Search results for "coronary circulation"
showing 10 items of 75 documents
Abnormal Myocardial Perfusion After Infarction in Patients With Persistent TIMI Grade-3 Flow. Only an Acute Phenomenon?
2007
Introduction and objectives It has been suggested that abnormal perfusion as derived from cardiovascular magnetic resonance imaging (CMR) is a transient dysfunction of microcirculation after myocardial infarction (MI) with TIMI 3 flow. We hypothesized that defects of myocardial perfusion may persist during the following months. Methods Forty-seven patients with MI and sustained TIMI 3 flow underwent intracoronary myocardial contrast echocardiography (MCE) 1 week and 6 months after infarction. Abnormal perfusion by MCE was regarded as >1 hypoperfused segment. Results At one week, 20 patients showed abnormal perfusion as derived from MCE. At six months 10 patients displayed chronic abnormal p…
Prognostic value of ST-segment resolution after rescue percutaneous coronary intervention. Data from the RICO survey
2008
Objectives: The goal of the present study was to test the impact of ST segment resolution (STR) after rescue percutaneous coronary intervention (PCI) on the short-term prognosis. Background: The prognostic value of STR after rescue PCI for acute ST elevation myocardial infarction (STEMI) remains undetermined. Methods: From the French regional database, we analyzed 168 consecutive patients with STEMI and failed lysis, defined by <50 percent STR, who underwent rescue PCI. Patients were classified into two groups according to the degree of STR from the maximal ST-elevation measured on the single worst ECG lead before lysis and after rescue PCI: the without STR group (<50% STR) vs. the with STR…
Prognostic Value of Microvascular Obstruction and Infarct Size, as Measured by CMR in STEMI Patients
2014
The aim of this study was to evaluate the value of microvascular obstruction (MO) and infarct size as a percentage of left ventricular mass (15%LV), as measured by contrast-enhanced cardiac magnetic resonance, in predicting major cardiovascular adverse events (MACE) at 2 years in patients with ST-segment elevation myocardial infarction reperfused by primary percutaneous coronary intervention. Individual data from 1,025 patients were entered into the pooled analysis. MO was associated with the occurrence of MACE, defined as a composite of cardiac death, congestive heart failure, and myocardial re-infarction (adjusted hazard ratio: 3.74; 95% confidence interval: 2.21 to 6.34). IS% LV >= 25% w…
European experience with the retrograde approach for the recanalization of coronary artery chronic total occlusions. A report on behalf of the EuroCT…
2008
Aims Recanalisation rates of coronary chronic total occlusions (CTO) remain sub-optimal. The retrograde technique was recently introduced to improve success rates. Methods and results From February 2005 until December 2007, 175 patients were treated with this technique in seven European centres by highly experienced operators: in 84 (48%) as primary strategy, in 41 (23.5%) immediately after antegrade failure and in 50 (28.5%) as a repeat procedure after previous antegrade failure. Baseline characteristics revealed a mean age 61.4 +/- 10.8 years with 29.5% and 39% of patients having diabetes and a prior history of MI, respectively. The mean occlusion duration was 50.8 months (determined in 3…
Comparison of myocardial perfusion reserve before and after coronary balloon predilatation and after stent implantation in patients with postangiopla…
1996
Background Stents provide a scaffold for coronary arteries after angioplasty and inhibit elastic recoil. Methods and Results In 25 patients with postangioplasty restenosis of the left anterior descending artery, ECG-gated digital subtraction coronary angiograms were recorded at baseline and during hyperemia (12 mg papaverine IC) before and after balloon predilatation (PTCA), after implantation of a Palmaz-Schatz stent, and after 6 months. Densitometric evaluation revealed different time and density parameters to calculate two definitions of myocardial perfusion reserve (MPR1 and MPR2) and maximum flow ratio (MaxFR). Poststenotic MPR1 increased from 1.57±0.14 to 2.59±0.86 after PTCA and to …
Emergency angioplasty of totally occluded left main coronary artery in acute myocardial infarction and unstable angina pectoris--institutional experi…
1994
Acute occlusion of the left main coronary artery (LMCA) is a rare angiographic finding. We report five patients with acute myocardial infarction (AMI) and one patient with unstable angina, in whom reperfusion was achieved or attempted with percutaneous transluminal coronary angioplasty (PTCA). All patients had a long history of stable angina pectoris. The indication for emergency PTCA was cardiogenic shock in the five patients with MI. PTCA was successful in five of six patients. Three patients with reperfusion survived, three died. All survivors underwent coronary artery bypass grafting (CABG) and were still alive at 23 months, 3 and 8 years respectively in NYHA functional class II or III.…
Combined medical and mechanical recanalization in acute myocardial infarction
1985
A technique of combined medical and mechanical recanalization was employed in 96 patients with acute transmural myocardial infarction. The mean time between onset of symptoms and admission to hospital was 170 +/- 65 min (X +/- SD). After 10 +/- 16 min, 250,000 U streptokinase was administered intravenously for 20 min. Intracoronary thrombolysis was commenced within 38 +/- 14 min. First coronary angiograms demonstrated reperfusion, an open vessel in 25/96 patients (26%). In 15/71 patients (21%) reperfusion occurred during thrombolysis therapy, before mechanical recanalization could be performed. Recanalization was achieved mechanically in 37/71 patients (52%) with occluded coronary vessels. …
Tako-tsubo cardiomyopathy and microcirculation.
2010
Takotsubo cardiomyopathy was described for the first time in Japan in the 1990s. It is very similar to the ischemic cardiopathy both for clinical and instrumental characteristics. His peculiarity is an alteration of the ventricular contraction mechanism with hypo-akinesis of the apex and lateral segments of the left ventricle, associated with hyper-kinesis of the heart base which is responsible for the typical echocardiographic aspect of a cruet during the systole. However, the etiology of this cardiomyopathy is still unknown despite the fact that numerous hypothesis have been made. A single study of 16 patients proved multivasal damage by a BLASH SCORE analysis of the coronary radiography.…
Long-term outcomes in men and women with ST-segment elevation myocardial infarction and incomplete reperfusion after a primary percutaneous coronary …
2019
Background The failure of reperfusion therapy in patients with ST-segment elevation myocardial infarction (STEMI) is more frequent than considered previously. Aim To evaluate sex-related differences in long-term outcomes in patients with STEMI and incomplete infarct-related artery reperfusion after a primary percutaneous coronary intervention. Patients and methods Of consecutive 42 752 patients with STEMI hospitalized between 2009 and 2011 in Poland, we analyzed a group of 766 (35%) women and 1453 (65%) men with less than thrombolysis in myocardial infarction (TIMI) flow grade 3 following a primary percutaneous coronary intervention. Results In the 2-year follow-up, the mortality rate among…
High dose naloxone does not improve cerebral or myocardial blood flow during cardiopulmonary resuscitation in pigs
1997
In a prospective, randomized, placebo-controlled, double-blind trial we tested the hypothesis that naloxone given during cardiopulmonary resuscitation (CPR) enhances cerebral and myocardial blood flow. Twenty-one anesthetized, normoventilated pigs were instrumented for measurements of right atrial and aortic pressures, and regional organ blood flow (radiolabeled microspheres). After 5 min of untreated fibrillatory arrest, CPR was commenced using a pneumatic chest compressor/ventilator. With onset of CPR, an i.v. bolus of 40 micrograms/kg b.w. of epinephrine was given, followed by an infusion of 0.4 micrograms/kg per min. After 5 min of CPR, either naloxone, 10 mg/kg b.w. (group N, n = 11) o…