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Challenging situation of coronary artery anomaly associated with ischemia and/or risk of sudden death
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作者 Shigenori Ito 《World Journal of Cardiology》 2024年第4期173-176,共4页
Coronary artery anomaly is known as one of the causes of angina pectoris and sudden death and is an important clinical entity that cannot be overlooked.The incidence of coronary artery anomalies is as low as 1%-2%of t... Coronary artery anomaly is known as one of the causes of angina pectoris and sudden death and is an important clinical entity that cannot be overlooked.The incidence of coronary artery anomalies is as low as 1%-2%of the general population,even when the various types are combined.Coronary anomalies are practically challenging when the left and right coronary ostium are not found around their normal positions during coronary angiography with a catheter.If there is atherosclerotic stenosis of the coronary artery with an anomaly and percutaneous coronary intervention(PCI)is required,the suitability of the guiding catheter at the entrance and the adequate back up force of the guiding catheter are issues.The level of PCI risk itself should also be considered on a caseby-case basis.In this case,emission computed tomography in the R-1 subtype single coronary artery proved that ischemia occurred in an area where the coronary artery was not visible to the naked eye.Meticulous follow-up would be crucial,because sudden death may occur in single coronary arteries.To prevent atherosclerosis with full efforts is also important,as the authors indicated admirably. 展开更多
关键词 Coronary artery anomaly Single coronary artery ISCHEMIA Sudden death Percutaneous coronary intervention Coronary vessel anomalies Myocardial ischemia Sudden cardiac death
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Drug-coated balloons for treating de novo lesions in large coronary vessels:A case report
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作者 Zhi-Qiang Zhang Yi-Ran Qin +4 位作者 Man Yin Xue-Heng Chen Lei Chen Wen-Yan Liang Xi-Qing Wei 《World Journal of Clinical Cases》 SCIE 2023年第20期4920-4925,共6页
BACKGROUND Percutaneous transluminal coronary angioplasty,while an effective intervention,can frequently lead to acute occlusion with severe consequences.Although clinical trials have demonstrated the efficacy of drug... BACKGROUND Percutaneous transluminal coronary angioplasty,while an effective intervention,can frequently lead to acute occlusion with severe consequences.Although clinical trials have demonstrated the efficacy of drug-coated balloons(DCB)in treating acute coronary artery occlusion and in preventing restenosis,there has been limited exploration on the use of DCB in treating de novo lesions in large vessels.Currently,DCB are only recommended for patients with small vessel lesions and in-stent restenosis lesions,those at high risk of bleeding,and other special groups of patients.CASE SUMMARY This report presents a case of successful drug-coated balloon treatment of de novo lesions in large coronary vessels.Postoperatively,the patient demonstrated favorable recovery,with subsequent examination results revealing no significant differences from the previous examination.CONCLUSION The successful treatment of the patient in our case highlights the potential of DCB in the treatment of de novo lesions in large coronary vessels. 展开更多
关键词 Drug-coated balloons De novo lesions Large coronary vessels Coronary artery disease Percutaneous coronary intervention Case report
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Protocol to study the effects of AMPK-mTOR/PINK-Parkin dual signaling pathways on the formation of coronary heart disease showing blood stasis symptom pattern based on traditional Chinese medicine theory of“heart governing blood and vessels”
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作者 An-Ni Chen Man-Li Zhou +4 位作者 Yun-Feng Yu Kang-Yan Tang Lin-Juan Yang Mo-Fei Shi Wei-Xiong Jian 《Aging Communications》 2023年第3期18-22,共5页
In this study,we aim to combine gene transfection techniques with the modeling methods previously employed by the research group to deeply investigate the corresponding theories of traditional Chinese medicine regard... In this study,we aim to combine gene transfection techniques with the modeling methods previously employed by the research group to deeply investigate the corresponding theories of traditional Chinese medicine regarding“myocardial energy metabolism”and“aortic thrombosis”.Our goal is to elucidate the biological mechanism underlying the occurrence and development of coronary heart disease with blood stasis syndrome from the perspectives of“heart and vessels”and“Qi(in traditional Chinese medicine,it refers to the most fundamental and subtle substances that constitute the human body and maintain life activities.At the same time,it also has the meaning of physiological function.In terms of traditional Chinese medicine,Qi and different words are used together to express different meanings)and blood”.The research content is divided into four modules as follows:1.establishment of an animal model of coronary heart disease with blood stasis syndrome through fibrinogen overexpression.2.Investigation of the mitochondrial quality control system in coronary heart disease with blood stasis syndrome under fibrinogen overexpression.3.Study of platelet autophagy in coronary heart disease with blood stasis syndrome under fibrinogen overexpression.4.Examination of the relationship between the AMPK-mTOR pathway and metabolism in platelet autophagy of coronary heart disease with blood stasis syndrome under fibrinogen overexpression.Ninety-six Sprague Dawley rats will be randomly assigned to the following groups:control group,model group,fibrinogen group and adeno-associated virus group.All rats will undergo a 14-week model construction process,and modern molecular biology methods will be employed to evaluate the model and examine relevant research indicators.The obtained data will be analyzed according to a predefined statistical analysis plan. 展开更多
