Usefulness of detecting atherosclerosis by computed tomography. A relation to coronary artery stenosis

International Nuclear Information System (INIS)

Takasu, Junichiro; Yamamoto, Rie; Yokoyama, Kenichi

1999-01-01

Reports evaluating coronary artery calcification detection by nonenhanced computed tomography (CT) have verified the usefulness for diagnosis of coronary artery disease. In the condition of a mobile CT scanning at a public health examination, however, determination of coronary calcification remains unclear. We investigated, under this scanning condition, a relation between the characteristic of coronary artery calcification determined by conventional CT and coronary disease on arteriogram. The quantification of aortic wall thickening by enhanced CT was examined on the usefulness of detecting coronary artery disease. The CT density score and the characteristics of aortic atherosclerosis for 159 male patients 30 year-old or more (average age 60.7 years) were examined the relation to coronary artery stenoses. The CT density score was the strongest independent variable for determining the existence of coronary disease. The CT density cutoff score for detection of coronary disease was 50 equal to 50 HU the maximal CT density in the coronary arteries. The maximal aortic wall thickness was the strongest significant variable independent of the noted coronary risk factors for the severity of coronary stenosis on arteriogram. (author)

Coronary artery disease - strategies for primary prevention in Pakistan

International Nuclear Information System (INIS)

Khan, M.H.

2000-01-01

Coronary artery disease is the leading cause of death among middle aged and elderly population. The increase in prevalence of coronary artery disease in Pakistan, has also involved the younger population and about 30% of the patients of coronary artery disease are below the age of 40 years. It seems that with this high prevalence of coronary artery disease, we will be entering in the new millennium with coronary artery disease as number one killer in young adults in Pakistan. This is the time, though belated, we must embark on strategies for primary prevention of this disease so that we are able to reduce the incidence of the disease and the economic burden it entails on the national exchequer. Before suggesting the strategies for the prevention of coronary artery disease in Pakistan, let us briefly review the significance of modifiable risk factors for coronary artery disease. Several studies have been found a significant relationship between physical inactivity and coronary artery disease. (A.B./orig.)

Coronary Artery Disease

DEFF Research Database (Denmark)

Christiansen, Morten Krogh

2017-01-01

A family history of coronary artery disease (CAD) is an important risk factor for adverse coronary events, in particular if the disease has an early onset. The risk of CAD is influenced by genetic and environmental factors with a greater genetic contribution earlier in life. Through recent years......), and to characterize and quantify subclinical atherosclerosis in their relatives. Furthermore, the aim was to explore the impact of common genetic risk variants on the age of onset, familial clustering and disease severity. In study I, 143 patients with early- onset CAD were recruited from the Western Denmark Heart...... Registry and risk factor control was evaluated. The study revealed that risk factors are common in early-onset CAD and that a large room for risk factor improvement remains. In study II, we used coronary computed tomography angiography to compare the coronary plaque burden and characteristics between 88...

Frequency and predictors of renal artery stenosis in patients with coronary artery disease

International Nuclear Information System (INIS)

Shah, S.S.; Hafeezullah, M.

2010-01-01

Background: Renal artery stenosis (RAS) is a common finding in patients undergoing coronary angiography. We designed this study to look for the frequency and any predictors of renal artery stenosis in patients with coronary artery disease (CAD). Methods: A total of 201 consecutive patients with CAD confirmed by coronary angiography underwent an abdominal aortogram in the same sitting to screen for RAS. Patient demographics and co-morbidities were analysed for any association with RAS. Results: Forty-one of the patients were female (20.4%); ninety patients were hypertensive (44.8%); 49 patients (24.4%) were smokers; 19 patients (9.5%) had renal insufficiency; 88 patients (43.8%) had high cholesterol levels; 44 patients (21.9%) were diabetic. Thirty-two patients (15.9%) had single coronary artery disease, 59 patients (29.4%) had two vessel disease, and 110 patients (54.7%) had three vessel disease. Significant renal artery stenosis (less or equal to 50% stenosis) was present in 26 patients (12.9%). Among the variables studied, only female gender was found to be associated with a higher frequency of renal artery stenosis (24.39% vs 10.0%, p=0.01). Conclusions: The frequency of renal artery stenosis in patients with coronary artery disease is 12.9%. Female gender is associated with a higher frequency of renal artery stenosis in patients with CAD. (author)

Ischemic stroke: carotid and vertebral artery disease

Energy Technology Data Exchange (ETDEWEB)

Vilela, P.; Goulao, A. [Hospital Garcia de Orta, Servico de Neurorradiologia, Almada (Portugal)

2005-03-01

Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

Ischemic stroke: carotid and vertebral artery disease

International Nuclear Information System (INIS)

Vilela, P.; Goulao, A.

2005-01-01

Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

Posterior cerebral artery involvement in moyamoya disease: initial infarction and angle between PCA and basilar artery.

Science.gov (United States)

Lee, Ji Yeoun; Kim, Seung-Ki; Cheon, Jung-Eun; Choi, Jung Won; Phi, Ji Hoon; Kim, In-One; Cho, Byung-Kyu; Wang, Kyu-Chang

2013-12-01

Moyamoya disease (MMD) is a chronic cerebrovascular occlusive disease, and progressive involvement of the posterior cerebral artery (PCA) has been reported. However, majority of MMD articles are presenting classic anterior circulation related issues. This study investigates the preoperative factors related to the long-term outcome of posterior circulation in MMD. Retrospective review of 88 MMD patients (166 PCAs in either hemisphere) without symptomatic disease involvement of PCA at initial diagnosis was done. Data at initial diagnosis regarding age, presence of infarction, status of the PCA, type of posterior communicating artery, and the angle between PCA and basilar artery were reviewed. Progressive stenosis of PCA was evaluated by symptom or radiological imaging during follow up. During an average follow up of 8.3 years, 29 out of 166 (18 %) evaluated PCAs showed progressive disease involvement. The average time of progression from the initial operation was 4.9 years, with the latest onset at 10.8 years. The patients who showed progressive stenosis of the PCA tended to be younger, present with infarction, have smaller angle between PCA and basilar artery, and have asymptomatic stenosis of the PCA at initial presentation. However, multivariate analysis confirmed only the presence of initial infarction and a smaller angle between PCA and basilar artery to be significantly associated with progressive stenosis of PCA. Involvement of PCA in MMD may occur in a delayed fashion, years after the completion of revascularization of anterior circulation. Persistent long-term follow-up regarding the posterior circulation is recommended.

Arterial spin labeling in patients with chic cerebral artery steno-occlusive disease - Correlation with 15O-PET

International Nuclear Information System (INIS)

Kamano, Hironori; Yoshiura, Takashi; Hiwatashi, Akio; Abe, Koichiro; Yamashita, Koji; Honda, Hiroshi; Togao, Osamu

2013-01-01

Background: Heterogeneity of arterial transit time due to cerebral artery steno-occlusive lesions hampers accurate regional cerebral blood flow measurement by arterial spin labeling (ASL). Purpose: To assess the feasibility of regional cerebral blood flow measurement by ASL with multiple-delay time sampling in patients with steno-occlusive diseases by comparing with positron emission tomography (PET), and to determine whether regional arterial transit time measured by this ASL technique is correlated with regional mean transit time, a PET index of perfusion pressure. Material and Methods: Sixteen patients with steno-occlusive diseases received both ASL and 15 O-PET. The mean regional cerebral blood flow measured by ASL and PET, regional arterial transit time by ASL, and regional mean transit time by PET were obtained by a region-of-interest analysis. Correlation between regional cerebral blood flow by ASL and that by PET, and correlation between regional arterial transit time by ASL and regional mean transit time by PET were tested using Pearson's correlation coefficient for both absolute and relative values. A multivariate regression analysis was performed to test whether regional arterial transit time by ASL was a significant contributor in modeling regional mean transit time by PET after controlling the effect of regional cerebral blood flow by ASL. Results: A significant positive correlation was found between regional cerebral blood flow by ASL and that by PET for both absolute (r = 0.520, P < 0.0001) and relative (r = 0.691, P < 0.0001) values. A significant positive correlation was found between regional arterial transit time by ASL and regional mean transit time by PET both for absolute (r = 0.369, P = 0.0002) and relative (r = 0.443, P < 0.0001) values. The regression analysis revealed that regional arterial transit time by ASL was a significant contributor in modeling regional mean transit time by PET after controlling regional cerebral blood flow by ASL

Coronary artery disease in patients with cerebrovascular disease: a prospective study

International Nuclear Information System (INIS)

Rokey, R.; Rolak, L.A.; Harati, Y.; Kutka, N.; Verani, M.S.

1984-01-01

Coronary artery disease is the cause of death in most patients who have transient ischemic attacks or stroke. Evaluation for this condition is not routinely performed in such patients, and no prospective studies have been reported. We prospectively examined 50 consecutive patients with transient ischemic attacks or mild stroke to determine the prevalence and importance of coronary artery disease. All patients were examined by a cardiologist and underwent both exercise thallium-201 scintigraphy and exercise radionuclide ventriculography. Sixteen patients were suspected to have coronary artery disease on the basis of clinical evaluation. In 15 of these the was confirmed by the nuclear scans. The remaining 34 patients had no clinical evidence of heart disease, yet 14 had abnormal cardiac scans. Twenty of 22 patients with abnormal scans who underwent cardiac catheterization had significant coronary artery disease or a cardiomyopathy. The discovery of heart disease altered clinical management in 13 patients. Overall, 29 of 50 patients had significant coronary artery disease, compared with a 7% prevalence of the condition in other patients of similar age at the same institution

Relationship between Renal Artery Stenosis and Severity of Coronary Artery Disease in Patients with Coronary Atherosclerotic Disease

Directory of Open Access Journals (Sweden)

Amirfarhang Zandparsa

2012-09-01

Full Text Available Objective: The aim of the present investigation was to explore probable association of renal artery stenosis (RAS with coronary artery disease (CAD and the prevalence of renal artery stenosis (RAS in patients with CAD. Patients and methods: This study comprised 165 consecutive patients with CAD, including 52.7% males and 47.2% females with respective mean ages of 60.3 ±8.9 and 59.5±10.1. The patients underwent simultaneous coronary and renal angiographies, and the lumen reduction of 50% or more was considered as significant stenosis. Indeed, stenosis of more than 70% of the arterial lumen was regarded as severe. Results: According to our findings, the prevalence of renal artery stenosis in our hypertensive and normotensive patients were 46.2% and 19.5% respectively (p=0.002. Renal artery angiography revealed that 64 (38.8% of the patients had simultaneous renal artery stenosis. RAS is more common in females than males (p=0.031. Multivariate analysis revealed that among all examined factors, hypertension and serum creatinine were associated with RAS. There was no correlations found between gensini score and RAS (p=0.63. Conclusion: We found a relatively high prevalence of RAS including 46.2% in hypertensive and 19.5% in normotensive patients in our patients with CAD.

Contribution of genetic background, traditional risk factors, and HIV-related factors to coronary artery disease events in HIV-positive persons

NARCIS (Netherlands)

Rotger, Margalida; Glass, Tracy R; Junier, Thomas; Lundgren, Jens; Neaton, James D; Poloni, Estella S; van 't Wout, Angélique B; Lubomirov, Rubin; Colombo, Sara; Martinez, Raquel; Rauch, Andri; Günthard, Huldrych F; Neuhaus, Jacqueline; Wentworth, Deborah; van Manen, Danielle; Gras, Luuk A; Schuitemaker, Hanneke; Albini, Laura; Torti, Carlo; Jacobson, Lisa P; Li, Xiuhong; Kingsley, Lawrence A; Carli, Federica; Guaraldi, Giovanni; Ford, Emily S; Sereti, Irini; Hadigan, Colleen; Martinez, Esteban; Arnedo, Mireia; Egaña-Gorroño, Lander; Gatell, Jose M; Law, Matthew; Bendall, Courtney; Petoumenos, Kathy; Rockstroh, Jürgen; Wasmuth, Jan-Christian; Kabamba, Kabeya; Delforge, Marc; De Wit, Stephane; Berger, Florian; Mauss, Stefan; de Paz Sierra, Mariana; Losso, Marcelo; Belloso, Waldo H; Leyes, Maria; Campins, Antoni; Mondi, Annalisa; De Luca, Andrea; Bernardino, Ignacio; Barriuso-Iglesias, Mónica; Torrecilla-Rodriguez, Ana; Gonzalez-Garcia, Juan; Arribas, José R; Fanti, Iuri; Gel, Silvia; Puig, Jordi; Negredo, Eugenia; Gutierrez, Mar; Domingo, Pere; Fischer, Julia; Fätkenheuer, Gerd; Alonso-Villaverde, Carlos; Macken, Alan; Woo, James; McGinty, Tara; Mallon, Patrick; Mangili, Alexandra; Skinner, Sally; Wanke, Christine A; Reiss, Peter; Weber, Rainer; Bucher, Heiner C; Fellay, Jacques; Telenti, Amalio; Tarr, Philip E; Schölvinck, Elisabeth H.

BACKGROUND: Persons infected with human immunodeficiency virus (HIV) have increased rates of coronary artery disease (CAD). The relative contribution of genetic background, HIV-related factors, antiretroviral medications, and traditional risk factors to CAD has not been fully evaluated in the

Association of Aortic Calcification on Plain Chest Radiography with Obstructive Coronary Artery Disease

Energy Technology Data Exchange (ETDEWEB)

Kang, Yeong Han; Chang, Jeong Ho [Dept. of Diagnostic Radiology, Daegu Catholic University Hospital, Daegu (Korea, Republic of); Park, Jong Sam [Dept. of Radiologic Tecnology, Daegu Health College, Daegu (Korea, Republic of)

2009-03-15

This study was conducted to determine an association between aortic calcification viewed on plain chest radiography and obstructive coronary artery disease. Retrospective review of all chest radiography obtained from consecutive patients undergoing coronary angiography. Chest PA images were reviewed by technical radiologist and radiologist. Considering the presence of aortic arch calcification, images were compared with the results of coronary angiography. In addition, the size of aortic arch calcification were divided into two groups - the smaller and the larger than 10 mm. Among the total 846 patients, the number of the patients with obstructive coronary artery disease is total 417 (88.3%) in males and 312 (83.4%) in females. Considering the presence of aortic arch calcification, the positive predictive value of relation between aortic arch calcification and obstructive coronary artery disease was 91.4% and the relative risk of the group with aortic arch calcification to the opposite group was 1.10. According to the size of aortic arch calcification and obstructive coronary artery disease, the positive predictive value was 91.9% and the relative risk between two groups was 1.04. This study shows that aortic calcification was closely associated with obstructive coronary artery disease. If the aortic calcification is notified on plain chest radiography, we strongly recommend to consult with doctor.

Assessment of coronary artery disease by post-mortem cardiac MR

International Nuclear Information System (INIS)

Ruder, Thomas D.; Bauer-Kreutz, Regula; Ampanozi, Garyfalia; Rosskopf, Andrea B.; Pilgrim, Thomas M.; Weber, Oliver M.; Thali, Michael J.; Hatch, Gary M.

2012-01-01

Objectives: Minimally invasive or virtual autopsies are being advocated as alternative to traditional autopsy, but have limited abilities to detect coronary artery disease. It was the objective of this study to assess if the occurrence of chemical shift artifacts (CSA) along the coronary arteries on non-contrast, post-mortem cardiac MR may be used to investigate coronary artery disease. Methods: We retrospectively compared autopsy and CT findings of 30 cases with significant (≥75%), insignificant (<75%), or absent coronary artery stenosis to post-mortem cardiac MR findings. The chi-square test was used to investigate if the occurrence of CSA depends on the presence or absence of stenosis. Sensitivity, specificity and predictive values were calculated for each finding. Results: CSA indicates the absence of (significant) stenosis (p < 0.001). The occurrence of paired dark bands in lieu of CSA on post-mortem cardiac MR suggests (significant) coronary arteries stenosis (p < 0.001). Both findings have a high specificity but low sensitivity. Conclusions: CSA is a marker of vessel patency. The presence of paired dark bands indicates stenosis. These criteria improve the ability of minimally invasive or virtual autopsy to detect coronary artery disease related deaths

Contribution of genetic background, traditional risk factors, and HIV-related factors to coronary artery disease events in HIV-positive persons

NARCIS (Netherlands)

Rotger, Margalida; Glass, Tracy R.; Junier, Thomas; Lundgren, Jens; Neaton, James D.; Poloni, Estella S.; van 't Wout, Angélique B.; Lubomirov, Rubin; Colombo, Sara; Martinez, Raquel; Rauch, Andri; Günthard, Huldrych F.; Neuhaus, Jacqueline; Wentworth, Deborah; van Manen, Danielle; Gras, Luuk A.; Schuitemaker, Hanneke; Albini, Laura; Torti, Carlo; Jacobson, Lisa P.; Li, Xiuhong; Kingsley, Lawrence A.; Carli, Federica; Guaraldi, Giovanni; Ford, Emily S.; Sereti, Irini; Hadigan, Colleen; Martinez, Esteban; Arnedo, Mireia; Egaña-Gorroño, Lander; Gatell, Jose M.; Law, Matthew; Bendall, Courtney; Petoumenos, Kathy; Rockstroh, Jürgen; Wasmuth, Jan-Christian; Kabamba, Kabeya; Delforge, Marc; de Wit, Stephane; Berger, Florian; Mauss, Stefan; de Paz Sierra, Mariana; Losso, Marcelo; Belloso, Waldo H.; Leyes, Maria; Campins, Antoni; Mondi, Annalisa; de Luca, Andrea; Bernardino, Ignacio; Barriuso-Iglesias, Mónica; Torrecilla-Rodriguez, Ana; Gonzalez-Garcia, Juan; Arribas, José R.; Fanti, Iuri; Gel, Silvia; Puig, Jordi; Negredo, Eugenia; Gutierrez, Mar; Domingo, Pere; Fischer, Julia; Fätkenheuer, Gerd; Alonso-Villaverde, Carlos; Macken, Alan; Woo, James; McGinty, Tara; Mallon, Patrick; Mangili, Alexandra; Skinner, Sally; Wanke, Christine A.; Reiss, Peter; Weber, Rainer; Bucher, Heiner C.; Fellay, Jacques; Telenti, Amalio; Tarr, Philip E.; Gras, A. Luuk; van Wout, Angelique B.; Arnedo-Valero, Mireia; Sierra, Mariana de Paz; Rodriguez, Ana Torrecilla; Garcia, Juan Gonzalez; Arribas, Jose R.; Aubert, V.; Barth, J.; Battegay, M.; Bernasconi, E.; Böni, J.; Bucher, H. C.; Burton-Jeangros, C.; Calmy, A.; Cavassini, M.; Egger, M.; Elzi, L.; Fehr, J.; Fellay, J.; Francioli, P.; Furrer, H.; Fux, C. A.; Gorgievski, M.; Günthard, H.; Haerry, D.; Hasse, B.; Hirsch, H. H.; Hirschel, B.; Hösli, I.; Kahlert, C.; Kaiser, L.; Keiser, O.; Kind, C.; Klimkait, T.; Kovari, H.; Ledergerber, B.; Martinetti, G.; Martinez de Tejada, B.; Metzner, K.; Müller, N.; Nadal, D.; Pantaleo, G.; Rauch, A.; Regenass, S.; Rickenbach, M.; Rudin, C.; Schmid, P.; Schultze, D.; Schöni-Affolter, F.; Schüpbach, J.; Speck, R.; Taffé, P.; Tarr, P.; Telenti, A.; Trkola, A.; Vernazza, P.; Weber, R.; Prins, Yerly S. J. M.; Kuijpers, T. W.; Scherpbier, H. J.; Boer, K.; van der Meer, J. T. M.; Wit, F. W. M. N.; Godfried, M. H.; van der Poll, T.; Nellen, F. J. B.; Lange, J. M. A.; Geerlings, S. E.; van Vugt, M.; Vrouenraets, S. M. E.; Pajkrt, D.; Bos, J. C.; van der Valk, M.; Schreij, G.; Lowe, S.; Oude Lashof, A.; Pronk, M. J. H.; Bravenboer, B.; van der Ende, M. E.; de Vries-Sluijs, T. E. M. S.; Schurink, C. A. M.; van der Feltz, M.; Nouwen, J. L.; Gelinck, L. B. S.; Verbon, A.; Rijnders, B. J. A.; van de Ven-de Ruiter, E. D.; Slobbe, L.; Haag, Den; Kauffmann, R. H.; Schippers, E. F.; Groeneveld, P. H. P.; Alleman, M. A.; Bouwhuis, J. W.; ten Kate, R. W.; Soetekouw, R.; Kroon, F. P.; van den Broek, P. J.; van Dissel, J. T.; Arend, S. M.; van Nieuwkoop, C.; de Boer, M. J. G.; Jolink, H.; den Hollander, J. G.; Pogany, K.; Bronsveld, W.; Kortmann, W.; van Twillert, G.; van Houte, D. P. F.; Polée, M. B.; van Vonderen, M. G. A.; ten Napel, C. H. H.; Kootstra, G. J.; Brinkman, K.; Blok, W. L.; Frissen, P. H. J.; Schouten, W. E. M.; van den Berk, G. E. L.; Juttmann, J. R.; van Kasteren, M. E. E.; Brouwer, A. E.; Mulder, J. W.; van Gorp, E. C. M.; Smit, P. M.; Weijer, S.; van Eeden, A.; Verhagen, D. W. M.; Sprenger, H. G.; Doedens, R.; Scholvinck, E. H.; van Assen, S.; Stek, C. J.; Hoepelman, I. M.; Mudrikova, T.; Schneider, M. M. E.; Jaspers, C. A. J. J.; Ellerbroek, P. M.; Peters, E. J. G.; Maarschalk-Ellerbroek, L. J.; Oosterheert, J. J.; Arends, J. E.; Wassenberg, M. W. M.; van der Hilst, J. C. H.; Richter, C.; van der Berg, J. P.; Gisolf, E. H.; Margolick, Joseph B.; Plankey, Michael; Crain, Barbara; Dobs, Adrian; Farzadegan, Homayoon; Gallant, Joel; Johnson-Hill, Lisette; Sacktor, Ned; Selnes, Ola; Shepard, James; Thio, Chloe; Phair, John P.; Wolinsky, Steven M.; Badri, Sheila; Conover, Craig; O'Gorman, Maurice; Ostrow, David; Palella, Frank; Ragin, Ann; Detels, Roger; Martínez-Maza, Otoniel; Aronow, Aaron; Bolan, Robert; Breen, Elizabeth; Butch, Anthony; Fahey, John; Jamieson, Beth; Miller, Eric N.; Oishi, John; Vinters, Harry; Visscher, Barbara R.; Wiley, Dorothy; Witt, Mallory; Yang, Otto; Young, Stephen; Zhang, Zuo Feng; Rinaldo, Charles R.; Becker, James T.; Cranston, Ross D.; Martinson, Jeremy J.; Mellors, John W.; Silvestre, Anthony J.; Stall, Ronald D.; Muñoz, Alvaro; Abraham, Alison; Althoff, Keri; Cox, Christopher; D'Souza, Gypsyamber; Gange, Stephen J.; Golub, Elizabeth; Schollenberger, Janet; Seaberg, Eric C.; Su, Sol; Huebner, Robin E.; Dominguez, Geraldina; Moroni, M.; Angarano, G.; Antinori, A.; Carosi, G.; Cauda, R.; Monforte, A. d'Arminio; Di Perri, G.; Galli, M.; Iardino, R.; Ippolito, G.; Lazzarin, A.; Perno, C. F.; Sagnelli, E.; Viale, P. L.; Von Schlosser, F.; d'Arminio Monforte, A.; Ammassari, A.; Andreoni, M.; Balotta, C.; Bonfanti, P.; Bonora, S.; Borderi, M.; Capobianchi, M. R.; Castagna, A.; Ceccherini-Silberstein, F.; Cozzi-Lepri, A.; de Luca, A.; Gargiulo, M.; Gervasoni, C.; Girardi, E.; Lichtner, M.; Lo Caputo, S.; Madeddu, G.; Maggiolo, F.; Marcotullio, S.; Monno, L.; Murri, R.; Mussini, C.; Puoti, M.; Torti, C.; Fanti, I.; Formenti, T.; Galli, Laura; Lorenzini, Patrizia; Montroni, M.; Giacometti, A.; Costantini, A.; Riva, A.; Tirelli, U.; Martellotta, F.; Ladisa, N.; Lazzari, G.; Verucchi, G.; Castelli, F.; Scalzini, A.; Minardi, C.; Bertelli, D.; Quirino, T.; Abeli, C.; Manconi, P. E.; Piano, P.; Vecchiet, J.; Falasca, K.; Carnevale, G.; Lorenzotti, S.; Sighinolfi, L.; Segala, D.; Leoncini, F.; Mazzotta, F.; Pozzi, M.; Cassola, G.; Viscoli, G.; Viscoli, A.; Piscopo, R.; Mazzarello, G.; Mastroianni, C.; Belvisi, V.; Caramma, I.; Chiodera, A.; Castelli, P.; Rizzardini, G.; Ridolfo, A. L.; Foschi, A.; Salpietro, S.; Galli, A.; Bigoloni, A.; Spagnuolo, V.; Merli, S.; Carenzi, L.; Moioli, M. C.; Cicconi, P.; Bisio, L.; Gori, A.; Lapadula, G.; Abrescia, N.; Chirianni, A.; de Marco, M.; Ferrari, C.; Borghi, R.; Baldelli, F.; Belfiori, B.; Parruti, G.; Ursini, T.; Magnani, G.; Ursitti, M. A.; Narciso, P.; Tozzi, V.; Vullo, V.; d'Avino, A.; Zaccarelli, M.; Gallo, L.; Acinapura, R.; Capozzi, M.; Libertone, R.; Trotta, M. P.; Tebano, G.; Cattelan, A. M.; Mura, M. S.; Caramello, P.; Orofino, G. C.; Sciandra, M.; Raise, N. N.; Ebo, F.; Pellizzer, G.; Manfrin, V.; Law, M.; Petoumenos, K.; McManus, H.; Wright, S.; Bendall, C.; Moore, R.; Edwards, S.

2013-01-01

Persons infected with human immunodeficiency virus (HIV) have increased rates of coronary artery disease (CAD). The relative contribution of genetic background, HIV-related factors, antiretroviral medications, and traditional risk factors to CAD has not been fully evaluated in the setting of HIV

Arterial innervation in development and disease.

Science.gov (United States)

Eichmann, Anne; Brunet, Isabelle

2014-09-03

Innervation of arteries by sympathetic nerves is well known to control blood supply to organs. Recent studies have elucidated the mechanisms that regulate the development of arterial innervation and show that in addition to vascular tone, sympathetic nerves may also influence arterial maturation and growth. Understanding sympathetic arterial innervation may lead to new approaches to treat peripheral arterial disease and hypertension. Copyright © 2014, American Association for the Advancement of Science.

Cone pathway function in relation to asymmetric carotid artery stenosis

DEFF Research Database (Denmark)

Kofoed, Peter Kristian; Munch, Inger Christine; Holfort, Stig K

2013-01-01

Purpose:  To examine retinal function in relation to retinal perfusion pressure in patients with carotid artery stenosis. Methods:  Thirteen patients with carotid artery stenosis without clinical eye disease underwent assessment of ophthalmic artery systolic blood pressure (OSP) by ocular...... pneumoplethysmography, carotid artery obstructive disease by ultrasonography, intraocular pressure by applanation tonometry, retinal perfusion by fluorescein angiography and retinal function by multifocal electroretinography (mfERG). Data analysis compared the eye on the most stenotic side with the fellow eye...... pressure (p = 0.0028, 0.011, 0.041 for N1, P1, N2 implicit times, respectively, and p = 0.0086, 0.016, 0.040 for N1, P1, N2 for amplitudes, respectively, corrected for OSP). Conclusion:  Cone function deviation was observed in clinically healthy eyes on the side with highest degree of carotid artery...

Presence of angina pectoris is related to extensive coronary artery disease in diabetic patients.

Science.gov (United States)

Celik, Atac; Karayakali, Metin; Erkorkmaz, Unal; Altunkas, Fatih; Karaman, Kayihan; Koc, Fatih; Ceyhan, Koksal; Kadi, Hasan; Avsar, Alaettin

2013-08-01

Due to sensorial autonomic neuropathy, the type and severity of angina pectoris in patients with diabetes mellitus (DM) may be rather different from the type and severity of angina pectoris in patients without DM. The aim of the study was to understand if angina pectoris is related to extensive coronary artery disease (CAD) in patients with DM. The study included 530 patients with DM who underwent coronary angiography at our center in 2009 and 2010. Patients were divided into 4 groups according to type of chest pain: group 1, noncardiac chest pain or no pain; group 2, angina equivalent; group 3, atypical angina; and group 4, typical angina. All angiograms were re-evaluated and Gensini scores were calculated. Three-vessel disease was diagnosed in the presence of stenosis >50% in all 3 coronary artery systems. There were no statistically significant differences between the groups with regard to age, sex, systolic or diastolic blood pressures, body mass index, creatinine clearance, or lipid profile. Fasting blood glucose was significantly higher in group 4 than in group 2. Gensini scores were not statistically different between groups 1 and 2 or between groups 3 and 4; however, the scores for groups 3 and 4 were higher than the score for either group 1 or group 2. Prevalence of 3-vessel disease was significantly higher in groups 3 and 4 compared with the other groups. The presence of angina pectoris was related to extensive CAD in patients with DM. The extent of CAD was not correlated with the type of angina (typical or atypical). © 2013 Wiley Periodicals, Inc.

Detecting asymptomatic coronary artery disease using routine ...

African Journals Online (AJOL)

ECG-monitored exercise testing has been proposed as a relatively inexpensive and effective means of screening for asymptomatic coronary artery disease in patients presenting for peripheral vascular surgery. Despite the fact that exercise thallium scintigraphy is also dependent on the patient's ability to exercise, using this ...

Diagnosis and therapy of coronary artery disease: Second edition

International Nuclear Information System (INIS)

Cohn, P.F.

1985-01-01

This book contains 18 selections. Some of the titles are: Nuclear cardiology; Diagnosis of acute myocardial infarction; Therapy of angina pectoris; Psychosocial aspects of coronary artery disease; Nonatherosclerotic coronary artery disease; and The epidemiology of coronary artery disease

Prolonged ischemic heart disease and coronary artery bypass - relation to contractile reserve

DEFF Research Database (Denmark)

Kofoed, Klaus F; Bangsgaard, Regitze; Carstensen, Steen

2002-01-01

OBJECTIVE: A major effect of coronary artery bypass grafting (CABG) in patients with ischemic heart disease and impaired left ventricular (LV) contractile function is believed to be an improvement in LV function due to recovery of dysfunctional, but viable myocardium. However, recent studies have...

Arterial aging and arterial disease : interplay between central hemodynamics, cardiac work, and organ flow-implications for CKD and cardiovascular disease

NARCIS (Netherlands)

London, Gerard; Covic, Adrian; Goldsmith, David; Wiecek, Andrzej; Suleymanlar, Gultekin; Ortiz, Alberto; Massy, Ziad; Lindholm, Bengt; Martinez-Castelao, Alberto; Fliser, Danilo; Agarwal, Rajiv; Jager, Kitty J.; Dekker, Friedo W.; Blankestijn, Peter J.; Zoccali, Carmine

Cardiovascular disease is an important cause of morbidity and mortality in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). All epidemiological studies have clearly shown that accelerated arterial and cardiac aging is characteristic of these populations. Arterial

Selective intra-arterial digital subtraction angiography (IADSA) in cerebrovascular disease

International Nuclear Information System (INIS)

Uchino, Akira; Satoh, Yoshiyuki; Ohno, Masato

1987-01-01

Selective right transbrachial intra-arterial digital subtraction angiography (transbrachial selective IADSA) was successfully performed for 24 of 26 patients with known or suspected cerebrovascular disease, four of whom were outpatients. Catheterization failed in two elderly hypertensive men because of tortuosity of their brachial arteries, and in one woman whose aberrant right subclavian artery (SCA) prevented bilateral common carotid arterial (CCA) catheterizations. No complications occurred. One-hundred and ten ''excellent'' images were obtained by means of 118 injections for the 24 patients. Iopamidol, the contrast medium, was diluted to 50 % concentration with saline, then warmed to 37 deg C. Nearly all the injections of both CCAs and right vertebral arteries (VAs) were completed using 10 ml injections and a 5 ml/sec flow rate. The mean examination time for the three-vessel study was 29.4 minutes. Transbrachial selective IADSA thus proved to be a safe, useful, and relatively easy means of diagnosing cerebrovascular disease. (author)

Progress in genetics of coronary artery disease

African Journals Online (AJOL)

Radwa Gamal

To the Editor. Coronary Heart Disease (CHD) is the leading cause of mortality and morbidity worldwide [1] and it is a result of coronary artery disease (CAD). Coronary artery disease refers to the build-up of atherosclerotic plaque in the blood vessels that supply oxygen and nutrients to the heart. Progressive infiltration of the ...

N-acetylcysteine improves arterial vascular reactivity in patients with chronic kidney disease

DEFF Research Database (Denmark)

Wittstock, Antje; Burkert, Magdalena; Zidek, Walter

2009-01-01

Patients with stage 5 chronic kidney disease show increased cardiovascular morbidity and mortality that are partly related to impaired arterial vascular reactivity. We investigated whether intravenous administration of the antioxidant acetylcysteine improves arterial vascular reactivity in these ...

Giant hepatic artery aneurysm associated with immunoglobulin G4-related disease successfully treated using a liquid embolic agent

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Rossi, Michele; Virgilio, Edoardo; Laurino, Florindo; Orgera, Gianluigi; Mene, Paolo; Pirozzi, Nicola; Ziparo, Vincenzo; Cavallini, Marco [St. Andrea Hospital, Rome (Italy)

2015-08-15

The occurrence of a giant hepatic artery aneurysm (GHAA) in a patient with systemic vasculitis is very rare. Herein, we describe our endovascular treatment experience of a GHAA associated with immunoglobulin G4-related disease (IgG4-RD) consisting primarily of a liquid embolic injection and deployment of a vascular plug.

Giant hepatic artery aneurysm associated with immunoglobulin G4-related disease successfully treated using a liquid embolic agent

International Nuclear Information System (INIS)

Rossi, Michele; Virgilio, Edoardo; Laurino, Florindo; Orgera, Gianluigi; Mene, Paolo; Pirozzi, Nicola; Ziparo, Vincenzo; Cavallini, Marco

2015-01-01

The occurrence of a giant hepatic artery aneurysm (GHAA) in a patient with systemic vasculitis is very rare. Herein, we describe our endovascular treatment experience of a GHAA associated with immunoglobulin G4-related disease (IgG4-RD) consisting primarily of a liquid embolic injection and deployment of a vascular plug

[Atherectomy for peripheral arterial disease].

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Londero, Louise Skovgaard; Høgh, Annette Langager; Lindholt, Jes Sanddal

2015-04-13

Symptomatic peripheral arterial disease is managed according to national and international guidelines and the number of vascular reconstructions performed each year has increased over the past decade mainly due to an increasing frequency of endovascular procedures. Atherectomy as an alternative to the established treatment of symptomatic peripheral arterial disease has recently been analysed in a Cochrane review. In Denmark, atherectomy is not performed and so far the evidence is poor as the method is not an alternative to the established treatment in this country.

Life styles related to coronary artery disease in Saudi males older than 12 years of age life styles related to coronary artery disease in Saudi males older than 12 years of age

International Nuclear Information System (INIS)

AlTurki, Yousef Abdullah

2007-01-01

The present study highlighted life styles related to coronary artery disease risk factors among patients attending a primary care clinic at King Khalid University Hospital, in Riyadh, Saudi Arabia Methods: We conducted a cross-sectional study at a primary care clinic at King Khalid University Hospital, Riyadh, Saudi Arabia, during the period from 18/4/2006 to 13/6/2006. All adult male patients older than 12 years of age who attended one consultant primary care clinic were included in the study. All patients were interviewed by one consultant in family medicine during the study period. The patients were asked about dietary habits, physical activity and type of exercise, and smoking habits. Weight and height was taken for all patients by the nurse in the clinic and body mass index (BMI) was calculated for all patients. The total numbers of participants were 246 patients. The data were analyzed using the Statistical Package of Social Science (SPSS) version 11.5. A p value of less than 0.05 was considered statistically significant. Results: Of the 246 male adult patients, 45.4% always consumed vegetables and fruits in their diet, 21.5% exercised on a daily bases, 51.2% exercised sometimes, and 26% did not exercise at all. The type of exercise practiced by active participants was walking (76.5%) and sports (22.9%). Sports included football, basketball, swimming, and other sport club activity. Only 20.7% of the participants had an ideal body weight (BMI<25), 37.4% were overweight (BMI 25 to <30), while 37.7% of the participants were obese (BMI ? 30). 8.9% of the participants were current smokers. Conclusion and recommendation: Overweight and obesity is a common health problem among male adult patients attending a primary care setting. Improved dietary habits (consumption of vegetables and fruits, and minimization of fat and sweets), encouraging exercise and walking, and helping current smokers to quit smoking are essential steps towards improving life styles in the

Subintimal Angioplasty for Peripheral Arterial Occlusive Disease: A Systematic Review

International Nuclear Information System (INIS)

Met, Rosemarie; Lienden, Krijn P. Van; Koelemay, Mark J. W.; Bipat, Shandra; Legemate, Dink A.; Reekers, Jim A.

2008-01-01

The objective of this study was to summarize outcomes of subintimal angioplasty (SA) for peripheral arterial occlusive disease. The Cochrane Library, Medline and Embase databases were searched to perform a systematic review of the literature from 1966 through May 2007 on outcomes of SA for peripheral arterial occlusive disease of the infrainguinal vessels. The keywords 'percutaneous intentional extraluminal revascularization,' 'subintimal angioplasty,' 'peripheral arterial disease,' 'femoral artery,' 'popliteal artery,' and 'tibial artery' were used. Assessment of study quality was done using a form based on a checklist of the Dutch Cochrane Centre. The recorded outcomes were technical and clinical success, primary (assisted) patency, limb salvage, complications, and survival, in relation to the clinical grade of disease (intermittent claudication or critical limb ischemia [CLI] or mixed) and location of lesion (femoropopliteal, crural, or mixed). Twenty-three cohort studies including a total of 1549 patients (range, 27 to 148) were included in this review. Methodological and reporting quality were moderate, e.g., there was selection bias and reporting was not done according to the reporting standards. These and significant clinical heterogeneity obstructed a meta-analysis. Reports about length of the lesion and TASC classification were too various to summarize or were not mentioned at all. The technical success rates varied between 80% and 90%, with lower rates for crural lesions compared with femoral lesions. Complication rates ranged between 8% and 17% and most complications were minor. After 1 year, clinical success was between 50% and 70%, primary patency was around 50% and limb salvage varied from 80% to 90%. In conclusion, taking into account the methodological shortcomings of the included studies, SA can play an important role in the treatment of peripheral arterial disease, especially in the case of critical limb ischemia. Despite the moderate patency

Carotid artery disease progression and related neurologic events after carotid endarterectomy.

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Avgerinos, Efthymios D; Go, Catherine; Ling, Jennifer; Naddaf, Abdallah; Steinmetz, Amy; Abou Ali, Adham N; Makaroun, Michel S; Chaer, Rabih A

2016-08-01

During the last decade, there has been a dramatic improvement in best medical treatment for patients with vascular disease. Yet, there is a paucity of contemporary long-term data for restenosis and contralateral internal carotid artery (ICA) progression. This study assessed ipsilateral and contralateral disease progression and cerebrovascular events after carotid endarterectomy (CEA). A consecutive cohort of CEAs between January 1, 2000, and December 31, 2010, was retrospectively analyzed. End points were restenosis ≥50% and ≥70%, contralateral carotid disease progression (50%-69%, 70%-99%, or occlusion) and stroke. Survival analysis and Cox regression models were used to assess the effect of baseline predictors. During the 11-year study period, 1639 patients underwent 1782 CEAs (50.0% patch closure, 23.9% primary closure, 26.1% eversion, and 2.5% combined with coronary artery bypass grafting). The combined stroke/death rate was 2.6% overall and 1.8% in the asymptomatic cohort. The rate of restenosis ≥50% at 2, 5, and 10 years was 8.5%, 15.6%, 27.2%, and the rate for restenosis ≥70% was 3.4%, 6.5%, 10.2%, respectively. Restenosis ≥50% was predicted by hypertension (hazard ratio [HR], 2.09; P = .027), female gender (HR, 1.43; P = .042), and younger age (≤65 years; HR, 1.56; P = .016), but not by statins, surgical technique, symptoms, or other baseline risk factors. Restenoses remained asymptomatic in 125 of 148 (84.5%). Progression of contralateral ICA disease at 2, 5, and 10 years was estimated at 5.4%, 15.5%, and 46.8%, respectively. Contralateral progression was only predicted by smoking (HR, 1.74; P = .008). The stroke rate in patients with disease progression of the contralateral ICA was not different compared with those without progression (7.0% vs 3.3%; P = .063). Any-stroke rates at 2, 5, and 10 years were 4.6%, 7.3%, and 15.7%, respectively. Predictors were symptomatic lesion (HR, 1.48; P = .039), renal insufficiency, defined as a

Plasma viscosity increase with progression of peripheral arterial atherosclerotic disease.

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Poredos, P; Zizek, B

1996-03-01

Increased blood and plasma viscosity has been described in patients with coronary and peripheral arterial disease. However, the relation of viscosity to the extent of arterial wall deterioration--the most important determinant of clinical manifestation and prognosis of the disease--is not well known. Therefore, the authors studied plasma viscosity as one of the major determinants of blood viscosity in patients with different stages of arterial disease of lower limbs (according to Fontaine) and its relation to the presence of some risk factors of atherosclerosis. The study encompassed four groups of subjects: 19 healthy volunteers (group A), 18 patients with intermittent claudication up to 200 m (stage II; group B), 15 patients with critical ischemia of lower limbs (stage III and IV; group C), and 16 patients with recanalization procedures on peripheral arteries. Venous blood samples were collected from an antecubital vein without stasis for the determination of plasma viscosity (with a rotational capillary microviscometer, PAAR), fibrinogen, total cholesterol, alpha-2-macroglobulin, and glucose concentrations. In patients with recanalization procedure local plasma viscosity was also determined from blood samples taken from a vein on the dorsum of the foot. Plasma viscosity was most significantly elevated in the patients with critical ischemia (1.78 mPa.sec) and was significantly higher than in the claudicants (1.68 mPa.sec), and the claudicants also had significantly higher viscosity than the controls (1.58 mPa.sec). In patients in whom a recanalization procedure was performed, no differences in systemic and local plasma viscosity were detected, neither before nor after recanalization of the diseased artery. In all groups plasma viscosity was correlated with fibrinogen concentration (r=0.70, P < 0.01) and total cholesterol concentration (r=0.24, P < 0.05), but in group C (critical ischemia) plasma viscosity was most closely linked to the concentration of alpha-2

Association of Genetic Variants Related to Serum Calcium Levels With Coronary Artery Disease and Myocardial Infarction.

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Larsson, Susanna C; Burgess, Stephen; Michaëlsson, Karl

2017-07-25

Serum calcium has been associated with cardiovascular disease in observational studies and evidence from randomized clinical trials indicates that calcium supplementation, which raises serum calcium levels, may increase the risk of cardiovascular events, particularly myocardial infarction. To evaluate the potential causal association between genetic variants related to elevated serum calcium levels and risk of coronary artery disease (CAD) and myocardial infarction using mendelian randomization. The analyses were performed using summary statistics obtained for single-nucleotide polymorphisms (SNPs) identified from a genome-wide association meta-analysis of serum calcium levels (N = up to 61 079 individuals) and from the Coronary Artery Disease Genome-wide Replication and Meta-analysis Plus the Coronary Artery Disease Genetics (CardiogramplusC4D) consortium's 1000 genomes-based genome-wide association meta-analysis (N = up to 184 305 individuals) that included cases (individuals with CAD and myocardial infarction) and noncases, with baseline data collected from 1948 and populations derived from across the globe. The association of each SNP with CAD and myocardial infarction was weighted by its association with serum calcium, and estimates were combined using an inverse-variance weighted meta-analysis. Genetic risk score based on genetic variants related to elevated serum calcium levels. Co-primary outcomes were the odds of CAD and myocardial infarction. Among the mendelian randomized analytic sample of 184 305 individuals (60 801 CAD cases [approximately 70% with myocardial infarction] and 123 504 noncases), the 6 SNPs related to serum calcium levels and without pleiotropic associations with potential confounders were estimated to explain about 0.8% of the variation in serum calcium levels. In the inverse-variance weighted meta-analysis (combining the estimates of the 6 SNPs), the odds ratios per 0.5-mg/dL increase (about 1 SD) in genetically

Correlation between obstructive coronary artery disease and electron beam tomography coronary artery calcium scan

International Nuclear Information System (INIS)

Lee, Sang Hoon; Hong, Yong Kook; Park, Sung Il; Lee, Hyang Mee; Choe, Kyu Ok

1998-01-01

To determine the correlation between obstructive coronary artery disease and electron beam tomography coronary artery calcium(EBT CAC) scan and to measure the difference in calcium score according to symptoms. Materials and Methods : Fifty-six patients underwent EBT CAC scanning and either coronary angiography or stress thallium 201 scanning or the treadmill test. When the results were positive, coronary artery obstructive disease(CAOD) was assumed to be present. The patients were divided into three groups : symptomatic CAOD,asymptomatic CAOD, and asymptomatic non- CAOD; those with a previous history of myocardial ischemia or who showed positive results in any of the three tests relating to typical symptoms of angina were assigned to the symptomatic group. Results : The number of cases assigned to group to group 1,2 and 3 was 19, 16 and 21, respectively; total CAC scores were 571 ± 751, 600 ± 726 293± 401, respectively. The difference in CAC score between asymptomatic CAOD and asymptomatic non- CAOD was not statistically significant(p=0.079) but in asymptomatic CAOD, the score tended to be higher. The CAC score was not different between symptomatic and asymptomatic CAOD(p>0.1). When the CAC threshold was 1, sensitivity was 89% and specificity was 14%;when the threshold was 200, sensitivity was 60% and specificity was 67%. Conclusion : When the EBT CAC score is high, further evaluation provides early evidence of coronary artery obstructive disease

A Structured Review of Antithrombotic Therapy in Peripheral Artery Disease With a Focus on Revascularization: A TASC (InterSociety Consensus for the Management of Peripheral Artery Disease) Initiative.

Science.gov (United States)

Hess, Connie N; Norgren, Lars; Ansel, Gary M; Capell, Warren H; Fletcher, John P; Fowkes, F Gerry R; Gottsäter, Anders; Hitos, Kerry; Jaff, Michael R; Nordanstig, Joakim; Hiatt, William R

2017-06-20

Peripheral artery disease affects >200 million people worldwide and is associated with significant limb and cardiovascular morbidity and mortality. Limb revascularization is recommended to improve function and quality of life for symptomatic patients with peripheral artery disease with intermittent claudication who have not responded to medical treatment. For patients with critical limb ischemia, the goals of revascularization are to relieve pain, help wound healing, and prevent limb loss. The baseline risk of cardiovascular and limb-related events demonstrated among patients with stable peripheral artery disease is elevated after revascularization and related to atherothrombosis and restenosis. Both of these processes involve platelet activation and the coagulation cascade, forming the basis for the use of antiplatelet and anticoagulant therapies to optimize procedural success and reduce postprocedural cardiovascular risk. Unfortunately, few high-quality, randomized data to support use of these therapies after peripheral artery disease revascularization exist, and much of the rationale for the use of antiplatelet agents after endovascular peripheral revascularization is extrapolated from percutaneous coronary intervention literature. Consequently, guideline recommendations for antithrombotic therapy after lower limb revascularization are inconsistent and not always evidence-based. In this context, the purpose of this structured review is to assess the available randomized data for antithrombotic therapy after peripheral arterial revascularization, with a focus on clinical trial design issues that may affect interpretation of study results, and highlight areas that require further investigation. © 2017 American Heart Association, Inc.

Localization of coronary artery disease with exercise electrocardiography: correlation with thallium-201 myocardial perfusion scanning

International Nuclear Information System (INIS)

Dunn, R.F.; Freedman, B.; Bailey, I.K.; Uren, R.F.; Kelly, D.T.

1981-01-01

In 61 patients with single vessel coronary artery disease (70 percent or greater obstruction of luminal diameter in only one vessel) and no previous myocardial infarction, the sites of ischemic changes on 12 lead exercise electrocardiography and on thallium-201 myocardial perfusion scanning were related to the obstructed coronary artery. The site of exercise-induced S-T segment depression did not identify which coronary artery was obstructed. In the 37 patients with left anterior descending coronary artery disease S-T depression was most often seen in the inferior leads and leads V4 to V6, and in the 18 patients with right coronary artery disease and in the 6 patients with left circumflex artery disease S-T depression was most often seen in leads V5 and V6. Although S-T segment elevation was uncommon in most leads, it occurred in lead V1 or a VL, or both, in 51 percent of the patients with left anterior descending coronary artery disease. A reversible anterior defect on exercise thallium scanning correlated with left anterior descending coronary artery disease (probability [p] less than 0.0001) and a reversible inferior thallium defect correlated with right coronary or left circumflex artery disease (p less than 0.0001). In patients with single vessel disease, the site of S-T segment depression does not identify the obstructed coronary artery; S-T segment elevation in lead V1 or aVL, or both, identifies left anterior descending coronary artery disease; and the site of reversible perfusion defect on thallium scanning identifies the site of myocardial ischemia and the obstructed coronary artery

Peripheral arterial disease and revascularization of the diabetic foot.

Science.gov (United States)

Forsythe, R O; Brownrigg, J; Hinchliffe, R J

2015-05-01

Diabetes is a complex disease with many serious potential sequelae, including large vessel arterial disease and microvascular dysfunction. Peripheral arterial disease is a common large vessel complication of diabetes, implicated in the development of tissue loss in up to half of patients with diabetic foot ulceration. In addition to peripheral arterial disease, functional changes in the microcirculation also contribute to the development of a diabetic foot ulcer, along with other factors such as infection, oedema and abnormal biomechanical loading. Peripheral arterial disease typically affects the distal vessels, resulting in multi-level occlusions and diffuse disease, which often necessitates challenging distal revascularisation surgery or angioplasty in order to improve blood flow. However, technically successful revascularisation does not always result in wound healing. The confounding effects of microvascular dysfunction must be recognised--treatment of a patient with a diabetic foot ulcer and peripheral arterial disease should address this complex interplay of pathophysiological changes. In the case of non-revascularisable peripheral arterial disease or poor response to conventional treatment, alternative approaches such as cell-based treatment, hyperbaric oxygen therapy and the use of vasodilators may appear attractive, however more robust evidence is required to justify these novel approaches. © 2014 John Wiley & Sons Ltd.

Ischemic stroke related to intracranial branch atheromatous disease and comparison with large and small artery diseases.

Science.gov (United States)

Kwan, May Wai-Mei; Mak, Windsor; Cheung, Raymond Tak-Fai; Ho, Shu-Leong

2011-04-15

The mechanism of ischemic stroke in intracranial branch atheromatous disease (BAD) is different from large artery atherothrombotic disease (LAD) or lacunar infarction (LACI). The concept of BAD is underused in clinical practice and research. Patients admitted over 24-months with ischemic stroke caused by atherosclerotic disease were reviewed retrospectively and classified according to radiological±clinical criteria into LAD, BAD and LACI. The BAD cases were further divided into 5 BAD syndromes. Clinical characteristics, vascular risk factors, results of vascular workup and outcome among these subgroups were compared. 123 cases of LAD (17% of all stroke patients or 33% of all studied patients), 147 BAD (20% or 40%) and 102 LACI (14% or 27%) presented during the study period. Compared to LAD, BAD patients had milder neurological deficits, were less often diabetic and carotid stenosis was less common, while stenosis of the intracranial arteries was more frequent in BAD as compared with LACI patients. Outcome in BAD patients was intermediate between LAD and LACI. Comparisons among the BAD syndromes indicated they were homogenous conditions. BAD is the most prevalent ischemic stroke subtype in our cohort. The homogeneity among the BAD syndromes suggests they might represent a distinctive stroke entity. Copyright © 2011 Elsevier B.V. All rights reserved.

Gender-related differences in critical limb ischemia due to peripheral arterial occlusive disease

Directory of Open Access Journals (Sweden)

Vanessa Prado dos Santos

2013-12-01

Full Text Available BACKGROUND: Mortality from cardiovascular disease has declined among men and increased among North American women. Recent studies have revealed differences between genders in the epidemiology of atherosclerotic disease. OBJECTIVE: To study possible differences between male and female patients with critical limb ischemia (CLI according to risk factors of atherosclerosis and clinical characteristics of lower limbs with peripheral arterial occlusive disease (PAOD. METHODS: The study included 171 male and female patients treated for CLI due to infrainguinal PAOD and compared clinical characteristics (Rutherford category and PAOD territory, risk factors for atherosclerosis (diabetes, age, smoking and hypertension and number of opacified arteries on digital angiograms of the leg. The EPI-INFO software was used for statistical analysis, and the level of significance was set at p<0.05. RESULTS: Mean age was 70 years, and 88 patients were men (52%. For most patients (both genders, Rutherford category was 5 (82 % of men and 70% of women; p=0.16. The group of women had higher mean age (73 vs. 67 years; p=0.0002 and greater prevalence of diabetes (66% vs. 45%; p=0.003 and hypertension (90% vs. 56%; p=0.0000001. Among men, the prevalence of smoking was higher (76% vs. 53%; p=0.0008. The analysis of digital angiograms revealed that opacification of only one artery in the leg was found for 74% of women (vs. 50% of men. CONCLUSION: The prevalence of risk factors for atherosclerosis and the characteristics of PAOD are different between male and female patients with CLI.

Relationship of daily arterial blood pressure monitoring readings and arterial stiffness profile in male patients with chronic obstructive pulmonary disease combined with arterial hypertension

Directory of Open Access Journals (Sweden)

Karoli N.A.

