scholarly journals Non-uniform Oxygen Supply to the Left Ventricular Myocardium by Systolic Perfusion of Coronary Artery

1979 ◽  
Vol 29 (3) ◽  
pp. 267-274 ◽  
Author(s):  
Tomiyasu KOYAMA ◽  
Masashi HORIMOTO ◽  
Yuji KIKUCHI ◽  
Yoshihiro KAKIUCHI ◽  
Takashi ARAI
Keyword(s):  
Coronary Artery ◽  
Oxygen Supply ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Left Ventricular Myocardium

scholarly journals Left Main PCI—Current Evidence, Techniques, and Triumph

2020 ◽  
Vol 1 (2) ◽  
pp. 86-93
Author(s):  
Pramod Kumar Kuchulakanti
Keyword(s):  
Coronary Artery ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Current Evidence ◽  
Left Ventricular Myocardium ◽  
Left Main ◽  
Fractional Flow ◽  
Flow Reserve

The left main coronary artery (LMCA) supplies majority of the left ventricular myocardium and atherosclerotic obstruction is associated with significant myocardial jeopardy. Coronary artery bypass surgery (CABG) has been the gold standard for LMCA disease in the past. The LMCA has special characteristics anatomically, poses different challenges with regard to percutaneous coronary intervention (PCI), and is often associated with multivessel disease. However, advancements in technology have established PCI to be a standard, safe, and reasonable alternative to CABG with comparable outcomes. Contemporary PCI of LMCA disease includes proper selection of the patients and correct technique, and is aided by intravascular ultrasound, optical coherence tomography, and physiological assessment with fractional flow reserve. In this review article, we discuss the anatomy, plaque characteristics of LMCA, current evidence from registries and randomized trials comparing with CABG, technical aspects of stent implantation, adjuvant technologies, mechanical circulatory supports, and triumph of PCI.

scholarly journals Cardiac and coronary artery study on sudden death cases in Hospital Canselor Tuanku Muhriz

2021 ◽  
Vol 5 (10) ◽  
Author(s):  
Shih Sheng Soo ◽  
Siti Balkis Budin ◽  
Ismarulyusda Ishak ◽  
Faridah Mohd Nor ◽  
Nur Najmi Mohamad Anuar
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Sudden Death ◽  
Thrombus Formation ◽  
Arterial Occlusion ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Left Ventricular Myocardium ◽  
Common Presentation ◽  
Acute Mi

Background: Sudden death (SD) is defined as an unexpected natural death within an hour onset of symptoms or unwitnessed death that occurs within 24 hours, which accounts for most cardiovascular deaths in Malaysia. This study aimed to evaluate the extent of histopathological changes in the heart and to study the demographic trend in SD cases in Kuala Lumpur, Malaysia. Methods: Specimens from all SD cases were received from 2017 to 2018 by the Forensic Unit, Hospital Canselor Tuanku Mukhriz (HCTM) were studied. The specimens were the left ventricular myocardium and left anterior descending artery (LAD), which were fixed in 10% formalin with haematoxylin and eosin staining. The tissues were graded histologically based on changes such as arterial occlusion, myocardial infarction, and/or thrombus formation. Results: Out of 545 medicolegal deaths, only 25 cases (4.6%) had samples available for analysis. Among these 25 patients, 24 (96%) were male patients and only one (4%) was a female patient. The available samples were from patients aged between 30 to 79 years old. In terms of ethinicity, Malays (40%) were the most numerous, followed by patients of Chinese and Indian ethnicities.The majority of the SD cases had a body mass index (BMI) that ranged between underweight (56%) and obese (40%). Besides, there were 10 (40%) cases of coronary artery with atheroma and 15 (60%) cases of myocardial infarction. The most common presentation of atherosclerosis was grade III and IV, and acute MI was the most common presentation at death, followed by healed infarcts and old infarcts. Discussion and Conclusion: Our findings reflect worsening risk factor levels in cardiovascular diseases, compounded by demographic trends. Further studies on biomarkers specific for cardiac diseases are warranted to understand imminent sudden cardiac death.

