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1.
Adv Exp Med Biol ; 1232: 331-337, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31893428

RESUMO

Obesity, a risk factor of coronary artery disease, is known to cause peripheral microcirculatory disturbances. This study evaluated the relationship between the degree of obesity and peripheral microcirculatory disturbances, using peripheral near infrared spectroscopy (NIRS) with a vascular occlusion test (VOT). We compared correlations between the NIRS parameter changes induced by VOT and body mass index (BMI) in patients with and without statin therapy. A NIRS probe was set on the right thenar eminence, brachial artery blood flow was blocked for 3 min, and then released. Although total hemoglobin (ΔcHb), deoxyhemoglobin (ΔHHb) and tissue oxygenation index (ΔTOI) were not correlated with BMI, a significant negative correlation was found between oxyhemoglobin (ΔO2Hb) and BMI in the overall study population (r = -0.255, p-value 0.02). In addition, a significant negative correlation was found between ΔO2Hb and BMI in patients without statin therapy (r = -0.353, p-value 0.02) but not in patients with statin therapy (r = -0.181, p-value 0.27). These findings suggest that ΔO2Hb may be a useful indicator to assess peripheral microcirculation.


Assuntos
Índice de Massa Corporal , Doença da Artéria Coronariana , Espectroscopia de Luz Próxima ao Infravermelho , Idoso , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Masculino , Microcirculação/fisiologia , Oxigênio , Consumo de Oxigênio , Oxiemoglobinas/metabolismo , Fatores de Risco , Espectroscopia de Luz Próxima ao Infravermelho/normas
2.
Adv Exp Med Biol ; 1232: 355-360, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31893431

RESUMO

Epicardial adipose tissue (EAT) is associated with visceral fat and various cardiac disorders, such as atrial fibrillation and adverse cardiovascular events. Therefore, it is important to develop a simple and non-invasive inspection method to assess EAT, to prevent unfavorable cardiac events. This study assessed correlations between near-infrared spectroscopy (NIRS) changes induced by a vascular occlusion test (VOT) and EAT volume measured by cardiac computed tomography (CCT) in patients with suspected coronary artery disease. We also assessed correlations between body mass index (BMI) and EAT volume in the same population. In addition, these correlations were compared in patients treated with statin therapy and in those without statin therapy. A NIRS probe was set on the right thenar eminence, and brachial artery blood flow was blocked for 3 min before being released. A negative correlation was found between oxyhemoglobin (ΔO2Hb) and EAT volume in the overall study population (r = -0.236, p = 0.03). Interestingly, although a strong correlation was observed in patients without statin therapy (r = -0.488, p < 0.001), this correlation was not observed in patients with statin therapy (r = 0.157, p = 0.34). These findings suggest that NIRS measurements with VOT may be a useful method to identify patients with high EAT volume and high cardiovascular risks.


Assuntos
Doença da Artéria Coronariana , Espectroscopia de Luz Próxima ao Infravermelho , Tecido Adiposo/metabolismo , Idoso , Índice de Massa Corporal , Angiografia por Tomografia Computadorizada , Doença da Artéria Coronariana/diagnóstico , Feminino , Humanos , Masculino , Oxiemoglobinas/metabolismo , Fatores de Risco
3.
Heart Vessels ; 34(12): 1925-1935, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31203393

RESUMO

Drug-coated balloon angioplasty (DCBA) has been recognized for its utility in preventing in-stent re-restenosis (ISR); however, imaging of the neointima immediately after treatment and during follow-up has only been described in a few case reports. This study aimed to determine the efficacy and mechanism of the DCBA using imaging studies both immediately after the DCBA and during the follow-up period. We enrolled 15 consecutive patients who underwent DCBA for in-stent restenosis (ISR). The in-stent neointimal volume was evaluated using optical coherence tomography (OCT), and the in-stent yellow grade was assessed using coronary angioscopy (CAS) immediately after DCBA and during the median follow-up period of 9 (8-15) months. The neointimal volume was significantly reduced from 77.1 ± 36.2 mm3 at baseline to 60.2 ± 23.9 mm3 immediately after DCBA (p = 0.0012 vs. baseline) and to 46.7 ± 21.9 mm3 during the follow-up (p = 0.0002 vs. post DCBA). The yellow grade of the residual plaques at the ISR lesion, which indicated plaque vulnerability, was significantly decreased in the follow-up CAG (from baseline: 1.79 ± 1.03, during the follow-up: 0.76 ± 0.82; p < 0.0001). These data suggest that DCBA may inhibit neointimal formation and provide angioscopic intimal stabilization for ISR lesions.