2013-06-01

Full Text Available The aim of the study was to determine correlation between arterial blood pressure daily rhythm and daily profile of arterial stiffness in male patients with chronic obstructive pulmonary disease (COPD and arterial hypertension. Materials et methods: Prospective investigation comprised 45 male patients with COPD and arterial hypertension. Individuals of 40 years younger and 80 years elder, patients with diabetes, stroke, angina pectoris, or heart infarction, vascular diseases, and exacerbation of chronic disease, bronchial and pulmonary diseases of other etiology were excluded from the analyses. Comparison group included 47 patients with essential arterial hypertension and without chronic respiratory diseases closely similar on general parameters with patients from main clinical series. Twenty-four-hour arterial blood pressure monitoring (ABPM and daily arterial stiffness monitoring were performed using BPLab® MnSDP-2 apparatus (Petr Telegin, Russian Federation. Results: Patients with COPD combined with arterial hypertension with raised arterial stiffness measures prevail over individuals in essential hypertension group. There is pathological alteration of the ABPM circadian rhythm and raised «Pressure load» values in raised arterial stiffness group. Conclusion: We found ABPM raised parameters in patients with COPD and arterial hypertension. It confirms necessity of ABPM in daily arterial stiffness assessment in patients with COPD.

Internal thoracic artery collateral to the external iliac artery in chronic aortoiliac occlusive disease

International Nuclear Information System (INIS)

Kim, Jinna; Won, Jong Yun; Park, Sung Il; Lee, Do Yun

2003-01-01

To evaluate the incidence and angiographic findings of the collateral pathway involving the internal thoracic artery in patients with chronic aortoiliac occlusive disease. Between March 2000 and Februrary 2001, 124 patients at our hospital underwent angiographic evaluation of chronic aortoiliac occlusive disease, and in 15 of these complete obstruction or severe stenosis of the aortoiliac artery was identified. The aortograms and collateral arteriograms obtained, including internal thoracic arteriograms, as well as the medical records of the patients involved, were evaluated. In nine patients there was complete occlusion of the infrarenal aorta, or diffuse stenosis of 75% or more in the descending thoracic aorta, and in the other six, a patent aorta but complete occlusion or stenosis of 75% or more of the common iliac artery was demonstrated. Collateral perfusion via hypertrophied internal thoracic arteries and rich anastomoses between the superior and inferior epigastric arteries, reconstituting the external iliac artery, were noted in all fifteen patients, regardless of symptom duration, which ranged from six months to twelve years. In patients with chronic aortoiliac occlusive disease, the internal thoracic artery, along with visceral collaterals and those from the contralateral side, is one of the major parietal collateral pathways

Arterial properties in acromegaly: relation to disease activity and associated cardiovascular risk factors.

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Yaron, Marianna; Izkhakov, Elena; Sack, Jessica; Azzam, Ibrahim; Osher, Etty; Tordjman, Karen; Stern, Naftali; Greenman, Yona

2016-06-01

Acromegaly is associated with increased cardiovascular morbidity and mortality when inadequately treated, which may be secondary to associated comorbidities or to direct IGF-1 effects on the cardiovascular system. By using a control group carefully matched for traditional cardiovascular risk factors, we aimed to assess the direct contribution of disease activity and IGF-1 levels to arterial damage as assessed by measurements of arterial stiffness and endothelial function. Twenty-nine subjects with acromegaly (11 males, 52 ± 14 year; 15 active acromegaly) and 24 matched controls underwent evaluation of large and small artery compliance using applanation tonometry, pulse wave velocity (PWV), augmentation index (Alx), carotid ultrasonography intima-media thickness, (IMT) and flow-mediated dilatation (FMD). IGF-1 expressed as times the upper limit of the normal range (x ULN) was 2.2 ± 1.1 in patients with active disease versus 0.7 ± 0.2 in patients in remission. Irrespective of disease activity, FMD was lower in patients with acromegaly than in control subjects, (3.4 ± 2.7 % in active acromegaly, 4.4 ± 3.3 % in controlled acromegaly and 7.5 ± 3.8 % in controls; p = 0.004). There were no significant differences in PWV, Alx, and IMT between groups. A positive correlation was found between IGF-1× ULN and IMT (r = 0.4; P = 0.02). Asymmetric dimethylarginine (ADMA), a novel cardiovascular risk factor, was positively correlated to arterial stiffness (r = 0.46; p = 0.017) and negatively with small vessel compliance (r = -0.44, p = 0.02). Patients with acromegaly have significantly impaired endothelial function as assessed by FMD, but other tested vascular parameters were similar to a control group that was adequately matched for cardiovascular risk factors.

Subclinical Coronary Plaque Burden in Asymptomatic Relatives of Patients With Documented Premature Coronary Artery Disease

DEFF Research Database (Denmark)

Christiansen, Morten Krogh; Jensen, Jesper Møller; Bøtker, Hans Erik

Introduction: A family history of premature coronary artery disease (CAD) is a well-known risk factor for adverse coronary events with age of onset being inversely related to the degree of heritability. Hypothesis: We hypothesized that asymptomatic first degree relatives, of patients with premature...... CAD, suffer a high burden of subclinical coronary atherosclerosis. Methods: First degree relatives, aged 30-65 years, of patients with a documented coronary revascularization procedure before the age of 40 years, were invited to participate in the study. Participants were matched by age, sex...... and absence of a family history, with patients referred for coronary CT angiography (CTA) because of atypical angina or non-anginal chest pain. A pooled blinded analysis was performed. The main outcome measure was the number of plaque-affected coronary segments. Results: 88 relatives and 88 symptomatic...

The relation between the change of pathology and the metergasis of immunity after thyroid arterial embolization in treating hyperthyroidism caused by Graves' disease

International Nuclear Information System (INIS)

Tian Min; Zhao Wei; Shen Jin; Yu Yongzhong; Yi Genfa; Xiang Shutian; Li Liyuan; Yang Huiying; Li Hong; Lu Guijun

2007-01-01

Objective: To study the relation between change of thyroid tissues and thyroid auto- antibody after thyroid arterial embolization in the treatment of hyperthyroidism caused by Graves' disease with observation on changes of histopathology and thyroid auto-antibody in 3 years after thyroid arterial embolization, and to understand the foundation of the therapeutic action after arterial embolization. Methods: 1. Thirty-eight patients with Graves' disease treated by transcathter arterial embolization had been tested serum TT3, TT4, FT3, FT4, rT3, TSH, TGAb, TPOAb, TRAb and followed up with color Doppler ultrasound respectively at different periods (before arterial embolization and 7 day, 6 month, 3 year after arterial embolization). 2. 23 patients underwent needle aspiration biopsy of the thyroid gland. Results: Volume of thyroid gland instantly dwindled in size after thyroid arterial embolization or within a few days. The changes of histopathology mainly showed acute ischemic necrosis 7 days after thyroid arterial embolization and followed by fibrous hyperplasia mesenchymal proliferation and follicular atrophy occurring 6 months and 3 years afterward. TGAb, TPOAb at the 3rd year after thyroid arterial embolization were higher than those before the thyriod arterial embolization. FT3, FT4, TRAb at 6 month after thyroid arterial embolization were lower than those of the 3 years. Conclusion: Maladjustment of immunity in GD patients would be improved through the treatment of thyroid arterial embolization, synchronously with the promotion in histopathology. The outcomings of the shrinkage of thyroid tissue, decrease of thyroxin secretion and improvement of immunity provide a combination therapy for GD. (authors)

Complementary therapies for peripheral arterial disease: systematic review.

Science.gov (United States)

Pittler, Max H; Ernst, Edzard

2005-07-01

While peripheral arterial disease (PAD) affects a considerable proportion of patients in the primary care setting, there is a high level of use of complementary treatment options. The aim was to assess the effectiveness of any type of complementary therapy for peripheral arterial disease. A systematic review was performed. Literature searches were conducted on Medline, Embase, Amed, and the Cochrane Library until December 2004. Hand-searches of medical journals and bibliographies were conducted. There were no restrictions regarding the language of publication. The screening of studies, selection, data extraction, the assessment of methodologic quality and validation were performed independently by the two reviewers. Data from randomized controlled trials, and systematic reviews and meta-analyses, which based their findings on the results of randomized controlled trials were included. Seven systematic reviews and meta-analyses and three additional randomized controlled trials met the inclusion criteria and were reviewed. The evidence relates to acupuncture, biofeedback, chelation therapy, CO(2)-applications and the dietary supplements Allium sativum (garlic), Ginkgo biloba (ginkgo), omega-3 fatty acids, padma 28 and Vitamin E. Most studies included only patients with peripheral arterial disease in Fontaine stage II (intermittent claudication). The reviewed RCTs, systematic reviews and meta-analyses which based their findings on the results of RCTs suggest that G. biloba is effective compared with placebo for patients with intermittent claudication. Evidence also suggests that padma 28 is effective for intermittent claudication, although more data are required to confirm these findings. For all other complementary treatment options there is no evidence beyond reasonable doubt to suggest effectiveness for patients with peripheral arterial disease.

Coronary artery calcification in Kawasaki disease

International Nuclear Information System (INIS)

Ino, T.; Shimazaki, S.; Akimoto, K.; Park, I.; Nishimoto, K.; Yabuta, K.; Tanaka, A.

1990-01-01

To evaluate the angiographic features of coronary lesions in Kawasaki disease with coronary artery calcification, cinefluoroscopy and cineangiography were retrospectively reviewed in 116 patients who had undergone coronary angiography between 1982 and 1989. Angiographic abnormalities of coronary arteries were demonstrated in 55 of 116 patients. In 5 (9.1%) of the 55 patients, 9 with calcification were identified by cinefluoroscopy and chest X-ray. Eight of the 9 calcified lesions showed a circular or ring-shape configuration. Coronary angiography revealed a total occlusion of the right coronary artery with collateral circulation from the distal left coronary artery in 2 patients and a severe stenosis of the right coronary artery in 2 patients, in whom anticoagulant therapy had not been continued during the follow-up periods. The remaining patient in whom anticoagulant therapy had been continued had bilateral aneurysms but no significant stenosis. These results indicate that a ring-shape calcification on chest X-ray in 2 patients with a history of Kawasaki disease may suggest an involvement by coronary artery stenosis even when anticoagulant drugs had been given. Therefore, coronary angiography should be performed to evaluate the stenotic lesions if this type of calcification is found by routine radiographic examination. (orig.)

Doppler changes of extracranial cerebral and peripheral arteries in cardiovascular diseases

International Nuclear Information System (INIS)

Dichev, P.

1995-01-01

In recent years Doppler sonography has been approved as a valuable noninvasive method for identification of the extracranial vascular obturations. On the other hand obturational pathology of the extracranial arteries have often been associated with different cardiovascular diseases, and this requires perfect awareness of blood flow changes in the latter. The current study considers the specific flow changes in extracranial cerebral arteries in patients with ischemic heart disease (III-IV) (functional grade - FG - NYHA), and those with concomitant congestive heart failure (III-IV FG), as compared to healthy subjects. In the patients with ischemic heart disease without heart failure the changes are not as significant as compared to healthy subjects (p<0.1). Congestive heart failure is related to significant changes in some of the Doppler parameters. In the last stage of congestive heart failure spectral waveform of the internal carotid arteries also changes. Additionally the changes of spectral waveform of the carotid arteries in different heart diseases are represented: Idiopathic Subvalvular Aortic Stenosis, Valvular Aortic Stenosis and Regurgitation, Supravalvular Aortic Stenosis, Aortic Coarctation, Patent Ductus Botalli, Orthostatismus, Tamponade. Some of the changes are very specific and the Doppler technique would be useful for diagnosis of these diseases. 7 refs., 12 figs. (author)

Clinical and angiographic features of coronary artery disease after chest irradiation

International Nuclear Information System (INIS)

McEniery, P.T.; Dorosti, K.; Schiavone, W.A.; Pedrick, T.J.; Sheldon, W.C.

1987-01-01

Coronary artery disease (CAD) developed in 15 patients at a mean of 16 years (range 3 to 29) after chest irradiation. The mean dose of radiation was 42 +/- 7 grays; irradiation was performed for Hodgkin's disease in 9 patients, lymphoma in 2, breast carcinoma in 3 and cystic hygroma in 1 patient. Mean age was 48 years (range 26 to 63) at diagnosis of CAD; 4 patients were younger than 35 years. Nine were women. Ten presented with angina, 3 with acute myocardial infarction, 1 patient with syncope and 1 with dyspnea. Twelve had no more than 2 risk factors of atherosclerosis. At coronary angiography, 8 had at least 50% diameter narrowing of the left main coronary artery and 4 had severe ostial stenosis of the right coronary artery. Eight patients also had valvular heart disease, 4 pericardial disease and 4 complete heart block. Mean left ventricular ejection fraction was 67 +/- 11% (range 53 to 80%). Nine had undergone coronary artery bypass grafting, but surgery was difficult or impossible in 3 because of severe mediastinal and pericardial fibrosis. Radiation-associated CAD is characterized by a high incidence of left main and right ostial coronary disease and often occurs in women with relatively few conventional risk factors for CAD

Clinical and angiographic features of coronary artery disease after chest irradiation

Energy Technology Data Exchange (ETDEWEB)

McEniery, P.T.; Dorosti, K.; Schiavone, W.A.; Pedrick, T.J.; Sheldon, W.C.

1987-11-01

Coronary artery disease (CAD) developed in 15 patients at a mean of 16 years (range 3 to 29) after chest irradiation. The mean dose of radiation was 42 +/- 7 grays; irradiation was performed for Hodgkin's disease in 9 patients, lymphoma in 2, breast carcinoma in 3 and cystic hygroma in 1 patient. Mean age was 48 years (range 26 to 63) at diagnosis of CAD; 4 patients were younger than 35 years. Nine were women. Ten presented with angina, 3 with acute myocardial infarction, 1 patient with syncope and 1 with dyspnea. Twelve had no more than 2 risk factors of atherosclerosis. At coronary angiography, 8 had at least 50% diameter narrowing of the left main coronary artery and 4 had severe ostial stenosis of the right coronary artery. Eight patients also had valvular heart disease, 4 pericardial disease and 4 complete heart block. Mean left ventricular ejection fraction was 67 +/- 11% (range 53 to 80%). Nine had undergone coronary artery bypass grafting, but surgery was difficult or impossible in 3 because of severe mediastinal and pericardial fibrosis. Radiation-associated CAD is characterized by a high incidence of left main and right ostial coronary disease and often occurs in women with relatively few conventional risk factors for CAD.

Reduced myocardial perfusion reserve in myocardium having coronary artery aneurysm of Kawasaki disease

International Nuclear Information System (INIS)

Yoon, S. N.; Lee, D. S.; Choi, J. Y.; Kil, H. R.; Jeong, Z. K.; Lee, M. C.; Ko, C. S.

1997-01-01

Kawasaki disease is a systemic vasculitis involving the coronary arteries at early childhood and cause coronary artery aneurysms and thrombotic occlusions. These coronary artery aneurysms were usually transformed later into stenotic or obstructive lesions, however, the majority of these aneurysms, even the giant ones, are known to be associated with normal epicardial coronary flow. Flow reserve is difficult to assess in aneurysmal arteries with echo or angiography. We performed this study to question if there are abnormalities in flow reserve in myocardial tissue with normal epicardial arterial flow on angiography in patients with Kawasaki disease, dipyridamole stress and rest Tc-99m-sestamibi SPECT were performed in 37 patients (28 boys, 9 girls, mean age 6.6 years). We compared SPECT findings with coronary angiography (CAG) findings in 21 patients who did both studies after finding abnormality on echocardiaography. On CAG, aneurysms were found in 26 arteries of 16 patients, i.e., 10 left main arteries, 6 left anterior descending arteries (LAD), 2 left circumflex arteries (LCX), and 8 right coronary arteries (RCA). Localized and segmental stenotic lesions were found in 11 arteries in 9 patients (LAD: 4, LCX: 1, RCA: 6). Eight of the 10 patients with aneurysms had no obvious stenosis. On stress-rest SPECT, 16(43%) out of 37 patients showed normal perfusion and the other 21(57%) showed reversible or persistent decrease. Among 11 stenotic artery territories, 3(27%) showed persistent and/or reversible perfusion defects. The other 8 were normal. Among 26 aneurysmal artery territories, 12 artery territories showe perfusion decrease. Three of the 5 patients with normal CAG showed persistent and/or transient perfusion defects. Among 14 artery territories with perfusion decrease in the 16 patients, 3(21%) could be localized to vascular territory having stenosis of supplying coronary arteries, 12(86%) were related to the coronary artery aneurysms. Two were not related to

Comparison of multi-slice CT (MSCT) and TI-201 myocardial SPECT in detection of coronary artery disease: relation to coronary arteriography

Energy Technology Data Exchange (ETDEWEB)

Pai, M. S.; Kim, Y. K.; Shim, S. S. [College of Medicine, Univ. of Ewha Womens, Seoul (Korea, Republic of)

2003-07-01

To evaluate the diagnostic potentials of MSCT and TI-201 SPECT in the assessment of coronary artery disease. Twenty-four patients (15 men, 9 women, 42-79 years) with clinically suspected coronary artery disease were studied by TI-201 myocardial SPECT and MSCT. MSCT data were obtained with 12 x 0.75 mm, 420ms rotation, multi-slice CT scanner (SOMATOM Sensation, Siemens) using non-ionic contrast, 80ml, 4ml/sec. Multiplanar reconstruction techniques were used for evaluation of coronary arteries. TI-201 myocardial SPECT were performed at stress with adenosine and at rest. Data from MSCT and TI-201 SPECT were compared territory by territory (divided into two segments; LAD and RCA/LCx) and related to coronary arteriography, in which more than 60% stenoses are regarded as significant. MSCT and TI-201 SPECT showed agreement in 37 out of 48 segments (77.1%). Out of 11 disagreed segments (22.9), TI-201 SPECT was superior in 6 segments and MSCT was superior in 5 segments. Sensitivities and specificities of MSCT and TI-201 SPECT by coronary arteriography are 81.8%, 69.2% and 86.3%, 76.9%, respectively. Agreed 4 segments between MSCT and TI-201 SPECT exhibited results that differ from the results of coronary arteriography. Myocardial bridge in two cases were detected as significant stenoses by MSCT but showed normal perfusion in TI-201 SPECT. Agreement between MSCT and TI-201 SPECT in the assessment of coronary artery disease was good but TI-201 SPECT has higher sensitivity and specificity for the detection of jeopardized myocardium than MSCT. MSCT and TI-201 SPECT provide complementary information in the assessment of coronary artery disease and could help reduce probable mistake in the interpretation of hemo dynamically insignificant lesion in coronary arteriography.

Hemodynamic effects of innominate artery occlusive disease on anterior cerebral artery.

Science.gov (United States)

Tan, Teng-Yeow; Lien, Li-Ming; Schminke, Ulf; Tesh, Paul; Reynolds, Patrick S; Tegeler, Charles H

2002-01-01

Stenoses of the innominate artery (IA) may affect flow conditions in the carotid arteries. However, alternating flow in ipsilateral anterior cerebral artery (ACA) due to IA stenosis is extremely rare. A 49-year-old woman who was evaluated for symptomatic cerebrovascular disease presented with right latent subclavian and right carotid system steal. Transcranial Doppler examination displayed systolic deceleration wave-forms in the right terminal internal carotid artery and alternating flow in the right ACA. Magnetic resonance angiography demonstrated tight stenosis of the right IA. For a thorough study of the hemodynamic effects of IA stenosis, a combination of duplex and transcranial Doppler examination is required.

ASSESSMENT OF AWARENESS LEVEL OF OWN DISEASE IN PATIENTS WITH STABLE ARTERIAL HYPERTENSION

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G. F. Andreeva

2005-01-01

Full Text Available Arterial hypertension (AH is the most frequent risk factor of cardiovascular diseases and related mortality in all developed countries. Altough therapy with antihypertensive drugs significantly reduces this risk, patients with stable mild hypertension have poor compliance with the treatment. The reasons and levels of inadequacy of antihypertensive therapy in this group of patients are well-known.Aim. To evaluate the awareness level of own disease, adequacy of therapy only in those patients with stable mild arterial hypertension, who are complied with recommendations of physicians concerning AH treatment and changing of mode of life. It was also planned to reveal possible grounds for inadequate secondary prevention of cardiovascular disease.Materials and methods. 76 patiens with stable mild arterial hypertension were included into study. They didn’t have any serious concomitant diseases and were complied with the recommendations of physicians concerning secondary prevention of cardiovascular disease. Questionnaire of State Research Center for Preventive Medicine “Assessment of awareness level of own disease in patients with stable arterial hypertension” was used in the study.Results. It was revealed, that the majority of patients, invoved in the study, were nonsmokers and regularly took antihypertensive drugs. 70% of questioned patients reached the target arterial blood pressure levels, while patients with arterial hypertension in general Russia population received regular and efficient treatment in less than 30-20%. Drugs treatment of questioned patients almost didn’t differ from that, which received patients in out-patient clinics of Moscow: in both cases ACE inhibitors were preferred. Only 29% of questioned patients knew their lipid levels in blood and none of the patients took drugs, reducing levels of lipids in blood. Half of the patients, that took part in our study, had increased level of body mass index.Conclusions. Inadequate

Evaluation of coronary artery disease by helical CT using retrospective ECG-gating

International Nuclear Information System (INIS)

Kawawa, Yoko

2001-01-01

The purpose of this study is to evaluate the usefulness of helical CT using retrospective ECG-gating for visualization of the coronary artery and detection of coronary artery disease. We performed a coronary artery phantom study and established this new application, with 1-mm collimation, 1-mm table increment, and 0.1-mm reconstruction (0.8 sec/rotation). Helical CT of 31 patients with 39 coronary artery diseases (34 coronary artery stenoses, 1 vasospastic angina, 1 coronary artery dissection, 1 coronary artery ectasia and 2 coronary artery aneurysms) was performed in a single breath hold and ECG-gating without and with intravenous injection of nonionic iodine contrast material. We selected the images which were not affected by cardiac motion from the reconstruction images, in order to visualize the coronary artery for detection of coronary artery disease. The coronary artery was well visualized in 32 out of 39 vessels (82%). A good visualization of the coronary artery was correlated with the heart rate. Further, in this well visualized group, coronary artery diseases were detected in 24 out of 31 cases (77%). One case of vasospastic angina was not included. It was difficult to detect coronary artery disease in cases of heavily calcified vessels or in the left circumflex artery. Helical CT using this retrospective ECG-gating is a useful noninvasive examination for evaluation of coronary artery disease. (author)

Life styles related to coronary artery disease in Saudi Males older than 12 years of age

International Nuclear Information System (INIS)

Al-Turki, Yousef Abdullah

2007-01-01

The present study highlighted life styles related to coronary artery disease risk factors among patients attending a primary care clinic at King Khalid University Hospital, in Riyadh, Saudi Arabia. We conducted a cross-sectional study at a primary care clinic at King Khalid University Hospital, Riyadh, Saudi Arabia, during the period from 18/4/2006 to 13/6/2006. All adult male patients older than 12 years of age who attended one consultant primary care clinic were included in the study. All patients were interviewed by one consultant in family medicine during the study period. The patients were asked about dietary habits, physical activity and type of exercise, and smoking habits. Weight and height was taken for all patients by the nurse in the clinic and body mass index (BMI) were calculated for all patients. The total number of participants was 246 patients. The data were analyzed using the Statistical Package of Social Science (SPSS) version 11.5. A p value of less than 0.05 was considered statistically significant. Of the 246 male adult patients, 45.4% always consumed vegetables and fruits in their diet, 21.5% exercised on a daily basis, 51.2% exercised sometimes and 26% did not exercise at all. The type of exercise practiced by active participants was walking (76.5%) and sports (22.9%). Sports included football, basketball, swimming and other sports club activity. Only 20.7% of the participants had an ideal body weight (BMI =30). 8.9% of the participants were current smokers. Overweight and obesity is a common health problem among male adult patients attending a primary care setting. Improved dietary habits (consumption of vegetables and fruits and minimization of fat and suits) encouraging exercise and walking and helping current smokers to quit smoking are essential steps towards improving life styles in the community. It is an important health plan priority to concentrate on improving life styles in the Saudi community, to prevent cardiovascular risk

Contribution of genetic background, traditional risk factors, and HIV-related factors to coronary artery disease events in HIV-positive persons

OpenAIRE

Rotger, Margalida; Glass, Tracy R; Junier, Thomas; Lundgren, Jens; Neaton, James D; Poloni, Estella S; van 't Wout, Angélique B; Lubomirov, Rubin; Colombo, Sara; Martinez, Raquel; Rauch, Andri; Günthard, Huldrych F; Neuhaus, Jacqueline; Wentworth, Deborah; van Manen, Danielle

2013-01-01

BACKGROUND: Persons infected with human immunodeficiency virus (HIV) have increased rates of coronary artery disease (CAD). The relative contribution of genetic background, HIV-related factors, antiretroviral medications, and traditional risk factors to CAD has not been fully evaluated in the setting of HIV infection. METHODS: In the general population, 23 common single-nucleotide polymorphisms (SNPs) were shown to be associated with CAD through genome-wide association analysis. Using the ...

Circulating Anti-Elastin Antibody Levels and Arterial Disease Characteristics: Associations with Arterial Stiffness and Atherosclerosis.

Science.gov (United States)

Lee, Seung-Hyun; Shin, Kihyuk; Park, Sungha; Kang, Seok-Min; Choi, Donghoon; Lee, Seung-Hyo; Lee, Sang-Hak

2015-11-01

Elastin is a major arterial structural protein, and elastin-derived peptides are related to arterial change. We previously reported on a novel assay developed using aortic elastin peptides; however, its clinical implications remain unclear. In this study, we assessed whether anti-elastin antibody titers reflect the risk of coronary artery disease (CAD) or its characteristics. We included 174 CAD patients and 171 age- and sex-matched controls. Anti-elastin antibody titers were quantified by enzyme-linked immunosorbent assay. Parameters of arterial stiffness, including the augmentation index (AI) and heart-to-femoral pulse wave velocity (hfPWV), were measured non-invasively. The clinical and angiographic characteristics of CAD patients were also evaluated. Associations between anti-elastin levels and vascular characteristics were examined by linear regression analysis. The median blood level of anti-elastin was significantly lower in the CAD group than in the controls [197 arbitrary unit (a.u.) vs. 63 a.u., pelastin were significantly lower in men and in subjects with hypertension, diabetes mellitus, hyperlipidemia, or high hfPWV. Nevertheless, anti-elastin levels were not dependent on atherothrombotic events or the angiographic severity of CAD. In a multivariate analysis, male sex (β=-0.38, pelastin levels. Lower levels of anti-elastin are related to CAD. The association between antibody titers and CAD is linked to arterial stiffness rather than the advancement of atherosclerosis.

Pulmonary artery hypertension in chronic obstructive lung disease

International Nuclear Information System (INIS)

Dinkel, E.; Mundinger, A.; Reinbold, W.D.; Wuertemberger, G.

1989-01-01

Standard biplane chest X-rays were tested for the validity of morphometric criteria in the diagnosis of pulmonary artery hypertension. Twenty-seven patients suffering from chronic obstructive lung disease were examined and compared with a control group without cardiopulmonary disease. The diameter of the right and left pulmonary artery, pulmonary conus and the hilar-to-thoracic ratio were significantly increased in patients with chronic obstructive lung disease (p [de

Hormones and arterial stiffness in patients with chronic kidney disease.

Science.gov (United States)

Gungor, Ozkan; Kircelli, Fatih; Voroneanu, Luminita; Covic, Adrian; Ok, Ercan

2013-01-01

Cardiovascular disease constitutes the major cause of mortality in patients with chronic kidney disease. Arterial stiffness is an important contributor to the occurrence and progression of cardiovascular disease. Various risk factors, including altered hormone levels, have been suggested to be associated with arterial stiffness. Based on the background that chronic kidney disease predisposes individuals to a wide range of hormonal changes, we herein review the available data on the association between arterial stiffness and hormones in patients with chronic kidney disease and summarize the data for the general population.

Color Doppler Indices of Orbital Arterial Flow in End-Stage Renal Disease Patients; Are the Changes Related to Chronic Hemodialysis or Chronic Renal Failure?

International Nuclear Information System (INIS)

Rokni Yazdi, Hadi; Faraji, Safoura; Ahmadi, Farokhlegha; Shahmirzae, Reza

2012-01-01

Endothelial injury is a well-known complication in chronic kidney disease (CKD) and hemodialysis. One of the sites in which early vascular changes may be detected is the retina. Of course, these flow changes may not be detected in ophthalmologic exams, but it seems that color Doppler sonography of retinal arteries may be helpful in these cases. In previous studies on CKD patients who underwent chronic hemodialysis,hemodynamic changes were noted in retinal arteries, but no study has been performed to determine which of the two processes (CKD or chronic hemodialysis) can produce these changes. In this study, we tried to answer this question. Doppler ultrasonography of the orbital vasculature including the ophthalmic artery and the central retinal artery was carried out in 17 patients (34 eyes) with chronic renal failure (CRF) who underwent hemodialysis, 17 patients (34 eyes)with CRF without a history of hemodialysis and 17 normal patients (34 eyes). The peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index were measured excluding hypertensive, diabetic patients and patients with cardiovascular disease. The mean PSV and EDV were lower only in the ophthalmic artery of CRF patients irrespective of the history of hemodialysis (PSV was 35.2 in hemodialysis, 38.8 in CRF and 51.6 in normal patients, P value = 0.001 and EDV was 7.4, 9.4, 11.8, respectively, P value =0.001) with no significant difference in the resistance index of the ophthalmic artery and other parameters [EDV, PSV, Resistance Index (RI)] in the central retinal artery. The mean PSV and DSV in the ophthalmic artery were lower only in the ophthalmic artery of CRF patients regardless of the history of hemodialysis. No significant difference in the resistance index of the ophthalmic artery and other parameters (EDV, PSV) of the central retinal artery were noted between different groups. These findings suggest that microvascular disease and endothelial cell dysfunction of the orbital

Arterial Ventricular Uncoupling with Age and Disease and Recoupling with Exercise

Science.gov (United States)

Chantler, Paul D

2017-01-01

The deterioration in arterial and cardiac function with aging impairs arterial ventricular coupling, an important determinant of cardiovascular performance. However, exercise training improves arterial ventricular coupling especially during exercise during the age and disease process. This review examines the concept of arterial-ventricular coupling, and how age, and disease uncouples but exercise training recouples the heart and arterial system. PMID:28072585

A Review of Coronary Artery Disease Research in Malaysia.

Science.gov (United States)

Ang, C S; Chan, K M J

2016-06-01

Coronary artery disease is the major cause of mortality and morbidity in Malaysia and worldwide. This paper reviews all research and publications on coronary artery disease in Malaysia published between 2000-2015. 508 papers were identified of which 146 papers were selected and reviewed on the basis of their relevance. The epidemiology, etiology, risk factors, prevention, assessment, treatment, and outcomes of coronary artery disease in the country are reviewed and summarized. The clinical relevance of the studies done in the country are discussed along with recommendations for future research.

Prevalence of diabetes mellitus among obese and non-obese patients with coronary artery disease

International Nuclear Information System (INIS)

Khan, S.B.; Rehman, H.U.; Hafeezullah, M.; Gul, A.M.

2010-01-01

Background: Globally, obesity is now recognised as an epidemic. The degree of obesity is proportional to the rate of development of cardiovascular diseases, hence, resulting in a dramatic increase in morbidity and mortality. Apart from obesity, diabetes mellitus is another well recognised risk factor contributing to coronary artery disease. The precise prevalence of obesity-related diabetes varies with age, race and gender; and is yet unknown in our population. We therefore, carried out study with the aim to determine the prevalence of diabetes mellitus in obese and non-obese patients with diagnosed coronary artery disease. Methods: This hospital based cross-sectional comparative study was conducted in Cardiology Department of Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, from March 15, 2005 to May 30, 2006. A total of 200 patients with diagnosed coronary artery disease were enrolled, 100 were classified as obese and 100 as non-obese. Results: Among these, 139 patients were male and 61 female. A total of 88 were found to be diabetic, 54 of these were obese and 34 non-obese (p =0.004). Conclusion: Diabetes mellitus was significantly more frequent among obese patients with coronary artery disease as compared to non obese patients with coronary artery disease. (author)

Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease

NARCIS (Netherlands)

P.W.J.C. Serruys (Patrick); M-C. Morice (Marie-Claude); A.P. Kappetein (Arie Pieter); A. Colombo (Antonio); D.R. Holmes Jr (David); M.J. Mack (Michael); E. Stahle (Elisabeth); T.E. Feldman (Ted); M.J.B.M. van den Brand (Marcel); E.J. Bass (Eric); N. van Dyck (Nic); K. Leadly (Katrin); K.D. Dawkins (Keith); F.W. Mohr (Friedrich)

2009-01-01

textabstractBACKGROUND Percutaneous coronary intervention (PCI) involving drug-eluting stents is increasingly used to treat complex coronary artery disease, although coronary-artery bypass grafting (CABG) has been the treatment of choice historically. Our trial compared PCI and CABG for treating

Accurate Prediction of Coronary Artery Disease Using Bioinformatics Algorithms

Directory of Open Access Journals (Sweden)

Hajar Shafiee

2016-06-01

Full Text Available Background and Objectives: Cardiovascular disease is one of the main causes of death in developed and Third World countries. According to the statement of the World Health Organization, it is predicted that death due to heart disease will rise to 23 million by 2030. According to the latest statistics reported by Iran’s Minister of health, 3.39% of all deaths are attributed to cardiovascular diseases and 19.5% are related to myocardial infarction. The aim of this study was to predict coronary artery disease using data mining algorithms. Methods: In this study, various bioinformatics algorithms, such as decision trees, neural networks, support vector machines, clustering, etc., were used to predict coronary heart disease. The data used in this study was taken from several valid databases (including 14 data. Results: In this research, data mining techniques can be effectively used to diagnose different diseases, including coronary artery disease. Also, for the first time, a prediction system based on support vector machine with the best possible accuracy was introduced. Conclusion: The results showed that among the features, thallium scan variable is the most important feature in the diagnosis of heart disease. Designation of machine prediction models, such as support vector machine learning algorithm can differentiate between sick and healthy individuals with 100% accuracy.

Isolated Unilateral Absent Branch Pulmonary Artery with Peripheral Pulmonary Stenosis and Coronary Artery Disease

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Sunil Abhishek B

2017-09-01

Full Text Available Isolated Unilateral Absent Pulmonary Artery (UAPA is a rare congenital anomaly. It is usually associated with congenital heart defects. A 45 year old male patient presented with complaints of fever with cough and expectoration for 15 days and retrosternal chest discomfort for the previous 2 days. ECG showed diffuse ST segment depression with T wave inversion in the inferior and lateral leads. Coronary Angiogram done through the right femoral approach revealed diffusely diseased Left Anterior Descending (LAD artery that was totally cut off at the mid segment. The Left Circumflex (LCx artery was providing blood supply to the right middle and lower lung areas. There was another collateral arising from the Left Subclavian Artery supplying the right middle and lower lung areas. The left pulmonary artery was normal, but branches supplying the middle and lower lobes of the right lung were absent and the upper lobe branch had pulmonary stenosis. UAPA is a rare clinical entity; collaterals from coronaries are extremely rare in this condition and till now there has not been any case report of unilateral absent branch pulmonary artery with peripheral stenosis of other branches, on the affected side and associated coronary artery disease.

Validation of aspirin response-related transcripts in patients with coronary artery disease and preliminary investigation on CMTM5 function.

Science.gov (United States)

Zhang, J W; Liu, T F; Chen, X H; Liang, W Y; Feng, X R; Wang, L; Fu, Sidney W; McCaffrey, Timothy A; Liu, M L

2017-08-15

Aspirin is widely used in the prevention of cardiovascular diseases, but the antiplatelet responses vary from one patient to another. To validate aspirin response related transcripts and illustrate their roles in predicting cardiovascular events, we have quantified the relative expression of 14 transcripts previously identified as related to high on-aspirin platelet reactivity (HAPR) in 223 patients with coronary artery disease (CAD) on regular aspirin treatment. All patients were followed up regularly for cardiovascular events (CVE). The mean age of our enrolled population was 75.80±8.57years. HAPR patients showed no significant differences in terms of co-morbidities and combined drugs. Besides, the relative expression of HLA-DQA1 was significantly lower in low on-aspirin platelet reactivity (LAPR) patients, when compared with HAPR and high normal (HN) group (p=0.028). What's more, the number of arteries involved, HAPR status and the relative expression of CLU, CMTM5 and SPARC were independent risk factors for CVE during follow up (p<0.05). In addition, overexpression of CMTM5 attenuated endothelial cells (ECs) migration and proliferation, with significantly decreased phosphorylated-Akt levels, while its inhibition promoted these processes in vitro (p<0.05).Our study provides evidence that circulating transcripts might be potential biomarkers in predicting cardiovascular events. CMTM5 might exert anti-atherosclerotic effects via suppressing migration and proliferation in the vessel wall. Nevertheless, larger-scale and long-term studies are still needed. Copyright © 2017 Elsevier B.V. All rights reserved.

Symptomatic coronary artery disease after mantle irradiation for Hodgkin's disease

International Nuclear Information System (INIS)

King, Vernon; Constine, Louis S.; Clark, Douglas; Schwartz, Ronald G.; Muhs, Ann G.; Henzler, Margaret; Hutson, Alan; Rubin, Philip

1996-01-01

Purpose: a) To assess the age-related incidence of morbid cardiac events including cardiac death (CD), nonfatal myocardial infarction (MI), and angina pectoris (AP) in all patients treated for Hodgkin's disease at a single institution; b) to examine the prevalence of cardiac risk factors and presence of coronary artery disease (CAD) in affected patients. Methods and materials: 475 patients were treated for Hodgkin's disease in our institution between 1954 and 1989. The status of 97% of the cohort was established either by patient visit and examination in 1992-1993, personal telephone contact, or documentation of death. The 326 of these patients who had mantle irradiation (RT) and survived 3 years formed the study population. Patients who experienced AP, MI, or CD secondary to CAD were assessed for the presence of specific cardiac risk factors. Cardiac catheterization and necropsy data were reviewed to determine the presence and degree of coronary artery stenosis. Results: Eighteen of 326 patients (5.5%) have had a morbid cardiac event directly related to CAD. Seven patients had CD. Seven patients experienced nonfatal MI, and four patients had AP. The mean interval from RT to morbid cardiac event was 13.1 years (range: 4.4-27.0), and the mean age at the time of the event was 39.4 years (range: 24-65). Four of these patients had morbid cardiac events between ages 24-29 years. Based on US statistics of CD secondary to MI, the relative risk of CD for the treated group was 2.8 (3.1 for males and 1.8 for females). Remarkably, no difference was found in the risk of experiencing a morbid cardiac endpoint in patients stratified by either decile of age at which RT was given, or by duration of follow-up. Only one patient experiencing an event (AP) had received an anthracycline. The mean RT dose to the central cardiac volume for the affected patients was 44.3 Gy (range: 35-60.4). Autopsy or catheterization data were available on 15 patients and revealed 90-100% stenosis of at

Relation of body mass index to outcome in patients with known or suspected coronary artery disease.

Science.gov (United States)

Galal, Wael; van Domburg, Ron T; Feringa, Harm H H; Schouten, Olaf; Elhendy, Abdou; Bax, Jeroen J; Awara, Adel M M; Klein, Jan; Poldermans, Don

2007-06-01

Increased body mass index (BMI), a parameter of total body fat content, is associated with an increased mortality in the general population. However, recent studies have shown a paradoxic relation between BMI and mortality in specific patient populations. This study investigated the association of BMI with long-term mortality in patients with known or suspected coronary artery disease. In a retrospective cohort study of 5,950 patients (mean age 61 +/- 13 years; 67% men), BMI, cardiovascular risk markers (age, gender, hypertension, diabetes, current smoking, angina pectoris, old myocardial infarction, heart failure, hypercholesterolemia, and previous coronary revascularization), and outcome were noted. The patient population was categorized as underweight, normal, overweight, and obese based on BMI according to the World Health Organization classification. Mean follow-up time was 6 +/- 2.6 years. Incidences of long-term mortality in underweight, normal, overweight, and obese were 39%, 35%, 24%, and 20%, respectively. In a multivariate analysis model, the hazard ratio (HR) for mortality in underweight patients was 2.4 (95% confidence interval [CI] 1.7 to 3.7). Overweight and obese patients had a significantly lower mortality than patients with a normal BMI (HR 0.65, 95% CI 0.6 to 0.7, for overweight; HR 0.61, 95% CI 0.5 to 0.7, for obese patients). In conclusion, BMI is inversely related to long-term mortality in patients with known or suspected coronary artery disease. A lower BMI was an independent predictor of long-term mortality, whereas an improved outcome was observed in overweight and obese patients.

Steal phenomenon through the anterior communicating artery in Moyamoya disease

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Lim, Soo Mee [Ewha Womans University, Department of Radiology, Mok-dong Hospital, College of Medicine, Seoul (Korea); Chae, Eun Jin; Kim, Min Yeong; Kim, Sang Joon; Choi, Choong Gon; Pyun, Hae Wook; Suh, Dae Chul [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea); Kim, Jae Kyun [Seoul Veterans Hospital, Department of Radiology, Seoul (Korea); Ahn, Jae Sung; Ra, Young-Shin [University of Ulsan, Asan Medical Center, Department of Neurosurgery, College of Medicine, Seoul (Korea); Kim, Jong-Uk; Hahm, Kyung Don [University of Ulsan, Asan Medical Center, Department of Anesthesiology, College of Medicine, Seoul (Korea)

2007-01-15

Branch occlusion of the anterior cerebral artery (ACA) is regarded as a part of Moyamoya disease. The purpose of this study is to define the ACA steal phenomenon (SP) in Moyamoya disease and to evaluate temporal changes according to the disease progression. From 139 Moyamoya patients we defined ACASP as narrowing of the ipsilateral A1-2 junction while preserving the anterior communicating artery and supplying the contralateral ACA cortical branches with the development of leptomeningeal collaterals by the ipsilateral middle cerebral artery into the hypoperfused ipsilateral ACA territory. Direction of the steal related to the stage in both hemispheres by Suzuki classification was statistically analyzed using the binomial test based on binomial distribution. Follow-ups of ACASP were evaluated in five patients. We identified ACASP in 13 (9%) patients (male:female=7:6, mean age 18 years, range: 2-58 years) of the 139 study patients. The presenting pattern was ischemic in 12 and hemorrhagic in one. The direction of SP occurred from the hemisphere in the lower to the higher stage of Suzuki classification (two-tail P value=0.0002). After revascularization surgery, ACASP disappeared or diminished. ACASP may occur in bilaterally different stages of Moyamoya disease as a transient self-adaptive process. It regresses after revascularization surgery. (orig.)

Imaging diagnosis of congenital heart disease with single coronary artery

International Nuclear Information System (INIS)

Zhu Ming; Li Yuhua; Zhong Yumin; Sun Aimin

2003-01-01

Objective: To report 56 cases of congenital heart disease with congenital single coronary artery and to evaluate the imaging diagnostic techniques. Methods: All 56 patients with congenital single coronary artery underwent angiocardiography. Contrast enhancement magnetic resonance angiography (CE MRA) was performed in 4 cases. 48 cases were confirmed by operation. Results: In these 56 cases, single left coronary artery was found in 44 cases and single right coronary artery was found in 12. Conclusion: Congenital heart disease with congenital single coronary artery is not rare and correct diagnosis is very important for surgery

Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

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... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults ... on Screening for Peripheral Artery Disease (PAD) and Cardiovascular Disease (CVD) Risk Assessment with Ankle Brachial Index (ABI) ...

Arterial Stiffness and Walk Time in Patients with End-Stage Renal Disease

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Abbi D. Lane

2013-04-01

Full Text Available Background: End-stage renal disease patients experience increased prevalence of cardiovascular disease. Heart-artery interaction may be shifted, impacting blood pressure lability, and exercise tolerance. The coupling ratio consists of the ratio of indexed arterial elastance (EaI, arterial load to ElvI, a measure of cardiac contractility or stiffness. Our purpose was to explore the relationship between elastances and functional capacity. We hypothesized that arterial stiffness (central pulse wave velocity, PWV and elastances would be correlated to shuttle walk time. Methods: We used applanation tonometry, ultrasonography, and a shuttle walk test to evaluate our hypothesis. Spearman's correlations were used to assess relationships between variables. Block regression was also performed. Results: Forty-two subjects on maintenance hemodialysis participated. Average age=44±5 years, body surface area=2.01 kg/m2. Mean EaI=4.45 and mean ElvI=6.89; the coupling ratio=0.82. Mean aortic pulse pressure=51 mmHg and PWV=9.6 m/s. PWV(r=-0.385 and EaI (r=-0.424 were significantly and inversely related to walking time while stroke volume index (SVI was positively correlated to shuttle walk time (r=0.337, pConclusions: We conclude that, like other clinical populations, both arterial and heart function predict walking ability and represent potential targets for intervention; arterial stiffness and SVI are strongly related to shuttle walk time in patients with ESRD.

Evaluation of patients with coronary artery disease during exercise: the relation between extent of disease and perfusion deficit

International Nuclear Information System (INIS)

Hakki, A.H.; DePace, N.; Iskandrian, A.S.

1984-01-01

The purpose of this study was to assess the relation between the extent of coronary artery disease (CAD) and size of exercise-induced myocardial hypoperfusion in 79 patients with angiographically documented CAD. None of the patients had Q-wave myocardial infarction. Fifty patients had one-vessel disease, ten had two-vessel disease, and 19 patients had three-vessel or left main disease. From a scintigraphic functional standpoint, patients were classified into two groups: 28 patients (35%) had large perfusion defects and 51 patients (65%) had small defects. The size of the thallium-201 perfusion defect during exercise was assessed as the perimeter of the defect in each projection expressed as a percentage abnormality of the total left ventricular perimeter in that projection. The average abnormality from the three projections was used in the final analysis. Eleven patients with large defects (39%) had one-vessel disease and 12 patients with small defects (24%) had multivessel disease. Stepwise multivariate discriminate analysis identified the number of diseased vessels (F . 13.9), the change in systolic blood pressure from rest to exercise (F . 10.8), the exercise heart rate (F . 9.1), and exercise electrocardiographic response (F . 7.8) as significant associates of the size of the perfusion defect (predictive accuracy . 70%). We conclude that the size of hypoperfused myocardium during exercise is variable in patients with CAD. Discriminate analysis identified the extent of CAD, exercise heart rate, change in systolic pressure from rest to exercise, and exercise electrocardiographic response as significant associates of the size of the defect

What Is Carotid Artery Disease?

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... Lack of physical activity . Too much sitting (sedentary lifestyle) and a lack of aerobic activity can worsen other risk factors for carotid artery disease, such as unhealthy blood cholesterol levels, high blood pressure, diabetes, and ...

Uncommon Diseases of The Popliteal Artery: A Pictorial Review

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Mohamed Jarraya

2016-08-01

Full Text Available Abstract Uncommon diseases of the popliteal artery include cystic adventitial disease, popliteal artery entrapment syndrome (PAES and popliteal artery aneurysm (PAA. Because all of these conditions may present with pain or intermittent claudication, imaging is crucial for differentiating them and directing management. Delayed diagnosis can lead to major complications, including acute limb ischemia. Our aim is to provide an illustrative overview of these conditions in order to make radiologists aware of them and avoid misdiagnosis for timely appropriate management. Teaching Points • Cystic adventitial disease diagnosis is based on evidence of cysts within artery walls. • A variety of anatomic variations may result in PAES. • PAES may be bilateral. • PAA is most commonly encountered in men. • Acute complications of PAA include acute thrombosis and distal embolization.

Congenital heart disease with high origin of coronary artery

International Nuclear Information System (INIS)

Zhu Ming; Li Yuhua; Zhong Yumin

2002-01-01

Objective: To report 6 cases of congenital heart disease with high origin of coronary artery and to evaluate the imaging method for diagnosis of congenital high origin of coronary artery. Methods: Six patients with congenital high origin of coronary artery underwent angiocardiography, echocardiography, and 2 patients also underwent magnetic resonance examination. All 6 cases were confirmed by operation. Results: All 6 cases were congenital high origin of right coronary artery. Angiocardiography made correct diagnosis in all 6 cases; MRI made the correct diagnosis in 1 of the 2 cases; echocardiography made 1 correct diagnosis. Conclusion: Correct diagnosis of congenital high origin of coronary artery was very important for patients with congenital heart disease. Angiocardiography was a very reliable imaging method and MRI can play an important role in preoperative diagnosis of congenital high origin of coronary artery

Cystic adventitial disease of popliteal artery with significant stenosis

International Nuclear Information System (INIS)

Gupta, Ranjana; Mittal, Puneet; Gupta, Praveen; Jindal, Nancy

2013-01-01

Cystic adventitial disease of popliteal artery is a rare condition of unknown etiology which usually presents in middle-aged men. We present Doppler and computed tomography angiography findings in a case of cystic adventitial disease with significant obstruction of popliteal artery, with secondary narrowing of popliteal vein

Pulmonary arterial capacitance in children with idiopathic pulmonary arterial hypertension and pulmonary arterial hypertension associated with congenital heart disease: relation to pulmonary vascular resistance, exercise capacity, and survival.

Science.gov (United States)

Sajan, Imran; Manlhiot, Cedric; Reyes, Janette; McCrindle, Brian W; Humpl, Tilman; Friedberg, Mark K

2011-09-01

Pediatric pulmonary arterial hypertension (PAH), whether idiopathic PAH (iPAH) or PAH associated with congenital heart disease (aPAH), carries high morbidity and mortality. Low pulmonary arterial capacitance (PAC), defined as right ventricular stroke volume/pulmonary artery pulse pressure, is a risk factor for mortality in adults with PAH. However, the relation of PAC to pulmonary vascular resistance (PVR), exercise endurance, and survival is poorly defined in children. Catheterization and clinical data of children with PAH (mean pulmonary artery pressure >25 mm Hg) were reviewed. Children with pulmonary shunts, stents, collaterals, or pulmonary venous hypertension were excluded. Primary outcomes were 6-minute walk distance and freedom from death/lung transplant. Forty-seven patients were studied. Nineteen (43%) had iPAH, and 28 (57%) had aPAH (7.1 ± 6.2 vs 8.4 ± 5.5 years, P = .45). Patients with iPAH had higher PVR indexed for body surface area (PVRi), lower indexed PAC (PACi), lower exercise tolerance, and lower freedom from death/lung transplant than patients with aPAH. Both higher PVRi (P 1.25 mL/mm Hg per square meter and a PVRi >13 Wood units × m(2) were associated with decreased freedom from death or lung transplant. The relationships between PVRi and PACi and survival were independent of each other and not confounded by etiologic group. Low PACi and high PVRi are independently associated with low 6-minute walk distance and survival in children with PAH. Therefore, both should be assessed for better prognostication and management in this high-risk population. Copyright © 2011 Mosby, Inc. All rights reserved.

Peripheral arterial tonometry cannot detect patients at low risk of coronary artery disease

NARCIS (Netherlands)

M.M. van den Heuvel (Mieke); O. Sorop (Oana); P. Musters (Paul); R.T. van Domburg (Ron); T.W. Galema (Tjebbe); D.J.G.M. Duncker (Dirk); W.J. van der Giessen (Wim); K. Nieman (Koen)

2015-01-01

textabstractBackground Endothelial dysfunction precedes coronary artery disease (CAD) and can be measured by peripheral arterial tonometry (PAT). We examined the applicability of PAT to detect a low risk of CAD in a chest pain clinic. Methods In 93 patients, PAT was performed resulting in reactive

Long-term outcomes of internal carotid artery disease treated using radial artery graft

International Nuclear Information System (INIS)

Murai, Yasuo; Teramoto, Akira; Mizunari, Takayuki; Kobayashi, Shiro; Umeoka, Katsuya; Tateyama, Kojiro

2009-01-01

Complex internal carotid artery disease presents a surgical challenge because limitations and difficulty are encountered with either clipping or endovascular treatment. Our review of previous reports suggests that no current vascular assessment can accurately predict occurrence of ischemic complications after internal carotid artery ligation. The present study concerns long-term clinical outcome of radial artery grafting followed by parent artery trapping or proximal occlusion for management of these difficult lesions. Between September 1997 and October 2007, we performed radial artery grafting followed immediately by parent artery occlusion in 20 sides of 19 patients with complex internal carotid arteries disease with follow-up for more than 36 months (5 men, 14 women; mean follow-up duration, 62 months). All patients underwent postoperative MRI and MR angiography (MRA) every year to assess graft patency, ischemic complications, and de novo aneurysm. Another 20 carotid aneurysms with visual disturbance were assessed concerning outcome. Among 13 patients with cranial nerve (III and VI) disturbances, all dysfunctions were improved in cases treated within 8 months of onset to operation. On the other hand, patients with second cranial nerve disturbances were not improved in cases treated after 4 months of onset. No long-term complications were discovered with MRI and MRA. With appropriate attention to surgical technique, radial artery grafting followed by acute parent artery occlusion is a safe treatment for complex internal carotid artery aneurysms. Long-term safety is satisfactory, with no delayed complications such as graft stenosis, ischemic complications or de novo aneurysm formations in follow-up periods of more than 3 years. Good clinical outcome of cranial nerve palsy was achieved in patients treated within 8 months of onset for cranial nerve (CN) III and VI, and 4 of CN II palsy. (author)

Radiation for not-so-benign coronary artery disease

International Nuclear Information System (INIS)

Massullo, Vincent

1996-01-01

The role of radiation therapy in the treatment of malignant disease has long been accepted. More limited application of radiation in the treatment of benign conditions has been proven but generally not pursued. On the centennial anniversary of radiation therapy, a promising, but as yet unproved, application of radiation for treatment of benign vascular disease has become an exciting field of research, speculation, and controversy. This panel presentation will discuss the rationales and dilemmas of applying radiation in the prevention of arterial restenosis after therapeutic intervention. Coronary artery bypass grafting and more recently coronary angioplasty have become accepted, effective therapies to reverse significant coronary stenosis, and thereby benefit the majority of patients with coronary artery disease. However, a large proportion of patients will suffer restenosis in spite of optimal conventional therapy. The search for a means to prevent such restenosis has been partially successful by therapies, and even engineering intravascular devices. In spite of these efforts, a significant number of patients will fail today's conventional therapy and suffer arterial restenosis. Fibroblast myointimal proliferation is felt to be a major element in this restenosis process. Clinical experience shows that radiation inhibits other similar benign fibroblast proliferative processes such as keloid scar formation and heterotopic ossification. Radiation is now being considered as a means to inhibit myointimal fibroblast proliferation and hopefully prevent attendant arterial restenosis as well. This has catalyzed various animal model investigations that have shown significant arteries. Promising results in the animal model and in very early human institutional trials. These trials are designed to determine if radiation is truly effective and can be safely delivered to prevent restenosis in diseased human arteries. This panel discussion will provide a firm basic science and

Contrast-induced nephropathy in patients with chronic kidney disease and peripheral arterial disease

International Nuclear Information System (INIS)

Kroneberger, Christian; Enzweiler, Christian N; Schmidt-Lucke, Andre; Rückert, Ralph-Ingo; Teichgräber, Ulf; Franiel, Tobias

2015-01-01

The risk for contrast-induced nephropathy (CIN) after intra-arterial application of an iodine-based contrast material is unknown for patients with chronic kidney disease (CKD) and peripheral arterial disease (PAD). To investigate the incidence of CIN in patients with CKD and PAD. This retrospective study was approved by the local ethics committee. One hundred and twenty patients with 128 procedures (73 with baseline eGFR in the range of 45–60 mL/min/1.73m 2 , 55 with eGFR < 45 mL/min/1.73m 2 ) were evaluated. All patients received intra-arterially an iodine-based low-osmolar contrast material (CM) after adequate intravenous hydration with isotonic NaCl 0.9% solution. CIN was defined as an increase in serum creatinine of more than 44 μmol/L within 4 days. The influence of patient-related risk factors (age, weight, body mass index, eGFR, serum creatinine, hypertension, diabetes mellitus, coronary heart disease, heart failure) and therapy-related risk factors (amount of CM, nephrotoxic drugs, number of CM applications) on CIN were examined. CIN developed in 0% (0/73) of procedures in patients with PAD and an eGFR in the range of 45–60 mL/min/1.73m 2 and in 10.9% (6/55) of procedures in patients with an eGFR <45 mL/min/1.73m 2 . No risk factor significantly influenced the development of CIN, although baseline serum creatinine (P = 0.06) and baseline eGFR (P = 0.10) showed a considerable dependency. Patients with an eGFR in the range of 45–60 mL/min/1.73m 2 and PAD seem not at risk for CIN after intra-arterial CM application and adequate hydration. Whereas, an eGFR < 45 mL/min/1.73m 2 correlated with a risk of 10.9% for a CIN

Clinical findings of intracranial vertebral artery disease using magnetic resonance angiography.

