abundant evidence from most clinical trials that mortality reduction is greatest in patients treated early with thrombolytic agents, although beneficial effects have been shown with treatment initiated up to 12 h after onset of symptoms. All studies on prehospital thrombolysis have conclusively shown the practicability and safety of patient selection and administration of the thrombolytic agent. The accuracy of diagnosis in the prehospital setting was comparable to trials of in-hospital thrombolysis, e.g., in the Myocardial Infarction Triage and Intervention Project (MITI) 98% of the patients enrolled had subsequent evidence of acute myocardial infarction. With regard to time savings, all randomized studies showed positive results. The smallest time gain was observed in the MITI trial: prehospital-treated patients received thrombolytic therapy an average of 33 min earlier than those treated in hospital. In the European Myocardial Infarction Project (EMIP) the difference in time between prehospital and hospital treatment was a median of 55 min. However, none of these trials was able to show a significant short-term mortality difference between the two groups. Only a meta analysis of five randomized studies with a combined median time gain of about 60 min showed a significant 17% reduction in short-term mortality for patients who received thrombolytic therapy in the prehospital phase. In the Grampian Region Early Anistreplase Trial (GREAT), a study performed in a more rural area than other studies, the time gain by prehospital initiation of thrombolysis was a median of 130 min. GREAT was the only study to date reporting a significant mortality benefit for prehospital-treated patients after 3 months and 1 year. In conclusion, prehospital thrombolysis is feasible and safe. Patients with acute myocardial infarction can be correctly identified and treated with

  6. Longitudinal Assessment of Motor Recovery of Contralateral Hand after Basal Ganglia Infarction Using Functional Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Yue Fu

    2016-01-01

    Full Text Available We used functional fMRI to study the brain activation during active finger movements at different time points during the recovery phase following basal ganglia infarction. Four hemiplegic patients with basal ganglia infarction were serially evaluated at different time points spanning the acute and chronic phase using fMRI. To evaluate motor recovery, the patients were asked to perform functional tasks arranged in a block design manner with their hand. On follow-up (chronic phase, three patients achieved significant recovery of motor function of affected limbs. Activation of bilateral sensorimotor cortex (SMC was observed in two of these patients, while activation of cerebellum was observed in all patients. No remarkable recovery of motor function was noted in one patient with left basal ganglia infarction. In this patient, the activation domain was located in SMC of both sides in acute phase and in ipsilateral SMC in chronic phase. Contralateral SMC appears to be involved in the functional rehabilitation following basal ganglia infarction. The cerebellum may act as an intermediary during functional recovery following basal ganglia infarction. The activation domain associated with active finger movement may be bilateral in acute phase; one patient was ipsilateral in the chronic stage.

  7. Treatment with the gap junction modifier rotigaptide (ZP123) reduces infarct size in rats with chronic myocardial infarction.

    Science.gov (United States)

    Haugan, Ketil; Marcussen, Niels; Kjølbye, Anne Louise; Nielsen, Morten Schak; Hennan, James K; Petersen, Jørgen Søberg

    2006-02-01

    Treatment with non-selective drugs (eg, long-chain alcohols, halothane) that reduce gap junction intercellular communication (GJIC) is associated with reduced infarct size after myocardial infarction (MI). Therefore, it has been suggested that gap junction intercellular communication stimulating compounds may increase infarct size. The antiarrhythmic peptide analogue rotigaptide (ZP123) increases cardiac gap junction intercellular communication and the purpose of the present study was to examine the effects of rotigaptide treatment on infarct size. Myocardial infarction was induced in male rats by ligation of the left anterior descending artery (LAD). Rats (n = 156) were treated with rotigaptide at three dose levels or vehicle from the onset of ischemia and for 3 weeks following LAD occlusion. Infarct size was determined using histomorphometry after 3 weeks treatment. Rotigaptide treatment producing steady state plasma levels of 0.8 +/- 0.1, 5.5 +/- 0.5, and 86 +/- 8 nmol/L had no effect on mortality, but reduced infarct size to 90 +/- 10% (P = 0.41), 67 +/- 7% (P = 0.005), and 82 +/- 7% (P = 0.13), respectively relative to vehicle-treated myocardial infarction rats (100 +/- 12%). In contrast to what was predicted, our data demonstrates that rotigaptide treatment was associated with a significant infarct size reduction. We conclude that whereas treatment with non-selective inhibitors of gap junction intercellular communication cause a reduction in infarct size, this information cannot be extrapolated to the effects of compounds that selectively increase gap junction intercellular communication.

  8. Infarct topography and hemiparesis profiles with cerebral convexity infarction: the Stroke Data Bank.

    Science.gov (United States)

    Mohr, J P; Foulkes, M A; Polis, A T; Hier, D B; Kase, C S; Price, T R; Tatemichi, T K; Wolf, P A

    1993-01-01

    For the 183 of 1276 patients in the NINDS Stroke Data Bank with convexity infarction in the middle cerebral artery territory, the size of the infarct did not differ between the two sides but the location of the main site of the infarct differed: on the left side, it was centred in the inferior parietal region, and was mid-frontal on the right. There was a good correlation between infarct size and weakness severity whether estimated by overall motor function on one side, arm, or hand alone. There was a poor correlation, however, for lesion location (lower third, middle third or upper third on either side of the Rolandic fissure) and any of the specific syndromes of focal weakness, no two cases sharing the same lesion for the same syndrome and several cases sharing the same lesion with a different syndrome. The findings indicated a difference in weakness syndromes between the two hemispheres and great individual variation of the acute syndrome caused by a given site of focal infarction along the Rolandic convexity. These variations may explain some of the difficulties showing effects of a given therapeutic agent in studies of acute ischaemic stroke. Large sample sizes will be required for the reliable assessment of any treatment using currently popular clinical stroke scales. Images PMID:8482953

  9. The relation between hypointense core, microvascular obstruction and intramyocardial haemorrhage in acute reperfused myocardial infarction assessed by cardiac magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kandler, Diana; Luecke, Christian; Grothoff, Matthias; Andres, Claudia; Lehmkuhl, Lukas; Nitzsche, Stefan; Riese, Franziska; Gutberlet, Matthias [University Leipzig - Heart Centre, Department of Diagnostic and Interventional Radiology, Leipzig (Germany); Mende, Meinhard [University Leipzig, Coordination Centre for Clinical Trials, Leipzig (Germany); Waha, Suzanne de; Desch, Steffen; Lurz, Philipp; Eitel, Ingo [University Leipzig - Heart Centre, Department of Internal Medicine/ Cardiology, Leipzig (Germany)

    2014-12-15

    Intramyocardial haemorrhage (IMH) and microvascular obstruction (MVO) represent reperfusion injury after reperfused ST-elevation myocardial infarction (STEMI) with prognostic impact and ''hypointense core'' (HIC) appearance in T{sub 2}-weighted images. We aimed to distinguish between IMH and MVO by using T{sub 2}{sup *}-weighted cardiovascular magnetic resonance imaging (CMR) and analysed influencing factors for IMH development. A total of 151 patients with acute STEMI underwent CMR after primary angioplasty. T{sub 2}-STIR sequences were used to identify HIC, late gadolinium enhancement to visualise MVO and T{sub 2}{sup *}-weighted sequences to detect IMH. IMH{sup +}/IMH{sup -} patients were compared considering infarct size, myocardial salvage, thrombolysis in myocardial infarction (TIMI) flow, reperfusion time, ventricular volumes, function and pre-interventional medication. Seventy-six patients (50 %) were IMH{sup +}, 82 (54 %) demonstrated HIC and 100 (66 %) MVO. IMH was detectable without HIC in 16 %, without MVO in 5 % and HIC without MVO in 6 %. Multivariable analyses revealed that IMH was associated with significant lower left ventricular ejection fraction and myocardial salvage index, larger left ventricular volume and infarct size. Patients with TIMI flow grade ≤1 before angioplasty demonstrated IMH significantly more often. IMH is associated with impaired left ventricular function and higher infarct size. T{sub 2} and HIC imaging showed moderate agreement for IMH detection. T{sub 2}{sup *} imaging might be the preferred CMR imaging method for comprehensive IMH assessment. (orig.)

  10. Acupuncture Therapy for Multiple Infarctional Dementia

    Institute of Scientific and Technical Information of China (English)

    SHEN Wei-dong; XIAO Yuan-chun

    2003-01-01

    Purpose To observe the clinical efficacy of combined electro-acupuncture and moxibustion in the treatment of multiple infarctional dementia. Methods Eighty-eight patients were randomized into two groups:treatment group in which 48 cases were treated by combined electro-acupuncture and moxibustion and control group in which 40 cases were treated by oral administration of Huperzine A. Results The total effective rate was 90% in treatment group and 71% in control group,with a significant difference ( P < 0.05 ); the score of Mini-mental State Examination (MMSE) increased more obviously in treatment group than in control group (P<0.05). Conclusion Combined electro-acupuncture and moxibustion is effective in improving the clinical symptoms of multiple infarctional dementia.

  11. MR imaging of acute hemorrhagic brain infarction

    International Nuclear Information System (INIS)

    Six patients with acute hemorrhagic brain infarct were imaged using spin-echo (SE) pulse sequences on a 1.5 Tesla MR scanner. Including two patients with repeated MR imaging, a total of eight examinations, all performed within 15 days after stroke, were analyzed retrospectively. Four patients revealed massive hemorrhages in the basal ganglia or cerebellum and three cases demonstrated multiple linear hemorrhages in the cerebral cortex. On T1-weighted images, hemorrhages were either mildly or definitely hyperintense relative to gray matter, while varied from mildly hypointense to hyperintense on T2-weighted images. T1-weighted images were superior to T2-weighted images in detection of hemorrhgage. CT failed to detect hemorrhage in two of five cases: indicative of MR superiority to CT in the diagnosis of acute hemorrhagic infarcts. (author)

  12. MR imaging of acute hemorrhagic brain infarction

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Ohnari, Norihiro; Ohno, Masato (Kyushu Rosai Hospital, Fukuoka (Japan))

    1989-11-01

    Six patients with acute hemorrhagic brain infarct were imaged using spin-echo (SE) pulse sequences on a 1.5 Tesla MR scanner. Including two patients with repeated MR imaging, a total of eight examinations, all performed within 15 days after stroke, were analyzed retrospectively. Four patients revealed massive hemorrhages in the basal ganglia or cerebellum and three cases demonstrated multiple linear hemorrhages in the cerebral cortex. On T1-weighted images, hemorrhages were either mildly or definitely hyperintense relative to gray matter, while varied from mildly hypointense to hyperintense on T2-weighted images. T1-weighted images were superior to T2-weighted images in detection of hemorrhgage. CT failed to detect hemorrhage in two of five cases: indicative of MR superiority to CT in the diagnosis of acute hemorrhagic infarcts. (author).

  13. MR imaging of acute myocardial infarction

    International Nuclear Information System (INIS)

    This paper reports on superparamagnetic iron oxide particles (AMI-25) evaluated in comparison with paramagnetic Gd-DOTA for the MR evaluation of acute myocardial infarct size. Twelve openchest dogs underwent 2 hours of LAD occlusion followed by 6 hours of reperfusion. AMI-25 and Gd-DOTA were intravenously injected 1 hour and 10 minutes before euthanasia, respectively, in two groups of six dogs. Gradient-echo and T1- and T2-weighted spin-echo images were obtained in six AMI-25-injected excised hearts, and T1- and T2-weighted images in six Gd-DOTA injected excised hearts. Infarct size was evaluated by planimetry of each 8-mm-thick transverse slice after ex vivo double staining and correlated with the planimetry of each 8-mm-thick transverse MR section

  14. The tole of ischemic preconditioning in acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Ristić Anđelka

    2005-01-01

    Full Text Available Introduction Ischemic preconditioning is a phenomenon in which brief episodes of ischemia and reperfusion increase myocardial tolerance and substantially reduce the infarction size. Case report Two patients with acute left anterior descending artery occlusion received fibrinolytic therapy within 6 hours of symptom onset, but nevertheless developed myocardial infarctions of different size. The first patient, without a history of preinfarction angina, developed a large anterior infarction, because there was no time for ischemic preconditioning or development of coronary collateral vessels. The second patient, with a 4-day history of preinfarction angina, had a more favorable outcome-he developed apical necrosis, with greater myocardial viability in the infarct-related area. Conclusion The beneficial effects of angina occurring 24-48h before infarction are resulting from ischemic preconditioning, which reduces cardiac mortality, infarct size and occurrence of life-threatening ventricular arrhythmias. .

  15. Gas Embolic Stroke Secondary to Bowel Infarction.

    Science.gov (United States)

    Parikh, Dhruv; Leyon, Joe Joseph; Chavda, Swarupsinh

    2016-01-01

    A 69-year-old gentleman with metastatic esophageal adenocarcinoma presented with acute abdominal pain to the emergency medicine department and subsequently developed an acute left hemiplegia while in the resuscitation unit. An unenhanced computed tomography (CT) scan of the head showed right frontal cerebral gas emboli while an unenhanced CT scan of the abdomen and pelvis showed extensive portal venous gas and pneumatosis intestinalis, presumed secondary to bowel infarction.

  16. Acute Myocardial Infarction, 1992-2001.

    OpenAIRE

    Robert Schmitz

    2005-01-01

    Heart disease is the leading cause of hospitalization and death in the United States among persons age 65 and older. Acute myocardial infarction (AMI), more commonly known as heart attack, accounted for more than 321,000 hospitalizations among Medicare beneficiaries in 2001. This report presents trends in AMI hospitalization, readmission, and mortality rates from 1992 through 2001 among Medicare fee-for-service beneficiaries across various demographic groups.

  17. Myocardial infarction induced by spontaneous pneumothorax

    OpenAIRE

    Clarke, Viktoriya; McWilliams, Eric

    2010-01-01

    Chest pain is a very common condition. Patients may have a benign condition or present with a potentially lethal condition such as acute myocardial infarction, aortic dissection or tension pneumothorax. It is important to remember that patients may present with more than one serious pathology and that other serious conditions may potentially precipitate an acute coronary syndrome in a susceptible individual. We report the case of an elderly man with a background of chronic obstructive pulmona...

  18. Fatigue in Older Adults Post Myocardial Infarction

    OpenAIRE

    Patricia Barton Crane; Jimmy eEfird; Willie Mae Abel

    2016-01-01

    Objective. The purpose of this study was to comprehensively examine putative factors that may independently contribute to fatigue and subsequent persistence of fatigue in elderly adults 6-8 months post myocardial infarction (MI). Studies suggest cardiac function, comorbidities, daytime sleepiness, depression, anemia, interleukins, and social support are correlates of fatigue; however, no studies have systematically examined these factors 6 months post MI in an aging population. Methods. Study...

  19. Fatigue in Older Adults Postmyocardial Infarction

    OpenAIRE

    Crane, Patricia Barton; Jimmy T. Efird; Abel, Willie Mae

    2016-01-01

    Objective The purpose of this study was to comprehensively examine putative factors that may independently contribute to fatigue and subsequent persistence of fatigue in elderly adults 6–8 months post-myocardial infarction (MI). Studies suggest cardiac function, comorbidities, daytime sleepiness, depression, anemia, interleukins, and social support are correlates of fatigue; however, no studies have systematically examined these factors 6 months post-MI in an aging population. Methods Study p...

  20. Renal infarction associated with adrenal pheochromocytoma.

    Science.gov (United States)

    Thewjitcharoen, Yotsapon; Atikankul, Taywin; Sunthornyothin, Sarat

    2013-09-01

    The coexistence of pheochromocytoma and renal artery stenosis had been reported occasionally from the possible mechanism of catecholoamine-induced vasospasm and extrinsic compression of renal artery in some reported cases. However, renal infarction caused by pheochromocytoma is an uncommon phenomenon. Herein, we report an interesting case of adrenal pheochromocytoma associated with renal artery thrombosis, which should be included in the differential diagnosis of pheochromocytoma patients who present with abdominal pain.

  1. Midterm renal functions following acute renal infarction.

    Science.gov (United States)

    Ongun, Sakir; Bozkurt, Ozan; Demir, Omer; Cimen, Sertac; Aslan, Guven

    2015-10-01

    The aim of this study was to explore clinical features of renal infarction (RI) that may have a role in diagnosis and treatment in our patient cohort and provide data on midterm renal functions. Medical records of patients with diagnosis of acute RI, established by contrast enhanced computed tomography (CT) and at least 1 year follow-up data, who were hospitalized in our clinic between 1998 and 2012 were retrospectively reviewed; including descriptive data, clinical signs and symptoms, etiologic factors, laboratory findings, and prescribed treatments. Patients with solitary infarct were treated with acetylsalicylic acid (ASA) only, whereas patients with atrial fibrillation (AF) or multiple or global infarct were treated with anticoagulants. Estimated Glomerular Filtration Rate (eGFR) referring to renal functions was determined by the Modification of Diet in Renal Disease (MDRD) formula. Twenty-seven renal units of 23 patients with acute RI were identified. The mean age was 59.7 ± 15.7 years. Fourteen patients (60.8%) with RI had atrial fibrillation (AF) as an etiologic factor of which four had concomitant mesenteric ischemia at diagnosis. At presentation, 20 patients (86.9%) had elevated serum lactate dehydrogenase (LDH), 18 patients (78.2%) had leukocytosis, and 16 patients (69.5%) had microscopic hematuria. Two patients with concomitant mesenteric ischemia and AF passed away during follow up. Mean eGFR was 70.8 ± 23.2 mL/min/1.73 m(2) at admission and increased to 82.3 ± 23.4 mL/min/1.73 m(2) at 1 year follow up. RI should be considered in patients with persistent flank or abdominal pain, particularly if they are at high risk of thromboembolism. Antiplatelet and/or anticoagulant drugs are both effective treatment options according to the amplitude of the infarct for preserving kidney functions.

  2. Dietary patterns and lifestyle of patients with myocardial infarction

    Directory of Open Access Journals (Sweden)

    Marta Lorková

    2015-08-01

    Full Text Available Civilization diseases, including cardiovascular, are major health problems in current modern society. Numerous studies provided sufficient evidence that variety of risk factors are involved in cardiovascular diseases formation. Of the most important is the lifestyle that largely contributes to our health, up to 50 - 60%. Lifestyle includes all modifiable risk factors that together affect the development of these diseases. In our study we searched and evaluated the nutritional parameters and lifestyle of patients hospitalized in Cardiocentre Nitra. In order to obtain the necessary information we chose the questionnaire method. In our survey 194 patients were included, of which 155 were men (79.89% and 39 (20.11% women. These patients were hospitalized with acute myocardial infarction diagnosis. The vast majority of patients had overweight and obesity caused by improper eating habits. The high prevalence of overweight, BMI in the range 25 - 30 kg/m2, was also confirmed as statistically significant, p <0.05 (P=0.02. BMI over 25 kg/m2 was present in 85% of men and 80% of women. The consumption of selected food commodities with evidence of a positive or negative impact on the emergence of acute myocardial infarction was not statistically significant (p >0.05 when evaluating dietary habits. But we can confirm too frequent consumption of chicken at the expense of other types of meat and relatively frequent consumption of fish (once a week. We recorded the preference of semi-skimmed dairy products, but also high and inappropriate consumption of full-fat dairy products in men and women (37% and 17.8%, respectively. Daily intake of fruits and vegetables was in 85.9% of women and 64.7% of men. Everyday intake of bread and pastries was confirmed by 100% of respondents. Lifestyle was evaluated according to the presence of smoking, excessive alcohol consumption, and physical activity. Up to 60.5% of men and 26.4% of women admitted smoking, while 34.6% of men

  3. Systemic inflammatory response following acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Lu FANG; Xiao-Lei Moore; Anthony M Dart; Le-Min WANG

    2015-01-01

    Acute cardiomyocyte necrosis in the infarcted heart generates damage-associated molecular patterns, activating complement and toll-like receptor/interleukin-1 signaling, and triggering an intense inflammatory response. Inflammasomes also recognize danger signals and mediate sterile inflammatory response following acute myocardial infarction (AMI). Inflammatory response serves to repair the heart, but excessive inflammation leads to adverse left ventricular remodeling and heart failure. In addition to local inflammation, profound systemic inflammation response has been documented in patients with AMI, which includes elevation of circulating inflammatory cytokines, chemokines and cell adhesion molecules, and activation of peripheral leukocytes and platelets. The excessive inflammatory response could be caused by a deregulated immune system. AMI is also associated with bone marrow activation and spleen monocytopoiesis, which sustains a continuous supply of monocytes at the site of inflammation. Accumulating evidence has shown that systemic inflammation aggravates atherosclerosis and markers for systemic inflammation are predictors of adverse clinical outcomes (such as death, recurrent myocardial in-farction, and heart failure) in patients with AMI.

  4. Myocardial infarction: management of the subacute period.

    Science.gov (United States)

    Mercado, Michael G; Smith, Dustin K; McConnon, Michael L

    2013-11-01

    Optimal management of myocardial infarction in the subacute period focuses on improving the discharge planning process, implementing therapies early to prevent recurrent myocardial infarction, and avoiding hospital readmission. Evidence-based guidelines for the care of patients with acute coronary syndrome are not followed up to 25% of the time. Antiplatelet therapy, renin-angiotensin-aldosterone system inhibitors, beta blockers, and statins constitute the foundation of medical therapy. Early noninvasive stress testing is an important risk assessment tool, especially in patients who do not undergo revascularization. Discharge preparation should include a review of medications, referral for exercise-based cardiac rehabilitation, activity recommendations, education about lifestyle modification and recognition of cardiac symptoms, and a clear follow-up plan. Because nonadherence to medications is common in patients after a myocardial infarction and is associated with increased mortality risk, modifiable factors associated with medication self-discontinuation should be addressed before discharge. Structured discharge processes should be used to enhance communication and facilitate the transition from the hospital to the family physician's care.

  5. INTRANASAL DELIVERY OF NERVE GROWTH FACTOR TO PROTECT THE CENTRAL NERVOUS SYSTEM AGAINST ACUTE CEREBRAL INFARCTION

    Institute of Scientific and Technical Information of China (English)

    Hong-mei Zhao; Xin-feng Liu; Xiao-wei Mao; Chun-fu Chen

    2004-01-01

    Objective To confirmed reliability and feasibility of intranasal nerve growth factor (NGF) bypassing the blood-brain barrier and its potential neuroprotective effects on acute cerebral ischemia.Methods (1) To assay NGF concentrations in different brain regions after middle cerebral artery occlusion (MCAO).Rats were randomly divided into intranasal (IN) NGF, intravenous (Ⅳ) NGF, and untreated group (n =4). The concentrations of NGF of different brain regions in the three groups after MCAO were measured by ELISA. (2) To observe neuroprotective action of NGF on focal cerebral ischemic damage. Rats were randomly assigned to 4 groups: IN vehicle, IN NGF,Ⅳ vehicle, Ⅳ NGF (n = 8). Treatment was initiated 30 minutes after onset of MCAO and given again 24 hours later. Three neurologic behavioral tests were performed 24 and 48 hours following onset of MCAO. Corrected infarct volumes were determined 48 hours after onset of MCAO.Results The olfactory bulb in IN NGF group obtained the highest concentration (3252 pg/g) of NGF among all regions, followed by the hippocumpus. The NGF concentrations in the olfactory bulb and hippocampus in IN NGF group were markedly higher than that in Ⅳ NGF and control groups. The infarct volume in IN NGF group was markedly reduced by 38.8% compared with IN vehicle group. IN NGF group vestibulum function markedly improved compared with IN vehicle group at 24 and 48 hours after onset of MCAO (P24h = 0.02 and P48h = 0.04, respectively).Conclusion Intranasal NGF could pass through the blood-brain barrier, reach the central nervous system, reduce infarct volume, and improve neurologic function in rats following MCAO. Intranasal delivery of NGF may be a promising treatment for stroke.

  6. Concurrent Diseases and Conditions in Cats with Renal Infarcts

    OpenAIRE

    Hickey, M.C.; Jandrey, K.; Farrell, K.S.; Carlson‐Bremer, D.

    2014-01-01

    Background Renal infarcts identified without definitive association with any specific disease process. Objective Determine diseases associated with diagnosis of renal infarcts in cats diagnosed by sonography or necropsy. Animals 600 cats underwent abdominal ultrasonography, necropsy, or both at a veterinary medical teaching hospital. Methods Information obtained from electronic medical records. Cats classified as having renal infarct present based on results of sonographic evaluation or necro...

