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隐静脉移植血管钙化的发生率、部位、程度及临床相关性:一项血管内超声及血管造影研究 被引量:3
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作者 Castagna M.T. mintz g.s. +2 位作者 Ohlmann P. N.J. Weissman 苏畅 《世界核心医学期刊文摘(心脏病学分册)》 2005年第9期39-39,共1页
Background-The pattern of saphenous vein graft(SVG) calcification before percutaneous intervention has not been studied. Methods and Results-We used diagnostic and preintervention intravascular ultrasound(IVUS) to det... Background-The pattern of saphenous vein graft(SVG) calcification before percutaneous intervention has not been studied. Methods and Results-We used diagnostic and preintervention intravascular ultrasound(IVUS) to determine the incidence and magnitude of SVG calcification in 334 SVG lesions in 274 consecutive patients. Calcium was found in 133 SVGs(40%). Calcium was uniformly distributed among 48 lesion sites(14%), 43 proximal references(13%), and 42 distal references(13%). Calcium was superficial in 20(40%) and deep in 28(60%). Over the entire length of the SVGs, the maximum arc and length of calcium(in calcium-containing SVGs) averaged 174±107°and 6.8±4.8mm, respectively. In calcium-containing SVGs, lesion site arc and length of calcium measured 1.51±107°and 4.1±3.7mm, similar to the proximal and distal references(175±121°and 4.0±2.3 mm and 177±121°and 4.1±2.5mm, respectively). Graft age(7.5±4.7 versus 10.5±4.7 years, P< 0.0001), insulin-treated diabetes mellitus(40%versus 60%, P=0.02), and tobacco use(44%versus 55%, P=0.06) were clinical independent predictors of SVG calcification. Conclusions-Sixty-five percent of calcium-containing SVGs had reference calcium in the absence of lesion calcium. Calcium was located primarily in SVG wall and not at the plaque. These data suggest that SVG calcium is not just part of lesion formation and maturation. SVG calcium occurred more commonly in older grafts, in insulin-treated diabetic patients, and in smokers. 展开更多
关键词 临床相关性 血管钙化 隐静脉 血管内超声 血管造影 远端部 移植血管 近端 移植时间 吸烟人群
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早期隐静脉移植失败的临床、血管造影以及血管内超声特征
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作者 Canos D.A. mintz g.s. +2 位作者 Berzingi C.O. N.J. Weissman 郝广华 《世界核心医学期刊文摘(心脏病学分册)》 2005年第2期51-52,共2页
Objectives We sought to examine saphenous vein graft (SVG) lesions that fail within the first year after operation. Background Saphenous vein grafts remain patent for approximately 10 years; how ever, up to 15%to 20%o... Objectives We sought to examine saphenous vein graft (SVG) lesions that fail within the first year after operation. Background Saphenous vein grafts remain patent for approximately 10 years; how ever, up to 15%to 20%of SVGs become occluded within the first year. Methods We studied 100 patients who underwent percutaneous coronary intervention(PCI) for early (< 1 year post implantation) SVG failure lesions and compared them with a diabetes and hypercholesterolemia matched cohort of late SVG failures (>1 yea r). Coronary angiography and intravascular ultrasound images were analyzed. Resu lts The majority of patients in both groups were males who presented with unstab le angina; 36%were diabetic. Graft ages were 6.0 ±2.9 months and 105.4 ±50.8 months, respectively. The early SVG failure lesion location was more often ostia l or proximal (62%vs. 42%, respectively). Early SVG failures were angiographic ally smaller than late failures (reference: 2.47 ±0.86 mm vs. 3.26 ±0.83 mm, p < 0.001) but had similar lesion lengths. Intravascular ultrasound showed that ea rly failure lesions had smaller proximal and distal reference lumen areas (7.3± 6.8mm2 vs. 10.6±3.8mm2, p=0.026) and greater reference plaque burden than late failures (52.3%vs. 36.1%, p < 0.001). After PCI, 20.6%of early and 30.6%of l ate failure lesions had creatine kinase myocardial band(CK MB) greater than tw ice normal. Conclusions Early SVG failure is mostly proximal or ostial, lesions appear focal, and early SVGs appear smaller than late SVGs. Intravascular ultras ound shows significant reference segment plaque burden, suggesting more severe, diffuse SVG disease. 展开更多