Science.gov (United States)

Liu, Lu-Han; Chen, Clayton Chi-Chang; Chang, Ming-Hong

2004-09-01

The vertebral artery lesion has a variety of clinical characteristics. We sought to clarify the clinical patterns and the location of the intracranial vertebral artery (ICVA) diseases according to analyses of images obtained using magnetic resonance angiography (MRA). We studied vascular lesions, risk factors, symptoms, signs, and outcomes in 35 patients with ICVA disease (3 had bilateral occlusion; 9, unilateral occlusion; 6, bilateral stenosis; and 17, unilateral stenosis). The most common site of unilateral and bilateral lesions was the distal ICVA after the origin of posterior inferior cerebellar artery (PICA). We found accompanying basilar artery disease in 28.6% of patients with unilateral and bilateral ICVA disease. The majority of the ICVA lesions were associated with internal carotid arteries disease (48.8%). The common vascular risk factors were hypertension (71%), diabetes mellitus (34%), hyperlipidemia (31%), smoking (29%), and coronary artery disease (23%). Eighteen patients (51.4%) had transient ischemic attacks (TIAs) only, 10 patients (28.6%) had TIAs before stroke, and 5 patients (14.3%) had strokes without TIAs. Most patients (80%) with TIAs, with or without stroke, had multiple episodes. Vertigo or dizziness, ataxia, limbs weakness and abnormal gait were the common symptoms and signs. At 6 months follow-up, 66.7% patients had no symptoms or only slight symptoms that caused no disability. Our data showed (1) the usual location of ICVA disease (occlusion or severe stenosis) was distal to PICA, especially near the vertebrobasilar junction; (2) the risk factors were hypertension, diabetes mellitus, hyperlipidemia, smoking, and coronary artery disease; (3) patients with ICVA disease had a high frequency of accompanying internal carotid, middle cerebral, or basilar artery disease; (4) vertigo or dizziness, and ataxia were the common symptoms and signs; (5) TIA was the most common clinical pattern; (6) the outcome was favorable, except in cases with

Peripheral vascular disease in patients with coronary artery disease

International Nuclear Information System (INIS)

Bashir, E. A.; Aslam, N.

2001-01-01

Objective: The prevalence of peripheral vascular disease (PVD) in patients with coronary artery disease (CAD) has been investigated in many different ways. It depends on the diagnostic methods used and definition of atherosclerotic manifestations in the different vascular beds. This study was carried out to determine the prevalence of PVD in the lower limbs in group of patients with CAD. Design: This is a prospective observational study. Place and duration of study: The study was conducted at Combined Military Hospital/Armed Forces institute of Cardiology, Rawalpindi, over a period of one year (January 1998 to January 1999). Subjects and methods: A total number of 200 patient (171 male and 29 females) aged 55-77 years with CAD. Diagnosed by coronary angiography were included in the study. In all patients blood pressure was recorded in both arms by sphygmomanometer and ankle systolic pressure by Doppler ultrasound. Ankle branchial index was calculated. Demographic data were obtained from the patient's hospital files. Results: The prevalence of PVD was 22.5% in patients with CAD in agreement with the results of most previous investigation. There was tendency towards increasing prevalence of PVD with more advanced CAD. Thirty patients (27%) showed evidence of triple vessel disease as compared to 13 patient (18%) with double vessel and 2 patients (1%) with single vessel disease. Conclusion: A non-invasive investigation of peripheral arterial circulation should be included early in the clinical consideration of patients with chest pain or similar symptoms suggesting coronary artery disease. Ankle systolic pressure appears to be simple and cheap technique for evaluation of results. (author)

Common carotid artery disease in Takayasu's arteritis

International Nuclear Information System (INIS)

Hamdan, Nabil; Calderon, Luis I; Castro, Pablo and others

2004-01-01

Takayasu's arteritis is a disease of unknown etiology with main involvement of the common carotid 5 artery and its branches. we report the case of a 69 years old female patient with Tokays arteritis with 2 bilateral involvements of the common carotid arteries, treated with percutaneous angioplasty and Stent implantation

The relation between ankle-brachial index (ABI and coronary artery disease severity and risk factors: an angiographic study

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Masoumeh Sadeghi

2011-07-01

Full Text Available BACKGROUND: The current study aims to determine the relation between ankle–brachialindex (ABI and angiographic findings and major cardiovascular risk factors in patients withsuspected coronary artery diseases (CAD in Isfahan.METHODS: In this cross-sectional descriptive-analytic research, patients with suspected CADwere studied. Characteristics of studied subjects including demographics, familial history, pastmedical history and atherosclerotic risk factors such as diabetes mellitus, hypertension,hyperlipidemia and smoking were obtained using a standard questionnaire. ABI was measuredin all studied patients. ABI ≤ 0.9 (ABI+ was considered as peripheral vessel disease and ABI >0.9 (ABI- was considered as normal. Then, all studied patients underwent coronary arteryangiography. The results of the questionnaire and angiographic findings were compared in ABI+and ABI- groups. Data were analyzed by SPSS 15 using ANOVA, t-test, Spearman's rankcorrelation coefficient, and discriminant analysis.RESULTS: In this study, 125 patients were investigated. ABI ≤ 0.9 was seen in 25 patients (20%.The prevalence of ABI+ among men and women was 25.9% and 7.5%, respectively (P = 0.01. Theprevalence of atherosclerotic risk factors was significantly higher in ABI+ patients than in ABIones(P < 0.05. ABI+ patients had more significant stenosis than ABI- ones. The mean ofocclusion was significantly higher in ABI+ patients with left main artery (LMA, right coronaryartery (RCA, left anterior descending artery (LAD, diagonal artery 1 (D1 and left circumflexartery (LCX involvements (P < 0.05.CONCLUSION: The findings of this research indicated that ABI could be a useful method inassessing both the atherosclerotic risk factors and the degree of coronary involvements insuspected patients. However, in order to make more accurate decisions for using this method indiagnosing and preventing CAD, we should plan further studies in large sample sizes of generalpopulation

Early results of coronary artery bypass grafting with coronary endarterectomy for severe coronary artery disease

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Toischer Karl

2009-09-01

Full Text Available Abstract Background Despite the existence of controversial debates on the efficiency of coronary endarterectomy (CE, it is still used as an adjunct to coronary artery bypass grafting (CABG. This is particularly true in patients with endstage coronary artery disease. Given the improvements in cardiac surgery and postoperative care, as well as the rising number of elderly patient with numerous co-morbidities, re-evaluating the pros and cons of this technique is needed. Methods Patient demographic information, operative details and outcome data of 104 patients with diffuse calcified coronary artery disease were retrospectively analyzed with respect to functional capacity (NYHA, angina pectoris (CCS and mortality. Actuarial survival was reported using a Kaplan-Meyer analysis. Results Between August 2001 and March 2005, 104 patients underwent coronary artery bypass grafting (CABG with adjunctive coronary endarterectomy (CE in the Department of Thoracic-, Cardiac- and Vascular Surgery, University of Goettingen. Four patients were lost during follow-up. Data were gained from 88 male and 12 female patients; mean age was 65.5 ± 9 years. A total of 396 vessels were bypassed (4 ± 0.9 vessels per patient. In 98% left internal thoracic artery (LITA was used as arterial bypass graft and a total of 114 vessels were endarterectomized. CE was performed on right coronary artery (RCA (n = 55, on left anterior descending artery (LAD (n = 52 and circumflex artery (RCX (n = 7. Ninety-five patients suffered from 3-vessel-disease, 3 from 2-vessel- and 2 from 1-vessel-disease. Closed technique was used in 18%, open technique in 79% and in 3% a combination of both. The most frequent endarterectomized localization was right coronary artery (RCA = 55%. Despite the severity of endstage atherosclerosis, hospital mortality was only 5% (n = 5. During follow-up (24.5 ± 13.4 months, which is 96% complete (4 patients were lost caused by unknown address 8 patients died (cardiac

Coronary artery disease and symptoms of depression in a Kenyan ...

African Journals Online (AJOL)

Coronary artery disease and symptoms of depression in a Kenyan population. ... death. Little is known about the co-morbidity of heart disease and depression in Africa. Objective: To describe the prevalence of depression in Black Africans with and without. Coronary Artery Disease as documented on coronary angiography ...

Serial right ventricle 201Tl imaging after exercise: relation to anatomy of the right coronary artery

International Nuclear Information System (INIS)

Brown, K.A.; Boucher, C.A.; Okada, R.D.; Strauss, H.W.; McKusick, K.A.; Pohost, G.M.

1982-01-01

The relation of the appearance of the right ventricle on serium 201 Tl myocardial imaging to coronary artery anatomy was examined in 88 consecutive patients undergoing exercise 201 Tl testing and coronary angiography for the evaluation of chest pain. Transient defects in the right ventricle were found in 8 patients. All had high grade (greater than or equal to 90%) stenosis of the proximal right coronary artery. Nonvisualization of right ventricular (RV) activity occurred in 10 patients. Nine of the 10 (90%) had significant (greater than or equal to 50% stenosis) disease of the proximal right coronary artery and 7 (70%) had high grade stenosis. The right ventricle appeared normal in 70 patients. Twenty-nine (41%) of these patients had significant proximal right coronary artery disease. Right ventricular appearance was not affected by the presence or absence of disease of the left anterior descending or left circumflex artery or by the appearance of the left ventricle. Thus, with serial RV thallium-201 myocardial imaging after exercise, we found that (1) RV transient defects suggest the presence of high grade proximal right coronary artery stenosis, (2) non-visualization of RV activity also predicts significant proximal right coronary disease, and (3) the right ventricle frequently appears normal despite proximal right coronary artery disease and therefore this finding does not exclude such disease

Imaging and intervention for coronary artery disease following irradiation of malignant thymoma

International Nuclear Information System (INIS)

Fatimi, S.H.

2012-01-01

Thymomas are rare malignant epithelial growths, constituting 20% of mediastinal tumours. Resection followed by irradiation may be employed in all thymomas except for stage 1 thymomas. Mediastinal irradiation is associated with coronary artery disease. The mean duration of presentation of post-irradiation coronary artery disease is 16 years (range 3-29 years). In our patient coronary artery disease was found only a year post irradiation. A 55 year old male who presented with complaints of dyspnoea, retrosternal chest pain and heaviness since one year underwent resection for malignant thymoma followed by radiotherapy. He presented with coronary artery disease a year after undergoing mediastinal irradiation. On follow-up, patient was treated successfully by coronary artery bypass graft. This case is an unusual occurrence and suggests that mediastinal irradiation may result in significant coronary artery disease as early as within one year. (author)

Skin autofluorescence is increased in patients with carotid artery stenosis and peripheral artery disease

NARCIS (Netherlands)

Noordzij, Marjon J.; Lefrandt, Joop D.; Loeffen, Erik A. H.; Saleem, Ben R.; Meerwaldt, Robbert; Lutgers, Helen L.; Smit, Andries J.; Zeebregts, Clark J.

Advanced glycation end products (AGEs) have a pivotal role in atherosclerosis. We evaluated skin autofluorescence (SAF), a non-invasive measurement of tissue AGE accumulation, in patients with carotid artery stenosis with and without coexisting peripheral artery occlusive disease (PAOD). SAF was

The association of opium with coronary artery disease.

Science.gov (United States)

Sadeghian, Saeed; Darvish, Soodabeh; Davoodi, Gholamreza; Salarifar, Mojtaba; Mahmoodian, Mehran; Fallah, Nader; Karimi, Abbas Ali

2007-10-01

The effects of opium consumption on coronary artery disease are still unknown. A cross-sectional study was conducted on 2405 patients admitted to the Angiographic Ward at Tehran Heart Center from 7 May 2005 to 13 August 2005. After adjusting for conventional cardiovascular risk factors, opium consumption was a significant risk factor for coronary artery disease (P=0.01 and odds ratio=1.8). Moreover, the amount of opium consumption was associated significantly with the severity of coronary atherosclerosis, as measured by clinical vessel score (r=0.2, P=0.002). To our knowledge, this is the first time that the adverse effects of opium consumption on coronary arteries was defined.

Physical Activity and Characteristics of the Carotid Artery Wall in High-Risk Patients-The SMART (Second Manifestations of Arterial Disease) Study.

Science.gov (United States)

Boss, H Myrthe; van der Graaf, Yolanda; Visseren, Frank L J; Van den Berg-Vos, Renske M; Bots, Michiel L; de Borst, Gert Jan; Cramer, Maarten J; Kappelle, L Jaap; Geerlings, Mirjam I

2017-07-23

Physical activity reduces the risk of vascular disease. This benefit is not entirely explained through an effect on vascular risk factors. We examined the relationship of physical activity and characteristics of the carotid artery wall in patients with vascular disease or risk factors. Cross-sectional analyses were performed in 9578 patients from the SMART (Second Manifestations of Arterial Disease) study, a prospective cohort study among patients with vascular disease or risk factors. Physical activity was assessed using questionnaires. Carotid intima-media thickness and carotid artery stenosis of both common carotid arteries was measured. In a subset of 3165 participants carotid diastolic diameter and distension were assessed. Carotid stiffness was expressed as the distensibility coefficient and Young's elastic modulus. Regression analyses adjusted for vascular risk factors showed that physical activity was inversely associated with diastolic diameter (fifth versus first quintile B=-0.13 mm; 95% CI, -0.21 to -0.05) and decreased risk of carotid artery stenosis (relative risk, 0.58; 95% CI, 0.48-0.69). A light level of physical activity was associated with less carotid stiffness (second versus first quintile; Young's elastic modulus B=-0.11 kPa -1 ×10 -3 ; 95% CI, -0.16 to -0.06; distensibility coefficient B=0.93 kPa×10 3 ; 95% CI, 0.34-1.51), but there was no additional benefit with increasing levels of physical activity. In patients with vascular disease, physical activity was inversely associated with common carotid intima-media thickness, but not in patients with vascular risk factors. In patients with vascular disease or risk factors, increased physical activity was associated with smaller carotid diastolic diameter, decreased risk of carotid artery stenosis, and less carotid stiffness, but it only showed benefits on carotid intima-media thickness in patients with vascular disease. © 2017 The Authors. Published on behalf of the American Heart

Analysis of the degree of pulmonary thallium washout after exercise in patients with coronary artery disease

International Nuclear Information System (INIS)

Levy, R.; Rozanski, A.; Berman, D.S.; Garcia, E.; Van Train, K.; Maddahi, J.; Swan, H.J.

1983-01-01

An abnormal increase in pulmonary thallium activity may be visualized on post-stress thallium images in patients with coronary artery disease. Because this increased pulmonary thallium activity usually disappears by the time of redistribution imaging, this study was designed to assess whether measurement of the degree of pulmonary thallium washout between stress and redistribution might improve the detection of increased pulmonary thallium activity in patients with coronary artery disease. Quantitative analysis revealed abnormal (that is, greater than 2 standard deviations of normal values) pulmonary thallium washouts in 59 (64%) of 92 patients with coronary artery disease, but in only 2 (25%) of 8 subjects with angiographically normal arteries (p less than 0.06). By comparison, the visual analysis of pulmonary thallium washout and use of initial pulmonary to myocardial thallium ratio were significantly (p less than 0.05) less sensitive in detecting abnormality in patients with coronary artery disease. Abnormal pulmonary thallium washout was related to both the anatomic extent and functional severity of disease: it occurred with greatest frequency in patients with multivessel disease and in those with exercise-induced left ventricular dysfunction (p less than 0.005). When added to the quantitative analysis of myocardial scintigraphy, the analysis of pulmonary thallium washout increased the detection of coronary artery disease from 84 to 93% (p less than 0.05), but the sample size was too small to assess specificity

Hsa-circRNA11783-2 in peripheral blood is correlated with coronary artery disease and type 2 diabetes mellitus.

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Li, Xuejie; Zhao, Zhenzhou; Jian, Dongdong; Li, Wentao; Tang, Haiyu; Li, Muwei

2017-11-01

The purpose of this study was to identify the expression characteristics of circular RNAs in the peripheral blood of coronary artery disease patients and type 2 diabetes mellitus patients. Circular RNA in the peripheral blood from 6 control individuals, 6 coronary artery disease patients, 6 type 2 diabetes mellitus patients and 6 coronary artery disease combined with type 2 diabetes mellitus patients was collected for microarray analysis, and a further independent cohort consisting of 20 normal individuals, 20 type 2 diabetes mellitus subjects and 20 coronary artery disease subjects was used to verify the expression of five circular RNAs chosen for further analysis. The findings were then tested in a third cohort using quantitative real-time polymerase chain reaction. In total, 40 circular RNAs differentially expressed between the three experimental groups and the control group were identified by microarray analysis: 13 were upregulated in the experimental groups, while 27 were downregulated. Of the five circular RNAs chosen for further analysis, three were significantly downregulated in the experimental groups. The crude odds ratios and adjusted odds ratios of hsa-circRNA11783-2 showed significant differences in both the coronary artery disease group and type 2 diabetes mellitus group. We then verified hsa-circRNA11783-2 in the third cohort, and it remained closely related to both coronary artery disease and type 2 diabetes mellitus. Hsa-circRNA11783-2 is closely related to both coronary artery disease and type 2 diabetes mellitus.

Cystatin C Is Not Causally Related to Coronary Artery Disease.

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Patrik Svensson-Färbom

Full Text Available Strong and independent associations between plasma concentration of cystatin C and risk of cardiovascular disease (CVD suggests causal involvement of cystatin C.The aim of our study was to assess whether there is a causal relationship between plasma concentration of cystatin C and risk of coronary artery disease (CAD using a Mendelian Randomization approach.We estimated the strength of association of plasma cystatin C on CAD risk and the strength of association of the strongest GWAS derived cystatin C SNP (rs13038305 on plasma cystatin C in the population-based Malmö Diet and Cancer Study (MDC and thereafter the association between rs13038305 and CAD in the MDC (3200 cases of CAD and 24418 controls and CARDIOGRAM (22233 cases of CAD and 64762 controls.Each standard deviation (SD increment of plasma cystatin C was associated with increased risk of CAD (OR = 1.20, 95% CI 1.07-1.34 after full adjustment. Each copy of the major allele of rs13038305 was associated with 0.34 SD higher plasma concentration of cystatin C (P98% to detect a significant relationship between rs13038305 and CAD in MDC and CARDIOGRAM pooled. The odds ratio for CAD (per copy of the major rs13038305 allele was 1.00 (0.94-1.07; P = 0.92 in MDC, 0.99 (0.96-1.03; P = 0.84 in CARDIOGRAM and 1.00 (0.97-1.03; P = 0.83 in MDC and CARDIOGRAM pooled.Genetic elevation of plasma cystatin C is not related to altered risk of CAD, suggesting that there is no causal relationship between plasma cystatin C and CAD. Rather, the association between cystatin C and CAD appears to be due to the association of eGFR and CAD.

Mechanical Recanalization of Subacute Vessel Occlusion in Peripheral Arterial Disease with a Directional Atherectomy Catheter

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Massmann, Alexander, E-mail: Alexander.Massmann@uks.eu; Katoh, Marcus [Saarland University Hospital, Department of Diagnostic and Interventional Radiology (Germany); Shayesteh-Kheslat, Roushanak [Saarland University Hospital, Department of General Surgery, Visceral, Vascular, and Pediatric Surgery (Germany); Buecker, Arno [Saarland University Hospital, Department of Diagnostic and Interventional Radiology (Germany)

2012-10-15

Purpose: To retrospectively examine the technical feasibility and safety of directional atherectomy for treatment of subacute infrainguinal arterial vessel occlusions. Methods: Five patients (one woman, four men, age range 51-81 years) with peripheral arterial disease who experienced sudden worsening of their peripheral arterial disease-related symptoms during the last 2-6 weeks underwent digital subtraction angiography, which revealed vessel occlusion in native popliteal artery (n = 4) and in-stent occlusion of the superficial femoral artery (n = 1). Subsequently, all patients were treated by atherectomy with the SilverHawk (ev3 Endovascular, USA) device. Results: The mean diameter of treated vessels was 5.1 {+-} 1.0 mm. The length of the occlusion ranged 2-14 cm. The primary technical success rate was 100%. One patient experienced a reocclusion during hospitalization due to heparin-induced thrombocytopenia. There were no further periprocedural complications, in particular no peripheral embolizations, until hospital discharge or during the follow-up period of 1 year. Conclusion: The recanalization of infrainguinal arterial vessel occlusions by atherectomy with the SilverHawk device is technically feasible and safe. In our limited retrospective study, it was associated with a high technical success rate and a low procedure-related complication rate.

Gene therapy and angiogenesis in patients with coronary artery disease

DEFF Research Database (Denmark)

Kastrup, Jens

2010-01-01

-blind placebo-controlled trials could not confirm the initial high efficacy of either the growth factor protein or the gene therapy approaches observed in earlier small trials. The clinical studies so far have all been without any gene-related serious adverse events. Future trials will focus on whether...... an improvement in clinical results can be obtained with a cocktail of growth factors or by a combination of gene and stem cell therapy in patients with severe coronary artery disease, which cannot be treated effectively with current treatment strategies....... of VEGF and FGF in patients with coronary artery disease. The initial small and unblinded studies with either recombinant growth factor proteins or genes encoding growth factors were encouraging, demonstrating both clinical improvement and evidence of angiogenesis. However, subsequent larger double...

Applied anatomy of thyroid arteries for interventional embolization of Graves' disease

International Nuclear Information System (INIS)

Ding Zhongxiang; Zhao Wei; Hou Jialin; Xiang Shutian; Li Liyuan; Zou Zhirong; Li Xingguo; Song Dianping; Yuan Jianhua

2007-01-01

Objective: To explore the anatomy and imaging manifestations of thyroid arteries for improving the efficiency and lowering the complication in interventional embolization of Graves' disease. Methods: Thyroid arteries were investigated, including 16 adult cadavers (Cadaver group), 8 non-thyropathic patients (Normal group)and 17 Graves patients (Graves group). The inner diameters of the trunk and supplying branches of thyroid artery, the angles between the origination of branches and the beginning of the trunk, and the angles between the trunk of thyroid artery and carotid or subclavian artery were measured. In addition, data of the three groups were statistically analyzed. Results: Many non-thyroid arterial branches arose from thyroid artery, with no statistical difference in their indexes between Cadaver group and Normal group. The thyroid arteries showed much longer, obviously wider in diameter, and larger angles between the trunk of thyroid artery and carotid artery in Graves group than those of Cadaver group and Normal group; outcoming with significant statistical differences; and furthermore, with increase of interglandular branches and dangerous internal and external anastomoses. Conclusions: The specific thyroid arterial changes of Graves' disease are helpful for the interventional embolization. Non-thyroid branches and dangerous anastomoses should not be embolized as far as possible, for decreasing the complications of the interventional procedure for Graves' disease. (authors)

Management of coronary artery disease

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Safri, Z.

2018-03-01

Coronary Artery Disease (CAD) is associated with significant morbidity and mortality, therefore it’s important to early and accurate detection and appropriate management. Diagnosis of CAD include clinical examination, noninvasive techniques such as biochemical testing, a resting ECG, possibly ambulatory ECG monitoring, resting echocardiography, chest X-ray in selected patients; and catheterization. Managements of CAD patients include lifestyle modification, control of CAD risk factors, pharmacologic therapy, and patient education. Revascularization consists of percutaneous coronary angioplasty and coronary artery bypass grafting. Cardiac rehabilitation should be considered in all patients with CAD. This comprehensive review highlights strategies of management in patients with CAD.

Epidemiology, classification, and modifiable risk factors of peripheral arterial disease

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Nicolas W Shammas

2007-05-01

Full Text Available Nicolas W ShammasMidwest Cardiovascular Research Foundation, Cardiovascular Medicine, PC, Davenport, IA, USAAbstract: Peripheral arterial disease (PAD is part of a global vascular problem of diffuse atherosclerosis. PAD patients die mostly of cardiac and cerebrovascular-related events and much less frequently due to obstructive disease of the lower extremities. Aggressive risk factors modification is needed to reduce cardiac mortality in PAD patients. These include smoking cessation, reduction of blood pressure to current guidelines, aggressive low density lipoprotein lowering, losing weight, controlling diabetes and the use of oral antiplatelet drugs such as aspirin or clopidogrel. In addition to quitting smoking and exercise, cilostazol and statins have been shown to reduce claudication in patients with PAD. Patients with critical rest limb ischemia or severe progressive claudication need to be treated with revascularization to minimize the chance of limb loss, reduce symptoms, and improve quality of life.Keywords: peripheral arterial disease, epidemiology, risk factors, classification

Nanomedicine in coronary artery disease.

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Ambesh, Paurush; Campia, Umberto; Obiagwu, Chukwudi; Bansal, Rashika; Shetty, Vijay; Hollander, Gerald; Shani, Jacob

Nanomedicine is one of the most promising therapeutic modalities researchers are working on. It involves development of drugs and devices that work at the nanoscale (10-9m). Coronary artery disease (CAD) is responsible for more than a third of all deaths in age group >35 years. With such a huge burden of mortality, CAD is one of the diseases where nanomedicine is being employed for preventive and therapeutic interventions. Nanomedicine can effectively deliver focused drug payload at sites of local plaque formation. Non-invasive strategies include thwarting angiogenesis, intra-arterial thrombosis and local inflammation. Invasive strategies following percutaneous coronary intervention (PCI) include anti-restenosis and healing enhancement. However, before practical application becomes widespread, many challenges need to be dealt with. These include manufacturing at the nanoscale, direct nanomaterial cellular toxicity and visualization. Copyright © 2017 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

Management of Infrapopliteal Arterial Disease: Critical Limb Ischemia.

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Mustapha, Jihad A; Diaz-Sandoval, Larry J

2014-10-01

According to the TransAtlantic Inter-Society Consensus Document on Management of Peripheral Arterial Disease, "there is increasing evidence to support a recommendation for angioplasty in patients with critical limb ischemia and infrapopliteal artery occlusion." Management of infrapopliteal artery disease starts with diagnosis using modern preprocedural noninvasive and invasive imaging. Interventionalists need to learn the role of chronic total occlusion cap analysis and collateral zone recognition in angiosome-directed interventions for management of critical limb ischemia and be familiar with equipment and device selection and a stepwise approach for endovascular interventions. Interventionalists need to know which crossing tools to use to successfully cross-complex chronic total occlusion caps. Copyright © 2014 Elsevier Inc. All rights reserved.

Pulmonary artery aneurysm in Bechcet's disease: helical computed tomography study

International Nuclear Information System (INIS)

Munoz, J.; Caballero, P.; Olivera, M. J.; Cajal, M. L.; Caniego, J. L.

2000-01-01

Behcet's disease is a vasculitis of unknown etiology that affects arteries and veins of different sizes and can be associated with pulmonary artery aneurysms. We report the case of a patient with Behcet's disease and a pulmonary artery aneurysm who was studied by means of plain chest X ray, helical computed tomography and pulmonary arteriography. Helical computed tomography is a reliable technique for the diagnosis and follow-up of these patients. (Author) 9 refs

Childhood Antecedents to Adult Coronary Artery Diseases. Special Reference Briefs.

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Winick, Myron

This reference brief deals with the childhood antecedents to atherosclerosis and hypertension. While diet is related to the development of coronary artery diseases, there is some disagreement about what dietary changes are necessary or desirable in children to prevent their development, and at what age such changes should be made. Fifty-five…

Cardiac and pulmonary artery mensuration in feline heartworm disease

International Nuclear Information System (INIS)

Schafer, M.; Berry, C.R.

1995-01-01

A retrospective study was undertaken to quantify thoracic radiographic changes in cats with heartworm diseases, (Dirofilaria immitis). Using a blinded study format, the cardiac silhouette, thoracic cavity and pulmonary arteries were measured from thoracic radiographs of 21 cats with feline heartworm disease and 30 cats without known cardiac or pulmonary vessel pathology. Measured data were normalized to the thoracic cavity or bony structures within the radiographic field of view. The measurements were compared between the two groups of cats using an unpaired, two-tailed Student's t-test, with a p value of < 0.05 being considered significant. Cats with feline heartworm disease had enlargement of the craniocaudal aspect of the cardiac silhouette and normalized cardiac:thoracic ratio (p < 0.05) on the lateral view. Also, there was significant enlargement of the central and peripheral caudal lobar pulmonary arteries and their normalized ratios (p < 0.05) in the heartworm infected cats as visualized on the ventrodorsal projection. Tortuosity of the pulmonary arteries was seen in three of the 21 infected cats. Eleven of the 21 cats with feline heartworm disease had pulmonary parenchymal changes. Based on the present study, central and peripheral pulmonary artery enlargement as viewed on the ventrodorsal radiograph was the single best radiographic indicator of feline heartworm disease

Identifying coronary artery disease in asymptomatic middle-aged sportsmen : The additional value of pulse wave velocity

NARCIS (Netherlands)

Braber, Thijs L.; Prakken, Niek H J; Mosterd, Arend; Mali, Willem P Th M; Doevendans, Pieter A F M; Bots, Michiel L.; Velthuis, Birgitta K.

2015-01-01

Background: Cardiovascular screening may benefit middle-aged sportsmen, as coronary artery disease (CAD) is the main cause of exercise-related sudden cardiac death. Arterial stiffness, as measured by pulse wave velocity (PWV), may help identify sportsmen with subclinical CAD. We examined the

Association of Peripheral Arterial and Cardiovascular Diseases in Familial Hypercholesterolemia

International Nuclear Information System (INIS)

Pereira, Carolina; Miname, Marcio; Makdisse, Marcia; Kalil, Roberto Filho; Santos, Raul D.

2014-01-01

Familial hypercholesterolemia (FH) is an autosomal dominant genetic disease characterized by an elevation in the serum levels of total cholesterol and of low-density lipoproteins (LDL- c). Known to be closely related to the atherosclerotic process, FH can determine the development of early obstructive lesions in different arterial beds. In this context, FH has also been proposed to be a risk factor for peripheral arterial disease (PAD). This observational cross-sectional study assessed the association of PAD with other manifestations of cardiovascular disease (CVD), such as coronary artery and cerebrovascular disease, in patients with heterozygous FH. The diagnosis of PAD was established by ankle-brachial index (ABI) values ≤ 0.90. This study assessed 202 patients (35% of men) with heterozygous FH (90.6% with LDL receptor mutations), mean age of 51 ± 14 years and total cholesterol levels of 342 ± 86 mg /dL. The prevalences of PAD and previous CVD were 17% and 28.2 %, respectively. On multivariate analysis, an independent association between CVD and the diagnosis of PAD was observed (OR = 2.50; 95% CI: 1.004 - 6.230; p = 0.049). Systematic screening for PAD by use of ABI is feasible to assess patients with FH, and it might indicate an increased risk for CVD. However, further studies are required to determine the role of ABI as a tool to assess the cardiovascular risk of those patients

Association of Peripheral Arterial and Cardiovascular Diseases in Familial Hypercholesterolemia

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Carolina Pereira

2014-08-01

Full Text Available Background: Familial hypercholesterolemia (FH is an autosomal dominant genetic disease characterized by an elevation in the serum levels of total cholesterol and of low-density lipoproteins (LDL- c. Known to be closely related to the atherosclerotic process, FH can determine the development of early obstructive lesions in different arterial beds. In this context, FH has also been proposed to be a risk factor for peripheral arterial disease (PAD. Objective: This observational cross-sectional study assessed the association of PAD with other manifestations of cardiovascular disease (CVD, such as coronary artery and cerebrovascular disease, in patients with heterozygous FH. Methods: The diagnosis of PAD was established by ankle-brachial index (ABI values ≤ 0.90. This study assessed 202 patients (35% of men with heterozygous FH (90.6% with LDL receptor mutations, mean age of 51 ± 14 years and total cholesterol levels of 342 ± 86 mg /dL. Results: The prevalences of PAD and previous CVD were 17% and 28.2 %, respectively. On multivariate analysis, an independent association between CVD and the diagnosis of PAD was observed (OR = 2.50; 95% CI: 1.004 - 6.230; p = 0.049. Conclusion: Systematic screening for PAD by use of ABI is feasible to assess patients with FH, and it might indicate an increased risk for CVD. However, further studies are required to determine the role of ABI as a tool to assess the cardiovascular risk of those patients.

Association of Peripheral Arterial and Cardiovascular Diseases in Familial Hypercholesterolemia

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Pereira, Carolina [Instituto do Coração HCFMUSP, São Paulo, SP (Brazil); Hospital Israelita Albert Einstein, São Paulo, SP (Brazil); Miname, Marcio [Instituto do Coração HCFMUSP, São Paulo, SP (Brazil); Makdisse, Marcia [Hospital Israelita Albert Einstein, São Paulo, SP (Brazil); Kalil, Roberto Filho [Instituto do Coração HCFMUSP, São Paulo, SP (Brazil); Santos, Raul D., E-mail: rdsf@cardiol.br [Instituto do Coração HCFMUSP, São Paulo, SP (Brazil); Hospital Israelita Albert Einstein, São Paulo, SP (Brazil)

2014-08-15

Familial hypercholesterolemia (FH) is an autosomal dominant genetic disease characterized by an elevation in the serum levels of total cholesterol and of low-density lipoproteins (LDL- c). Known to be closely related to the atherosclerotic process, FH can determine the development of early obstructive lesions in different arterial beds. In this context, FH has also been proposed to be a risk factor for peripheral arterial disease (PAD). This observational cross-sectional study assessed the association of PAD with other manifestations of cardiovascular disease (CVD), such as coronary artery and cerebrovascular disease, in patients with heterozygous FH. The diagnosis of PAD was established by ankle-brachial index (ABI) values ≤ 0.90. This study assessed 202 patients (35% of men) with heterozygous FH (90.6% with LDL receptor mutations), mean age of 51 ± 14 years and total cholesterol levels of 342 ± 86 mg /dL. The prevalences of PAD and previous CVD were 17% and 28.2 %, respectively. On multivariate analysis, an independent association between CVD and the diagnosis of PAD was observed (OR = 2.50; 95% CI: 1.004 - 6.230; p = 0.049). Systematic screening for PAD by use of ABI is feasible to assess patients with FH, and it might indicate an increased risk for CVD. However, further studies are required to determine the role of ABI as a tool to assess the cardiovascular risk of those patients.

The Relation of Serum Bilirubin Level With Coronary Artery Disease Based on Angiographic Findings

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Taban Sadeghi Mohammadreza

2015-10-01

Full Text Available Objective: Lipid oxidation and generation of free radicals are important factors contributing to the formation of atherosclerotic plaque. Bilirubin is supposed to play a protective role against atherosclerosis, coronary artery diseases (CAD and inflammation for its strong antioxidant property. Thus, this study aims at investigating the relationship of bilirubin level with the severity and type of coronary artery stenosis (CAS in different patient groups. Materials and Methods: In this cross-sectional study 200 consecutive patients, who underwent elective angiography in Madani Heart hospital, Tabriz, Iran, were selected and their blood samples were measured for total, direct, and indirect bilirubin level, with Diazo method using colorimetric technique. Following angiography, comparisons were made between the severity and location of CAS and therapeutic follow-up plan with total, direct, and indirect bilirubin level. Results: Of 200 studied patients, 129 (64.5% and 71 (35.5% subjects were male and female, respectively. The cases were classified into 5 subgroups based on angiography results as follows: 59 (29.5% cases with normal angiography, 11 cases (5.5% with minimal CAD, 56 cases (28% with single vessel involvement, 35 (17.5% cases with two vessel involvement and 39 cases (19.5% with three vessel involvement. The mean total bilirubin level was 1.47 ± 0.8 mg/dl, 1.27 ± 0.12 mg/dl, 1.27 ± 0.06 mg/dl, 1.6 ± 0.04 mg/dl and 0.98 ± 0.05 mg/dl, respectively for the cases with above order. The mean difference in serum total bilirubin between normal angiography group and three-vessel involvement group was 0.49 mg/dl (P < .0001. There was a significant inverse relation between bilirubin level (total, direct and indirect and number of involved vessels and involvement intensity increased as serum bilirubin level decreased. Severity of coronary arteries stenosis as well as the number of involved vessels increased as serum bilirubin level decreased

Hypertension, obesity, and coronary artery disease in the survivors of congenital heart disease.

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Roche, S Lucy; Silversides, Candice K

2013-07-01

Obesity, hypertension, and coronary artery disease are prevalent in the general population and well recognized as contributors to cardiac morbidity and mortality. With surgical and medical advances, there is a growing and aging population with congenital heart disease who are also at risk of developing these comorbidities. In addition, some congenital cardiac lesions predispose patients to conditions such as hypertension or coronary artery disease. The effect of these comorbidities on the structurally abnormal heart is not well understood, but might be very important, especially in those with residual abnormalities. Thus, in addition to surveillance for and treatment of late complications it is important for the congenital cardiologist to consider and aggressively manage acquired comorbidities. In this review we explore the prevalence of hypertension, obesity, and coronary artery disease, discuss congenital lesions that predispose to these conditions and review management strategies for this unique population. Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

The peripheral artery questionnaire: a new disease-specific health status measure for patients with peripheral arterial disease.

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Spertus, John; Jones, Philip; Poler, Sherri; Rocha-Singh, Krishna

2004-02-01

The most common indication for treating patients with peripheral arterial disease is to improve their health status: their symptoms, function, and quality of life. Quantifying health status requires a valid, reproducible, and sensitive disease-specific measure. The Peripheral Artery Questionnaire (PAQ) is a 20-item questionnaire developed to meet this need by quantifying patients' physical limitations, symptoms, social function, treatment satisfaction, and quality of life. Psychometric and clinical properties of the PAQ were evaluated in a prospective cohort study of 44 patients undergoing elective percutaneous peripheral revascularization. To establish reproducibility, 2 assessments were performed 2 weeks apart and before revascularization. The change in scores before and 6 weeks after revascularization were used to determine the instruments' responsiveness and were compared with the Short Form-36 and the Walking Impairment Questionnaire. A series of cross-sectional analyses were performed to establish the construct validity of the PAQ. The 7 domains of the PAQ were internally reliable, with Cronbach alpha = 0.80 to 0.94. The test-retest reliability analyses revealed insignificant mean changes of 0.6 to 2.3 points (P = not significant for all). Conversely, the change after revascularization ranged from 13.7 to 41.9 points (P PAQ to clinical improvement. The PAQ Summary Scale was the most sensitive of all scales tested. Construct validity was established by demonstrating correlations with other measures of patient health status. The PAQ is a valid, reliable, and responsive disease-specific measure for patients with peripheral arterial disease. It may prove to be a useful end point in clinical trials and a potential aid in disease management.

Exercise thallium-201 myocardial imaging in left main coronary artery disease: sensitive but not specific

International Nuclear Information System (INIS)

Rehn, T.; Griffith, L.S.; Achuff, S.C.; Bailey, I.K.; Bulkley, B.H.; Burow, R.; Pitt, B.; Becker, L.C.

1981-01-01

To determine the usefulness of thallium-201 scintigraphy for identifying left main coronary artery disease, the results of scintigraphy at rest and during exercise were compared in 24 patients with 50 percent or greater narrowing of the left main coronary artery and 80 patients with 50 percent or greater narrowing of one or more of the major coronary arteries but without left main coronary involvement. By segmental analysis of the scintigrams, perfusion defects were assigned to the left anterior descending, left circumflex or right coronary artery, singly or in combination, and the pattern of simultaneous left anterior descending and circumflex arterial defects was used to identify left main coronary artery disease. Of the 24 patients with left main coronary artery disease, 22 (92 percent) had abnormal exercise scintigrams. Despite this high sensitivity, the pattern of perfusion defects was not specific; the ''left main pattern'' was found in 3 patients (13 percent) with left main coronary artery disease but also in 3 (33 percent) of 9 patients with combined left anterior descending and left circumflex arterial disease, 4 (19 percent) of 21 patients with three vessel disease and 3 (6 percent) of 50 patients with one or two vessel disease but excluding the group with left anterior descending plus left circumflex arterial disease. The pattern of perfusion defects in the patients with left main coronary artery disease was determined by the location and severity of narrowings in the coronary arteries downstream from the left main arterial lesion. Concomitant lesions in other arteries were found in all patients with left main coronary disease (one vessel in 1 patient, two vessels in 7 patients and three vessels in 16). For this reason, it is unlikely that even with improvements in radiopharmaceutical agents and imaging techniques, myocardial perfusion scintigraphy will be sufficiently specific for definitive identification of left main coronary artery disease

What Is Peripheral Artery Disease?

Science.gov (United States)

... or bluish color to the skin A lower temperature in one leg compared to the other leg Poor nail growth on the toes and decreased hair growth on the legs Erectile dysfunction, especially among men who have diabetes Diagnosis Peripheral artery disease (P.A.D.) is diagnosed based ...

CIRCADIAN ARTERIAL TENSION PROFILE IN THE PATIENTS WITH BRONCHIAL ASTHMA AND COMORBID HYPERTENSIVE DISEASE

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T. N. Zaripova

2016-01-01

Full Text Available The aim of research is to study the state of circadian arterial tension profile in the patients with bronchial asthma and hypertensive disease as comorbid disease. Materials and methods. The research has been performed at 76 patients with bronchial asthma and hypertensive disease as comorbid disease (the main group and 52 patients with hypertensive disease as the comparison group. The groups were comparable with respect to the gender and age sign. Investigation was performed in the period of clinical remission. The main method used in this research was the investigation of day arterial tension profile in the time of its monitoring. Results. It has been revealed the presence of frequent and expressed change from the side of the studied indexes, especially in the patients with comorbid pathology, which were characterized by more frequent and more significant disorders from the side of diastolic blood pressure, especially at night in combination with more considerable and more rapid rise in early morning hours. The day arterial tension profile was characterized either with insufficient decline of arterial pressure at night or, opposite, with its sharp decrease. Specified disorders were increased as far as heaving of main and comorbid diseases, presence of disorders from the side of lipid exchange were not related to the phase of bronchial asthma (remission, exacerbation and level of its flow control. 

Iskemia pada Jari Tangan Penderita Diabetes Melitus: Suatu Keadaan Peripheral Arterial Disease

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Eva Decroli

2015-05-01

Full Text Available Abstrak Pendahuluan: Peripheral Arterial Disease (PAD adalah penyumbatan pada arteri perifer akibat proses atherosklerosis atau proses inflamasi yang menyebabkan lumen arteri menyempit (stenosis, atau pembentukantrombus. Tempat tersering terjadinya PAD adalah daerah tungkai bawah dan jarang ditemukan pada jari tangan.Metode: Laporan kasus. Hasil: Telah dilaporkan suatu kasus iskemia jari tangan yang jarang ditemui di klinik, merupakan suatu PAD. Pembahasan: Selain adanya faktor risiko konvensional seperti diabetes melitus dan keganasan untuk terjadinya trombosis, juga didapatkan suatu kelainan herediter berupa defisiensi antikoagulan yaitu defisiensi protein S, sekalipun protein C dalam batas normal yang secara bersama-sama diduga mempermudah terjadinya trombosis pada arteri perifer. Kata kunci: Diabetes, Iskemia, Peripheral arterial disease, Protein S, Trombosis Abstract Introduction: Peripheral Arterial Disease (PAD is occlusion in peripheral artery caused by atherosclerosis or inflammation process that make stenosis in artery, or thrombus formation. High incidence of PAD occur in lower extremity, and rarely in hand and finger. Method: Case report. Result: Has been reported hand ischaemia that rarely found in hand and finger. Discussion: Despite conventional risk factor for thrombosis like diabetes mellitus and malignancy, hereditary disorder of anticoagulant factor deficiency played the same role, like protein S deficiency,eventhough protein C in normal limit. These risk factors made thrombosis at peripheral arteri easier to occur.Keywords:  Diabetes, Ischaemia, Peripheral arterial disease, Protein S, Thrombosis

[Hyperhomocysteinemia in coronary artery diseases. Apropos of a study on 102 patients].

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Blacher, J; Montalescot, G; Ankri, A; Chadefaux-Vekemans, B; Benzidia, R; Grosgogeat, Y; Kamoun, P; Thomas, D

1996-10-01

Homocystein is at the crossroads of the metabolic pathways of sulphuric amino acids. Homocystinuria is a congenital autosomal recessive disease, usually related to cystathionine beta-synthetase deficiency. Children with homozygotic forms of the disease have early vascular complications which represent the main cause of death. Moderately elevated serum homocystein levels are related to two major genetic factors (heterozygotic cystathionine beta-synthetase deficiency and mutation of the 5-10 methylene tetrahydrofolate reductase) and several minor, genetic and non-genetic factors (folic acid, vitamins B6 and B12 and betain deficiencies). Previous studies have suggested that hyperhomocysteinaemia could be a cardiovascular risk factor. This study was based on 222 subjects including 102 consecutive patients with angiographically documented coronary artery disease and 120 control subjects without vascular disease. No relationship was observed between serum homocystein concentrations and the classical cardiovascular risk factors. Coronary patients had higher average homocystein concentrations than control subjects (11.27 +/- 0.52 vs 8.77 +/- 0.31 mumol/l); p 15.67 mumol/l) was higher in the coronary group (15.7%) than in the controls (2.5%). A significant relationship was also observed between homocystein concentrations and the severity of the coronary disease (defined by a coronary score) and the number of diseased vascular territories. These results underline the relationship between homocystein and vascular risk, especially that of coronary artery disease. The treatment of hyperhomocysteinaemia by folic acid supplements is effective in correcting plasma levels, without side effects and at a relatively low cost.

ABO Blood Group and Risk of Thromboembolic and Arterial Disease

DEFF Research Database (Denmark)

Vasan, Senthil K; Rostgaard, Klaus; Majeed, Ammar

2016-01-01

BACKGROUND: ABO blood groups have been shown to be associated with increased risks of venous thromboembolic and arterial disease. However, the reported magnitude of this association is inconsistent and is based on evidence from small-scale studies. METHODS AND RESULTS: We used the SCANDAT2...... (Scandinavian Donations and Transfusions) database of blood donors linked with other nationwide health data registers to investigate the association between ABO blood groups and the incidence of first and recurrent venous thromboembolic and arterial events. Blood donors in Denmark and Sweden between 1987......-up. Compared with blood group O, non-O blood groups were associated with higher incidence of both venous and arterial thromboembolic events. The highest rate ratios were observed for pregnancy-related venous thromboembolism (incidence rate ratio, 2.22; 95% confidence interval, 1.77-2.79), deep vein thrombosis...

Gender differences in the prevalence of coronary artery tortuosity and its association with coronary artery disease

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Joseph Chiha

2017-03-01

Conclusion: There is a significant relationship between coronary artery tortuosity and gender. Women with severe tortuosity are more likely to have normal coronary arteries or less severe disease than men despite presenting with chest pain.

Challenges associated with peripheral arterial disease in women

Directory of Open Access Journals (Sweden)

Barochiner J

2014-03-01

Full Text Available Jessica Barochiner, Lucas S Aparicio, Gabriel D Waisman Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina Abstract: Peripheral arterial disease (PAD is an increasingly recognized disorder that is associated with functional impairment, quality-of-life deterioration, increased risk of cardiovascular ischemic events, and increased risk of total and cardiovascular mortality. Although earlier studies suggested that PAD was more common in men, recent reports based on more sensitive tests have shown that the prevalence of PAD in women is at least the same as in men, if not higher. PAD tends to present itself asymptomatically or with atypical symptoms more frequently in women than in men, and is associated with comorbidities or situations particularly or exclusively found in the female sex, such as osteoporosis, hypothyroidism, the use of oral contraceptives, and a history of complications during pregnancy. Fat-distribution patterns and differential vascular characteristics in women may influence the interpretation of diagnostic methods, whereas sex-related vulnerability to drugs typically used in subjects with PAD, differences in risk-factor distribution among sexes, and distinct responses to revascularization procedures in men and women must be taken into account for proper disease management. All these issues pose important challenges associated with PAD in women. Of note, this group has classically been underrepresented in research studies. As a consequence, several sex-related challenges regarding diagnosis and management issues should be acknowledged, and research gaps should be addressed in order to successfully deal with this major health issue. Keywords: peripheral arterial disease, women, diagnosis, management

A simplified approach for evaluating multiple test outcomes and multiple disease states in relation to the exercise thallium-201 stress test in suspected coronary artery disease

International Nuclear Information System (INIS)

Pollock, S.G.; Watson, D.D.; Gibson, R.S.; Beller, G.A.; Kaul, S.

1989-01-01

This study describes a simplified approach for the interpretation of electrocardiographic and thallium-201 imaging data derived from the same patient during exercise. The 383 patients in this study had also undergone selective coronary arteriography within 3 months of the exercise test. This matrix approach allows for multiple test outcomes (both tests positive, both negative, 1 test positive and 1 negative) and multiple disease states (no coronary artery disease vs 1-vessel vs multivessel coronary artery disease). Because this approach analyzes the results of 2 test outcomes simultaneously rather than serially, it also negates the lack of test independence, if such an effect is present. It is also demonstrated that ST-segment depression on the electrocardiogram and defects on initial thallium-201 images provide conditionally independent information regarding the presence of coronary artery disease in patients without prior myocardial infarction. In contrast, ST-segment depression on the electrocardiogram and redistribution on the delayed thallium-201 images may not provide totally independent information regarding the presence of exercise-induced ischemia in patients with or without myocardial infarction

GATA2 is associated with familial early-onset coronary artery disease.

Directory of Open Access Journals (Sweden)

Jessica J Connelly

2006-08-01

Full Text Available The transcription factor GATA2 plays an essential role in the establishment and maintenance of adult hematopoiesis. It is expressed in hematopoietic stem cells, as well as the cells that make up the aortic vasculature, namely aortic endothelial cells and smooth muscle cells. We have shown that GATA2 expression is predictive of location within the thoracic aorta; location is suggested to be a surrogate for disease susceptibility. The GATA2 gene maps beneath the Chromosome 3q linkage peak from our family-based sample set (GENECARD study of early-onset coronary artery disease. Given these observations, we investigated the relationship of several known and novel polymorphisms within GATA2 to coronary artery disease. We identified five single nucleotide polymorphisms that were significantly associated with early-onset coronary artery disease in GENECARD. These results were validated by identifying significant association of two of these single nucleotide polymorphisms in an independent case-control sample set that was phenotypically similar to the GENECARD families. These observations identify GATA2 as a novel susceptibility gene for coronary artery disease and suggest that the study of this transcription factor and its downstream targets may uncover a regulatory network important for coronary artery disease inheritance.

Haemodynamic evaluation of carotid artery disease

DEFF Research Database (Denmark)

Sillesen, H; Schroeder, T

1989-01-01

Cerebral ischaemia in the region of an internal carotid artery (ICA) stenosis may be caused by embolism or cerebral hypoperfusion. A severe ICA stenosis may be well compensated by collateral blood supply, however, in some patients the capacity of the collateral blood supply is insufficient. Studies...... evaluating therapeutic modalities or natural history of carotid artery disease should therefore include a test capable of assessing cerebral haemodynamics. However, most studies, invasive as well as non-invasive, have focused on the ability of the test to diagnose the ICA lesions itself, rather than...

Circulating tocopherols and risk of coronary artery disease: A systematic review and meta-analysis.

Science.gov (United States)

Li, Guangxiao; Li, Ying; Chen, Xin; Sun, Hao; Hou, Xiaowen; Shi, Jingpu

2016-05-01

Circulating level of tocopherols was supposed to be associated with risk of coronary artery disease. However, the results from previous studies remain controversial. Therefore, we conducted a meta-analysis based on observational studies to evaluate the association between circulating tocopherols and coronary artery disease risk for the first time. Meta-analysis. PubMed, Embase and Cochrane databases were searched to retrieve articles published during January 1995 and May 2015. Articles were included if they provided sufficient information to calculate the weighted mean difference and its corresponding 95% confidence interval. Circulating level of total tocopherols was significantly lower in coronary artery disease patients than that in controls (weighted mean difference -4.33 μmol/l, 95% confidence interval -6.74 to -1.91, P tocopherol alone was not significantly associated with coronary artery disease risk. Results from subgroup analyses showed that a lower level of circulating total tocopherols was merely associated with higher coronary artery disease risk in studies with higher sex ratio in cases (tocopherols was associated with early onset coronary artery disease rather than late onset coronary artery disease (tocopherols when the studies were stratified by matching status and assay methods. Our findings suggest that a deficiency in circulating total tocopherols might be associated with higher coronary artery disease risk. Whereas circulating α-tocopherol alone could not protect us from developing coronary artery disease. Further prospective studies were warranted to confirm our findings. © The European Society of Cardiology 2015.