Canine myocardial creatine kinase isoenzyme response to coronary artery occlusion

1989 ◽  
Vol 256 (2) ◽  
pp. H508-H514 ◽  
Author(s):  
S. W. Sharkey ◽  
K. J. Elsperger ◽  
M. Murakami ◽  
F. S. Apple
Keyword(s):  
Creatine Kinase ◽  
Coronary Artery ◽  
Coronary Artery Occlusion ◽  
Ventricular Myocardium ◽  
Artery Occlusion ◽  
Left Ventricular ◽  
Left Ventricular Myocardium ◽  
Base Line ◽  
Creatine Kinase Mb ◽  
Total Creatine

The response of the myocardial creatine kinase system to acute coronary artery occlusion is not well defined. In the present study, we measured serial changes in myocardial creatine kinase and creatine kinase-MB activities after acute occlusion of the left anterior descending (LAD) coronary artery in 20 open-chest pentobarbital-anesthetized dogs. Tissue samples were obtained from both ischemic and nonischemic left ventricular myocardium at base line and 1-, 3-, and 5-h intervals after LAD occlusion and assayed for total creatine kinase and the isoenzymes creatine kinase-MM, and creatine kinase-MB. Total creatine kinase activity declined significantly in both the ischemic and the nonischemic tissue because of a decline in creatine kinase-MM activity. Concomitantly, creatine kinase-MB activity increased significantly in both the ischemic and the nonischemic tissue. These changes were observed when the duration of the LAD occlusion was 3 h or longer, but not when the duration of the occlusion was 1 h. Thus acute myocardial ischemia causes pronounced changes in the canine myocardial creatine kinase system. These rapid biochemical alterations occur both locally in ischemic tissue and remotely in nonischemic tissue.

scholarly journals Clinical outcome of proximal left anterior descending revascularization with everolimus eluting stents via transradial route: a single centre experience in Western Rajasthan, India

2017 ◽  
Vol 5 (5) ◽  
pp. 2091
Author(s):  
Rohit Mathur ◽  
Goutam Kumar ◽  
Deepak Gupta ◽  
Sanjeev Sanghvi ◽  
Anil Baroopal
Keyword(s):  
Coronary Artery ◽  
Clinical Outcome ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Artery Stenosis ◽  
Left Ventricular Myocardium ◽  
Large Area ◽  
Proximal Site ◽  
Percutaneous Revascularization ◽  
Acute Stent Thrombosis

Background: The proximal left anterior descending (LAD) artery stenosis represents the most important proximal site for obstructive coronary artery, as it supplies 40%–50% of the total left ventricular myocardium and could result in ischemia to a large area of myocardium. This study assesses the clinical outcome of patients with coronary artery diseases undergoing percutaneous revascularization with everolimus eluting stent implantation in the proximal left anterior descending coronary artery via trans radial route.Methods: 150 patients with significant angiographic lesion of proximal LAD artery stenosis treated with PTCA and stenting to proximal LAD via TRA were selected for study and were followed for one year.Results: Total 15 events were recorded 4 (2.6%) deaths and 11 (7%) MI and TLR was noted in 4% of patients. One (0.6%) case of acute stent thrombosis was recorded.Conclusions: Total MACE of this record (10% at 12 months of clinical follow-up) is consistent with those observed in the large randomized and multi-center studies with drug-eluting stents implanted in the proximal left anterior descending artery.

The Validity of the Total Myocardial Blood Flow Determination by Means of 113Xe in Regional Ischemia

1976 ◽  
Vol 15 (03) ◽  
pp. 115-118 ◽  
Author(s):  
J. Kasalický
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Left Coronary Artery ◽  
Ventricular Myocardium ◽  
Total Radioactivity ◽  
Left Ventricular ◽  
Left Ventricular Myocardium ◽  
The Difference ◽  
133Xe Washout

SummaryRegional MBF in the ischemic and healthy left ventricular myocardium was measured in 21 mongrel dogs by means of locally injected 133Xe and its washout one week after ligation of the left anterior descending coronary. Simultaneously the total MBF was calculated from the precordial washout determination of 133Xe injected into the left coronary artery. The 133Xe measurements were compared with the regional 86Rb uptake. The values of total MBF determination after left coronary artery injection did not diminish adequately to the size of the ischemic area; these values were usually higher as compared with the calculated mean MBF evaluated from the regional left ventricular blood flow and did not agree with regional MBF in the intact left ventricular myocardium. The difference of perfusion between the necrotic and the healthy left ventricular myocardium determined from the local 133Xe washout was higher in comparison to 86Rb uptake. The method of total MBF determination by means of precordially determined 133Xe washout injected into the coronary artery yields artificially higher values in cases with greater ischemic areas. This may be accounted for by a low initial radioactivity of the hypoperfused areas and their negligible contribution to the total radioactivity changes produced predominantly by the well perfused areas. The relatively low 86Rb uptake difference in the healthy and the necrotic left ventricular myocardium may be caused by affected extraction coefficients of 86Rb in the necrotic tissue.

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