Evidence of Improved Regional Myocardial Function in Patients With Chronic Stable Angina and Apparent Normal Ventricular Function—A Tissue Doppler Study Before and After Percutaneous Coronary Intervention

2009 ◽  
Vol 22 (2) ◽  
pp. 177-182 ◽  
Author(s):  
Gerhard-Paul Diller ◽  
Balvinder S. Wasan ◽  
Simon A. McG Thom ◽  
Rodney A. Foale ◽  
Alun D. Hughes ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Stable Angina ◽  
Myocardial Function ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Tissue Doppler ◽  
Regional Myocardial Function ◽  
Doppler Study ◽  
Percutaneous Coronary ◽  
Before And After

scholarly journals A study of changes in various echocardiographic parameters in patients with chronic stable angina undergoing percutaneous coronary intervention (PCI)

2015 ◽  
Vol 9 (2) ◽  
pp. 99-106
Author(s):  
Muhammad Mobarock Hossain ◽  
AKM Fazlur Rahman ◽  
Md Abu Siddique ◽  
Sajal Krishna Banerjee ◽  
Chowdhury Meskat Ahmed ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Strain Rate ◽  
Doppler Echocardiography ◽  
Stable Angina ◽  
Myocardial Function ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Percutaneous Coronary

PCI has been used increasingly for revascularization in ischemic heart disease patients. In the cardiology practice, the assessment of left ventricular (LV) function is of paramount importance. Two-dimensional echocardiography and Doppler echocardiography remain the most important diagnostic tests/tool for the evaluation of left ventricular function. The present study was conducted to determine the impact of PCI on myocardial function assessed by 2D, M mode and tissue Doppler echocardiography in patients with chronic stable angina. The interventional study was carried out in the Department of Cardiology, University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University Hospital, Dhaka over a period of 1 year between January 2013 to December 2013. Patients with chronic stable angina undergoing percutaneous coronary intervention (PCI) during the study period were the study population. A total of 40 such patients were consecutively included in the study. The myocardial function parameters were assessed by 2D, M mode and Tissue Doppler echocardiography before PCI and 48 hours and 6 weeks after PCI. Left ventricular end diastolic dimension (LVEDD) did not experience any change 2 days after PCI, but a significant reduction was noted 6 weeks after PCI (P < 0.001). Similarly no change was observed 48 hours after PCI in left ventricular end systolic dimension (LVESD) but a significant decrease was evident 6 weeks after PCI (p < 0.001). LVEF also did not exhibit any change in the first 2 days after PCI, but significantly raised 6 weeks after PCI (p < 0.001). Tissue Doppler Imaging (TDI) showed that there was insignificant improvement in Em, Am, and Em/ Am ratio 48 hours after PCI. But there was significant improvement of the same parameters at the lateral mitral annulus 6 weeks after PCI (p = 0.044, p = 0.036 and p = 0.021 respectively). While DTm did not experience any change in first 2 days after PCI, it exhibited significant change at endpoint of study (p = 0.018), RTm and Sm peak velocity however, did not improve following PCI. Q-wave increased from 7.0 cm/sec before PCI to 7.2 cm/ sec 48 hours after PCI and 7.5 cm 6 weeks after PCI (p < 0.001). Percentage of strain decreased from -15.0 before PCI to -15.4 at the endpoint (p < 0.001) and strain rate from -1.3% before PCI to -1.4% 6 at the endpoint. From the findings of the study it can be concluded that Tissue Doppler echocardiographic indices Strain, strain rate and Q analysis can detect the early changes of improvement in the left ventricular myocardium in patient with chronic stable angina after 48 hours of PCI . Other 2D , M mode and tissue Doppler echocardiographic indices showed improvement after 6 weeks of PCI.University Heart Journal Vol. 9, No. 2, July 2013; 99-106

Chronic Stable Angina

2017 ◽  
Author(s):  
Benjamin J Scirica ◽  
J. Antonio T. Gutierrez
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Coronary Artery ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Artery Disease