Contemporary Management of Patients with Concomitant Coronary and Carotid Artery Disease.

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Poi, Mun J; Echeverria, Angela; Lin, Peter H

2018-01-01

The ideal management of concomitant carotid and coronary artery occlusive disease remains elusive. Although researchers have advocated the potential benefits of varying treatment strategies based on either concomitant or staged surgical treatment, there is no consensus in treatment guidelines among national or international clinical societies. Clinical studies show that coronary artery bypass grafting (CABG) with either staged or synchronous carotid endarterectomy (CEA) is associated with a high procedural stroke or death rate. Recent clinical studies have found carotid artery stenting (CAS) prior to CABG can lead to superior treatment outcomes in asymptomatic patients who are deemed high risk of CEA. With emerging data suggesting favorable outcome of CAS compared to CEA in patients with critical coronary artery disease, physicians must consider these diverging therapeutic options when treating patients with concurrent carotid and coronary disease. This review examines the available clinical data on therapeutic strategies in patients with concomitant carotid and coronary artery disease. A treatment paradigm for considering CAS or CEA as well as CABG and percutaneous coronary intervention is discussed.

Scintigraphic anatomy of coronary artery disease in digital thallium-201 myocardial images

International Nuclear Information System (INIS)

Wainwright, R.J.

1981-01-01

One hundred and eight patients with single and multiple vessel coronary artery disease confirmed by arteriography were evaluated by exercise thallium-201 ( 201 Tl) myocardial scintigraphy to determine the scintigraphic appearances of specific coronary stenoses. In general proximal stenoses caused more widespread, but not necessarily more severe, myocardial tracer deficit, than distal stenoses. In particular, proximal dominant right coronary artery disease was specifically associated with extensive inferior wall tracer deficit in the anterior scintigram, whereas proximal left circumflex disease caused similar tracer depletion best visualised in the left lateral scintigram. A triad of uptake defects was caused by left anterior descending coronary artery disease; one of these defects called 'diagonal window tracer deficit' was the most useful scintigraphic sign distinguishing proximal from distal disease in the left anterior descending coronary artery. Certain scintigraphic patterns of 201 Tl myocardial accumulation appear invaluable in the noninvasive localisation of stenoses within specific coronary arteries and thus may be useful in predicting life-threatening coronary artery disease which should be confirmed by definitive coronary arteriography. The digital 201 Tl myocardial scintigram also provides an independent functional guide to the interpretation of coronary arteriograms and may be helpful in the planning of aortocoronary bypass graft surgery. (author)

Carotid disease in diabetic patients undergoing coronary artery bypass grafting

International Nuclear Information System (INIS)

Shahid, M.; Abid, A.R.; Dar, M.A.; Noeman, A.; Amin, S.; Azhar, M.

2012-01-01

Objective: To compare the severity of carotid artery disease in diabetic and non-diabetic patients undergoing coronary artery bypass grafting. Methods: From January to June 2008, 379 patients undergoing elective coronary artery bypass surgery were preoperatively evaluated for the presence of carotid stenoses by duplex scanning. Patients were divided into two groups, Group I, 156 (41.2%) diabetic patients and Group II, 223 (58.8%) non-diabetic patients. Results: There were 314 (82.8%) males and 65 (17.2%) females with a mean age of 57.2+-9.1 years. In diabetic group there were 125 (80.1%) males and 31 (19.9%) females with a mean age of 56.3+-8.9 years. Left main stem stenosis was present in 59 (37.8%) diabetics and 45 (20.2%) non-diabetics (p 70% stenosis was present in 20 (5.3%) with 13 (8.3%) diabetics and 7 (3.1%) non-diabetics (p<0.025). Stenosis of 50-70% was observed in 30 (7.9%) of which 17 (10.9%) were diabetics and 13 (5.8%) were non-diabetics. Conclusion: Presence of diabetes mellitus is associated with diffuse coronary artery disease and significant carotid artery disease in patients undergoing coronary artery bypass grafting. (author)

IgG4-related cardiovascular disease. The emerging role of cardiovascular imaging.

Science.gov (United States)

Mavrogeni, Sophie; Markousis-Mavrogenis, George; Kolovou, Genovefa

2017-01-01

Immunoglobulin 4-related disease (IgG4-related disease) is a systemic inflammatory disease that presents with increases of serum IgG4. It may affect various systems, including the cardiovascular (CV) system. Assessment of serum IgG4 levels and involved organ biopsy are necessary for diagnosis. IgG4-related disease is characterized by fibrosclerosis, lymphocytic infiltration and presence of IgG4-positive plasma cells. The disease usually responds to treatment with corticosteroids and/or immunosuppressive medication. CV involvement may manifest as cardiac pseudotumors, inflammatory periaortitis, coronary arteritis and/or pericarditis. IgG4-related cardiovascular disorders can severely affect patient prognosis. Various imaging techniques, including echocardiography, Computed Tomography (CT), 18FDG-PET, Cardiovascular Magnetic Resonance (CMR) and cardiac catheterisation, have been successfully used for early disease detection and follow-up. Echocardiography and vascular ultrasound are the most commonly used non-invasive, non-radiating imaging techniques for the evaluation of IgG4-related CV disease. Periaortitis/periarteritis can be also assessed by CT, showing a soft tissue thickening around arteries. Coronary artery aneurysms can be easily diagnosed by coronary CT. In case of active periarterial or coronary artery inflammation, 18FDG-PET will show FDG uptake at the area of the lesion. CMR, due to its capability to perform function and tissue characterisation, can offer an integrated imaging of aorta, coronary arteries and the heart, assessment of disease acuity, extent of fibrosis and guide further treatment. However, multimodality imaging may be necessary for assessment of disease activity and fibrosis extent in those cases with multifocal CV involvement. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Imaging popliteal artery disease in young adults with claudication: self-assessment module.

Science.gov (United States)

Chew, Felix S; Bui-Mansfield, Liem T

2007-09-01

The educational objectives of this self-assessment module on imaging popliteal artery disease in young adults with intermittent claudication are for the participant to exercise, self-assess, and improve his or her knowledge of the imaging and clinical features of popliteal artery entrapment syndrome, cystic adventitial disease,and masses associated with popliteal artery obstruction.

Risk prediction and risk reduction in patients with manifest arterial disease

NARCIS (Netherlands)

Goessens, B.M.B.; Goessens, B.M.B.

2006-01-01

Risicovoorspelling en risicoverlaging bij patienten met manifest vaatlijden Engelstalig abstract The number of patients with clinical manifest arterial disease is increasing because of the aging of the population. Patients with manifest arterial disease have an increased risk of a new vascular event

Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease

DEFF Research Database (Denmark)

Anand, Sonia S; Bosch, Jackie; Eikelboom, John W

2018-01-01

BACKGROUND: Patients with peripheral artery disease have an increased risk of cardiovascular morbidity and mortality. Antiplatelet agents are widely used to reduce these complications. METHODS: This was a multicentre, double-blind, randomised placebo-controlled trial for which patients were...... recruited at 602 hospitals, clinics, or community practices from 33 countries across six continents. Eligible patients had a history of peripheral artery disease of the lower extremities (previous peripheral bypass surgery or angioplasty, limb or foot amputation, intermittent claudication with objective...... evidence of peripheral artery disease), of the carotid arteries (previous carotid artery revascularisation or asymptomatic carotid artery stenosis of at least 50%), or coronary artery disease with an ankle-brachial index of less than 0·90. After a 30-day run-in period, patients were randomly assigned (1...

Frequency of undiagnosed chronic obstructive pulmonary disease in patients with coronary artery disease

International Nuclear Information System (INIS)

Ullah, R.; Ghaffar, T.; Khan, I.; Muhammad, R.; Salman, S.

2017-01-01

Chronic obstructive airway disease (COPD) is considered as risk factor for coronary artery disease (CAD) along with other risk factors. This study was conducted to determine the frequency of undiagnosed chronic obstructive pulmonary disease in patients with coronary artery disease. Methods: This cross-sectional study was conducted in the Pulmonology and Cardiology wards/OPD's of Khyber Teaching Hospital Peshawar. Patients more than 35 years of age, diagnosed with CAD of either gender were included. Patients already diagnosed with COPD, recent myocardial infarction (within 7 days), left ventricular impairment, pneumothorax, bronchiectasis, comatose patient, asthmatic and those with chest trauma were excluded. All the patients underwent spirometry examination before and after administration of salbutamol (5 mg for 5 minutes) via nebulizer. FEV1/FVC less than 70% confirmed the presence of COPD. Results: Out of 151 patients, 57 (37.7%) were found to have COPD. Among them, 39 (68.42%) were male and 18 (31.57%) were female. Among male patients with COPD, 82.05% (n=32) were smokers and 17.94% (n=7) were nonsmokers while in females with COPD no one was smoker. Conclusion: COPD is an under-diagnosed progressive disease in patients with high risk patients with coronary artery disease. (author)

Relative risk of hypertension and coronary artery disease in diabetes mellitus

International Nuclear Information System (INIS)

Chaudhary, G.M.D.

2001-01-01

During the year 1996-1997, 3275 diabetic patients, registered in Diabetic Clinic of Jinnah Hospital, Lahore, were studied to note the effect of various variables of diabetes mellitus (DM) on hypertension (HTN) and coronary artery diseases (CAD). Out of these 1402 (42.8%) were hypertensive patients. HTN was observed more frequently in obese, older age, longer duration of DM, poor glycemic control and dyslipidemia with p<0.0001. The relative risk (RR) of HTN was significantly increased (p<0.001) in obese (M2.53, F7.77 times), older age (M 3.69,F 9.64 times), longer duration of Dm (2.3 times for both sexes), poor glycemic control (M 2.89, F 4.75 times) and dyslipedemia (M 1.62-5.27, F2.56-9.53 times). While the RR of CAD due to HTN was 4.6 times (M5.4, F4.2 times) (p<0.0001) as compared to normotensive diabetic patients. The risk of developing HTN is more in female diabetics and of CAD in male hypertensive diabetic patients. It is concluded that obesity, older age, poor glycemic control, longer duration of DM and dyslipidemia increases the risk of HTN 2-9.5 times and HTN increases the risk of CAD by 4-5 times, hence requiring aggressive and comprehensive treatment of the diabetes mellitus syndrome. (author)

Relative risk of hypertension and coronary artery disease in diabetes mellitus

Energy Technology Data Exchange (ETDEWEB)

Chaudhary, G M.D. [Nishter Medical Coll., Multan (Pakistan). Dept. of Medicine

2001-03-01

During the year 1996-1997, 3275 diabetic patients, registered in Diabetic Clinic of Jinnah Hospital, Lahore, were studied to note the effect of various variables of diabetes mellitus (DM) on hypertension (HTN) and coronary artery diseases (CAD). Out of these 1402 (42.8%) were hypertensive patients. HTN was observed more frequently in obese, older age, longer duration of DM, poor glycemic control and dyslipidemia with p<0.0001. The relative risk (RR) of HTN was significantly increased (p<0.001) in obese (M2.53, F7.77 times), older age (M 3.69,F 9.64 times), longer duration of Dm (2.3 times for both sexes), poor glycemic control (M 2.89, F 4.75 times) and dyslipedemia (M 1.62-5.27, F2.56-9.53 times). While the RR of CAD due to HTN was 4.6 times (M5.4, F4.2 times) (p<0.0001) as compared to normotensive diabetic patients. The risk of developing HTN is more in female diabetics and of CAD in male hypertensive diabetic patients. It is concluded that obesity, older age, poor glycemic control, longer duration of DM and dyslipidemia increases the risk of HTN 2-9.5 times and HTN increases the risk of CAD by 4-5 times, hence requiring aggressive and comprehensive treatment of the diabetes mellitus syndrome. (author)

IgG4-related cardiovascular disease. The emerging role of cardiovascular imaging

Energy Technology Data Exchange (ETDEWEB)

Mavrogeni, Sophie, E-mail: soma13@otenet.gr; Markousis-Mavrogenis, George; Kolovou, Genovefa

2017-01-15

Highlights: • Assessment of serum IgG4 levels and involved organ biopsy are necessary for diagnosis of IgG4-related disease. • CV involvement may manifest as cardiac pseudotumors, inflammatory periaortitis, coronary arteritis and/or pericarditis. • Echocardiography and vascular ultrasound are the most commonly used non-invasive, non-radiating imaging techniques. • CT can assess periarteritis and coronary artery aneurysms, while 18FDG-PET shows FDG uptake at the area of the lesion. • CMR offers an integrated imaging of CV system, including assessment of disease acuity, extent of fibrosis and can guide further treatment. - Abstract: Immunoglobulin 4-related disease (IgG4-related disease) is a systemic inflammatory disease that presents with increases of serum IgG4. It may affect various systems, including the cardiovascular (CV) system. Assessment of serum IgG4 levels and involved organ biopsy are necessary for diagnosis. IgG4-related disease is characterized by fibrosclerosis, lymphocytic infiltration and presence of IgG4-positive plasma cells. The disease usually responds to treatment with corticosteroids and/or immunosuppressive medication. CV involvement may manifest as cardiac pseudotumors, inflammatory periaortitis, coronary arteritis and/or pericarditis. IgG4-related cardiovascular disorders can severely affect patient prognosis. Various imaging techniques, including echocardiography, Computed Tomography (CT), 18FDG-PET, Cardiovascular Magnetic Resonance (CMR) and cardiac catheterisation, have been successfully used for early disease detection and follow-up. Echocardiography and vascular ultrasound are the most commonly used non-invasive, non-radiating imaging techniques for the evaluation of IgG4-related CV disease. Periaortitis/periarteritis can be also assessed by CT, showing a soft tissue thickening around arteries. Coronary artery aneurysms can be easily diagnosed by coronary CT. In case of active periarterial or coronary artery inflammation, 18

IgG4-related cardiovascular disease. The emerging role of cardiovascular imaging

International Nuclear Information System (INIS)

Mavrogeni, Sophie; Markousis-Mavrogenis, George; Kolovou, Genovefa

2017-01-01

Highlights: • Assessment of serum IgG4 levels and involved organ biopsy are necessary for diagnosis of IgG4-related disease. • CV involvement may manifest as cardiac pseudotumors, inflammatory periaortitis, coronary arteritis and/or pericarditis. • Echocardiography and vascular ultrasound are the most commonly used non-invasive, non-radiating imaging techniques. • CT can assess periarteritis and coronary artery aneurysms, while 18FDG-PET shows FDG uptake at the area of the lesion. • CMR offers an integrated imaging of CV system, including assessment of disease acuity, extent of fibrosis and can guide further treatment. - Abstract: Immunoglobulin 4-related disease (IgG4-related disease) is a systemic inflammatory disease that presents with increases of serum IgG4. It may affect various systems, including the cardiovascular (CV) system. Assessment of serum IgG4 levels and involved organ biopsy are necessary for diagnosis. IgG4-related disease is characterized by fibrosclerosis, lymphocytic infiltration and presence of IgG4-positive plasma cells. The disease usually responds to treatment with corticosteroids and/or immunosuppressive medication. CV involvement may manifest as cardiac pseudotumors, inflammatory periaortitis, coronary arteritis and/or pericarditis. IgG4-related cardiovascular disorders can severely affect patient prognosis. Various imaging techniques, including echocardiography, Computed Tomography (CT), 18FDG-PET, Cardiovascular Magnetic Resonance (CMR) and cardiac catheterisation, have been successfully used for early disease detection and follow-up. Echocardiography and vascular ultrasound are the most commonly used non-invasive, non-radiating imaging techniques for the evaluation of IgG4-related CV disease. Periaortitis/periarteritis can be also assessed by CT, showing a soft tissue thickening around arteries. Coronary artery aneurysms can be easily diagnosed by coronary CT. In case of active periarterial or coronary artery inflammation, 18

Coronary artery disease risk in young women with polycystic ovary syndrome.

Science.gov (United States)

Ding, Dah-Ching; Tsai, I-Ju; Wang, Jen-Hung; Lin, Shinn-Zong; Sung, Fung-Chang

2018-02-02

Women with polycystic ovary syndrome are characterized by obesity, menstruation irregularity, hirsutism and infertility, and prevalent with cardiometabolic comorbidities, but population-based studies on the risk of developing coronary artery disease are limited. From claims data of the Taiwan National Health Insurance, we identified 8048 women with polycystic ovary syndrome aged 15-49 years newly diagnosed in 1998-2013, and 32192 women without the syndrome and CAD as controls, frequency matched by age and diagnosis date. By the end of 2013, after a mean follow-up period of 5.9 years, the overall incidence of coronary artery disease was 63% higher in women with polycystic ovary syndrome than in controls (2.25 vs. 1.38 per 1000 person-years). The adjusted hazard ratio [aHR] of coronary artery disease was 1.44 (95% confidence interval (CI) = 1.14-1.81) for women with polycystic ovary syndrome, compared with controls. Hazards of coronary artery disease were significant during follow-up periods of 3-4 years (aHR = 1.52, 95% CI = 1.00-2.30) and of 5-9 years (aHR = 1.58, 95% CI = 1.07-2.32). The incidence of coronary artery disease increased further in those with cardiometabolic comorbidities. Among women with polycystic ovary syndrome, those with comorbid diabetes had an incidence of 35.2 per 1000 person-years, 20-fold greater than those without cardiometabolic comorbidities. In conclusion, women with polycystic ovary syndrome are at an elevated risk of coronary artery disease. Preventive interventions should be provided to them, particularly for those with the comorbidity of metabolism symptom.

Computerized analysis of coronary artery disease: Performance evaluation of segmentation and tracking of coronary arteries in CT angiograms

Energy Technology Data Exchange (ETDEWEB)

Zhou, Chuan, E-mail: chuan@umich.edu; Chan, Heang-Ping; Chughtai, Aamer; Kuriakose, Jean; Agarwal, Prachi; Kazerooni, Ella A.; Hadjiiski, Lubomir M.; Patel, Smita; Wei, Jun [Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109 (United States)

2014-08-15

Purpose: The authors are developing a computer-aided detection system to assist radiologists in analysis of coronary artery disease in coronary CT angiograms (cCTA). This study evaluated the accuracy of the authors’ coronary artery segmentation and tracking method which are the essential steps to define the search space for the detection of atherosclerotic plaques. Methods: The heart region in cCTA is segmented and the vascular structures are enhanced using the authors’ multiscale coronary artery response (MSCAR) method that performed 3D multiscale filtering and analysis of the eigenvalues of Hessian matrices. Starting from seed points at the origins of the left and right coronary arteries, a 3D rolling balloon region growing (RBG) method that adapts to the local vessel size segmented and tracked each of the coronary arteries and identifies the branches along the tracked vessels. The branches are queued and subsequently tracked until the queue is exhausted. With Institutional Review Board approval, 62 cCTA were collected retrospectively from the authors’ patient files. Three experienced cardiothoracic radiologists manually tracked and marked center points of the coronary arteries as reference standard following the 17-segment model that includes clinically significant coronary arteries. Two radiologists visually examined the computer-segmented vessels and marked the mistakenly tracked veins and noisy structures as false positives (FPs). For the 62 cases, the radiologists marked a total of 10191 center points on 865 visible coronary artery segments. Results: The computer-segmented vessels overlapped with 83.6% (8520/10191) of the center points. Relative to the 865 radiologist-marked segments, the sensitivity reached 91.9% (795/865) if a true positive is defined as a computer-segmented vessel that overlapped with at least 10% of the reference center points marked on the segment. When the overlap threshold is increased to 50% and 100%, the sensitivities were 86

A Variant in COX-2 Gene Is Associated with Left Main Coronary Artery Disease and Clinical Outcomes of Coronary Artery Bypass Grafting

Directory of Open Access Journals (Sweden)

Hanning Liu

2017-01-01

Full Text Available As a particular severe phenotype of coronary artery disease (CAD, left main coronary artery disease (LMCAD is heritable. Genetic variants related to prostaglandin metabolism are associated with LMCAD. Cyclooxygenase-2 (COX-2, a key synthase in prostaglandin pathways, displays high density in atherosclerotic lesions and promotes early atherosclerosis in CAD progression. We hypothesized that genetic variants in COX-2 gene contribute to LMCAD phenotype susceptibility compared to more peripheral coronary artery disease (MPCAD. In this study, we genotyped COX-2 rs5275, rs5277, and rs689466 of 1544 CAD patients undergoing coronary artery bypass grafting (CABG and found that rs5277 C allele carriage was associated with LMCAD (adjusted OR: 1.590; 95% CI: 1.103~2.291; p=0.013. Furtherly, long-term follow-up data suggested that rs5277 C allele carriage increased risk of major adverse cardiac and cerebrovascular events (MACCE in the whole cohort (adjusted HR: 1.561; 95% CI: 1.025~2.377; p=0.038 and LMCAD subgroup (adjusted HR: 2.014; 95% CI: 1.036~3.913; p=0.039 but not in MPCAD subgroup (adjusted HR: 1.375; 95% CI: 0.791~2.392; p=0.259. In conclusion, we demonstrate that COX-2 rs5277 C allele increases the risk of left main coronary artery lesion and is also correlated with poor prognosis of LMCAD patients with CABG therapy.

[Risk management of coronary artery disease--pharmacological therapy].

Science.gov (United States)

Hofmann, Thomas

2004-06-01

Treatment of coronary artery disease primarily aims at reducing the severity and frequency of cardiac symptoms and improving prognosis. Both goals can be achieved by the administration of beta-receptor blockers, which are now used as first-line therapy in these patients. Calcium channel blockers or nitrates should be given in the event of contraindications or severe intolerance to beta-receptor blocking therapy. Only long-acting calcium channel blockers should be used in this setting. Another indication for additional treatment with calcium channel blockers and nitrates is given when the efficacy of beta-blocker therapy is not sufficient to relieve symptoms. Nitroglycerin and nitrates are the drugs of choice for the treatment of the acute angina pectoris attack. Calcium channel blockers are used as first-line treatment in patients with vasospastic angina. In patients with syndrome X, nitrates as well as calcium channel blockers or beta-receptor blockers can be administered. In the absence of contraindications, every patient with coronary artery disease should be given aspirin. A daily dosage of 75 to 150 mg is sufficient to reduce the rate of future cardiac events. Clopidogrel should be given in every patient with intolerance or contraindications for aspirin. Increased plasma homocystein levels seem to be a risk factor for coronary artery disease. Homocystein levels can be reduced by dietary means as well as supplementation of folic acid or vitamin B complex. There is no evidence from controlled randomised studies that a decrease of homocystein is beneficial for the prognosis of patients with coronary artery disease.

Arterial spin labelling reveals prolonged arterial arrival time in idiopathic Parkinson's disease.

Science.gov (United States)

Al-Bachari, Sarah; Parkes, Laura M; Vidyasagar, Rishma; Hanby, Martha F; Tharaken, Vivek; Leroi, Iracema; Emsley, Hedley C A

2014-01-01

Idiopathic Parkinson's disease (IPD) is the second most common neurodegenerative disease, yet effective disease modifying treatments are still lacking. Neurodegeneration involves multiple interacting pathological pathways. The extent to which neurovascular mechanisms are involved is not well defined in IPD. We aimed to determine whether novel magnetic resonance imaging (MRI) techniques, including arterial spin labelling (ASL) quantification of cerebral perfusion, can reveal altered neurovascular status (NVS) in IPD. Fourteen participants with IPD (mean ± SD age 65.1 ± 5.9 years) and 14 age and cardiovascular risk factor matched control participants (mean ± SD age 64.6 ± 4.2 years) underwent a 3T MRI scan protocol. ASL images were collected before, during and after a 6 minute hypercapnic challenge. FLAIR images were used to determine white matter lesion score. Quantitative images of cerebral blood flow (CBF) and arterial arrival time (AAT) were calculated from the ASL data both at rest and during hypercapnia. Cerebrovascular reactivity (CVR) images were calculated, depicting the change in CBF and AAT relative to the change in end-tidal CO2. A significant (p = 0.005) increase in whole brain averaged baseline AAT was observed in IPD participants (mean ± SD age 1532 ± 138 ms) compared to controls (mean ± SD age 1335 ± 165 ms). Voxel-wise analysis revealed this to be widespread across the brain. However, there were no statistically significant differences in white matter lesion score, CBF, or CVR between patients and controls. Regional CBF, but not AAT, in the IPD group was found to correlate positively with Montreal cognitive assessment (MoCA) scores. These findings provide further evidence of alterations in NVS in IPD.

Should the patient with coronary artery disease use sildenafil?

Science.gov (United States)

Cheitlin, Melvin D

2003-01-01

Since the etiology of erectile dysfunction is frequently related to endothelial dysfunction, a problem in common with much vascular disease, erectile dysfunction disproportionately affects patients with cardiovascular disease. With the development of phosphodiesterase 5 inhibitors, the first of which was sildenafil (Viagra), an effective oral medication became available. The question of safety of these drugs, especially in patients with latent or overt coronary artery disease, is of concern. Sildenafil relaxes smooth muscle and therefore lowers systolic and diastolic blood pressure slightly. With organic nitrates, the drop in blood pressure is potentiated, at times dangerously, thereby making it contraindicated to take nitrates within 24 hours of using sildenafil. In double-blind, placebo-controlled trials, there was no difference between sildenafil subjects and control patients in the incidence of myocardial infarction, cardiovascular, and total deaths. Coronary disease patients with stable angina, controlled on medications, were included in the trials. Therefore, sildenafil, as a drug, is safe in such patients. With a patient with coronary artery disease suddenly engaging in the physical exercise associated with sexual intercourse, there is the danger of increased risk of precipitating myocardial infarction or death. The cardiovascular metabolic cost of sexual activity is reviewed and appears to be approximately at the level of 3-5 metabolic equivalents of exercise. Sexual activity occurs within 2 hours of the onset of an acute myocardial infarction in life will be markedly improved by their ability to engage in sexual activity.

Physiological assessment of sensitivity of noninvasive testing for coronary artery disease

International Nuclear Information System (INIS)

Simonetti, I.; Rezai, K.; Rossen, J.D.; Winniford, M.D.; Talman, C.L.; Hollenberg, M.; Kirchner, P.T.; Marcus, M.L.

1991-01-01

The sensitivity of three noninvasive tests for coronary artery disease was assessed by means of quantitative indexes of disease severity in three different groups of patients. The overall population consisted of 110 subjects with limited coronary artery disease and no myocardial infarction. Planar dipyridamole- 201 Tl scintigraphy was evaluated in 31 patients, computer-assisted exercise treadmill in 28, and high-dose dipyridamole echocardiography testing in 51. Sensitivity was assessed by rigorous gold standards to define disease severity, such as measurement of minimum cross-sectional area and percent area of stenosis, by quantitative computerized coronary angiography (Brown/Dodge method). On the basis of the results of previous studies, the presence of physiologically significant coronary artery disease was indicated by a stenotic minimum cross-sectional area (MCSA) of less than 2.0 mm 2 or a greater than 75% area of stenosis. With MCSA as the gold standard, dipyridamole- 201 Tl scintigraphy, computerized exercise treadmill, and dipyridamole echocardiography testing showed sensitivities of 52%, 54%, and 61%, respectively, in the three different patient cohorts enrolled. With percent area of stenosis as the gold standard, the sensitivity figures obtained for dipyridamole- 201 Tl, computerized exercise treadmill, and dipyridamole echocardiography testing were 64%, 54%, and 69%, respectively. For each of the three tests, sensitivity increased with increasing lesion severity. Sensitivity was also better in patients with left anterior descending coronary (LAD) disease when compared with patients with left circumflex or right coronary artery disease. Results of these studies demonstrate that in patients with limited coronary artery disease none of the tests evaluated is definitely superior in sensitivity

Value and limitations of segmental analysis of stress thallium myocardial imaging for localization of coronary artery disease

International Nuclear Information System (INIS)

Rigo, P.; Bailey, I.K.; Griffith, L.S.C.; Pitt, B.; Borow, R.D.; Wagner, H.N.; Becker, L.C.

1980-01-01

This study was done to determine the value of thallium-201 myocardial scintigraphic imaging (MSI) for identifying disease in the individual coronary arteries. Segmental analysis of rest and stress MSI was performed in 133 patients with ateriographically proved coronary artery disease (CAD). Certain scintigraphic segments were highly specific (97 to 100%) for the three major coronary arteries: anterior wall and septum for the left anterior descending (LAD) coronary artery; the inferior wall for the right coronary artery (RCA); and the proximal lateral wall for the circumflex (LCX) artery. Perfusion defects located in the anterolateral wall in the anterior view were highly specific for proximal disease in the LAD involving the major diagonal branches, but this was not true for septal defects. The apical segments were not specific for any of the three major vessels. Although MSI was abnormal in 89% of these patients with CAD, it was less sensitive for identifying individual vessel disease: 63% for LAD, 50% for RCA, and 21% for LCX disease (narrowings > = 50%). Sensitivity increased with the severity of stenosis, but even for 100% occlusions was only 87% for LAD, 58% for RCA and 38% for LCX. Sensitivity diminished as the number of vessels involved increased: with single-vessel disease, 80% of LAD, 54% of RAC and 33% of LCX lesions were detected, but in patients with triple-vessel disease, only 50% of LAD, 50% of RCA and 16% of LCX lesions were identified. Thus, although segmented analysis of MSI can identify disease in the individual coronary arteries with high specificity, only moderate sensitivity is achieved, reflecting the tendency of MSI to identify only the most severely ischemic area among several that may be present in a heart. Perfusion scintigrams display relative distributions rather than absolute values for myocardial blood flow

Correlation of Deviance in Arterial Oxygenation with Severity of Chronic Liver Disease

International Nuclear Information System (INIS)

Shaukat, A. A.; Zuhaid, M.

2016-01-01

Background: Hepatitis B and C related chronic liver diseases have led to development of a serious threat to the people of South Asia. The main aim of this study was to evaluate the correlation of magnitude of arterial deoxygention to the severity of liver disease. Methods: It was a hospital based cross sectional descriptive study, carried out in the Medical Department of Khyber Teaching Hospital Peshawar. All in all 115 patients were assessed for the severity of the liver diseases and were correlated with arterial deoxygenation using linear regression models. Results: Male to female ratio was 1.5:1. Males infected with hepatitis B, hepatitis C and both were 9, 60 and 1, while females suffered from hepatitis B, Hepatitis C and both were 2, 42 and 1 respectively. The linear relationship between A-a DO2 with severity of liver disease showed positive correlation while PO2 showed negative correlation with severity of liver disease. Conclusion: There was a positive correlation between A-a DO2 and severity of liver diseases while PO2 and severity of liver diseases showed negative correlation. (author)

Successful Intra-Arterial Chemotherapy for Extramammary Paget’s Disease of the Axilla in a Patient with Parkinson’s Disease

International Nuclear Information System (INIS)

Damascelli, Bruno; Ticha, Vladimira

2011-01-01

Extramammary Paget’s disease (EMPD) is a rare intraepithelial neoplasm occurring less frequently in men and even more rarely in the axilla. A 59-year-old man with severe Parkinson’s disease presented with axillary EMPD. The neurological comorbidity made treatment of the EMPD problematical and prompted us to propose locoregional intra-arterial chemotherapy in single short sessions. Two innovative chemotherapeutic macrocomplexes were used: doxorubicin incorporated in large liposomes and the taxane paclitaxel incorporated in albumin nanoparticles. A therapeutic response was seen right from the first treatment and was macroscopically close to complete after four cycles. Five months after the end of treatment the patient had minimal visible disease and had enjoyed a distinct improvement in quality of life, with no noteworthy complications related to the intra-arterial chemotherapy with percutaneous transfemoral catheterization.

Cardiac PET/CT for the diagnosis and prognostic evaluation of coronary artery disease

International Nuclear Information System (INIS)

Geronazzo, R.J.; Romero, R.L.; Campisi, R.

2014-01-01

Coronary artery disease is considered by de World Health Organization (WHO) to be pandemic. Eighty percent of the deaths occurs secondary to coronary artery disease, stroke and diabetes, thus they can be prevented. All of them are related to the same risk factors. Ischemic heart disease is the mayor cause of death in Argentina in the elderly population. Primary prevention strategies are essential in the health system. Hence, image complementary methods are very important to accomplish risk stratification, secondary prevention and pre-surgical evaluation. Nuclear cardiology has occupied this place through myocardial perfusion studies with radiopharmaceuticals, using SPECT (Single photon emission computed tomography) that have improved the level of sensitivity and specificity with ECG gated. Furthermore, positron emission tomography (PET) can evaluate relative myocardial perfusion, quantify absolute myocardial blood flow and coronary flow reserve. With its capacity to quantify rest-peak stress left ventricular systolic function we can underscore for example “balance ischemia”. By using hybrid PET/CT, also we can get information of coronary artery calcium scoring and coronary angiography. Currently, with the available softwares, we can acquire images in List mode. It means, from a single acquisition, it allows multiple image reconstructions, along with the associated electrocardiographic phase. PET/CT uses radiopharmaceuticals with short physical half life, and in conjunction with the possibility of acquiring in 3D mode, the perfusion studies can be done in a short time and offers lower radiation exposure to the patient. The new softwares for routine correction of misalignments between transmission and emission images have helped to reduce the frequency of artifacts and improve diagnostic accuracy. Hybrid PET/CT technology allows functional evaluation of myocardial perfusion combined with anatomic characterization of the epicardial coronary arteries, thereby

Association of lower extremity arterial calcification with amputation and mortality in patients with symptomatic peripheral artery disease.

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Chi-Lun Huang

Full Text Available OBJECTIVE: The clinical implication of the coronary artery calcium score (CS is well demonstrated. However, little is known about the association between lower extremity arterial calcification and clinical outcomes. METHODS AND RESULTS: Eighty-two patients with symptomatic peripheral artery disease (age 61.0±12.4 years were followed for 21±11 months. CSs, ranging from the common iliac artery bifurcation to the ankle area, were analyzed through noncontrast multidetector computed tomography images retrospectively. The primary endpoints of this study were amputation and mortality. Old age, diabetes, hyperlipidemia, and end-stage renal disease were associated with higher CSs. Patients with more advanced Fontaine stages also tended to have significantly higher CSs (p = 0.03. During the follow-up period (21±11 months, 29 (35% patients underwent amputation, and 24 (29% patients died. Among the patients who underwent amputation, there were no significant differences in CSs between the amputated legs and the non-amputated legs. In the Cox proportional hazard model with CS divided into quartiles, patients with CS in the highest quartile had a 2.88-fold (95% confidence interval [CI] 1.18-12.72, p = 0.03 and a 5.16-fold (95% CI 1.13-21.61, p = 0.04 higher risk for amputation and all-cause mortality, respectively, than those with CS in the lowest quartile. These predictive effects remained after conventional risk factor adjustment. CONCLUSION: Lower extremity arterial CSs are associated with disease severity and outcomes, including amputation and all-cause mortality, in patients with symptomatic peripheral artery disease. However, the independent predictive value needs further investigation in large scale, prospective studies.

Relationship between the arterial calcification detected in mammography and coronary artery disease

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Topal, Ugur [Department of Radiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey)], E-mail: utopal@uludag.edu.tr; Kaderli, Aysel [Department of Cardiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Topal, Naile Bolca [Department of Radiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Ozdemir, Buelent; Yesilbursa, Dilek; Cordan, Jale [Department of Cardiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Ediz, Buelent [Department of Statistics, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Aydinlar, Ali [Department of Cardiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey)

2007-09-15

Objective: Arterial calcification is frequently encountered in mammography. The frequency of breast arterial calcification (BAC) increases with increasing age. Studies have shown that BAC is seen more frequently among the people who are under the risk of coronary artery diseases (CAD) such as diabetes and hypertension. The objective of this study is to investigate the relationship between the arterial calcification detected in mammography and the CAD. Material and methods: Screening mammography was performed in 123 women above the age of 40 years who had been examined with coronary angiography for the evaluation of CAD. The presence of BAC, number of affected vessels, and the distribution of calcification in the vessel wall were evaluated in the mammography. Subjects were questioned in terms of the cardiovasculary risk factors. The severity of CAD was evaluated according to the Gensini scoring. In addition, the number of blood vessels with stenosis of more than 50% was used as the vascular score. The correlation between Gensini and the vascular scores, and BAC was statistically evaluated using Mann-Whitney U and Kruskal-Wallis tests. Results: Eighty (65%) of 123 patients had CAD. BAC was detected in the mammography of 49 (39.8%) subjects. The ages and duration of menopause of the cases with BAC were significantly higher than those without BAC (p < 0.001). There was an almost significant correlation between the BAC and Gensini scores (p = 0.059). There was a significant increase in the frequency of BAC among subjects with more than two vessels with stenosis (p = 0.033). Conclusion: Frequency of BAC increases with increasing age. BAC is also frequently seen in subjects having severe coronary artery disease. Although increasing age may be a factor increasing the frequency of BAC, BAC may also be an indicator of CAD. Therefore, the mentioning of arterial calcification in mammography reports may be important in warning the clinician in terms of CAD.

Prevalence of coronary artery disease in Japanese patients with cerebral infarction. Impact of metabolic syndrome and intracranial large artery atherosclerosis

International Nuclear Information System (INIS)

Hoshino, Atsushi; Enomoto, Satoko; Kawahito, Hiroyuki; Nakamura, Takashi; Kurata, Hiroyuki; Nakahara, Yoshifumi; Ijichi, Toshiharu

2008-01-01

Patients with cerebral infarction have a high prevalence of asymptomatic coronary artery disease (CAD) and other vascular diseases, but there is a lack of such data for Japanese patients, so the present study investigated the prevalence of cardiovascular disease (CVD) in Japanese patients and determined the predictors of CAD. The study group comprised 104 patients with cerebral infarction who had no history of CVD. All patients underwent coronary computed tomographic angiography, and systematic evaluation was done on the basis of the presence of other vascular diseases, CVD risk markers, and the degree of atherosclerosis. Of the total, 39 patients (37.5%) had CAD, 9 (8.7%) had carotid artery stenosis, 9 (8.7%) had peripheral artery disease of the lower limbs, and 3 (2.9%) had atherosclerotic renal artery stenosis. Multiple regression analysis showed that the presence of CAD was independently associated with metabolic syndrome (odds ratio (OR) 5.008, 95% confidence interval (CI) 1.538-16.309; p<0.01) and intracranial large artery atherosclerosis (OR 4.979, 95% CI 1.633-15.183; p<0.01). Japanese patients with cerebral infarction have a high prevalence of CVD, especially asymptomatic CAD. Both metabolic syndrome and intracranial large artery atherosclerosis may be potential predictors for identifying patients with cerebral infarction who are at the highest risk of asymptomatic CAD. (author)

Outcomes of coronary artery bypass grafting versus percutaneous coronary intervention with drug-eluting stents for patients with multivessel coronary artery disease.

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Javaid, Aamir; Steinberg, Daniel H; Buch, Ashesh N; Corso, Paul J; Boyce, Steven W; Pinto Slottow, Tina L; Roy, Probal K; Hill, Peter; Okabe, Teruo; Torguson, Rebecca; Smith, Kimberly A; Xue, Zhenyi; Gevorkian, Natalie; Suddath, William O; Kent, Kenneth M; Satler, Lowell F; Pichard, Augusto D; Waksman, Ron

2007-09-11

Advances in coronary artery bypass grafting (CABG) surgery and percutaneous coronary intervention (PCI) with drug-eluting stents have dramatically improved results of these procedures. The optimal treatment for patients with multivessel coronary artery disease is uncertain given the lack of prospective, randomized data reflecting current practice. This study represents a "real-world" evaluation of current technology in the treatment of multivessel coronary artery disease. A total of 1680 patients undergoing revascularization for multivessel coronary artery disease were identified. Of these, 1080 patients were treated for 2-vessel disease (196 CABG and 884 PCI) and 600 for 3-vessel disease (505 CABG and 95 PCI). One-year mortality, cerebrovascular events, Q-wave myocardial infarction, target vessel failure, and composite major adverse cardiovascular and cerebrovascular events were compared between the CABG and PCI cohorts. Outcomes were adjusted for baseline covariates and reported as hazard ratios. The unadjusted major adverse cardiovascular and cerebrovascular event rate was reduced with CABG for patients with 2-vessel disease (9.7% CABG versus 21.2% PCI; P<0.001) and 3-vessel disease (10.8% CABG versus 28.4% PCI; P<0.001). Adjusted outcomes showed increased major adverse cardiovascular and cerebrovascular event with PCI for patients with 2-vessel (hazard ratio 2.29; 95% CI 1.39 to 3.76; P=0.01) and 3-vessel disease (hazard ratio 2.90; 95% CI 1.76 to 4.78; P<0.001). Adjusted outcomes for the nondiabetic subpopulation demonstrated equivalent major adverse cardiovascular and cerebrovascular event with PCI for 2-vessel (hazard ratio 1.77; 95% CI 0.96 to 3.25; P=0.07) and 3-vessel disease (hazard ratio 1.70; 95% CI 0.77 to 3.61; P=0.19). Compared with PCI with drug-eluting stents, CABG resulted in improved major adverse cardiovascular and cerebrovascular event in patients with 2- and 3-vessel coronary artery disease, primarily in those with underlying diabetes

Oral Health and Coronary Artery Disease, A Review Article

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Alireza Rostami

2016-03-01

Full Text Available Atherosclerosis is the most common cause of myocardial infarction and ischemic stroke. Various risk factors have been identified for atherosclerosis. Recently, bacterial and viral organisms, which are involved in chronic inflammatory processes, have been also implicated in atherosclerosis development. Individuals with a prior history of periodontal diseases and/or tooth loss are considered to be at a higher risk for peripheral arterial disease, compared to those without periodontal diseases or tooth loss. Evidence suggests that periodontitis contributes to the overall burden of infection and inflammation and may lead to cardiovascular events and stroke in susceptible patients. In this article, we aimed to review the available data on the relationship between periodontal diseases and cardiovascular diseases, especially coronary artery disease. At least sixty papers were reviewed during 2014-15. Of these, 44 were included in our study.

Dynamic contrast-enhanced ultrasound and transient arterial occlusion for quantification of arterial perfusion reserve in peripheral arterial disease

International Nuclear Information System (INIS)

Amarteifio, E.; Wormsbecher, S.; Krix, M.; Demirel, S.; Braun, S.; Delorme, S.; Böckler, D.; Kauczor, H.-U.; Weber, M.-A.

2012-01-01

Objective: To quantify muscular micro-perfusion and arterial perfusion reserve in peripheral arterial disease (PAD) with dynamic contrast-enhanced ultrasound (CEUS) and transient arterial occlusion. Materials and methods: This study had local institutional review board approval and written informed consent was obtained from all subjects. We examined the dominant lower leg of 40 PAD Fontaine stage IIb patients (mean age, 65 years) and 40 healthy volunteers (mean age, 54 years) with CEUS (7 MHz; MI, 0.28) during continuous intravenous infusion of 4.8 mL microbubbles. Transient arterial occlusion at mid-thigh level simulated physical exercise. With time–CEUS–intensity curves obtained from regions of interest within calf muscles, we derived the maximum CEUS signal after occlusion (max) and its time (t max ), slope to maximum (m), vascular response after occlusion (AUC post ), and analysed accuracy, receiver operating characteristic (ROC) curves, and correlations with ankle-brachial index (ABI) and walking distance. Results: All parameters differed in PAD and volunteers (p max was delayed (31.2 ± 13.6 vs. 16.7 ± 8.5 s, p post as optimal parameter combination for diagnosing PAD and therefore impaired arterial perfusion reserve. Conclusions: Dynamic CEUS with transient arterial occlusion quantifies muscular micro-perfusion and arterial perfusion reserve. The technique is accurate to diagnose PAD.

Linkages between oral commensal bacteria and atherosclerotic plaques in coronary artery disease patients

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Chhibber-Goel, Jyoti; Singhal, Varsha; Bhowmik, Debaleena; Vivek, Rahul; Parakh, Neeraj; Bhargava, Balram; Sharma, Amit

2016-01-01

Coronary artery disease is an inflammatory disorder characterized by narrowing of coronary arteries due to atherosclerotic plaque formation. To date, the accumulated epidemiological evidence supports an association between oral bacterial diseases and coronary artery disease, but has failed to prove a causal link between the two. Due to the recent surge in microbial identification and analyses techniques, a number of bacteria have been independently found in atherosclerotic plaque samples from...

Measures of chronic kidney disease and risk of incident peripheral artery disease: a collaborative meta-analysis of individual participant data.

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Matsushita, Kunihiro; Ballew, Shoshana H; Coresh, Josef; Arima, Hisatomi; Ärnlöv, Johan; Cirillo, Massimo; Ebert, Natalie; Hiramoto, Jade S; Kimm, Heejin; Shlipak, Michael G; Visseren, Frank L J; Gansevoort, Ron T; Kovesdy, Csaba P; Shalev, Varda; Woodward, Mark; Kronenberg, Florian

2017-09-01

Some evidence suggests that chronic kidney disease is a risk factor for lower-extremity peripheral artery disease. We aimed to quantify the independent and joint associations of two measures of chronic kidney disease (estimated glomerular filtration rate [eGFR] and albuminuria) with the incidence of peripheral artery disease. In this collaborative meta-analysis of international cohorts included in the Chronic Kidney Disease Prognosis Consortium (baseline measurements obtained between 1972 and 2014) with baseline measurements of eGFR and albuminuria, at least 1000 participants (this criterion not applied to cohorts exclusively enrolling patients with chronic kidney disease), and at least 50 peripheral artery disease events, we analysed adult participants without peripheral artery disease at baseline at the individual patient level with Cox proportional hazards models to quantify associations of creatinine-based eGFR, urine albumin-to-creatinine ratio (ACR), and dipstick proteinuria with the incidence of peripheral artery disease (including hospitalisation with a diagnosis of peripheral artery disease, intermittent claudication, leg revascularisation, and leg amputation). We assessed discrimination improvement through c-statistics. We analysed 817 084 individuals without a history of peripheral artery disease at baseline from 21 cohorts. 18 261 cases of peripheral artery disease were recorded during follow-up across cohorts (median follow-up was 7·4 years [IQR 5·7-8·9], range 2·0-15·8 years across cohorts). Both chronic kidney disease measures were independently associated with the incidence of peripheral artery disease. Compared with an eGFR of 95 mL/min per 1·73 m 2 , adjusted hazard ratios (HRs) for incident study-specific peripheral artery disease was 1·22 (95% CI 1·14-1·30) at an eGFR of 45 mL/min per 1·73 m 2 and 2·06 (1·70-2·48) at an eGFR of 15 mL/min per 1·73 m 2 . Compared with an ACR of 5 mg/g, the adjusted HR for incident study

Limitations of regional myocardial thallium clearance for identification of disease in individual coronary arteries

International Nuclear Information System (INIS)

Becker, L.C.; Rogers, W.J. Jr.; Links, J.M.; Corn, C.

1989-01-01

The purpose of this study was to critically evaluate the usefulness of postexercise regional myocardial thallium-201 clearance for identifying disease in individual coronary arteries. Exercise and redistribution planar imaging studies were performed in 114 subjects, including 19 normal volunteers and 95 patients undergoing cardiac catheterization (70 with and 25 without greater than or equal to 50% narrowing in one or more coronary arteries). Thallium clearance was measured from predefined myocardial regions corresponding to the left anterior descending, left circumflex and right coronary arteries and was expressed as the percent decrease in activity at 4 h, assuming monoexponential clearance. In regions perfused by a normal or insignificantly diseased coronary artery, mean 4 h clearance was 58.9 +/- 9.4% for normal volunteers, 43.1 +/- 15.5% for catheterized patients without coronary artery disease and 36.3 +/- 24.9% for catheterized patients with coronary artery disease (p less than 0.001 patients with coronary artery disease versus normal volunteers). Clearance from normal regions was significantly associated with two measures of exercise performance: percent of predicted maximal heart rate achieved (r = 0.49) and exercise duration (r = 0.35). In regions perfused by a stenotic coronary artery, mean clearance was lower (31.1 +/- 19.8%) but was not significantly different from that in normal regions in the same patients. Clearance from diseased regions was also associated with maximal exercise heart rate (r = 0.28) and exercise duration (r = 0.41), but not with percent coronary artery stenosis (r = 0.02). After taking exercise performance into account, the number of diseased vessels or the presence or absence of disease in a given vessel had little influence on regional thallium clearance

The Infrapopliteal Arterial Occlusions Similar to Buerger Disease: Report of Two Cases

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Kimihiro Igari

2014-01-01

Full Text Available We herein present two cases that required the differential diagnosis of Buerger disease. Case 1 involved a 55-year-old male with a smoking habit who was admitted with ulcers and coldness in his fingers and toes. Angiography showed blockage in both the radial and posterior tibial arteries, which led to an initial diagnosis of Buerger disease. However, a biopsy of the right posterior tibial artery showed pathological findings of fibromuscular dysplasia (FMD. Case 2 involved a 28-year-old male with intermittent claudication who was examined at another hospital. Angiography showed occlusion of both popliteal and crural arteries, and the patient was suspected to have Buerger disease. However, computed tomography disclosed an abnormal slip on both sides of the popliteal fossa, and we diagnosed him with bilateral popliteal artery entrapment syndrome (PAES. These cases illustrate that other occlusive diseases, such as FMD and PAES, may sometimes be misdiagnosed as Buerger disease.

A COMPUTATIONAL FRAMEWORK INVOLVING CFD AND DATA MINING TOOLS FOR ANALYZING DISEASE IN CAROTID ARTERY BIFURCATION

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Tabib, Mandar; Rasheed, Adil; Fonn, Eivind

2017-01-01

Cardiovascular diseases, like Carotid Artery Disease and Coronary Artery Disease (CAD) are associated with the narrowing of artery due to build-up of fatty substances and cholesterol deposits (called plaque). Carotid Artery Disease increases the chances of brain stroke. Hence, the main objective of this work is to apply computational tools to help differentiate between the healthy and unhealthy artery (with 25% stenosis) using a combination of Computational Fluid Dynamics (CFD) and data minin...

Quantitative thallium-201 single-photon emission computed tomography during maximal pharmacologic coronary vasodilation with adenosine for assessing coronary artery disease

International Nuclear Information System (INIS)

Nishimura, S.; Mahmarian, J.J.; Boyce, T.M.; Verani, M.S.

1991-01-01

The diagnostic value of maximal pharmacologic coronary vasodilation with intravenously administered adenosine in conjunction with thallium-201 single-photon emission computed tomography (SPECT) for detection of coronary artery disease was investigated in 101 consecutive patients who had concomitant coronary arteriography. Tomographic images were assessed visually and from computer-quantified polar maps of the thallium-201 distribution. Significant coronary artery disease, defined as greater than 50% luminal diameter stenosis, was present in 70 patients. The sensitivity for detecting patients with coronary artery disease using quantitative analysis was 87% in the total group, 82% in patients without myocardial infarction and 96% in those with prior myocardial infarction; the specificity was 90%. The sensitivity for diagnosing coronary artery disease in patients without infarction with single-, double-and triple-vessel disease was 76%, 86% and 90%, respectively. All individual stenoses were identified in 68% of patients with double-vessel disease and in 65% of those with triple-vessel disease. The extent of the perfusion defects, as quantified by polar maps, was directly related to the extent of coronary artery disease. In conclusion, quantitative thallium-201 SPECT during adenosine infusion has high sensitivity and specificity for diagnosing the presence of coronary artery disease, localizing the anatomic site of coronary stenosis and identifying the majority of affected vascular regions in patients with multivessel involvement

The impact of coronary artery disease and left ventricular ejection fraction on the prognosis of patients with peripheral artery disease.

Science.gov (United States)

Tsujimura, Takuya; Iida, Osamu; Ishihara, Takayuki; Fujita, Masashi; Masuda, Masaharu; Okamoto, Shin; Nanto, Kiyonori; Kanda, Takashi; Sunaga, Akihiro; Takahara, Mitsuyoshi; Uematsu, Masaaki

2017-11-01

The impact of the severity of coronary artery disease (CAD) and left ventricular ejection fraction (LVEF) on the prognosis of patients with peripheral artery disease (PAD) has not been systematically studied. We retrospectively analysed 622 patients with PAD (intermittent claudication (IC): n = 446; critical limb ischaemia (CLI): n = 176). The association of SYNTAX score and LVEF with mortality was analysed using the Cox proportional hazard model. In patients with IC, a high SYNTAX score was significantly associated with mortality, whereas reduced LVEF was significantly associated with mortality in patients with CLI. The prognostic impact of CAD and LVEF appears different between patients with IC and CLI. © 2017 Royal Australasian College of Physicians.

Relative associations between depression and anxiety on adverse cardiovascular events: does a history of coronary artery disease matter? A prospective observational study

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Pelletier, Roxanne; Bacon, Simon L; Arsenault, Andr?; Dupuis, Jocelyn; Laurin, Catherine; Blais, Lucie; Lavoie, Kim L

2015-01-01

Objectives To assess whether depression and anxiety increase the risk of mortality and major adverse cardiovascular events (MACE), among patients with and without coronary artery disease (CAD). Design and setting, and patients DECADE (Depression Effects on Coronary Artery Disease Events) is a prospective observational study of 2390 patients referred at the Montreal Heart Institute. Patients were followed for 8.8?years, between 1998 and 2009. Depression and anxiety were assessed using a psychi...

Peripheral Arterial Disease Can Be a Killer

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... Bar Home Current Issue Past Issues Special Section Peripheral Arterial Disease Can Be a Killer Past Issues / ... Color changes in skin, paleness, or blueness Lower temperature in one leg compared to the other leg ...

Relations among impaired coronary flow reserve, left ventricular hypertrophy and thallium perfusion defects in hypertensive patients without obstructive coronary artery disease

International Nuclear Information System (INIS)

Houghton, J.L.; Frank, M.J.; Carr, A.A.; von Dohlen, T.W.; Prisant, L.M.