关键词 coronary heart disease with blood stasis syndrome heart governing blood and vessels AMPK-mTOR/PINK-Parkin energy metabolism platelet autophagy study protocol
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Correlation of neutrophil to lymphocyte ratio to severity of coronary artery disease and in-hospital clinical outcomes in patients with acute coronary syndrome: A prospective observational study
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作者 Vinodhkumar Kandibendla GThiruvikrama Prakash +1 位作者 Subash Chandra Bose Prafull Dhewle 《Journal of Acute Disease》 2024年第1期14-19,共6页
Objective:To explore correlation of neutrophil-to-lymphocyte ratio(NLR)to severity of coronary artery disease(CAD)and in-hospital clinical outcomes in patients with acute coronary syndrome(ACS).Methods:In this prospec... Objective:To explore correlation of neutrophil-to-lymphocyte ratio(NLR)to severity of coronary artery disease(CAD)and in-hospital clinical outcomes in patients with acute coronary syndrome(ACS).Methods:In this prospective and observational study,we recruited 500 patients with ACS.For all the eligible patients,demographic details were collected,and laboratory parameters were evaluated.The CAD severity was evaluated in terms of the number of involved vessels.The NLR was calculated based on neutrophils and lymphocytes and the correlation of various risk factors and severity and outcome of CAD was performed.Results:77.2%of Patients was male,and 52%of the patients aged between 55-70 years.Based on the type of ACS,396 out of 500 patients had ST-elevation myocardial infarction.An ascending trend in the white blood cell levels and NLR value was noted as the severity of the ACS increased and the highest white blood cell levels and NLR was noted among classⅣpatients.The mean NLR value among the non-survivors were higher compared to the survivors(9.52±5.72 vs.4.76±2.36;P<0.01).Receiver operating curve showed that the cut-off NLR value was 5.76 with a sensitivity of 75.0%and a specificity of 77.3%.Conclusions:The NLR can be used as an independent prognostic marker in ACS.An elevated NLR value serves as a reliable predictor for short-term complications,notably in-hospital mortality. 展开更多
关键词 Acute coronary syndrome Coronary artery disease Coronary vessels Hospital mortality LYMPHOCYTES NEUTROPHILS Prognosis Risk factors
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Intracoronary thrombolysis combined with drug balloon angioplasty in a young ST-segment elevation myocardial infarction patient:A case report
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作者 Li-Qiong She De-Kui Gao +3 位作者 Le Hong Yin Tian Hui-Zhen Wang Sheng Huang 《World Journal of Cardiology》 2024年第9期531-541,共11页
BACKGROUND The combination of acute ST-segment elevation myocardial infarction(STEMI)and gastric ulcers poses a challenge to primary percutaneous coronary intervention(PPCI),particularly for young patients.The role of... BACKGROUND The combination of acute ST-segment elevation myocardial infarction(STEMI)and gastric ulcers poses a challenge to primary percutaneous coronary intervention(PPCI),particularly for young patients.The role of drug-coated balloons(DCBs)in the treatment of de novo coronary artery lesions in large vessels remains unclear,especially for patients with STEMI.Our strategy is to implement drug balloon angioplasty following the intracoronary administration of low-dose prourokinase and adequate pre-expansion.CASE SUMMARY A 54-year-old male patient presented to the emergency department due to chest pain on June 24,2019.Within the first 3 minutes of the initial assessment in the emergency room,the electrocardiogram(ECG)showed significant changes.There was atrial fibrillation with ST-segment elevation.Subsequently,atrial fibrillation terminated spontaneously and reverted to sinus rhythm.Soon after,the patient experienced syncope.The ECG revealed torsades de pointes ventricular tachycardia.A few seconds later,it returned to sinus rhythm.High-sensitivity tropon in I was normal.The diagnosis was acute STEMI.Emergency coronary angiography revealed subtotal occlusion with thrombus formation in the proximal segment of the left anterior descending artery.Considering the patient's age and history of peptic ulcer disease,after the intracoronary injection of prourokinase,percutaneous transluminal coronary angioplasty and cutting balloon angioplasty were conducted for thorough preconditioning,and paclitaxel drug-eluting balloon angioplasty was performed without any stents,achieving favorable outcomes.CONCLUSION A PPCI without stents may be a viable treatment strategy for select patients with STEMI,and further research is warranted. 展开更多
关键词 STsegment elevation myocardial infarction Recombinant human prourokinase De novo coronary lesion Large vessels Drug-eluting balloon angioplasty Case report
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A Systematic Review of Cannabidiol Effects in Coronary Syndromes: Challenges to Clinical Translation
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作者 Mario E. Zuñiga-Ayala Alejandra Meaney-Martínez +3 位作者 Alejandro Alcocer-Chauvet Vidal Gonzalez-Coronado Nestor Rubio-Infante Gerardo Garcia-Rivas 《Journal of Biosciences and Medicines》 2024年第4期246-263,共18页