  7. Hepatic infarction in HELLP syndrome; a case report

    International Nuclear Information System (INIS)

    Hepatic infarction is a rare but potentially life-threatening complication of pregnancy-associated preeclampsia or HELLP (hemolysis, elevated liver function tests, low platelets) syndrome. We present a case of hepatic infarction subsequent to HELLP syndrome and occurring during the immediate postpartum, and the associated radiologic findings. Sonography revealed poorly defined hypoechoic zones of infarction. Computed tomography(CT) demonstrated the characteristic features of nonenhancing, low attenuation, relatively well-defined, wedge shaped or geographic hepatic lesions, without mass effect

  8. Hepatic infarction in HELLP syndrome; a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Jeong; Kim, Hong [Keimyung Univ. School of Medicine, Taegu (Korea, Republic of)

    2000-11-01

    Hepatic infarction is a rare but potentially life-threatening complication of pregnancy-associated preeclampsia or HELLP (hemolysis, elevated liver function tests, low platelets) syndrome. We present a case of hepatic infarction subsequent to HELLP syndrome and occurring during the immediate postpartum, and the associated radiologic findings. Sonography revealed poorly defined hypoechoic zones of infarction. Computed tomography(CT) demonstrated the characteristic features of nonenhancing, low attenuation, relatively well-defined, wedge shaped or geographic hepatic lesions, without mass effect.

  9. The value of exercise tests after acute myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, F E; Nielsen, S L; Knudsen, F;

    1992-01-01

    The aim of the present study was to relate the clinical course in patients after a first acute myocardial infarction with the response to exercise-tests performed one month after discharge. 90 consecutive patients who suffered an acute myocardial infarction for the first time were followed-up after...... (W) were predictive with respect to mortality, heart failure, and angina pectoris requiring drug treatment. Exercise tests following acute myocardial infarction could not predict the chances of returning to work....

  10. Anti-Cardiolipin Antibody in Acute Myocardial Infarction

    OpenAIRE

    Abdolreza S. Jahromi; Mohammad Shojaie; Samira Dana; Abdoulhossain Madani

    2010-01-01

    Problem statement: Myocardial infarction is the combined result of environmental and personal factors. Data concerning the relation between anti-Phospholipid (aPL) antibodies and myocardial infarction in subjects without evidence of overt autoimmune disease are conflicting. Anticardiolipin antibody is detected in various diseases like rheumatoid arthritis, systemic lupus erythematosus and anti-phospholipid antibody syndrome. The study of Anticardiolipin antibody in Acute Myocardial Infarction...

  11. Electrocardiographic localization of infarct related coronary artery in acute ST elevation myocardial infarction

    Directory of Open Access Journals (Sweden)

    C.S. Thejanandan Reddy

    2013-07-01

    Full Text Available The electrocardiogram (ECG remains a crucial tool in the identification and management of acute myocardial infarction (MI. A detailed analysis of patterns of ST-segment elevation may influence decisions regarding the use of reperfusion therapy. The early and accurate identification of the infarct-related artery on the ECG can help predict the amount of myocardium at risk and guide decisions regarding the urgency of revascularization. The specificity of the ECG in acute MI is limited by individual variations in coronary anatomy as well as by the presence of preexisting coronary artery disease, particularly in patients with a previous MI, collateral circulation, or previous coronary-artery bypass surgery. The ECG is also limited by its inadequate representation of the posterior, lateral, and apical walls of the left ventricle. Despite these limitations, the electrocardiogram can help in identifying proximal occlusion of the coronary arteries, which results in the most extensive and most severe myocardial infarctions.

  12. Quantification of infarct size on focal cerebral ischemia model of rats using a simple and economical method.

    Science.gov (United States)

    Yang, Y; Shuaib, A; Li, Q

    1998-10-01

    Quantification of infarct size is a very useful index to assess models of focal cerebral ischemia and effects of new therapies. Currently-used image analysis systems to carry out this task usually involve dedicated and expensive equipment. We present a low-cost and simple method to perform the image acquisition and analysis. Twelve Wistar rats were subject to focal cerebral ischemia and scarified 24 h after the insult. 2,3,5-triphenyl tetrazolium chloride (TTC) stain was used as a conventional method to differentiate ischemic damage from healthy brain tissue. Digital images were captured from the stained coronal sections using a flatbed color scanner and analyzed with a commercial image processing software. To evaluate the accuracy and reproducibility of this method, the data obtained with the current procedure was correlated with those from a dedicated standard image analysis system and intra-observor correlation coefficient was estimated. Also the sensitivity of this method in quantification of infarct volume was tested in two different experimental settings. There was close correlation in the outcome of infarct size measurement between the current method and the standard system (r = 0.93, p < 0.001). A high agreement of measurement of the percentage of infarct volume between two different examiners with the same source of samples (r = 0.98, p < 0.001). We demonstrated that this method was sensitive in detection of difference of infarct sizes when placebo-treated animals (n = 6) were compared to the group treated with a neuroprotective agent (n = 6). Our data demonstrated that ischemic lesion of focal cerebral ischemia in rat can be accurately and reproducibly quantified using this method. The low-cost and simplicity of this method may facilitate the application in determination of ischemic damage.

  13. Microvascular function at the margins of early experimental myocardial infarcts in isolated rabbit hearts.

    Science.gov (United States)

    Sage, M D; Gavin, J B

    1986-01-01

    Injection of low-viscosity resin was used to identify in situ functional blood vessels at the margins of developing regional myocardial infarcts. The ventral interventricular branch (VIB) of the left coronary artery was occluded for 0-240 min in 20 isolated perfused rabbit hearts. After perfusion fixation with glutaraldehyde, resin was injected into the coronary arteries--that injected into the VIB contained dispersed lead dioxide and that injected into the remainder of the heart contained Fat Red 7B dye. This allowed macroscopic and microscopic identification of functional blood vessels. Following transmural freeze fracture, left ventricles were examined using back-scattered electron imaging in a scanning electron microscope. Close to 60% of capillaries in nonischemic myocardium allowed the passage of resin. Thirty minutes of ischemia produced a hyperemic increase to 80%-90% in the proportion of filled vessels. After 60 min, however, a severe reperfusion defect corresponding to the "no-reflow" phenomenon had developed, with virtually all vessels collapsed and less than 10% functional. Among the structurally normal myocytes adjacent to the infarct margin there was a significant reduction (to 30%-40%) in the proportion of functional capillaries. This was due to groups of dilated vessels which were not accessible to arterial supply. Although these marginal "low-flow" regions were of small volume at any one point in time, they seem likely to contribute to the progression of ischemic necrosis, and are probably nonfunctional due to the compression of their venous drainage traversing the infarct.

  14. Computational Modeling of the Effects of Myocardial Infarction on Left Ventricular Hemodynamics

    Science.gov (United States)

    Vedula, Vijay; Seo, Jung Hee; Mittal, Rajat; Fortini, Stefania; Querzoli, Giorgio

    2012-11-01

    Most in-vivo and modeling studies on myocardial infarction and ischemia have been directed towards understanding the left ventricular wall mechanics including stress-strain behavior, end systolic pressure-volume correlations, ejection fraction and stroke work. Fewer studies have focused on the alterations in the intraventricular blood flow behavior due to local infarctions. Changes in the motion of the endocardium can cause local circulation and stagnation regions; these increase the blood cell residence time in the left ventricle and may eventually be implicated in thrombus formation. In the present study, we investigate the effects of myocardial infarction on the ventricular hemodynamics in simple models of the left ventricle using an immersed-boundary flow solver. Apart from the Eulerian flow features such as vorticity and velocity flow fields, pressure distribution, shear stress, viscous dissipation and pump work, we also examine the Lagrangian dynamics of the flow to gain insights into the effect of flow dynamics on thrombus formation. The study is preceded by a comprehensive validation study which is based on an in-vitro experimental model of the left ventricle and this study is also described. This research is supported by the U.S. National Science Foundation through (NSF) CDI-Type II grant IOS-1124804. Computational resources for some of the simulations were also provided in part through the NSF grant NSF-OCI-108849.

  15. Absolute Cerebral Blood Flow Infarction Threshold for 3-Hour Ischemia Time Determined with CT Perfusion and 18F-FFMZ-PET Imaging in a Porcine Model of Cerebral Ischemia.

    Science.gov (United States)

    Wright, Eric A; d'Esterre, Christopher D; Morrison, Laura B; Cockburn, Neil; Kovacs, Michael; Lee, Ting-Yim

    2016-01-01

    CT Perfusion (CTP) derived cerebral blood flow (CBF) thresholds have been proposed as the optimal parameter for distinguishing the infarct core prior to reperfusion. Previous threshold-derivation studies have been limited by uncertainties introduced by infarct expansion between the acute phase of stroke and follow-up imaging, or DWI lesion reversibility. In this study a model is proposed for determining infarction CBF thresholds at 3hr ischemia time by comparing contemporaneously acquired CTP derived CBF maps to 18F-FFMZ-PET imaging, with the objective of deriving a CBF threshold for infarction after 3 hours of ischemia. Endothelin-1 (ET-1) was injected into the brain of Duroc-Cross pigs (n = 11) through a burr hole in the skull. CTP images were acquired 10 and 30 minutes post ET-1 injection and then every 30 minutes for 150 minutes. 370 MBq of 18F-FFMZ was injected ~120 minutes post ET-1 injection and PET images were acquired for 25 minutes starting ~155-180 minutes post ET-1 injection. CBF maps from each CTP acquisition were co-registered and converted into a median CBF map. The median CBF map was co-registered to blood volume maps for vessel exclusion, an average CT image for grey/white matter segmentation, and 18F-FFMZ-PET images for infarct delineation. Logistic regression and ROC analysis were performed on infarcted and non-infarcted pixel CBF values for each animal that developed infarct. Six of the eleven animals developed infarction. The mean CBF value corresponding to the optimal operating point of the ROC curves for the 6 animals was 12.6 ± 2.8 mL·min-1·100g-1 for infarction after 3 hours of ischemia. The porcine ET-1 model of cerebral ischemia is easier to implement then other large animal models of stroke, and performs similarly as long as CBF is monitored using CTP to prevent reperfusion.

  16. Absolute Cerebral Blood Flow Infarction Threshold for 3-Hour Ischemia Time Determined with CT Perfusion and 18F-FFMZ-PET Imaging in a Porcine Model of Cerebral Ischemia.

    Directory of Open Access Journals (Sweden)

    Eric A Wright

    Full Text Available CT Perfusion (CTP derived cerebral blood flow (CBF thresholds have been proposed as the optimal parameter for distinguishing the infarct core prior to reperfusion. Previous threshold-derivation studies have been limited by uncertainties introduced by infarct expansion between the acute phase of stroke and follow-up imaging, or DWI lesion reversibility. In this study a model is proposed for determining infarction CBF thresholds at 3hr ischemia time by comparing contemporaneously acquired CTP derived CBF maps to 18F-FFMZ-PET imaging, with the objective of deriving a CBF threshold for infarction after 3 hours of ischemia. Endothelin-1 (ET-1 was injected into the brain of Duroc-Cross pigs (n = 11 through a burr hole in the skull. CTP images were acquired 10 and 30 minutes post ET-1 injection and then every 30 minutes for 150 minutes. 370 MBq of 18F-FFMZ was injected ~120 minutes post ET-1 injection and PET images were acquired for 25 minutes starting ~155-180 minutes post ET-1 injection. CBF maps from each CTP acquisition were co-registered and converted into a median CBF map. The median CBF map was co-registered to blood volume maps for vessel exclusion, an average CT image for grey/white matter segmentation, and 18F-FFMZ-PET images for infarct delineation. Logistic regression and ROC analysis were performed on infarcted and non-infarcted pixel CBF values for each animal that developed infarct. Six of the eleven animals developed infarction. The mean CBF value corresponding to the optimal operating point of the ROC curves for the 6 animals was 12.6 ± 2.8 mL·min-1·100g-1 for infarction after 3 hours of ischemia. The porcine ET-1 model of cerebral ischemia is easier to implement then other large animal models of stroke, and performs similarly as long as CBF is monitored using CTP to prevent reperfusion.

  17. Absolute Cerebral Blood Flow Infarction Threshold for 3-Hour Ischemia Time Determined with CT Perfusion and 18F-FFMZ-PET Imaging in a Porcine Model of Cerebral Ischemia.

    Science.gov (United States)

    Wright, Eric A; d'Esterre, Christopher D; Morrison, Laura B; Cockburn, Neil; Kovacs, Michael; Lee, Ting-Yim

    2016-01-01

    CT Perfusion (CTP) derived cerebral blood flow (CBF) thresholds have been proposed as the optimal parameter for distinguishing the infarct core prior to reperfusion. Previous threshold-derivation studies have been limited by uncertainties introduced by infarct expansion between the acute phase of stroke and follow-up imaging, or DWI lesion reversibility. In this study a model is proposed for determining infarction CBF thresholds at 3hr ischemia time by comparing contemporaneously acquired CTP derived CBF maps to 18F-FFMZ-PET imaging, with the objective of deriving a CBF threshold for infarction after 3 hours of ischemia. Endothelin-1 (ET-1) was injected into the brain of Duroc-Cross pigs (n = 11) through a burr hole in the skull. CTP images were acquired 10 and 30 minutes post ET-1 injection and then every 30 minutes for 150 minutes. 370 MBq of 18F-FFMZ was injected ~120 minutes post ET-1 injection and PET images were acquired for 25 minutes starting ~155-180 minutes post ET-1 injection. CBF maps from each CTP acquisition were co-registered and converted into a median CBF map. The median CBF map was co-registered to blood volume maps for vessel exclusion, an average CT image for grey/white matter segmentation, and 18F-FFMZ-PET images for infarct delineation. Logistic regression and ROC analysis were performed on infarcted and non-infarcted pixel CBF values for each animal that developed infarct. Six of the eleven animals developed infarction. The mean CBF value corresponding to the optimal operating point of the ROC curves for the 6 animals was 12.6 ± 2.8 mL·min-1·100g-1 for infarction after 3 hours of ischemia. The porcine ET-1 model of cerebral ischemia is easier to implement then other large animal models of stroke, and performs similarly as long as CBF is monitored using CTP to prevent reperfusion. PMID:27347877

  18. Digoxin:A systematic review in atrial fibrillation,congestive heart failure and post myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Sebastiano; Virgadamo; Richard; Charnigo; Yousef; Darrat; Gustavo; Morales; Claude; S; Elayi

    2015-01-01

    more controversial. The extent to which discrepancies among studies are based on statistical methods is currently unclear, as these studies’ findings are generated by retrospective analyses that employed different techniques to address confounding. CONCLUSION: Based on the potential risks and benefits, as well as the presence of alternative drugs, there is a limited role for digoxin in the management of patients with normal sinus rhythm and congestive heart failure. Based on the retrospective studies reviewed there is a growing volume of data showing increased mortality in those with only atrial fibrillation. The pro-per role of digoxin is, however, less certain in other subgroups of patients, such as those with both atrial fibrillation and systolic congestive heart failure or after a myocardial infarction. Further studies may provide helpful information for such subgroups of patients.

  19. Predictors of ventricular remodelling in patients with reperfused acute myocardial infarction and left ventricular dysfunction candidates for bone marrow cell therapy: insights from the BONAMI trial

    Energy Technology Data Exchange (ETDEWEB)

    Manrique, Alain [Nuclear Medicine, CHU de Caen, Caen (France); Universite de Caen Normandie, EA 4650, Caen (France); CHU de Caen et GIP Cyceron, Caen cedex 6 (France); Lemarchand, Patricia; Delasalle, Beatrice; Lamirault, Guillaume; Trochu, Jean-Noel; Le Tourneau, Thierry [L' Institut du thorax, INSERM, UMR1087, Nantes (France); CNRS, UMR 6291, Nantes (France); Universite de Nantes, Nantes (France); CHU de Nantes, Nantes (France); Lairez, Olivier; Roncalli, Jerome [Institut CARDIOMET-Toulouse, Cardiac Imaging Center, CIC Biotherapies, CHU de Toulouse, Toulouse (France); Sportouch-Duckan, Catherine; Piot, Christophe [Universite Montpellier, Institut de Genomique Fonctionnelle, INSERM U661, CNRS UMR 5203, Montpellier (France); Clinique du Millenaire, Montpellier (France); Le Corvoisier, Philippe [Hopital Henri Mondor, INSERM, Centre d' Investigation Clinique 1430 et U955 equipe 3, Creteil (France); Neuder, Yannick [CHU de Grenoble, Pole Thorax et Vaisseaux, Grenoble (France); Richardson, Marjorie [CHRU Lille, Service d' Explorations Fonctionnelles Cardiovasculaires, Hopital Cardiologique, Lille (France); Lebon, Alain [CHU de Caen, Service de Cardiologie, Caen (France); Teiger, Emmanuel [Hopital Henri Mondor, AP-HP, Unite de Cardiologie Interventionnelle et Federation de Cardiologie, Creteil (France); Hossein-Foucher, Claude [Hopital Salengro CHRU de Lille, Service de Medecine Nucleaire, Lille (France); Universite de Lille 2, UFR de Medecine, Lille (France)

    2016-04-15

    Few data are available regarding the relation of left ventricular (LV) mechanical dyssynchrony to remodelling after acute myocardial infarction (MI) and stem cell therapy. We evaluated the 1-year time course of both LV mechanical dyssynchrony and remodelling in patients enrolled in the BONAMI trial, a randomized, multicenter controlled trial assessing cell therapy in patients with reperfused MI. Patients with acute MI and ejection fraction (EF) ≤ 45 % were randomized to cell therapy or to control and underwent thallium single-photon emission computed tomography (SPECT), radionuclide angiography, and echocardiography at baseline, 3 months, and 1 year. Eighty-three patients with a comprehensive 1-year follow-up were included. LV dyssynchrony was assessed by the standard deviation (SD) of the LV phase histogram using radionuclide angiography. Remodelling was defined as a 20 % increase in LV end-systolic volume index (LVESVI) at 1 year. At baseline, LVEF, wall motion score index, and perfusion defect size were significantly impaired in the 43 patients (52 %) with LV remodelling (all p < 0.001), without significant increase in LV mechanical dyssynchrony. During follow-up, there was a progressive increase in LV SD (p = 0.01). Baseline independent predictors of LV remodelling were perfusion SPECT defect size (p = 0.001), LVEF (p = 0.01) and a history of hypertension (p = 0.043). Bone marrow cell therapy did not affect the time-course of LV remodelling and dyssynchrony. LV remodelling 1 year after reperfused MI is associated with progressive LV dyssynchrony and is related to baseline infarct size and ejection fraction, without impact of cell therapy on this process. (orig.)

  20. Acute myocardial infarction and infarct size: do circadian variations play a role?

    Directory of Open Access Journals (Sweden)

    Ibáñez B

    2012-08-01

    Full Text Available Aída Suárez-Barrientos,1 Borja Ibáñez1,21Cardiovascular Institute, Hospital Clínico San Carlos, 2Centro Nacional de Investigaciones Cardiovasculares, Madrid, SpainAbstract: The circadian rhythm influences cardiovascular system physiology, inducing diurnal variations in blood pressure, heart rate, cardiac output, endothelial functions, platelet aggregation, and coronary arterial flow, among other physiological parameters. Indeed, an internal circadian network modulates cardiovascular physiology by regulating heart rate, metabolism, and even myocyte growth and repair ability. Consequently, cardiovascular pathology is also controlled by circadian oscillations, with increased morning incidence of cardiovascular events. The potential circadian influence on the human tolerance to ischemia/reperfusion has not been systematically scrutinized until recently. It has since been proven, in both animals and humans, that infarct size varies during the day depending on the symptom onset time, while circadian fluctuations in spontaneous cardioprotection in humans with ST-segment elevation myocardial infarction (STEMI have also been demonstrated. Furthermore, several studies have proposed that the time of day at which revascularization occurs in patients with STEMI may also influence infarct size and reperfusion outcomes. The potential association of the circadian clock with infarct size advocates the acknowledgment of time of day as a new prognostic factor in patients suffering acute myocardial infarction, which would open up a new field for chronotherapeutic targets and lead to the inclusion of time of day as a variable in clinical trials that test novel cardioprotective strategies.Keywords: cardioprotection, circadian rhythm, reperfusion injury, ST-segment elevation myocardial infarction

  1. Spinal cord infarction: a rare cause of paraplegia.

    Science.gov (United States)

    Patel, Sonali; Naidoo, Khimara; Thomas, Peter

    2014-06-25

    Spinal cord infarction is rare and represents a diagnostic challenge for many physicians. There are few reported cases worldwide with a prevalence of 1.2% of all strokes. Circulation to the spinal cord is supplied by a rich anastomosis. The anterior spinal artery supplies the anterior two thirds of the spinal cord and infarction to this area is marked by paralysis, spinothalamic sensory deficit and loss of sphincter control depending on where the lesion is. Treatment of spinal cord infarction focuses on rehabilitation with diverse outcomes. This report presents a case of acute spinal cord infarction with acquisition of MRI to aid diagnosis.

  2. Evaluation of cat brain infarction model using microPET

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Jin; Lee, Dong Soo; Kim, Yun Hui; Hwang, Do Won; Kim, Jin Su; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of); Lim, Sang Moo [Korea Institite of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2004-12-01

    PET has some disadvantage in the imaging of small animal due to poor resolution. With the advent of microPET scanner, it is possible to image small animals. However, the image quality was not good enough as human image. Due to larger brain, cat brain imaging was superior to mouse or rat. In this study, we established the cat brain infarction model and evaluate it and its temporal change using microPET scanner. Two adult male cats were used. Anesthesia was done with xylazine and ketamine HCI. A burr hole was made at 1 cm right lateral to the bregma. Collagenase type IV 10 {mu}l was injected using 30 G needle for 5 minutes to establish the infarction model. {sup 18}F-FDG microPET (Concorde Microsystems Inc., Knoxville, TN) scans were performed 1, 11 and 32 days after the infarction. In addition, {sup 18}F-FDG PET scans were performed using human PET scanner (Gemini, Philips medical systems, CA, USA) 13 and 47 days after the infarction. Two cat brain infarction models were established. The glucose metabolism of an infarction lesion improved with time. An infarction lesion was also distinguishable in the human PET scan. We successfully established the cat brain infarction model and evaluated the infarcted lesion and its temporal change using {sup 18}F-FDG microPET scanner.

  3. Evaluation of cat brain infarction model using microPET

    International Nuclear Information System (INIS)

    PET has some disadvantage in the imaging of small animal due to poor resolution. With the advent of microPET scanner, it is possible to image small animals. However, the image quality was not good enough as human image. Due to larger brain, cat brain imaging was superior to mouse or rat. In this study, we established the cat brain infarction model and evaluate it and its temporal change using microPET scanner. Two adult male cats were used. Anesthesia was done with xylazine and ketamine HCI. A burr hole was made at 1 cm right lateral to the bregma. Collagenase type IV 10 μl was injected using 30 G needle for 5 minutes to establish the infarction model. 18F-FDG microPET (Concorde Microsystems Inc., Knoxville, TN) scans were performed 1, 11 and 32 days after the infarction. In addition, 18F-FDG PET scans were performed using human PET scanner (Gemini, Philips medical systems, CA, USA) 13 and 47 days after the infarction. Two cat brain infarction models were established. The glucose metabolism of an infarction lesion improved with time. An infarction lesion was also distinguishable in the human PET scan. We successfully established the cat brain infarction model and evaluated the infarcted lesion and its temporal change using 18F-FDG microPET scanner

  4. The prognostic importance of creatinine clearance after acute myocardial infarction

    DEFF Research Database (Denmark)

    Sørensen, C R; Brendorp, B; Rask-Madsen, C;

    2002-01-01

    AIMS: The purpose of this study was to assess renal dysfunction as an independent predictor of mortality after acute myocardial infarction. METHODS: The study population was 6252 patients with a myocardial infarction admitted alive from 1990 to 1992. The mortality status was obtained after at least.......9-1.3) respectively. CONCLUSION: Renal dysfunction is an important risk factor after acute myocardial infarction. When the risk is adjusted for available competing risk factors only severely reduced renal function is associated with an important and independent risk of mortality after acute myocardial infarction...