1990-01-01

Invasive Doppler catheter-derived coronary flow reserve, echocardiographic measurements of left ventricular hypertrophy and intravenous dipyridamole-limited stress thallium-201 scintigraphy were compared in 48 patients (40 were hypertensive or diabetic) with clinical ischemic heart disease and no or minor coronary artery disease. Abnormal vasodilator reserve (ratio less than 3:1) occurred in 50% of the study group and markedly abnormal reserve (less than or equal to 2:1) occurred in 27%. Coronary vasodilator reserve was significantly lower (2.2 +/- 0.8 versus 3.5 +/- 1.3, p = 0.003) and indexed left ventricular mass significantly higher (152.6 +/- 42.2 versus 113.6 +/- 24.0 g, p = 0.0007) in patients with a positive (n = 11) versus a negative (n = 32) thallium perfusion scan. Coronary flow reserve was linearly related in coronary basal flow velocity as follows: y = -0.17x + 4.59; r = -0.57; p = 0.00002. The decrement in flow reserve was not linearly related to the degree of left ventricular hypertrophy. Abnormal vasodilator reserve subsets found in hypertensive patients were defined on the basis of basal flow velocity, indexed left ventricular mass and clinical factors. In this series, diabetes did not cause a detectable additional decrement in flow reserve above that found with hypertension alone. These findings demonstrate that thallium perfusion defects are associated with depressed coronary vasodilator reserve in hypertensive patients without obstructive coronary artery disease. Left ventricular hypertrophy by indexed mass criteria is predictive of which hypertensive patients are likely to have thallium defects

Risk indicators in coronary cardiac disease and occlusive disease of the peripheral arteries

International Nuclear Information System (INIS)

Roth, H.

1982-01-01

In 160 patients with clinically confirmed coronary heart diseases, angiograms of the coronary vessels, the left ventricle, the abdominal aorta, the pelvic and femoral arteries and the supra-aortic vessels were taken. At the same time the incidence of the risk indicators overweight, hypercholesterinaemia, hypertriglyceridaemia, hyperuricaemia, diabetes mellitus, hypertension and cigarette smoking was established and compared with the angiograms. Hypercholesterinaemia, hypertriglyceridaemia, diabetes mellitus and hypertension are found to be in a clearly positive correlation with the frequency and severity of coronary and peripheral vascular diseases. For hyperuricaemia and overweight a relation to the frequency and severity of peripheral but not coronary vascular stenoses is outlined. Cigarette smoking, again, proves to be a clear risk indicator. (orig./MG) [de

Analysis of complications in thyroid arterial embolization for hyperthyroidism caused by Graves' disease

International Nuclear Information System (INIS)

Gao Bulang; Zhao Wei; Huang Jianqiang; Xiang Shutian; Li Liyuan; Li Minghua

2006-01-01

Objective: To investigate complications and causes of thyroid arterial embolization for hyperthyroidism caused by Graves' disease. Methods: Twenty-eight patients with hyperthyroidism caused by Graves' disease had been treated through transcathter arterial embolization with mid-term follow up. The thyroid angiography, interventional treatment, complications and causes were investigated. Results Followed up for over one year (12-24 months), mid-term rate of efficiency was 78.6% with recurrent rate of one year being 14.2%. Two patients (7.1%) had brain infarction with one partially recovered after proper therapy and the other died due to subsequent hyperthyroidism crisis. One case had temporary hypothyroidism, and another hypoparathyroidism but no permanent hypothyroidism or hypoparathyroidism occurred. One patient suffered relatively severe post-embolization syndrome. All the other complications disappeared after proper treatment. Followed up for more than a year, no other complications occurred. Conclusion: Misembolization due to regurgitation of embolized agent is one of the most important factors leading to complications of arterial embolization for Graves' disease. In order to reduce complications and improve therapeutic efficacy, it is essential to superselectively catheterize the thyroid, avoid dangerous anastomose, prevent regurgitation misembolization and strictly operate under fluoroscopy. (authors)

Perfectionism dimensions and dependency in relation to personality vulnerability and psychosocial adjustment in patients with coronary artery disease.

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Dunkley, David M; Schwartzman, Deborah; Looper, Karl J; Sigal, John J; Pierre, Andrena; Kotowycz, Mark A

2012-06-01

The present study sought to illuminate self-criticism and personal standards dimensions of perfectionism and dependency as specific cognitive-personality vulnerability factors that might contribute to a better understanding of numerous psychosocial problem areas that are relevant to coronary artery disease (CAD). One hundred and twenty-three patients diagnosed with clinically significant CAD completed self-report questionnaires. Zero-order correlations and factor analysis results revealed that self-criticism was primarily related to personality vulnerability (aggression/anger/hostility, Type D negative affectivity) and psychosocial maladjustment (depressive symptoms, worry, avoidant coping, support dissatisfaction), whereas personal standards was primarily related to adaptive coping (problem-focused coping, positive reinterpretation) and dependency was primarily related to worry. Hierarchical regression results demonstrated the incremental utility of self-criticism, personal standards, and dependency in relation to (mal)adjustment over and above aggression/anger/hostility, negative affectivity, and social inhibition. Continued efforts to understand the role of perfectionism dimensions and dependency in CAD appear warranted.

Surco diagonal en el lóbulo de la oreja: ¿signo de enfermedad arterial coronaria? Diagonal earlobe crease: a sign of coronary artery disease?

Directory of Open Access Journals (Sweden)

Sebastián B. Lamot

2007-08-01

Full Text Available El surco diagonal es un signo encontrado en el lóbulo de la oreja, que estaría relacionado con la enfermedad arterial coronaria. Nuestro objetivo fue estudiar la utilidad del signo. Se examinaron 104 pacientes (entre 30 y 80 años clasificados por sexo y edad. Cuarenta y nueve tenían enfermedad arterial coronaria diagnosticada por coronariografía (obstrucción > del 70% en una de las grandes arterias y/o gamagrafía de perfusión miocárdica con Talio 201 (defecto fijo. El grupo control estuvo compuesto por 55 pacientes (asintomáticos, con electrocardiograma normal. Los datos obtenidos fueron sensibilidad (61.2%, especificidad (78.2%, valor predictivo positivo de (71.4% y valor predictivo negativo (69.3%.. Observamos una relación significativa entre la presencia de surco diagonal y enfermedad arterial coronaria. Consideramos que este signo podría resultar de utilidad en la práctica clínica, fundamentalmente para los pacientes entre 30 y 60 años.The diagonal earlobe crease is a sign theorically related to coronary artery disease. The purpose of this study was to prove the usefulness of this sign. A total of 104 patients were examined (ages 30 to 80 grouped by age and sex. Forty nine of them were diagnosed of having coronary artery disease by coronary angiography (a 70% obstruction of one of the major arteries, and/or myocardial perfusion imaging with Thallium 201 (fixed defects. The control group included 55 patients (asymptomatic with normal electrocardiogram. Data here obtained included sensitivity (61.2%, specificity (78.2%, positive predictive value (71.4% and negative predictive value (69.3%. We found a significant relation between the presence of the diagonal earlobe crease and coronary artery disease. We consider it a sign that could prove useful in clinical practice, mainly among patients aged between 30 and 60.

Betel nut usage is a major risk factor for coronary artery disease.

Science.gov (United States)

Khan, Muhammad Shahzeb; Bawany, Faizan Imran; Ahmed, Muhammad Umer; Hussain, Mehwish; Khan, Asadullah; Lashari, Muhammad Nawaz

2013-12-27

The objective of our study was to assess betel nut usage as one of the major risk factors associated with coronary artery disease. This case control study consisted of 300 controls and 300 cases. A structured questionnaire was administered to the participants to assess consumption of betel nut and confounding variables. A respondent was considered a regular consumer of betel nut if he/she consumed one or more pieces of betel nut every day for a period of greater than 6 months. About 8 in 10 betel nut chewers developed coronary artery disease. After adjusting for diabetes and hypertension, the odds ratio analysis depicted 7.72 times greater likelihood for coronary artery disease in patients who chewed betel nut for more than 10 years. Our study concludes that betel nut chewing is a significant risk factor leading to the development of coronary artery disease.

Exclusive use of arterial grafts in coronary artery bypass operations for three-vessel disease : Use of both thoracic arteries and the gastroepiploic artery in 256 consecutive patients

NARCIS (Netherlands)

Grandjean, JG; Voors, AA; Boonstra, PW; denHeyer, P; Ebels, T

1996-01-01

Methods: From September 1989 to September 1994 we operated on a consecutive group of 256 patients with three-vessel disease in whom we used the right gastroepiploic artery together with both internal thoracic arteries, Vein grafts were not used in these patients, This population consisted of 233 men

Cardiac symptoms before sudden cardiac death caused by coronary artery disease

DEFF Research Database (Denmark)

Jabbari, Reza; Risgaard, Bjarke; Holst, Anders G

2013-01-01

The aim of this nationwide case-control study was to identify and characterise symptoms before sudden death of young persons who had died due to coronary artery disease (CAD).......The aim of this nationwide case-control study was to identify and characterise symptoms before sudden death of young persons who had died due to coronary artery disease (CAD)....

Intra-arterial infusion of prostaglandin E1 in normal subjects and patients with peripheral arterial disease

DEFF Research Database (Denmark)

Nielsen, P E; Nielsen, S L; Holstein, P

1976-01-01

Acute vasodilatation was produced by infusion of prostaglandin E1 (PGE1) in the femoral artery in 6 patients with occlusive arterial disease of the legs and in 3 normal subjects. The effect on blood flow and on blood pressure was measured at different segments of the leg with the strain gauge...

Hepatic telangiectasia in Osler's disease treated with arterial embolization

Energy Technology Data Exchange (ETDEWEB)

Goethlin, J H; Nordgard, K; Jonsson, K; Nyman, U

1982-02-01

Hepatic hereditary telangiectasia in 2 females was treated with hepatic artery embolization. In one patient both peripheral and central arterial occlusion was performed; the patient died of massive gastro-intestinal bleeding 2 months later. Autopsy showed extensive regions with necrosis in the right liver lobe. In the next patient only central occlusion of the right hepatic artery was performed and the arterio-venous shunting in the left liver lobe left remaining. After a long reconvalescence period the patient recovered completely. It is advocated to centrally occlude only that hepatic artery supplying the most affected parts of the liver in Osler's disease. Thus extensive necrosis with possible ensuing death may be avoided.

Haptoglobin phenotypes as a risk factor for coronary artery disease ...

African Journals Online (AJOL)

Haptoglobin phenotypes as a risk factor for coronary artery disease in type 2 ... Recognition of diabetic individuals at greatest risk of developing coronary artery ... CAD, Group II: 48 type 2DM patients with developed CAD, Group III: 40 age and ...

The Features of Extrahepatic Collateral Arteries Related to Hepatic Artery Occlusion and Benefits in the Trans arterial Management of Liver Tumors

International Nuclear Information System (INIS)

Yang, L.; Zhang, X.M.; Ren, Y.J.; Miao, N.D.; Huang, X.H.; Dong, G.L.

2013-01-01

To investigate the extrahepatic collateral arteries related to hepatic artery occlusion (HAO) and to determine its benefits in the trans arterial management of liver tumors. Methods and Findings. Eleven patients (7 hepatocellular carcinomas, 3 liver metastases, and 1 with hemangioma) with HAO confirmed with digital subtraction angiography (DSA) were admitted to our hospital. Of the 11 patients, 7 were men and 4 were women, with an average age of 41.5 ± 15.5 years (range: 29 to 70 years). DSA was performed to evaluate the collateral routes to the liver. In the 11 patients with HAO, DSA showed complete occlusion of the common hepatic artery in 9 patients and the proper hepatic artery (PHA) in 2 patients. Extrahepatic collateral arteries supplying the liver were readily evident. The collateral arteries originated from the superior mesenteric artery (SMA) in 8 patients, from the gastroduodenal artery in 2 patients, and from the left gastric artery (LGA) in 1 patient. Transcatheter treatment was successfully performed via the collateral artery in all patients except the one who had hemangioma. Conclusions. DSA is an effective method for detecting collateral circulation related to HAO and may provide information to guide transcatheter management decisions.

Radial artery spasm occurred in transradial coronary intervention for coronary heart disease: its occurrence and predictors

International Nuclear Information System (INIS)

Zhong Jiming; Li Lang; Lu Yongguang; Zeng Shuyi

2011-01-01

Objective: To discuss the incidence and clinical predictors of radial artery spasm occurred in performing transradial coronary intervention for coronary heart disease. Methods: A total of 1020 patients, who underwent transradial coronary procedures for coronary heart disease during the period of May 2007 Jan 2010 in authors' hospital, were enrolled in this study. All clinical information and medication were recorded in detail. Arteriography via radial artery was performed in all patients. The diameter of the radial artery as well as the arterial anatomy, including arterial variations, were determined and observed, which was follow by coronary angiography or percutaneous coronary intervention. Multivariate Logistic regression analysis was adopted to evaluate the variables, such as clinical parameters, angiographic characteristics of the radial artery and procedure-related factors, in predicting the occurrence of radial artery spasm. Results: Radial artery spasm occurred in 209 (20.5%) patients. Multivariate Logistic regression analysis showed that the following eight factors were independently associated with the occurrence of radial artery spasm. These factors were as follows: female gender (OR=2.8, 95% CI 2.5-5.8; P=0.001), age (OR=0.68, 95% CI 0.60-0.92; P=0.003), smoking (OR=2.3, 95% CI 1.8-4.1; P=0.026), moderate-to-severe pain of forearm during radial artery cannulation (OR=3.0, 95% CI 2.3-4.8; P=0.006), radial artery anatomical abnormalities (OR=4.7, 95% CI 3.6-7.2; P=0.002), the ratio of radial artery diameter to patient's height (RAH) (OR=5.2, 95% CI 3.7-8.1; P=0.012), the ratio of radial artery diameter to outer diameter of the sheath (RAOD) (OR=5.8, 95% CI 4.2-6.9; P=0.006) and the number of catheter exchange (OR=2.3, 95% CI 1.4-4.3; P=0.038). Conclusion: Radial artery spasm occurred in performing transradial coronary intervention for coronary heart disease is frequently seen in clinical practice. Female gender, younger age, smoking, forearm pain during

Decreased physical effort, fatigue, and mental distress in patients with coronary artery disease : Importance of personality-related differences

NARCIS (Netherlands)

Bunevicius, A.; Brozaitiene, J.; Staniute, M.; Gelziniene, V.; Duoneliene, I.; Pop, V.J.M.; Bunevicius, R.; Denollet, J.

2014-01-01

Background Identification of cardio-toxic psychological symptoms in coronary artery disease (CAD) patients is important. Purpose We examined the association of negative affectivity (NA), social inhibition (SI), and their combination in the distressed (Type D) personality with functional status,

Exercise, stress or what. The non-invasive detection of latent coronary artery disease

International Nuclear Information System (INIS)

Coltart, J.; Robinson, P.S.

1978-01-01

This communication discusses the methods of detecting latent coronary artery disease in an entirely asymptomatic individual with no previous symptoms or signs suggestive of coronary artery disease. Isotope techniques are being increasingly employed in the detection and assessment of coronary artery disease in that they may enable the confirmation of the presence of ischaemia, the extent and location of the underlying coronary artery disease and the effect of ischaemia on overall and regional left ventricular function. Three groups of techniques are commonly employed: 1. assessment of myocardial perfusion; 2. labelling of acute myocardial infarction; 3. overall and regional left ventricular function studies. Isotopes of potassium were initially studied, and, despite technical problems with imaging, 43 K has proved a useful agent in that over a range of coronary flow rates from normal to severely reduced flow, myocardial uptake parallels myocardial blood flow. Myocardial perfusion imaging should enhance the sensitivity and specificity of exercise testing in the symptomatic population and should also be helpful in the asymptomatic population although data on such populations are as yet extremely limited. Acute infarct labelling has little relevance to the very early detection of coronary artery disease. Assessment of overall and regional left ventricular function using gated blood pool scanning at rest and possibly also during exercise has potentially very wide applications in ischaemic heart disease and in combination with myocardial perfusion scanning in the assessment of symptomatic ischaemic heart disease and the detection of ischaemia and coronary artery disease in the asymptomatic population. (Auth.)

Relation of Aortic Valve and Coronary Artery Calcium in Patients With Chronic Kidney Disease to the Stage and Etiology of the Renal Disease

NARCIS (Netherlands)

Piers, Lieuwe H.; Touw, Hugo R. W.; Gansevoort, Ron; Franssen, Casper F. M.; Oudkerk, Matthijs; Zijlstra, Felix; Tio, Rene A.

2009-01-01

Patients with chronic renal failure have increased cardiac calcium loads. Previous studies have investigated the prevalence and quantitative extent of aortic valve calcium (AVC) and coronary artery calcium (CAC) in patients with various stages of chronic kidney disease (CKD). However, the impact of

Atherectomy in Peripheral Artery Disease: A Review.

Science.gov (United States)

Bhat, Tariq M; Afari, Maxwell E; Garcia, Lawrence A

2017-04-01

Peripheral arterial disease (PAD) is a clinical manifestation of systemic atherosclerosis and is associated with significant morbidity and mortality. The physiological force and shear stress from angioplasty and stenting have made PAD treatment challenging. Atherectomy devices have continued to emerge as a major therapy in the management of peripheral vascular disease. This article presents a review of the current literature for the atherectomy devices used in PAD.

Bioresorbable scaffolds in the treatment of coronary artery disease

Directory of Open Access Journals (Sweden)

Zhang Y

2013-03-01

Full Text Available Yaojun Zhang,1,2 Christos V Bourantas,1 Vasim Farooq,1 Takashi Muramatsu,1 Roberto Diletti,1 Yoshinobu Onuma,1 Hector M Garcia-Garcia,1 Patrick W Serruys11Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands; 2Division of Cardiovascular Diseases, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of ChinaAbstract: Drug-eluting stents have reduced the risk of in-stent restenosis and have broadened the application in percutaneous coronary intervention in coronary artery disease. However, the concept of using a permanent metallic endovascular device to restore the patency of a stenotic artery has inherited pitfalls, namely the presence of a foreign body within the artery causing vascular inflammation, late complications such as restenosis and stent thrombosis, and impeding the restoration of the physiologic function of the stented segment. Bioresorbable scaffolds (BRS were introduced to potentially overcome these limitations, as they provide temporary scaffolding and then disappear, liberating the treated vessel from its cage. Currently, several BRSs are available, undergoing evaluation either in clinical trials or in preclinical settings. The aim of this review is to present the new developments in BRS technology, describe the mechanisms involved in the resorption process, and discuss the potential future prospects of this innovative therapy.Keywords: bioresorbable scaffold, drug-eluting stent, biodegradable, design, mechanism, coronary artery disease

Peripheral artery disease: potential role of ACE-inhibitor therapy

Directory of Open Access Journals (Sweden)

Giuseppe Coppola

2008-12-01

Full Text Available Giuseppe Coppola, Giuseppe Romano, Egle Corrado, Rosa Maria Grisanti, Salvatore NovoDepartment of Internal Medicine, Cardiovascular and Nephro-Urological Diseases, Chair of Cardiovascular Disease, University of Palermo, Palermo, ItalyAbstract: Subjects with peripheral arterial disease (PAD of the lower limbs are at high risk for cardiovascular and cerebrovascular events and the prevalence of coronary artery disease in such patients is elevated. Recent studies have shown that regular use of cardiovascular medications, such as therapeutic and preventive agents for PAD patients, seems to be promising in reducing long-term mortality and morbidity. The angiotensin-converting-enzyme (ACE system plays an important role in the pathogenesis and progression of atherosclerosis, and ACE-inhibitors (ACE-I seem to have vasculoprotective and antiproliferative effects as well as a direct antiatherogenic effect. ACE-I also promote the degradation of bradykinin and the release of nitric oxide, a potent vasodilator; further, thay have shown important implications for vascular oxidative stress. Other studies have suggested that ACE-I may also improve endothelial dysfunction. ACE-I are useful for reducing the risk of cardiovascular events in clinical and subclinical PAD. Particularly, one agent of the class (ie, ramipril has shown in many studies to able to significantly reduce cardiovascular morbidity and mortality in patients with PAD.Keywords: atherosclerosis, peripheral arterial disease, endothelial dysfunction, ACE-inhibitors

DOMINANCE OF CORONARY ARTERY DISEASE AMONG PATIENTS WITH ANEURYSM OF ABDOMINAL AORTA

Directory of Open Access Journals (Sweden)

Maja Zdravkovic

2007-12-01

Full Text Available Persons with aneurysm of the abdominal aorta have high prevalence of risk factors of cardiovascular disease. It cannot be stated with certainty whether these persons die in a large number due to the existence of risk factors or the genesis and complications of aneurysm itself. In patients with aneurysm of the abdominal aorta, there is a high correlation with the coronary artery disease; therefore, the aim of the study was to prove whether or not this is the case. The patients in preparation for the resection of the abdominal aorta aneurysm at the Institute of Cardiovascular Disease underwent the examination. The study included 377 examinees, of whom 341 males and 36 females, aged 45 to 83 years, during the three-year interval (from 2004 to 2006. The aim of the study was to determine the dominance of the coronary artery disease among the patients with aneurysm of the abdominal aorta. In the process of analyzing the data obtained from patients and medical evidence, it was found out that a large number of the abdominal aortic aneurysm patients were at the same time the coronary artery disease patients (55,2%; Hi=15,04; p80 kg was larger, as well as the percentage of patients with hypertension (89% and increased levels of cholesterol and triglycerides (67%. There was a great number of those with the inherited factor (40%. It has been proven that the risk factors for the development of coronary artery disease are in direct association with the risk factors for the abdominal aortic aneurysm. Also, there is a great predominance of the coronary artery disease among the patients with aneurysm of the abdominal aorta. The coronary artery disease is one of the main risk factors. If we managed to prevent the appearance of this disease or achieve the timely diagnosing of it and eventual curing, we would be able to decrease the development of the abdominal aortic aneurysm well as the consequences and further complications.

Coronary artery disease risk assessment from unstructured electronic health records using text mining.

Science.gov (United States)

Jonnagaddala, Jitendra; Liaw, Siaw-Teng; Ray, Pradeep; Kumar, Manish; Chang, Nai-Wen; Dai, Hong-Jie

2015-12-01

Coronary artery disease (CAD) often leads to myocardial infarction, which may be fatal. Risk factors can be used to predict CAD, which may subsequently lead to prevention or early intervention. Patient data such as co-morbidities, medication history, social history and family history are required to determine the risk factors for a disease. However, risk factor data are usually embedded in unstructured clinical narratives if the data is not collected specifically for risk assessment purposes. Clinical text mining can be used to extract data related to risk factors from unstructured clinical notes. This study presents methods to extract Framingham risk factors from unstructured electronic health records using clinical text mining and to calculate 10-year coronary artery disease risk scores in a cohort of diabetic patients. We developed a rule-based system to extract risk factors: age, gender, total cholesterol, HDL-C, blood pressure, diabetes history and smoking history. The results showed that the output from the text mining system was reliable, but there was a significant amount of missing data to calculate the Framingham risk score. A systematic approach for understanding missing data was followed by implementation of imputation strategies. An analysis of the 10-year Framingham risk scores for coronary artery disease in this cohort has shown that the majority of the diabetic patients are at moderate risk of CAD. Copyright © 2015 Elsevier Inc. All rights reserved.

Effect of intra-arterial CO2 insufflation on occlusive arterial disease in the lower leg

International Nuclear Information System (INIS)

Lantz, B.M.T.; Nordqvist, P.; Henning, A.

1978-01-01

Twenty patients with a mean age of 79 years were followed over a period of 6 months after intra-arterial insufflation of CO 2 in the lower extremity. All patients had severe peripheral occlusive arterial disease caused by atherosclerosis and were scheduled for amputation. A significant increase of the distal perfusion pressure was obtained in the majority of the cases resulting in pain relief and healing of ulcers and gangrenes. (Auth.)

Atherectomy for peripheral arterial disease.

Science.gov (United States)

Ambler, Graeme K; Radwan, Rami; Hayes, Paul D; Twine, Christopher P

2014-03-17

Symptomatic peripheral arterial disease may be treated by a number of options including exercise therapy, angioplasty, stenting and bypass surgery. Atherectomy is an alternative technique where atheroma is excised by a rotating cutting blade. The objective of this review was to analyse randomised controlled trials comparing atherectomy against any established treatment for peripheral arterial disease in order to evaluate the effectiveness of atherectomy. The Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last searched November 2013) and CENTRAL (2013, Issue 10). Trials databases were searched for details of ongoing or unpublished studies. Randomised controlled trials (RCTs) comparing atherectomy and other established treatments were selected for inclusion. All participants had symptomatic peripheral arterial disease with either claudication or critical limb ischaemia and evidence of lower limb arterial disease. Two review authors (GA and CT) screened studies for inclusion, extracted data and assessed the quality of the trials. Any disagreements were resolved through discussion. Four trials were included with a total of 220 participants (118 treated with atherectomy, 102 treated with balloon angioplasty) and 259 treated vessels (129 treated with atherectomy, 130 treated with balloon angioplasty). All studies compared atherectomy with angioplasty. No study was properly powered or assessors blinded to the procedures and there was a high risk of selection, attrition, detection and reporting biases.The estimated risk of success was similar between the treatment modalities although the confidence interval (CI) was compatible with small benefits of either treatment for the initial procedural success rate (Mantel-Haenszel risk ratio (RR) 0.92, 95% CI 0.44 to 1.91, P = 0.82), patency at six months (Mantel-Haenszel RR 0.92, 95% CI 0.51 to 1.66, P = 0.79) and patency at 12 months (Mantel-Haenszel RR 1.17, 95% CI 0

Gene therapy and angiogenesis in patients with coronary artery disease

DEFF Research Database (Denmark)

Kastrup, Jens

2010-01-01

Not all patients with severe coronary artery disease can be treated satisfactorily with current recommended medications and revascularization techniques. Various vascular growth factors have the potential to induce angiogenesis in ischemic tissue. Clinical trials have only evaluated the effect...... of VEGF and FGF in patients with coronary artery disease. The initial small and unblinded studies with either recombinant growth factor proteins or genes encoding growth factors were encouraging, demonstrating both clinical improvement and evidence of angiogenesis. However, subsequent larger double...

Fifteen new risk loci for coronary artery disease highlight arterial-wall-specific mechanisms

DEFF Research Database (Denmark)

Howson, Joanna M. M.; Zhao, Wei; Barnes, Daniel R

2017-01-01

Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. Although 58 genomic regions have been associated with CAD thus far, most of the heritability is unexplained, indicating that additional susceptibility loci await identification. An efficient discovery strategy ...

The ethnicity-specific association of biomarkers with the angiographic severity of coronary artery disease

NARCIS (Netherlands)

Gijsberts, C M; Bank, I E M; Seneviratna, A; den Ruijter, H M; Asselbergs, F W; Agostoni, P; Remijn, J A; Pasterkamp, G; Kiat, H C; Roest, M; Richards, A M; Chan, M Y; de Kleijn, D P V; Hoefer, I E

BACKGROUND: Risk factor burden and clinical characteristics of patients with coronary artery disease (CAD) differ among ethnic groups. We related biomarkers to CAD severity in Caucasians, Chinese, Indians and Malays. METHODS: In the Dutch-Singaporean UNICORN coronary angiography cohort (n = 2033) we

Frequency and clinical predictors of coronary artery disease in chronic renal failure renal transplant candidates.

Science.gov (United States)

de Albuquerque Seixas, Emerson; Carmello, Beatriz Leone; Kojima, Christiane Akemi; Contti, Mariana Moraes; Modeli de Andrade, Luiz Gustavo; Maiello, José Roberto; Almeida, Fernando Antonio; Martin, Luis Cuadrado

2015-05-01

Cardiovascular diseases are major causes of mortality in chronic renal failure patients before and after renal transplantation. Among them, coronary disease presents a particular risk; however, risk predictors have been used to diagnose coronary heart disease. This study evaluated the frequency and importance of clinical predictors of coronary artery disease in chronic renal failure patients undergoing dialysis who were renal transplant candidates, and assessed a previously developed scoring system. Coronary angiographies conducted between March 2008 and April 2013 from 99 candidates for renal transplantation from two transplant centers in São Paulo state were analyzed for associations between significant coronary artery diseases (≥70% stenosis in one or more epicardial coronary arteries or ≥50% in the left main coronary artery) and clinical parameters. Univariate logistic regression analysis identified diabetes, angina, and/or previous infarction, clinical peripheral arterial disease and dyslipidemia as predictors of coronary artery disease. Multiple logistic regression analysis identified only diabetes and angina and/or previous infarction as independent predictors. The results corroborate previous studies demonstrating the importance of these factors when selecting patients for coronary angiography in clinical pretransplant evaluation.

Systematic Review of Guidelines on Peripheral Artery Disease Screening

NARCIS (Netherlands)

Ferket, Bart S.; Spronk, Sandra; Colkesen, Ersen B.; Hunink, M. G. Myriam

2012-01-01

BACKGROUND: Peripheral artery disease (PAD) screening may be performed to prevent progression of PAD or future cardiovascular disease in general. Recommendations for PAD screening have to be derived indirectly because no randomized trials comparing screening versus no screening have been performed.

Evaluation of Cognitive Schemas Based on the Presence of Anxiety Disorder among Coronary Artery Disease Patients

Directory of Open Access Journals (Sweden)

Huri ASLAN

2012-11-01

Full Text Available Objective: The relationship between psychological factors and cardiac diseases has been concerned for a long but our knowledge about the cognitive profiles which could be important etiological factor in cardiac disease and comorbid psychiatric disorders is limited. In this study, we aimed to compare the cognitive profiles of coronary artery disease patients with or without comorbid anxiety disorder. Method: A total of 35 coronary artery disease patients with anxiety disorder and 20 coronary artery disease patients without comorbid anxiety disorders were enrolled into the study. Beck Anxiety Inventory and the Young Schema Questionnaire-Short Form 3 were applied to each participant. Results: Disconnection, rejection, impaired autonomy self-manifestation, extreme vigilance, unrelenting standards, other-directedness, and impaired limits schema domain scores were significantly higher in coronary artery disease patients with anxiety disorder comorbidity compared to coronary artery disease patients without anxiety disorder. Conclusion: Our study has revealed significant differences in cognitive profiles of coronary artery disease patients with comorbidity of anxiety disorders. These findings show the importance of cognitive profiles which were observed in coronary artery disease patients with anxiety disorders. Schema-focused approach might be useful in the treatment of such patients. Further studies with schema-focused therapy approaches are needed to illustrate the issue.

The value of coronary artery calcium score assessed by dual-source computed tomography coronary angiography for predicting presence and severity of coronary artery disease

International Nuclear Information System (INIS)

Almasi, Alireza; Pouraliakbar, Hamidreza; Sedghian, Ahmad; Karimi, Mohammad Ali; Firouzi, Ata; Tehrai, Mahmood

2014-01-01

Measuring coronary artery calcium score (CACS) using a dual-source CT scanner is recognized as a major indicator for assessing coronary artery disease. The present study aimed to validate the clinical significance of CACS in predicting coronary artery stenosis and its severity. This prospective study was conducted on 202 consecutive patients who underwent both conventional coronary angiography and dual-source (256-slice) computed tomography coronary angiography (CTA) for any reason in our cardiac imaging center from March to September 2013. CACS was measured by Agatston algorithm on non-enhanced CT. The severity of coronary artery disease was assessed by Gensini score on conventional angiography. There was a significant relationship between the number of diseased coronary vessels and mean calcium score, i.e. the mean calcium score was 202.25±450.06 in normal coronary status, 427.50±607.24 in single-vessel disease, 590.03±511.34 in two-vessel disease, and 953.35±1023.45 in three-vessel disease (p<0.001). There was a positive association between calcium score and Gensini score (r=0.636, p<0.001). In a linear regression model, calcium score was a strong determinant of the severity of coronary artery disease. Calcium scoring had an acceptable value for discriminating coronary disease from normal condition with optimal cutoff point of 350, yielding a sensitivity and specificity of 83% and 70%, respectively. Our study confirmed the strong relationship between the coronary artery calcium score and the presence and severity of stenosis in coronary arteries assessed by both the number of diseased coronary vessels and also by the Gnesini score

Cerebellar cortical infarct cavities and vertebral artery disease

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Cocker, Laurens J.L. de [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Kliniek Sint-Jan Radiologie, Brussels (Belgium); Compter, A.; Kappelle, L.J.; Worp, H.B. van der [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, Utrecht (Netherlands); Luijten, P.R.; Hendrikse, J. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands)

2016-09-15

Cerebellar cortical infarct cavities are a newly recognised entity associated with atherothromboembolic cerebrovascular disease and worse physical functioning. We aimed to investigate the relationship of cerebellar cortical infarct cavities with symptomatic vertebrobasilar ischaemia and with vascular risk factors. We evaluated the MR images of 46 patients with a recent vertebrobasilar TIA or stroke and a symptomatic vertebral artery stenosis ≥50 % from the Vertebral Artery Stenting Trial (VAST) for the presence of cerebellar cortical infarct cavities ≤1.5 cm. At inclusion in VAST, data were obtained on age, sex, history of vertebrobasilar TIA or stroke, and vascular risk factors. Adjusted risk ratios were calculated with Poisson regression analyses for the relation between cerebellar cortical infarct cavities and vascular risk factors. Sixteen out of 46 (35 %) patients showed cerebellar cortical infarct cavities on the initial MRI, and only one of these 16 patients was known with a previous vertebrobasilar TIA or stroke. In patients with symptomatic vertebrobasilar ischaemia, risk factor profiles of patients with cerebellar cortical infarct cavities were not different from patients without these cavities. Cerebellar cortical infarct cavities are seen on MRI in as much as one third of patients with recently symptomatic vertebral artery stenosis. Since patients usually have no prior history of vertebrobasilar TIA or stroke, cerebellar cortical infarct cavities should be added to the spectrum of common incidental brain infarcts visible on routine MRI. (orig.)

Right ventricular ejection fraction during exercise in normal subjects and in coronary artery disease patients: assessment by multiple-gated equilibrium scintigraphy

International Nuclear Information System (INIS)

Maddahi, J.; Berman, D.S.; Matsuoka, D.T.; Waxman, A.D.; Forrester, J.S.; Swan, H.J.C.

1980-01-01

The response of right ventricular ejection fraction (RVEF) during exercise and its relationship to the location and extent of coronary artery disease are not fully understood. We have recently developed and validated a new method for scintigraphic evaluation of RVEF using rapid multiple-gated equilibrium scintigraphy and multiple right ventricular regions of interest. The technique has been applied during upright bicycle exercise in 10 normal subjects and 20 patients with coronary artery disease. Resting RVEF was not significantly different between the groups (0.49 +- 0.04 vs 0.47 +- 0.09, respectively, mean +- SD). In all 10 normal subjects RVEF rose (0.49 +- 0.04 to 0.66 +- 0.08, p < 0.01) at peak exercise. At peak exercise in coronary artery disease patients, the group RVEF remained unchanged (0.47 +- 0.09 to 0.50 +- 0.11, p = NS), but the individual responses varied. In the coronary artery disease patients, the relationship between RVEF response to exercise and exercise left ventricular function, septal motion and right coronary artery stenosis were studied. Significant statistical association was found only between exercise RVEF and right coronary artery stenosis. RVEF rose during exercise in seven of seven patients without right coronary artery stenosis (0.42 +- 0.06 to 0.58 +- 0.08, p = 0.001) and was unchanged or fell in 12 of 13 patients with right coronary artery stenosis (0.50 +- 0.09 to 0.45 +- 0.10, p = NS). We conclude that (1) in normal subjects RVEF increases during upright exercise and (2) although RVEF at rest is not necessarily affected by coronary artery disease, failure of RVEF to increase during exercise, in the absence of chronic obstructive pulmonary disease or valvular heart disease, may be related to the presence of significant right coronary artery stenosis

Right ventricular ejection fraction during exercise in normal subjects and in coronary artery disease patients: assessment by multiple-gated equilibrium scintigraphy

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Maddahi, J.; Berman, D.S.; Matsuoka, D.T.; Waxman, A.D.; Forrester, J.S.; Swan, H.J.C.

1980-07-01

The response of right ventricular ejection fraction (RVEF) during exercise and its relationship to the location and extent of coronary artery disease are not fully understood. We have recently developed and validated a new method for scintigraphic evaluation of RVEF using rapid multiple-gated equilibrium scintigraphy and multiple right ventricular regions of interest. The technique has been applied during upright bicycle exercise in 10 normal subjects and 20 patients with coronary artery disease. Resting RVEF was not significantly different between the groups (0.49 +- 0.04 vs 0.47 +- 0.09, respectively, mean +- SD). In all 10 normal subjects RVEF rose (0.49 +- 0.04 to 0.66 +- 0.08, p < 0.01) at peak exercise. At peak exercise in coronary artery disease patients, the group RVEF remained unchanged (0.47 +- 0.09 to 0.50 +- 0.11, p = NS), but the individual responses varied. In the coronary artery disease patients, the relationship between RVEF response to exercise and exercise left ventricular function, septal motion and right coronary artery stenosis were studied. Significant statistical association was found only between exercise RVEF and right coronary artery stenosis. RVEF rose during exercise in seven of seven patients without right coronary artery stenosis (0.42 +- 0.06 to 0.58 +- 0.08, p = 0.001) and was unchanged or fell in 12 of 13 patients with right coronary artery stenosis (0.50 +- 0.09 to 0.45 +- 0.10, p = NS). We conclude that (1) in normal subjects RVEF increases during upright exercise and (2) although RVEF at rest is not necessarily affected by coronary artery disease, failure of RVEF to increase during exercise, in the absence of chronic obstructive pulmonary disease or valvular heart disease, may be related to the presence of significant right coronary artery stenosis.

Effect of programmed ventricular stimulation on myocardial lactate extraction in patients with and without coronary artery disease

International Nuclear Information System (INIS)

Morady, F.; DiCarlo, L.A. Jr.; Krol, R.B.; de Buitleir, M.; Nicklas, J.M.; Annesley, T.M.

1986-01-01

The arterial-coronary sinus lactate difference was measured in 17 patients after each step of a programmed ventricular stimulation protocol consisting of single, double, and triple extrastimuli, first at a basic drive cycle length of 600 msec, then at 400 msec, with an inter-train interval of 4 seconds. Four patients had no structural heart disease, four had an idiopathic dilated cardiomyopathy, and nine had coronary artery disease with a significant stenosis in at least one branch of the left coronary artery. Net myocardial lactate production during programmed ventricular stimulation was observed in three patients with coronary artery disease, but not in any patient without coronary artery disease. Among the patients who had coronary artery disease, net myocardial lactate production generally occurred in the patients who had more severe coronary artery disease. Exercise-induced ischemia, as demonstrated by a stress thallium-201 test, did not correlate with myocardial lactate production during programmed ventricular stimulation. Programmed ventricular stimulation, with a stimulation protocol typically used in many electrophysiology laboratories, is capable of inducing myocardial ischemia in at least some patients who have coronary artery disease. This finding suggests that myocardial ischemia may potentially influence the results of programmed ventricular stimulation in some patients with coronary artery disease

The value and limitation thallium scintigraphy in the detection of coronary artery disease

International Nuclear Information System (INIS)

Khan, A.; Rehman, A.; Amin, W.; Khan, Z.A.; Ahmed, S.A.

1986-01-01

In this study we randomly selected 45 patients whose coronary angiograms were abnormal i.e. showing triple, double and single vessel disease out of a pool of 80 patients who had undergone stress thallium imaging and coronary angiography during the one year. Majority of these patients were males, their ages ranged between 34-54 years. Resting ECG's were normal in 25 patients, 15 patients had suffered inferior myocardial infraction and 5 had sustained anterior myocardial infraction in the past. Coronary angiography revealed triple vessel disease in 20 patients, double vessel disease in 15, and single vessel coronary artery disease in 10. We analysed their coronary angiograms and compared them with the scintigraphic finding. It is concluded that although thallium scanning has high sensitivity for detection of coronary artery disease in general, it has only moderate sensitivity for detection of stenosis in individual coronary arteries. In this study thallium scan identified 75% of RCA lesions, 66% of LAD lesions and 38% of circumflex lesions. The sensitivity is much higher in single vessel coronary artery disease. (author)

Metallic stent implantation in patients with iliac artery occlusion: long-term patency rate and factors related to recurrence

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Chung, Seok Kyun; Kim, Jae Kyu; Yoon, Woong; Kim, Jeong; Park, Jin Gyoon; Kang, Heoung Keun; Choi, Soo JinNa [Chonnam National University Hospital School of Medicine, Gwangju (Korea, Republic of)

2003-09-01

To determine the long-term patency rate in 68 patients with iliac artery occlusion who underwent metallic stent implantation, and to analyze the factors related to recurrence. Sixty-eight patients with occlusive disease of the iliac artery underwent implantation of a self-expandable metallic stent. The clinical symptoms were intermittent claudication (n=48), resting pain (n=11), and gangrene (n=9). Stent patency was determined by follow-up angiography and color Doppler imaging, and the cumulative patency rate using the Kaplan-Meier method. Cox's proportional hazard model was used to analyse recurrence-related factors involving clinical symptoms (Fontaine stage), risk factors, and anatomical factors such as lesion location, length, and the development of collaterals. The duration of follow-up varied from 1 day to 73 months (mean, 23.8 months). Arterial occlusion recurred in 16 of 68 patients (23.5%), and the cumulative patency rate was as follows: 95.4% at one month, 93.2% at six months, 80.1% at one year, 73.2% at two years, 68.9% at three years, and 62% at five years. According to a statistical analysis of risk factors, the recurrence (p=0.04) than in those without it, but in patients who smoked, hypertension, DM, and previous cerebrovascular disease were not statistically significant. With regard to anatomical factors, the recurrent rate for lesions involving the external iliac artery was 6.5 times higher (p=0.02) than for those involving the common iliac artery. Variations in the fontaine stage were not statistically significant indicators of recurrence. The recurrence rate after implantation of an iliac artery stent is higher in patients with heart disease than in those without it, and higher for occlusive lesions involving the external iliac artery than for those of the common iliac artery.

Metallic stent implantation in patients with iliac artery occlusion: long-term patency rate and factors related to recurrence

International Nuclear Information System (INIS)

Chung, Seok Kyun; Kim, Jae Kyu; Yoon, Woong; Kim, Jeong; Park, Jin Gyoon; Kang, Heoung Keun; Choi, Soo JinNa

2003-01-01

To determine the long-term patency rate in 68 patients with iliac artery occlusion who underwent metallic stent implantation, and to analyze the factors related to recurrence. Sixty-eight patients with occlusive disease of the iliac artery underwent implantation of a self-expandable metallic stent. The clinical symptoms were intermittent claudication (n=48), resting pain (n=11), and gangrene (n=9). Stent patency was determined by follow-up angiography and color Doppler imaging, and the cumulative patency rate using the Kaplan-Meier method. Cox's proportional hazard model was used to analyse recurrence-related factors involving clinical symptoms (Fontaine stage), risk factors, and anatomical factors such as lesion location, length, and the development of collaterals. The duration of follow-up varied from 1 day to 73 months (mean, 23.8 months). Arterial occlusion recurred in 16 of 68 patients (23.5%), and the cumulative patency rate was as follows: 95.4% at one month, 93.2% at six months, 80.1% at one year, 73.2% at two years, 68.9% at three years, and 62% at five years. According to a statistical analysis of risk factors, the recurrence (p=0.04) than in those without it, but in patients who smoked, hypertension, DM, and previous cerebrovascular disease were not statistically significant. With regard to anatomical factors, the recurrent rate for lesions involving the external iliac artery was 6.5 times higher (p=0.02) than for those involving the common iliac artery. Variations in the fontaine stage were not statistically significant indicators of recurrence. The recurrence rate after implantation of an iliac artery stent is higher in patients with heart disease than in those without it, and higher for occlusive lesions involving the external iliac artery than for those of the common iliac artery

C-reactive protein predicts further ischemic events in first-ever transient ischemic attack or stroke patients with intracranial large-artery occlusive disease.

Science.gov (United States)

Arenillas, Juan F; Alvarez-Sabín, José; Molina, Carlos A; Chacón, Pilar; Montaner, Joan; Rovira, Alex; Ibarra, Bernardo; Quintana, Manuel

2003-10-01

The role of inflammation in intracranial large-artery occlusive disease is unclear. We sought to investigate the relationship between high-sensitivity C-reactive protein (CRP) levels and the risk of further ischemic events in first-ever transient ischemic attack (TIA) or stroke patients with intracranial large-artery occlusive disease. Of a total of 127 consecutive first-ever TIA or ischemic stroke patients with intracranial stenoses detected by transcranial Doppler ultrasonography, 71 fulfilled all inclusion criteria, which included angiographic confirmation. Serum high-sensitivity CRP level was determined a minimum of 3 months after the qualifying event. Patients were followed up during 1 year after blood sampling. Thirteen patients (18.3%) with intracranial large-artery occlusive disease experienced an end point event: 9 cerebral ischemic events, 7 of which were attributable to intracranial large-artery occlusive disease, and 4 myocardial infarctions. Patients in the highest quintile of high-sensitivity CRP level had a significantly higher adjusted odds ratio for new events compared with those in the first quintile (odds ratio, 8.66; 95% CI, 1.39 to 53.84; P=0.01). A high-sensitivity CRP level above the receiver operating characteristic curve cutoff value of 1.41 mg/dL emerged as an independent predictor of new end point events (hazard ratio, 7.14; 95% CI, 1.77 to 28.73; P=0.005) and of further intracranial large-artery occlusive disease-related ischemic events (hazard ratio, 30.67; 95% CI, 3.6 to 255.5; P=0.0015), after adjustment for age, sex, and risk factors. Kaplan-Meier curves showed that a significantly lower proportion of patients with a high-sensitivity CRP >1.41 mg/dL remained free of a new ischemic event (P<0.0001). High-sensitivity CRP serum level predicts further intracranial large-artery occlusive disease-related and any major ischemic events in patients with first-ever TIA or stroke with intracranial large-artery occlusive disease. These findings

Genetically Determined Height and Coronary Artery Disease

NARCIS (Netherlands)

Nelson, Christopher P.; Hamby, Stephen E.; Saleheen, Danish; Hopewell, Jenna C.; Zeng, Lingyao; Assimes, Themistocles L.; Kanoni, Stavroula; Willenborg, Christina; Burgess, Stephen; Amouyel, Phillipe; Anand, Sonia; Blankenberg, Stefan; Boehm, Bernhard O.; Clarke, Robert J.; Collins, Rory; Dedoussis, George; Farrall, Martin; Franks, Paul W.; Groop, Leif; Hall, Alistair S.; Hamsten, Anders; Hengstenberg, Christian; Hovingh, G. Kees; Ingelsson, Erik; Kathiresan, Sekar; Kee, Frank; König, Inke R.; Kooner, Jaspal; Lehtimäki, Terho; März, Winifred; McPherson, Ruth; Metspalu, Andres; Nieminen, Markku S.; O'Donnell, Christopher J.; Palmer, Colin N. A.; Peters, Annette; Perola, Markus; Reilly, Muredach P.; Ripatti, Samuli; Roberts, Robert; Salomaa, Veikko; Shah, Svati H.; Schreiber, Stefan; Siegbahn, Agneta; Thorsteinsdottir, Unnur; Veronesi, Giovani; Wareham, Nicholas; Willer, Cristen J.; Zalloua, Pierre A.; Erdmann, Jeanette

2015-01-01

BACKGROUND The nature and underlying mechanisms of an inverse association between adult height and the risk of coronary artery disease (CAD) are unclear. METHODS We used a genetic approach to investigate the association between height and CAD, using 180 height-associated genetic variants. We tested

Diabetic retinopathy: A predictor of coronary artery disease

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Fawzia El Demerdash

2012-06-01

Conclusion: Diabetic retinopathy is a good predictor of coronary artery disease that exceeds the conventional risk factors. Diabetics with retinopathy would benefit from early coronary angiography and diabetic retinocoronary clinics are warranted.

Mechanical characterization and constitutive modeling of the coronary artery

NARCIS (Netherlands)

Broek, van den C.N.

2010-01-01

Coronary heart disease is the most frequently occurring cardiovascular disease in Europe. The components of the arterial wall are strongly related to the arterial mechanical behavior, and the composition may change because of remodeling processes that take place in the arterial wall, upon disease or

High-Intensity Statin Therapy Is Associated With Improved Survival in Patients With Peripheral Artery Disease.

Science.gov (United States)

Foley, T Raymond; Singh, Gagan D; Kokkinidis, Damianos G; Choy, Ho-Hin K; Pham, Thai; Amsterdam, Ezra A; Rutledge, John C; Waldo, Stephen W; Armstrong, Ehrin J; Laird, John R

2017-07-15

The relative benefit of higher statin dosing in patients with peripheral artery disease has not been reported previously. We compared the effectiveness of low- or moderate-intensity (LMI) versus high-intensity (HI) statin dose on clinical outcomes in patients with peripheral artery disease. We reviewed patients with symptomatic peripheral artery disease who underwent peripheral angiography and/or endovascular intervention from 2006 to 2013 who were not taking other lipid-lowering medications. HI statin use was defined as atorvastatin 40-80 mg or rosuvastatin 20-40 mg. Baseline demographics, procedural data, and outcomes were retrospectively analyzed. Among 909 patients, 629 (69%) were prescribed statins, and 124 (13.6%) were treated with HI statin therapy. Mean low-density lipoprotein level was similar in patients on LMI versus HI (80±30 versus 87±44 mg/dL, P =0.14). Demographics including age (68±12 versus 67±10 years, P =0.25), smoking history (76% versus 80%, P =0.42), diabetes mellitus (54% versus 48%, P =0.17), and hypertension (88% versus 89%, P =0.78) were similar between groups (LMI versus HI). There was a higher prevalence of coronary artery disease (56% versus 75%, P =0.0001) among patients on HI statin (versus LMI). After propensity weighting, HI statin therapy was associated with improved survival (hazard ratio for mortality: 0.52; 95% confidence interval, 0.33-0.81; P =0.004) and decreased major adverse cardiovascular events (hazard ratio: 0.58; 95% confidence interval 0.37-0.92, P =0.02). In patients with peripheral artery disease who were referred for peripheral angiography or endovascular intervention, HI statin therapy was associated with improved survival and fewer major adverse cardiovascular events compared with LMI statin therapy. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Evaluation of arterial diseases by intravenous digital angiography (IVSDA) and risk factors in patients with cerebrovascular disease

International Nuclear Information System (INIS)

Fukui, Toshiya

1989-01-01

Intravenous digital angiography (IVSDA) has been performed in 1,031 consecutive patients during the previous 4 years. Complications of IVSDA, such as coughing, dermal reaction, nausea and vomiting, occurred in 77 patients (7.5%). Among them, 234 patients with a definite diagnosis of cerebrovascular disease were entered onto this study. On the basis of findings of IVSDA, the patients were largely classified into six groups: internal carotid artery (ICA) occlusion, ICA stenosis, middle cerebral artery (MCA) occlusion, MCA stenosis, marked arterial elongation, and normal findings. A group of the patients with ICA occlusion was characterized by having sudden onset with less complicated hypertension. In this group, etiological factors seemed to be embolism, intra-atheromatic hemorrhage, and dissecting aneurysm, as well as atherosclerosis. Major risk factors were hypertension, smoking, diabetes mellitus, and ischemic heart disease for lesions of the main trunk; and severe hypertension, high hematocrit levels and elevated platelet aggregability for lesions of perforating and small cortical arteries and arterioles. In the case of arterial elongation, platelet aggregability elicited by ADP was not suppressed by antiplatelet agents. These patients need to receive intensive treatment to prevent relapse of the disease. (Namekawa, K)

Importance of diastolic velocities in the detection of celiac and mesenteric artery disease by duplex ultrasound

DEFF Research Database (Denmark)

Perko, M J; Just, S; Schroeder, T V

1997-01-01

To assess the predictive value of ultrasound duplex scanning in the detection of superior mesenteric artery (SMA) and celiac artery (CA) occlusive disease.......To assess the predictive value of ultrasound duplex scanning in the detection of superior mesenteric artery (SMA) and celiac artery (CA) occlusive disease....

Use of paravascular admittance waveforms to monitor relative change in arterial blood pressure

Science.gov (United States)

Zielinski, Todd M.; Hettrick, Doug; Cho, Yong

2010-04-01

Non-invasive methods to monitor ambulatory blood pressure often have limitations that can affect measurement accuracy and patient adherence [1]. Minimally invasive measurement of a relative blood pressure surrogate with an implantable device may provide a useful chronic diagnostic and monitoring tool. We assessed a technique that uses electrocardiogram and paravascular admittance waveform morphology analysis to one, measure a time duration (vascular tone index, VTI in milliseconds) change from the electrocardiogram R-wave to admittance waveform peak and two, measure the admittance waveform minimum, maximum and magnitude as indicators of change in arterial compliance/distensibility or pulse pressure secondary to change in afterload. Methods: Five anesthetized domestic pigs (32 ± 4.2 kg) were used to study the effects of phenylephrine (1-5 ug/kg/min) on femoral artery pressure and admittance waveform morphology measured with a quadrapolar electrode array catheter placed next to the femoral artery to assess the relative change in arterial compliance due to change in peripheral vascular tone. Results: Statistical difference was observed (p blood pressure may be suitable for implantable devices to detect progression of cardiovascular disease such as hypertension.

[Echo-tracking technology for evaluating femoral artery endothelial function in patients with Grave's disease].

Science.gov (United States)

Wei, Wei; Wang, Jingyuan; Zhao, Qiaoling; Yang, Jinru

2012-10-01

To assess the value of echo-tracking technology in evaluating endothelial function of the femoral artery in patients with Grave's disease. Thirty-four patients with Grave's disease patients and 30 normal adults as controls were recruited in this study. The intima-media thickness (IMT), arterial stiffness (β), pressure strain elastic modulus (Ep), arterial compliance (AC), pulse wave conducting velocity (PWVβ) and augmentation index (AI) parameters were examined using echo-tracking technology for evaluating the right femoral arterial elasticity. Compared with the control subjects, the patients with Grave's disease showed significantly increased β, Ep, and PWVβ and significantly decreased AC (P0.05). In patients with Grave's disease, β and Ep were positively correlated with FT3, FT4, TT3, TT4, and PWVβ was positively correlated with FT3 and FT4. Echo-tracking technology can provide more accurate quantitative evidences for early diagnosis of femoral artery endothelial dysfunction in patients with Grave's disease, but the influence of procedural factors on the measurement accuracy should be considered in the evaluation.