4.
Cardiovasc Interv Ther ; 31(1): 42-50, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26188645

RESUMO

Patients with acute coronary syndrome (ACS) are thought to have multiple vulnerable coronary plaques. We analyzed non-culprit plaques in patients with ACS vs. stable angina pectoris (SAP) by means of color-coded intravascular ultrasound (iMap-IVUS). Patients who underwent percutaneous coronary intervention were divided into an ACS group (n = 39) and an SAP group (n = 35). Non-culprit lesions were imaged by 40-MHz iMap-IVUS, and the plaque characteristics were compared between the two groups. Plaque volume was similar between the two groups. The fibrotic volume (%FV) was less in the ACS group than in the SAP group (70.2 ± 10.4 vs. 76.5 ± 7.2 %, respectively, P < 0.01), whereas the lipidic volume and necrotic volume (%NV) were greater in the ACS group (8.2 ± 0.4 vs. 6.3 ± 0.4 %, P < 0.01; 15.1 ± 7.9 vs. 9.9 ± 4.8 %, P < 0.01). An inverse correlation was found between %FV and total plaque volume (ACS group: r = -0.52, P < 0.01; SAP group: r = -0.31, P = 0.01), and a positive correlation was found between %NV and total plaque volume (ACS group: r = 0.56, P < 0.01; SAP group: r = 0.41, P < 0.01). Furthermore, the slope of the regression line showing the relation between plaque volume and necrotic volume was significantly steeper for the ACS group than for the SAP group (P < 0.05). Non-culprit lesions are particularly vulnerable in ACS patients. Non-culprit lesions are particularly vulnerable in ACS patients. Furthermore, the stronger correlation between plaque volume and %NV was observed in ACS patients than in SAP patients.


Assuntos
Síndrome Coronariana Aguda/diagnóstico por imagem , Angina Estável/diagnóstico por imagem , Placa Aterosclerótica/diagnóstico por imagem , Ultrassonografia de Intervenção , Idoso , Feminino , Fibrose , Humanos , Lipídeos/análise , Masculino , Análise Multivariada , Necrose , Intervenção Coronária Percutânea
5.
Open Med (Wars) ; 11(1): 155-157, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28352785

RESUMO

Saphenous vein graft aneurysm (SVGA) is one of the chronic complications after coronary aorta bypass grafting (CABG) and may be caused by atherosclerosis-like phenomena of the vein graft, weakness around the vein valve, rupturing of the suture of the graft anastomosis, or perioperative graft injury. We describe a case of a large, growing saphenous vein graft aneurysm that was followed serially by chest radiography and computed tomography. Eighteen years after CABG, an SVGA (23 × 24 mm) was incidentally detected. The patient was asymptomatic and was followed conservatively. Four years later, coronary computed tomographic angiography showed that the giant aneurysm had grown to 52.1 by 63.8 mm and revealed a second, smaller aneurysm. Finally, the SVG was ultimately resected without bypass via off-pump surgery. Therefore, this case suggested that aggressive treatment that includes surgical intervention should be considered before the aneurysm becomes larger, even if it is asymptomatic.