  5. Development of an assisting detection system for early infarct diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Sim, K. S.; Nia, M. E.; Ee, C. S. [Faculty of Engineering and Technology, Multimedia University, Melaka (Malaysia)

    2015-04-24

    In this paper, a detection assisting system for early infarct detection is developed. This new developed method is used to assist the medical practitioners to diagnose infarct from computed tomography images of brain. Using this assisting system, the infarct could be diagnosed at earlier stages. The non-contrast computed tomography (NCCT) brain images are the data set used for this system. Detection module extracts the pixel data from NCCT brain images, and produces the colourized version of images. The proposed method showed great potential in detecting infarct, and helps medical practitioners to make earlier and better diagnoses.

  6. Unexpected Coexisting Myocardial Infarction Detected by Delayed Enhancement MRI

    Directory of Open Access Journals (Sweden)

    Edouard Gerbaud

    2009-01-01

    Full Text Available We report a case of an unexpected coexisting anterior myocardial infarction detected by delayed enhancement MRI in a 41-year-old man following a presentation with a first episode of chest pain during inferior acute myocardial infarction. This second necrotic area was not initially suspected because there were no ECG changes in the anterior leads and the left descending coronary artery did not present any significant stenoses on emergency coronary angiography. Unrecognised myocardial infarction may carry important prognostic implications. CMR is currently the best imaging technique to detect unexpected infarcts.

  7. Bilateral renal infarction: an uncommon presentation of fibromuscular dysplasia.

    Science.gov (United States)

    Ayach, Taha; Kazory, Amir

    2013-12-01

    While fibromuscular dysplasia (FMD) is an established cause of secondary hypertension, its association with renal infarction is less well recognized. We report a middle-aged man who presented with complaints of loin pain and severe hypertension. Computed tomography angiography of the abdomen revealed bilateral renal infarction with multiple short-segment arterial dissection compatible with FMD in the absence of systemic vasculitis and other risk factors for thromboembolic events. Bilateral renal infarction complicating FMD is extremely rare and has so far been reported only in a handful of cases. Physicians encountering cases of otherwise unexplained renal infarction/ischemia need to be aware of this complication.

  8. The importance of early patency after acute myocardial infarction.

    Science.gov (United States)

    Grover, A; Rihal, C S

    1995-07-01

    The importance of achieving rapid patency of the infarct-related artery during acute myocardial infarction has become well recognized. Early, sustained patency of the infarct-related vessel correlates with improved left ventricular function, better in-hospital outcomes, and lower mortality. Various strategies designed to improve early patency, including "prehospital" thrombolysis, use of an accelerated recombinant tissue plasminogen activator regimen, and immediate angioplasty have been studied. This paper reviews the importance of achieving early patency, the various strategies employed, and the evidence for their efficacy. Future directions in treatment of acute myocardial infarction are touched upon briefly. PMID:7549077

  9. Dynamic MRI of ferumoxide-labeled bone mesenchmal stem cells after transplantation in infarcted myocardium

    International Nuclear Information System (INIS)

    Objective: To investigate the ability of magnetic resonance imaging (MRI) in tracking magnetically labeled mesenchymal stem cells (MR-MSCs) in a swine myocardial infarction (MI) model. Methods: Adult Chinese mini-pigs (n=6) were subjected to open-chest experimental MI operation. Their autogeneic bone marrow-derived mesenchymal stem cells (MSCs) was cultured and doubly labeled with ferumoxides and DAPI. On the 14 th day after MSCs transplantation, the size and location of the myocardial infarction were assessed by using delayed-enhancement MRI (DE-MRI). Then the labeled MSCs were injected intramyocardially into peri-infarct zone and normal myocardium. At 24 hrs and 3 weeks after injection, the contrast and the volume of the MR-MSCs hypointense lesion from the MR images were acquired, and the contrast was determined using the difference in signal intensity between the hypointense and normal myocardium divided by signal intensity of the normal region. After humane euthanasia, the heart was excised and histology corresponding to MRI slices that demonstrated MR-MSCs lesions was performed. Repeated-measures ANOVA and a paired t test were used for comparison of the contrast and the volume of the MR-MSCs hypointense lesion at different time points. Comparisons between independent groups were performed with the standard Student t test. Results: The labeling efficiency of ferumoxides and DAPI was 100%. On the 14 th day after the MI operation, the average percentage of infracted myocardial area was (33.6±8.9)%. Twenty- four hours after MSCs transplantation, MSCs injection sites appeared as ovoid hypointensive lesions with sharp border on T2* images. At 24 h after injection, the signal contrast [(67.00±5.48)% vs (61.92±7.76)%,t=1.65, P=0.1158] and the size [(0.56±0.24) cm2 vs (0.52±0.25) cm2, t=0.39, P=0.7044] of the lesions showed no statistical difference between the peri-infarct zone and the normal myocardium. At 3 weeks after injection, the signal contrast decreased

  10. Case report: necrosis of the anterolateral papillary muscle--an unusual mechanical complication of myocardial infarction.

    Science.gov (United States)

    Abu Saleh, Walid K; Aljabbari, Odeaa; Ramlawi, Basel; Ramchandani, Mahesh

    2015-01-01

    We report the case of a 66-year-old woman with no significant past medical history who presented to the Emergency Department at Houston Methodist Hospital with 24 hours of chest pain. An electrocardiogram was done, an electrocardiogram confirmed a posterolateral ST elevation myocardial infarction. An immediate and successful percutaneous coronary intervention of a totally occluded ramus intermedius was performed. Six hours later she developed pulmonary edema, cardiogenic shock, severe acidosis, and anuria. Echocardiography showed severe mitral regurgitation due to a ruptured anterolateral papillary muscle, and emergency surgery revealed necrosis of this muscle. A bioprosthetic mitral valve was placed, and extracorporeal membrane oxygenation was needed for 3 days. This is a rare mechanical complication of myocardial infarction, which usually affects the posteromedial papillary muscle. The patient subsequently made a good recovery. One month later, just prior to discharge home, the patient developed pneumonia and sepsis, and she expired from multiorgan failure. PMID:25793030

  11. [Exertion tolerance in the early period after myocardial infarction, the results of echocardiographic examination and the clinical course of infarction].

    Science.gov (United States)

    Straburzyńska-Migaj, E

    1992-01-01

    The relation between exercise test, echocardiography and clinical course of acute myocardial infarction was investigated. 17-34 days after an acute myocardial infarction, before hospital discharge, 58 patients underwent exercise test and 17-28 days- echocardiography. Low exercise capacity was significant related to angina before infarction, maximal CKNAC and complications during clinical course. There was inverted correlation of asynergy index calculated from echocardiography with maximal workload achieved during exercise test.

  12. Quantitative assessment of harmonic power doppler myocardial perfusion imaging with intravenous levovist™ in patients with myocardial infarction: comparison with myocardial viability evaluated by coronary flow reserve and coronary flow pattern of infarct-related artery

    Directory of Open Access Journals (Sweden)

    Nagai Kunihiko

    2005-08-01

    Full Text Available Abstract Background Myocardial contrast echocardiography and coronary flow velocity pattern with a rapid diastolic deceleration time after percutaneous coronary intervention has been reported to be useful in assessing microvascular damage in patients with acute myocardial infarction. Aim To evaluate myocardial contrast echocardiography with harmonic power Doppler imaging, coronary flow velocity reserve and coronary artery flow pattern in predicting functional recovery by using transthoracic echocardiography. Methods Thirty patients with anterior acute myocardial infarction underwent myocardial contrast echocardiography at rest and during hyperemia and were quantitatively analyzed by the peak color pixel intensity ratio of the risk area to the control area (PIR. Coronary flow pattern was measured using transthoracic echocardiography in the distal portion of left anterior descending artery within 24 hours after recanalization and we assessed deceleration time of diastolic flow velocity. Coronary flow velocity reserve was calculated two weeks after acute myocardial infarction. Left ventricular end-diastolic volumes and ejection fraction by angiography were computed. Results Pts were divided into 2 groups according to the deceleration time of coronary artery flow pattern (Group A; 20 pts with deceleration time ≧ 600 msec, Group B; 10 pts with deceleration time Conclusion The preserved microvasculature detecting by myocardial contrast echocardiography and coronary flow velocity reserve is related to functional recovery after acute myocardial infarction.

  13. Migraine with aura and risk of silent brain infarcts and white matter hyperintensities: an MRI study.

    Science.gov (United States)

    Gaist, David; Garde, Ellen; Blaabjerg, Morten; Nielsen, Helle H; Krøigård, Thomas; Østergaard, Kamilla; Møller, Harald S; Hjelmborg, Jacob; Madsen, Camilla G; Iversen, Pernille; Kyvik, Kirsten O; Siebner, Hartwig R; Ashina, Messoud

    2016-07-01

    A small number of population-based studies reported an association between migraine with aura and risk of silent brain infarcts and white matter hyperintensities in females. We investigated these relations in a population-based sample of female twins. We contacted female twins ages 30-60 years identified through the population-based Danish Twin Registry. Based on questionnaire responses, twins were invited to participate in a telephone-based interview conducted by physicians. Headache diagnoses were established according to the International Headache Society criteria. Cases with migraine with aura, their co-twins, and unrelated migraine-free twins (controls) were invited to a brain magnetic resonance imaging scan performed at a single centre. Brain scans were assessed for the presence of infarcts, and white matter hyperintensities (visual rating scales and volumetric analyses) blinded to headache diagnoses. Comparisons were based on 172 cases, 34 co-twins, and 139 control subjects. Compared with control subjects, cases did not differ with regard to frequency of silent brain infarcts (four cases versus one control), periventricular white matter hyperintensity scores [adjusted mean difference (95% confidence interval): -0.1 (-0.5 to 0.2)] or deep white matter hyperintensity scores [adjusted mean difference (95% confidence interval): 0.1 (-0.8 to 1.1)] assessed by Scheltens' scale. Cases had a slightly higher total white matter hyperintensity volume compared with controls [adjusted mean difference (95% confidence interval): 0.17 (-0.08 to 0.41) cm(3)] and a similar difference was present in analyses restricted to twin pairs discordant for migraine with aura [adjusted mean difference 0.21 (-0.20 to 0.63)], but these differences did not reach statistical significance. We found no evidence of an association between silent brain infarcts, white matter hyperintensities, and migraine with aura. PMID:27190013

  14. Ataxia telangiectasia-mutated kinase deficiency exacerbates left ventricular dysfunction and remodeling late after myocardial infarction.

    Science.gov (United States)

    Daniel, Laura L; Scofield, Stephanie L C; Thrasher, Patsy; Dalal, Suman; Daniels, Christopher R; Foster, Cerrone R; Singh, Mahipal; Singh, Krishna

    2016-08-01

    Ataxia telangiectasia-mutated kinase (ATM), a cell cycle checkpoint protein, is activated in response to DNA damage and oxidative stress. We have previously shown that ATM deficiency is associated with increased apoptosis and fibrosis and attenuation of cardiac dysfunction early (1-7 days) following myocardial infarction (MI). Here, we tested the hypothesis that enhanced fibrosis and apoptosis, as observed early post-MI during ATM deficiency, exacerbate cardiac dysfunction and remodeling in ATM-deficient mice late post-MI. MIs were induced in wild-type (WT) and ATM heterozygous knockout (hKO) mice by ligation of the left anterior descending artery. Left ventricular (LV) structural and functional parameters were assessed by echocardiography 14 and 28 days post-MI, whereas biochemical parameters were measured 28 days post-MI. hKO-MI mice exhibited exacerbated LV dysfunction as observed by increased LV end-systolic volume and decreased percent fractional shortening and ejection fraction. Infarct size and thickness were not different between the two genotypes. Myocyte cross-sectional area was greater in hKO-MI group. The hKO-MI group exhibited increased fibrosis in the noninfarct and higher expression of α-smooth muscle actin (myofibroblast marker) in the infarct region. Apoptosis and activation of GSK-3β (proapoptotic kinase) were significantly lower in the infarct region of hKO-MI group. Matrix metalloproteinase 2 (MMP-2) expression was not different between the two genotypes. However, MMP-9 expression was significantly lower in the noninfarct region of hKO-MI group. Thus ATM deficiency exacerbates cardiac remodeling late post-MI with effects on cardiac function, fibrosis, apoptosis, and myocyte hypertrophy. PMID:27288435

  15. The relationship between ECG signs of atrial infarction and the development of supraventricular arrhythmias in patients with acute myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, F E; Andersen, H H; Gram-Hansen, P;

    1992-01-01

    ECGs obtained on arrival at the hospital from 277 patients with acute myocardial infarction were analyzed retrospectively for PR displacements, which were classified as major or minor criteria for atrial infarction and related to the later occurrence of supraventricular arrhythmia in the hospital...... arrhythmias, giving odds ratios of 9.9 and 3.7, respectively. Enzyme-estimated infarct size, the occurrence of heart failure, and mortality rates did not differ in patients with or without major criteria for atrial infarction. We conclude that the occurrence of PR segment displacements on the admission ECG...

  16. Change in C3G protein expression in the peri-infarct myocardium and its significance in rats

    Directory of Open Access Journals (Sweden)

    Li-ping WANG

    2012-08-01

    Full Text Available Objective To investigate the change in expression of C3G protein, a Crk SH3 domain-binding guanine nucleotide-releasing factor, in the peri-infarct myocardium in rats. Methods Male SD rats were randomly divided into experimental myocardial infarction (MI group and sham-operated (SO group using Litwin method. The rats in the MI and SO groups were sacrificed at 24 hours and 12 weeks after the operation, and the myocardium was harvested from the cardiac apex in the SO group and the infarct area in the MI group for determination of types Ⅰand Ⅲcollagen and C3G protein expression with picric acid-sirius red staining and immunohistochemistry. Non-infarcted myocardium in the MI group and the normal myocardium in the SO group were havrested for measuring the relative expression level of C3G protein by Western blotting. Results The picric acid-sirius red staining showed that typesⅠand Ⅲcollagen volume was respectively 14.01±2.73 and 4.80±0.64 12 weeks after MI, 3.15±0.70 and 1.42±0.48 24 hours after SO, 3.68±0.95 and 1.53±0.61 24 hours after MI, and 3.27±0.65 and 1.47±0.52 (P 0.05. Western blotting revealed that the C3G protein expression 12 weeks after MI was significantly increased compared with that in the other three groups (P 0.05. C3G protein expression in the non-infarct myocardium at 12-week post MI (0.56±0.06, n=8 was significantly higher as compared with that in the cardiac apex 12 weeks (0.22±0.04, n=8, 24 hours (0.22±0.04, n=8 after SO and in the non-infarct myocardium 24 hours after MI (0.29±0.02, n=8 respectively (All P < 0.05. Conclusions C3G protein exists in the myocardium in rats. C3G protein expression could significantly increase in the peri-infarct myocardium. The increased C3G protein expression could be involved in post-infarction cardiac remodeling.

  17. Osteoprotegerin predicts long-term outcome in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Pedersen, Sune Folke; Bjerre, Mette; Mogelvang, Rasmus;

    2012-01-01

    : 1.03-1.59; p = 0.03), repeat myocardial infarction (HR: 1.30; CI: 1.00-1.68; p = 0.05) and admission with heart failure (HR: 1.50; CI: 1.18-1.90; p = 0.001). Conclusion: This study shows that OPG independently predicts long-term outcome in STEMI patients treated with pPCI. Eventually, this knowledge...... patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods: We included 716 consecutive STEMI patients admitted to a single high-volume invasive heart center from September 2006 to December 2008. Endpoints were all...

  18. Ventricular-arterial uncoupling in heart failure with preserved ejection fraction after myocardial infarction in dogs - invasive versus echocardiographic evaluation

    Directory of Open Access Journals (Sweden)

    Bartunek Jozef

    2010-06-01

    Full Text Available Abstract Background Heart failure with preserved left ventricular ejection fraction and abnormal diastolic function is commonly observed after recovery from an acute myocardial infarction. The aim of this study was to investigate the physiopathology of heart failure with preserved ejection fraction in a model of healed myocardial infarction in dogs. Methods Echocardiography, levels of neurohormones and conductance catheter measurements of left ventricular pressure-volume relationships were obtained in 17 beagle dogs 2 months after a coronary artery ligation, and in 6 controls. Results Healed myocardial infarction was associated with preserved echocardiographic left ventricular ejection fraction (0.57 ± 0.01, mean ± SEM and altered Doppler mitral indices of diastolic function. NT-proBNP was increased, aldosterone was decreased, and norepinephrine was unchanged. Invasive measurements showed a markedly decreased end-systolic elastance (2.1 ± 0.2 vs 6.1 ± 0.8, mmHg/ml, p Conclusions In the canine model of healed myocardial infarction induced by coronary ligation, heart failure is essentially characterized by an altered contractility with left ventricular-arterial uncoupling despite vascular compensation rather than by abnormal diastolic function

  19. Purinergic receptor stimulation reduces cytotoxic edema and brain infarcts in mouse induced by photothrombosis by energizing glial mitochondria.

    Directory of Open Access Journals (Sweden)

    Wei Zheng

    Full Text Available Treatments to improve the neurological outcome of edema and cerebral ischemic stroke are severely limited. Here, we present the first in vivo single cell images of cortical mouse astrocytes documenting the impact of single vessel photothrombosis on cytotoxic edema and cerebral infarcts. The volume of astrocytes expressing green fluorescent protein (GFP increased by over 600% within 3 hours of ischemia. The subsequent growth of cerebral infarcts was easily followed as the loss of GFP fluorescence as astrocytes lysed. Cytotoxic edema and the magnitude of ischemic lesions were significantly reduced by treatment with the purinergic ligand 2-methylthioladenosine 5' diphosphate (2-MeSADP, an agonist with high specificity for the purinergic receptor type 1 isoform (P2Y(1R. At 24 hours, cytotoxic edema in astrocytes was still apparent at the penumbra and preceded the cell lysis that defined the infarct. Delayed 2MeSADP treatment, 24 hours after the initial thrombosis, also significantly reduced cytotoxic edema and the continued growth of the brain infarction. Pharmacological and genetic evidence are presented indicating that 2MeSADP protection is mediated by enhanced astrocyte mitochondrial metabolism via increased inositol trisphosphate (IP(3-dependent Ca(2+ release. We suggest that mitochondria play a critical role in astrocyte energy metabolism in the penumbra of ischemic lesions, where low ATP levels are widely accepted to be responsible for cytotoxic edema. Enhancement of this energy source could have similar protective benefits for a wide range of brain injuries.

  20. Noninvasive quantitation of myocardial infarction with technetium-99m pyrophosphate

    International Nuclear Information System (INIS)

    We sought to quantitate infarct size using radioactive imaging techniques. Infarcts were created in closed chest dogs. Using a scintillation camera interfaced to a computer, infarct images were made in the anterior, left lateral, LAO, and RAO projections, 48 hours after infarction and 75 to 90 min following the intravenous injection of 15 mCi of technetium-99m pyrophosphate (Tc-PYP). Images were computer enhanced and area was calibrated with a radioactive grid source of known dimensions. Image radioactivity was normalized for decay and dose corrected for body weight. Animals were sacrificed two hours following the injection of Tc-PYP. Postmortem images were also computer enhanced and calibrated. Gross infarct area and weight were estimated and transmural biopsies were evaluated for Tc-PYP activity and analyzed for creatine phosphokinase (CPK) content. Contiguous biopsies were pathologically analyzed and graded. There was a negative correlation between tissue Tc-PYP activity and CPK content (r = -0.89). Pathologic severity worsened with increased Tc-PYP activity and diminished CPK content. There was a good correlation between gross infarct area and image infarct area, both in vivo (r = 0.79), and at post-mortem examination (r = 0.95). Gross infarct weight also correlated well with image infarct activity in vivo (r = 0.83 in the RAO view) and at postmortem examination (r = 0.87). An additional correlation between gross infarct weight and in vivo image infarct area (r = 0.92 in the LAO view) appeared most promising for future clinical evaluation. These experimental relationships are analyzed and future patient application of these imaging techniques are considered

  1. Early association of electrocardiogram alteration with infarct size and cardiac function after myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    TAO Ze-wei (陶则伟); HUANG Yuan-wei (黄元伟); XIA Qiang (夏强); FU Jun (傅军); ZHAO Zhi-hong (赵志宏); LU Xian (陆贤); BRUCE I.C.

    2004-01-01

    Objective: Myocardial infarction (MI) is the main cause of heart failure, but the relationship between the extent of MI and cardiac function has not been clearly determined. The present study was undertaken to investigate early changes in the electrocardiogram associated with infarct size and cardiac function after MI. Methods: MI was induced by ligating the left anterior descending coronary artery in rats. Electrocardiograms, echocardiographs and hemodynamic parameters were assessed and myocardial infarct size was measured from mid-transverse sections stained with Masson's trichrome. Results: The sum of pathological Q wave amplitudes was strongly correlated with myocardial infarct size (r = 0.920, P < 0.0001), left ventricular ejection fraction (r = (0.868, P < 0.0001) and left ventricular end diastolic pressure (r = 0.835, P < 0.0004). Furthermore, there was close relationship between MI size and cardiac function as assessed by left ventricular ejection fraction (r = (0.913, P < 0.0001) and left ventricular end diastolic pressure (r = 0.893, P < 0.0001). Conclusion: The sum of pathological Q wave amplitudes after MI can be used to estimate the extent of MI as well as cardiac function.

  2. A detailed family history of myocardial infarction and risk of myocardial infarction

    DEFF Research Database (Denmark)

    Ranthe, Mattis Flyvholm; Petersen, Jonathan Aavang; Bundgård, Henning;

    2015-01-01

    BACKGROUND: Family history of myocardial infarction (MI) is an independent risk factor for MI. Several genetic variants are associated with increased risk of MI and family history of MI in a first-degree relative doubles MI risk. However, although family history of MI is not a simple dichotomous...

  3. Early association of electrocardiogram alteration with infarct size and cardiac function after myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    陶则伟; 黄元伟; 夏强; 傅军; 赵志宏; 陆贤; BRUCEI.C.

    2004-01-01

    Objective:Myocardial infarction (MI) is the main cause of heart failure, but the relationship between the extent of MI and cardiac function has not been clearly determined.The present study was undertaken to investigate early changes in the electrocardiogram associated with infarct size and cardiac function after MI. Methods: MI was induced by ligating the left anterior descending coronary artery in rats. Electrocardiograms, echocardiographs and hemodynamic parameters were assessed and myocardial infarct size was measured from mid-transverse sections stained with Masson's trichrome. Results:The sum of pathological Q wave amplitudes was strongly correlated with myocardial infarct size (r=0.920, P<0.0001), left ventricular ejection fraction (r=-0.868, P<0.0001) and left ventricular end diastolic pressure (r=0.835, P<0.0004).Furthermore, there was close relationship between MI size and cardiac function as assessed by left ventricular ejection fraction (r=-0.913, P<0.0001) and left ventricular end diastolic pressure (r=0.893, P<0.0001).Conclusion: The sum of pathological Q wave amplitudes after MI can be used to estimate the extent of MI as well as cardiac function.

  4. Iron deposition following chronic myocardial infarction as a substrate for cardiac electrical anomalies: initial findings in a canine model.