Specific perfusion pattern in stress 201Tl myocardial scintigraphy of left main coronary artery disease

International Nuclear Information System (INIS)

Wakasugi, Shigetoshi; Shibata, Nobuhiko; Kobayashi, Tohru; Fudemoto, Yoshiyuki; Hasegawa, Yoshihisa; Nakano, Shunichi

1986-01-01

The usefulness of stress 201 Tl myocardial scintigraphy for identifying left main coronary artery disease was evaluated with data from 23 patients with 50% or more narrowing of the left main coronary artery and 56 patients with 75% or more narrowing of the major coronary arteries but without left main coronary artery involvement (no left main coronary artery disease). Quantitative evaluation of stress perfusion scintigrams in all five patients with narrowing of the left main coronary artery of 90% or more showed a characteristic perfusion pattern (left main pattern) of extensive homogeneous defect over the whole anterolateral segment and simultaneous defects in all radii of the high anteroseptal and high posterolateral segments. On the other hand, such a perfusion pattern was noted in only 1 of 18 patients with less than 90% stenosis of the left main coronary artery and in only 1 of 56 patients with no left coronary artery disease. (orig.)

Relationship between chronic obstructive pulmonary disease and subclinical coronary artery disease in long-term smokers

DEFF Research Database (Denmark)

Rasmussen, Thomas; Køber, Lars; Pedersen, Jesper Holst

2013-01-01

Cardiovascular conditions are reported to be the most frequent cause of death in patients with chronic obstructive pulmonary disease (COPD). However, it remains unsettled whether severity of COPD per se is associated with coronary artery disease (CAD) independent of traditional cardiovascular risk...... factors. The aim of this study was to examine the relationship between the presence and severity of COPD and the amount of coronary artery calcium deposit, an indicator of CAD and cardiac risk, in a large population of current and former long-term smokers....

Neovascularization in Vertebral Artery Atheroma-A Dynamic Contrast-Enhanced Magnetic Resonance Imaging-Based Comparative Study in Patients with Symptomatic and Asymptomatic Carotid Artery Disease.

Science.gov (United States)

Usman, Ammara; Yuan, Jianmin; Patterson, Andrew J; Graves, Martin J; Varty, Kevin; Sadat, Umar; Gillard, Jonathan H

2018-05-24

Atherosclerosis is a systemic inflammatory disease intertwined with neovascularization. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) enables the assessment of plaque neovascularization. This study aimed to explore the systemic nature of atherosclerosis by assessing difference in severity of neovascularization as quantified by DCE-MRI of vertebral arteries (VAs) between patients with symptomatic and asymptomatic carotid artery disease. Ten consecutive patients with asymptomatic VA stenosis and concomitant symptomatic carotid artery disease (group 1) and 10 consecutive patients with asymptomatic VA stenosis and concomitant asymptomatic carotid artery disease (group 2) underwent 3-dimensional DCE-MRI of their cervical segment of VAs. A previously validated pharmacokinetic modeling approach was used for DCE-MRI analysis. K trans was calculated in the adventitia and plaque as a measure of neovessel permeability. Both patient groups were comparable for demographics and comorbidities. Mean luminal stenosis was comparable for both groups (54.4% versus 52.27%, P = .32). Group 1 had higher adventitial K trans and plaque K trans (.08 ± .01 min -1 , .07 ± .01 min -1 ) compared with Group 2 (.06 ± .01 min -1 , .06 ± .01 min -1 ) (P = .004 and .03, respectively). Good correlation was present among the two image analysts (intraclass correlation coefficient = .78). Vertebral Artery atheroma of patients with symptomatic carotid artery disease had increased neovessel permeability compared with the patients with asymptomatic carotid artery disease. These findings are consistent with the hypothesis that atherosclerosis is a systemic inflammatory disease. The VA atherosclerosis is likely to have increased severity of neovascularization if another arterial territory is symptomatic in the same patient cohort. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Hemodynamic significance of internal carotid artery disease

DEFF Research Database (Denmark)

Schroeder, T

1988-01-01

Neurologic symptoms in the region of an internal carotid artery stenosis are considered to be embolic in most instances. Only in a subgroup has carotid occlusive disease with impairment of the collateral supply, caused a state of hemodynamic failure with marked reduction of perfusion pressure. Th...

Coronary artery disease in Brazil: contemporary management and future perspectives.

Science.gov (United States)

Polanczyk, C A; Ribeiro, J P

2009-06-01

Cardiovascular diseases are responsible for 32% of total mortality in Brazil, mostly due to cerebrovascular and coronary artery disease. Epidemiological and socio-economical factors play a pivotal role on the distribution, severity and management of coronary artery disease, and the burden is greater in the southeast and south regions of the country, with a higher mortality in low-income populations. The Brazilian healthcare structure is divided into two complementary systems-public and private-but 75% of the population is covered exclusively by the public system. Some Brazilian institutions offer state-of-the-art care to patients with acute and chronic coronary artery disease, but regional inequalities in medical care are still significant. National policies will have to be implemented to fight risk factors, to ensure primary prevention strategies, including assistance on drugs with known protective effects, areas to be tackled by both the private and the public health sectors. Finally, large investments will have to be made to improve tertiary care, to reorganise systems of care for acute patients and mainly to ensure prompt access and continuity of cardiac care and secondary prevention strategies for the whole population.

Updates in management of coronary artery disease

International Nuclear Information System (INIS)

Yang, Dong Heon; Chae, Shung Chull

2005-01-01

Coronary artery disease (CAD) has been increasing during the last decade and is the one of major causes of death. The management of patients with coronary artery disease has evolved considerably. There are two main strategies in the management of CAD, complementary, not competitive, each other; the pharmacologic therapy to prevent and treat CAD and the percutaneous coronary intervention (PCI) to restore coronary flow. Antiplatelet drugs and cholesterol lowering drugs have central roles in pharmacotherapy. Drug eluting stent (DES) bring about revolutional changes in PCL in the management of patients with ST segment elevation acute myocardial infarction (AMI), there has been a debate on the better strategy for the restoration of coronary flow. Thrombolytic therapy is widely available and easy to administer, whereas primary PCI is less available and more complex, but more complete. Recently published evidences in the pharmacologic therapy including antiplatelet and statin, and PCI including DES and reperfusion therapy in patients with ST segment elevation AMI were reviewed

Updates in management of coronary artery disease

Energy Technology Data Exchange (ETDEWEB)

Yang, Dong Heon; Chae, Shung Chull [Kyungpook National University Medical School, Daegu (Korea, Republic of)

2005-02-15

Coronary artery disease (CAD) has been increasing during the last decade and is the one of major causes of death. The management of patients with coronary artery disease has evolved considerably. There are two main strategies in the management of CAD, complementary, not competitive, each other; the pharmacologic therapy to prevent and treat CAD and the percutaneous coronary intervention (PCI) to restore coronary flow. Antiplatelet drugs and cholesterol lowering drugs have central roles in pharmacotherapy. Drug eluting stent (DES) bring about revolutional changes in PCL in the management of patients with ST segment elevation acute myocardial infarction (AMI), there has been a debate on the better strategy for the restoration of coronary flow. Thrombolytic therapy is widely available and easy to administer, whereas primary PCI is less available and more complex, but more complete. Recently published evidences in the pharmacologic therapy including antiplatelet and statin, and PCI including DES and reperfusion therapy in patients with ST segment elevation AMI were reviewed.

Prevalence and nature of cardiovascular disease in methamphetamine-related death: A national study.

Science.gov (United States)

Darke, Shane; Duflou, Johan; Kaye, Sharlene

2017-10-01

Methamphetamine dependence is a major public health problem. This study examined the nature, and extent, of cardiovascular disease amongst cases of methamphetamine-related death in Australia, 2009-2015. Analysis of 894 cases of methamphetamine-related death with full autopsy reports retrieved from the National Coronial Information System. The mean age was 37.9yrs (range 15-69yrs) and 78.5% were male. A quarter (26.3%) of cases had enlarged hearts and left ventricular hypertrophy was diagnosed in 18.9%. Severe coronary artery disease was present in 19.0%, the left coronary artery being the vessel most frequently stenosed (16.6%). Replacement fibrosis (evidence of earlier ischaemic events) in the heart muscle was observed in 19.8% of cases, and cardiomyopathy was diagnosed in 5.5%. Histological evidence of hypertension was observed in 32.7% of cases. With the exception of cardiomyopathy, equally common amongst both sexes, cardiovascular disease was more common amongst males, and those aged >35yrs. Clinically significant levels of cardiovascular disease were also observed amongst cases where the cause of death was not attributed to cardiovascular disease: cardiomegaly (19.3%), left ventricular hypertrophy (14.6%), severe coronary artery disease (9.4%), replacement fibrosis (14.4%), cardiomyopathy (3.3%). Cardiovascular disease was highly prevalent, despite the relatively young age of cases. With methamphetamine use increasing rapidly in major regions, cardiovascular disease and cardiovascular-related death will likely increase amongst methamphetamine users. Copyright © 2017 Elsevier B.V. All rights reserved.

Stress scintigraphy using single-photon emission computed tomography in the evaluation of coronary artery disease

International Nuclear Information System (INIS)

Nohara, R.; Kambara, H.; Suzuki, Y.; Tamaki, S.; Kadota, K.; Kawai, C.; Tamaki, N.; Torizuka, K.

1984-01-01

Twenty-seven patients with angina pectoris, 24 with postmyocardial infarction angina and 7 with normal coronary arteries were examined by exercise thallium-201 emission computed tomography (SPECT) and planar scintigraphy. Exercise SPECT was compared with the reperfusion imaging obtained approximately 2 to 3 hours after exercise. The sensitivity and specificity of demonstrating involved coronary arteries by identifying the locations of myocardial perfusion defects were 96 and 87% for right coronary artery, 88 and 89% for left anterior descending artery (LAD) and 78 and 100% for left circumflex artery (LC). These figures are higher than those for planar scintigraphy (85 and 87% for right coronary artery, 73 and 89% for LAD and 39 and 100% for LC arteries). In patients with 3-vessel disease, sensitivity of SPECT (100, 88 and 75% for right coronary artery, LAD and LC, respectively) was higher than planar imaging (88, 63 and 31%, respectively), with a significant difference for LC (p less than 0.05). In 1, 2 and 0-vessel disease the sensitivity and specificity of the 2 techniques were comparable. Multivessel disease was more easily identified as multiple coronary involvement than planar imaging with a significant difference in 3-vessel disease (p less than 0.05). In conclusion, stress SPECT provides useful information for the identification of LC lesions in coronary heart disease, including 3-vessel involvement

Mechanical Recanalization of Subacute Vessel Occlusion in Peripheral Arterial Disease with a Directional Atherectomy Catheter

International Nuclear Information System (INIS)

Massmann, Alexander; Katoh, Marcus; Shayesteh-Kheslat, Roushanak; Buecker, Arno

2012-01-01

Purpose: To retrospectively examine the technical feasibility and safety of directional atherectomy for treatment of subacute infrainguinal arterial vessel occlusions. Methods: Five patients (one woman, four men, age range 51–81 years) with peripheral arterial disease who experienced sudden worsening of their peripheral arterial disease–related symptoms during the last 2–6 weeks underwent digital subtraction angiography, which revealed vessel occlusion in native popliteal artery (n = 4) and in-stent occlusion of the superficial femoral artery (n = 1). Subsequently, all patients were treated by atherectomy with the SilverHawk (ev3 Endovascular, USA) device. Results: The mean diameter of treated vessels was 5.1 ± 1.0 mm. The length of the occlusion ranged 2–14 cm. The primary technical success rate was 100%. One patient experienced a reocclusion during hospitalization due to heparin-induced thrombocytopenia. There were no further periprocedural complications, in particular no peripheral embolizations, until hospital discharge or during the follow-up period of 1 year. Conclusion: The recanalization of infrainguinal arterial vessel occlusions by atherectomy with the SilverHawk device is technically feasible and safe. In our limited retrospective study, it was associated with a high technical success rate and a low procedure-related complication rate.

Peripheral artery disease in type II diabetes

International Nuclear Information System (INIS)

Ali, Z.; Ahmed, S.M.; Bhutto, A.R.; Chaudhry, A.; Munir, S.M.

2012-01-01

Objective: To determine the frequency of peripheral arterial disease (PAD) in type 2 diabetic patients. Study Design: Cross-sectional observational study. Place and Duration of Study: Diabetes Clinic, Medical Unit III, Jinnah Postgraduate Medical Centre, Karachi, from January to June 2010. Methodology:Three hundred and eighty seven (387) type II diabetic patients of either gender and any age were included. Patients with a previous history of trauma to the arterial vasculature, pregnancy and those who underwent in the study arterial graft procedures were excluded. Non-purposive convenient sampling technique was used to enroll patients in the study. PAD was diagnosed when ankle-brachial index (ABI) was less than 0.9. Ap-value of less than 0.05 was considered statistically significant. Results: Out of 387 studied patients, 128 were males (33.1%) and 259 were females (66.9%). Mean age was 52.22 +- 6.39 years. PAD was detected in 152 9.671 (22 - 76) years in the entire cohort. Mean duration of diabetes was 9.38 +- (39.28%) of the total study subjects. Thirty-one of 128 male patients (24.22%) had PAD disease while 121 out of 259 female patients (46.71%) had evidence of PAD (p = 0.001). Hypertension was a significantly associated factor (p = 0.002). Conclusion: A high frequency of PAD was observed in the diabetic population particularly with hypertension and more prevalent in females. (author)

Von Willebrand disease protects against arterial thrombosis

NARCIS (Netherlands)

Sanders, Y.V.; Eikenboom, J.C.; De Wee, E.M.; Van Der Bom, J.G.; Cnossen, M.H.; Degenaar-Dujardin, M.E.; Fijnvandraat, K.; Kamphuisen, P.W.; Laros-Van Gorkum, B.A.; Meijer, K.; Mauser -Bunschoten, E.P.; Leebee k, F.W.

Background and Aims: Von Willebrand disease (VWD) is caused by reduced levels of or dysfunctional von Willebrand factor (VWF) and is characterized by a bleeding tendency. It is well known that individuals with high VWF levels have a higher risk for arterial thrombosis. Although it has never been

Abdominal fat and risk of coronary heart disease in patients with peripheral arterial disease

NARCIS (Netherlands)

Brouwer, Beate G.; Visseren, Frank L. J.; Stolk, Ronald P.; van der Graaf, Yolanda

Objective: We investigated whether the presence of concomitant coronary heart disease (CHD) in patients with peripheral arterial disease (PAD) can be explained by intra-abdominal fat accumulation and compared different measures of adiposity as predictors of CHD in patients with PAD. Research Methods

Pathological evaluation of thyroid glands in Graves' disease after thyroid arteries embolization

International Nuclear Information System (INIS)

Zhuang Wenquan; Xiao Haipeng; Cheng Wei; Yang Jianyong; Chen Guorui; Ling Qibo

2003-01-01

Objective: To study the pathological morphology of thyroid specimen after thyroid arteries embolization. In order to select appropriate size of embolizing granules, the diameters of thyroid arteries in Graves' disease were measured. Methods: Multiple slides of embolized thyroid tissues from superior pole, body and inferior pole of the resected thyroid glands were made. After being embedded and stained, pathological morphology was observed and diameters of arteries in various parts of thyroid glands were measured under microscopy. Results: Pathological examination of thyroid glands showed that superior and inferior thyroid arteries and most of their branches were embolized with ischemic necrosis and fibrosis in the embolized thyroid tissue. Follicular epithelium appeared as flat or cubic shapes with colloid reduction. Average diameter of main branches of superior artery was 440-550 μm and that of inferior artery was 300-375 μm. The diameters of capillary network in the thyroid body was 120-250 μm, and the non-embolized ones was 40-110 μm. The diameter of isthmus was 130-150 μm. Conclusions: Pathological morphology of Graves' disease after thyroid arteries embolization showed that the excretion of thyroid glands would be decreased and equivalents to subtotal thyroidectomy

Serum adiponectin levels in patients with coronary artery disease

International Nuclear Information System (INIS)

Fayyaz, I.; Shah, S.I.; Ghani, M.

2009-01-01

Adiponectin is an adipocytokine secreted from white adipose tissue. Serum level of adiponectin has been shown to be reduced in several disease states like obesity and diabetes. Hypoadiponectinemia has also been included in the list of newer risk factors for Coronary Artery Disease (CAD). In this analytical cross-sectional study serum adiponectin level was measured by Enzyme Linked Immunosorbant Assay (ELISA) in 60 cases of coronary artery disease (CAD) (both sexes, aged 40-60 yrs) and 60 healthy controls. Low levels of adiponectin were seen in CAD patients as well as controls. These levels were lower as compared to western standards. Our study conforms to the previous observation of lower serum adiponectin levels in South Asians compared to the western standards. Serum adiponectin level should be considered in the laboratory work-up of CAD patients. (author)

Elastin organization in pig and cardiovascular disease patients' pericardial resistance arteries

DEFF Research Database (Denmark)

Bloksgaard, Maria; Leurgans, Thomas; Nissen, Inger

2015-01-01

Peripheral vascular resistance is increased in essential hypertension. This involves structural changes of resistance arteries and stiffening of the arterial wall, including remodeling of the extracellular matrix. We hypothesized that biopsies of the human parietal pericardium, obtained during...... coronary artery bypass grafting or cardiac valve replacement surgeries, can serve as a source of resistance arteries for structural research in cardiovascular disease patients. We applied two-photon excitation fluorescence microscopy to study the parietal pericardium and isolated pericardial resistance...... of 100 mm Hg) is fiber like, and no prominent external elastic lamina could be observed. This microarchitecture is very different from that in rat mesenteric arteries frequently used for resistance artery research. In conclusion, we add three-dimensional information on the structure of the extracellular...

Coronary CT angiography in clinical triage of patients at high risk of coronary artery disease

DEFF Research Database (Denmark)

Kühl, J Tobias; Hove, Jens D; Kristensen, Thomas S

2017-01-01

OBJECTIVES: To test if cardiac computed tomography angiography (CCTA) can be used in the triage of patients at high risk of coronary artery disease. DESIGN: The diagnostic value of 64-detector CCTA was evaluated in 400 patients presenting with non-ST segment elevation myocardial infarction using...... invasive coronary angiography (ICA) as the reference method. The relation between the severity of disease by CCTA and a combined endpoint of death, re-hospitalization due to new myocardial infarction, or symptom-driven coronary revascularization was assessed. RESULTS: CCTA detects significant (>50...... in patients with high likelihood of coronary artery disease and could, in theory, be used to triage high risk patients. As many obstacles remain, including logistical and safety issues, our study does not support the use of CCTA as an additional diagnostic test before ICA in an all-comer NSTEMI population....

Minimum training requirement in ultrasound imaging of peripheral arterial disease.

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Eiberg, J P; Hansen, M A; Grønvall Rasmussen, J B; Schroeder, T V

2008-09-01

To demonstrate the minimum training requirement when performing ultrasound of peripheral arterial disease. Prospective and blinded comparative study. 100 limbs in 100 consecutive patients suffering from peripheral arterial disease, 74% suffering critical limb ischemia, were enrolled during a 9 months period. One physician with limited ultrasound experience performed all the ultrasound examinations of the arteries of the most symptomatic limb. Before enrolling any patients 15 duplex ultrasound examinations were performed supervised by an experienced vascular technologist. All patients had a digital subtraction arteriography performed by an experienced vascular radiologist, unaware of the ultrasound result. The number of insufficiently insonated segments (non-diagnostic segments) was significantly reduced during the study; from 9% among the initial 50 limbs to 2% among the last 50 limbs (Pultrasound and arteriography from the initial 50 patients (overall Kappa=0.66, (95%-CI: 0.60-0.72); supragenicular Kappa=0.73 (95%-CI: 0.64-0.82); infragenicular Kappa=0.61 (95%-CI: 0.54-0.69)) to the last 50 patients (overall Kappa=0.66 (95%-CI: 0.60-0.72), supragenicular Kappa=0.67 (95%-CI: 0.57-0.76); infragenicular Kappa=0.66 (95%-CI: 0.58-0.73)). The minimum training requirement in ultrasound imaging of peripheral arterial disease appears to be less than 50 ultrasound examinations (probably only 15 examinations) for the supragenicular segments and 100 examinations for the infragenicular segments.

Thallium-201 myocardial imaging in the detection of coronary artery disease

International Nuclear Information System (INIS)

McKillop, J.H.; Murray, R.G.; Turner, J.G.; Gray, H.W.; Bessent, R.G.; Lorimer, A.R.; Greig, W.R.

1978-01-01

Thallium-201 myocardial imaging can detect abnormalities of myocardial perfusion. Visual interpretation of the images is complicated by some inhomogeneity of tracer uptake normally present. Using a quantitative approach we have established the regional variation of Thallium-201 uptake present in 23 normal controls and applied the same technique to 49 patients who had undergone selective coronary arteriography with left ventriculography because of chest pain. Half of the patients with significant coronary artery disease had abnormal rest Thallium-201 images, usually corresponding to areas of abnormal wall motion at ventriculography. Stress Thallium-201 images were abnormal in over 90% of patients with coronary artery disease. The stress image abnormalities and the arteriographic lesions correlated well in most patients with single and double vessel disease but in triple vessel disease the correspondence between the two studies was poor. Two of a group of patients with normal coronary arteriograms had abnormal Thallium-201 images due to other myocardial pathology. Our technique was highly sensitive in the non-invasive detection of significant coronary artery disease in a group of patients with chest pain. A small number of positive studies were also encountered due to other myocardial disorders. (author)

Peripheral arterial disease in a female using high-dose combined oral contraceptive pills.

Science.gov (United States)

Pallavee, P; Samal, Sunita; Samal, Rupal

2013-01-01

The association between oral contraceptive (OC) pills and vascular diseases is well-known, although, the present generation of pills is considered to be relatively safer in this regard. Hormonal treatment for severe abnormal uterine bleeding is usually considered after ruling out malignancy, when such bleeding is resistant to all other forms of treatment. We report a case of severe peripheral arterial disease in a female, who had been on high-dose OC pills for an extended period of time for severe uterine bleeding.

Relation between intracranial artery calcifications and aortic atherosclerosis in ischemic stroke patients.

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Bugnicourt, Jean-Marc; Chillon, Jean-Marc; Tribouilloy, Christophe; Canaple, Sandrine; Lamy, Chantal; Massy, Ziad A; Godefroy, Olivier

2010-08-01

We previously demonstrated a strong relation between carotid atherosclerosis (defined as carotid artery stenosis > or =50%) and intracranial artery calcification (IAC) in ischemic stroke patients. The purpose of this study was to evaluate the relation between aortic atherosclerosis and IAC. Four hundred fifty-four patients with ischemic stroke were included. Complex aortic plaques (CAP) were assessed by transesophageal echocardiography (TEE) and defined as plaques > or =4 mm thick or with mobile components in the proximal aorta. IAC were assessed in the seven major cerebral arteries and a semiquantitative score system was applied, ranging from 0 (no calcification) to 7. Forty-two patients (9.3%) had CAP. Patients with CAP were older compared with patients without CAP (73.6 vs. 63.6 years, p vs. 1.8; p stroke or TIA (OR 3.3; 95%CI 1.5-7.0; p = 0.002), carotid artery stenosis > or =50% (OR 3.7; 95%CI 1.7-8.0; p = 0.001), chronic kidney disease (OR 3.8; 95%CI 1.9-7.8; p stroke patients, the absence of IAC strongly points to the lack of CAP. However, these results warrant confirmation in prospective studies before concluding the non-utility of the use of TEE to exclude CAP as a potential source of cerebral embolism in patients without IAC.

Relation of coronary vasoreactivity and coronary calcification in asymptomatic subjects with a family history of premature coronary artery disease

International Nuclear Information System (INIS)

Pirich, Christian; Leber, Alexander; Knez, Andreas; Bengel, Frank M.; Nekolla, Stephan G.; Schwaiger, Markus; Haberl, Ralph

2004-01-01

Electron-beam computed tomography (EBCT) allows non-invasive imaging of coronary calcification and has been promoted as a screening tool for coronary artery disease (CAD) in asymptomatic high-risk subjects. This study assessed the relation of coronary calcifications to alterations in coronary vascular reactivity by means of positron emission tomography (PET) in asymptomatic subjects with a familial history of premature CAD. Twenty-one subjects (mean age 51±10 years) underwent EBCT imaging for coronary calcifications expressed as the coronary calcium score (CCS according to Agatston) and rest/adenosine-stress nitrogen-13 ammonia PET with quantification of myocardial blood flow (MBF) and coronary flow reserve (CFR). The mean CCS was 237±256 (median 146, range 0-915). The CCS was 100 units in 13. As defined by age-related thresholds, 15 subjects had an increased CCS (>75th percentile). Overall mean resting and stress MBF and CFR were 71±16 ml 100 g -1 min -1 , 218±54 ml 100 g -1 min -1 and 3.20±0.77, respectively. Three subjects with CCS ranging from 114 to 451 units had an abnormal CFR (<2.5). There was no relation between CCS and resting or stress MBF or CFR (r=0.17, 0.18 and 0.10, respectively). In asymptomatic subjects a pathological CCS was five times more prevalent than an abnormal CFR. The absence of any close relationship between CCS and CFR reflects the fact that quantitative myocardial perfusion imaging with PET characterises the dynamic process of vascular reactivity while EBCT is a measure of more stable calcified lesions in the arterial wall whose presence is closely related to age. (orig.)

Novel risk factors for premature peripheral arterial occlusive disease in non-diabetic patients: a case-control study.

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Annie M Bérard

Full Text Available BACKGROUND: This study aimed to determine the prevalence of genetic and environmental vascular risk factors in non diabetic patients with premature peripheral arterial disease, either peripheral arterial occlusive disease or thromboangiitis obliterans, the two main entities of peripheral arterial disease, and to established whether some of them are specifically associated with one or another of the premature peripheral arterial disease subgroups. METHODS AND RESULTS: This study included 113 non diabetic patients with premature peripheral arterial disease (diagnosis <45-year old presenting either a peripheral arterial occlusive disease (N = 64 or a thromboangiitis obliterans (N = 49, and 241 controls matched for age and gender. Both patient groups demonstrated common traits including cigarette smoking, low physical activity, decreased levels of HDL-cholesterol, apolipoprotein A-I, pyridoxal 5'-phosphate (active form of B6 vitamin and zinc. Premature peripheral arterial occlusive disease was characterized by the presence of a family history of peripheral arterial and carotid artery diseases (OR 2.3 and 5.8 respectively, 95% CI, high lipoprotein (a levels above 300 mg/L (OR 2.3, 95% CI, the presence of the factor V Leiden (OR 5.1, 95% CI and the glycoprotein Ia(807T,837T,873A allele (OR 2.3, 95% CI. In thromboangiitis obliterans group, more patients were regular consumers of cannabis (OR 3.5, 95% CI and higher levels in plasma copper has been shown (OR 6.5, 95% CI. CONCLUSIONS: According to our results from a non exhaustive list of study parameters, we might hypothesize for 1 a genetic basis for premature peripheral arterial occlusive disease development and 2 the prevalence of environmental factors in the development of thromboangiitis obliterans (tobacco and cannabis. Moreover, for the first time, we demonstrated that the 807T/837T/873A allele of platelet glycoprotein Ia may confer an additional risk for development of peripheral

Associations of job strain and lifestyle risk factors with risk of coronary artery disease: a meta-analysis of individual participant data.

Science.gov (United States)

Kivimäki, Mika; Nyberg, Solja T; Fransson, Eleonor I; Heikkilä, Katriina; Alfredsson, Lars; Casini, Annalisa; Clays, Els; De Bacquer, Dirk; Dragano, Nico; Ferrie, Jane E; Goldberg, Marcel; Hamer, Mark; Jokela, Markus; Karasek, Robert; Kittel, France; Knutsson, Anders; Koskenvuo, Markku; Nordin, Maria; Oksanen, Tuula; Pentti, Jaana; Rugulies, Reiner; Salo, Paula; Siegrist, Johannes; Suominen, Sakari B; Theorell, Töres; Vahtera, Jussi; Virtanen, Marianna; Westerholm, Peter J M; Westerlund, Hugo; Zins, Marie; Steptoe, Andrew; Singh-Manoux, Archana; Batty, G David

2013-06-11

It is unclear whether a healthy lifestyle mitigates the adverse effects of job strain on coronary artery disease. We examined the associations of job strain and lifestyle risk factors with the risk of coronary artery disease. We pooled individual-level data from 7 cohort studies comprising 102 128 men and women who were free of existing coronary artery disease at baseline (1985-2000). Questionnaires were used to measure job strain (yes v. no) and 4 lifestyle risk factors: current smoking, physical inactivity, heavy drinking and obesity. We grouped participants into 3 lifestyle categories: healthy (no lifestyle risk factors), moderately unhealthy (1 risk factor) and unhealthy (2-4 risk factors). The primary outcome was incident coronary artery disease (defined as first nonfatal myocardial infarction or cardiac-related death). There were 1086 incident events in 743,948 person-years at risk during a mean follow-up of 7.3 years. The risk of coronary artery disease among people who had an unhealthy lifestyle compared with those who had a healthy lifestyle (hazard ratio [HR] 2.55, 95% confidence interval [CI] 2.18-2.98; population attributable risk 26.4%) was higher than the risk among participants who had job strain compared with those who had no job strain (HR 1.25, 95% CI 1.06-1.47; population attributable risk 3.8%). The 10-year incidence of coronary artery disease among participants with job strain and a healthy lifestyle (14.7 per 1000) was 53% lower than the incidence among those with job strain and an unhealthy lifestyle (31.2 per 1000). The risk of coronary artery disease was highest among participants who reported job strain and an unhealthy lifestyle; those with job strain and a healthy lifestyle had half the rate of disease. A healthy lifestyle may substantially reduce disease risk among people with job strain.

Three-dimensional power Doppler sonography in screening for carotid artery disease.

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Keberle, M; Jenett, M; Beissert, M; Jahns, R; Haerten, R; Hahn, D

2000-01-01

Color Doppler sonography has gained considerable recognition as a noninvasive method to detect carotid artery disease and to assess the degree of carotid artery stenosis. However, results are highly operator-dependent and cannot be presented as survey images. The purpose of this study was to evaluate real-time 3-dimensional (3D) power Doppler sonography as a method for screening for atherosclerosis in the carotid arteries. We prospectively screened 75 patients for carotid artery disease using both conventional color Doppler sonography and 3D power Doppler sonography, and the results from the 2 modalities were compared. A total of 150 common carotid arteries, 150 internal carotid arteries, and 150 external carotid arteries were examined utilizing a 7.5-MHz linear-array transducer combined with tissue harmonic imaging. Color Doppler sonography detected 297 normal or atherosclerotic arteries without stenosis, 57 arteries with mild (1-49%) stenosis, 41 with moderate (50-69%) stenosis, 32 with severe (70-99%) stenosis, and 9 with occlusions. The degree of stenosis determined by color Doppler sonography correlated with that determined by 3D power Doppler sonography (r = 0.982-0.998). Moreover, there was a good correlation between the measurements for both the length of the lesion and its distance from the bulb as determined by the 3D volume surveys and by color Doppler sonography (r = 0.986). The interobserver variability rate was 3.7% +/- 0.5%. Generally, the acquisition and reconstruction of the 3D data took less than 5 minutes. 3D power Doppler sonography is easy to perform and is an accurate method in screening for atherosclerotic lesions of the carotid arteries. Moreover, it provides excellent 3D volume surveys that may be helpful in the planning of surgical treatment. Copyright 2000 John Wiley & Sons, Inc.

Concomitant use of proton pump inhibitors and clopidogrel in patients with coronary, cerebrovascular, or peripheral artery disease in the factores de Riesgo y ENfermedad Arterial (FRENA) registry.

Science.gov (United States)

Muñoz-Torrero, Juan Francisco Sánchez; Escudero, Domingo; Suárez, Carmen; Sanclemente, Carmen; Pascual, Ma Teresa; Zamorano, José; Trujillo-Santos, Javier; Monreal, Manuel

2011-01-01

Among patients receiving clopidogrel for coronary artery disease, concomitant therapy with proton pump inhibitors (PPIs) has been associated with an increased risk for recurrent coronary events. Factores de Riesgo y ENfermedad Arterial (FRENA) is an ongoing, multicenter, observational registry of consecutive outpatients with coronary artery disease, cerebrovascular disease, or peripheral artery disease. We retrospectively examined the influence of concomitant use of PPIs on outcome in patients receiving clopidogrel. As of March 2009, 1222 patients were using clopidogrel: 595 had coronary artery disease, 329 cerebrovascular disease, and 298 had peripheral artery disease. Of these, 519 (42%) were concomitantly using PPIs. Over a mean follow-up of 15 months, 131 patients (11%) had 139 subsequent ischemic events: myocardial infarction 44, ischemic stroke 40, and critical limb ischemia 55. Seventeen of them (13%) died within 15 days of the subsequent event. PPI users had a higher incidence of myocardial infarction (rate ratio, 2.5; 95% confidence interval [CI], 1.3-4.8), ischemic stroke (rate ratio, 1.9; 95% CI, 1.03-3.7), and a nonsignificantly higher rate of critical limb ischemia (rate ratio, 1.6; 95% CI, 0.95-2.8) than nonusers. On multivariate analysis, concomitant use of clopidogrel and PPIs was independently associated with an increased risk for subsequent ischemic events both in the whole series of patients (hazard ratio, 1.8; 95% CI, 1.1-2.7) and in those with cerebrovascular disease or peripheral artery disease (hazard ratio, 1.5; 95% CI, 1.01-2.4). In patients with established arterial disease, concomitant use of PPIs and clopidogrel was associated with a nearly doubling of the incidence of subsequent myocardial infarction or ischemic stroke. This higher incidence persisted after multivariate adjustment.

Coronary artery anomalies and clinically important anatomy in patients with congenital heart disease: multislice CT findings

International Nuclear Information System (INIS)

Goo, Hyun Woo; Seo, Dong-Man; Yun, Tae-Jin; Park, Jeong-Jun; Park, In-Sook; Ko, Jae Kon; Kim, Young Hwee

2009-01-01

In patients with congenital heart disease, coronary artery anomalies are common and have different clinical importance from individuals with structurally normal hearts. Visibility of the coronary arteries by CT has markedly improved due to high temporal resolution and ECG-synchronized data acquisition. In this article we describe current multislice CT techniques for coronary artery imaging and illustrate coronary artery anomalies and clinically important coronary artery anatomy from the point of view of congenital heart disease. (orig.)

Coronary artery anomalies and clinically important anatomy in patients with congenital heart disease: multislice CT findings

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Goo, Hyun Woo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea); Seo, Dong-Man; Yun, Tae-Jin; Park, Jeong-Jun [University of Ulsan College of Medicine, Department of Pediatric Cardiac Surgery, Asan Medical Center, Seoul (Korea); Park, In-Sook; Ko, Jae Kon; Kim, Young Hwee [University of Ulsan College of Medicine, Department of Pediatric Cardiology, Asan Medical Center, Seoul (Korea)

2009-03-15

In patients with congenital heart disease, coronary artery anomalies are common and have different clinical importance from individuals with structurally normal hearts. Visibility of the coronary arteries by CT has markedly improved due to high temporal resolution and ECG-synchronized data acquisition. In this article we describe current multislice CT techniques for coronary artery imaging and illustrate coronary artery anomalies and clinically important coronary artery anatomy from the point of view of congenital heart disease. (orig.)

Remodelling of the microarchitecture of resistance arteries in cardiovascular diseases

DEFF Research Database (Denmark)

Bloksgaard, Maria; Brewer, Jonathan R.; Leurgans, Thomas

Small resistance artery structure is an independent predictor of cardiovascular events in essential hypertension [1, 2] and diabetes (types I and II) [3, 4]. In particular, the media-to-lumen ratio (M:L) is predictive of cardiovascular events. The exact nature of this resistance artery remodeling...... in comparison to other well-studied microvascular beds (e.g. rat mesentery). In the future we aim to compare the microarchitecture of small resistance arteries from parietal pericardial biopsies between patients with and without (treated) hypertension, diabetes and/or ischemic heart disease. 1. Buus, N.H., et...... al., Small artery structure during antihypertensive therapy is an independent predictor of cardiovascular events in essential hypertension. J Hypertens, 2013. 31(4): p. 791-7. 2. Mathiassen, O.N., et al., Small artery structure is an independent predictor of cardiovascular events in essential...

Understanding gene expression in coronary artery disease through ...

Indian Academy of Sciences (India)

Understanding gene expression in coronary artery disease through global profiling, network analysis ... A_33_P3249595 B-cell CLL/lymphoma 11A (zinc finger protein). BCL11A. 2.29 ..... It acts as a cytoplasmic sensor for viral infection and ...

Myocardial perfusion SPECT in diabetic patients for detection of coronary artery disease

International Nuclear Information System (INIS)

Saeed, M.A.; Fatima, S.; Fatmi, S.; Kureshi, S.

2003-01-01

The aim of this study was to evaluate the efficacy of myocardial SPECT perfusion scan in the diagnosis of coronary artery disease in diabetic patients. A total number of thirty diabetic patients (21 males, 9 females) were included in the study. All the patients had strong risk-factors for coronary artery disease (strong family history, chronic smokers, hyperlipidemia, history of chest pain). All patients underwent coronary angiography and stress/rest myocardial perfusion SPECT scans with Tc-99m MIBI (two days protocol). Twenty two patients had significant coronary artery stenosis and 8 had normal coronary arteries. Myocardial perfusion scintigraphy (MPS) was positive in 19 subjects out of the 22 patients with significant stenosis (Sensitivity 86.4%) and negative (false negative) in only three. Out of 8 patients with normal angiography 7 had normal MPS (Specificity 87.5%) whereas only one patient revealed abnormality in the myocardial perfusion study. When compared with coronary angiography the positive predictive value and negative predictive value for Tc-99m MIBI myocardial perfusion scan was 86.4% and 87.5% respectively. In conclusion, Tc-99m MIBI myocardial perfusion scintigraphy is a useful screening modality for the detection of coronary artery disease in diabetic patients. (author)

Value of Resistive lndex of the lntrascrotal Artery in ScrotaI Inflammatory Disease

International Nuclear Information System (INIS)

Jee, Won Hee; Yoon, Yeo Dong; Hwang, Sung Su; Choi, Byung Gil; Son, Kyung Myung; Lee, Sung Yong; Kim, Ki Tae; Shinn, Kyung Sub

1995-01-01

This prospective study was designed to investigate the utility of resistive indices(RIs) of intratesticular and epididymal arteries in inflammatory scrotal disease. Gray-scale and color Doppler ultrasonographic images were obtained in 19 consecutive patients of scrotal inflammatory disease from Nov.1993 to Oct. 1994. Eleven cases of epididymitis and 11 of epididymoorchitis(EO) were included. RIs of epididymal and centripetal arteries were calculated in 19 patients and 30 cases of control. All EO and epididymitis cases showed increased color signal at color Doppler ultrasonogram at representative sites. Mean RI of centripetal artery was 0.46±0.06 in EO and 0.66±0.07 in normal control, hence RI in EO was significantly lower than that of normal control(P<0.001). The diagnostic sensitivity was 91% when the value of 0.5 or less is estimated abnormal.Mean RI of centripetal artery was 0.67±0.07 in epididymitis, and was not significantly different from that of normal control(P=0.687). Mean RI of epididymal artery in epididymitis and EO was 0.48±0.12 and resistive index of all patients were below 0.7. Color Doppler can demonstrate the hyperemic response to scrotal inflammatory disease that it can supplement the gray scale finding leading to increased diagnostic confidence. RI of centripetal artery may be confirmative in the diagnosis of inflammatory scrotal inflammatory scrotal diseases when increased color flow on color flow imaging is present

An Update on Renal Artery Denervation and Its Clinical Impact on Hypertensive Disease

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Aditya Bhat

2015-01-01

Full Text Available Hypertension is a globally prevalent condition, with a heavy clinical and economic burden. It is the predominant risk factor for premature cardiovascular and cerebrovascular disease, and is associated with a variety of clinical disorders including stroke, congestive cardiac failure, ischaemic heart disease, chronic renal failure, and peripheral arterial disease. A significant subset of hypertensive patients have resistant hypertensive disease. In this group of patients, catheter-based renal artery denervation has emerged as a potential therapy, with favourable clinical efficacy and safety in early trials. Additional benefits of this therapy are also being identified and include effects on left ventricular remodeling, cardiac performance, and symptom status in congestive cardiac failure. Utility of renal denervation for the management of resistant hypertension, however, has become controversial since the release of the Symplicity HTN-3 trial, the first large-scale blinded randomised study investigating the efficacy and safety of renal artery denervation. The aim of this paper is to evaluate the history, utility, and clinical efficacy of renal artery denervation technology, including an in-depth appraisal of the current literature and principal trials.

An Update on Renal Artery Denervation and Its Clinical Impact on Hypertensive Disease

Science.gov (United States)

Kuang, Ye Min; Gan, Gary C. H.; Burgess, David; Denniss, Alan Robert

2015-01-01

Hypertension is a globally prevalent condition, with a heavy clinical and economic burden. It is the predominant risk factor for premature cardiovascular and cerebrovascular disease, and is associated with a variety of clinical disorders including stroke, congestive cardiac failure, ischaemic heart disease, chronic renal failure, and peripheral arterial disease. A significant subset of hypertensive patients have resistant hypertensive disease. In this group of patients, catheter-based renal artery denervation has emerged as a potential therapy, with favourable clinical efficacy and safety in early trials. Additional benefits of this therapy are also being identified and include effects on left ventricular remodeling, cardiac performance, and symptom status in congestive cardiac failure. Utility of renal denervation for the management of resistant hypertension, however, has become controversial since the release of the Symplicity HTN-3 trial, the first large-scale blinded randomised study investigating the efficacy and safety of renal artery denervation. The aim of this paper is to evaluate the history, utility, and clinical efficacy of renal artery denervation technology, including an in-depth appraisal of the current literature and principal trials. PMID:26495305

Gender Differences in the Association between Lipid Profile and Sexual Function among Patients with Coronary Artery Disease

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Shervin Assari

2014-03-01

Full Text Available Background: Although several studies have been conducted on the association between lipid profile and sexual function among men with coronary artery disease, there is a paucity of knowledge about this association among women with coronary artery disease. Objectives: Our study aimed to evaluate the link between lipid profile and sexual function in men and women with coronary artery disease. Methods: One hundred and twenty patients with documented coronary artery disease were consecutively sampled from an outpatient cardiovascular clinic. The patients were assessed for lipid profile and sexual relationship using the Relation and Sexuality Scale (RSS. In addition, the Hospital Anxiety and Depression Scale (HADS was used to measure the symptoms of anxiety and depression. The characteristics of chest pain were also measured using the Rose Angina Questionnaire. The data were analyzed through linear regression analysis. Results: This study was conducted on 91 males (75.8% and 29 females (24.2%. Multivariate analysis showed that low-density lipoprotein cholesterol was correlated with sexual function (B = 0.01, P = 0.010 and total sexual relationship (B = 0.01, P = 0.050. A correlation was also observed between the level of high-density lipoprotein and sexual frequency score (B = -0.02, P = 0.040. Gender moderated these correlations. Among males, serum cholesterol (r = 0.193, P = 0.047 and low-density lipoprotein (r = 0.224, P = 0.037 were correlated to sexual function. In females, however, low-density lipoprotein was correlated to the total sexual relationship (r = 0.426, P = 0.021 and high-density lipoprotein was correlated to sexual frequency (r = -0.334, P = 0.046. Conclusions: The findings of this study showed a relationship between lipid profile and sexual relationship among both male and female patients with coronary artery disease. The link between lipid profile and sexual function of the patients with coronary artery disease is thus beyond just

Asymptomatic carotid artery stenosis in patients with severe peripheral vascular diseases

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Rasoul Mirsharifi

2009-04-01

Full Text Available

• BACKGROUND: The prevalence of carotid artery stenosis (CAS in the  eneral population is not high enough to justify screening programs. This study was done to determine the prevalence of asymptomatic carotid artery stenosis (ACAS among patients with severe peripheral vascular disease (PVD.
• METHODS: Between March 2005 and February 2006, 54 consecutive  atients with severe PVD admitted at a vascular surgery unit and underwent carotid duplex scanning in a prospective study. A  uestionnaire was used to collect data concerning known risk factors. Significant CAS was defined as a stenosis of 70% or greater.
• RESULTS: The mean age was 62.5 years (51-72. Out of 54 patients, 2 (3.7% had an occluded internal carotid artery. Significant CAS was found in 9 (16.7% and its presence was correlated with diabetes, hypertension, hypercholesterolemia, hypertriglyceridemia, coronary artery disease, severity of symptoms, ankle-brachial index, and carotid bruit. On multivariate analysis, only hypercholesterolemia and carotid bruit seemed to have independent influence.
• CONCLUSION: The prevalence of significant ACAS is higher among  atients with severe PVD. This patient population may indicate a  uitable subgroup for screening of ACAS, especially when hypercholesterolemia and carotid bruit are present.
• KEYWORDS: Carotid artery stenosis, duplex ultrasound scanning, peripheral vascular disease, carotid endarterectomy,
• cerebrovascular accident.

Evaluation of Cognitive Schemas Based on the Presence of Anxiety Disorder among Coronary Artery Disease Patients

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Huri ASLAN

2012-12-01

Results: Disconnection, rejection, impaired autonomy self-manifestation, extreme vigilance, unrelenting standards, other-directedness, and impaired limits schema domain scores were significantly higher in coronary artery disease patients with anxiety disorder comorbidity compared to coronary artery disease patients without anxiety disorder. Conclusion: Our study has revealed significant differences in cognitive profiles of coronary artery disease patients with comorbidity of anxiety disorders. These findings show the importance of cognitive profiles which were observed in coronary artery disease patients with anxiety disorders. Schema-focused approach might be useful in the treatment of such patients. Further studies with schema-focused therapy approaches are needed to illustrate the issue. [JCBPR 2012; 1(3.000: 171-177

Lower Extremity Arterial Calcification as a Predictor of Coronary Atherosclerosis in Patients with Peripheral Arterial Disease

International Nuclear Information System (INIS)

Shin, Hwa Seon; Jung Park, Mi; Nyeo Jeon, Kyung; Min Cho, Jae; Soo Bae, Kyung; Seob Choi, Dae; Boem Na, Jae; Cheol Choi, Ho; Young Choi, Hye; Eun Kim, Ji; Bueum Cho, Soo; Eun Park, Sung

2016-01-01

Until now, there has been no study on the relationship between the calcification of the lower extremity arteries and significant coronary arterial disease (CAD). To evaluate whether lower extremity calcium scores (LECS) are associated with CAD and whether this can predict multivessel-CAD in patients with peripheral arterial disease (PAD). We retrospectively enrolled 103 PAD patients without cardiac symptoms or known CAD. All patients underwent cardiac computed tomography (CT) and lower extremity CT within 1 month and were categorized as nonsignificant CAD, single-CAD, or multivessel-CAD. The coronary calcium scores (CCS) were quantitatively measured according to the Agatston method and LECS were semi-quantitatively measured according to the presence of lower extremity calcification in the segment. The extent of CAD was evaluated according to the presence of ≥ 50% luminal diameter stenosis in the segment of CAD. LECS in multivessel-CAD were significantly higher than those in nonsignificant CAD (10.0 ± 5.8 versus 4.0 ± 3.1, P < 0.001). LECS significantly correlated with CCS (r = 0.831, P < 0.001) and the extent of CAD (r = 0.631, P < 0.001). Multivariate regression analysis demonstrated LECS and log-transformed CCS were independent predictors for multivessel-CAD. In receiver operating characteristic curve analysis, the diagnostic performance of LECS was 0.807 (95% confidence interval = 0.724-0.891, P < 0.001) for predicting multivessel-CAD. Peripheral arterial calcification is significantly correlated with CAD extent in patients with PAD. Peripheral arterial calcification can be a useful marker for predicting multivessel-CAD

CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ARTERIAL HYPERTENSION: VASCULAR WALL AS THE TARGET ORGAN IN COMORBID PATIENTS

OpenAIRE

N. A. Karoli; A. P. Rebrov

2017-01-01

Studies of endothelial dysfunction in patients with respiratory diseases have become relevant in recent years. Perhaps endothelial dysfunction and high arterial stiffness bind bronchopulmonary and cardiovascular diseases.Aim. To reveal features of disturbances of arterial wall vasoregulatory function in patients with chronic obstructive pulmonary disease (COPD) in the presence and absence of arterial hypertension (HT).Material and methods. The study included 50 patients with COPD with normal ...

Depressive symptoms in patients with coronary artery disease

Directory of Open Access Journals (Sweden)

Débora Maria Mendonça da Cunha

Full Text Available Objective.To assess the presence of depressive symptoms in patients with coronary artery disease in the preoperative period for coronary artery bypass surgery (CABG in Aracaju, Sergipe, Brazil. Methods. A cross-sectional study with 63 hospitalized patients prior to CABG. Two instruments were used for data collection; one for the sociodemographic and clinical characteristics, and the other to evaluate the presence of depressive symptoms, Beck Depression Inventory (BDI. Results. The mean age was 58 years; most were male (60.3%; with a partner (81% low educational level (71.4% attended school through elementary school. Among the patients, 36.5% were classified with dysphoria, and 25.4% had some degree of depression (6.3% mild, 17.5% moderate, and 1.6% severe. The group of patients with lower educational level presented higher depressive symptoms. Conclusion. Six of every ten patients with coronary artery disease showed dysphoria or some degree of depression. The results of this study can support the planning of nursing care for patients before and after CABG, as well as the development of public health policies to ensure complete, quality care for these patients, understanding depression as a variable that can interfere with recovery after cardiac surgery.

Management standards for stable coronary artery disease in India

Directory of Open Access Journals (Sweden)

Sundeep Mishra

2016-12-01

Full Text Available Coronary artery disease (CAD is one of the important causes of cardiovascular morbidity and mortality globally, giving rise to more than 7 million deaths annually. An increasing burden of CAD in India is a major cause of concern with angina being the leading manifestation. Stable coronary artery disease (SCAD is characterised by episodes of transient central chest pain (angina pectoris, often triggered by exercise, emotion or other forms of stress, generally triggered by a reversible mismatch between myocardial oxygen demand and supply resulting in myocardial ischemia or hypoxia. A stabilised, frequently asymptomatic phase following an acute coronary syndrome (ACS is also classified as SCAD. This definition of SCAD also encompasses vasospastic and microvascular angina under the common umbrella.

Association of Endodontic Lesions with Coronary Artery Disease

OpenAIRE

Liljestrand, J. M.; Mäntylä, P.; Paju, S.; Buhlin, K.; Kopra, K. A. E.; Persson, G. R.; Hernandez, M.; Nieminen, M. S.; Sinisalo, J.; Tjäderhane, L.; Pussinen, P. J.

2016-01-01

An endodontic lesion (EL) is a common manifestation of endodontic infection where Porphyromonas endodontalis is frequently encountered. EL may associate with increased risk for coronary artery disease (CAD) via similar pathways as marginal periodontitis. The aim of this cross-sectional study was to delineate the associations between EL and CAD. Subgingival P. endodontalis, its immune response, and serum lipopolysaccharide were examined as potential mediators between these 2 diseases. The Finn...

Segmental quantitative analysis of digital thallium-201 myocardial scintigrams in diagnosis of coronary artery disease

International Nuclear Information System (INIS)

Wainwright, R.J.; Maisey, M.N.; Sowton, E.

1981-01-01

One hundred and forty-nine patients with suspected ischaemic heart disease were evaluated by exercise thallium-201 myocardial scintigraphy ( 201 Tl SMS), single lead exercise electrocardiography, and coronary arteriography. Myocardial distribution of tracer was assessed semi-quantitatively from digital 201 Tl scintigrams and compared with tracer distribution in subjects with normal hearts. Fifty-two of 54 (96%) patients with normal coronary arteries had normal myocardial scintigrams whereas three patients had a positive ischaemic exercise electrocardiogram and were scan normal. Conversely, 36 of 95 (38%) patients with coronary artery disease had a positive ischaemic electrocardiogram compared with 94 of 95 (99%) patients who had a positive myocardial scintigram. Disease was predicted correctly in 76 out of 80 (95%) of left anterior descending coronary stenoses, in 48 out of 64 (75%) of right coronary artery stenoses, and in 55 out of 64 (85%) of left circumflex coronary artery stenoses, despite the presence of infarcted myocardium in other territories. 201 Tl SMS with segmental quantitative analysis is a highly sensitive and specific technique in the diagnosis of coronary artery disease and may be a useful screening procedure to select patients for further investigation, particularly those with evidence of life-threatening severe left coronary artery disease. (author)

The application of super-selective external carotid artery embolization in head and neck diseases

International Nuclear Information System (INIS)

Xin Yongtong; Wei Dingtai; Lin Shifeng; Ye Jian'an; Chen Youying

2006-01-01

Objective: To study the application of super-selective external carotid artery embolization in head and neck diseases. Methods: DSA and super-selective external carotid artery embolization were carried out in 41 cases of head and neck diseases including 12 cases of epistaxis, 7 nasopharyngeal fibroangioma, 1 traumatic arterial bleeding, 14 vascular malformation, and 7 malignancies. Results: No recurrence of nose bleeding after embolization of epistaxis was seen within 6-12 month follow up. The operative bleeding was reduced significantly by preoperative embolization in nasopharyngeal fibroangioma. No recurrence of bleeding was reduced significantly by preoperative embolization in nasopharyngeal fibroangioma. No recurrence of bleeding was achieved after embolization of traumatic artery. Among the case of vascular malformation, 3 were proven to be significantly efficient, 6 efficient, and 5 inefficient in the 6-12 month follow up. Among the 7 malignant cases, 3 survived more than 2 years. Conclusion: Super-selective external carotid artery embolization is safe and effective in the treatment of head and neck diseases. (authors)

Elevated arterial compliance in patients with cirrhosis is not related to arterial endothelin-1

DEFF Research Database (Denmark)

Møller, Søren; Gülberg, V; Becker, U

2002-01-01

study was to investigate a potential relation between altered arterial compliance and arterial ET-1 in patients with cirrhosis. As ET-1 may be manipulated by somastostatin, the study includes infusion of octreotide in a subset of patients. METHODS: A total of 67 patients with cirrhosis and 27 controls...