Background: Myocardial ischemia in addition to other several cardiac syndromes represent a pathological proinflammatory state alongside a complex cellular microenvironment that can be modified by using cannabinoids. C... Background: Myocardial ischemia in addition to other several cardiac syndromes represent a pathological proinflammatory state alongside a complex cellular microenvironment that can be modified by using cannabinoids. Cannabidiol (CBD), a non-psychoactive compound of cannabis has been recently proposed as an immudomodulatory and cardioprotective drug. Objectives: In this systematic review we sought to clarify and summarize the clinical and preclinical evidence of potential benefit of the use of CBD in coronary syndromes. Methods: We conducted a systematic search and review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Review of Animal Data from Experimental Studies (CAMARADES) guidelines, in the electronic database from PubMed, Web of Science and Scopus up to April 2022 using predefined search terms. Pre-specified exclusion and inclusion criteria were considered, finally 11 articles were chosen to be included for this peer review. Results: Currently there are no good-quality clinical trials with the use of CBD in acute or chronic coronary syndromes. A total of 11 preclinical studies where prescreened and 5 demonstrated reproducible positive cardiovascular outcomes on in-vivo models treated with CBD. Mechanisms of CBD cardioprotection observed: 1) reduction in oxidative stress and inflammation, 2) activation of adenosine receptors and 3) increased expression of angiotensin type 2-receptor. Experimental models included ischemia/reperfusion injury, myocardial infarction, arrhythmias, and metabolic syndrome-like conditions. Conclusion: No clinical recommendation can be issued with the current evidence, on the use of CBD in acute and chronic coronary syndromes. Based on preclinical evidence, we considered there is enough evidence to propose the development of well-designed clinical trials that include CBD in the management of coronary syndromes. 展开更多
关键词 CANNABIS CANNABIDIOL Acute Coronary Syndromes Myocardial Infarction Myocardial Ischemia and Oxidative Stress
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Portal venous gas complication following coronary angiography:A case report
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作者 Zhang-Xiang Yu Zhang Bin +1 位作者 Zhu-Kai Lun Xu-Jian Jiang 《World Journal of Radiology》 2024年第10期586-592,共7页
BACKGROUND Portal vein gas(PVG)is an abnormal accumulation of gas within the portal and intrahepatic portal veins.It is associated with various abdominal diseases,ranging from benign conditions to life-threatening one... BACKGROUND Portal vein gas(PVG)is an abnormal accumulation of gas within the portal and intrahepatic portal veins.It is associated with various abdominal diseases,ranging from benign conditions to life-threatening ones that require immediate surgical intervention.Coronary angiography is the standard diagnostic procedure for coronary artery disease.There were no prior reports are available of PVG as a complication of coronary angiography.CASE SUMMARY In the specific case described here,the patient did not show signs of peritoneal irritation;however,computed tomography scans findings revealed pneumatosis in the wall of the small intestine,hepatic portal vein,and mesenteric vein,along with acute enteritis(etiology pending classification).A cesarean section was not performed,and the patient received treatment with fasting,rehydration,and antiinfection therapy.Subsequently,the patient's symptoms of abdominal distension and pain improved,and follow-up computed tomography scans indicated resolution of the portal system pneumatosis and intestinal wall edema,resulting in a favorable clinical outcome.CONCLUSION Portal venous gas complication following coronary angiography was a complication of coronary angiography. 展开更多
关键词 Coronary angiography Portal venous gas Mesenteric artery Intestinal ischemia Intestinal infarction Case report
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Evaluation of Clinical Outcomes of ses Stent in Patients with Coronary Artery Disease After Intracoronary Stenting in Small Vessels
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作者 葛长江 吕树铮 柳弘 《心肺血管病杂志》 CAS 2010年第S1期67-67,共1页
Background:Limited data are available for sirolimus-eluting stent(SES,Cypher)implantation in patients with coronary artery disease in small vessels.The clinical longtermoutcomes of SES in patients with coronary artery... Background:Limited data are available for sirolimus-eluting stent(SES,Cypher)implantation in patients with coronary artery disease in small vessels.The clinical longtermoutcomes of SES in patients with coronary artery disease after intracoronary stenting in small vessels has not been yet evaluated. 展开更多
关键词 Evaluation of Clinical Outcomes of ses Stent in Patients with Coronary Artery Disease After Intracoronary Stenting in Small Vessels
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Myocardial ischemia is a key factor in the management of stable coronary artery disease 被引量:13
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作者 Kohichiro Iwasaki 《World Journal of Cardiology》 CAS 2014年第4期130-139,共10页