    Directory of Open Access Journals (Sweden)

    Ivan Cokic

    Full Text Available PURPOSE: Iron deposition has been shown to occur following myocardial infarction (MI. We investigated whether such focal iron deposition within chronic MI lead to electrical anomalies. METHODS: Two groups of dogs (ex-vivo (n = 12 and in-vivo (n = 10 were studied at 16 weeks post MI. Hearts of animals from ex-vivo group were explanted and sectioned into infarcted and non-infarcted segments. Impedance spectroscopy was used to derive electrical permittivity ([Formula: see text] and conductivity ([Formula: see text]. Mass spectrometry was used to classify and characterize tissue sections with (IRON+ and without (IRON- iron. Animals from in-vivo group underwent cardiac magnetic resonance imaging (CMR for estimation of scar volume (late-gadolinium enhancement, LGE and iron deposition (T2* relative to left-ventricular volume. 24-hour electrocardiogram recordings were obtained and used to examine Heart Rate (HR, QT interval (QT, QT corrected for HR (QTc and QTc dispersion (QTcd. In a fraction of these animals (n = 5, ultra-high resolution electroanatomical mapping (EAM was performed, co-registered with LGE and T2* CMR and were used to characterize the spatial locations of isolated late potentials (ILPs. RESULTS: Compared to IRON- sections, IRON+ sections had higher[Formula: see text], but no difference in[Formula: see text]. A linear relationship was found between iron content and [Formula: see text] (p1.5% with similar scar volumes (7.28% ± 1.02% (Iron (1.5%, p = 0.51 but markedly different iron volumes (1.12% ± 0.64% (Iron (1.5%, p = 0.02, QT and QTc were elevated and QTcd was decreased in the group with the higher iron volume during the day, night and 24-hour period (p<0.05. EAMs co-registered with CMR images showed a greater tendency for ILPs to emerge from scar regions with iron versus without iron. CONCLUSION: The electrical behavior of infarcted hearts with iron appears to be different from those without iron. Iron within infarcted zones may

  5. MicroRNA-208b Alleviates Post-Infarction Myocardial Fibrosis in a Rat Model by Inhibiting GATA4

    Science.gov (United States)

    Zhou, Chaoyuan; Cui, Qintao; Su, Guobao; Guo, Xiaoliang; Liu, Xiaochen; Zhang, Jie

    2016-01-01

    Background Myocardial infarction affects the health of many people. Post-infarction myocardial fibrosis has attracted much attention, but details of the mechanism remain elusive. In this study, the role of microRNA-208b (miR-208b) in modulating post-infarction myocardial fibrosis and the related mechanism were investigated. Material/Methods A rat model of myocardial infarction induced by ligating the left anterior descending artery was used to analyze the expression and roles of miR-208b by overexpression with the lentivirus vector of pre-miR-208b. Myocardial function was assessed and the expression of fibrosis-related factors type I collagen (COL1) and ACTA2 (alias αSMA) was detected. Myocardial fibroblasts isolated from newborn rats were transfected with luciferase reporter vectors containing wild-type or mutant Gata4 3′ UTR to verify the relationship between Gata4 and miR-208b. We then transfected the specific small interference RNA of Gata4 to detect changes in COL1 and ACTA2. Results miR-208b was down-regulated in hearts of model rats (P<0.01). Overexpressing miR-208b improved myocardial functions, such as reducing the infarction area (P<0.05) and promoting LVEF and LVFS (P<0.01), and inhibited COL1 and ACTA2 (P<0.01). Luciferase reporter assay proved Gata4 to be the direct target of miR-208b, with the target sequence in the 3′UTR. Inhibiting GATA4 resulted in the down-regulation of COL1 and ACTA2, suggesting that the role of miR-208b was achieved via regulating GATA4. Conclusions This study demonstrates the protective function of miR-208b via GATA4 in post-infarction myocardial fibrosis, providing a potential therapeutic target for treating myocardial fibrosis. PMID:27236543

  6. Nonfasting glucose, ischemic heart disease, and myocardial infarction

    DEFF Research Database (Denmark)

    Benn, Marianne; Tybjaerg-Hansen, Anne; McCarthy, Mark I;

    2012-01-01

    The purpose of this study was to test whether elevated nonfasting glucose levels associate with and cause ischemic heart disease (IHD) and myocardial infarction (MI).......The purpose of this study was to test whether elevated nonfasting glucose levels associate with and cause ischemic heart disease (IHD) and myocardial infarction (MI)....

  7. Mechanisms and therapeutic modulation of myocardial infarct healing

    NARCIS (Netherlands)

    Timmers, L.

    2008-01-01

    This thesis aimed to increase the basic mechanistic understanding of myocardial infarct healing and to develop novel approaches to prevent heart failure following myocardial infarction (MI). Different approaches have been tested to reduce myocardial injury in the acute phase of MI, leading to reduce

  8. Left ventricular assessment in myocardial infarction - The VALIANT registry

    NARCIS (Netherlands)

    Hernandez, AF; Velazquez, EJ; Solomon, SD; Kilaru, R; Diaz, R; O'Connor, CM; Ertl, G; Maggioni, AP; Rouleau, JL; van Gilst, W; Pfeffer, MA; Califf, RM

    2005-01-01

    Background: How often echocardiography and cardiac catheterization are used to evaluate left ventricular (LV) function in patients with myocardial infarction (MI) and how they are associated with quality of care is unknown. Methods: Patients with MI in the Valsartan in Acute Myocardial Infarction (V

  9. Anterior Myocardial Infarction And Developing Ventricular Aneurysm After Cannabis Use

    OpenAIRE

    Murat Yalcin

    2014-01-01

        Incidence of drug abuse and cannabis have increased in young adults, recently. Cannabis induced myocardial infarction has rarely been reported in these people. Herein, we reported 20 years old male who had acute anterior myocardial infarction and developing apical ventricular aneurysm after heavy cannabis use.

  10. Sex differences in clinical characteristics and outcomes after myocardial infarction

    DEFF Research Database (Denmark)

    Lam, Carolyn S P; McEntegart, Margaret; Claggett, Brian;

    2015-01-01

    BACKGROUND: We examined the association of sex with clinical characteristics and outcomes in patients following myocardial infarction (MI) in the Valsartan in Acute Myocardial Infarction Trial (VALIANT). METHODS AND RESULTS: A total of 4570 women and 10 133 men with heart failure (HF), left ventr...

  11. Low High-Density Lipoprotein and Risk of Myocardial Infarction

    Science.gov (United States)

    Ramirez, A.; Hu, P. P.

    2015-01-01

    Low HDL is an independent risk factor for myocardial infarction. This paper reviews our current understanding of HDL, HDL structure and function, HDL subclasses, the relationship of low HDL with myocardial infarction, HDL targeted therapy, and clinical trials and studies. Furthermore potential new agents, such as alirocumab (praluent) and evolocumab (repatha) are discussed. PMID:26692765

  12. Recirculation usually precedes malignant edema in middle cerebral artery infarcts

    DEFF Research Database (Denmark)

    Nielsen, T H; Ståhl, N; Schalén, W;

    2012-01-01

    In patients with large middle cerebral artery (MCA) infarcts, maximum brain swelling leading to cerebral herniation and death usually occurs 2-5 days after onset of stroke. The study aimed at exploring the pattern of compounds related to cerebral energy metabolism in infarcted brain tissue....

  13. Evaluation of cat brain infarction model using microPET

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J. J.; Lee, D. S.; Kim, J. H.; Hwang, D. W.; Jung, J. G.; Lee, M. C [College of Medicine, Seoul National University, Seoul (Korea, Republic of); Lim, S. M [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2004-07-01

    PET has some disadvantage in the imaging of small animal due to poor resolution. With the advance of microPET scanner, it is possible to image small animals. However, the image quality was not so much satisfactory as human image. As cats have relatively large sized brain, cat brain imaging was superior to mice or rat. In this study, we established the cat brain infarction model and evaluate it and its temporal change using microPET scanner. Two adult male cats were used. Anesthesia was done with xylazine and ketamine HCl. A burr hole was made at 1cm right lateral to the bregma. Collagenase type IV 10 ul was injected using 30G needle for 5 minutes to establish the infarction model. F-18 FDG microPET (Concorde Microsystems Inc., Knoxville. TN) scans were performed 1. 11 and 32 days after the infarction. In addition. 18F-FDG PET scans were performed using Gemini PET scanner (Philips medical systems. CA, USA) 13 and 47 days after the infarction. Two cat brain infarction models were established. The glucose metabolism of an infraction lesion improved with time. An infarction lesion was also distinguishable in the Gemini PET scan. We successfully established the cat brain infarction model and evaluated the infarcted lesion and its temporal change using F-18 FDG microPET scanner.

  14. Prognostic importance of complete atrioventricular block complicating acute myocardial infarction

    DEFF Research Database (Denmark)

    Aplin, Mark; Engstrøm, Thomas; Vejlstrup, Niels G;

    2003-01-01

    Third-degree atrioventricular block after acute myocardial infarction is considered to have prognostic importance. However, its importance in conjunction with thrombolytic therapy and its relation to left ventricular function remains uncertain. This report also outlines an important distinction...... between atrioventricular block in the setting of anterior and inferior wall acute myocardial infarction, with profound clinical and prognostic implications....

  15. Thrombotic stroke and myocardial infarction with hormonal contraception

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Løkkegaard, Ellen; Jensen, Aksel Karl Georg;

    2012-01-01

    Although several studies have assessed the risk of venous thromboembolism with newer hormonal contraception, few have examined thrombotic stroke and myocardial infarction, and results have been conflicting.......Although several studies have assessed the risk of venous thromboembolism with newer hormonal contraception, few have examined thrombotic stroke and myocardial infarction, and results have been conflicting....

  16. Predictors of Appraisal and Coping Dimensions in Myocardial Infarction Victims.

    Science.gov (United States)

    Lee, Hyong Sil; Martin, Peter

    This study attempted to identify predictors of perception and coping after the occurrence of a myocardial infarction. Sixty males and 17 females who had suffered from a myocardial infarction within 3 months prior to the research were recruited from a hospital rehabilitation program. Subjects completed the Peri-Life Events Scale, the 16-PF…

  17. Galectin-3 and post-myocardial infarction cardiac remodeling

    NARCIS (Netherlands)

    Meijers, Wouter C.; van der Velde, A. Rogier; Pascual-Figal, Domingo A.; de Boer, Rudolf A.

    2015-01-01

    This review summarizes the current literature regarding the involvement and the putative role(s) of galectin-3 in post-myocardial infarction cardiac remodeling. Post-myocardial infarction remodeling is characterized by acute loss of myocardium, which leads to structural and biomechanical changes in

  18. MRI findings on lacunar infarction with no clinical symptoms

    International Nuclear Information System (INIS)

    The purpose of this study was to examine how lacunar infarction developed and what its characteristics were. As this disease had little noticeable clinical symptoms and is likely to draw less attention than other types of cerebrovascular diseases like panhemispheric infarction, it's difficult to make an early diagnosis of it or treat it successfully. The subjects in this study were 196 people who showed no clinical symptoms and took a MRI test. When the MRI test data were analyzed, signal intensity and the part where that disease was detected were primarily taken into account. As a result, it's found that 116 people had no lacunar infarction and 80 people suffered from that disease, including 13 with very mild lacunar infarction, 41 with mild lacunar infarction and 26 with lacunar infarction. However, very mild and mild lacunar infarction could not be viewed as clinically significant cases, and only 26 people, which accounted for 13 percent of the subjects, should be considered to be diagnosed with lacunar infarction. The most common part where that disease was found was white matter and basal ganglia, regardless of gender. Accordingly, those who are exposed to health hazards such as hypertension or diabetes should take a MRI test to prevent cerebrovascular diseases that might be caused by those illnesses

  19. MRI findings on lacunar infarction with no clinical symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ham Gyum [Ansan College, Ansan (Korea, Republic of)

    2003-12-15

    The purpose of this study was to examine how lacunar infarction developed and what its characteristics were. As this disease had little noticeable clinical symptoms and is likely to draw less attention than other types of cerebrovascular diseases like panhemispheric infarction, it's difficult to make an early diagnosis of it or treat it successfully. The subjects in this study were 196 people who showed no clinical symptoms and took a MRI test. When the MRI test data were analyzed, signal intensity and the part where that disease was detected were primarily taken into account. As a result, it's found that 116 people had no lacunar infarction and 80 people suffered from that disease, including 13 with very mild lacunar infarction, 41 with mild lacunar infarction and 26 with lacunar infarction. However, very mild and mild lacunar infarction could not be viewed as clinically significant cases, and only 26 people, which accounted for 13 percent of the subjects, should be considered to be diagnosed with lacunar infarction. The most common part where that disease was found was white matter and basal ganglia, regardless of gender. Accordingly, those who are exposed to health hazards such as hypertension or diabetes should take a MRI test to prevent cerebrovascular diseases that might be caused by those illnesses.

  20. Exercise test in acute myocardial infarction.

    Science.gov (United States)

    Hsi, W L; Lai, J S

    1996-01-01

    Although maximal oxygen consumption (VO2max) and oxygen consumption at anaerobic threshold (VO2AT) were used to measure cardiac function, the clinical significance in acute myocardial infarction (MI) has not been reported. The purpose of this study was to compare VO2max and VO2AT between post-MI patients and healthy men and to correlate the parameters to other clinical measures. Forty-three active healthy men, 44 sedentary healthy men, and 43 post-MI patients were studied using incremental cycle exercise test. Their work rates, oxygen consumption, heart rates, oxygen pulses, ventilation, and other parameters at VO2max and VO2AT were determined with spirometer, gas concentration analyzer, and electrocardiograph. Anaerobic threshold was determined by analyzing the ventilatory parameters. Most of the exercise test parameters at VO2max were greatest in the active men, intermediate in the sedentary men, and least in the post-MI patients (P pressure products of the active men and sedentary men were not significantly different from each other and were greater than those of the post-MI patients (P < 0.01). In the post-MI patients, VO2max was inversely correlated to the peak serum level of creatine phosphokinase MB isoenzyme (P < 0.01) and associated with extensive infarction (P < 0.05). Most of the parameters at VO2AT were greater in the active men than in the sedentary men (P < 0.01) but not significantly different between the sedentary men and post-MI patients. In the post-MI patients, VO2AT was significantly correlated to left ventricular ejection fraction (P < 0.01) and associated with heart failure (P < 0.05). The results revealed that VO2max and VO2AT had different clinical significance in post-MI patients; VO2max was related to the infarct size, and VO2AT was related to the pumping function of heart. PMID:8777021

  1. The electrocardiogram in acute myocardial infarction

    International Nuclear Information System (INIS)

    In 2006, 94 years after Eindhoven W. performed the first electrocardiogram (ECG) three derivations, J. Willis Hurst said: The treatment of acute coronary syndrome is based entirely on electrocardiogram a normalities. Therefore, the correct interpretation of the electrocardiogram is needed now more than ever in the history of medicine.This article will address those aspects of the subject that we consider most useful for clinical cardiologists should assist patients with acute myocardial infarction (AMI) in the crucial first minutes or hours of their evolution

  2. Spatial disorientation in right-hemisphere infarction.

    Science.gov (United States)

    Meerwaldt, J D; van Harskamp, F

    1982-01-01

    Spatial orientation was tested with the rod orientation test. The subjects were 40 normal controls and 68 brain-damaged patients with cerebral infarcts. Patients in whom the lesion included the post-rolandic region of the right hemisphere performed worse than controls or patients with lesions at other sites. Patients with an exclusively postrolandic (usually occipital) lesion showed higher error rates than patients with a combined prerolandic and postrolandic lesion, but only for the visual part of the test. These patients were re-examined one year after the stroke. Most of them showed an incomplete recovery of spatial function. PMID:7119828

  3. Embolic renal infarction mimicking renal colic

    OpenAIRE

    Mahamid M; Francis A.; Abid A; Awawde M; Abu-Elhija O

    2014-01-01

    Mahmud Mahamid,1,3 Adi Francis,2 Ali Abid,1 Mohammed Awawde,1 Omar Abu-Elhija11Department of Internal Medicine, 2Cardiac Care Unit, Holy Family Hospital, Bar-Ilan University, Nazareth, Israel; 3Digestive Disease Institute, Liver Unit, Shaare Zedek Medical Center, Jerusalem, IsraelAbstract: Atrial fibrillation is a major health problem with risk of systemic arterial embolism. Acute embolic renal infarction is a rare condition with symptoms that are often nonspecific. We present a 36-year-old p...

  4. ST Elevation Myocardial Infarction in the elderly

    Institute of Scientific and Technical Information of China (English)

    Marcelo Franken; Amit Nussbacher; Alberto Liberman; Mauricio Wajngarten

    2012-01-01

    Acute coronary syndromes (ACS) are the leading causes of death in the elderly. The suspicion and diagnosis of ACS in this age group is more difficult, since typical angina is less frequent. The morbidity and mortality is greater in older age patients presenting ACS. Despite the higher prevalence and greater risk, elderly patients are underrepresented in major clinical trials from which evidence based recommendations are formulated. The authors describe, in this article, the challenges in the diagnosis and management of ST elevation myocardial infarction in the elderly, and discuss the available evidence.

  5. [Cognitive structure and risk of myocardial infarct].

    Science.gov (United States)

    Günther, C; Günther, R; Reinhardt, F; Meissner, D; Dresler, F; Guhr, R; Hubl, W; Keil, J; Schüttig, R

    1990-08-01

    In a psychophysiological experiment with 18 patients with cardiovascular disorders but without infarction we proved the influence of habituallized cognitive structures on reactivity under mental load. We used the concepts of different causal attribution (Explanatory style: Peterson and Seligman) and psychic regulation of activity and action (Activity style: Günther). It can be shown that patients with pessimistic explanatory style as well as with diffuse psychic activity control show coronary-prone reaction patterns under load (indicators: cortisol and triglycerids in serum). PMID:2267852

  6. Predictors of thrombus burden and no-reflow of infarct-related artery in patients with ST-segment elevation myocardial infarction: importance of platelet indices.

    Science.gov (United States)

    Cakici, Musa; Cetin, Mustafa; Balli, Mehmet; Akturk, Erdal; Dogan, Adnan; Oylumlu, Muhammed; Abus, Sabri; Yildiz, Emrah; Sungur, Azmi; Celiker, Meral

    2014-10-01

    Preprocedural high-thrombus burden (HTB) of infarct-related artery (IRA) is a harbinger of procedural complications following primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). The HTB of IRA can lead to poor outcomes by various mechanisms, including no-reflow phenomenon, increased myocardial necrosis and with subsequent reduced survival benefit at follow-up. In this study, we investigated the relationship between all platelet indices on admission and thrombus burden and the no-reflow phenomenon after primary PCI of IRA in patients with STEMI. We retrospectively enrolled 475 patients with STEMI undergoing primary PCI. Study population was divided into two groups according to the thrombolysis in myocardial infarction thrombus grade of IRA as low-thrombus burden or HTB. There were no statistically significant differences in platelet indices, including platelet count, platelet-large cell ratio (P-LCR), mean platelet volume (MPV) and platelet distribution with (PDW) among the groups. However, in the subgroup analysis, P-LCR, MPV and PDW were significantly higher in the no-reflow patients than reflow patients despite similar platelet count (P for all < 0.001). The cutoff value of P-LCR for predicting no-reflow was 26.5% with a sensitivity of 67.0% and a specificity of 62% (area under the curve, 0.689; 95% confidence interval, 0.614-0.765; P < 0.001). Furthermore, P-LCR, MPV and PDW had similar AUC (0.689, P < 0.001; 0.688, P < 0.001; and 0.677, P < 0.001; respectively) for predicting no-reflow phenomenon after primary PCI. As a result, all of the platelet indices have no effect on thrombus load of IRA, however, these parameters seem to impair epicardial perfusion after primary PCI. PMID:24806326

  7. [Case of infective endocarditis diagnosed with renal infarction].

    Science.gov (United States)

    Nakayama, Takayuki; Yokoyama, Minato; Saito, Kazutaka; Takenaka, Shunsuke; Kubo, Yuichi; Iimura, Yasumasa; Numao, Noboru; Sakai, Yasuyuki; Koga, Fumitaka; Fujii, Yasuhisa; Kobayashi, Tsuyoshi; Kawakami, Satoru; Kihara, Kazunori

    2009-03-01

    A 46-year-old woman with sudden on set strong right flank pain was transferred to our hospital with the diagnosis of right renal infarction. Cardiac ultrasonography revealed a vegetation on the posterior cusp of the mitral valve, and the renal infarction was thought to be caused by renal artery embolism from infective endocarditis. Since the vegetation remained after antimicrobial therapy as conservative management, the patient was surgically treated by mitral annuloplasty. It has been known that infective endocarditis can cause renal infarction. Infective endocarditis requires immediate and adequate treatment because of high mortality. Therefore, the appropriate diagnosis of infective endocarditis is needed for patients with renal infarction without any other disorder causing renal infarction.

  8. Glycemic Control for Patients With Acute Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    Hai-peng XIAO; Juan CHEN

    2009-01-01

    @@ The risk of myocardial infarction increases in patients with diabetes mellitus. The incidence of myocardial in-farction is similar in patients with type 2 diabetes without history of myocardial infarction and in non-diabetic pa-tients with history of myocardial infarction. Diabetes mellitus was considered as a coronary disease equivalent by the National Cholesterol Education Program. Strict glycemic control can improve the long-term outcome of both type 1 and type 2 diabetes mellitus. Whatever with diabetic or non-diabetic, strict glycemic control with in-tensive insulin therapy can reduce the mortality of criti-cally ill patients in hospital. After myocardial infarction, there would be a worse outcome for patients with poor glycemic control, whatever in diabetic or non-diabetic patients with stress hyperglycemia.

  9. Effect of hepatocyte growth factor on left ventricular remodeling after acute myocardial infarction in canine

    Institute of Scientific and Technical Information of China (English)

    Ping LI; Tingshu YANG; Liling LIANG

    2006-01-01

    Background and objectives To investigate the effect of hepatocyte growth factor (HGF) on left ventricular (LV) remodeling after acute myocardial infarction (AMI). Methods AMI was produced by ligation of proximal left anterior descending coronary artery(LAD) in 12 mongrel canines. These animals were randomized into 2 groups. In HGF group (n=6), canines were injected with pcDNA3-HGF lml (about 300ug) at the margin of infarcted myocardium; in control group (n=6) canines were injected with equal volume of normal saline. Cardiac function and left ventricular remodeling were evaluated with echocardiography at 1, 4, 8 weeks after MI. LV myocardium specimens were obtained at 8 weeks and stained with hematoxylin and eosin for histological examination or with sirius red to assess the collagen content. Results Compared with control group, LVEF in HGF group was significantly higher at 4 weeks (49.61+6.66 vs 39.84+6.39; P<0.05) and at 8 weeks (51.57+8.53 vs 40.61+7.67; P<0.05) after AMI, while LVESV was significantly lower in HGF group than that in control group at 8 weeks after AMI (18.98+3.47 vs 25.66+5.86; P<0.05). Posterior left ventricular wall thickness decreased significantly from 1 wk to 8 wks after AMI in control group, while remained unchanged in HGF group. Compared with control group, histological examination showed more neovascularization and less scar, and sirius red staining indicated higher volume of type Ⅲ collagen (7.10±4.06% vs 3.77±1.09%; P<0.05) and lower collagen Ⅰ/Ⅲ ratio value (1.11±0.52 vs 2.94±2.48; P<0.05)in HGF group. Conclusion HGF gene transfer might improve cardiac function and LV remodeling after acute myocardial infarction by stimulating angiogenesis, reducing fibrosis, and reducing myocardial scarring.

  10. CURRENT REPERFUSION THERAPY POSSIBILITIES IN MYOCARDIAL INFARCTION AND ISCHEMIC STROKE

    Directory of Open Access Journals (Sweden)

    E. V. Konstantinova

    2015-01-01

    Full Text Available Myocardial infarction and ischemic stroke remain to be of the greatest medical and social importance because of their high prevalence, disability, and mortality rates. Intractable thrombotic occlusion of the respective artery leads to the formation of an ischemic lesion focus in the tissue of the heart or brain. Emergency reperfusion serves to decrease a necrotic focus, makes its formation reversible, and reduces patient death rates. The paper considers main reperfusion therapy lines: medical (with thrombolytic drugs and mechanical (with primary interventions one and their combination in treating patients with acute myocardial and cerebral ischemia. Each reperfusion procedure is discussed in view of its advantages, disadvantages, available guidelines, and possibilities of real clinical practice. Tenecteplase is assessed in terms of its efficacy, safety, and capacities for bolus administration, which allows its use at any hospital and at the pre-hospital stage. Prehospital thrombolysis permits reperfusion therapy to bring much closer to the patient and therefore aids in reducing time to reperfusion and in salvaging as much the myocardial volume as possible. The rapidest recovery of myocardial and cerebral perfusion results in a decreased necrotic area and both improved immediate and late prognosis. The results of randomized clinical trials studying the possibilities of the medical and mechanical methods to restore blood flow are analyzed in the context of evidence-based medicine. The reason why despite the available contraindications, limited efficiency, and the risk of hemorrhagic complications, thrombolytic therapy remains the method of choice for prehospital reperfusion, an alternative to primary percutaneous coronary intervention (PCI if it cannot be carried out in patients with myocardial infarction at the stated time, and the only treatment ischemic stroke treatment that has proven its efficiency and safety in clinical trials is under

  11. Stromal cell-derived factor-1α promotes angiogenesis in the peri-infarct region in adults with cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    凌莉

    2014-01-01

    Objective To investigate the possible effects of exogenous stromal cell-derived factor-1α(SDF-1α)on cell proliferation and angiogenesis in the ipsilateral thalamic ventroposterior nucleus(VPN)in adult rats with focal cortical infarction.Methods Thirty-six hypertensive rats with focal cortical infarction were divided randomly into the SDF-1αgroup,vehicle

  12. Peri-infarct zone pacing to prevent adverse left ventricular remodelling in patients with large myocardial infarction

    DEFF Research Database (Denmark)

    Stone, Gregg W; Chung, Eugene S; Stancak, Branislav;

    2016-01-01

    AIMS: We sought to determine whether peri-infarct pacing prevents left ventricular (LV) remodelling and improves functional and clinical outcomes in patients with large first myocardial infarction (MI). METHODS AND RESULTS: A total of 126 patients at 27 international sites within 10 days of onset...