Early-stage differentiation between presenile Alzheimer’s disease and frontotemporal dementia using arterial spin labeling MRI

NARCIS (Netherlands)

R.M.E. Steketee (Rebecca); E.E. Bron (Esther); R. Meijboom (Rozanna); G.C. Houston (Gavin); S. Klein (Stefan); H.J.M.M. Mutsaerts (Henri J. M.); C. Méndez Orellana (Carolina); F.J. De Jong (Frank J.); J.C. van Swieten (John); A. van der Lugt (Aad); M. Smits (Marion)

2016-01-01

textabstractObjective: To investigate arterial spin labeling (ASL)-MRI for the early diagnosis of and differentiation between the two most common types of presenile dementia: Alzheimer’s disease (AD) and frontotemporal dementia (FTD), and for distinguishing age-related from pathological perfusion

Early-stage differentiation between presenile Alzheimer’s disease and frontotemporal dementia using arterial spin labeling MRI

NARCIS (Netherlands)

R.M.E. Steketee (Rebecca); E.E. Bron (Esther); Meijboom, R. (Rozanna); Houston, G.C. (Gavin C.); Klein, S. (Stefan); H.J.M.M. Mutsaerts (Henri J. M.); Orellana, C.P.M. (Carolina P. Mendez); F.J. de Jong (Fransina); J.C. van Swieten (John); A. van der Lugt (Aad); M. Smits (Marion)

2015-01-01

textabstractObjective: To investigate arterial spin labeling (ASL)-MRI for the early diagnosis of and differentiation between the two most common types of presenile dementia: Alzheimer’s disease (AD) and frontotemporal dementia (FTD), and for distinguishing age-related from pathological perfusion

The association between uric acid levels and different clinical manifestations of coronary artery disease

DEFF Research Database (Denmark)

Larsen, Trine R; Gerke, Oke; Diederichsen, Axel C P

2018-01-01

AIMS: Uric acid (UA) has been associated with the presence and severity of coronary artery disease. To further assess the role of UA role in coronary artery disease, we investigated UA levels in both healthy asymptomatic middle-aged individuals and in different subgroups of hospitalized patients...

Significant association of RNF213 p.R4810K, a moyamoya susceptibility variant, with coronary artery disease.

Science.gov (United States)

Morimoto, Takaaki; Mineharu, Yohei; Ono, Koh; Nakatochi, Masahiro; Ichihara, Sahoko; Kabata, Risako; Takagi, Yasushi; Cao, Yang; Zhao, Lanying; Kobayashi, Hatasu; Harada, Kouji H; Takenaka, Katsunobu; Funaki, Takeshi; Yokota, Mitsuhiro; Matsubara, Tatsuaki; Yamamoto, Ken; Izawa, Hideo; Kimura, Takeshi; Miyamoto, Susumu; Koizumi, Akio

2017-01-01

The genetic architecture of coronary artery disease has not been fully elucidated, especially in Asian countries. Moyamoya disease is a progressive cerebrovascular disease that is reported to be complicated by coronary artery disease. Because most Japanese patients with moyamoya disease carry the p.R4810K variant of the ring finger 213 gene (RNF213), this may also be a risk factor for coronary artery disease; however, this possibility has never been tested. We genotyped the RNF213 p.R4810K variant in 956 coronary artery disease patients and 716 controls and tested the association between p.R4810K and coronary artery disease. We also validated the association in an independent population of 311 coronary artery disease patients and 494 controls. In the replication study, the p.R4810K genotypes were imputed from genome-wide genotyping data based on the 1000 Genomes Project. We used multivariate logistic regression analyses to adjust for well-known risk factors such as dyslipidemia and smoking habits. In the primary study population, the frequency of the minor variant allele was significantly higher in patients with coronary artery disease than in controls (2.04% vs. 0.98%), with an odds ratio of 2.11 (p = 0.017). Under a dominant model, after adjustment for risk factors, the association remained significant, with an odds ratio of 2.90 (95% confidence interval: 1.37-6.61; p = 0.005). In the replication study, the association was significant after adjustment for age and sex (odds ratio = 4.99; 95% confidence interval: 1.16-21.53; p = 0.031), although it did not reach statistical significance when further adjusted for risk factors (odds ratio = 3.82; 95% confidence interval: 0.87-16.77; p = 0.076). The RNF213 p.R4810K variant appears to be significantly associated with coronary artery disease in the Japanese population.

Quantitative analysis of exercise 201Tl myocardial emission CT in patients with coronary artery disease

International Nuclear Information System (INIS)

Okada, Mitsuhiro; Kawai, Naoki; Yamamoto, Shuhei

1984-01-01

The clinical usefulness of quantitative analysis of exercise thallium-201 myocardial emission computed tomography (ECT) was evaluated in coronary artery disease (CAD). The subjects consisted of 20 CAD patients and five normal controls. All CAD patients underwent coronary angiography. Tomographic thallium-201 myocardial imaging was performed with a rotating gamma camera, and long-axial and short-axial myocardial images of the left ventricle were reconstructed. The tomographic images were interpreted quantitatively using circumferential profile analysis. Based on features of regional myocardial thallium-201 kinetics, two types of abnormalities were studied: (1) diminished initial distribution (stress defect) and (2) slow washout of thallium-201, as evidenced by patients' initial thallium-201 uptake and 3-hour washout rate profiles which fell below the normal limits, respectively. Two diagnostic criteria including the stress defect and a combination of the stress defect and slow washout were used to detect coronary artery lesions of significance (>=75 % luminal narrowing). The ischemic volumes were also evaluated by quantitative analysis using thallium-201 ECT. The diagnostic accuracy of the stress defect criterion was 95 % for left anterior descending, 90 % for right, and 70 % for left circumflex coronary artery lesions. The combined criteria of the stress defect and slow washout increased detection sensitivity with a moderate loss of specificity for identifying individual coronary artery lesion. A relatively high diagnostic accuracy was obtained using the stress defect criterion for multiple vessel disease (75 %). Ischemic myocardial volume was significantly larger in triple vessel than in single vessel disease (p < 0.05) using the combined criteria. It was concluded that quantitative analysis of exercise thallium-201 myocardial ECT images proves useful for evaluating coronary artery lesions. (author)

Long-term results of peripheral arterial disease rehabilitation

NARCIS (Netherlands)

Menard, J.R.; Smith, H.E.; Riebe, D.; Braun, C.M.; Blissmer, B.; Patterson, R.B.

2004-01-01

Purpose Although the Peripheral Arterial Disease Rehabilitation Program (PADRx) improves walking ability and quality of life over brief periods of follow-up, the long-term durability of results has not been established. This study examined functional status, walking ability, and quality of life in

Understanding gene expression in coronary artery disease through ...

Indian Academy of Sciences (India)

Understanding gene expression in coronary artery disease through global profiling, network analysis and independent validation of key candidate genes. Prathima ... Table 2. Differentially expressed genes in CAD compared to age and gender matched controls. .... Regulation of nuclear pre-mRNA domain containing 1A.

Detection of coronary calcium with electron beam tomography in coronary artery disease

International Nuclear Information System (INIS)

Haberl, R.; Knez, A.; Becker, A.; Becker, C.; Bruening, R.; Reiser, M.; Maass, A.; Steinbeck, G.

1998-01-01

Purpose: Coronary calcium is a powerful indicator of arteriosclerosis and can be detected very precisely with electron beam tomography. The method can be applied in patients with known coronary artery disease or in asymptomatic patients at risk of arteriosclerotic disease. Results: At the University of Munich we performed an EBT scan of the heart in 1100 patients within the last year. In 567 patients coronary angiography was performed also (±3 days). Confirming previous reports in the literature, we found a correlation of the calcium score with the age and gender of the patients. Severe coronary artery disease (stenoses ≥ 75%) was associated with significantly more calcium than less severe CAD. The calcium score did not discriminate between one-, two- and three-vessel disease. The site of calcification does not correlate with the localization of stenoses. Thirty-three percent of the patients with significant coronary artery disease showed a normal age-adjusted calcium score; a total of 8.1% of patients with severe stenoses did not reveal any coronary calcification (score =0). With asymptomatic patients there are only a few studies available. Soft plaques cannot be detected with EBT, but in most patients soft plaques occur together with hard plaques. Our results show that spiral CT of the newest generation may also be used for calcium screening. There was an excellent correlation of the calcium scores of EBT and spiral CT at all levels of calcification. Discussion: Coronary calcium is a sensitive marker of coronary artery disease. In the clinical setting EBT is indicated in patients with known coronary artery disease (to evaluate prognosis), in patients who are unable to perform a stress test, and in patients with atypical chest pain. However, lack of calcification may be associated with severe stenoses in a minority of patients. The clinical value in asymptomatic patients needs to be defined: Randomized studies are necessary. We see a possible indication in

Role of Doppler ultrasonography evaluation of superior mesenteric artery flow volume in the assessment of Crohn's disease activity

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Fabiana Paiva Martins

2013-09-01

Full Text Available Objective To investigate superior mesenteric artery flow measurement by Doppler ultrasonography as a means of characterizing inflammatory activity in Crohn's disease. Materials and Methods Forty patients were examined and divided into two groups – disease activity and remission – according to their Crohn's disease activity index score. Mean superior mesenteric artery flow volume was calculated for each group and correlated with Crohn's disease activity index score. Results The mean superior mesenteric artery flow volume was significantly greater in the patients with active disease (626 ml/min ± 236 × 376 ml/min ± 190; p = 0.001. As a cut off corresponding to 500 ml/min was utilized, the superior mesenteric artery flow volume demonstrated sensitivity of 83% and specificity of 82% for the diagnosis of Crohn's disease activity. Conclusion The present results suggest that patients with active Crohn's disease have increased superior mesenteric artery flow volume as compared with patients in remission. Superior mesenteric artery flow measurement had a good performance in the assessment of disease activity in this study sample.

Impact of cardiac symptoms on self-reported household task performance in women with coronary artery disease.

Science.gov (United States)

Kimble, L P

2001-01-01

Household tasks are highly salient physical activities for women. Inability to perform household tasks may serve as an important marker of limitations imposed by cardiac symptoms. The purpose of this study was to examine the impact of cardiac symptoms on perceived ability to perform household tasks in women with coronary artery disease and to examine relationships among age, whether the woman lived alone, ability to perform household tasks, and cardiac-related quality of life. Forty-one women with confirmed diagnosis of coronary artery disease and a mean age of 66 years (SD 12 years) were interviewed about the impact of their cardiac symptoms and perceived ability to perform household tasks (Household Activities Scale) and cardiac-related quality of life (Seattle Angina Questionnaire). The women were primarily white (89.4%) and retired (65.9%). Forty-six percent were married, and 26.8% lived alone. "Washing dishes" (51.3%) was the only task a majority of the sample could perform without limitation. Household tasks most commonly reported as no longer performed included carrying laundry (24.4%), vacuuming (30.0%), and scrubbing the floor (51.2%). The task most commonly modified because of cardiac symptoms was changing bed linens (60%). Of the 14 household tasks, women performed a mean of 3.39 (SD 3.36) activities without difficulty. Total number of household activities performed without difficulty was associated with better quality of life in the area of exertional capacity (r = 0.50, P = 0.001). Women who lived alone reported greater perceived ability to perform household tasks than women who did not live alone (r = 0.31, P = 0.05). Age was not significantly associated with perceived household task performance (r = -0.22, P = 0.17). Women with coronary artery disease (CAD) perceived cardiac symptoms as disrupting their ability to perform household tasks. Future research is needed to determine the independent impact of cardiac symptoms on functional limitations

Control of drug treatment of chronic coronary artery disease: possibilities of a regional registry

Directory of Open Access Journals (Sweden)

Rachkova S.A.

2016-03-01

Full Text Available The article describes the results of the Register of hypertension, coronary artery disease, chronic heart failure (Register of AH, CAD, HF in the Ivanovo region in 2015. The frequency of prescribing of the main groups of drugs in patients with coronary artery disease was estimated.

Imaging of Small Animal Peripheral Artery Disease Models: Recent Advancements and Translational Potential

Directory of Open Access Journals (Sweden)

Jenny B. Lin

2015-05-01

Full Text Available Peripheral artery disease (PAD is a broad disorder encompassing multiple forms of arterial disease outside of the heart. As such, PAD development is a multifactorial process with a variety of manifestations. For example, aneurysms are pathological expansions of an artery that can lead to rupture, while ischemic atherosclerosis reduces blood flow, increasing the risk of claudication, poor wound healing, limb amputation, and stroke. Current PAD treatment is often ineffective or associated with serious risks, largely because these disorders are commonly undiagnosed or misdiagnosed. Active areas of research are focused on detecting and characterizing deleterious arterial changes at early stages using non-invasive imaging strategies, such as ultrasound, as well as emerging technologies like photoacoustic imaging. Earlier disease detection and characterization could improve interventional strategies, leading to better prognosis in PAD patients. While rodents are being used to investigate PAD pathophysiology, imaging of these animal models has been underutilized. This review focuses on structural and molecular information and disease progression revealed by recent imaging efforts of aortic, cerebral, and peripheral vascular disease models in mice, rats, and rabbits. Effective translation to humans involves better understanding of underlying PAD pathophysiology to develop novel therapeutics and apply non-invasive imaging techniques in the clinic.

Association Between Coronary Artery Disease Genetic Variants and Subclinical Atherosclerosis: An Association Study and Meta-analysis.

Science.gov (United States)

Zabalza, Michel; Subirana, Isaac; Lluis-Ganella, Carla; Sayols-Baixeras, Sergi; de Groot, Eric; Arnold, Roman; Cenarro, Ana; Ramos, Rafel; Marrugat, Jaume; Elosua, Roberto

2015-10-01

Recent studies have identified several genetic variants associated with coronary artery disease. Some of these genetic variants are not associated with classical cardiovascular risk factors and the mechanism of such associations is unclear. The aim of the study was to determine whether these genetic variants are related to subclinical atherosclerosis measured by carotid intima media thickness, carotid stiffness, and ankle brachial index. A cross-sectional study nested in the follow-up of the REGICOR cohort was undertaken. The study included 2667 individuals. Subclinical atherosclerosis measurements were performed with standardized methods. Nine genetic variants were genotyped to assess associations with subclinical atherosclerosis, individually and in a weighted genetic risk score. A systematic review and meta-analysis of previous studies that analyzed these associations was undertaken. Neither the selected genetic variants nor the genetic risk score were significantly associated with subclinical atherosclerosis. In the meta-analysis, the rs1746048 (CXCL12; n = 10581) risk allele was directly associated with carotid intima-media thickness (β = 0.008; 95% confidence interval, 0.001-0.015), whereas the rs6725887 (WDR12; n = 7801) risk allele was inversely associated with this thickness (β = -0.013; 95% confidence interval, -0.024 to -0.003). The analyzed genetic variants seem to mediate their association with coronary artery disease through different mechanisms. Our results generate the hypothesis that the CXCL12 variant appears to influence coronary artery disease risk through arterial remodeling and thickening, whereas the WDR12 risk variant could be related to higher plaque vulnerability. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Arterial pressure profile in patients with cirrhosis

DEFF Research Database (Denmark)

Henriksen, Jens H; Fuglsang, Stefan; Bendtsen, Flemming

2012-01-01

Patients with cirrhosis have cardiovascular dysfunction and altered mechanical properties of large and small arteries. This study was undertaken in order to analyze the arterial pressure curve in relation to mean arterial pressure level, stroke volume, and severity of liver disease....

C-reactive protein, dietary n-3 fatty acids, and the extent of coronary artery disease

DEFF Research Database (Denmark)

Madsen, Trine; Skou, Helle Aarup; Hansen, Vibeke Ellegaard

2001-01-01

The acute-phase reactant C-reactive protein (CRP) has emerged as an independent risk factor for coronary artery disease. Experimental and clinical studies provide evidence of anti-inflammatory effects of n-3 polyunsaturated fatty acids (PUFA) derived from fish. We have studied the effect of marin.......003). The inverse correlation between CRP and DHA may reflect an anti-inflammatory effect of DHA in patients with stable coronary artery disease and suggest a novel mechanism by which fish consumption may decrease the risk of coronary artery disease. (C) 2001 by Excerpta Medica, Inc....

Detection of Cardiac Artery Disease by Using the DCAD (b Module

Directory of Open Access Journals (Sweden)

Vahid Khalilzad Sharghi

2009-06-01

Full Text Available Introduction: In patients with cardiac artery disease, a myocardial perfusion scan, which is a non-invasive method, is utilized. This study is conducted to develop an advantageous software applicable to quantitative myocardial SPECT perfusion. Material and Methods: Each cross-section of the left ventricle was segmented by applying a fuzzy clustering method. After obtaining the myocardial skeleton of the left ventricle from its short axis cross sections, we made use of fuzzy logic to decide whether the pixel belongs to the myocardial muscle and any perfusion perturbation or not. The reconstructed image was divided into 18 equivolume sectors. The features were extracted in each sector and, finally, were compared with a normal data bank. Results: Abnormal critical conditions in rest and stress studies and coronary artery disease diagnosis were investigated in a set of about 317 images. Measurement and allocation of different myocardial sectors to specific coronary arteries were accomplished by utilizing collected information about the patients (75 men and 62 women, and the validity of the artery obstruction diagnosis has been proven in 40 patients undergoing coronary angiography. Conclusion: Our developed software DCAD (b has demonstrated a considerably good performance in the diagnosis of coronary artery occlusion and can be a promising method aiding nuclear medicine specialists in their diagnosis.

Discussion of vascular vagovagal reflexes in interventional approach of peripheral arterial diseases

International Nuclear Information System (INIS)

Zhuang Baixi; Yu Chunli; Ma Lubo; Yang Miao; Shi Bo

2007-01-01

Objective: To investigate the vascular vagovagal reflexes (VVRs) during interventional approach of peripheral arterial disease (PAD). Methods: Twelve patients with VVRs during intervention of 528 patients with peripheral arterial diseases were analyzed retrospectively. Results: The 12 patients with VVRs belonging to mixed type, included 2 cases of occurrence during intervention and 10 cases after intervention. All patients recovered well without adverse reaction. Conclusion: VVRs should always be looking after and prompt management be ready in hand. (authors)

Pulmonary arterial hypertension in congenital heart disease: Correlation of radiologic index with hemodynamic data

International Nuclear Information System (INIS)

Choi, Young Hi

1984-01-01

It is well known that pulmonary arterial hypertension in congenital heart disease is an important prognostic factor, as is pulmonary vascular resistance. So it is tempting to get certain radiologic index that could predict the presence and the degree of pulmonary arterial hypertension. A total of 152 cases of left to right shunt with pulmonary arterial hypertension and 50 cases of left to right shunt without pulmonary arterial hypertension is presented, in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between March 1981 and February 1983. Statistical analysis of plain radiography findings with the emphasis on the correction of radiologic index with the hemodynamic data. The results are as follows: 1. The incidence of pulmonary arterial hypertension is much less in arterial septal defect than other two disease groups of left to right shunt. 2. PA/T ratio correlates well with pulmonary arterial pressure (r=0.674), especially in mild pulmonary hypertension group. No correlation in moderate pulmonary hypertension group in significant level. 3. PA/T ratio is below 38 in total cases of normal control group and in 32 cases (21.0%) among 152 cases of pulmonary arterial hypertension group. 4. The average PA/T ratio in normal pressure group of left to right shunt is 35.3, which has no significant difference from that of normal control group. 5. The average CT ratio of pulmonary arterial hypertension group is 59.0, which is larger than 49.1 of normal control group. The CT ratio shows no correlation with the pulmonary arterial pressure in statistically significant level. 6. The higher the pulmonary arterial pressure, the larger the Rp/Rs value. The Rp/Rs in atrial septal defect is 0.193 in average, the lowest value in comparison with other two disease groups.

Linkages between oral commensal bacteria and atherosclerotic plaques in coronary artery disease patients.

Science.gov (United States)

Chhibber-Goel, Jyoti; Singhal, Varsha; Bhowmik, Debaleena; Vivek, Rahul; Parakh, Neeraj; Bhargava, Balram; Sharma, Amit

2016-01-01

Coronary artery disease is an inflammatory disorder characterized by narrowing of coronary arteries due to atherosclerotic plaque formation. To date, the accumulated epidemiological evidence supports an association between oral bacterial diseases and coronary artery disease, but has failed to prove a causal link between the two. Due to the recent surge in microbial identification and analyses techniques, a number of bacteria have been independently found in atherosclerotic plaque samples from coronary artery disease patients. In this study, we present meta-analysis from published studies that have independently investigated the presence of bacteria within atherosclerotic plaque samples in coronary artery disease patients. Data were collated from 63 studies covering 1791 patients spread over a decade. Our analysis confirms the presence of 23 oral commensal bacteria, either individually or in co-existence, within atherosclerotic plaques in patients undergoing carotid endarterectomy, catheter-based atherectomy, or similar procedures. Of these 23 bacteria, 5 ( Campylobacter rectus , Porphyromonas gingivalis , Porphyromonas endodontalis , Prevotella intermedia , Prevotella nigrescens ) are unique to coronary plaques, while the other 18 are additionally present in non-cardiac organs, and associate with over 30 non-cardiac disorders. We have cataloged the wide spectrum of proteins secreted by above atherosclerotic plaque-associated bacteria, and discuss their possible roles during microbial migration via the bloodstream. We also highlight the prevalence of specific poly-microbial communities within atherosclerotic plaques. This work provides a resource whose immediate implication is the necessity to systematically catalog landscapes of atherosclerotic plaque-associated oral commensal bacteria in human patient populations.

Coronary artery disease in patients undergoing cardiac surgery for non-coronary lesions in a tertiary care centre

Directory of Open Access Journals (Sweden)

Cholenahally Nanjappa Manjunath

2014-01-01

Conclusion: The overall prevalence of CAD among patients undergoing non-coronary cardiac surgery is 8.7%. Coronary artery disease is relatively uncommon in patients with rheumatic VHD (4.9%, while its prevalence is highest in DAVD (23.4%.

Arm exercise-thallium imaging testing for the detection of coronary artery disease

International Nuclear Information System (INIS)

Balady, G.J.; Weiner, D.A.; Rothendler, J.A.; Ryan, T.J.

1987-01-01

Patients with lower limb impairment are often unable to undergo a standard bicycle or treadmill test for the evaluation of coronary artery disease. To establish an alternative method of testing, 50 subjects (aged 56 +/- 10 years) performed arm ergometry testing in conjunction with myocardial thallium scintigraphy. All underwent coronary angiography; significant coronary artery disease (greater than or equal to 70% stenosis) in at least one vessel was present in 41 (82%) of the 50 patients. Thallium scintigraphy was found to have an 83% sensitivity and 78% specificity for detecting coronary disease, compared with a sensitivity and specificity of 54% (p less than 0.01) and 67% (p = NS), respectively, for exercise electrocardiography. In the subgroup of 23 patients who had no prior myocardial infarction or left bundle branch block and were not taking digitalis, thallium scintigraphy had a sensitivity of 80% versus 50% for exercise electrocardiography. Scintigraphy yielded a sensitivity of 84, 74 and 90% for one, two and three vessel disease, respectively. Noninvasive arm ergometry exercise-thallium imaging testing appears to be reliable and useful and should be considered in the evaluation of coronary artery disease in patients with lower limb impairment

Correlates of lung/heart ratio of thallium-201 in coronary artery disease

International Nuclear Information System (INIS)

Homma, S.; Kaul, S.; Boucher, C.A.

1987-01-01

We studied 306 patients with chest pain (262 with coronary artery disease and 44 with no coronary artery disease) to determine which of 23 clinical, exercise, thallium, and angiographic variables best discriminate between patients with increased lung/heart ratios of thallium versus those with normal ratios. Normal lung/heart ratio values were defined using an additional 45 subjects with less than 1% probability of coronary artery disease. The number of diseased vessels was the best discriminator between patients with increased ratios versus those with normal ratios. Double product at peak exercise, number of segments with abnormal wall motion, patient gender, and duration of exercise were also significant discriminators. Using discriminant function analysis these variables could correctly identify 81% of cases with increased lung/heart ratios and 72% of cases with normal ratios. These results indicate that an increased lung/heart ratio of thallium reflects exercise-induced left ventricular dysfunction and affords a better understanding of why this thallium parameter is a powerful prognostic indicator in patients with chest pain

Diagnosis of coronary artery disease

International Nuclear Information System (INIS)

Pfisterer, M.; Gordon, D.; Battler, A.; Ashburn, W.; Froelicher, V.; Kantonsspital Basel

1979-01-01

In order to compare the three non-invasive exercise tests Ecg, Thallium myocardial perfusion imaging and radionuclide angiography in the diagnosis of coronary artery disease, the results of these tests in a consecutive series of 30 patients and 14 controls were analyzed. In all 88 symptom-limited exercise tests a significantly higher double product (heart rate x systolic blood pressure, mm Hg/min) was reached on a treadmill test (for Ecg and Thallium scintigraphy) as compared to the supine bicycle ergometer exercise (for radionuclide angiography): 243.1 +- 61.1 vs. 215.2 +- 46.5 x 10 2 (p [de

Peripheral arterial disease and intermittent claudication: Efficacy of ...

African Journals Online (AJOL)

Objective. To compare the effect of two training programmes and advice to exercise at home on physiological adaptations in patients with peripheral arterial disease (PAD). Design. 30 patients with a typical history of PAD and intermittent claudication were randomised to either an upper body strength training programme ...

Atrial Fibrillation and Coronary Artery Disease as Risk Factors of Retinal Artery Occlusion: A Nationwide Population-Based Study

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Ju-Chuan Yen

2015-01-01

Full Text Available We use Taiwanese national health insurance research database (NHIRD to investigate whether thrombolism (carotid artery disease (CAD as a surrogate or embolism (atrial fibrillation (AF as a surrogate plays roles in later retinal artery occlusion (RAO development and examine their relative weights. The relative risks of RAO between AF and CAD patients and controls were compared by estimating the crude hazard ratio with logistic regression. Kaplan-Meier analysis was used to calculate the cumulative incidence rates of developing RAO, and a log-rank test was used to analyze the differences between the survival curves. Separate Cox proportional hazard regressions were done to compute the RAO-free rate after adjusting for possible confounding factors such as age and sex. The crude hazard ratios were 7.98 for the AF group and 5.27 for the CAD group, and the adjusted hazard ratios were 8.32 and 5.34 for the AF and CAD groups, respectively. The observation time with RAO-free was shorter for AF compared with CAD group (1490 versus 1819 days. AF and CAD were both risk factors for RAO with different hazard ratios. To tackle both AF and CAD is crucial for curbing RAO.

Increased arterial compliance in decompensated cirrhosis

DEFF Research Database (Denmark)

Henriksen, Jens Henrik; Møller, Søren; Schifter, S

1999-01-01

BACKGROUND/AIMS: In patients with cirrhosis, the systemic circulation is hyperdynamic with low arterial blood pressure and reduced systemic vascular resistance. The present study was undertaken to estimate the compliance of the arterial tree in relation to severity of cirrhosis, circulating level...... of the vasodilator, calcitonin gene-related peptide (CGRP) and mean arterial blood pressure (MAP). METHODS: Arterial compliance (COMPart=deltaV/deltaP) was determined as the stroke volume relative to pulse pressure (i.e. systolic minus diastolic blood pressure) during a haemodynamic evaluation of portal hypertension...... of CGRP (r=0.34, pcompliance in cirrhosis is directly related to the severity of the disease and to the elevated level of circulating vasodilator peptide CGRP, and inversely related...

Increased arterial compliance in decompensated cirrhosis

DEFF Research Database (Denmark)

Henriksen, Jens Henrik Sahl; Møller, Søren; Schifter, S

1999-01-01

of the vasodilator, calcitonin gene-related peptide (CGRP) and mean arterial blood pressure (MAP). METHODS: Arterial compliance (COMPart=deltaV/deltaP) was determined as the stroke volume relative to pulse pressure (i.e. systolic minus diastolic blood pressure) during a haemodynamic evaluation of portal hypertension......BACKGROUND/AIMS: In patients with cirrhosis, the systemic circulation is hyperdynamic with low arterial blood pressure and reduced systemic vascular resistance. The present study was undertaken to estimate the compliance of the arterial tree in relation to severity of cirrhosis, circulating level...... of CGRP (r=0.34, parterial compliance in cirrhosis is directly related to the severity of the disease and to the elevated level of circulating vasodilator peptide CGRP, and inversely related...

Heparin-bonded, expanded polytetrafluoroethylene-lined stent graft in the treatment of femoropopliteal artery disease: 1-year results of the VIPER (Viabahn Endoprosthesis with Heparin Bioactive Surface in the Treatment of Superficial Femoral Artery Obstructive Disease) trial.

Science.gov (United States)

Saxon, Richard R; Chervu, Arun; Jones, Paul A; Bajwa, Tanvir K; Gable, Dennis R; Soukas, Peter A; Begg, Richard J; Adams, John G; Ansel, Gary M; Schneider, Darren B; Eichler, Charles M; Rush, Michael J

2013-02-01

To evaluate the performance of a heparin-bonded, expanded polytetrafluoroethylene (ePTFE)-lined nitinol endoprosthesis in the treatment of long-segment occlusive disease of the femoropopliteal artery (FPA) and to identify factors associated with loss of patency. In a single-arm, prospective, 11-center study (VIPER [Gore Viabahn Endoprosthesis with Heparin Bioactive Surface in the Treatment of Superficial Femoral Artery Obstructive Disease] trial), 119 limbs (113 patients; 69 men; mean age, 67 y), including 88 with Rutherford category 3-5 disease and 72 with Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II) C or D lesions of the FPA, underwent stent graft implantation. The mean lesion length was 19 cm; 56% of lesions were occlusions. Follow-up evaluations included color duplex ultrasonography in all patients, with patency defined as a peak systolic velocity ratio20% was 70% (P = .047). Primary patency was not significantly affected by device diameter (5 vs 6 vs 7 mm) or lesion length (≤20 cm vs>20 cm). The 30-day major adverse event rate was 0.8%. The heparin-bonded, ePTFE/nitinol stent graft provided clinical improvement and a primary patency rate of 73% at 1 year in the treatment of long-segment FPA disease. Careful sizing of the device relative to vessel landing zones is essential for achieving optimal outcomes. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.

Classification of coronary artery tissues using optical coherence tomography imaging in Kawasaki disease

Science.gov (United States)

Abdolmanafi, Atefeh; Prasad, Arpan Suravi; Duong, Luc; Dahdah, Nagib

2016-03-01

Intravascular imaging modalities, such as Optical Coherence Tomography (OCT) allow nowadays improving diagnosis, treatment, follow-up, and even prevention of coronary artery disease in the adult. OCT has been recently used in children following Kawasaki disease (KD), the most prevalent acquired coronary artery disease during childhood with devastating complications. The assessment of coronary artery layers with OCT and early detection of coronary sequelae secondary to KD is a promising tool for preventing myocardial infarction in this population. More importantly, OCT is promising for tissue quantification of the inner vessel wall, including neo intima luminal myofibroblast proliferation, calcification, and fibrous scar deposits. The goal of this study is to classify the coronary artery layers of OCT imaging obtained from a series of KD patients. Our approach is focused on developing a robust Random Forest classifier built on the idea of randomly selecting a subset of features at each node and based on second- and higher-order statistical texture analysis which estimates the gray-level spatial distribution of images by specifying the local features of each pixel and extracting the statistics from their distribution. The average classification accuracy for intima and media are 76.36% and 73.72% respectively. Random forest classifier with texture analysis promises for classification of coronary artery tissue.

Sensitivity of thallium scintigraphy in the detection of individual coronary artery disease

International Nuclear Information System (INIS)

Khan, A.; Rehman, A.; Wiqar, M.A.; Khan, Z.A.; Ahmad, S.A.

1988-01-01

In this study we randomly selected 45 patients whose coronary angiograms were abnormals i.e. showing triple, double and single vessel disease. Out of 80 patients who had undergone stress thallium imaging and coronary angiography during the one year. Majority of these patients were males and their ages ranged between 34-54 years. Fifteen patients had suffered inferior myocardial infraction and 5 had sustained anterior myocardial infraction in the fast. We analysed their coronary angiograms and compared them with the scintigraphic findings. It is concluded that although thallium scanning has high sensitivity for detection of coronary artery disease in general, it has only moderate sensitivity for detection of stenosis in individual coronary arteries. In this study thallium scan identified 75% of RCA lesions, 66% of LAD lesions and 38% circumflex lesions. Thallium scan sometimes fails to identify the less serve lesions in presence of more severe coronary lesions in the some patients. The sensitivity is much higher in single vessel coronary artery disease. (author)

Classification of peripheral occlusive arterial diseases based on symptoms, signs and distal blood pressure measurements

DEFF Research Database (Denmark)

Tønnesen, K H; Noer, Ivan; Paaske, William

1980-01-01

Systolic blood pressures at toe and ankle were measured in 459 consecutive patients with occlusive arterial disease. Fifty-eight per cent had intermittent claudication with arterial disease of all degrees of severity. Seventeen per cent complained of rest pain having toe systolic pressures below 30...

Elevated oxidative stress among coronary artery disease patients on statin therapy: A cross sectional study

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Sabitha Palazhy

2015-05-01

Conclusions: Though coronary artery disease subjects had healthy lipid profile, oxidative stress, a recognized risk factor for coronary events, was still elevated among this patient group. Novel risk factors were not found to be major predictors for coronary artery disease among the study subjects.

Peripheral arterial disease, gender, and depression in the Heart and Soul Study

NARCIS (Netherlands)

Grenon, S. Marlene; Cohen, Beth E.; Smolderen, Kim; Vittinghoff, Eric; Whooley, Mary A.; Hiramoto, Jade

2014-01-01

Background Despite the high prevalence of peripheral arterial disease (PAD) in women, risk factors for PAD in women are not well understood. Methods Gender-specific risk factors for PAD were examined in a prospective cohort study of 1024 patients (184 women and 840 men) with stable coronary artery

Electrical neuromodulation for disabling angina pectoris related to isolated stenoses of small epicardial coronary arteries

NARCIS (Netherlands)

Jessurun, GAJ; Hautvast, RWM; DeJongste, MJL; Meyler, WJ; van Boven, AJ; Crijns, HJGM

Patients with symptomatic small vessel coronary artery disease may be inadequate candidates for revascularization procedures. They may suffer from refractory angina, which does not respond to maximal anti-anginal drug therapy. In addition to patients with end stage coronary artery disease and

A Common LPA Null Allele Associates With Lower Lipoprotein(a) Levels and Coronary Artery Disease Risk

NARCIS (Netherlands)

Kyriakou, Theodosios; Seedorf, Udo; Goel, Anuj; Hopewell, Jemma C.; Clarke, Robert; Watkins, Hugh; Farrall, Martin; van der Hout, A.H.

Objective-Increased levels of lipoprotein(a) are a highly heritable risk factor for coronary artery disease (CAD). The genetic determinants of lipoprotein(a) levels are mainly because of genetic variation in the apolipoprotein(a) gene (LPA). We have tested the association of a relatively common null

Cardiogenic shock due to coronary artery disease associated with interrupted aortic arch

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Luís Alberto Oliveira Dallan

2013-06-01

Full Text Available Acute pulmonary edema is a serious event. Its occurrence in association with interrupted aortic arch and coronary heart disease is rare. Recently, an old patient developed cardiogenic shock and acute pulmonary edema due to acute coronary insufficiency, associated with interrupted aortic arch. The coronary angiography revealed occlusion of the right coronary artery and 95% obstruction in the left main coronary artery, associated with interruption of the descending aorta. Coronary artery bypass graft was performed, without extracorporeal circulation, to the anterior descending coronary artery. We discuss the initial management, given the seriousness of the case.

High prevalence of peripheral arterial disease in patients with previous cerebrovascular or coronary event

DEFF Research Database (Denmark)

Mehlsen, Jesper; Wiinberg, Niels; Joergensen, Bjarne S

2010-01-01

The presence of peripheral arterial disease (PAD) in patients with other manifestations of cardiovascular disease identifies a population at increased risk of complications both during acute coronary events and on a long-term basis and possibly a population in whom secondary prevention of cardiov......The presence of peripheral arterial disease (PAD) in patients with other manifestations of cardiovascular disease identifies a population at increased risk of complications both during acute coronary events and on a long-term basis and possibly a population in whom secondary prevention...

Evaluation of pulmonary arterial morphology and function in cyanotic congenital heart disease by MRI and cine MRI

International Nuclear Information System (INIS)

Hashimoto, Ikuo; Tsubata, Shinichi; Miyazaki, Ayumi; Ichida, Fukiko; Okada, Toshio; Murakami, Arata; Futatsuya, Ryuusuke; Nakajima, Kenshuu; Nakajima, Akio

1993-01-01

Pulmonary arterial anatomy was evaluated by magnetic resonance imaging (MRI), angiography and two-dimensional echocardiography in 20 patients with cyanotic heart disease associated with decreased pulmonary blood flow. Excellent correlation between MRI and angiographic estimates of pulmonary artery diameter was obtained (main pulmonary artery, r=0.87; right pulmonary artery, r=0.96; left pulmonary artery, r=0.95). However, echocardiography could not describe peripheral pulmonary arteries obviously, especially left pulmonary artery. In the assessment of peripheral pulmonary stenosis or obstruction, cine MRI was superior to echocardiography. We conclude that MRI and cine MRI will play an important role in the serial evaluation of pulmonary arterial morphology and function in patients with cyanotic congenital heart disease before and after surgical repair. (author)

Evaluation of pulmonary arterial morphology and function in cyanotic congenital heart disease by MRI and cine MRI

Energy Technology Data Exchange (ETDEWEB)

Hashimoto, Ikuo; Tsubata, Shinichi; Miyazaki, Ayumi; Ichida, Fukiko; Okada, Toshio; Murakami, Arata; Futatsuya, Ryuusuke; Nakajima, Kenshuu; Nakajima, Akio [Toyama Medical and Pharmaceutical Univ. (Japan)

1993-01-01

Pulmonary arterial anatomy was evaluated by magnetic resonance imaging (MRI), angiography and two-dimensional echocardiography in 20 patients with cyanotic heart disease associated with decreased pulmonary blood flow. Excellent correlation between MRI and angiographic estimates of pulmonary artery diameter was obtained (main pulmonary artery, r=0.87; right pulmonary artery, r=0.96; left pulmonary artery, r=0.95). However, echocardiography could not describe peripheral pulmonary arteries obviously, especially left pulmonary artery. In the assessment of peripheral pulmonary stenosis or obstruction, cine MRI was superior to echocardiography. We conclude that MRI and cine MRI will play an important role in the serial evaluation of pulmonary arterial morphology and function in patients with cyanotic congenital heart disease before and after surgical repair. (author).

S3 guidelines for diagnostics and treatment of peripheral arterial occlusive disease

International Nuclear Information System (INIS)

Huppert, P.; Tacke, J.; Lawall, H.

2010-01-01

This report summarizes the most important aspects of the new German S3 guidelines for the diagnostics and treatment of peripheral arterial occlusive disease (PAOD) from March 2009. The guidelines include definitions and epidemiology of peripheral arterial occlusive disease, diagnostic methods including clinical and technical procedures as well as imaging methods, treatment by non-invasive, interventional and surgical methods and patient care during follow-up. In key messages recommendations are given which are graded corresponding to the scientific evidence concluded from the literature. (orig.) [de

The obesity paradox in patients with peripheral arterial disease

NARCIS (Netherlands)

W. Galal (Wael); Y.R.B.M. van Gestel (Yvette); S.E. Hoeks (Sanne); D.D. Sin; T.A. Winkel (Tamara); J.J. Bax (Jeroen); H.J.M. Verhagen (Hence); A.M.M. Awara (Adel); J. Klein (Jan); R.T. van Domburg (Ron); D. Poldermans (Don)

2008-01-01

textabstractBackground: Cardiac events are the predominant cause of late mortality in patients with peripheral arterial disease (PAD). In these patients, mortality decreases with increasing body mass index (BMI). COPD is identified as a cardiac risk factor, which preferentially affects underweight

Learning Style Preferences of Elderly Coronary Artery Disease Patients.

Science.gov (United States)

Theis, Saundra L.; Merritt, Sharon L.

1992-01-01

The Patient Learning Styles Questionnaire derived from Canfield and administered to 134 elderly coronary artery disease patients revealed the following order of learning preferences: structure, iconics, listening, direct experience, reading, achievement, affiliation, and eminence. Level of education significantly influenced preferred learning…

[Peripheral artery disease in patients younger than 50 years old: Which etiology?].

Science.gov (United States)

Cotard, S; Nouni, A; Jaquinandi, V; Gladu, G; Kaladji, A; Mahé, G

2016-09-01

Peripheral arterial disease (PAD) encompasses disease of all arteries of the body except the coronary arteries. The main etiology whatever the patient's age is atherosclerosis. Different etiologies can induce PAD especially when patients are younger than 50 years old and have no cardiovascular risk factors (smoking, hypertension, diabetes…). PAD that appears before 50 years old can be named juvenile PAD (JPAD) although there is no consensus about the definition. The aim of this work is to present the different etiologies of JPAD according to their hereditary, acquired or mixed origins. The following hereditary causes are addressed: Marfan syndrome, Ehlers-Danlos syndrome, homocystinuria, pseudoxanthoma elasticum, osteogenesis imperfecta "mid-aortic" syndrome. Among the acquired etiologies, inflammatory JPADs without extravascular signs such as atherosclerosis and Buerger's disease, inflammatory JPADs with extravascular signs as Takayasu's disease, Behçet's disease and Cogan's syndrome, JPADs like aortitis, embolic JPADs, iatrogenic JPADs, and mechanical or traumatic JPADs are described. Finally, mixed origins as thrombotic disease and fibromuscular dysplasia are presented. This work will assist clinicians in the diagnosis of JPAD. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Relationship of femoral artery ultrasound measures of atherosclerosis with chronic kidney disease.

Science.gov (United States)

Hsu, Simon; Rifkin, Dena E; Criqui, Michael H; Suder, Natalie C; Garimella, Pranav; Ginsberg, Charles; Marasco, Antoinette M; McQuaide, Belinda J; Barinas-Mitchell, Emma J; Allison, Matthew A; Wassel, Christina L; Ix, Joachim H

2017-12-22

Chronic kidney disease (CKD) is strongly associated with peripheral artery disease (PAD). Detection of subclinical PAD may allow early interventions for or prevention of PAD in persons with CKD. Whether the presence of atherosclerotic plaque and femoral intima-media thickness (IMT) are associated with kidney function is unknown. We performed a cross-sectional observational study of 1029 community-living adults. We measured superficial and common femoral artery IMT and atherosclerotic plaque presence by ultrasound. Estimated glomerular filtration rate (eGFR; continuous) and eGFR <60 mL/min/1.73 m 2 (binary) were evaluated as outcomes. Mean age was 70 ± 10 years, mean eGFR was 78 ± 17 mL/min/1.73 m 2 , and 156 (15%) individuals had eGFR <60 mL/min/1.73 m 2 ; 260 (25%) had femoral artery plaque. In models adjusted for demographics and cardiovascular risk factors, individuals with femoral artery plaque had mean eGFR approximately 3.0 (95% confidence interval, -5.3 to -0.8) mL/min/1.73 m 2 lower than those without plaque (P < .01). The presence of plaque was also associated with a 1.7-fold higher odds of eGFR <60 mL/min/1.73 m 2 (95% confidence interval, 1.1-2.8; P < .02). Associations were similar in persons with normal ankle-brachial index. The directions of associations were similar for femoral IMT measures with eGFR and CKD but were rendered no longer statistically significant with adjustment for demographic variables and cardiovascular disease risk factors. Femoral artery plaque is significantly associated with CKD prevalence in community-living individuals, even among those with normal ankle-brachial index. Femoral artery ultrasound may allow evaluation of relationships and risk factors linking PAD and kidney disease earlier in its course. Copyright © 2017 Society for Vascular Surgery. All rights reserved.

Heart and coronary artery damage related to Kawasaki syndrome

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A. A. Leontyeva

2014-01-01

Full Text Available Kawasaki syndrome is an acute systemic vasculitis of unknown etiology, which mainly affects children within the first 5 years of fife. At the present time, Kawasaki syndrome is recognized to be a leading cause of acquired organic heart diseases in children, which may result in coronary heart disease, myocardial infarction, and sudden death in children and young people. Most complications are associated with the cardiovascular system, with coronary artery changes in particular. Transthoracic echocardiography, which, besides coronary artery assessment, makes it possible to evaluate right and left ventricular systolic and diastolic functions and to study the cardiac valves and changes in pericardial effusion, is a major technique in Kawasaki syndrome. The paper outlines an update on the epidemiology, etiology, pathogenetic mechanisms, and pathomorphology of Kawasaki syndrome and considers possible coronary and noncoronary changes, outcomes, and clinical manifestations.

Systemic inflammation is higher in peripheral artery disease than in stable coronary artery disease.

Science.gov (United States)

Rein, Philipp; Saely, Christoph H; Silbernagel, Günther; Vonbank, Alexander; Mathies, Rainer; Drexel, Heinz; Baumgartner, Iris

2015-04-01

The knowledge on the level of systemic inflammation in peripheral artery disease (PAD) is less well established than that in coronary artery disease (CAD). Systemic inflammation frequently coincides with atherosclerosis, but also with various traits of the metabolic syndrome (MetS). The individual contribution of CAD, PAD, and the MetS to inflammation is not known. We enrolled a total of 1396 patients, 460 patients with PAD Fontaine stages IIa-IV verified by duplex ultrasound (PAD group) and 936 patients free of limb claudication undergoing coronary angiography, of whom 507 had significant CAD with coronary stenoses ≥50% (CAD group), and 429 did not have significant CAD at angiography (control group). C-reactive protein (CRP) was significantly higher in the PAD than in the CAD or in the control group (0.86 ± 1.85 mg/dl versus 0.44 ± 0.87 mg/dl and 0.39 ± 0.52 mg/dl, respectively, p < 0.001 for both comparisons). These significant differences were confirmed when patients with and subjects without the MetS were analyzed separately. In particular, within the PAD group, CRP was significantly higher in patients with the MetS than in subjects without the MetS (1.04 ± 2.01 vs. 0.67 ± 1.64 mg/dl; p = 0.001) and both, the presence of PAD and the MetS proved to be independently associated with CRP in analysis of covariance (F = 31.84; p < 0.001 and F = 10.52; p = 0.001, respectively). Inflammatory activity in PAD patients is higher than in CAD patients and is particularly high in PAD patients affected by the MetS. Low grade systemic inflammation is independently associated with both the MetS and PAD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Pulmonary artery hypertension in childhood: The transforming growth factor-β superfamily-related genes

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Shi-Min Yuan

2018-04-01

Full Text Available Pulmonary artery hypertension (PAH is very rare in childhood, and it can be divided into heritable, idiopathic drug- and toxin-induced and other disease (connective tissue disease, human immunodeficiency virus infection, portal hypertension, congenital heart disease, or schistosomiasis-associated types. PAH could not be interpreted solely by pathophysiological theories. The impact of the transforming growth factor-β superfamily-related genes on the development of PAH in children remains to be clarified. Pertinent literature on the transforming growth factor-β superfamily-related genes in relation to PAH in children published after the year 2000 was reviewed and analyzed. Bone morphogenetic protein receptor type II gene mutation promotes cell division or prevents cell death, resulting in an overgrowth of cells in small arteries throughout the lungs. About 20% of individuals with a bone morphogenetic protein receptor type II gene mutation develop symptomatic PAH. In heritable PAH, bone morphogenetic protein receptor type II mutations may be absent; while mutations of other genes, such as type I receptor activin receptor-like kinase 1 and the type III receptor endoglin (both associated with hereditary hemorrhagic telangiectasia, caveolin-1 and KCNK3, the gene encoding potassium channel subfamily K, member 3, can be detected, instead. Gene mutations, environmental changes and acquired adjustment, etc. may explain the development of PAH. The researches on PAH rat model and familial PAH members may facilitate the elucidations of the mechanisms and further provide theories for prophylaxis and treatment of PAH. Key Words: bone morphogenetic proteins, mutation, pulmonary hypertension

Relative associations between depression and anxiety on adverse cardiovascular events: does a history of coronary artery disease matter? A prospective observational study.

Science.gov (United States)

Pelletier, Roxanne; Bacon, Simon L; Arsenault, André; Dupuis, Jocelyn; Laurin, Catherine; Blais, Lucie; Lavoie, Kim L

2015-12-15

To assess whether depression and anxiety increase the risk of mortality and major adverse cardiovascular events (MACE), among patients with and without coronary artery disease (CAD). DECADE (Depression Effects on Coronary Artery Disease Events) is a prospective observational study of 2390 patients referred at the Montreal Heart Institute. Patients were followed for 8.8 years, between 1998 and 2009. Depression and anxiety were assessed using a psychiatric interview (Primary Care Evaluation of Mental Disorders, PRIME-MD). Outcomes data were obtained from Quebec provincial databases. All-cause mortality and MACE. After adjustment for covariates, patients with depression were at increased risks of all-cause mortality (relative risk (RR)=2.84; 95% CI 1.25 to 6.49) compared with patients without depression. Anxiety was not associated with increased mortality risks (RR=0.86; 95% CI 0.31 to 2.36). When patients were stratified according to CAD status, depression increased the risk of mortality among patients with no CAD (RR=4.39; 95% CI 1.12 to 17.21), but not among patients with CAD (RR=2.32; 95% CI 0.78 to 6.88). Neither depression nor anxiety was associated with MACE among patients with or without CAD. Depression, but not anxiety, was an independent risk factor for all-cause mortality in patients without CAD. The present study contributes to a better understanding of the relative and unique role of depression versus anxiety among patients with versus without CAD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Constriction of collateral arteries induced by "head-up tilt" in patients with occlusive arterial disease of the legs

DEFF Research Database (Denmark)

Agerskov, K; Henriksen, O; Tønnesen, K H

1981-01-01

The effect of head-up tilt on leg blood flow and segmental arterial blood pressures was studied in 21 patients with occlusion or severe stenosis of the common or superficial femoral artery. Arterial pressure was measured directly in the brachial artery, common femoral artery and popliteal artery....... Relative change in blood flow in the leg during tilt was estimated by changes in arterio-venous oxygen differences and by the indicator dilution technique in nine patients. Head-up tilt caused a decrease in leg blood flow of 36% corresponding to an increase in total vascular resistance of 57%. Tilt did...... not change the pressure gradient from femoral to popliteal artery in the patients with occlusion of the superficial femoral artery, indicating that the flow resistance offered by the collateral arteries had increased. In a bilateral sympathectomised patient the increase in collateral resistance was almost...

Coronary artery disease in Bangladesh: A review

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A.K.M. Monwarul Islam

2013-07-01

Full Text Available Coronary artery disease (CAD is an increasingly important medical and public health problem, and is the leading cause of mortality in Bangladesh. Like other South Asians, Bangladeshis are unduly prone to develop CAD, which is often premature in onset, follows a rapidly progressive course and angiographically more severe. The underlying pathophysiology is poorly understood. Genetic predisposition, high prevalence of metabolic syndrome and conventional risk factors play important role. Lifestyle related factors, including poor dietary habits, excess saturated and trans fat, high salt intake, and low-level physical activity may be important as well. Some novel risk factors, including hypovitaminosis D, arsenic contamination in water and food-stuff, particulate matter air pollution may play unique role. At the advent of the new millennium, we know little about our real situation. Largescale epidemiological, genetic and clinical researches are needed to explore the different aspects of CAD in Bangladesh.

CORONARY ARTERY DISEASE IN INDIAN WOMEN

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Mohammed Umar Farooque

2017-05-01

Full Text Available BACKGROUND Cardiovascular disease is the leading cause of death among women regardless of race or ethnicity accounting for deaths of 1 in 3 women. The aim of the study is to identify the important risk factors contributing to the coronary artery disease in Indian women. MATERIALS AND METHODS Study conducted on 120 women patients of age >40 yrs. visiting a female outpatient department of Jawahar Lal Nehru Medical College, Bhagalpur, who presented with complaints related to CAD cases diagnosed from the electrocardiogram findings, clinical features and biochemical marker as per World Health Organization guidelines. RESULTS 50-59 years age group is most effected group in study with 44.2%. Most of the women are of postmenopausal age group. The maximum number of cases was seen in upper lower socioeconomic status (37.5% followed by lower (19.2%. CAD incidence was minimum in upper class. Chest pain was the main complaint in patients, next in frequency was sweating and followed by breathlessness. The major risk factors in the study group were hypertension (74.1, diabetes (63.3, sedentary habits (49.1, stress (34.2, family history (29.2 and tobacco consumption (21.8. 25 patients had obesity and 54 peoples were overweight. In our study, 48 patients had 3 children, 19 had more than 3 children. 61.7% of the patients are with hypercholesterolaemia, which most of the patients found with 2 vessel block is most common blocks observed. CONCLUSION Despite this delay in onset, mortality from coronary heart disease is increasing more rapidly among women than men.

Association of ischemic stroke to coronary artery disease using computed tomography coronary angiography

DEFF Research Database (Denmark)

Jensen, Jesper Møller; Medina, Hector; Nørgaard, Bjarne Linde

2012-01-01

BACKGROUND: While patients with coronary artery disease (CAD) and cerebrovascular disease share similar risk factor profiles, data on whether IS can be considered a "CAD equivalent" are limited. We aimed to determine whether ischemic stroke is an independent predictor of CAD by using cardiac...... increase odds of having coronary artery plaque (odds ratio [OR] 4.9, P4 segments of plaque than 0-4 segments as compared to patients without stroke (OR 18.3, P...

Liver cirrhosis and arterial hypertension

DEFF Research Database (Denmark)

Henriksen, Jens Henrik; Møller, Søren

2006-01-01

blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most...

Statistical dependence of clinical data on the chosen treatment of patients with a multivessel coronary artery disease.