Previous studies demonstrated that coronary revascularization,especially percutaneous coronary intervention(PCI),does not significantly decrease the incidence of cardiac death or myocardial infarction in patients with... Previous studies demonstrated that coronary revascularization,especially percutaneous coronary intervention(PCI),does not significantly decrease the incidence of cardiac death or myocardial infarction in patients with stable coronary artery disease.Many studies using myocardial perfusion imaging(MPI) showed that,for patients with moderate to severe ischemia,revascularization is the preferred therapy for survival benefit,whereas for patients with no to mild ischemia,medical therapy is the main choice,and revascularization is associated with increased mortality.There is some evidence that revascularization in patients with no or mild ischemia is likely to result in worsened ischemia,which is associated with increased mortality.Studies using fractional flow reserve(FFR) demonstrate that ischemia-guided PCI is superior to angiography-guided PCI,and the presence of ischemia is the key to decisionmaking for PCI.Complementary use of noninvasive MPI and invasive FFR would be important to compensate for each method's limitations.Recent studies of appropriateness criteria showed that,although PCI in the acute setting and coronary bypass surgery are properly performed in most patients,PCI in the non-acute set-ting is often inappropriate,and stress testing to identify myocardial ischemia is performed in less than half of patients.Also,some studies suggested that revascularization in an inappropriate setting is not associated with improved prognosis.Taken together,the presence and the extent of myocardial ischemia is a key factor in the management of patients with stable coronary artery disease,and coronary revascularization in the absence of myocardial ischemia is associated with worsened prognosis. 展开更多
关键词 CORONARY artery BYPASS surgery CORONARY REVASCULARIZATION Fractional flow reserve MYOCARDIAL ischemia MYOCARDIAL PERFUSION imaging PERCUTANEOUS CORONARY intervention
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Ultrasound-assessed non-culprit and culprit coronary vessels differ by age and gender 被引量:8
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作者 Andreas W Schoenenberger Nadja Urbanek +3 位作者 Stefan Toggweiler Andreas E Stuck Thérèse J Resink Paul Erne 《World Journal of Cardiology》 CAS 2013年第3期42-48,共7页
AIM: To investigate age-and gender-related differences in non-culprit versus culprit coronary vessels assessed with virtual histology intravascular ultrasound (VH-IVUS). METHODS: In 390 patients referred for coronary ... AIM: To investigate age-and gender-related differences in non-culprit versus culprit coronary vessels assessed with virtual histology intravascular ultrasound (VH-IVUS). METHODS: In 390 patients referred for coronary angiography to a single center (Luzerner Kantonsspital, Switzerland) between May 2007 and January 2011, 691 proximal vessel segments in left anterior descending, circumflex and/or right coronary arteries were imaged by VH-IVUS. Plaque burden and plaque composition(fibrous, fibro-fatty, necrotic core and dense calcium volumes) were analyzed in 3 age tertiles, according to gender and separated for vessels containing non-culprit or culprit lesions. To classify as vessel containing a culprit lesion, the patient had to present with an acute coronary syndrome, and the VH-IVUS had to be performed in a vessel segment containing the culprit lesion according to conventional coronary angiography. RESULTS: In non-culprit vessels the plaque burden increased significantly with aging (in men from 37% ± 12% in the lowest to 46% ± 10% in the highest age tertile, P < 0.001; in women from 30% ± 9% to 40% ± 11%, P < 0.001); men had higher plaque burden than women at any age (P < 0.001 for each of the 3 age tertiles). In culprit vessels of the lowest age tertile, plaque burden was significantly higher than that in non- culprit vessels (in men 48% ± 6%, P < 0.001 as compared to non-culprit vessels; in women 44% ± 18%, P = 0.004 as compared to non-culprit vessels). Plaque burden of culprit vessels did not significantly change during aging (plaque burden in men of the highest age tertile 51% ± 9%, P = 0.523 as compared to lowest age tertile; in women of the highest age tertile 49% ± 8%, P = 0.449 as compared to lowest age tertile). In men, plaque morphology of culprit vessels became increasingly rupture-prone during aging (increasing percentages of necrotic core and dense calcium), whereas plaque morphology in non-culprit vessels was less rupture-prone and remained constant during aging. In women, necrotic core in non-culprit vessels was very low at young age, but increased during aging resulting in a plaque morphology that was very similar to men. Plaque morphology in culprit vessels of young women and men was similar. CONCLUSION: This study provides evidence that age-and gender-related differences in plaque burden and plaque composition significantly depend on whether the vessel contained a non-culprit or culprit lesion. 展开更多
关键词 CORONARY vessels ANATOMY and HISTOLOGY CORONARY ARTERY ULTRASONOGRAPHY CORONARY ARTERY disease Atherosclerosis ETIOLOGY Age factors
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Electro-acupuncture at Conception and Governor vessels and transplantation of umbilical cord bloodderived mesenchymal stem cells for treating cerebral ischemia/reperfusion injury 被引量:14
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作者 Haibo Yu Pengdian Chen +4 位作者 Zhuoxin Yang Wenshu Luo Min Pi Yonggang Wu Ling Wang 《Neural Regeneration Research》 SCIE CAS CSCD 2014年第1期84-91,共8页