关键词 隐静脉 血管内超声 血管造影 血管损伤 稳定性心绞痛 冠状血管 移植术 高胆固醇血症 近端 移植物
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风险评分预测的心血管风险与系列血管内超声检测的冠状动脉左主干斑块发展之间的关系
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作者 Von Birgelen C. Hartmann M. +1 位作者 mintz g.s. 梁磊 《世界核心医学期刊文摘(心脏病学分册)》 2005年第2期24-25,共2页
Background Intravascular ultrasound(IVUS) is increasingly used as an end poin t in studies aimed at reducing progression or inducing regression of coronary ar tery disease. However, data linking serial changes by IVUS... Background Intravascular ultrasound(IVUS) is increasingly used as an end poin t in studies aimed at reducing progression or inducing regression of coronary ar tery disease. However, data linking serial changes by IVUS with clinical outcome s are scarce. Methods and Results In the absence of a validated risk score for secondary prevention, we compared 3 established risk scores for primary preventi on PROCAM, SCORE, and Framingham with plaque progression and lumen reduction a s assessed with serial IVUS(follow up, 18±9 months) in atherosclerotic left ma in coronary arteries of 56 patients with established atherosclerosis. For all 3 algorithms, patients at highest estimated risk of events showed greater plaque p rogression than patients at lowest risk (P< 0.05 to< 0.01). There were positive linear relationships between the risk of clinical events and plaque progression (r=0.41 to 0.60; P< 0.002 to< 0.0001). This translated into a greater decrease i n lumen dimensions with increasing risk(P< 0.05, PROCAM and SCORE). Risk predict ion using the PROCAM algorithm showed the strongest relation with serial IVUS. D uring follow up, 18 patients suffered from adverse cardiovascular events; these patients had an annual plaque progression that was significantly greater than o ther patients (25.2±19.4%versus 5.9±15.6%,P<0.001). Conclusions There was a positive linear relationship between the estimated risk of clinical events deri ved from all 3 established risk score algorithms and the extent of plaque progr ession measured by serial IVUS. This translated into stenosis progression (reduc tion in lumen dimensions) with increasing clinical risk. 展开更多
关键词 冠状动脉左主干 心血管风险 血管内超声 临床事件 心脏事件 心血管事件 一级预防 二级预防 血管内径 冠脉狭窄
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基线斑块负荷与粥样硬化冠状动脉左主干继发重构的关系:一项长期(≥12个月)随访的系列血管内超声研究
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作者 Hartmann M. Von Birgelen C. +1 位作者 mintz g.s. 雷聪 《世界核心医学期刊文摘(心脏病学分册)》 2007年第1期44-44,共1页
目的:Glagov的病理组织学所见和非系列血管内超声研究(IVUS)推断:当动脉粥样斑块负荷达到40%时,代偿性冠状动脉重构便会减少。作者应用系列IVUS对此假设进行检验。方法与结果:应用系列IVUS检查了46例无狭窄的粥样硬化冠状动脉左主干(时... 目的:Glagov的病理组织学所见和非系列血管内超声研究(IVUS)推断:当动脉粥样斑块负荷达到40%时,代偿性冠状动脉重构便会减少。作者应用系列IVUS对此假设进行检验。方法与结果:应用系列IVUS检查了46例无狭窄的粥样硬化冠状动脉左主干(时间间隔18±8个月),对结果进行分析以评估基线斑块负荷[(斑块面积+中膜面积)/血管面积]和系列重构(基线时血管面积-随访时血管面积)的关系。共有25例基线斑块负荷【40%(30.1%±6.6%,A组),21例基线斑块负荷≥40%(46.1%±5.8%,B组)。 展开更多
关键词 斑块负荷 冠状动脉左主干 粥样硬化 血管内超声 斑块面积 粥样斑块 中膜面积 病理组织学 时间间隔
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西罗莫司洗脱支架边缘斑块大小对支架置入后血管重构的影响
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作者 Asano T. Kobayashi Y. +1 位作者 mintz g.s. 杜媛 《世界核心医学期刊文摘(心脏病学分册)》 2007年第3期33-33,共1页