  13. Peri-infarct dysfunction in post-myocardial infarction: assessment of 3-T tagged and late enhancement MRI

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Yuma; Nagao, Michinobu; Higashino, Hiroshi; Hosokawa, Kohei; Kido, Teruhito; Kurata, Akira; Mochizuki, Teruhito [Ehime University Graduate School of Medicine, Department of Diagnostic and Therapeutic Radiology, Toon-city, Ehime (Japan); Yang, Xiaomei [Sichuan University, College of Electrical Engineering and Information Technology, Sichuan (China); Okayama, Hideki; Higaki, Jitsuo [Ehime University Graduate School of Medicine, Department of Integrated Medicine and Informatics, Matsuyama City (Japan); Murase, Kenya [Osaka University Medical School, Department of Medical Engineering Division of Allied Health Sciences, Osaka (Japan)

    2010-05-15

    To determine LV function at different distances from myocardial infarction (MI) by using 3-T tagged MRI and late gadolinium enhancement (LGE). Cardiac MR images were acquired from 21 patients with previous MI. The harmonic phase (HARP) method was used to calculate radial and circumferential strain (RS, CS). The two strains were synchronised by subtracting the CS from the RS at the same time, and this was defined as the efficient strain (ES). Peak strain (P-RS, P-CS, P-ES) and time to peak strain (T-RS, T-CS, T-ES) were used as estimates of contractile function. Based on the presence of LGE, myocardium was classified into infarct, border zone, adjacent and remote areas. P-RS and P-ES were significantly greater for remote than for adjacent and infarct areas. P-CS values were significantly greater for remote and border zone than for infarct areas. T-RS and T-ES were significantly shorter for remote and border zone than for infarct areas. T-CS was significantly shorter for border zone than for infarct areas. Contractile dysfunction demonstrated by peak strain was correlated with location at different distances from the infarct. In the border zone, contractile deformation was characterised as earlier T-RS, T-CS and T-ES and greater P-CS than in the infarct area. (orig.)

  14. Diabetic Muscle Infarction: A Rare Cause of Acute Limb Pain in Dialysis Patients

    Directory of Open Access Journals (Sweden)

    G. De Vlieger

    2013-01-01

    Full Text Available Diabetic muscle infarction is a rare microangiopathic complication occurring in patients with advanced diabetes mellitus. Diabetic patients with chronic kidney disease stage Vd are prone to develop this complication. The presenting symptom is a localized painful swelling of the affected limb. Symptoms usually resolve spontaneously during the following weeks, but frequent relapse can occur and in some cases swelling may lead to compartment syndrome. Biochemical blood analyses show an elevated C-reactive protein, but creatine kinase is often normal. Diagnosis can be made on clinical presentation and imaging, with magnetic resonance imaging as the gold standard. Histology is often not contributive. Treatment consists of rest, analgesics, rigorous glycemic control and low-dose aspirin. Severe cases of compartment syndrome require fasciotomy. In the current paper, we present two diabetic patients with cystic fibrosis, who are treated with automated peritoneal dialysis and suffered from episodic lower limb infarction. We subsequently review 48 episodes of diabetic muscle infarction previously reported in the literature in patients with end-stage renal disease.

  15. Motor outcomes of patients with a complete middle cerebral artery territory infarct*

    Institute of Scientific and Technical Information of China (English)

    Sung Ho Jang; Min Cheol Chang

    2013-01-01

    Detailed knowledge of motor outcomes enables to establish proper goals and rehabilitation strate-gies for stroke patients. Several previous studies have reported functional or motor outcomes in patients with a middle cerebral artery territory infarct. However, little is known about motor outcome in patients with a complete middle cerebral artery territory infarct. In this study, we investigated the motor outcomes in 23 patients with a complete middle cerebral artery territory infarct. Al of these patients received comprehensive rehabilitative management, including movement therapy and neuromuscular electrical stimulation of the affected finger extensors and ankle dorsiflexors, for more than 3 months. Motor outcomes were measured at 6 months after stroke onset using the Medical Research Council, Motricity Index, the modified Brunnstrom Classification, and Functional Ambula-tion Category scores. The motor function of the lower extremities was found to be better than that of the upper extremities. After receiving rehabilitation treatments for 3-6 months, about 70%of these patients were able to walk independently (Functional Ambulation Category scores>3), but no pa-tient achieved functional hand recovery.

  16. Guides of clinical practice in the management of acute myocardial infarction. Two different periods.

    Directory of Open Access Journals (Sweden)

    Brandy Viera Valdés

    2006-08-01

    Full Text Available Background: The elaboration of clinical practice guides has each day a greater significance in the medical attention, but we should not forget its efficacy assessment once they have been established. Objectives: To evaluate the application and impact of the clinical practice guides in the final result of the acute myocardial infarction inn-patients, comparing two different periods of its application (1997 and 2001. Methods: A prospective study of a series of cases in its respective years was done. A total of 315 patients were involved, 154 in 1997; and 161 in 2001. The following variables were analyzed: risk factors, symptoms, complementary tests result, medical attention related aspects, as well as the patient evaluation until dismissal. Results: When comparatively analyzed the two series, a significant mortality reduction in the year 2001 was observed: it lowered from 35, 0 % in 1997 to 17, 4 % in the second patients group. In 2001 the risk of dying from an infarction was two times less than in 1997 (relative risk: 2, 02 (1, 35 – 3, 01. Conclusions: Mortality reduction for myocardial infarction in this hospital could be related, in a high percentage, with the adequate use of the clinical practice guides, used nowadays in the management of such affection.

  17. Computer-based assessment of left ventricular regional ejection fraction in patients after myocardial infarction

    Science.gov (United States)

    Teo, S.-K.; Su, Y.; Tan, R. S.; Zhong, L.

    2014-03-01

    After myocardial infarction (MI), the left ventricle (LV) undergoes progressive remodeling which adversely affects heart function and may lead to development of heart failure. There is an escalating need to accurately depict the LV remodeling process for disease surveillance and monitoring of therapeutic efficacy. Current practice of using ejection fraction to quantitate LV function is less than ideal as it obscures regional variation and anomaly. Therefore, we sought to (i) develop a quantitative method to assess LV regional ejection fraction (REF) using a 16-segment method, and (ii) evaluate the effectiveness of REF in discriminating 10 patients 1-3 months after MI and 9 normal control (sex- and agematched) based on cardiac magnetic resonance (CMR) imaging. Late gadolinium enhancement (LGE) CMR scans were also acquired for the MI patients to assess scar extent. We observed that the REF at the basal, mid-cavity and apical regions for the patient group is significantly lower as compared to the control group (P infarction. The results suggest that REF could potentially be used as a discriminator for MI and employed to measure myocardium homogeneity with respect to degree of infarction. The computational performance per data sample took approximately 25 sec, which demonstrates its clinical potential as a real-time cardiac assessment tool.

  18. Akinetic Mutism Following Bilateral Anterior Cerebral Artery Territory Infarction Due to Aneurysm: A Case Report

    Directory of Open Access Journals (Sweden)

    Zeynep Özözen Ayas

    2014-04-01

    Full Text Available BACKGROUND AND PURPOSE: Bilateral anterior cerebral artery (ACA territory infarction is rare localization in stroke which should always prompt a search for an anterior communicating artery (ACoA aneurysm. The common neurological manifestations are contralateral weakness predominate in the lower extremite, behavior disturbance, motor inertia, muteness, incontinence, grasp reflex, diffuse rigidity, akinetic mutism. CASE DESCRIPTION: We describe a 38-year-old woman presented with a left sided hemiparesia and decrease of speech for last days. She was a smoker and morbide obese. She had no any diagnosed disease. Her neurological examination had weakness of left extremites affected leg more than the arm and akinetic mutism like as no spontaneously speech and move and grasp reflex. CT showed bilateral ACA infarction which included cingulate gyrus, the right side more than left and subarachnoid hemorrhage in the interhemispheric fissure. MRI angiography showed the appearance of AcoA aneurysm. CONCLUSION: We report a patient with bilateral infarction in the ACA which a rare localization and clinicians must be alert to exist AcoA aneurysm which may bleed, different symptoms and signs like as akinetic mutism, primitive reflexes.

  19. Effect of Metformin Treatment on Lipoprotein Subfractions in Non-Diabetic Patients with Acute Myocardial Infarction: A Glycometabolic Intervention as Adjunct to Primary Coronary Intervention in ST Elevation Myocardial Infarction (GIPS-III Trial.

    Directory of Open Access Journals (Sweden)

    Ruben N Eppinga

    Full Text Available Metformin affects low density lipoprotein (LDL and high density (HDL subfractions in the context of impaired glucose tolerance, but its effects in the setting of acute myocardial infarction (MI are unknown. We determined whether metformin administration affects lipoprotein subfractions 4 months after ST-segment elevation MI (STEMI. Second, we assessed associations of lipoprotein subfractions with left ventricular ejection fraction (LVEF and infarct size 4 months after STEMI.371 participants without known diabetes participating in the GIPS-III trial, a placebo controlled, double-blind randomized trial studying the effect of metformin (500 mg bid during 4 months after primary percutaneous coronary intervention for STEMI were included of whom 317 completed follow-up (clinicaltrial.gov Identifier: NCT01217307. Lipoprotein subfractions were measured using nuclear magnetic resonance spectroscopy at presentation, 24 hours and 4 months after STEMI. (Apolipoprotein measures were obtained during acute STEMI and 4 months post-STEMI. LVEF and infarct size were measured by cardiac magnetic resonance imaging.Metformin treatment slightly decreased LDL cholesterol levels (adjusted P = 0.01, whereas apoB remained unchanged. Large LDL particles and LDL size were also decreased after metformin treatment (adjusted P<0.001. After adjustment for covariates, increased small HDL particles at 24 hours after STEMI predicted higher LVEF (P = 0.005. In addition, increased medium-sized VLDL particles at the same time point predicted a smaller infarct size (P<0.001.LDL cholesterol and large LDL particles were decreased during 4 months treatment with metformin started early after MI. Higher small HDL and medium VLDL particle concentrations are associated with favorable LVEF and infarct size.

  20. Effect of Metformin Treatment on Lipoprotein Subfractions in Non-Diabetic Patients with Acute Myocardial Infarction: A Glycometabolic Intervention as Adjunct to Primary Coronary Intervention in ST Elevation Myocardial Infarction (GIPS-III) Trial

    Science.gov (United States)

    Eppinga, Ruben N.; Hartman, Minke H. T.; van Veldhuisen, Dirk J.; Lexis, Chris P. H.; Connelly, Margery A.; Lipsic, Erik; van der Horst, Iwan C. C.; van der Harst, Pim; Dullaart, Robin P. F.

    2016-01-01

    Objective Metformin affects low density lipoprotein (LDL) and high density (HDL) subfractions in the context of impaired glucose tolerance, but its effects in the setting of acute myocardial infarction (MI) are unknown. We determined whether metformin administration affects lipoprotein subfractions 4 months after ST-segment elevation MI (STEMI). Second, we assessed associations of lipoprotein subfractions with left ventricular ejection fraction (LVEF) and infarct size 4 months after STEMI. Methods 371 participants without known diabetes participating in the GIPS-III trial, a placebo controlled, double-blind randomized trial studying the effect of metformin (500 mg bid) during 4 months after primary percutaneous coronary intervention for STEMI were included of whom 317 completed follow-up (clinicaltrial.gov Identifier: NCT01217307). Lipoprotein subfractions were measured using nuclear magnetic resonance spectroscopy at presentation, 24 hours and 4 months after STEMI. (Apo)lipoprotein measures were obtained during acute STEMI and 4 months post-STEMI. LVEF and infarct size were measured by cardiac magnetic resonance imaging. Results Metformin treatment slightly decreased LDL cholesterol levels (adjusted P = 0.01), whereas apoB remained unchanged. Large LDL particles and LDL size were also decreased after metformin treatment (adjusted P<0.001). After adjustment for covariates, increased small HDL particles at 24 hours after STEMI predicted higher LVEF (P = 0.005). In addition, increased medium-sized VLDL particles at the same time point predicted a smaller infarct size (P<0.001). Conclusion LDL cholesterol and large LDL particles were decreased during 4 months treatment with metformin started early after MI. Higher small HDL and medium VLDL particle concentrations are associated with favorable LVEF and infarct size. PMID:26808474

  1. Occipital lobe infarction and positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Tagawa, Koichi; Nagata, Ken; Shishido, Fumio (Research Inst. of Brain and Blood Vessels, Akita (Japan))

    1990-08-01

    Even though the PET study revealed a total infarct in the territory of the left PCA in our 3 cases of pure alesia, it is still obscure which part of the left occipital lobe is most closely associated with the occurrence of the pure alexia. In order to elucidate the intralobar localization of the pure alexia, it is needed to have an ideal case who shows an pure alexia due to the localized lesion within the left occipital lobe. Furthermore, high-resolution PET scanner will circumvent the problem in detecting the metabolism and blood flow in the corpus callosum which plays an important role in the pathogenesis. We have shown that the occlusion of the right PCA also produced a left unilateral agnosia which is one of the common neurological signs in the right MCA infarction. To tell whether the responsible lesion for the unilateral spatial agnosia differs between the PCA occlusion and the MCA occlusion, the correlation study should be carried out in a greater number of the subjects. Two distinctive neuropsychological manifestations, cerebral color blidness and prosopagnosia, have been considered to be produced by the bilateral occipital lesion. The PET studies disclosed reduction of blood flow and oxygen metabolism in both occipital lobes in our particular patient who exibited cerebral color blindness and posopagnosia. (author).

  2. [On the actual nomenclature of myocardial infarcts].

    Science.gov (United States)

    Medrano, Gustavo A; Aranda, Alberto; Meléndez, Gabriela; de Micheli, Alfredo

    2010-01-01

    Certain criteria are examined for infarctions currents defined as inferior or inferolateral. To do this, certain considerations on the anatomical aspects of isolated and in situ heart are laid out. The topographical relationship of the in situ heart with other adjacent thoracic organs is described. The heart is schematically represented as a pyramid with a triangular base and its walls and borders are related to walls of the thorax. The spatial orientation of the main resulting vectors from ventricular depolarization and repolarization are summarized also. Usefulness of registering the unipolar thoracic leads V7, V8, V9 or a complete electrocardiographic thoracic circle, is underlined. This method allows to detect for of the existence of an acute myocardial infarction in the inferior and inferolateral segments in as third basal and mid cardiac regions previously denominated posterolateral. On the base of previous electroanatomical comparisons, it is concluded that the thoracic posterior leads V7 - V9, as well as the magnetic resonance images, explore the same heart regions. Therefore, these two methods: electrocardiography which is an essentially functional method and magnetic resonance that especially focus on structural changes are not contradictory but rather complementary tests." PMID:21147577

  3. Medical image of the week: splenic infarction

    Directory of Open Access Journals (Sweden)

    Casey DJ

    2016-08-01

    Full Text Available No abstract available. Article truncated after 150 words. A 52-year-old Hispanic woman with a past medical history significant for Type 1 Diabetes Mellitus, hypertension, and rheumatoid arthritis presented with left upper quadrant pain for one day. Her review of systems was positive for bloating, severe epigastric and left upper quadrant tenderness that radiated to the back and left shoulder, nausea with non-bilious emesis, and diarrhea for one day prior to admission. Physical exam only revealed epigastric and left upper quadrant tenderness to light palpation without rebound or guarding. Abdominal computed tomography of the abdomen demonstrated a new acute or subacute splenic infarct with no clear evidence of an embolic source in the abdomen or pelvis (Figure 1. Echocardiogram with bubble study and contrast did not demonstrate valve abnormalities, cardiac mass, vegetation, valve or wall motion abnormalities and no evidence of patent foramen ovale. Splenic infarction should be suspected when patients present with sharp, acute left upper quadrant pain ...

  4. Abnormal glucose metabolism in acute myocardial infarction: influence on left ventricular function and prognosis

    DEFF Research Database (Denmark)

    Høfsten, Dan E; Løgstrup, Brian B; Møller, Jacob E;

    2009-01-01

    to be particularly attributable to an increased incidence of post-infarction congestive heart failure. A relationship between glucose metabolism and LV function could potentially explain this excess mortality. METHODS: In patients without known diabetes, glucose metabolism was determined using an oral glucose...... atrial volume index) and by measuring plasma N-terminal pro-B-type natriuretic peptide levels. RESULTS: After adjustment for age and gender, a linear relationship between the degree of abnormal glucose metabolism was observed for each marker of LV dysfunction (p(trend) ... atrial volume index (p = 0.10). During a median follow-up of 21 months, 32 patients died, and 39 patients met the secondary end point of death or hospitalization for heart failure. After adjustment for differences in LV function, as well as other relevant characteristics, newly detected, as well as known...

  5. Global and regional left ventricular strain indices in post-myocardial infarction patients with ventricular arrhythmias and moderately abnormal ejection fraction.

    Science.gov (United States)

    Nguyen, Bich Lien; Capotosto, Lidia; Persi, Alessandro; Placanica, Attilio; Rafique, Asim; Piccirillo, Gianfranco; Gaudio, Carlo; Gang, Eli S; Siegel, Robert J; Vitarelli, Antonio

    2015-02-01

    The aim of the study described here was to compare myocardial strains in ischemic heart patients with and without sustained ventricular tachycardia (VT) and moderately abnormal left ventricular ejection fraction (LVEF) to investigate which index could better predict VT on the basis of the analysis of global and regional left ventricular (LV) dysfunction. We studied 467 patients with previous myocardial infarction and LVEF >35%. Fifty-one patients had documented VT, and 416 patients presented with no VT. LV volumes and score index were obtained by 2-D echocardiography. Longitudinal, radial and circumferential strains were determined. Strains of the infarct, border and remote zones were also obtained. There were no differences in standard LV 2-D parameters between patients with and those without VT. Receiver operating characteristic values were -12.7% for global longitudinal strain (area under the curve [AUC] = 0.72), -4.8% for posterior-inferior wall circumferential strain (AUC = 0.80), 61 ms for LV mechanical dispersion (AUC = 0.84), -10.1% for longitudinal strain of the border zone (AUC = 0.86) and -9.2% for circumferential strain of the border zone (AUC = 0.89). In patients with previous myocardial infarction and moderately abnormal LVEF, peri-infarct circumferential strain was the strongest predictor of documented ventricular arrhythmias among all strain quantitative indices. Additionally, strain values from posterior-inferior wall infarctions had a higher association with arrhythmic events compared with global strain.

  6. Sustained myocardial production of stromal cell-derived factor-1α was associated with left ventricular adverse remodeling in patients with myocardial infarction.

    Science.gov (United States)

    Uematsu, Manabu; Yoshizaki, Toru; Shimizu, Takuya; Obata, Jun-ei; Nakamura, Takamitsu; Fujioka, Daisuke; Watanabe, Kazuhiro; Watanabe, Yosuke; Kugiyama, Kiyotaka

    2015-11-15

    The role of stromal cell-derived factor-1α (SDF-1α) expressed in infarcted myocardium is unknown in humans. We examined whether SDF-1α produced in an infarcted myocardial lesion may play a role in left ventricle (LV) remodeling and dysfunction in patients with acute myocardial infarction (AMI). We measured SDF-1α levels in plasma obtained from aortic root (AO) and anterior interventricular vein (AIV) in the early phase (2 wk after MI) and the chronic phase (6 mo after MI) in 80 patients with anterior MI. An increment in SDF-1α level from AO to AIV, reflecting SDF-1α release from infarcted myocardium, was more frequent in patients with MI in the early phase of MI [n = 52 (65%), P = 0.03] but not in the chronic phase of MI [n = 46 (58%), P = 0.11] compared with that in control patients [n = 6/17 (35%)]. On linear regression analysis, the transmyocardial gradient in SDF-1α level in the chronic phase of MI was correlated with percentage changes in LV end-diastolic volume index (r = 0.39, P infarcted myocardium in the chronic phase of MI was associated with LV adverse remodeling and progressive dysfunction in AMI survivors.

  7. Effects of autonomic balance and fluid and electrolyte changes on cardiac function in infarcted rats: A serial study of sexual dimorphism.

    Science.gov (United States)

    Souza, N S; Dos-Santos, R C; Silveira, Anderson Luiz Bezerra da; R, Sonoda-Côrtes; Gantus, Michel Alexandre Villani; Fortes, F S; Olivares, Emerson Lopes

    2016-04-01

    Premenopausal women are known to show lower incidence of cardiovascular disease than men. During myocardial infarction (MI), homeostatic responses are activated, including the sympathetic autonomic nervous system and the rennin-angiotensin-aldosterone system, which is related to the fluid and electrolyte balance, both aiming to maintain cardiac output. This study sought to perform a serial evaluation of sexual dimorphism in cardiac autonomic control and fluid and electrolyte balance during the development of MI-induced heart failure in rats. Experimental MI was induced in male (M) and female (F) adult (7-9 weeks of age) Wistar rats. The animals were placed in metabolic cages to assess fluid intake and urine volume 1 and 4 weeks after inducing MI (male myocardial infarction (MMI) and female myocardial infarction (FMI) groups). They subsequently underwent echocardiographic evaluation and spectral analysis of heart rate variability. After completing each protocol, the animals were killed for postmortem evaluation and histology. The MMI group showed earlier and more intense cardiac morphological and functional changes than the FMI group, although the extent of MI did not differ between groups (P > 0.05). The MMI group showed higher sympathetic modulation and sodium and water retention than the FMI group (P < 0.05), which may partly explain both the echocardiographic and pathological findings. Females subjected to infarction seem to show attenuation of sympathetic modulation, more favourable fluid and electrolyte balances, and better preserved cardiac function compared to males subjected to the same infarction model. PMID:26748814

  8. The size does not matter – The presence of microvascular obstruction but not its extent corresponds to larger infarct size in reperfused STEMI

    Energy Technology Data Exchange (ETDEWEB)

    Małek, Łukasz A., E-mail: lmalek@ikard.pl [Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw (Poland); Śpiewak, Mateusz, E-mail: mspiewak@ikard.pl [Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Kłopotowski, Mariusz, E-mail: mklopotowski@hotmail.com [Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw (Poland); Miśko, Jolanta, E-mail: jmisko@wp.pl [Magnetic Resonance Unit, Department of Radiology, Institute of Cardiology, Warsaw (Poland); Rużyłło, Witold, E-mail: wruzyllo@ikard.pl [Institute of Cardiology, Warsaw (Poland); Witkowski, Adam, E-mail: witkowski@hbz.pl [Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw (Poland)

    2012-10-15

    Background: Microvascular obstruction (MVO) is a cardiac magnetic resonance (CMR) marker of no-reflow in ST-segment elevation myocardial infarction (STEMI). It remains unresolved whether the infarct size corresponds only to the presence of MVO or also to its extent. Methods: The study included 53 patients with first STEMI (median age 61.5 years, 77% male) treated with percutaneous coronary intervention (PCI) who underwent CMR after median 5 days from PCI. Small MVO was defined as patchy, non-confluent spots of dark areas of absent contrast surrounded by late gadolinium enhancement (LGE). Large MVO was defined as confluent areas of MVO comprising a large amount of the infarct zone. Results: Microvascular obstruction was observed in 32 patients (60%) including 18 patients with small MVO (36%) and 14 patients with large MVO (24%). Patients with MVO were more likely to have TIMI 0/1 grade flow on initial angiogram, higher levels of necrotic markers, larger infarct size, larger left ventricular end-diastolic and end-systolic volume and lower ejection fraction in comparison to patients without MVO. These differences were not observed between patients with large and small MVO. Conclusions: The presence of MVO but not its extent corresponds to larger infarct size in STEMI.