Science.gov (United States)

Walichiewicz, P; Wodniecki, J; Szczurek-Katański, K; Jacheć, W; Nowalany-Kozielska, E; Trzeciak, P; Janik, J

2001-01-01

In this study we tried to check which clinical data are connected with the choice of treatment in patients with a multivessel coronary artery disease. The data of 137 patients with a multivessel coronary artery disease, were analysed retrospectively. The patients were divided into three groups: treated conservatively, CABG and PTCA. Multivessel coronary artery disease was recognised when there were atherosclerotic changes in more a 2 vessels with a not less a 2 mm in diameter. Patients with previous CABG or a left main coronary artery disease were excluded. The data were analysed by means of several methods, variance analysis, correlation analysis, discriminant functions, chi-square test and T-Student test. For treatment decision making in multivessel coronary artery disease of statistical significance were: the state of the left anterior descendent artery below the first diagonal branch, the state of the first diagonal branch and peripheral parts of the left anterior descendent artery and right coronary artery, the systolic function of the antero-lateral, apical and phrenic segments of the left ventricle, the global left ventricular ejection fraction in angiography and echocardiography, local systolic disturbances of the left ventricular observed in echocardiography, the coexistence of symptoms of heart failure as well as unstable angina. Treatment decision making will always depend not only on diagnostic procedures but also on all the clinical data about the patient and the experience of coworking cardiology and surgery centres.

Severity of coronary artery disease in obese patients undergoing coronary angiography

International Nuclear Information System (INIS)

Javed, A.; Ali, J.; Kayani, A.M.

2012-01-01

Objective: To assess the relationship of severity of coronary artery disease with obesity in patients undergoing coronary angiography. Design: Cross sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology - National Institute of Heart Diseases (AFIC-NIHD), 1st February 2010 to 31st August 2010 Patients and Methods: The study population included 468 patients undergoing coronary angiography. Obesity was classified according to the BMI using the National Institutes of Health (NIH) criteria as normal (BMI 21-24 kg/m2), overweight (BMI 25-29 kg/m2), obesity class I (BMI 30-34 kg/m2), obesity class II (BMI 35 to 39 kg/m2 and obesity class III (BMI 40 or above kg/m2). Coronary angiography data were obtained from the Siemens Queries software system, which maintains the database including detailed angiographic findings of all patients at this institution. Significant lesions were defined as those with >70% diameter narrowing of coronary arteries (>50% for the left main coronary artery). We attempted to quantify the 'severity of CAD' by ascertaining the prevalence of High-Risk Coronary Anatomy (HRCA). Results: Insignificant difference was observed in traditional risk factors i.e. age, diabetes mellitus and smoking except hypertension and gender. Statistically significantly low prevalence of HRCA was encountered in the obese group (57.7%) as compared to normal/overweight group (75.8%) (p < 0.05). Conclusion: We conclude that obesity is associated with less severe coronary artery disease. (author)

Prevalence of Risk Factors for Coronary Artery Disease in Southern ...

African Journals Online (AJOL)

(48.5 %), fatty food consumption (47.5 %), obesity (38 %) and smoking (37 %), respectively. Other less ... Keywords: Risk factors, Prevalence, Coronary artery disease, Diabetes, Southern Punjab ... developing world, including Pakistan [1]. The.

Angiographic prevalence and pattern of coronary artery disease in women.

Science.gov (United States)

Ezhumalai, Babu; Jayaraman, Balachander

2014-01-01

There are not many studies describing the prevalence and pattern of "coronary artery disease" (CAD) in women undergoing "coronary angiography" (CAG). Hence, uncertainty thrives with regard to the angiographic prevalence and pattern of CAD in women. Our objective was to study the prevalence and pattern of CAD among women undergoing CAG. Data of 500 women who underwent CAG for suspected CAD over 3 years were retrospectively analyzed. They were classified into young group (age right coronary artery. Bifurcation lesion involving distal left main coronary artery is the most prevalent pattern of LMD. There has been a change with regard to clinical presentation and onset of risk factors for CAD at young age, but the load of atherosclerotic burden and pattern of involvement of coronary arteries have not changed in women. Copyright © 2014 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

Myocardial fatty acid utilisation during exercise induced ischemia in patients with coronary artery disease

International Nuclear Information System (INIS)

Virtanen, K.S.; Nikkinen, P.; Lindroth, L.; Kuikka, J.T.

2002-01-01

Aim: Reversible or irreversible myocardial damage due to ischemia correlates with altered membrane functions of the cells. To compare myocardial free fatty acid (FFA) metabolism and flow during exercise induced ischemia we studied ten patients with coronary artery disease but without previous myocardial infarction. Methods: A series of post-exercise single-photon emission computed tomography (SPECT) measurements was performed after injection of 123 I labelled heptadecanoic acid (HDA). Myocardial perfusion was estimated from the separately performed exercise-redistribution thallium study. Fatty acid metabolic rate, thallium uptake and washout were calculated for anterior, lateral, posterior and septal segments. Results: The more reduced post-exercise FFA metabolic rate (-63±18%, mean ±1 SD) compared to flow (-36±16%) was related to the severity of myocardial ischemia and wall motion abnormalities. Conclusion: In this small group of patients, the reduced post-exercise FFA metabolic rate tentatively suggests a parsimonious workload of the exercising myocardium by reducing oxygen consumption in patients with coronary artery disease. (orig.) [de

CoViCAD : comprehensive visualization of coronary artery disease

NARCIS (Netherlands)

Temeer, M.; Olivan Bescos, J.; Breeuwer, M.; Vilanova, A.; Gerritsen, F.A.; Gröller, E.

2007-01-01

We present novel, comprehensive visualization techniques for the diagnosis of patients with Coronary Artery Disease using segmented cardiac MRI data. We extent an accepted medical visualization technique called the bull’s eye plot by removing discontinuities, preserving the volumetric nature of the

Risk stratification of patients suspected of coronary artery disease

DEFF Research Database (Denmark)

Jensen, Jesper M; Voss, Mette; Hansen, Vibeke Bøgelund

2012-01-01

To compare the performance of five risk models (Diamond-Forrester, the updated Diamond-Forrester, Morise, Duke, and a new model designated COronary Risk SCORE (CORSCORE) in predicting significant coronary artery disease (CAD) in patients with chest pain suggestive of stable angina pectoris....

Polimorfismo genético do fibrinogênio na doença arterial periférica Genetic polymorphisms of fibrinogen in peripheral artery disease

Directory of Open Access Journals (Sweden)

Antônio C. Brandão

2004-01-01

alterations in their clinical examinations of peripheral artery disease. Individuals with renal disease, liver disease or diabetes mellitus were excluded. Analysis of the fibrinogen b-chain was performed using polymerase chain reaction and restriction fragment length polymorphism with Bcl I endonuclease. Three genotypes, B1/B1, B1/B2 and B2/B2 were identified. Statistical analysis was made using the Fisher Exact test, odds ratio, Kruskal-Wallis test and variance analysis (ANOVA. A p-value = 0.05 was considered significant. The B1 allele was the most prevalent in both patients and the control group (0.819 and 0.857, respectively, with prevalence of the B1/B1 genotype in patients and controls (65.9% vs. 71.4% respectively, followed by B1/B2 (31.8% vs. 28.6% respectively. No significant difference was observed in relation to the Bcl I polymorphisms of the fibrinogen b-chain and obstructive and aneurysmal peripheral artery disease. In conclusion, the B1 and B2 polymorphisms of the fibrinogen b-chain and their respective genotypes do not have any influence in peripheral artery disease.

Hipertensão arterial pulmonar e doenças da tireoide Pulmonary arterial hypertension and thyroid disease

Directory of Open Access Journals (Sweden)

Denise Rossato Silva

2009-02-01

Full Text Available Estudos recentes têm sugerido uma associação entre hipertensão arterial pulmonar (HAP e tireoidopatias (hipotireoidismo e hipertireoidismo. Esta associação tem um bom prognóstico, porque o aumento na pressão da artéria pulmonar geralmente é leve e reversível com o tratamento da tireoidopatia. O mecanismo exato envolvido na patogênese desta associação não está estabelecido, e a influência direta dos hormônios da tireoide e a autoimunidade são consideradas como hipóteses. Devido à alta prevalência de doenças da tireoide em pacientes com HAP, testes de função tireoidiana devem ser considerados na investigação de todo paciente com HAP. Neste artigo de revisão, descrevemos a prevalência de HAP em pacientes com doenças da tireoide e a prevalência de tireoidopatias em pacientes com HAP, assim como destacamos os principais efeitos das doenças da tireoide no sistema respiratório. A seguir, relatamos os efeitos do tratamento destas patologias.Recent studies have suggested an association between pulmonary arterial hypertension (PAH and thyroid diseases (hypothyroidism and hyperthyroidism. This combination has a good prognosis, because the increase in the pulmonary artery pressure is usually slight and reverses after the treatment of the thyroid disease. Although the exact mechanism involved in the pathogenesis of this combination has not yet been established, it has been hypothesized that thyroid hormones and autoimmunity have a direct influence. Due to the high prevalence of thyroid disease in patients with PAH, thyroid function tests should be considered in the investigation of every patient with PAH. In this review, we describe the prevalence of PAH in patients with thyroid diseases and the prevalence of thyroid disease in patients with PAH, as well as addressing the principal effects that thyroid diseases have on the respiratory system. In addition, we report the treatment effects in patients with these diseases.

Myocardial scintigraphy using a fatty acid analogue detects coronary artery disease in hemodialysis patients.

Science.gov (United States)

Nishimura, Masato; Hashimoto, Tetsuya; Kobayashi, Hiroyuki; Fukuda, Toyofumi; Okino, Koji; Yamamoto, Noriyuki; Fujita, Hiroshi; Inoue Tsunehiko Nishimura, Naoto; Ono, Toshihiko

2004-08-01

Coronary artery disease contributes significantly to mortality in end-stage renal disease (ESRD) patients. Single-photon emission computed tomography (SPECT) using an iodinated fatty acid analogue, iodine-123-methyl iodophenylpentadecanoic acid (123I-BMIPP), can assess fatty acid metabolism in the myocardium. We investigated the ability of 123I-BMIPP SPECT to detect coronary artery disease in hemodialysis patients compared with 201thallium chloride (201Tl) SPECT. We prospectively studied 130 ESRD patients undergoing hemodialysis for a mean of 88.6 months (male/female, 77/53; mean age, 63.8 years). Dual SPECT using 123I-BMIPP and 201Tl was performed, followed by coronary angiography. SPECT findings were graded in 17 segments on a five-point scale (0, normal uptake; 4, none) and assessed as a summed score. By coronary angiography, 71.5% of patients (93/130) had significant coronary stenosis (> or =75%), and five patients showed coronary spasm without coronary stenosis. When a BMIPP summed score of 6 or more was defined as abnormal, sensitivity, specificity, and accuracy for detecting coronary artery disease by BMIPP SPECT were 98.0%, 65.6%, and 90.0%, respectively; in contrast, these parameters for detecting coronary artery disease by Tl SPECT were 84.7%, 46.9%, and 75.0%, respectively, when a Tl summed score of 1 or more was defined as abnormal. In receiver operating characteristic analysis, the area under the curve was 0.895 in BMIPP and 0.727 in Tl SPECT, respectively. Resting BMIPP SPECT is superior to Tl SPECT for detecting coronary lesions, and provides safe screening for coronary artery disease among maintenance hemodialysis patients.

Non-dipping blood pressure patterns and arterial stiffness parameters in patients with Behcet's disease.

Science.gov (United States)

Celik, Gulperi; Yilmaz, Sema; Ergulu Esmen, Serpil

2015-12-01

Behcet's disease is a multisystemic vasculitis involving veins and arteries of various sizes. Non-dipping status, augmentation index and pulse wave velocity are important determinants of cardiovascular mortality and morbidity. We investigated the non-dipping status and arterial stiffness in patients with Behcet's disease. In this cross-sectional study, we examined the vascular parameters of 96 patients with Behcet's disease (53% female) and 60 age- and sex-matched control subjects. The non-dipping status and arterial distensibility were assessed using a Mobil-O-Graph Arteriograph, an automatic oscillometric device. In total, 65.6% of 96 patients were systolic non-dippers, and 34.4% exhibited high augmentation indices. Ten percent of the control subjects were systolic non-dippers, and 11.7% exhibited high augmentation indices. Nocturnal decreases in systolic blood pressure correlated with central systolic blood pressure and diastolic blood pressure, as well as nocturnal decreases in diastolic blood pressure. Furthermore, non-dipper patients with Behcet's disease exhibited higher nocturnal cardiac outputs than did dipper patients with Behcet's disease. Augmentation index correlated negatively with C-reactive protein and correlated positively with both 24 h and nocturnal peripheral resistance, as well as 24 h pulse wave velocity. The patients with high augmentation indices exhibited lower creatinine clearance, as well as lower nocturnal cardiac outputs, higher 24 h peripheral resistance and higher 24 h pulse wave velocities. Non-dipping status and arterial stiffness may exacerbate the harmful cardiovascular effects of the other. In addition to conventional risk factors, non-dipping status and arterial stiffness should be examined during the follow-up evaluations of patients with Behcet's disease.

Clinical Significance of the Champagne Bottle Neck Sign in the Extracranial Carotid Arteries of Patients with Moyamoya Disease.

Science.gov (United States)

Yasuda, C; Arakawa, S; Shimogawa, T; Kanazawa, Y; Sayama, T; Haga, S; Morioka, T

2016-05-26

The champagne bottle neck sign represents a rapid reduction in the extracranial ICA diameters and is a characteristic feature of Moyamoya disease. However, the clinical significance of the champagne bottle neck sign is unclear. We investigated the relationship between the champagne bottle neck sign and the clinical and hemodynamic stages of Moyamoya disease. We analyzed 14 patients with Moyamoya disease before revascularization (5 men, 9 women; age, 43.2 ± 19.3 years). The ratio of the extracranial ICA and common carotid artery diameters was determined using carotid ultrasonography or cerebral angiography; a ratio of champagne bottle neck sign-positive. The clinical disease stage was determined using the Suzuki angiographic grading system. CBF and cerebral vasoreactivity also were measured. The ICA/common carotid artery ratio (expressed as median [interquartile range]) decreased as the clinical stage advanced (stages I-II, 0.71 [0.60-0.77]; stages III-IV, 0.49 [0.45-0.57]; stages V-VI, 0.38 [0.34-0.47]; P champagne bottle neck sign-positive arteries were classified as Suzuki stage ≥III, 73% were symptomatic, and 89% exhibited reduced cerebral vasoreactivity. In contrast, all champagne bottle neck sign-negative arteries were Suzuki stage ≤III, 67% were asymptomatic, and all showed preserved cerebral vasoreactivity. The champagne bottle neck sign was related to advanced clinical stage, clinical symptoms, and impaired cerebral vasoreactivity. Thus, detection of the champagne bottle neck sign might be useful in determining the clinical and hemodynamic stages of Moyamoya disease. © 2016 American Society of Neuroradiology.

Relationship between haemodynamic impairment and collateral blood flow in carotid artery disease

DEFF Research Database (Denmark)

Hartkamp, Nolan S; Petersen, Esben T; Chappell, Michael A

2018-01-01

Collateral blood flow plays a pivotal role in steno-occlusive internal carotid artery (ICA) disease to prevent irreversible ischaemic damage. Our aim was to investigate the effect of carotid artery disease upon cerebral perfusion and cerebrovascular reactivity and whether haemodynamic impairment...... is influenced at brain tissue level by the existence of primary and/or secondary collateral. Eighty-eight patients with steno-occlusive ICA disease and 29 healthy controls underwent MR examination. The presence of collaterals was determined with time-of-flight, two-dimensional phase contrast MRA and territorial....... In conclusion, both CBF and cerebrovascular reactivity were found to be reduced in symptomatic patients with steno-occlusive ICA disease. The presence of collateral flow is associated with further haemodynamic impairment. Recruitment of secondary collaterals is associated with severe haemodynamic impairment....

Fifteen new risk loci for coronary artery disease highlight arterial wall-specific mechanisms

OpenAIRE

Howson, Joanna M.M.; Zhao, Wei; Barnes, Daniel R.; Ho, Weang-Kee; Young, Robin; Paul, Dirk S.; Waite, Lindsay L.; Freitag, Daniel F.; Fauman, Eric B.; Salfati, Elias L.; Sun, Benjamin B.; Eicher, John D.; Johnson, Andrew D.; Sheu, Wayne H.H.; Nielsen, Sune F.

2017-01-01

Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. Although 58 genomic regions have been associated with CAD thus far, most of the heritability is unexplained, indicating that additional susceptibility loci await identification. An efficient discovery strategy may be larger-scale evaluation of promising associations suggested by genome-wide association studies (GWAS). Hence, we genotyped 56,309 participants using a targeted gene array derived from earlier G...

Fifteen new risk loci for coronary artery disease highlight arterial-wall-specific mechanisms

OpenAIRE

Howson, Joanna McCammond; Zhao, W; Barnes, Daniel Robert; Ho, W-K; Young, R; Paul, Dirk Stefan; Waite, LL; Freitag, DF; Fauman, EB; Salfati, EL; Sun, Benjamin; Eicher, JD; Johnson, AD; Sheu, WHH; Nielsen, SF

2017-01-01

Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. Although 58 genomic regions have been associated with CAD thus far, most of the heritability is unexplained, indicating that additional susceptibility loci await identification. An efficient discovery strategy may be larger-scale evaluation of promising associations suggested by genome-wide association studies (GWAS). Hence, we genotyped 56,309 participants using a targeted gene array derived from earlier G...

Quality of medical management in coronary artery disease.

Science.gov (United States)

Al Shammeri, Owayed; Stafford, Randall S; Alzenaidi, Ahlam; Al-Hutaly, Bushra; Abdulmonem, Alaa

2014-01-01

Patients with coronary artery disease (CAD) are at high risk of recurrent adverse cardiac events. Such risk can be diminished through a guideline-recommend optimal medical therapy (OMT), defined as adherence to appropriate antiplatelet therapy, lipid-lowering agents, beta-blockers and angio.tensin-converting enzyme inhibitors, blood pressure investment in strategies to achieve OMT in these high-risk patients.

Patient- and lesion-tailored algorithm of endovascular treatment for arterial occlusive disease of extracranial arteries supplying the brain: safety of the treatment at 30-day follow-up.

Science.gov (United States)

Latacz, Paweł; Simka, Marian; Brzegowy, Paweł; Janas, Piotr; Kazibudzki, Marek; Pieniążek, Piotr; Ochała, Andrzej; Popiela, Tadeusz; Mrowiecki, Tomasz

2017-01-01

Although surgical endarterectomy remains the treatment of choice for carotid artery stenosis, stenting plays an important role as an alternative treatment modality, especially in high-risk patients. The actual safety profile associated with stenting procedures is probably better than that reported by randomized controlled trials. To assess the safety of stent implantations in extracranial arteries supplying the brain, and also to identify risk factors associated with this procedure. This was a post hoc analysis, with 30-day follow-up. We analyzed the results of treatment of 372 patients who underwent 408 procedures, 197 such procedures in asymptomatic, and 211 in symptomatic individuals. Stenting procedures were performed using a technique and armamentarium which were tailored to the type and anatomy of lesions. There were 6 (1.5%) strokes, including 2 (0.5%) major strokes, 1 ipsi- and 1 contralateral, and 4 (1.0%) minor strokes. In asymptomatic patients there was 1 (0.3%) minor stroke. Transient ischemic attacks occurred in 5 (1.2%) patients. There were 2 (0.5%) non-STEMI myocardial infarctions and 2 (0.5%) non-stroke related fatalities. Risk factors of these adverse events were diabetes mellitus, lesions localized in a tortuous segment of the artery, embolic material in the filter and bilateral stenoses of carotid arteries. Additional risk factors in asymptomatic patients were renal impairment and advanced coronary artery disease; and in symptomatic patients, grade 3 arterial hypertension, dislipidemia, cigarette smoking and lesions requiring predilatation. Stenting procedures of extracranial arteries supplying the brain, which are tailored to the type and anatomy of lesions, seem to be relatively safe.

Variability of the fractal dimension of the left coronary tree in-patient with disease arterial severe occlusive

International Nuclear Information System (INIS)

Rodriguez, Javier; Alvarez, Luisa F; Marino, Martha E and others

2004-01-01

Fractal geometry is a chapter of mathematics that allows the measurement of irregularity in natural objects. The adequate measures in order to characterize the forms of the human body are the fractal dimensions. Coronary ramification is a fractal object, which enables the diagnosis of occlusive arterial disease by the measurement of an arterial segment obtained by coronary angiography, without measuring the impact of the obstruction in the whole ramification. Fractal dimension evaluates the irregularity of the whole coronary ramification. The right anterior oblique projection (RAO) of the left coronary ramifications (LCR) obtained through arteriography is evaluated with fractal dimensions, using the box counting method. Images of the ramification between systole and diastole were measured in 14 patients, 7 of them without occlusive arterial disease, group 1, and 7 with severe occlusive arterial disease, group 2. Patients without occlusive arterial disease showed a greater variability in the fractal dimensions sequence evaluated with the net difference, being in general this difference other than zero

Exercise thallium-201 scintigraphy in the diagnosis and prognosis of coronary artery disease

International Nuclear Information System (INIS)

Kotler, T.S.; Diamond, G.A.

1990-01-01

The objective of this study is to determine the discriminant accuracy of exercise thallium-201 myocardial perfusion scintigraphy for the diagnosis and prognosis of patients with known or suspected coronary artery disease. This is a survey of the National Library of Medicine MEDLINE database. The key medical subject headings used were coronary disease, myocardial infarction, radionuclide imaging, and thallium. A total of 122 retrieved studies were considered relevant and were reviewed in depth. Only studies reporting both the sensitivity and specificity of thallium scintigraphy were analyzed. Discriminant accuracy for diagnosis and prognosis was summarized in terms of pooled sensitivity and specificity. Exercise thallium scintigraphy is useful in the noninvasive diagnosis of coronary artery disease, especially in patients with abnormal resting electrocardiograms, restricted exercise tolerance, and intermediate probability of having disease at the time of testing as well as of defining the prognosis of patients with known or suspected coronary artery disease, especially in those with previous myocardial infarction. Because of various shortcomings in the published record, however, the marginal discriminant accuracy and cost effectiveness of thallium scintigraphy compared with conventional clinical assessment and exercise electrocardiography remain controversial. 193 references

Statin therapy in lower limb peripheral arterial disease: Systematic review and meta-analysis.

Science.gov (United States)

Antoniou, George A; Fisher, Robert K; Georgiadis, George S; Antoniou, Stavros A; Torella, Francesco

2014-11-01

To investigate and analyse the existing evidence supporting statin therapy in patients with lower limb atherosclerotic arterial disease. A systematic search of electronic information sources was undertaken to identify studies comparing cardiovascular outcomes in patients with lower limb peripheral arterial disease treated with a statin and those not receiving a statin. Estimates were combined applying fixed- or random-effects models. Twelve observational cohort studies and two randomised trials reporting 19,368 patients were selected. Statin therapy was associated with reduced all-cause mortality (odds ratio 0.60, 95% confidence interval 0.46-0.78) and incidence of stroke (odds ratio 0.77, 95% confidence interval 0.67-0.89). A trend towards improved cardiovascular mortality (odds ratio 0.62, 95% confidence interval 0.35-1.11), myocardial infarction (odds ratio 0.62, 95% confidence interval 0.38-1.01), and the composite of death/myocardial infarction/stroke (odds ratio 0.91, 95% confidence interval 0.81-1.03), was identified. Meta-analyses of studies performing adjustments showed decreased all-cause mortality in statin users (hazard ratio 0.77, 95% confidence interval 0.68-0.86). Evidence supporting statins' protective role in patients with lower limb peripheral arterial disease is insufficient. Statin therapy seems to be effective in reducing all-cause mortality and the incidence cerebrovascular events in patients diagnosed with peripheral arterial disease. Copyright © 2014 Elsevier Inc. All rights reserved.

The Features of Extrahepatic Collateral Arteries Related to Hepatic Artery Occlusion and Benefits in the Transarterial Management of Liver Tumors

International Nuclear Information System (INIS)

Yang, Lin; Zhang, Xiao Ming; Ren, Yong Jun; Miao, Nan Dong; Huang, Xiao Hua; Dong, Guo Li

2013-01-01

Purpose. To investigate the extrahepatic collateral arteries related to hepatic artery occlusion (HAO) and to determine its benefits in the transarterial management of liver tumors. Methods and Findings. Eleven patients (7 hepatocellular carcinomas, 3 liver metastases, and 1 with hemangioma) with HAO confirmed with digital subtraction angiography (DSA) were admitted to our hospital. Of the 11 patients, 7 were men and 4 were women, with an average age of 41.5 ± 15.5 years (range: 29 to 70 years). DSA was performed to evaluate the collateral routes to the liver. In the 11 patients with HAO, DSA showed complete occlusion of the common hepatic artery in 9 patients and the proper hepatic artery (PHA) in 2 patients. Extrahepatic collateral arteries supplying the liver were readily evident. The collateral arteries originated from the superior mesenteric artery (SMA) in 8 patients, from the gastroduodenal artery in 2 patients, and from the left gastric artery (LGA) in 1 patient. Transcatheter treatment was successfully performed via the collateral artery in all patients except the one who had hemangioma. Conclusions. DSA is an effective method for detecting collateral circulation related to HAO and may provide information to guide transcatheter management decisions

Hemodynamic significance of internal carotid artery disease

DEFF Research Database (Denmark)

Schroeder, T

1988-01-01

Neurologic symptoms in the region of an internal carotid artery stenosis are considered to be embolic in most instances. Only in a subgroup has carotid occlusive disease with impairment of the collateral supply, caused a state of hemodynamic failure with marked reduction of perfusion pressure...... stenosis. This is considered a result of chronic low perfusion pressure with subsequent loss of autoregulation, and autoregulatory control is first regained after some days.(ABSTRACT TRUNCATED AT 400 WORDS)...

Impact of sex on uric acid levels and its relationship with the extent of coronary artery disease: A single-centre study

NARCIS (Netherlands)

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

2015-01-01

BACKGROUND: Serum uric acid (SUA) elevation has been largely addressed in the past as a possible risk factor for cardiovascular disease. However, uric acid has not clearly emerged as independent risk factor for coronary artery disease. Several studies in literature have assessed sex-related

Evaluation of arterial stiffness in nondiabetic chronic kidney disease patients

Directory of Open Access Journals (Sweden)

Bodanapu Mastanvalli

2017-01-01

Full Text Available Chronic kidney disease (CKD is a growing problem worldwide. Clinical and epidemiologic studies have shown that structural and functional changes that occur in major arteries are a major contributing factor to the high mortality in uremic patients. Recent studies have shown a stepwise increase of the carotid-femoral pulse wave velocity (cfPWV from CKD Stage 1 to Stage 5. We evaluated the cfPWV and augmentation index (AIx, as indirect markers of arterial stiffness in patients with nondiabetic CKD and compared the values with normal population; we also evaluated the relationship between various stages of CKD and arterial stiffness markers. This cross-sectional study was carried out in the Department of Nephrology for a duration of two years from January 15, 2012, to January 14, 2014. Fifty patients with nondiabetic CKD were studied along with 50 healthy volunteers who did not have CKD, who served as controls. Assessment of arterial stiffness (blood pressure, PWV, heart rate, aortic augmentation pressure, and AIx was performed using the PeriScope device. PWV positively correlated with systolic and diastolic blood pressure, mean aortic arterial pressure, serum creatinine, and serum uric acid and negatively correlated with estimated glomerular filtration rate. Arterial stiffness increased as CKD stage increased and was higher in nondiabetic CKD group than in the general population. Arterial stiffness progressed gradually from CKD Stage 2 to 5, and then abruptly, in dialysis patients. Measures to decrease the arterial stiffness and its influence on decreasing cardiovascular events need further evaluation.

Evaluation of the grading and disorder assessment of congenital heart disease with pulmonary arterial hypertension

International Nuclear Information System (INIS)

Ding Zhongru; Qin Yongwen

2008-01-01

Pulmonary arterial hypertension is one of the most common and serious complications in congenital heart disease. Identification of whether the pulmonary, arterial hypertension is dynamic or resistance remains as the great importance for deciding to transfer for surgery, intervention or conservative therapy and directly concerning with the prognosis and choice of treatment. This review mainly deals with the problems such as grading, staging, pathophysiology and the correlative mechanism with clinical assessment of pulmonary. arterial hypertension in congenital heart disease and furthermore providing comprehensive informations for clinical diagnosis and treatment. (authors)

Nanotechnology in diagnosis and treatment of coronary artery disease.

Science.gov (United States)

Karimi, Mahdi; Zare, Hossein; Bakhshian Nik, Amirala; Yazdani, Narges; Hamrang, Mohammad; Mohamed, Elmira; Sahandi Zangabad, Parham; Moosavi Basri, Seyed Masoud; Bakhtiari, Leila; Hamblin, Michael R

2016-01-01

Nanotechnology could provide a new complementary approach to treat coronary artery disease (CAD) which is now one of the biggest killers in the Western world. The course of events, which leads to atherosclerosis and CAD, involves many biological factors and cellular disease processes which may be mitigated by therapeutic methods enhanced by nanotechnology. Nanoparticles can provide a variety of delivery systems for cargoes such as drugs and genes that can address many problems within the arteries. In order to improve the performance of current stents, nanotechnology provides different nanomaterial coatings, in addition to controlled-release nanocarriers, to prevent in-stent restenosis. Nanotechnology can increase the efficiency of drugs, improve local and systematic delivery to atherosclerotic plaques and reduce the inflammatory or angiogenic response after intravascular intervention. Nanocarriers have potential for delivery of imaging and diagnostic agents to precisely targeted destinations. This review paper will cover the current applications and future outlook of nanotechnology, as well as the main diagnostic methods, in the treatment of CAD.

Clinical study of color Doppler sonography in Graves' disease blood flow changes after thyroid arteries embolization

International Nuclear Information System (INIS)

Zhuang Wenquan; Li Weiduo; Yang Jianyong; Chen Wei; Huang Yonghui; Guo Wenbo; Li Jiaping

2003-01-01

Objective: To study the color doppler image characteristics of thyroid arteries pre- and post-interventional procedure and to assess the clinical efficacy in Gnaves' disease. Methods: 11 from 31 patients diagnosed as Graves' disease undertaken thyroid arteries embolization, were analyzed. Color Doppler sonography was applied to monitor the pre-and post- procedure thyroid size and diameters of thyroid arteries. Power Doppler was used to detect the Vmax, Vmin, RI and blood flow. Results: After thyroid arteries embolization, the size and vascularity of thyroids were reduced. The thyroid arteries showed shrinkage and stoppage blood flow at the embolized site. The changes of RI, blood parameters of Vmax, Vmin and diameters of the thyroid arteries pre- and post-procedure turned out to be statistically significant for clinical restriction. Conclusion: The color Doppler sonography plays an important role for preoperative diagnosis and predicting the prognosis

Protein-bound homocyst(e)ine. A possible risk factor for coronary artery disease.

Science.gov (United States)

Kang, S S; Wong, P W; Cook, H Y; Norusis, M; Messer, J V

1986-01-01

The development of atherosclerotic changes and thromboembolism are common features in homocystinurics. Hence, we postulate a positive correlation between the level of homocyst(e)ine in the blood and the occurrence of coronary artery disease. Homocysteine is found either as free homocystine, cysteine-homocysteine mixed disulfide, or protein-bound homocyst(e)ine. In nonhomocystinuric subjects, most homocysteine molecules are detectable in the protein-bound form. Thus, protein-bound homocyst(e)ine in stored plasma which reflected total plasma homocyst(e)ine was determined in 241 patients with coronary artery disease (173 males and 68 females). The mean +/- SD total plasma homocyst(e)ine was 5.41 +/- 1.62 nmol/ml in male patients, 4.37 +/- 1.09 nmol/ml in male controls, 5.66 +/- 1.93 nmol/ml in female patients, and 4.16 +/- 1.62 nmol/ml in female controls. The differences between the patients with coronary artery disease and the controls were statistically significant (P less than 0.0005). PMID:3700650

Impact of posterior communicating artery on basilar artery steno-occlusive disease.

Science.gov (United States)

Hong, J M; Choi, J Y; Lee, J H; Yong, S W; Bang, O Y; Joo, I S; Huh, K

2009-12-01

Acute brainstem infarction with basilar artery (BA) occlusive disease is the most fatal type of all ischaemic strokes. This report investigates the prognostic impact of the posterior communicating artery (PcoA) and whether its anatomy is a safeguard or not. Consecutive patients who had acute brainstem infarction with at least 50% stenosis of BA upon CT angiography (CTA) were studied. The configuration of PcoA was divided into two groups upon CTA: "textbook" group (invisible PcoA with good P1 and P2 segment) and "fetal-variant of PcoA" group (only visible PcoA with absent P1 segment). Baseline demographics, radiological findings and stroke mechanisms were analysed. A multiple regression analysis was performed to predict clinical outcome at 30 days (modified Rankin disability Scale (mRSPcoA (26 bilateral, 18 unilateral). By multiple logistic regression analysis, the atherosclerotic mechanism (OR 18.0; 95% CI 3.0 to 107.0) and presence of fetal-variant PcoA (OR 5.1; 95% CI 1.4 to 18.8) were independent predictors for good prognosis and initial NIH stroke scale score (OR 1.24 per one-point increase; 95% CI 1.1 to 1.4) for poor prognosis. Fetal-variant PcoA appears to act as a safeguard against ischaemic insult in acute stroke victims involving the brainstem with BA occlusive disease. This result can be explained by the fact that patients with fetal-variant PcoA have a smaller area of posterior circulation and a possibility of retrograde filling into the upper brainstem through the fetal-variant PcoA.

Genetics of Coronary Artery Disease

DEFF Research Database (Denmark)

McPherson, Ruth; Tybjærg-Hansen, Anne

2016-01-01

Genetic factors contribute importantly to the risk of coronary artery disease (CAD), and in the past decade, there has been major progress in this area. The tools applied include genome-wide association studies encompassing >200,000 individuals complemented by bioinformatic approaches, including...... identified. Furthermore, a total of 202 independent signals in 109 loci have achieved a false discovery rate (qgenetic risk scores that can improve risk prediction beyond conventional risk...... have led to a broader understanding of the genetic architecture of CAD and demonstrate that it largely derives from the cumulative effect of multiple common risk alleles individually of small effect size rather than rare variants with large effects on CAD risk. Despite this success, there has been...

MRI in coronary artery disease

International Nuclear Information System (INIS)

Barkhausen, Joerg; Hunold, Peter; Waltering, Kai-Uwe

2004-01-01

Diagnosis of coronary artery disease (CAD) is a major challenge for medical imaging, because CAD is the leading cause of death in developed nations. Several non-invasive tests are used in clinical routine for the detection of CAD. However, due to limited sensitivity and specificity, the reliable diagnosis as well as the exclusion of CAD can only be established by catheter angiography. In patients with known CAD, therapeutic decisions require accurate information on myocardial function, ischemia and viability. Recently, magnetic resonance (MR) imaging has emerged as a non-invasive cardiac imaging technique that provides information on cardiac morphology, cardiac function, myocardial viability, and coronary morphology. This review discusses technical aspects and the clinical impact of different MR techniques. (orig.)

Relationship between haemodynamic impairment and collateral blood flow in carotid artery disease.

Science.gov (United States)

Hartkamp, Nolan S; Petersen, Esben T; Chappell, Michael A; Okell, Thomas W; Uyttenboogaart, Maarten; Zeebregts, Clark J; Bokkers, Reinoud Ph

2017-01-01

Collateral blood flow plays a pivotal role in steno-occlusive internal carotid artery (ICA) disease to prevent irreversible ischaemic damage. Our aim was to investigate the effect of carotid artery disease upon cerebral perfusion and cerebrovascular reactivity and whether haemodynamic impairment is influenced at brain tissue level by the existence of primary and/or secondary collateral. Eighty-eight patients with steno-occlusive ICA disease and 29 healthy controls underwent MR examination. The presence of collaterals was determined with time-of-flight, two-dimensional phase contrast MRA and territorial arterial spin labeling (ASL) imaging. Cerebral blood flow and cerebrovascular reactivity were assessed with ASL before and after acetazolamide. Cerebral haemodynamics were normal in asymptomatic ICA stenosis patients, as opposed to patients with ICA occlusion, in whom the haemodynamics in both hemispheres were compromised. Haemodynamic impairment in the affected brain region was always present in symptomatic patients. The degree of collateral blood flow was inversely correlated with haemodynamic impairment. Recruitment of secondary collaterals only occurred in symptomatic ICA occlusion patients. In conclusion, both CBF and cerebrovascular reactivity were found to be reduced in symptomatic patients with steno-occlusive ICA disease. The presence of collateral flow is associated with further haemodynamic impairment. Recruitment of secondary collaterals is associated with severe haemodynamic impairment.

Blood pressure and calf muscle oxygen extraction during plantar flexion exercise in peripheral artery disease.

Science.gov (United States)

Luck, J Carter; Miller, Amanda J; Aziz, Faisal; Radtka, John F; Proctor, David N; Leuenberger, Urs A; Sinoway, Lawrence I; Muller, Matthew D

2017-07-01

Peripheral artery disease (PAD) is an atherosclerotic vascular disease that affects 200 million people worldwide. Although PAD primarily affects large arteries, it is also associated with microvascular dysfunction, an exaggerated blood pressure (BP) response to exercise, and high cardiovascular mortality. We hypothesized that fatiguing plantar flexion exercise that evokes claudication elicits a greater reduction in skeletal muscle oxygenation (SmO 2 ) and a higher rise in BP in PAD compared with age-matched healthy subjects, but low-intensity steady-state plantar flexion elicits similar responses between groups. In the first experiment, eight patients with PAD and eight healthy controls performed fatiguing plantar flexion exercise (from 0.5 to 7 kg for up to 14 min). In the second experiment, seven patients with PAD and seven healthy controls performed low-intensity plantar flexion exercise (2.0 kg for 14 min). BP, heart rate (HR), and SmO 2 were measured continuously using near-infrared spectroscopy (NIRS). SmO 2 is the ratio of oxygenated hemoglobin to total hemoglobin, expressed as a percent. At fatigue, patients with PAD had a greater increase in mean arterial BP (18 ± 2 vs. vs. 10 ± 2 mmHg, P = 0.029) and HR (14 ± 2 vs. 6 ± 2 beats/min, P = 0.033) and a greater reduction in SmO 2 (-54 ± 10 vs. -12 ± 4%, P = 0.001). However, both groups had similar physiological responses to low-intensity, nonpainful plantar flexion exercise. These data suggest that patients with PAD have altered oxygen uptake and/or utilization during fatiguing exercise coincident with an augmented BP response. NEW & NOTEWORTHY In this laboratory study, patients with peripheral artery disease performed plantar flexion exercise in the supine posture until symptoms of claudication occurred. Relative to age- and sex-matched healthy subjects we found that patients had a higher blood pressure response, a higher heart rate response, and a greater reduction in skeletal muscle oxygenation as

Endovascular Procedures in Treatment of Infrapopliteal Arterial Occlusive Disease: Single Center Experience With 69 Infrapopliteal Procedures.

Science.gov (United States)

Janko, Pasternak J; Nebojsa, Budakov B; Andrej, Petres V

2018-03-01

Peripheral arterial occlusive disease (PAD) includes acute and chronic disorders of the blood supply as a result of obstruction of blood flow in the arteries of the limb. Treatment of PAD can be conservative, surgical and endovascular. Percutaneous transluminal angioplasty with or without stenting has become a recognized method, which is increasingly used in treatment of arterial occlusive disease. This study aimed to determine early results of endovascular treatment of critical limb ischemia (CLI) patients with infrapopliteal lesions. The study included 69 patients (46 men; mean age 65 years, range 38-84) with CLI (class 4 to 6 according to Rutherford). The primary study endpoints were absence of major amputation of the target limb at 6 months and occurance of local and systemic complications specifically related to use of endovascular treatment. Major amputation was avoided in 61 patients. Through 6 months, 6 patients underwent additional revascularization. One local complication (clinicaly significant dissection of popliteal artery) occurred, and it was resolved by stent implantation. There were no cases of systemic complications and death during the follow-up period. Rates of major amputation were 12.3% for diabetics versus 8.3% for non-diabetics. Our data showed that endovascular treatment of infrapopliteal disease is an effective and safe treatment in patients experiencing CLI, provides high limb preservation and low complication rates. Study outcomes support endovascular treatment as a primary option for patients experiencing CLI due to below the knee (BTK) occlusive disease. © 2018 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

GST polymorphisms and early-onset coronary artery disease in ...

African Journals Online (AJOL)

Dysfunctional detoxification enzymes are responsible for prolonged exposure to reactive molecules and can contribute to endothelial damage, an underlying factor in coronary artery disease (CAD). Objectives. We aimed to assess 2 common polymorphic variant isoforms in GSTM1 and GSTP1 of GST in young CAD patients ...

Invasive assessment of renal artery atherosclerotic disease and resistant hypertension before renal sympathetic denervation.

Science.gov (United States)

Ribichini, Flavio; Pighi, Michele; Zivelonghi, Carlo; Gambaro, Alessia; Valvo, Enrico; Lupo, Antonio; Vassanelli, Corrado

2013-01-01

Renal sympathetic denervation (RSD) is emerging as a new therapeutic option for patients with severe hypertension refractory to medical therapy. The presence of a renal artery stenosis may be both a cause of secondary hypertension and a contraindication to RSD if a renal artery stent is implanted; therefore, the definition of the functional importance of a renal artery stenosis in a patient with refractory hypertension is crucial. We describe the imaging and functional intravascular assessment of an angiographically severe stenosis of the renal artery in a patient with severe refractory hypertension, by means of intravascular ultrasound (IVUS), and measurement of the translesional pressure gradient with a pressure wire. Pressure wire examination excluded any severity of the stenosis, and IVUS showed the presence of a dissected plaque that resolved spontaneously after 3 months of intensive medical therapy and high-dose statin. Subsequently the patient was treated with RSD, achieving a significant effect on blood pressure control. Intravascular imaging and functional assessment of renal artery anatomy in patients with atherosclerotic disease may prove particularly suited to patients with refractory hypertension and multilevel vascular disease who are considered for endovascular therapies, either renal artery stenting or RSD.

Electrical neuromodulation for disabling angina pectoris related to isolated stenoses of small epicardial coronary arteries.

Science.gov (United States)

Jessurun, G A; Hautvast, R W; DeJongste, M J; Meyler, W J; van Boven AJ; Crijns, H J

1999-07-01

Patients with symptomatic small vessel coronary artery disease may be inadequate candidates for revascularization procedures. They may suffer from refractory angina, which does not respond to maximal anti-anginal drug therapy. In addition to patients with end stage coronary artery disease and syndrome X, this newly defined group of subjects with an isolated stenosis of a small coronary artery may benefit from electrical neurostimulation. We describe two patients with intractable angina caused by a significant narrowing of a diagonal branch. This treatment modality should be considered as an alternative method for unsatisfactory revascularization procedures.

Porphyromonas gingivalis-dendritic cell interactions: consequences for coronary artery disease.

Science.gov (United States)

Zeituni, Amir E; Carrion, Julio; Cutler, Christopher W

2010-12-21

An estimated 80 million US adults have one or more types of cardiovascular diseases. Atherosclerosis is the single most important contributor to cardiovascular diseases; however, only 50% of atherosclerosis patients have currently identified risk factors. Chronic periodontitis, a common inflammatory disease, is linked to an increased cardiovascular risk. Dendritic cells (DCs) are potent antigen presenting cells that infiltrate arterial walls and may destabilize atherosclerotic plaques in cardiovascular disease. While the source of these DCs in atherosclerotic plaques is presently unclear, we propose that dermal DCs from peripheral inflamed sites such as CP tissues are a potential source. This review will examine the role of the opportunistic oral pathogen Porphyromonas gingivalis in invading DCs and stimulating their mobilization and misdirection through the bloodstream. Based on our published observations, combined with some new data, as well as a focused review of the literature we will propose a model for how P. gingivalis may exploit DCs to gain access to systemic circulation and contribute to coronary artery disease. Our published evidence supports a significant role for P. gingivalis in subverting normal DC function, promoting a semimature, highly migratory, and immunosuppressive DC phenotype that contributes to the inflammatory development of atherosclerosis and, eventually, plaque rupture.

Porphyromonas gingivalis–dendritic cell interactions: consequences for coronary artery disease

Directory of Open Access Journals (Sweden)

Amir E. Zeituni

2010-12-01

Full Text Available An estimated 80 million US adults have one or more types of cardiovascular diseases. Atherosclerosis is the single most important contributor to cardiovascular diseases; however, only 50% of atherosclerosis patients have currently identified risk factors. Chronic periodontitis, a common inflammatory disease, is linked to an increased cardiovascular risk. Dendritic cells (DCs are potent antigen presenting cells that infiltrate arterial walls and may destabilize atherosclerotic plaques in cardiovascular disease. While the source of these DCs in atherosclerotic plaques is presently unclear, we propose that dermal DCs from peripheral inflamed sites such as CP tissues are a potential source. This review will examine the role of the opportunistic oral pathogen Porphyromonas gingivalis in invading DCs and stimulating their mobilization and misdirection through the bloodstream. Based on our published observations, combined with some new data, as well as a focused review of the literature we will propose a model for how P. gingivalis may exploit DCs to gain access to systemic circulation and contribute to coronary artery disease. Our published evidence supports a significant role for P. gingivalis in subverting normal DC function, promoting a semimature, highly migratory, and immunosuppressive DC phenotype that contributes to the inflammatory development of atherosclerosis and, eventually, plaque rupture.

Sex differences in disease-specific health status measures in patients with symptomatic peripheral artery disease: Data from the PORTRAIT study.

Science.gov (United States)

Roumia, Mazen; Aronow, Herbert D; Soukas, Peter; Gosch, Kensey; Smolderen, Kim G; Spertus, John A; Abbott, J Dawn

2017-04-01

Peripheral artery disease (PAD) is associated with poor health status (symptoms, functioning, quality of life (QOL)). Whether sex differences exist in PAD-specific health status is unknown. In patients presenting to a specialty clinic with new-onset or recent exacerbation of PAD, we examined sex differences as assessed by the Peripheral Artery Questionnaire (PAQ). The Patient-centered Outcomes Related to TReatment Practices in Peripheral Arterial Disease: Investigating Trajectories (PORTRAIT) study is a multicenter, international prospective study of patients with new or worsening PAD symptoms. Baseline characteristics and mean PAQ scores were compared among women ( n=481) and men ( n=793) before they underwent treatment. The independent association of sex with health status was assessed with multivariable linear regression. As compared with men, women were less often Caucasian, married and employed, and more often lacking health insurance, living alone (36.2% vs 23.6%, pPAQ scores on all domains (physical functioning adjusted mean difference of -8.40, p<0.001; social functioning adjusted mean difference of -6.8, p<0.001; QOL adjusted mean difference of -6.7, p<0.001), although no differences were observed in treatment satisfaction (adjusted mean difference -0.20, p=0.904). Despite similar ABIs, women presenting with symptoms of PAD had poorer PAD-specific functioning as compared with men, impacting all major health status domains, independent of socio-economic and clinical characteristics.

Normal left ventricular emptying in coronary artery disease at rest: analysis by radiographic and equilibrium radionuclide ventriculography

International Nuclear Information System (INIS)

Denenberg, B.S.; Makler, P.T.; Bove, A.A.; Spann, J.F.

1981-01-01

The volume ejected early in systole has been proposed as an indicator of abnormal left ventricular function that is present at rest in patients with coronary artery disease with a normal ejection fraction and normal wall motion. The volume ejected in systole was examined by calculating the percent change in ventricular volume using both computer-assisted analysis of biplane radiographic ventriculograms at 60 frames/s and equilibrium gated radionuclide ventriculograms. Ventricular emptying was examined with radiographic ventriculography in 33 normal patients and 23 patients with coronary artery disease and normal ejection fraction. Eight normal subjects and six patients with coronary artery disease had both radiographic ventriculography and equilibrium gated radionuclide ventriculography. In all patients, there was excellent correlation between the radiographic and radionuclide ventricular emptying curves (r . 0.971). There were no difference in the ventricular emptying curves of normal subjects and patients with coronary artery disease whether volumes were measured by radiographic or equilibrium gated radionuclide ventriculography. It is concluded that the resting ventricular emptying curves are identical in normal subjects and patients with coronary artery disease who have a normal ejection fraction and normal wall motion

Risk of bleeding related to antithrombotic treatment in cardiovascular disease

DEFF Research Database (Denmark)

Sørensen, Rikke; Olesen, Jonas B; Charlot, Mette

2012-01-01

Antithrombotic therapy is a cornerstone of treatment in patients with cardiovascular disease with bleeding being the most feared complication. This review describes the risk of bleeding related to different combinations of antithrombotic drugs used for cardiovascular disease: acute coronary...... syndrome (ACS), atrial fibrillation (AF), cerebrovascular (CVD) and peripheral arterial disease (PAD). Different risk assessment schemes and bleeding definitions are compared. The HAS-BLED risk score is recommended in patients with AF and in ACS patients with AF. In patients with ACS with or without...

Women with coronary artery disease report worse health-related quality of life outcomes compared to men

Directory of Open Access Journals (Sweden)

Galbraith P Diane

2004-05-01

Full Text Available Abstract Background Although there have been substantial medical advances that improve the outcomes following cardiac ischemic events, gender differences in the treatment and course of recovery for patients with coronary artery disease (CAD continue to exist. There is a general paucity of data comparing the health related quality of life (HRQOL in men and women undergoing treatment for CAD. The purpose of this study was to compare HRQOL outcomes of men and women in Alberta, at one-year following initial catheterization, after adjustment for known demographic, co-morbid, and disease severity predictors of outcome. Method The HRQOL outcome data were collected by means of a self-reported questionnaire mailed to patients on or near the one-year anniversary of their initial cardiac catheterization. Using the Seattle Angina Questionnaire (SAQ, 5 dimensions of HRQOL were measured: exertional capacity, anginal stability, anginal frequency, quality of life and treatment satisfaction. Data from the APPROACH registry were used to risk-adjust the SAQ scale scores. Two analytical strategies were used including general least squares linear modeling, and proportional odds modeling sometimes referred to as the "ordinal logistic modeling". Results 3392 (78.1% patients responded to the follow-up survey. The adjusted proportional odds ratios for men relative to women (PORs > 1 = better indicated that men reported significantly better HRQOL on all 5 SAQ dimensions as compared to women. (PORs: Exertional Capacity 3.38 (2.75–4.15, Anginal Stability 1.23 (1.03–1.47, Anginal Frequency 1.70 (1.43–2.01, Treatment Satisfaction 1.27 (1.07–1.50, and QOL 1.74 (1.48–2.04. Conclusions Women with CAD consistently reported worse HRQOL at one year follow-up compared to men. These findings underline the fact that conclusions based on research performed on men with CAD may not be valid for women and that more gender-related research is needed. Future studies are needed to

Patient-related factors influencing detectability of coronary arteries in 320-row CT angiography in infants with complex congenital heart disease.

Science.gov (United States)

Yamasaki, Yuzo; Kawanami, Satoshi; Kamitani, Takeshi; Sagiyama, Koji; Shin, Seitaro; Hino, Takuya; Nagata, Hazumu; Yabuuchi, Hidetake; Nagao, Michinobu; Honda, Hiroshi

2018-05-05

To investigate the performance of second-generation 320-row computed tomographic (CT) angiography (CTA) in detecting coronary arteries and identify factors influencing visibility of the coronary arteries in infants with complex congenital heart disease (CHD). Data of 60 infants (aged 0-2 years, median 2 months) with complex CHD who underwent examination using 320-row CTA with low-dose prospective electrocardiogram-triggered volume target scanning were reviewed. The coronary arteries of each infant were assessed using a 0-4-point scoring system based on the number of coronary segments with a visible course. Clinical parameters, the CT value in the ascending aorta, image noise, and the radiation dose were subjected to univariate and multivariate analyses. The mean coronary score for all examinations was 2.6 ± 1.5 points. The mean attenuation in the ascending aorta was 306.7 ± 66.2 HU and the mean standard deviation was 21.7 ± 4.4. The mean effective radiation dose was 1.27 ± 0.39 mSv. Multivariate regression analysis showed significant correlations between coronary score and body weight (p < 0.05) and between coronary score and the CT value in the ascending aorta (p < 0.02). Second-generation 320-row CTA with prospective electrocardiogram-triggered volume target scanning and hybrid iterative reconstruction allows good visibility of the coronary arteries in infants with complex CHD. Body weight and the CT value in the ascending aorta are important factors influencing the visibility of the coronary arteries in infants.

Superficial temporal artery calcification in patients with end-stage renal disease: Association with vascular risk factors and ischemic cerebrovascular disease

International Nuclear Information System (INIS)

Anwar, Zeeshan; Zan, Elcin; Carone, Marco; Ozturk, Arzu; Sozio, Stephen M; Yousem, David M

2011-01-01

Extracranial superficial temporal artery (STA) calcification is an unusual finding seen in patients with chronic kidney disease and has unknown ramifications with respect to intracranial ischemic disease. We sought to determine the association between the risk factors for vascular calcification and this rare phenomenon, in patients with chronic renal failure, and to assess the coexistence of cerebral ischemia. Medical records and laboratory data on risk factors for vascular calcification were retrospectively retrieved for 453 patients with a discharge diagnosis of end-stage renal disease (ESRD). CT head examinations were reviewed to identify and associate STA calcification with 1) risk factors for the vascular calcification, 2) intracranial artery calcification, and 3) cerebral ischemia (white matter and/or cortical ischemic changes). STA calcification was present in 9.9% (45/453) of the studied cohort. The prevalence of cerebral ischemia was 24.4% (11/45) in patients with STA calcification and 9.3% (38/408) in patients without it. Diabetes mellitus (OR: 2.56, 95% CI: 1.059-6.208; P=0.037) was independently associated with the risk of STA calcification. The risk of cerebral ischemia, however, was not related to STA calcification (P=0.221). The presence of diabetes mellitus is important in describing the risk of STA calcification in patients with ESRD, whereas age, gender, hypertension, serum calcium, serum phosphate, or serum hemoglobin levels are not. The risk of cerebral ischemia is not related to STA calcification but has the strongest association with diabetes mellitus

The relationship between fractional flow reserve, platelet reactivity and platelet leukocyte complexes in stable coronary artery disease