针对33处病变,对西罗莫司洗脱支架(SES)近端和远端的5mm参照节段进行系列(基线时和随访9个月时)血管内超声分析。将近端和远端的参照节段分成长1mm的小段。
关键词 血管内超声分析 血管重构 近端 远端的 血管内超声检查 再狭窄 小段 大小对 外弹性膜
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重塑指数与采用长期(≥12月)连续血管内超声所评估粥样硬化性左冠状动脉实际血管重塑的比较
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作者 Von Birgelen C. Hartmann M. +1 位作者 mintz g.s. 王亭忠 《世界核心医学期刊文摘(心脏病学分册)》 2006年第9期41-42,共2页
OBJECTIVES: We present the remodeling index(RI) versus serial intravascular ul trasound(IVUS) data. BACKGROUND: The RI, derived by comparing lesion external el astic membrane(EEM) cross-sectional area versus the refer... OBJECTIVES: We present the remodeling index(RI) versus serial intravascular ul trasound(IVUS) data. BACKGROUND: The RI, derived by comparing lesion external el astic membrane(EEM) cross-sectional area versus the reference at one time point , is used in various IVUS studies as a substitute of true remodeling(change in E EM over time), assuming that it represents true remodeling. METHODS:We studied 4 6 non-stenotic left main arteries using serial IVUS(follow-up 18±8 months). P laques were divided into subgroups according to the follow-up RI: follow-up RI >1(n=27) versus follow-up RI ≤1(n=19). RESULTS: Lesions with a follow-up RI >1 had an increase in lumen despite an increase in plaque because of an increase in EEM. Conversely, lesions with a follow-up RI ≤1 had a reduction in lumen a s a result of both a plaque increase and EEM decrease. Overall, the follow-up R I correlated directly with changes in lesion site EEM(baseline-to-follow-up). Although there was no correlation between the follow-up RI and changes in refe rence EEM area, changes in reference EEM area did correlate directly with change s in lesion EEM area. In nearly 90%of lesions with a follow-up RI >1, there wa s a previously documented increase in EEM area. Using multivariate linear regres sion analysis, the follow-up RI was dependent on the baseline RI, the increase in lesion EEM area, and the decrease in reference EEM area. The follow-up RI wa s not dependent on changes in lesion plaque area. CONCLUSIONS: The vast majority of left main lesions with a remodeling index >1 had evidence of a previous incr ease in lesion-site EEM area. 展开更多
关键词 血管内超声 左冠状动脉 血管重塑 硬化性 病变部位 冠状动脉左主干 横截面积 评估
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辛伐他汀对冠状动脉病变部位重构的影响:连续的血管内超声研究
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作者 Jensen L.O. Thayssen P. +1 位作者 mintz g.s. 罗亮 《世界核心医学期刊文摘(心脏病学分册)》 2007年第4期17-18,共2页
背景:冠状动脉重构的直接证据只能依据外弹性膜(EEM)和斑块面积的连续改变而获得。本研究旨在通过连续的血管内超声(IVUS)
关键词 冠状动脉病 血管内超声 斑块面积 斑块负荷 外弹性膜 低脂饮食
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支架内再狭窄冠状动脉内放射治疗后,晚期完全阻塞和无晚期完全阻塞但治疗失败的患者血管造影和临床结果的比较
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作者 Wolfram R. Cheneau E. +1 位作者 mintz g.s. 李天霞 《世界核心医学期刊文摘(心脏病学分册)》 2005年第7期59-59,共1页
This study aimed to compare the outcomes of patients with late total occlusion(LTO) versus patients with recurrence in the absence of LTO after intracoronary radiation therapy for in-stent restenosis. LTO, especially ... This study aimed to compare the outcomes of patients with late total occlusion(LTO) versus patients with recurrence in the absence of LTO after intracoronary radiation therapy for in-stent restenosis. LTO, especially in the context of acute myocardial infarction, after intracoronary radiation therapy for in-stent restenosis, is associated with negative clinical outcomes after 6 and 12 months compared with in-stent restenosis without LTO. 展开更多
关键词 支架内再狭窄 血管造影 急性心肌梗死
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