  9. Non-photic solar associations of heart rate variability and myocardial infarction

    Science.gov (United States)

    Cornélissen, Germaine; Halberg, Franz; Breus, Tamara; Syutkina, Elena V.; Baevsky, Roman; Weydahl, Andi; Watanabe, Yoshihiko; Otsuka, Kuniaki; Siegelova, Jarmila; Fiser, Bohumil; Bakken, Earl E.

    2002-03-01

    Alignment of serial epidemiological, physiological, including electrocardiographic data with variations in galactic cosmic rays, geomagnetic activity, and atmospheric pressure suggests the possibility of links among these physical environmental variations and health risks, such as myocardial infarctions and ischemic strokes, among others. An increase in the incidence of myocardial infarction in association with magnetic storms, reported by several investigators from Russia, Israel, Italy and Mexico, accounts in Minnesota for a 5% (220cases/year) increase in mortality during years of maximal solar activity by comparison with years of minimal solar activity. Magnetic storms are also found to decrease heart rate variability (HRV), indicating a possible mechanism since a reduced HRV is a prognostic factor for coronary artery disease and myocardial infarction. Longitudinal electrocardiographic monitoring for a week or much longer spans in different geographic locations, notably in the auroral oval, further suggests that the decrease in HRV affects spectral regions other than that around 3.6s (0.15-0.40Hz), reportedly associated with the parasympathetic nervous system. Differences in some associations are observed from solar cycle to solar cycle, and as a function of solar cycle stage, a finding resolving controversies. Coordinated physiological and physical monitoring, the scope of an international project on the Biosphere and the Cosmos, seeks reference values for a better understanding of environmental effects on human health and for testing the merit of space weather reports that could prompt countermeasures in space and on earth. Physiological data being collected systematically worldwide and morbidity/mortality statistics from causes such as myocardial infarction and stroke constitute invaluable data bases for assessing changes within the physiological range, for detecting environmental effects and for recognizing endogenous as well as exogenous disease

  10. Impact of cardiac care variation on ST-elevation myocardial infarction outcomes in Malaysia.

    Science.gov (United States)

    Selvarajah, Sharmini; Fong, Alan Y Y; Selvaraj, Gunavathy; Haniff, Jamaiyah; Hairi, Noran N; Bulgiba, Awang; Bots, Michiel L

    2013-05-01

    Developing countries face challenges in providing the best reperfusion strategy for patients with ST-segment elevation myocardial infarction because of limited resources. This causes wide variation in the provision of cardiac care. The aim of this study was to assess the impact of variation in cardiac care provision and reperfusion strategies on patient outcomes in Malaysia. Data from a prospective national registry of acute coronary syndromes were used. Thirty-day all-cause mortality in 4,562 patients with ST-segment elevation myocardial infarctions was assessed by (1) cardiac care provision (specialist vs nonspecialist centers), and (2) primary reperfusion therapy (thrombolysis or primary percutaneous coronary intervention [P-PCI]). All patients were risk adjusted by Thrombolysis In Myocardial Infarction (TIMI) risk score. Thrombolytic therapy was administered to 75% of patients with ST-segment elevation myocardial infarctions (12% prehospital and 63% in-hospital fibrinolytics), 7.6% underwent P-PCI, and the remainder received conservative management. In-hospital acute reperfusion therapy was administered to 68% and 73% of patients at specialist and nonspecialist cardiac care facilities, respectively. Timely reperfusion was low, at 24% versus 31%, respectively, for in-hospital fibrinolysis and 28% for P-PCI. Specialist centers had statistically significantly higher use of evidence-based treatments. The adjusted 30-day mortality rates for in-hospital fibrinolytics and P-PCI were 7% (95% confidence interval 5% to 9%) and 7% (95% confidence interval 3% to 11%), respectively (p = 0.75). In conclusion, variation in cardiac care provision and reperfusion strategy did not adversely affect patient outcomes. However, to further improve cardiac care, increased use of evidence-based resources, improvement in the quality of P-PCI care, and reduction in door-to-reperfusion times should be achieved.

  11. Human cord blood cells and myocardial infarction: effect of dose and route of administration on infarct size.

    Science.gov (United States)

    Henning, Robert J; Burgos, Jose D; Vasko, Mark; Alvarado, Felipe; Sanberg, Cyndy D; Sanberg, Paul R; Morgan, Michael B

    2007-01-01

    There is no consensus regarding the optimal dose of stem cells or the optimal route of administration for the treatment of acute myocardial infarction. Bone marrow cells, containing hematopoietic and mesenchymal stem cells, in doses of 0.5 x 10(6) to >30 x 10(6) have been directly injected into the myocardium or into coronary arteries or infused intravenously in subjects with myocardial infarctions to reduce infarct size and improve heart function. Therefore, we determined the specific effects of different doses of human umbilical cord blood mononuclear cells (HUCBC), which contain hematopoietic and mesenchymal stem cells, on infarct size. In order to determine the optimal technique for stem cell administration, HUCBC were injected directly into the myocardium (IM), or into the LV cavity with the ascending aorta transiently clamped to facilitate coronary artery perfusion (IA), or injected intravenously (IV) in rats 1-2 h after the left anterior coronary artery was permanently ligated. Immune suppressive therapy was not given to any rat. One month later, the infarct size in control rat hearts treated with only Isolyte averaged 23.7 +/- 1.7% of the LV muscle area. Intramyocardial injection of HUCBC reduced the infarct size by 71% with 0.5 x 10(6) HUCBC and by 93% with 4 x 10(6) HUCBC in comparison with the controls (p p p p < 0.05). Nevertheless, IM, IA, and IV HUCBC all produced significant reductions in infarct size in comparison with Isolyte-treated infarcted hearts without requirements for host immune suppression. The present experiments demonstrate that the optimal dose of HUCBC for reduction of infarct size in the rat is 4 x 10(6) IM, 4 x 10(6) IA, and 16 x 10(6) IV, and that the IM injection of HUCBC is the most effective technique for reduction in infarct size.

  12. Remodeling after acute myocardial infarction: mapping ventricular dilatation using three dimensional CMR image registration

    Directory of Open Access Journals (Sweden)

    O’Regan Declan P

    2012-06-01

    Full Text Available Abstract Background Progressive heart failure due to remodeling is a major cause of morbidity and mortality following myocardial infarction. Conventional clinical imaging measures global volume changes, and currently there is no means of assessing regional myocardial dilatation in relation to ischemic burden. Here we use 3D co-registration of Cardiovascular Magnetic Resonance (CMR images to assess the long-term effects of ischemia-reperfusion injury on left ventricular structure after acute ST-elevation myocardial infarction (STEMI. Methods Forty six patients (age range 33–77 years underwent CMR imaging within 7 days following primary percutaneous coronary intervention (PPCI for acute STEMI with follow-up at one year. Functional cine imaging and Late Gadolinium Enhancement (LGE were segmented and co-registered. Local left ventricular wall dilatation was assessed by using intensity-based similarities to track the structural changes in the heart between baseline and follow-up. Results are expressed as means, standard errors and 95% confidence interval (CI of the difference. Results Local left ventricular remodeling within infarcted myocardium was greater than in non-infarcted myocardium (1.6% ± 1.0 vs 0.3% ± 0.9, 95% CI: -2.4% – -0.2%, P = 0.02. One-way ANOVA revealed that transmural infarct thickness had a significant effect on the degree of local remodeling at one year (P 20% (4.8% ± 1.4 vs −0.15% ± 1.2, 95% CI: -8.9% – -0.9%, P = 0.017. Conclusions The severity of ischemic injury has a significant effect on local ventricular wall remodeling with only modest dilatation observed within non-ischemic myocardium. Limitation of chronic remodeling may therefore depend on therapies directed at modulating ischemia-reperfusion injury. CMR co-registration has potential for assessing dynamic changes in ventricular structure in relation to therapeutic interventions.

  13. Risk assessment in patients with acute myocardial infarction treated with thrombolysis

    OpenAIRE

    Samad, Bassem Abdel

    1999-01-01

    Risk stratification in patients with acute myocardial infarction is essential for guiding the clinical decision concerning management. Thrombolytic therapy and other new management policies have led to a significant reduction in mortality from myocardial infarction. Several clinical variables and non-invasive methods have been shown in post-infarction studies to provide independent prognostic information. However, risk stratification of patients with myocardial infarction ...

  14. Diver CE versus Guardwire Plus for thrombectomy in patients with inferior myocardial infarction: a trial of aspiration of thrombus during primary angioplasty for inferior myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    YAN Hong-bing; ZHANG Hong; WANG Jian; LI Nan; ZHU Xiao-ling; GAO Hai; AI Hui; LI Xiang; YE Ming; CHI Yun-peng

    2007-01-01

    Background Different feasible and safe thrombectomy and distal protection devices have been used in clinical practice.The efficiency and safety of adjunct thrombectomy using Diver CE device (Invatec, Italy) versus Guardwire Plus device(Medtronic, USA) before percutaneous coronary intervention (PCI) were compared in patients with acute inferior ST-segment-elevation myocardial infarction (STEMI) for less than 12 hours, thrombolysis in myocardial infarction (TIMI)flow grade 0 to 1, and total occlusion of the proximal right coronary artery (≥3 mm in diameter) in a prospective randomized single-center study.Methods The primary end point was the magnitude of ST-segment resolution (STR) (>70%) measured immediately, 90minutes and 6 hours after PCI, myocardial blush grade and slow flow or no-reflow. Secondary end points were left ventricular end-diastolic volume (LVEDV), left ventricle ejection fraction (LVEF) and major adverse cardiac events (MACEs) including death, myocardial infarction, target vessel revascularization and stroke at 30 days.Results A total of 122 patients were equally divided into Diver CE group and Guardwire Plus group, which were comparable by age ((60± 14) years vs (60± 13) years), male (82% vs 84%), diabetes (31% vs 28%), previous coronary artery disease (25% vs 23%), onset-to-angiogram ((350± 185) min vs (345± 180) min), and use of glycoprotein Ⅱb/Ⅲa inhibitor (11% vs 13%). The magnitude of ST-segment resolution was similar in the two groups as ST-segment resolution >70% (57% vs 59%; P>0.05). Similar slow flow/no-reflow rates were observed in the Diver CE group (8%) and the Guardwire Plus group (7%). TIMI flow grade 3 was obtained in 95% vs 97% patients, respectively (P>0.05). Myocardial blush grade 3 was similar (70% vs 72%; P>0.05). Thirty-day clinical outcome was comparable (LVEF, 0.54±0.12 vs 0.53±0.11; death, 3% vs 3%; myocardial infarction, 2% vs 0%; and target vessel revascularization, 2% vs 2%; P>0.05,respectively

  15. Effect of high-intensity statin therapy on atherosclerosis in non-infarct-related coronary arteries (IBIS-4)

    DEFF Research Database (Denmark)

    Räber, Lorenz; Taniwaki, Masanori; Zaugg, Serge;

    2015-01-01

    -point was the change in per cent atheroma volume (PAV). After 13 months, low-density lipoprotein cholesterol (LDL-C) had decreased from a median of 3.29 to 1.89 mmol/L (P high-density lipoprotein cholesterol (HDL-C) levels had increased from 1.10 to 1.20 mmol/L (P ...AIM: The effect of long-term high-intensity statin therapy on coronary atherosclerosis among patients with acute ST-segment elevation myocardial infarction (STEMI) is unknown. The aim of this study was to quantify the impact of high-intensity statin therapy on plaque burden, composition......-infarct-related epicardial coronary arteries (non-IRA) after successful primary PCI. Patients were treated with high-intensity rosuvastatin (40 mg/day) throughout 13 months and serial intracoronary imaging with the analysis of matched segments was available for 82 patients with 146 non-IRA. The primary IVUS end...

  16. Clinical study of cerebral infarction in hemodialysis patients

    International Nuclear Information System (INIS)

    Stroke is one of the leading causes of death in patients undergoing chronic dialysis. However, few clinical studies have so far examined stroke, especially brain infarction, under such conditions. We retrospectively evaluated the clinical features and risk factors for brain infarction in 33 patients undergoing hemodialysis (hemodialysis, 29 patients; continuous ambulatory peritoneal dialysis, 4 patients; male:female ratio, 25:8) between May 2003 and August 2006. The mean age was 68.5±10.9 (mean±standard deviation (SD)) years. The basal renal diseases were chronic glomerulonephritis (n=16), diabetes mellitus (n=10) and other diseases (n=7). The mean duration of maintenance dialysis before the onset of stroke was 5.6±5.2 years. All 33 patients developed brain infarction, including the atherothrombotic (n=13), lacunar (n=9) and cardioembolic (n=11) types. The complications included a high frequency of hypertension (79%) in all groups, diabetes mellitus (36%) and atrial fibrillation (21%). Four of the patients, 2 with lacunar and 2 with atherothrombotic infarction, developed brain infarction within 3 hours after hemodialysis. Hemodynamic changes might have caused the infarction in these patients. The proportion of patients with a modified Rankin Scale grade of 4-6 at discharge was 42%, and the mortality rate was high (15%). The prognosis of brain infarction was poorer in patients with hemodialysis than in those without. (author)

  17. Pharmacological prevention of reperfusion injury in acute myocardial infarction. A potential role for adenosine as a therapeutic agent.

    Science.gov (United States)

    Quintana, Miguel; Kahan, Thomas; Hjemdahl, Paul

    2004-01-01

    last years, three relatively large placebo-controlled clinical trials have been conducted: Acute Myocardial Infarction Study of Adenosine Trial (AMISTAD) I and II and Attenuation by Adenosine of Cardiac Complications (ATTACC). In the AMISTAD trials, the final infarct size was reduced and the LV systolic function was improved by adenosine treatment, mainly in patients with anterior MI localization. However, morbidity and mortality were not affected. In the ATTACC study, the LV systolic function was not affected by adenosine, however, trends towards improved survival were observed in patients with anterior MI localization. The possibility of obtaining a Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow in the infarct-related artery in up to 95% of patients with acute MI (increasing the occurrence of reperfusion injury) has turned back the interest towards the protection of myocardial cells from the impending ischemic and reperfusion injury in which adenosine alone or together with other cardio-protective agents may exert important clinical effects. PMID:15134468

  18. Analysis of the Influence of the Electrical Asynchrony on Regional Mechanics of the Infarcted Left Ventricle Using Electromechanical Heart Models

    Science.gov (United States)

    Liu, Feng; Xia, Ling; Zhang, Xin

    Asynchronous electrical activation, as induced by myocardial infarction, causes various abnormalities in left ventricle function. The influence of the electrical asynchrony on regional mechanics of the left ventricle is simulated using a mechanical heart model and an electrical heart model. The mechanical model accounts for the ventricular geometry, the fiber nature of the myocardial tissue, and the dependency of the activation sequence of the ventricular wall. The electrical model is based on a heart-torso model with realistic geometry, and different action potential waveforms with variables in duration are used to simulate the abnormal electrical activation after myocardial infarction. Regional deformation, strain and stress are calculated during systole phase. The preliminary results show that asynchronous electrical activation, as an important factor, significantly affects regional mechanical performance of the infarcted left ventricle, it indicates heterogeneous contraction pattern and elevated systolic stresses near the injured region. The simulated results are compared with solutions obtained in the literature. This simulation suggests that such coupled heart models can be used to assess the mechanical function of the left ventricle with diseases such as myocardial infarction, and more realistic models of cardiac function are essential for clinical evaluation of heart disease.

  19. The association between phenomena on the Sun, geomagnetic activity, meteorological variables, and cardiovascular characteristic of patients with myocardial infarction

    Science.gov (United States)

    Vencloviene, Jone; Babarskiene, Ruta; Slapikas, Rimvydas; Sakalyte, Gintare

    2013-09-01

    It has been found that solar and geomagnetic activity affects the cardiovascular system. Some evidence has been reported on the increase in the rate of myocardial infarction, stroke and myocardial infarction related deaths during geomagnetic storms. We investigated the association between cardiovascular characteristics of patients, admitted for myocardial infarction with ST elevation (STEMI), and geomagnetic activity (GMA), solar proton events (SPE), solar flares, and meteorological variables during admission. The data of 1,979 patients hospitalized at the Hospital of Lithuanian University of Health Sciences (Kaunas) were analyzed. We evaluated the association between environmental variables and patient's characteristics by multivariate logistic regression, controlling patient's gender and age. Two days after geomagnetic storms the risk of STEMI was over 1.5 times increased in patients who had a medical history of myocardial infarction, stable angina, renal or pulmonary diseases. The dose-response association between GMA level and STEMI risk for patients with renal diseases in history was observed. Two days after SPE the risk of STEMI in patients with stable angina in anamnesis was increased over 1.5 times, adjusting by GMA level. The SPE were associated with an increase of risk for patients with renal diseases in history. This study confirms the strongest effect of phenomena in the Sun in high risk patients.

  20. Somatic/affective symptoms, but not cognitive/affective symptoms, of depression after acute coronary syndrome are associated with 12-month all-cause mortality

    NARCIS (Netherlands)

    Roest, Annelieke M.; Thombs, Brett D.; Grace, Sherry L.; Stewart, Donna E.; Abbey, Susan E.; de Jonge, Peter

    2011-01-01

    Background: Symptom dimensions of post myocardial infarction (MI) depression may be differently related to prognosis. Somatic/affective symptoms appear to be associated with a worse cardiac outcome than cognitive/affective symptoms. We examined the relationship between depressive symptom dimensions

  1. Acute arterial infarcts in patients with severe head injuries

    Directory of Open Access Journals (Sweden)

    Deepak Agrawal

    2012-01-01

    Full Text Available Aims and Objectives: To study the incidence, demographic profile, and outcome of patients with severe closed head injuries who develop acute arterial infarcts. Materials and Methods: Patients with severe head injury (Glasgow coma score (GCS ≤8 presenting within 8 h of injury in the Department of Neurosurgery over a period of 5 months were enrolled in the study. Patients with penetrating head injury, infarct due to herniation and iatrogenic arterial injuries were excluded from the study. Only arterial infarcts developing within 8 h of injury were included in the study. A computed tomography (CT head was done on all patients within 8 h of injury and repeated if necessary. Arterial infarct was defined as well-demarcated wedge-shaped hypodensity corresponding to an arterial territory on plain CT of the head. Outcome was assessed using Glasgow outcome score (GOS at 1 month post-injury or at death (whichever came earlier. Results: Forty-four patients of severe head injury were included in the study during the above period. Of these, four patients (9.1% had arterial infarcts on the initial CT scan. The male:female ratio was 1:3. The mean age was 54 years (range 3-85 years. Two patients had infarcts in the middle cerebral artery distribution and two in the superior cerebellar artery distribution. Poor outcome (GOS 1-3 was seen in 100% of the patients with arterial infarct compared to 52.5% (n=21 in patients with severe head injury without arterial infarct. Conclusions: A significant percentage of patients with severe head injury have arterial infarcts on admission, which may imply arterial injury. Our study shows that these patients have a poorer prognosis vis-a-vis patient without these findings.

  2. The zebrafish heart regenerates after cryoinjury-induced myocardial infarction

    Directory of Open Access Journals (Sweden)

    Rainer Gregor

    2011-04-01

    Full Text Available Abstract Background In humans, myocardial infarction is characterized by irreversible loss of heart tissue, which becomes replaced with a fibrous scar. By contrast, teleost fish and urodele amphibians are capable of heart regeneration after a partial amputation. However, due to the lack of a suitable infarct model, it is not known how these animals respond to myocardial infarction. Results Here, we have established a heart infarct model in zebrafish using cryoinjury. In contrast to the common method of partial resection, cryoinjury results in massive cell death within 20% of the ventricular wall, similar to that observed in mammalian infarcts. As in mammals, the initial stages of the injury response include thrombosis, accumulation of fibroblasts and collagen deposition. However, at later stages, cardiac cells can enter the cell cycle and invade the infarct area in zebrafish. In the subsequent two months, fibrotic scar tissue is progressively eliminated by cell apoptosis and becomes replaced with a new myocardium, resulting in scarless regeneration. We show that tissue remodeling at the myocardial-infarct border zone is associated with accumulation of Vimentin-positive fibroblasts and with expression of an extracellular matrix protein Tenascin-C. Electrocardiogram analysis demonstrated that the reconstitution of the cardiac muscle leads to the restoration of the heart function. Conclusions We developed a new cryoinjury model to induce myocardial infarction in zebrafish. Although the initial stages following cryoinjury resemble typical healing in mammals, the zebrafish heart is capable of structural and functional regeneration. Understanding the key healing processes after myocardial infarction in zebrafish may result in identification of the barriers to efficient cardiac regeneration in mammals.

  3. Triggering of Transmural Infarctions, but Not Nontransmural Infarctions, by Ambient Fine Particles

    OpenAIRE

    Rich, David Q.; Kipen, Howard M.; Zhang, Junfeng; Kamat, Leena; Wilson, Alan C.; Kostis, John B; ,

    2010-01-01

    Background Previous studies have reported increased risk of myocardial infarction (MI) after increases in ambient particulate matter (PM) air pollution concentrations in the hours and days before MI onset. Objectives We hypothesized that acute increases in fine PM with aerodynamic diameter ≤ 2.5 μm (PM2.5) may be associated with increased risk of MI and that chronic obstructive pulmonary disease (COPD) and diabetes may increase susceptibility to PM2.5. We also explored whether both transmural...