Mesenchymal stem cell transplantation is a novel means of treating cerebral ischemia/reper- fusion, and can promote angiogenesis and neurological functional recovery. Acupuncture at Conception and Governor vessels als... Mesenchymal stem cell transplantation is a novel means of treating cerebral ischemia/reper- fusion, and can promote angiogenesis and neurological functional recovery. Acupuncture at Conception and Governor vessels also has positive effects as a treatment for cerebral ischemia/ reperfusion. Therefore, we hypothesized that electro-acupuncture at Conception and Governor vessels plus mesenchymal stem cell transplantation may have better therapeutic effects on the promotion of angiogenesis and recovery of neurological function than either treatment alone. In the present study, human umbilical cord blood-derived mesenchymal stem cells were isolated, cultured, identified and intracranially transplanted into the striatum and subcortex of rats at 24 hours following cerebral ischemia/reperfusion. Subsequently, rats were electro-acupunctured at Conception and Governor vessels at 24 hours after transplantation. Modified neurological severity scores and immunohistochemistry findings revealed that the combined interventions of electro-acupuncture and mesenchymal stem cell transplantation clearly improved neurological impairment and up-regulated vascular endothelial growth factor expression around the isch- emic focus. The combined intervention provided a better outcome than mesenchymal stem cell transplantation alone. These findings demonstrate that electro-acupuncture at Conception and Governor vessels and mesenchymal stem cell transplantation have synergetic effects on promot- ing neurological function recovery and angiogenesis in rats after cerebral ischemia/reperfusion. 展开更多
关键词 nerve regeneration acupuncture human umbilical cord blood-derived mesenchymalstem cells ELECTRO-ACUPUNCTURE cerebral ischemia/reperfusion vascular endothelial growth factor angiogenesis Conception vessel Governor vessel modified neurological severity score NSFC grant neural regeneration
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A Study of Myocardial Ischemia Model Induced by Left Coronary Artery Ligation in Rats 被引量:6
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作者 Hailin Wang Chunyu Cao +7 位作者 Lianqiang Hui Ting Liu Yanli Wang Shuangrong Gao Yi Zhang Ran Hao Chun Li Chen Zang 《World Journal of Cardiovascular Diseases》 2016年第5期133-142,共10页
Objective: Coronary artery was ligated to study the characteristics of myocardial ischemia in rats. Methods: The left anterior descending artery was ligated to establish the rat model of acute myocardial ischemia. All... Objective: Coronary artery was ligated to study the characteristics of myocardial ischemia in rats. Methods: The left anterior descending artery was ligated to establish the rat model of acute myocardial ischemia. All animals were divided into normal control group, sham operation group and model group. 1, 2 and 4 weeks after modeling, ECG (II lead) was recorded, the weight of whole heart and left ventricle were recorded and organ indexes were calculated;myocardial infarct size was determined by TTC;CK, CK-MB, LDH, AST contents of serum were detected;cardiac function was determined by left ventricular intubation via carotid artery and left ventricular was taken to perform pathological observation. Results: 1 week after modeling, compared with the sham operation group, the ECG and heart function index of rats model had significant change, but the myocardial enzymes did not change significantly;4 weeks after modeling, the ECG and cardiac function of animal models had a recovery trend, but the myocardial enzymes, including CK, CK-MB, LDH, AST, were significantly increased;1 week after modeling, the left ventricular indexes of model rats were increased;the infarct size was about 30%, myocardial cell necrosis and granulation tissue hyperplasia could be observed in infarction area;with the modeling time extended, from 2 to 4 weeks, the left ventricular and heart indexes of model group were significantly increased;the infarct size was relatively constant, left ventricular became thickly, and fibrous or granulation tissue was significantly proliferated in infarction area under microscope. Conclusion: The indexes of myocardial ischemia induced by coronary artery ligation in rats are different at different time points. The results suggest that the time point should be selected to observe the anti-myocardial ischemia effect of the subjects from different aspects. 展开更多
关键词 Coronary Artery Ligation Myocardial Ischemia RAT
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Significance of inferior wall ischemia in non-dominant right coronary artery anatomy 被引量:2
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作者 Ali Osama Malik Oliver Abela +5 位作者 Subodh Devabhaktuni Arhama Aftab Malik Gayle Allenback Chowdhury H Ahsan Sanjay Malhotra Jimmy Diep 《World Journal of Cardiology》 CAS 2017年第3期261-267,共7页
AIM To investigate the relationship of inferior wall ischemia on myocardial perfusion imaging in patients with nondominant right coronary artery anatomy.METHODS This was a retrospective observational analysis of conse... AIM To investigate the relationship of inferior wall ischemia on myocardial perfusion imaging in patients with nondominant right coronary artery anatomy.METHODS This was a retrospective observational analysis of consecutive patients who presented to the emergency department with primary complaint of chest pain.Only patients who underwent single photon emission computed tomography(SPECT)myocardial perfusion imaging(MPI)were included.Patients who showed a reversible defect on SPECT MPI and had coronary angiography during the same hospitalization was analyzed.Patients with prior history of coronary artery disease(CAD)including history of percutaneous coronary intervention and coronary artery bypass graft surgerys were excluded.True positive and false positive results were identified on the basis of hemodynamically