By definition, chronic stable angina is angina that has been stable with regard to frequency and severity for at least 2 months. Chronic stable angina is the initial manifestation of coronary heart disease in approximately 50% of patients. Typically, this type of angina occurs in the setting of atherosclerotic coronary arterial narrowing, although other causes are possible. This review covers the epidemiology, pathophysiology, initial evaluation, differential diagnosis, management, and treatment of patients with chronic stable angina. Figures show noninvasive testing and the probability of coronary artery disease; diagnosis of patients with suspected ischemic heart disease; probability of severe coronary artery disease; coronary outcomes for high- versus low-intensity statin therapy; optimal medical therapy (OMT) versus OMT and percutaneous coronary intervention for chronic angina; OMT versus percutaneous coronary intervention for stable coronary heart disease; and coronary artery bypass grafting versus percutaneous coronary intervention for diabetes and coronary artery disease. Tables list the grading of angina pectoris by the Canadian Cardiovascular Society classification system, the differential diagnosis of chest pain, conditions promoting myocardial oxygen supply and demand mismatch, the features of typical angina, the classification of chest pain, a comparison of the pretest likelihood of coronary heart disease (CHD) in low-risk and high-risk symptomatic patients, the posttest probability of significant CHD based on pretest probabilities of CHD and normal or abnormal results of noninvasive studies, survival according to risk groups based on Duke treadmill scores, high- and moderate-intensity statin therapy, revascularization to improve survival compared with medical therapy, revascularization to improve symptoms with significant anatomic (≥ 50% left main or ≥ 70% nonleft main coronary artery disease) or physiologic (fractional flow reserve ≤ 0.80) coronary artery stenoses, and questions recommended by an expert panel for patients with chronic stable angina at follow-up visits. This review contains 7 highly rendered figures, 13 tables, and 109 references.

scholarly journals Effect of Ticagrerol versus Clopidogrel on Oxidative Stress Bio-markers in Patients with Chronic Stable Angina after Percutaneous Coronary Intervention

2017 ◽  
Vol 12 (1) ◽  
pp. 26-30
Author(s):  
Elora Sharmin ◽  
Jasmine Fauzia Dewan ◽  
Syed Ali Ahsan ◽  
Harisul Hoque ◽  
Sheikh Foyez Ahmed ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Percutaneous Coronary Intervention ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
P2y12 Receptor ◽  
Oxidative Stress Markers ◽  
Stress Markers ◽  
Percutaneous Coronary

Background: Ischemic heart disease remains the leading cause of death in both developed and under developed countries. The use of antiplatelet drugs specifically the thienopyridine has become a standard for the treatment of acute coronary syndrome. These drugs irreversibly inhibit the platelet aggregation by blocking the P2Y12 receptor. But currently this therapeutic choice has become limited due to potential interaction with other drugs, slow hepatic conversion, genetic resistance and narrow therapeutic safety margin. Ticagrerol, a reversible P2Y12 receptor inhibitor may represent a significant advancement over currently available oral antiplatelet drugs.Objectives: The study was intended to compare the effect of Ticagrelor and Clopidogrel on oxidative stress markers in patients of chronic stable angina (CSA) following percutaneous coronary intervention (PCI).Materials & Methods: The present prospective observational study was carried out in the Department of Pharmacology, Cardiology and Microbiology, BSMMU, Dhaka from September 2014 to February 2016. The study included a total of 100 CSA patients. Patients were divided into two groups, Ticagrelor and Clopidogrel treated groups (each having 50 patients). The baseline laboratory parameters-Malondihyde (MDA), Reduced glutathione (GSH), bleeding time, clotting time and platelet count, were measured and then patients of both groups underwent PCI. The same parameters were again assessed at follow up after 4 weeks of intervention. Total 12 patients from Ticagrelor and 14 patients from Clopidogrel groups were dropped out. Comparisons of the laboratory parameters were made between two groups at baseline and at follow up and also within group before and after intervention.Result: In the present study at baseline characteristics of patients treated with ticagrelor and clopidogrel were almost identical in terms of age, sex, diabetes and hypertension. The level of plasma MDA in ticagrelor group was significantly reduced from baseline to follow up(4.5 ± 1.8 to 1.4 ± 0.7, p <0.001) and in clopidogrel group (4.2 ± 1.2 to 1.3 ± 0.7, p <0.001). GSH level was increased from 0.7 mg/dl to 2.5 mg/dl (p <0.001) in ticagrerol group and in clopidogrel group 0.6 mg/dl to 1.4 mg/dl, p <0.001).Conclusion: The study concluded that both ticagrelor and clopidogrel are similar effect on oxidative stress markers, resulting from oxidative injury processes in patients of chronic stable angina.University Heart Journal Vol. 12, No. 1, January 2016; 26-30

scholarly journals PATIENT BELIEFS REGARDING BENEFITS OF PERCUTANEOUS CORONARY INTERVENTION IN CHRONIC STABLE ANGINA: HAVE THEY CHANGED?

2015 ◽  
Vol 65 (10) ◽  
pp. A1653
Author(s):  
Auras R. Atreya ◽  
Mohammad Amin Kashef ◽  
Reva Kleppel ◽  
Paul Visintainer ◽  
Janice Fitzgerald ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Patient Beliefs ◽  
Percutaneous Coronary
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