  4. Arrhythmia in Acute Right Ventricular Infarction

    Directory of Open Access Journals (Sweden)

    Azin Alizadeh Asl

    2007-09-01

    Full Text Available Acute inferior myocardial infarction (MI frequently involves the right ventricle (RV.1-3 We assessed the prognostic impact of RV myocardial involvement in patients with inferior MI. One hundred seventy patients were admitted to the cardiac care unit of Madani Heart Hospital (Tabriz-Iran with the diagnosis of inferior MI with (group1 or without (group2 the simultaneous involvement of RV during the study period (from 2005 to 2006. Patients presenting within 12h of symptom onset were eligible for inclusion. Patients with simultaneous anterior wall MI or renal impairment (creatinine > 2 mg/dl, as well as those undergoing primary percutaneous translational coronary angioplasty, were excluded. Eighty eight percent of the patients with RVMI and 75% of those with isolated inferior MI had some type of arrhythmia. Atrioventricular (AV block occurred in 42% of the infarctions with RV involvement and only in 29% of the control group. Intra-ventricular conduction disturbance (IVCD was also more frequent in RVMI (29.4% vs. 13.1%, p=0.021, especially right bundle branch block (RBBB (20% vs. 7.4%, P=0.003. There was, however, no meaningful difference in the incidence of left bundle branch block (LBBB between the two groups (3.5% vs. 2.35%, P=0.95. Ventricular fibrillation (VF was observed in 5.2% and 1.2% and ventricular tachycardia in 26% and 12.2% of the patients in groups 1 and 2, respectively. In 27% of patients with RVMI, it was necessary to implant a pacemaker as compared to 10% of those in the control group. Mortality was higher in the patients with inferior infarction extended to the RV (15.3% vs. 3.5%, P= 0.0001. Thus, the differences between the findings in the two groups in terms of the occurrence of post-MI arrhythmias and conduction disorders were quite significant, but there was no meaningful difference with respect to the incidence of LBBB between the two groups. Additionally, patients with inferior MI who also had RV myocardial involvement were

  5. Recombinant Tissue Plasminogen Activator Induces Neurological Side Effects Independent on Thrombolysis in Mechanical Animal Models of Focal Cerebral Infarction: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Wei, You-Dong; Liu, Yi-Yun; Ren, Yi-Fei; Liang, Zi-Hong; Wang, Hai-Yang; Zhao, Li-Bo; Xie, Peng

    2016-01-01

    Background and Purpose Recombinant tissue plasminogen activator (rtPA) is the only effective drug approved by US FDA to treat ischemic stroke, and it contains pleiotropic effects besides thrombolysis. We performed a meta-analysis to clarify effect of tissue plasminogen activator (tPA) on cerebral infarction besides its thrombolysis property in mechanical animal stroke. Methods Relevant studies were identified by two reviewers after searching online databases, including Pubmed, Embase, and ScienceDirect, from 1979 to 2016. We identified 6, 65, 17, 12, 16, 12 and 13 comparisons reporting effect of endogenous tPA on infarction volume and effects of rtPA on infarction volume, blood-brain barrier, brain edema, intracerebral hemorrhage, neurological function and mortality rate in all 47 included studies. Standardized mean differences for continuous measures and risk ratio for dichotomous measures were calculated to assess the effects of endogenous tPA and rtPA on cerebral infarction in animals. The quality of included studies was assessed using the Stroke Therapy Academic Industry Roundtable score. Subgroup analysis, meta-regression and sensitivity analysis were performed to explore sources of heterogeneity. Funnel plot, Trim and Fill method and Egger’s test were obtained to detect publication bias. Results We found that both endogenous tPA and rtPA had not enlarged infarction volume, or deteriorated neurological function. However, rtPA would disrupt blood-brain barrier, aggravate brain edema, induce intracerebral hemorrhage and increase mortality rate. Conclusions This meta-analysis reveals rtPA can lead to neurological side effects besides thrombolysis in mechanical animal stroke, which may account for clinical exacerbation for stroke patients that do not achieve vascular recanalization with rtPA. PMID:27387385

  6. Recombinant Tissue Plasminogen Activator Induces Neurological Side Effects Independent on Thrombolysis in Mechanical Animal Models of Focal Cerebral Infarction: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Mei-Xue Dong

    Full Text Available Recombinant tissue plasminogen activator (rtPA is the only effective drug approved by US FDA to treat ischemic stroke, and it contains pleiotropic effects besides thrombolysis. We performed a meta-analysis to clarify effect of tissue plasminogen activator (tPA on cerebral infarction besides its thrombolysis property in mechanical animal stroke.Relevant studies were identified by two reviewers after searching online databases, including Pubmed, Embase, and ScienceDirect, from 1979 to 2016. We identified 6, 65, 17, 12, 16, 12 and 13 comparisons reporting effect of endogenous tPA on infarction volume and effects of rtPA on infarction volume, blood-brain barrier, brain edema, intracerebral hemorrhage, neurological function and mortality rate in all 47 included studies. Standardized mean differences for continuous measures and risk ratio for dichotomous measures were calculated to assess the effects of endogenous tPA and rtPA on cerebral infarction in animals. The quality of included studies was assessed using the Stroke Therapy Academic Industry Roundtable score. Subgroup analysis, meta-regression and sensitivity analysis were performed to explore sources of heterogeneity. Funnel plot, Trim and Fill method and Egger's test were obtained to detect publication bias.We found that both endogenous tPA and rtPA had not enlarged infarction volume, or deteriorated neurological function. However, rtPA would disrupt blood-brain barrier, aggravate brain edema, induce intracerebral hemorrhage and increase mortality rate.This meta-analysis reveals rtPA can lead to neurological side effects besides thrombolysis in mechanical animal stroke, which may account for clinical exacerbation for stroke patients that do not achieve vascular recanalization with rtPA.

  7. CONTRAST STUDY ON CT AND BA IN DIAGNOSIS OF PATIENTS WITH ATHEROTHROMBOTIC BRAIN INFARCTION

    Institute of Scientific and Technical Information of China (English)

    Mingshun Liu; Haixiang Gao; Xiaomei Fu; Po Ma

    2007-01-01

    Objectives: To explore applied value on CT and BA in diagnosis of patients with atherothrombotic brain infarction. Methods:CT and BA were examined in 246 patients with atherothrombotic brain infarction. Results:The different change of CT and BA were showed in 246 patients with atherothrombotic brain infarction. Conclusions: There were separately different advantage and shortcoming in CT and BA in diagnosis of atherothrombotic brain infarction. The value of clinical application of BA was important in diagnosis of atherothrombotic brain infarction.

  8. Specificity of pyrophosphate myocardial scintigrams in patients with prior myocardial infarction: concise communication

    International Nuclear Information System (INIS)

    Fifty-five patients with old (9 days to 10 yr) transmural infarcts but with no evidence of recent infarction, were imaged with Tc-99m pyrophosphate. Discrete uptake was rare in the setting of an old infarct. Diffuse uptake was neither sensitive to, nor specific for, acute infarction. Prior infarction will rarely cause diagnostic error if the discrete pattern is required for a positive diagnosis

  9. Survival and cause of death after myocardial infarction

    DEFF Research Database (Denmark)

    Brønnum-Hansen, H; Jørgensen, Torben; Davidsen, M;

    2001-01-01

    As part of the Danish WHO MONICA study, a register of patients with myocardial infarction was established in 1982, covering 11 municipalities in the western part of Copenhagen County, Denmark. During the period 1982-91, all cases of myocardial infarction among citizens aged 25-74 years were...... registered and validated according to the criteria set up for the WHO MONICA project. Short-term (28 days) and long-term (up to 15 years) survival in three periods were compared. The rate of mortality after a non-fatal myocardial infarction was compared with that of the general population, and causes...

  10. Sickle cell disease with orbital infarction and epidural hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Naran, A.D.; Fontana, L. [Dept. of Diagnostic Radiology, New York Methodist Hospital, Brooklyn, NY (United States)

    2001-04-01

    Although bone infarction is a common feature in sickle cell disease, the involvement of the orbit is an unusual complication. Intracranial bleeding is another uncommon and serious complication. Few cases of orbital infarction alone have been reported. We report imaging findings (CT, bone scan, MRI) in a 16-year-old boy with sickle cell disease with orbital infarction and epidural hematoma. The precise cause of epidural hematoma is not well known, but it is probably related to vaso-occlusive episodes and the tearing of small vessels. (orig.)

  11. Holmium:YAG laser coronary angioplasty in acute myocardial infarction

    Science.gov (United States)

    Topaz, On; Luxenberg, Michael; Schumacher, Audrey

    1994-07-01

    Patients who sustain complicated acute myocardial infarction in whom thrombolytic agents either fail or are contraindicated often need mechanical revascularization other than PTCA. In 24 patients with acute infarction complicated by continuous chest pain and ischemia who either received lytics or with contraindication to lytics, a holmium:YAG laser (Eclipse Surgical Technologies, Palo Alto, CA) was utilized for thrombolysis and plaque ablation. Clinical success was achieved in 23/24 patients, with 23 patients (94%) surviving the acute infarction. Holmium:YAG laser is very effective and safe in thrombolysis and revascularization in this complicated clinical setting.

  12. Justification for intravenous magnesium therapy in acute myocardial infarction

    DEFF Research Database (Denmark)

    Rasmussen, H S

    1988-01-01

    Recent studies have shown that patients with acute myocardial infarction (AMI) are magnesium-deficient and develop an additional transient decrease in serum magnesium concentrations (S-Mg c) during the acute phase of the infarct. Animal experiments, as well as studies on humans, have indicated...... of routine practice for patients with acute myocardial infarction....... that the acute decrease in S-Mg c as well as a more chronic magnesium (Mg) deficiency state are harmful to the myocardium in the setting of acute ischaemia. This knowledge has led during the last couple of years to the performance of four double-blind placebo controlled studies in which the effect of i...

  13. Differentiating between Hemorrhagic Infarct and Parenchymal Intracerebral Hemorrhage

    International Nuclear Information System (INIS)

    Differentiating hemorrhagic infarct from parenchymal intracerebral hemorrhage can be difficult. The immediate and long-term management of the two conditions are different and hence the importance of accurate diagnosis. Using a series of intracerebral hemorrhage cases presented to our stroke unit, we aim to highlight the clues that may be helpful in distinguishing the two entities. The main clue to the presence of hemorrhagic infarct on computed tomography scan is the topographic distribution of the stroke. Additional imaging modalities such as computed tomography angiogram, perfusion, and magnetic resonance imaging may provide additional information in differentiating hemorrhagic infarct from primary hemorrhages.

  14. Cerebral infarctions due to CNS infection with Enterobacter sakazakii

    Energy Technology Data Exchange (ETDEWEB)

    Gallagher, P.G. (Cincinnati Univ., OH (USA). Dept. of Pediatrics Children' s Hospital Medical Center, Cincinnati, OH (USA)); Ball, W.S. (Cincinnati Univ., OH (USA). Dept. of Radiology Children' s Hospital Medical Center, Cincinnati, OH (USA))

    1991-02-01

    Recent reports have implicated Enterobacter sakazakii, a gram-negative enteric bacillus, in neonatal sepsis and meningitis. Cases of severe central nervous system involvement, including ventriculitis, brain abscess, infarction, and cyst formation, have been described. We present serial head CT findings in a case of neonatal E. sakazakii meningitis complicated by a ring enhancing cerebral infarction which mimicked abscess formation. In meningitis secondary to this agent, a recognized pattern of cerebral hypodensity with or without cystic degeneration late in the course of the infection is likely to represent cerebral infarction rather than an abscess especially if there is a lack of culture evidence of a bacterial infection. (orig.).

  15. Inferior ST-Elevation Myocardial Infarction Associated with Takotsubo Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Oliver Koeth

    2010-01-01

    Full Text Available Takotsubo cardiomyopathy (TCM is usually characterized by transient left ventricular apical ballooning. Due to the clinical symptoms which include chest pain, electrocardiographic changes, and elevated myocardial markers, Takotsubo cardiomyopathy is frequently mimicking ST-elevation myocardial infarction in the absence of a significant coronary artery disease. Otherwise an acute occlusion of the left anterior descending coronary artery can produce a typical Takotsubo contraction pattern. ST-elevation myocardial infarction (STEMI is frequently associated with emotional stress, but to date no cases of STEMI triggering TCM have been reported. We describe a case of a female patient with inferior ST-elevation myocardial infarction complicated by TCM.

  16. Acute myocardial infarction and renal infarction in a bodybuilder using anabolic steroids.

    Science.gov (United States)

    Ilhan, Erkan; Demirci, Deniz; Güvenç, Tolga Sinan; Calık, Ali Nazmi

    2010-06-01

    A 41-year-old male bodybuilder was admitted with acute inferior myocardial infarction. The patient had been using oxymetholone and methenolone to increase his performance for 15 years and quitted smoking three years before. He underwent successful primary percutaneous coronary intervention (PCI) and bare metal stenting for total occlusion of the proximal right coronary artery. Angiography also showed a critical lesion in the left anterior descending (LAD) coronary artery. Five hours after primary PCI, the patient had severe right flank pain. Abdominal computed tomography showed a large renal infarction in the right kidney. Subcutaneous enoxaparin was added to dual antiplatelet treatment. Doppler renal ultrasound performed on the eighth day showed findings of reperfusion in the right kidney and normal-size kidneys. Transthoracic echocardiography demonstrated disappearance of previously detected thrombus remnant in the left ventricle and only mild hypokinesia around the apical and middle segments of the inferior and inferoseptal walls. The patient was discharged on the 10th day. Renal arteriography during elective LAD intervention 18 days after discharge showed complete revascularization, stent patency, and improved blood flow. This is the first case of renal infarction that developed in the early hours of primary PCI, despite effective anticoagulant and antiplatelet treatment. Intensive coronary artery and left ventricular thrombi may be explained by the use of anabolic steroids.

  17. Acute myocardial infarction and renal infarction in a bodybuilder using anabolic steroids.

    Science.gov (United States)

    Ilhan, Erkan; Demirci, Deniz; Güvenç, Tolga Sinan; Calık, Ali Nazmi

    2010-06-01

    A 41-year-old male bodybuilder was admitted with acute inferior myocardial infarction. The patient had been using oxymetholone and methenolone to increase his performance for 15 years and quitted smoking three years before. He underwent successful primary percutaneous coronary intervention (PCI) and bare metal stenting for total occlusion of the proximal right coronary artery. Angiography also showed a critical lesion in the left anterior descending (LAD) coronary artery. Five hours after primary PCI, the patient had severe right flank pain. Abdominal computed tomography showed a large renal infarction in the right kidney. Subcutaneous enoxaparin was added to dual antiplatelet treatment. Doppler renal ultrasound performed on the eighth day showed findings of reperfusion in the right kidney and normal-size kidneys. Transthoracic echocardiography demonstrated disappearance of previously detected thrombus remnant in the left ventricle and only mild hypokinesia around the apical and middle segments of the inferior and inferoseptal walls. The patient was discharged on the 10th day. Renal arteriography during elective LAD intervention 18 days after discharge showed complete revascularization, stent patency, and improved blood flow. This is the first case of renal infarction that developed in the early hours of primary PCI, despite effective anticoagulant and antiplatelet treatment. Intensive coronary artery and left ventricular thrombi may be explained by the use of anabolic steroids. PMID:20935436

  18. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy

    Directory of Open Access Journals (Sweden)

    Krsmanović Željko

    2011-01-01

    Full Text Available Introduction. Fast and precise diagnostics of the disease from the large group of adult leukoencephalopathy is difficult but responsible job, because the outcome of the disease is very often determined by its name. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL is caused by the mutation of Notch 3 gene on chromosome locus 19p13. Beside the brain arterioles being the main disease targets, extracerebral small blood vessels are affected by the pathological process. Clinically present signs are recurrent ischemic strokes and vascular dementia. CADASIL in its progressive form shows a distinctive pattern of pathological changes on MRI of endocranium. The diagnosis is confirmed by the presence of granular osmiophilic material (GOM in histopathological skin biopsies. Case reports. Two young adult patients manifested ischemic strokes of unknown etiology, cognitive deterioration, migraine and psychopathological phenomenology. MRI of endocranium pointed on CADASIL. Ultrastructural examination of skin biopsy proved the presence of GOM in the basal lamina and near smooth muscle cells of arteriole dermis leading to CADASIL diagnosis. The presence of GOM in histopathological preparation is 100% specific for CADASIL. The patients were not searched for mutation in Notch 3 gene on chromosome 19, because some other leukoencephalopathy was disregarded. Conclusion. Suggestive clinical picture, distinctive finding of endocranium MRI, the presence of GOM by ultrastructural examination of histopathological skin biopsies are sufficient to confirm CADASIL diagnosis.

  19. Lingual infarction in Wegener's Granulomatosis: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Brizman Eitan

    2008-08-01

    Full Text Available Abstract Wegener's granulomatosis (WG is a multi-system disease, characterised by the triad of necrotising granulomata affecting the upper and lower respiratory tracts, disseminated vasculitis and glomerulonephritis. Oral lesions are associated with up to 50% of cases, although are rare as a presenting feature. The most common oral lesions associated with WG are ulceration and strawberry gingivitis. We review the literature regarding oral manifestations of WG and present a case of lingual infarction, an extremely rare oral lesion associated with WG, in a severe, rapidly progressive and ultimately fatal form of the disease.

  20. Serum and salivary cardiac analytes in acute myocardial infarction related to oral health status

    Science.gov (United States)

    Ebersole, Jeffrey L.; Kryscio, Richard J.; Campbell, Charles; Kinane, Denis F.; McDevitt, John T.; Christodoulides, Nicolaos; Floriano, Pierre N.; Miller, Craig S.

    2014-06-01

    With the advent of an increased emphasis on the potential to utilize biomarkers in saliva for systemic diseases, the issue of existing oral disease is an important consideration that could adversely affect the interpretation of diagnostic results obtained from saliva. We addressed the question does a patient's oral inflammation status confound biomarker levels used in diagnosis of acute myocardial infarction (AMI). The results demonstrated that multiple serum biomarkers and a few salivary biomarkers reflected the cardiac event. Importantly, oral health of the individual had minimal impact on the validity of the serum or salivary biomarker effectiveness.

  1. Thrombolysis significantly reduces transient myocardial ischaemia following first acute myocardial infarction

    DEFF Research Database (Denmark)

    Mickley, H; Pless, P; Nielsen, J R;

    1992-01-01

    In order to investigate whether thrombolysis affects residual myocardial ischaemia, we prospectively performed a predischarge maximal exercise test and early out-of-hospital ambulatory ST segment monitoring in 123 consecutive men surviving a first acute myocardial infarction (AMI). Seventy...... less than 0.02). Thrombolysis resulted in a non-significant reduction in exercise-induced ST segment depression: prevalence 43% vs 62% in controls. However, during ambulatory monitoring the duration of transient myocardial ischaemia was significantly reduced in thrombolysed patients: 322 min vs 1144...... myocardial ischaemia. This may explain the improvement in myocardial function during physical activities, which was also observed in this study....

  2. Comparison and Relationships Between Social Support and Coping Strategies in Patients with Myocardial Infarction and in the Control Groups

    OpenAIRE

    F Asghari; Sadeghi, A.; Mehraban, F.; S Saadat

    2015-01-01

    Introduction: Heart diseases involve the first and most prevalent causes of morbidity as well as mortality in Iran, which can be affected by various factors. Hence, this study aimed to explore the comparison and relationships between social support and coping strategies in patients with myocardial infarction and in the control group in Rasht. Methods: In this descriptive study, the study healthy population consisted of all males aged 40-90 living in Rasht, among which 125 males were select...

  3. Early pharmacologic intervention may prevent the deterioration in endothelial function after experimental myocardial infarction in rats: effects of ibopamine and captopril.

    NARCIS (Netherlands)

    Buikema, H.; van Veldhuisen, D.J.; Hegeman, H.; van Gilst, W.H.

    1997-01-01

    BACKGROUND: Endothelial function is progressively disturbed after myocardial infarction (MI), which may be related to both neurohumoral activation and hemodynamic alterations. Consequently, it may be suggested that drugs that favorably affect these factors may also have a positive effect on endothel

  4. Coronary microvascular obstruction in acute myocardial infarction.

    Science.gov (United States)

    Niccoli, Giampaolo; Scalone, Giancarla; Lerman, Amir; Crea, Filippo

    2016-04-01

    The success of a primary percutaneous intervention (PCI) in the setting of ST elevation myocardial infarction depends on the functional and structural integrity of coronary microcirculation. Coronary microvascular dysfunction and obstruction (CMVO) occurs in up to half of patients submitted to apparently successful primary PCI and is associated to a much worse outcome. The current review summarizes the complex mechanisms responsible for CMVO, including pre-existing coronary microvascular dysfunction, and highlights the current limitations in the assessment of microvascular function. More importantly, at the light of the substantial failure of trials hitherto published on the treatment of CMVO, this review proposes a novel integrated therapeutic approach, which should overcome the limitations of previous studies.

  5. Renal infarction caused by medium vessel vasculitis.

    Science.gov (United States)

    Kavarthapol Jayaraman, Vinothkumar; Chakera, Aron

    2015-04-24

    A 44-year-old Italian man presented to the emergency department on three occasions over 4 days with severe left flank pain. Initial investigations including a renal tract ultrasound were normal and he was discharged with analgaesia. On his third presentation, a CT angiogram was performed due to persisting pain, which demonstrated infarction of his left kidney as well as thickening of the anterior branch of left renal artery and complete occlusion with focal intimal dissection of the coeliac artery. His antineutrophil cytoplasmic antibody was negative. A medium vessel vasculitis was suspected and confirmed on positron emission tomography-CT, which revealed increased metabolic activity involving the right internal mammary artery and coeliac artery. Treatment with pulse methylprednisolone was started followed by a tapering prednisolone regimen, with a rapid reduction in his inflammatory indices. Twenty-four months later his renal function remains normal off all immunosuppression.

  6. [Cerebral infarction and transient ischemic attack].

    Science.gov (United States)

    Sahara, Noriyuki; Kuwashiro, Takahiro; Okada, Yasushi

    2016-04-01

    Japanese Guidelines for the Management of Stroke 2015 was published. Here, we describe several points revised from the 2009 edition about "Cerebral infarction and transient ischemic attack (TIA)". The revision points are as follows; 1. Extension of possible time window of intravenous recombinant tissue-plasminogen activator treatment (from within 3 hours to within 4.5 hours); 2. Antiplatelet therapy in acute stage (dual antiplatelet therapy (DAPT) for non-cardioembolic ischemic stroke or TIA); 3. Endovascular recanalization therapy in acute stage; 4. Antiplatelet therapy in chronic stage (Cilostazol is recommended similar to aspirin or clopidogrel); 5. Non-vitamin K antagonist oral anticoagulants (NOACs) for non-valvular atrial fibrillation (NVAF) stroke or TIA patients; 6. Management of TIA. We explain the revised points of the guideline in the text.

  7. Chronic ischemic mitral regurgitation and papillary muscle infarction detected by late gadolinium-enhanced cardiac magnetic resonance imaging in patients with ST-segment elevation myocardial infarction

    NARCIS (Netherlands)

    Bouma, Wobbe; Willemsen, Hendrik M; Lexis, Chris P H; Prakken, Niek H; Lipsic, Erik; van Veldhuisen, Dirk J; Mariani, Massimo A; van der Harst, Pim; van der Horst, Iwan C C

    2016-01-01

    BACKGROUND: Both papillary muscle infarction (PMI) and chronic ischemic mitral regurgitation (CIMR) are associated with reduced survival after myocardial infarction. The influence of PMI on CIMR and factors influencing both entities are incompletely understood. OBJECTIVES: We sought to determine the

  8. New-onset atrial fibrillation predicts malignant arrhythmias in post-myocardial infarction patients - A Cardiac Arrhythmias and RIsk Stratification after acute Myocardial infarction (CARISMA) substudy

    DEFF Research Database (Denmark)

    Ruwald, Anne Christine Huth; Bloch Thomsen, Poul Erik; Gang, Uffe Jakob Ortved;

    2013-01-01

    After myocardial infarction (MI) the risk of sudden cardiac death due to arrhythmias is substantial.......After myocardial infarction (MI) the risk of sudden cardiac death due to arrhythmias is substantial....

  9. Motor recovery by anterior choroidal artery territory in a patient with middle cerebral artery infarct

    Institute of Scientific and Technical Information of China (English)

    Ji Heon Hong; Sung Ho Jang

    2010-01-01

    In this study,the uninjured periventricular area of a female patient who presented with complete paralysis of the left extremities following middle cerebral artery infarction was analyzed using diffusion tensor tractography,transcranial magnetic stimulation,and functional magnetic resonance imaging.Diffusion tensor tractography revealed interrupted corticospinal tract at the infarct lesion in the corona radiata at 2 weeks after onset,which descended through the spared periventricular area at 6 months after onset.Transcranial magnetic stimulation and functional magnetic resonance imaging revealed a motor pathway of the affected hand that was compatible with the lateral corticospinal tract.At 6 months after onset,motor function in the affected extremities recovered to normal levels,which suggested that motor function in the affected hand recovered by the corticospinal tract that passed through the spared periventricular area.The arterial territory of the spared periventricular area corresponded with the anterior choroidal artery.These results suggest that care should be taken in spared periventricular areas in patients with lesions at the corona radiata level.

  10. Affective Urbanism

    DEFF Research Database (Denmark)

    Samson, Kristine

    . Under these circumstances affective aesthetics operate strategically within the urban field of interests, capital flows and desires of the social. This ‘affective urbanism’ (Anderson & Holden 2008) is linked to a society influenced by new kinds of information flows, where culture is mediated and enacted...... and cultural festivals, both practices indicate that design is implemented as means of creating affective spaces in the city. Both cases show how immaterial production of affects and emotions in the city can be seen in relation to economic potential and urban development. Finally, I will discuss whether urban......Urban design and architecture are increasingly used as material and affective strategies for setting the scene, for manipulation and the production of urban life: The orchestration of atmospheres, the framing and staging of urban actions, the programming for contemplation, involvement, play...

  11. Residual Myocardial Iron Following Intramyocardial Hemorrhage During the Convalescent Phase of Reperfused ST-Segment–Elevation Myocardial Infarction and Adverse Left Ventricular Remodeling

    Science.gov (United States)

    Bulluck, Heerajnarain; Rosmini, Stefania; Abdel-Gadir, Amna; White, Steven K.; Bhuva, Anish N.; Treibel, Thomas A.; Fontana, Marianna; Ramlall, Manish; Hamarneh, Ashraf; Sirker, Alex; Herrey, Anna S.; Manisty, Charlotte; Yellon, Derek M.; Kellman, Peter; Moon, James C.