significant CAD on coronary angiography,in the same territory as identified on SPECT MPI.Coronary artery dominance was determined on coronary angiography.Patients were divided into group 1 and group 2.Group1 included patients with non-dominant right coronary artery(RCA)(left dominant and codominant).Group2 included patients with dominant RCA anatomy.Demographics,baseline characteristics and positive predictive value(PPV)were analyzed for the two groups.RESULTS The mean age of the study cohort was 57.6 years.Sixtyone point seven percent of the patients were males.The prevalence of self-reported diabetes mellitus,hypertension and dyslipidemia was 36%,71.9%and 53.9%respectively.A comparison of baseline characteristics between the two groups showed that patients with a non-dominant RCA were more likely to be men.For inferior wall ischemia on SPECT MPI,patients in study group 2 had a significantly higher PPV,32/42(76.1%),compared to patients in group 1,in which only 3 out of the 29 patients(10.3%)had true positive results(P value<0.001 Z test).The difference remained statistically significant even when only patients with left dominant coronary system(without co-dominant)were compared to patients with right dominant system(32/40,76.1%in right dominant group,3/19,15.8%in left dominant group,P value<0.001 Z test).There was no significant difference in mean hospital stay,re-hospitalization,and in-hospital mortality between the two groups.CONCLUSION The positive predictive value of SPECT MPI for inferior wall ischemia is affected by coronary artery dominance.More studies are needed to explain this phenomenon. 展开更多
关键词 Myocardial perfusion imaging Single photon emission commuted tomography False positive results Coronary artery dominance Inferior wall ischemia
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Transmural myocardial ischemia due to slow coronary flow
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作者 Qing Lin Meilin Liu Yixin Song 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2007年第3期182-185,共4页
Slow coronary flow phenomenon(SCFP) is an angiographic observation characterized by delayed distal vessel opacifi-cation in the absence of significant epicardial coronary disease. Only limited studies have been focuse... Slow coronary flow phenomenon(SCFP) is an angiographic observation characterized by delayed distal vessel opacifi-cation in the absence of significant epicardial coronary disease. Only limited studies have been focused on the etiologies,clinical manifestations and treatment of this unique angiographic phenomenon. In our case report,we described an 85-year-old man who came with significant ST segment elevation in leads V1-V4 and V3R-V5R without increase in myocardial enzyme. The patient also developed respiratory failure requiring intubation and mechanical ventilation. Coronary angiography revealed only mild atherosclerosis without spasm or thromboembolic occlusion. Slow flow was seen in all coronary arteries,especially in the left anterior descending and right coronary arteries. This case speculated that transmural myocardial ischemia with ST segment elevation might be resulted from slow coronary flow. Transmural myocardial ischemia can occur owing to abnormalities of the coronary microcirculation. 展开更多
关键词 SLOW CORONARY flow phenomenon ST segment elevation transmural MYOCARDIAL ischemia CORONARY MICROCIRCULATION
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Experimental Study on the Prevention of Anterior Segment Ischemia by Preservation of Anterior Ciliary Vessels 被引量:1
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作者 YannaLi GuanghuanMai +6 位作者 ZhijianWang XinpingYu HuanyunYu] YanGuo XiaomingLin DamingDeng YingKang 《Eye Science》 CAS 2003年第1期25-32,共8页
Purpose: To observe the effect of preserving anterior ciliary vessels (ACVs) on anteriorsegments of rabbit eyes undergoing tenotomy of extraocular muscles.Methods: Thirty-two adult New Zealand white rabbits were divid... Purpose: To observe the effect of preserving anterior ciliary vessels (ACVs) on anteriorsegments of rabbit eyes undergoing tenotomy of extraocular muscles.Methods: Thirty-two adult New Zealand white rabbits were divided into four groups.Same procedures were done in both eyes in each group except that left eyes underwentpreservation of ACVs. In the first group medial and lateral recti, in the second group,superior and inferior recti, in the third group, medial, lateral and superior or inferior rectiand in the fourth group, all four recti, underwent tenotomy. Slit-lamp examination,intraocular pressure (IOP) measurement, total protein and lactic acid quantification inaqueous humor were done in all eyes pre- and post-operatively. By four weeks afteroperation, the eyes were enucleated for histological examination and electron microscopy.All data were analyzed using SPSS version 10.Results: In the left eyes of both group 1 and group 2, no inflammatory response wasobserved. In the left eyes of group 3 and 4, we observed mild inflammatory response withslit-lamp examination, which disappeared in one wk. However, we did not findsignificant changes in IOP, total protein and lactic acid of aqueous humor, histology andelectron microscopic examination in these groups. In the right eyes in group 2, 3 and 4,we observed moderate to severe inflammatory changes, a few even developed anteriorsegment ischemia, appeared as decreased IOP, increased total protein and lactic acid inaqueous humor, along with pathological and electron-microscopic changes.Conclusion: Simultaneous tenotomy of three or four recti or two vertical recti on one eyemay decrease anterior segment blood flow even lead to ischemia. ACVs preservation mayprotect the blood circulation in anterior segment. Our study suggests that ACVspreservation in strabismus surgeries especially those involving multi-recti tenotomies mayprevent potential anterior segment ischemia. 展开更多
