Search results for "Vascularization"

Stress cardiac magnetic resonance for mortality prediction and decision-making: registry of 2496 elderly patients with chronic coronary syndrome

2022

Abstract Introduction and objectives The management of elderly patients with chronic coronary syndrome (CCS) is challenging. We explored the prognostic value and usefulness for decision-making of ischemic burden determined by vasodilator stress cardiac magnetic resonance (CMR) imaging in elderly patients with known or suspected CCS. Methods The study group comprised 2496 patients older than 70 years who underwent vasodilator stress CMR for known or suspected CCS. The ischemic burden (number of segments with stress-induced perfusion deficit) was calculated following the 17-segment model. Subsequently, we retrospectively analyzed its association with all-cause mortality and the effect of CMR-…

Indicaciones actuales de revascularización

2012

Randomized controlled trials in patients with chronic ischemic heart disease and stable angina indicate that the majority of cases can be managed by optimum medical treatment. The exceptions are patients with conditions that could benefit from revascularization, such as recurrent angina, extensive inducible ischemia or complex coronary anatomy. However, since studies have traditionally excluded patients with significant comorbidity, it is not clear which treatment approach would be best in these circumstances. Although patients with comorbidities are usually treated conservatively in routine clinical practice, some recent studies in elderly patients have raised the possibility that this sub…

Therapeutic decision-making for patients with fluctuating mitral regurgitation

2015

Mitral regurgitation (MR) is a common, progressive, and difficult-to-manage disease. MR is dynamic in nature, with physiological fluctuations occurring in response to various stimuli such as exercise and ischaemia, which can precipitate the development of symptoms and subsequent cardiac events. In both chronic primary and secondary MR, the dynamic behaviour of MR can be reliably examined during stress echocardiography. Dynamic fluctuation of MR can also have prognostic value; patients with a marked increase in regurgitant volume or who exhibit increased systolic pulmonary artery pressure during exercise have lower symptom-free survival than those who do not experience significant changes in…

Predictors and prognosis for complex coronary lesions in patients with acute myocardial infarction

2007

Background We aimed to investigate the determinants and outcomes of multiple complex lesions (MCLs) on coronary angiography in patients with an acute myocardial infarction. Methods One thousand one hundred fifty-two consecutive nonselected myocardial infarction patients who underwent coronary angiography within 24 hours after admission were analyzed. A complex lesion was defined by the presence of thrombus, ulceration, irregular plaque, and flow impairment. Patients with ≤1 complex lesion were considered with single complex lesion (SCL), and patients with >1 complex lesions with MCLs. Results Multiple complex lesions were identified in 360 patients (31%). Patients from the MCL group were ol…

Differences in patients and lesion and procedure characteristics depending on the age of the coronary chronic total occlusion

2018

Introduction: Whether duration of chronic total occlusion (CTO) affects lesion and procedural characteristics remains largely unknown. Aim: To investigate whether CTO duration influences lesion characteristics and revascularization success. Material and methods: EuroCTO Registry data on patients who had CTO percutaneous coronary intervention between January 2015 and April 2017 were analyzed. Three groups were created based on occlusion age: 3 to 6 months (n = 1415), 7 to 12 months (n = 973), > 12 months (n = 1656). Results: Patients with greater CTO duration were older (63.0 (56.0–70.0); 63.0 (56.0–71.0); 66.0 (59.0–73.0) years respectively; p < 0.001), had more 3-vessel disease (32.2…

Stress cardiovascular magnetic resonance and mortality in a registry of 2496 elderly patients with chronic coronary syndrome. Prognosis and decision-…

2021

Abstract Funding Acknowledgements Type of funding sources: None. Background. In recent guidelines, non-invasive imaging techniques play a pivotal role in the management of chronic coronary syndrome (CCS). The elderly represent a large percentage of our routine CCS population and risk stratification in this scenario is challenging. The potential of vasodilator stress cardiovascular magnetic resonance (CMR) for this purpose is unknown. Purpose. We explore the prognostic value and the usefulness for decision-making of the ischemic burden determined by vasodilator stress CMR imaging in a large cohort of elderly patients with known or suspected CCS. Methods. The study group was made up of 2496 p…

Selecting the best candidates for revascularization: A challenging issue in stable coronary artery disease.

2018

Nitric oxide synthases: regulation and function

2011

Nitric oxide (NO), the smallest signalling molecule known, is produced by three isoforms of NO synthase (NOS; EC 1.14.13.39). They all utilize l-arginine and molecular oxygen as substrates and require the cofactors reduced nicotinamide-adenine-dinucleotide phosphate (NADPH), flavin adenine dinucleotide (FAD), flavin mononucleotide (FMN), and (6R-)5,6,7,8-tetrahydrobiopterin (BH(4)). All NOS bind calmodulin and contain haem. Neuronal NOS (nNOS, NOS I) is constitutively expressed in central and peripheral neurons and some other cell types. Its functions include synaptic plasticity in the central nervous system (CNS), central regulation of blood pressure, smooth muscle relaxation, and vasodila…

Development of choroidal neovascularization following transpupillary thermotherapy (TTT) for a small malignant melanoma of the choroid at the posteri…

2010

Abstract Introduction The malignant melanoma of the choroid is the most common primary malignant intraocular tumor in adults. There are currently several methods available for the treatment of choroidal melanomas. Among others, hyperthermia represents a therapeutic approach in which infrared radiation is delivered through the dilated pupil, called “transpupillary thermotherapy (TTT)”. The method was initially assumed to cause only a few side effects but gradually more and more complications have been observed. The treatment is associated with a number of vascular responses, for example arterial and venous occlusions. However neovascularizations of the choroid have only been detected twice s…

Utility of Intravascular Ultrasound in Percutaneous Revascularization of Chronic Total Occlusions

2016

Intravascular ultrasound has been used for >20 years to guide percutaneous coronary intervention in different subsets of coronary lesions. During the last decade, the interest in percutaneous coronary intervention for chronic total occlusion (CTO) has increased dramatically, leading to high success rates. Failure of guidewire crossing is the most common reason for failed CTO attempts. Certain angiographic features, such as blunt proximal CTO cap, tortuosity, heavy calcification, and lack of visibility of path in the distal vessel, increase procedural difficulty. A better understanding of the behavior of the guidewire within the CTO segment may represent a key issue to achieve successful …