6.
J Atheroscler Thromb ; 22(2): 144-51, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25185780

RESUMO

AIM: Epicardial adipose tissue (EAT) is implicated in the development of coronary atherosclerosis.We sought to investigate the association between the EAT thickness and presence of multivessel disease (MV) in patients with acute myocardial infarction (AMI). METHODS: We enrolled 45 consecutive patients with AMI who underwent primary percutaneous coronary intervention (PCI). The EAT thickness was measured on echocardiography. A follow-up study was performed using coronary angiography with coronary angioscopy two weeks after primary PCI. RESULTS: Based on the angiographic findings, 21 patients had single-vessel disease (SV) and 24 patients had MV. The EAT thickness in the patients with SV was significantly smaller than that in the patients with MV (1.9±0.9 mm vs 2.8±1.3 mm, p=0.005, respectively). A multivariate logistic analysis demonstrated that the EAT thickness was the only independent predictor of MV (odds ratio=1.987, 95% confidence interval: 1.089-3.626, p=0.025). An EAT thickness of 2.3 mm was determined to be the optimal cut-off value for predicting MV, with a sensitivity of 70.8% and specificity of 71.4%. Between the thin EAT (<2.3 mm) and the thick EAT (≥2.3 mm) groups, there were no difference in the number of intense yellow plaques in the non-infarct-related artery evaluated on angioscopy (2.0±2.2 vs 1.8±2.0, p=0.365, respectively). CONCLUSIONS: The EAT thickness is closely associated with the presence of MV, but not vessel vulnerability in the non-infarct-related artery, in patients with AMI. Measuring the EAT provides important information for treating patients with AMI.


Assuntos
Tecido Adiposo/patologia , Doença da Artéria Coronariana/patologia , Infarto do Miocárdio/patologia , Pericárdio/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/etiologia , Ecocardiografia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Infarto do Miocárdio/diagnóstico por imagem , Prognóstico , Curva ROC , Cintilografia , Fatores de Risco
8.
Int Heart J ; 55(5): 391-6, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25070121

RESUMO

Periprocedural myocardial infarction (PMI) is one of the major complications of percutaneous coronary intervention (PCI). We investigated the influence of coronary plaque burden and characteristics on PMI using intravascular ultrasound (IVUS) with radiofrequency-based tissue characterization technology (iMAP). The study population consisted of 33 consecutive patients with stable angina pectoris who underwent PCI. IVUS images were recorded before and after PCI for offline analysis, and coronary flow reserve (CFR) was measured after PCI. PMI was defined as a post-PCI cardiac troponin T elevation > 5 × 99(th) percentile of the upper reference limit (0.014 ng/mL). Plaque volume in patients with PMI (n = 12) was significantly greater than that in patients without PMI (n = 21) (240.4 ± 106.0 mm(3) versus 152.1 ± 76.9 mm(3), P = 0.0096). The iMAP-IVUS analysis demonstrated that the fibrotic, lipidic, and necrotic tissue volume within culprit lesions were also greater in patients with PMI than in patients without PMI (129.4 ± 52.2 mm(3) versus 94.6 ± 40.8 mm(3), P = 0.041; 26.8 ± 10.5 mm(3) versus 15.8 ± 11.5 mm(3), P = 0.011; and 81.3 ± 48.4 mm(3) versus 40.2 ± 33.6 mm(3), P = 0.0071, respectively). Multivariate logistic analysis demonstrated that necrotic tissue volume was the only independent predictor of PMI. Multiple regression analysis demonstrated that the post-PCI CFR values signifi cantly correlated with percent plaque burden, and there were no correlations with the percent tissue burden of each plaque component. In conclusion, the iMAP-IVUS analyses demonstrate that necrotic tissue volume is a potent predictor of PMI. Microcirculatory disturbance after PCI is significantly influenced by percent plaque burden, regardless of plaque compositions.


Assuntos
Angina Pectoris/cirurgia , Reserva Fracionada de Fluxo Miocárdico , Infarto do Miocárdio/etiologia , Intervenção Coronária Percutânea/efeitos adversos , Placa Aterosclerótica/complicações , Ultrassonografia de Intervenção/métodos , Idoso , Angina Pectoris/complicações , Angina Pectoris/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/fisiopatologia , Placa Aterosclerótica/diagnóstico por imagem , Complicações Pós-Operatórias , Estudos Prospectivos , Fatores de Risco
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