    2016-01-01

    Background— The presence of intramyocardial hemorrhage (IMH) in ST-segment–elevation myocardial infarction patients reperfused by primary percutaneous coronary intervention has been associated with residual myocardial iron at follow-up, and its impact on adverse left ventricular (LV) remodeling is incompletely understood and is investigated here. Methods and Results— Forty-eight ST-segment–elevation myocardial infarction patients underwent cardiovascular magnetic resonance at 4±2 days post primary percutaneous coronary intervention, of whom 40 had a follow-up scan at 5±2 months. Native T1, T2, and T2* maps were acquired. Eight out of 40 (20%) patients developed adverse LV remodeling. A subset of 28 patients had matching T2* maps, of which 15/28 patients (54%) had IMH. Eighteen of 28 (64%) patients had microvascular obstruction on the acute scan, of whom 15/18 (83%) patients had microvascular obstruction with IMH. On the follow-up scan, 13/15 patients (87%) had evidence of residual iron within the infarct zone. Patients with residual iron had higher T2 in the infarct zone surrounding the residual iron when compared with those without. In patients with adverse LV remodeling, T2 in the infarct zone surrounding the residual iron was also higher than in those without (60 [54–64] ms versus 53 [51–56] ms; P=0.025). Acute myocardial infarct size, extent of microvascular obstruction, and IMH correlated with the change in LV end-diastolic volume (Pearson’s rho of 0.64, 0.59, and 0.66, respectively; P=0.18 and 0.62, respectively, for correlation coefficient comparison) and performed equally well on receiver operating characteristic curve for predicting adverse LV remodeling (area under the curve: 0.99, 0.94, and 0.95, respectively; P=0.19 for receiver operating characteristic curve comparison). Conclusions— The majority of ST-segment–elevation myocardial infarction patients with IMH had residual myocardial iron at follow-up. This was associated with

  12. Renormalized Volume

    CERN Document Server

    Gover, A Rod

    2016-01-01

    For any conformally compact manifold with hypersurface boundary we define a canonical renormalized volume functional and compute an explicit, holographic formula for the corresponding anomaly. For the special case of asymptotically Einstein manifolds, our method recovers the known results. The anomaly does not depend on any particular choice of regulator, but the coefficients of divergences do. We give explicit formulae for these divergences valid for any choice of regulating hypersurface; these should be relevant to recent studies of quantum corrections to entanglement entropies. The anomaly is expressed as a conformally invariant integral of a local Q-curvature that generalizes the Branson Q-curvature by including data of the embedding. In each dimension this canonically defines a higher dimensional generalization of the Willmore energy/rigid string action. We show that the variation of these energy functionals is exactly the obstruction to solving a singular Yamabe type problem with boundary data along the...

  13. Pulsed Doppler echocardiographic analysis of mitral regurgitation after myocardial infarction.

    Science.gov (United States)

    Loperfido, F; Biasucci, L M; Pennestri, F; Laurenzi, F; Gimigliano, F; Vigna, C; Rossi, E; Favuzzi, A; Santarelli, P; Manzoli, U

    1986-10-01

    In 72 patients with previous myocardial infarction (MI), mitral regurgitation (MR) was assessed by pulsed-wave Doppler echocardiography and compared with physical and 2-dimensional echocardiographic findings. MR was found by Doppler in 29 of 42 patients (62%) with anterior MI, 11 of 30 (37%) with inferior MI (p less than 0.01) and in none of 20 normal control subjects. MR was more frequent in patients who underwent Doppler study 3 months after MI than in those who underwent Doppler at discharge (anterior MI = 83% vs 50%, p less than 0.01; inferior MI = 47% vs 27%, p = not significant). Of 15 patients who underwent Doppler studies both times, 3 (all with anterior MI) had MR only on the second study. Of the patients with Doppler MR, 12 of 27 (44%) with a left ventricular (LV) ejection fraction (EF) greater than 30% and 1 of 13 (8%) with an EF of 30% or less (p less than 0.01) had an MR systolic murmur. Mitral prolapse or eversion and papillary muscle fibrosis were infrequent in MI patients, whether or not Doppler MR was present. The degree of Doppler MR correlated with EF (r = -0.61), LV systolic volume (r = 0.47), and systolic and diastolic mitral anulus circumference (r = 0.52 and 0.51, respectively). Doppler MR was present in 24 of 28 patients (86%) with an EF of 40% or less and in 16 of 44 (36%) with EF more than 40% (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3766410

  14. Infarct burden following multivessel PCI vs. infarct-only PCI in patients with acute STEMI: the Glasgow PRAMI CMR sub-study

    OpenAIRE

    Mangion, Kenneth; Carrick, David; Payne, Alexander; McClure, John; Mason, Maureen; Petrie, Mark; McEntegart, Margaret; Eteiba, Hany; Oldroyd, Keith; Berry, Colin

    2015-01-01

    Background: In the Preventive Angioplasty in Myocardial Infarction trial (PRAMI; ISRCTN73028481), immediate multivessel PCI (MV-PCI) of non-IRA (infarct related artery) lesions in patients with acute ST elevation myocardial infarction (STEMI) and multivessel coronary disease (MVD) improved long term prognosis. We assessed infarct distribution and size in a pre-specified cardiac magnetic resonance (CMR) sub-study. Methods: In this single centre prospective sub-study, PRAMI participan...

  15. Segmental testicular infarction: sonographic findings and pathologic correlation.

    Science.gov (United States)

    Aquino, Michael; Nghiem, Hanh; Jafri, Syed Zafar; Schwartz, John; Malhotra, Rajwant; Amin, Mitual

    2013-02-01

    Segmental testicular infarction can mimic testicular carcinoma on sonography and can lead to unnecessary orchiectomy. This case series describes and correlates sonographic and histologic findings of 7 pathologically proven segmental testicular infarction cases. Segmental testicular infarction should be suspected on sonography when a geographic lesion with low or mixed echogenicity has absent or near-absent flow in a patient with scrotal pain. A hyperechoic rim and peripheral hyperemia correspond to interstitial hemorrhage and inflammatory changes. As an infarct evolves, it becomes more discrete and hypoechoic as ghost outlines replace seminiferous tubules. Follow-up or contrast-enhanced magnetic resonance imaging or sonography can increase diagnostic confidence in suspected cases and prevent unnecessary orchiectomy.

  16. Cytopathologic diagnosis of spontaneous infarction of fibroadenoma of the breast.

    Science.gov (United States)

    Wadhwa, Neelam; Joshi, Richa; Mangal, Nidhi; Khan, Nirupma Panikar; Joshi, Mohit

    2014-01-01

    Infarction is an uncommon event in a fibroadenoma, which is the commonest benign tumor of the breast. Most often it occurs in pregnancy, lactation or is secondary to fine needle aspiration. Spontaneous infarction of a fibroadenoma in the absence of a predisposing condition is very rare. The cytopathologic features of infarction are necrosis and worrisome nuclear features, which are often misinterpreted as either inflammation or malignancy. We detail a report of accurate cytopathologic diagnosis of spontaneous infarction of fibroadenoma in a 17-year-old adolescent non pregnant girl. Careful attention to the cytopathologic clues like uniform thickness of the necrotic epithelial fragments, branching pattern reminiscent of the staghorn pattern despite atypical nuclear features and clinical details like young age of the patient and recent onset pain in a pre-existing lump helped arrive at the correct diagnosis and spared the patient of a radical excision. To the best of our knowledge, there are no earlier reports of correct cytopathologic diagnosis.

  17. Lacunar infarcts: no black holes in the brain are benign.

    Science.gov (United States)

    Norrving, Bo

    2008-08-01

    Lacunar infarcts--small subcortical infarcts that result from occlusion of a single penetrating artery--account for about one quarter of all ischaemic strokes. However, there are many diagnostic pitfalls, and causes other than penetrating small vessel disease in up to one third of cases. Recent studies have shown that the prognosis after lacunar infarcts is not benign; the risk of recurrent stroke is no lower than for other ischaemic stroke subtypes, and there is an increased risk for cognitive decline, dementia and death in the long term. Furthermore, silent small vessel disease in the brain at the time of an index stroke has significant prognostic implications. In the acute phase, response to intravenous thrombolysis appears to be similar to other subtypes of ischaemic strokes. Antiplatelet drugs, careful blood pressure control, statins and modification of lifestyle risk factors are key elements in secondary prevention after lacunar infarcts. PMID:18644908

  18. Chronic radium intoxication: morphology of bone and marrow infarcts

    International Nuclear Information System (INIS)

    Using direct and polarized light microscopy and a variety of standard histologic stains, the morphology of two groups of bone and marrow infarcts are compared. One group is from patients whose infarcts can, with confidence, be related to ischemia, trauma, or embolization and whose histories exclude radium ingestion or exposure. The second group is from radium dial painters whose pre-terminal body burdens of 226Ra ranged from 1.67 μCi to some value equal to or below 0.0042 μCi. The individual bone or marrow infarct among the radium cases does not differ radically from those in the ischemia-injury group, although taken as a whole, the radium-related infarcts are marked by less osteogenetic activity, a less prominent blood supply, much less cellular fibrous tissue and more extensive deposits of basophilic bone debris than the ischemia-injury group

  19. Aneurysm of the left aortic sinus causing acute myocardial infarction

    International Nuclear Information System (INIS)

    This report describes the findings and management of a young male who presented with an acute ST-segment elevation myocardial infarction due to compression of the circumflex coronary artery by a large aneurysm of left sinus of Valsalva

  20. Bilateral orbital bone infarction in sickle-cell disease.

    Science.gov (United States)

    Ghafouri, Roya H; Lee, Irene; Freitag, Suzanne K; Pira, Tony N

    2011-01-01

    This is a case of a 2-year-old boy with sickle cell disease who presented with bilateral eyelid swelling, limited extraocular motility, and lateral subperiosteal fluid collection associated with bilateral lateral orbital wall infarctions on MRI. The patient was managed medically with intravenous fluids, analgesics, broad-spectrum antibiotics, systemic steroids, and clinically improved. Patients with sickle cell disease are susceptible to infarction of the orbital bones during vaso-occlusive crises. Orbital wall infarction can lead to acute proptosis and restricted extraocular motility. Orbital wall infarction should be considered in sickle cell patients with orbital diseases so that appropriate treatment can be instituted promptly to prevent the serious sequelae of orbital compression syndrome. PMID:20577135

  1. Sildenafil and diastolic dysfunction after acute myocardial infarction trial

    DEFF Research Database (Denmark)

    Andersen, Mads J; Gustafsson, Finn; Hassager, Christian;

    2013-01-01

    Diastolic dysfunction following myocardial infarction is an important predictor of outcome, irrespective of left ventricular systolic function. Previous studies suggest that phosphordiesterase-5 inhibition has a favorable effect on the myocardium as well as on the pulmonary and systemic vasculature....

  2. Secondary prevention with calcium antagonists after acute myocardial infarction

    DEFF Research Database (Denmark)

    Hansen, J F

    1992-01-01

    Experimental studies have demonstrated that the 3 calcium antagonists nifedipine, diltiazem, and verapamil have a comparable effect in the prevention of myocardial damage during ischaemia. Secondary prevention trials after acute myocardial infarction, which aimed at improving survival...

  3. Aldosterone blockade in post-acute myocardial infarction heart failure

    NARCIS (Netherlands)

    Pitt, Bertram; Ferrari, Roberto; Gheorghiade, Mihai; van Veldhuisen, Dirk J.; Krum, Henry; McMurray, John; Lopez-Sendon, Jose

    2006-01-01

    Development of heart failure (HF) or left ventricular systolic dysfunction (LVSD) significantly increases mortality post acute myocardial infarction (AMI). Aldosterone contributes to the development and progression of HF post AMI, and major guidelines now recommend aldosterone blockade in this setti

  4. Beyond textbook neuroanatomy: The syndrome of malignant PCA infarction.

    Science.gov (United States)

    Gogela, Steven L; Gozal, Yair M; Rahme, Ralph; Zuccarello, Mario; Ringer, Andrew J

    2015-01-01

    Given its limited vascular territory, occlusion of the posterior cerebral artery (PCA) usually does not result in malignant infarction. Challenging this concept, we present 3 cases of unilateral PCA infarction with secondary malignant progression, resulting from extension into what would classically be considered the posterior middle cerebral artery (MCA) territory. Interestingly, these were true PCA infarctions, not "MCA plus" strokes, since the underlying occlusive lesion was in the PCA. We hypothesize that congenital and/or acquired variability in the distribution and extent of territory supplied by the PCA may underlie this rare clinical entity. Patients with a PCA infarction should thus be followed closely and offered early surgical decompression in the event of malignant progression. PMID:26337546

  5. EVOLUTION OF THROMBOLYTIC THERAPY IN THE TREATMENT OF MYOCARDIAL INFARCTION

    OpenAIRE

    P. G. Kesov; O. M. Reytblat; Z. M. Safiullina; S. V. Shalaev

    2015-01-01

    History of thrombolytic therapy is shortly reflected, main trials of various thrombolytics in acute ST-segment elevation myocardial infarction (STEMI) are analyzed. Perspectives of modern thrombolytic therapy in patients with STEMI are discussed.

  6. Clinical Manifestation of Acute Myocardial Infarction in the Elderly

    Directory of Open Access Journals (Sweden)

    Miftah Suryadipradja

    2003-12-01

    Full Text Available A retrospective study were performed in patients with acute myocardial infarction (AMI that hospitalized in ICCU Cipto Mangunkusumo hospital, Jakarta during the period of January 1994 until Decmber 1999. There were 513 patients hospitalized with MCI, 227 patients (44.2% were classified as elderly, and 35.2% of them were female. Most of the elderly AMI patients reported typical chest pain just like their younger counterparts. Elderly AMI patients tend to come later to the hospital, and more Q-wave myocardial infarction were identified compared to non- Q-wave myocardial infarction. Risk factors of diabetes mellitus and hypertension were more common among the elderly. The prevalence of atrial fibrillation and the mortality rate were higher among elderly AMI patients. (Med J Indones 2003; 12: 229-35 Keywords: clinical manifestation, acute myocardial infarction, elderly

  7. Aneurysm of the left aortic sinus causing acute myocardial infarction

    OpenAIRE

    Jan-Peter Smedema; Vernon Freeman; Johan Brink

    2011-01-01

    This report describes the findings and management of a young male who presented with an acute ST-segment elevation myocardial infarction due to compression of the circumflex coronary artery by a large aneurysm of left sinus of Valsalva.

  8. Class of Antiretroviral Drugs and the Risk of Myocardial Infarction

    DEFF Research Database (Denmark)

    2007-01-01

    BACKGROUND: We have previously demonstrated an association between combination antiretroviral therapy and the risk of myocardial infarction. It is not clear whether this association differs according to the class of antiretroviral drugs. We conducted a study to investigate the association...... of cumulative exposure to protease inhibitors and nonnucleoside reverse-transcriptase inhibitors with the risk of myocardial infarction. METHODS: We analyzed data collected through February 2005 from our prospective observational study of 23,437 patients infected with the human immunodeficiency virus....... The incidence rates of myocardial infarction during the follow-up period were calculated, and the associations between myocardial infarction and exposure to protease inhibitors or nonnucleoside reverse-transcriptase inhibitors were determined. RESULTS: Three hundred forty-five patients had a myocardial...

  9. Myocardial infarction among Danish HIV-infected individuals

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Helleberg, Marie; May, Margaret T;

    2015-01-01

    BACKGROUND: Human immunodeficiency virus-infected individuals have increased risk of myocardial infarction (MI); however, the contribution from smoking and potentiating effects of HIV are controversial. METHODS: From the Danish HIV Cohort Study and the Copenhagen General Population Study, we...

  10. Breckinridge Project, initial effort. Report XI, Volume III. Critical design areas. [Identification of critical design areas; design or materials problems, trade-off areas, items affecting operability and reliability

    Energy Technology Data Exchange (ETDEWEB)

    None

    1982-01-01

    Several meetings have been held with representatives from Ashland Synthetic Fuels, Inc.; Airco Energy Company, Inc.; Bechtel Group, Inc.; and HRI Engineering, Inc. to identify critical design areas in the Phase Zero work. (Critical design areas are defined as those requiring additional data or further work to finalize design or material selection, to optimize the trade-off between capital investment and operating cost, or to enhance system operability and reliability.) The critical design areas so identified are summarized by plant in this volume of Report XI. Items of a proprietary nature have been omitted from this report, but are included in the limited access version.

  11. Xueshuantong improves cerebral blood perfusion in elderly patients with lacunar infarction

    Institute of Scientific and Technical Information of China (English)

    Qifeng Gui; Yunmei Yang; Shihong Ying; Minming Zhang

    2013-01-01

    A total of 64 patients with acute lacunar infarction were enrolled within 24 hours of onset. The patients received conventional therapy (antiplatelet drugs and hypolipidemic drugs) alone or conventional therapy plus 450 mg Xueshuantong once a day. The main ingredient of the Xueshuantong lyophilized powder used for injection was Panax notoginseng saponins. Assessments were made at admission and at discharge using the National Institutes of Health Stroke Scale, the Activity of Daily Living and the Mini-Mental State Examination. Additionally, the relative cerebral blood flow, relative cerebral blood volume and relative mean transit time in the region of interest were calculated within 24 hours after the onset of lacunar infarction, using dynamic susceptibility contrast magnetic resonance perfusion imaging technology. Patients underwent a follow-up MRI scan after 4 weeks of treatment. There was an improvement in the Activity of Daily Living scores and a greater reduction in the scores on the National Institutes of Health Stroke Scale in the treatment group than in the control group. However, the Mini-Mental State Examination scores showed no significant differences after 4 weeks of treatment. Compared with the control group, the relative cerebral blood flow at discharge had increased and showed a greater improvement in the treatment group. Furthermore, there was a reduction in the relative mean transit time at discharge and the value was lower in the treatment group than in the control group. The experimental findings indicate that Xueshuantong treatment improves neurological deficits in elderly patients with lacunar infarction, and the mechanism may be related to increased cerebral perfusion.

  12. Chronic experimental myocardial infarction produces antinatriuresis by a renal nerve-dependent mechanism

    Directory of Open Access Journals (Sweden)

    Souza D.R.B.

    2004-01-01

    Full Text Available The present study focused on the role of sympathetic renal nerve activity, in mediating congestive heart failure-induced sodium retention following experimental chronic myocardial infarction. Groups of male Wistar rats (240-260 g were studied: sham-operated coronary ligation (CON3W, N = 11, coronary ligation and sham-operated renal denervation (INF3W, N = 19, 3 weeks of coronary ligation and sympathetic renal nerve denervation (INF3WDX, N = 6, sham-operated coronary ligation (N = 7, and 16 weeks of coronary ligation (INF16W, N = 7. An acute experimental protocol was used in which the volume overload (VO; 5% of body weight was applied for 30 min after the equilibration period of continuous iv infusion of saline. Compared to control levels, VO produced an increase (P < 0.01, ANOVA in urine flow rate (UFR; 570% and urinary sodium excretion (USE; 1117% in CON3W. VO induced a smaller increase (P < 0.01 in USE (684% in INF3W. A similar response was also observed in INF16W. In INF3WDX, VO produced an immediate and large increase (P < 0.01 in UFR (547% and USE (1211%. Similarly, in INF3W VO increased (P < 0.01 UFR (394% and USE (894%. Compared with INF3W, VO induced a higher (P < 0.01 USE in INF3WDX, whose values were similar to those for CON3W. These results suggest that renal sympathetic activity may be involved in sodium retention induced by congestive heart failure. This premise is supported by the observation that in bilaterally renal denervated INF3WDX rats myocardial infarction was unable to reduce volume expansion-induced natriuresis. However, the mechanism involved in urinary volume regulation seems to be insensitive to the factors that alter natriuresis.

  13. The Clinical Differentiation of Cerebellar Infarction from Common Vertigo Syndromes

    OpenAIRE

    Nelson, James A.; Viirre, Erik

    2009-01-01

    This article summarizes the emergency department approach to diagnosing cerebellar infarction in the patient presenting with vertigo. Vertigo is defined and identification of a vertigo syndrome is discussed. The differentiation of common vertigo syndromes such as benign paroxysmal positional vertigo, Meniere’s disease, migrainous vertigo, and vestibular neuritis is summarized. Confirmation of a peripheral vertigo syndrome substantially lowers the likelihood of cerebellar infarction, as do ind...

  14. Macrophage depletion suppresses sympathetic hyperinnervation following myocardial infarction

    OpenAIRE

    Wernli, G.; Hasan, W.; Bhattacherjee, A.; Rooijen, van, J.; Smith, P K

    2009-01-01

    Myocardial infarction induces sympathetic axon sprouting adjacent to the necrotic region, and this has been implicated in the etiology of arrhythmias resulting in sudden cardiac death. Previous studies show that nerve growth factor (NGF) is essential for enhanced post-infarct sympathetic sprouting, but the cell types necessary to supply this neurotrophic protein are unknown. The objective of the present study was to determine whether macrophages, which are known to synthesize NGF, are necessa...

  15. Perinatal hepatic infarction in twin-twin transfusion.

    LENUS (Irish Health Repository)

    O'Sullivan, M J

    2012-02-03

    We report a case of a twin pregnancy which was complicated by a twin-twin transfusion in which the recipient twin was noted to have an intra-abdominal echogenic mass. This twin died at two days of age of hepatic infarction. The donor twin was healthy at birth, at thirty weeks\\' gestation, and did not have any subsequent problems. Fetal intra-abdominal echogenicity may be a marker of hepatic infarction.

  16. Maternal floor infarction: management of an underrecognized pathology.

    Science.gov (United States)

    Al-Sahan, Nada; Grynspan, David; von Dadelszen, Peter; Gruslin, Andrée

    2014-01-01

    Maternal floor infarction is a relatively rare condition characterized clinically by severe early onset fetal growth restriction with features of uteroplacental insufficiency. It has a very high recurrence rate and carries a significant risk or fetal demise. Pathological characteristics include massive and diffuse fibrin deposition along the decidua basalis and the perivillous space of the basal plate. We present a case of recurrent maternal floor infarction and propose diagnostic clues as well as potential therapeutic options.

  17. Magnetic Resonance Imaging Criteria for Thrombolysis in Hyperacute Cerebral Infarction

    OpenAIRE

    AHMETGJEKAJ, ILIR; KABASHI-MUÇAJ, SERBEZE; LASCU, LUANA CORINA; KABASHI, ANTIGONA; BONDARI, A.; Bondari, Simona; DEDUSHI-HOTI, KRESHNIKE; BIÇAKU, ARDIAN; SHATRI, JETON

    2014-01-01

    Purpose: Selection of patients with cerebral infarction for MRI that is suitable for thrombolytic therapy as an emerging application. Although the efficiency of the therapy with i.v. tissue plasminogen activator (tPA) within 3 hours after onset of symptoms has been proven in selected patients with CT, now these criteria are determined by MRI, as the data we gather are fast and accurate in the first hours. Material and methods: MRI screening in patients with acute cerebral infarction before ap...

  18. Acute Myocardial Infarction in Puerperium Stage. A Case Presentation

    OpenAIRE

    Teresa Oliva Rivero; Israel Sotolongo Castro; Maria Victoria Jó Díaz

    2007-01-01

    A 38 year-old hypertensive, smoker female patient was presented. She suferred from an acute myocardial infarction in the mediate puerperium stage of an normal deliver. She was assisted in the Heart intensive care unit taking into consideration the basic care principles for this kind of patient. The infarct was diagnosed due to the clinical picture, and the electrographic alterations as well as the enzimatic alterations. The case is presented because it is a low frequency complication and it i...

  19. Paradoxical coronary artery embolism - A rare cause of myocardial infarction

    OpenAIRE

    Hakim, Fayaz A.; Kransdorf, Evan P.; Abudiab, Muaz M.; Sweeney, John P.

    2014-01-01

    Paradoxical coronary artery embolism is a rare, but often an underdiagnosed cause of acute myocardial infarction. It should be considered in patient who presents with chest pain and otherwise having a low risk profile for atherosclerosis coronary artery disease. We describe a case of paradoxical coronary artery embolism causing ST segment elevation myocardial infarction in a patient with upper extremity venous thrombosis. Echocardiography demonstrated a patent foramen ovale (PFO) with bidirec...

  20. Lessons from the management of acute myocardial infarction

    OpenAIRE

    Pearson, M.

    2005-01-01

    The National Service Framework for coronary heart disease set a number of challenging targets for the care of patients following an acute myocardial infarction. The Myocardial Infarction National Audit Project (MINAP) was devised to monitor progress and has been notably successful in winning professional support and participation and helping trusts to meet these targets. The new challenge is in translating this success to other areas of medicine. Heart failure is one such area, although it po...