关键词 前纤毛状血管 节段性缺血 眼外肌 眼外科学 实验研究
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Atrial fibrillation and coronary artery disease:An integrative review focusing on therapeutic implications of this relationship 被引量:3
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作者 Akash Batta Juniali Hatwal +2 位作者 Akshey Batta Samman Verma Yash Paul Sharma 《World Journal of Cardiology》 2023年第5期229-243,共15页
The incidence of both atrial fibrillation(AF)and coronary artery disease(CAD)increases with advancing age.They share common risk factors and very often coexist.Evidence points to an intricate relationship between atri... The incidence of both atrial fibrillation(AF)and coronary artery disease(CAD)increases with advancing age.They share common risk factors and very often coexist.Evidence points to an intricate relationship between atrial tissue excitability and neuronal remodeling with ischemia at the microcirculatory level.In this review,we delineated this complex relationship,identified a common theme between the two,and discussed how the knowledge of this relationship translates into a positive and meaningful impact in patient management.Recent research indicates a high prevalence of CAD among AF patients undergoing coronary angiography.Further,the incidence of AF is much higher in those suffering from CAD compared to age-matched adults without CAD underlying this reciprocal relationship.CAD adversely affects AF by promoting progression via re-entry and increasing excitability of atrial tissue as a result of ischemia and electrical inhomogeneity.AF in turn accelerates atherosclerosis via endothelial dysfunctional and inflammation and together with enhanced thrombogenicity and hypercoagulability contribute to micro and macrothrombi throughout cardiovascular system.In a nutshell,the two form a vicious cycle wherein one disease promotes the other.Most AF recommendations focuses on rate/rhythm control and prevention of thromboembolism.Very few studies have discussed the importance of unmasking coexistent CAD and how the treatment of underlying ischemia will impact the burden of AF in these patients.Inflammation and endothelial dysfunction remain central to both disease processes and form a handsome therapeutic target in the management of the two diseases.The relationship between AF and CAD is complex and much more than mere coincidence.The two diseases share common risk factor and pathophysiology.Hence,it is impractical to treat them in isolation.Accordingly,we share the implications of managing underlying ischemia and inflammation to positively impact and improve quality of life among AF patients. 展开更多
关键词 Atrial fibrillation Coronary artery disease Antithrombotic therapy ISCHEMIA Early rhythm control Endothelial dysfunction
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Acute mesenteric ischemia due to percutaneous coronary intervention:A case report
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作者 Peng Ding Yuan Zhou +2 位作者 Kun-Lan Long Song Zhang Pei-Yang Gao 《World Journal of Clinical Cases》 SCIE 2022年第28期10244-10251,共8页
BACKGROUND Percutaneous coronary intervention(PCI) is extensively used to treat acute coronary syndromes(ACS).Acute mesenteric ischemia is a life-threatening disease if untreated.CASE SUMMARY An 81-year-old female pre... BACKGROUND Percutaneous coronary intervention(PCI) is extensively used to treat acute coronary syndromes(ACS).Acute mesenteric ischemia is a life-threatening disease if untreated.CASE SUMMARY An 81-year-old female presented with 3 d of lethargy and 1 d of dyspnea.On November 16,2021,the patient developed a coma.Her oxygen saturation dropped to 70%-80%,the patient was admitted to the intensive care unit for further treatment.Chest computed tomography(CT) showed chronic bronchitis,emphysema,and multiple lung infections.Abdominal CT scan showed no obvious abnormalities,but have severely calcified abdominal vessels.The patient received assisted ventilation,and vasoactive,and anti-infection drugs.Troponin level was elevated.Since the patient was in a coma,it could not be determined whether she had chest pain.The cardiologist assumed that the patient had developed ACS;therefore,the patient underwent PCI via the left femoral artery approach,and no obvious abnormalities were found in the left and right coronary arteries.On the second postoperative day,the patient presented with abdominal distension and decreased bowel sounds;constipation was considered and a glycerin enema was administered.On day 4,the patient suddenly lost consciousness,and had decreased blood pressure,abdominal wall swelling with increased tension,and absence of bowel sounds.An urgent abdominal CT scan revealed gas in her hepatic portal system with extensive bowel wall necrosis.The patient died on day 5 due to intractable shock.CONCLUSION The potential serious complications in patients undergoing PCI,especially the patients who are hemodynamically unstable and have severely calcified abdominal vessels,should all be considered. 展开更多
关键词 Percutaneous coronary intervention Acute mesenteric ischemia Acute coronary syndrome Vascular calcification Case report
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A Clinical Investigation on Tong Xin Luo Capsule in Treatment of Coronary Heart Disease with Silent Myocardial Ischemia
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作者 张昱 周鸿 +1 位作者 王恩普 毛树章 《Journal of Traditional Chinese Medicine》 SCIE CAS CSCD 2000年第2期93-95,共3页
