Interaction between coronary artery stenosis and coronary microcirculation in ischemic heart disease

2000 ◽  
Vol 89 (0) ◽  
pp. IX126-IX131 ◽  
Author(s):  
G. Sambuceti ◽  
M. Marzilli ◽  
C. Marini ◽  
A. L'Abbate
2006 ◽  
Vol 13 (11) ◽  
pp. 1387-1393 ◽  
Author(s):  
Muharrem Unlu ◽  
Yonca Anik ◽  
Ali Demirci ◽  
Dilek Ural ◽  
Goksel Kahraman ◽  
...  

Medicina ◽  
2008 ◽  
Vol 44 (1) ◽  
pp. 40
Author(s):  
Aušra Burkauskienė ◽  
Vidmantas Aželis ◽  
Žibuoklė Senikienė ◽  
Vitas Linonis ◽  
Irina Ramanauskienė

The aim of this study was to investigate and evaluate morphometrically the relationship between changes in the structure of myocardial nerve plexus of the right atrium auricle and myocardial ischemia, parameters reflecting functional status of the heart, and age. A total of 56 females and males aged 20–94 years were investigated. Ischemic heart disease group consisted of 39 persons (their mean age was 63.83±15.67 years). The control group comprised 17 persons (the mean age was 60.53±9.89 years). Control group consisted of deceased persons who according to the pathologic and anatomic examination were not diagnosed with cardiac pathology leading to heart lesions or overload. Ischemic heart disease group consisted of patients who underwent aorta-coronary artery bypass grafting surgery. In ischemic heart disease group, degree of coronary artery stenosis was evaluated as well as the major indicators reflecting the size of atria and formation of postinfarction scar. After examination, postinfarction scars were found in 18 (46.2%) persons; no scars were found in 21 (53.8%) persons. Neurohistochemical method and video microscopy were employed for the evaluation of quantitative changes in the structure of the myocardial nerve plexus. In ischemic heart disease group, the structures of nerve plexus occupied 5.0±1.0% of the area, perimeter was 10 488±2134 mm, and number of the structures was 2698±981; the same parameters in the control group were 6.0±1.4%, 13 008±443 mm, and 3469±1511, respectively. In persons with postinfarction scar, the number of nerve plexus structures was lower by 9.3%, area by 8.9%, perimeter by 9.7% on average as compared to ischemic heart disease group without a scar. Regression analysis did not reveal any statistically significant correlation between the degree of coronary artery stenosis and quantitive parameters of nerve plexus (P>0.05). Changes in quantitative parameters of nerve plexus were not related to compensatory dilation of the atria – echoscopy parameters of long and short axes. The results showed that the number, area, and perimeter of nerve plexus structures decreases at the same rate both in healthy subjects and patients with ischemic heart disease starting the fifth decade of life.


2020 ◽  
Vol 26 ◽  
Author(s):  
Maria Bergami ◽  
Marialuisa Scarpone ◽  
Edina Cenko ◽  
Elisa Varotti ◽  
Peter Louis Amaduzzi ◽  
...  

: Subjects affected by ischemic heart disease with non-obstructive coronary arteries constitute a population that has received increasing attention over the past two decades. Since the first studies with coronary angiography, female patients have been reported to have non-obstructive coronary artery disease more frequently than their male counterparts, both in stable and acute clinical settings. Although traditionally considered a relatively infrequent and low-risk form of myocardial ischemia, its impact on clinical practice is undeniable, especially when it comes to infarction, where the prognosis is not as benign as previously assumed. Unfortunately, despite increasing awareness, there are still several questions left unanswered regarding diagnosis, risk stratification and treatment. The purpose of this review is to provide a state of the art and an update on current evidence available on gender differences in clinical characteristics, management and prognosis of ischemic heart disease with non-obstructive coronary arteries, both in the acute and stable clinical setting.


1969 ◽  
Vol 23 (1) ◽  
pp. 127-128
Author(s):  
J.A. McEachen ◽  
R.T. Smith ◽  
J.A. Cannon ◽  
P.G. Gaal ◽  
J.H. Davis ◽  
...  

Author(s):  
Harindra C Wijeysundera ◽  
Feng Qiu ◽  
Maria C Bennell ◽  
Madhu K Natarajan ◽  
Warren J Cantor ◽  
...  

Background: Wide variation exists in the diagnostic yield of coronary angiography in stable ischemic heart disease (IHD). Previous work has primarily focused on patient factors for this variation. We sought to understand if system and physician factors, specifically hospital and physician type, as well as physician self-referral, have incremental impacts on the yield of coronary angiography, above and beyond that of patient factors alone. Methods: All patients who underwent a diagnostic coronary angiogram for possible stable IHD, at the 18 cardiac centers in Ontario, Canada were identified from October 1st, 2008 to September 30th, 2011. Obstructive coronary artery disease was defined as stenosis greater than 70% in the main coronary arteries or greater than 50% in the left main artery. Physicians were classified as either invasive or interventional. Hospitals were categorized into cath only, stand-alone PCI and full service centers. Multi-variable hierarchical logistic models were developed to identify system and physician level predictors of obstructive coronary artery disease, having adjusted for patient factors. Results: Our cohort consisted of 60,986 patients who underwent a diagnostic angiogram for possible stable IHD, of which 33,483 had obstructive coronary artery disease (54.9%), ranging from 41.0% to 70.2% across centers. Self-referral rates varied from 4.8% to 74.6%. Fewer self-referral patients (52.5%) had obstructive coronary artery disease compared to non-self-referral patients (56.5%), with an odds ratio (OR) of 0.89 (95% CI 0.85-0.93;p <0.001), after accounting for patient factors. Angiograms performed by interventional physicians had a higher likelihood of showing obstructive coronary artery disease (60.1% vs. 50.8%; OR 1.22; 95% CI 1.17-1.28; p<0.001). Fewer angiograms at cath only centers showed obstructive disease (45.0%) compared to full service centers (58.1%); this was of borderline significance (OR 0.59; 95% CI 0.34-1.00; p=0.05). Conclusion: Physician and system factors are important predictors of the diagnostic yield of coronary angiography in stable IHD, even after accounting for patient characteristics. Further study into the drivers of how these physician and system factors impact diagnostic yield is an important focus for quality improvement.


1982 ◽  
Vol 63 (3) ◽  
pp. 15-17
Author(s):  
E. V. Tsybulina ◽  
L. A. Emelyanova

A comparative analysis of the effectiveness of antianginal drugs (papaverine, persantine, intensain, nitrong, anaprilin) in combination with climacteric myocardial dystrophy in women was carried out. The data obtained make it possible to recommend beta-blockers (anaprilin, obzidan) for the treatment of coronary artery disease in women against the background of pathological menopause for wider use.


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