36 cases of coronary heart disease with silent myocardial ischemia (SMI) were treated sequentially with Tong Xin Luo (TXL) capsule and isosorbide dinitrate in random order. The results showed that both drugs were effe... 36 cases of coronary heart disease with silent myocardial ischemia (SMI) were treated sequentially with Tong Xin Luo (TXL) capsule and isosorbide dinitrate in random order. The results showed that both drugs were effective in decreasing episodes of SMI and shortening the duration of asymptomatic myocardial ischemia. TXL, however, was found with a better action and was superior to isosorbide dinitrate. It was also found that TXL could improve diastolic function of the left ventricle as well. 展开更多
关键词 ADULT CAPSULES Comparative Study Coronary Disease Drugs Chinese Herbal FEMALE Humans Isosorbide Dinitrate Male Middle Aged Myocardial Ischemia
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Comparison of Clinical Efficacy of Ticagrelor and Clopidogrel for Treatment of Coronary Heart Disease with Myocardial Ischemia
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作者 Shuo Huang 《Journal of Clinical and Nursing Research》 2019年第6期5-8,共4页
Objective.To compare clinical efficacy of ticagrelor and clopidogrel for treatment of coronary heart disease with myocardial ischemia to provide references for later phase of clinical treatment.Methods.Ninety-six coro... Objective.To compare clinical efficacy of ticagrelor and clopidogrel for treatment of coronary heart disease with myocardial ischemia to provide references for later phase of clinical treatment.Methods.Ninety-six coronary heart disease patients with myocardial ischemia admitted to our hospital from July 20 to July 2019 were recruited as subjects.They were randomly divided into study group and control group according to parity of case number,with 48 patients in each group.Control group was given treatment with clopidogrel,while patients in study group were given treatment with ticagrelor.Clinical efficacy was compared between the both groups.Results.Comparison showed that total effective rate of clinical treatment was higher in study group when compared to control group(P<0.05).Frequency of ST segment depression,duration of ST segment depression,systolic blood pressure,diastolic blood pressure,heart rate and other clinical indicators in study group were superior to control group(P<0.05).Whole blood viscosity at low shear rate,whole blood viscosity at high shear rate,plasma viscosity shear rate,total cholesterol,triglyceride and other haemorheological parameters in study group were superior to control group(P<0.05).Conclusion.Application of ticagrelor has higher clinical efficacy than clopidogreal for coronary heart disease patients with myocardial ischemia.Clinical indicators and haemorheological parameters of myocardial ischemia patients were significantly improved.It should be promoted for application. 展开更多
关键词 Ticagrelor CLOPIDOGREL CORONARY HEART disease with MYOCARDIAL ISCHEMIA
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Effects of Aerobic Exercise Combined with Resistance Training on Patients with Myocardial Ischemia Caused by Coronary Heart Disease
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作者 Jian-Quan Yang Wen-Jun Wang 《Journal of Hainan Medical University》 2019年第24期28-31,共4页
Objective:To explore the clinical effect of long-term aerobic exercise combined with resistance training in patients with myocardial ischemia caused by coronary heart disease and its influence on cardiac function, exe... Objective:To explore the clinical effect of long-term aerobic exercise combined with resistance training in patients with myocardial ischemia caused by coronary heart disease and its influence on cardiac function, exercise endurance and quality of life. Methods:100 patients with myocardial ischemia caused by coronary heart disease from January 2017 to January 2019 were randomly divided into control group (n = 50 cases) and observation group (n = 50 cases). The control group was given resistance training, while the observation group was combined with long-term aerobic exercise on the basis of the control group. The two groups were treated for 3 months. The cardiac function, exercise endurance and quality of life were compared between the two groups. Results:The levels of IVST (8.20+1.32) mm, LVDD (46.43+4.13) mm and LVSD (32.59+3.15) mm in the observation group were lower than those in the control group at 3 months after treatment. The level of LVEF (67.49+5.77)% in the observation group was higher than that in the control group at 3 months after treatment. The difference between the two groups was significant (P<0.05). The ET (55.42+2.9) in the observation group was higher than that in the control group (P<0.05). 2) The levels of ng/L and TXB2 (93.23 + 6.26) ng/L were significantly lower than those of the control group, and the difference between the two groups was statistically significant (P<0.05). The 6-minute walking distance (561.25 +43.64) m and the quality of life score (95.31 +6.39) in the observation group were higher than those in the control group 3 months after treatment, and the difference between the two groups was statistically significant (P<0.05). Conclusions:Long-term aerobic exercise combined with resistance training can improve cardiac function, exercise tolerance and quality of life in patients with myocardial ischemia caused by coronary heart disease, which is worthy of popularization and application. 展开更多
关键词 Long-term AEROBIC EXERCISE Resistance training Coronary heart disease MYOCARDIAL ISCHEMIA Cardiac function level EXERCISE ENDURANCE Quality of life
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