Academic literature on the topic 'Coronary artery haemodynamic'
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Journal articles on the topic "Coronary artery haemodynamic"
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Owen, David G., Torsten Schenkel, Duncan E. T. Shepherd, and Daniel M. Espino. "Assessment of surface roughness and blood rheology on local coronary haemodynamics: a multi-scale computational fluid dynamics study." Journal of The Royal Society Interface 17, no. 169 (August 2020): 20200327. http://dx.doi.org/10.1098/rsif.2020.0327.
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The surface roughness of the coronary artery is associated with the onset of atherosclerosis. The study applies, for the first time, the micro-scale variation of the artery surface to a 3D coronary model, investigating the impact on haemodynamic parameters which are indicators for atherosclerosis. The surface roughness of porcine coronary arteries have been detailed based on optical microscopy and implemented into a cylindrical section of coronary artery. Several approaches to rheology are compared to determine the benefits/limitations of both single and multiphase models for multi-scale geometry. Haemodynamic parameters averaged over the rough/smooth sections are similar; however, the rough surface experiences a much wider range, with maximum wall shear stress greater than 6 Pa compared to the approximately 3 Pa on the smooth segment. This suggests the smooth-walled assumption may neglect important near-wall haemodynamics. While rheological models lack sufficient definition to truly encompass the micro-scale effects occurring over the rough surface, single-phase models (Newtonian and non-Newtonian) provide numerically stable and comparable results to other coronary simulations. Multiphase models allow for phase interactions between plasma and red blood cells which is more suited to such multi-scale models. These models require additional physical laws to govern advection/aggregation of particulates in the near-wall region.
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Geerlings-Batt, Jade, and Zhonghua Sun. "Evaluation of the Relationship between Left Coronary Artery Bifurcation Angle and Coronary Artery Disease: A Systematic Review." Journal of Clinical Medicine 11, no. 17 (August 31, 2022): 5143. http://dx.doi.org/10.3390/jcm11175143.
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Recent studies have suggested a relationship between wide left coronary artery bifurcation (left anterior descending [LAD]-left circumflex [LCx]) angle and coronary artery disease (CAD). Current literature is multifaceted. Different studies have analysed this relationship using computational fluid dynamics, by considering CAD risk factors, and from simple causal-comparative and correlational perspectives. Hence, the purpose of this systematic review was to critically evaluate the current literature and determine whether there is sufficient evidence available to prove the relationship between LAD-LCx angle and CAD. Five electronic databases (ProQuest, Scopus, PubMed, CINAHL Plus with Full Text, and Emcare) were used to locate relevant texts, which were then screened according to predefined eligibility criteria. Thirteen eligible articles were selected for review. Current evidence suggests individuals with a wide LAD-LCx angle experience altered haemodynamics at the bifurcation site compared to those with narrower angles, which likely facilitates a predisposition to developing CAD. However, further research is required to determine causality regarding relationships between LAD-LCx angle and CAD risk factors. Insufficient valid evidence exists to support associations between LAD-LCx angle and degree of coronary stenosis, and future haemodynamic analyses should explore more accurate coronary artery modelling, as well as CAD progression in already stenosed bifurcations.
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&NA;. "Enoximone improves haemodynamic parameters in coronary artery disease." Inpharma Weekly &NA;, no. 807 (October 1991): 20. http://dx.doi.org/10.2165/00128413-199108070-00054.
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Illescas, Edgar, Thomas Cuisset, Jean-Charles Spychaj, and Pierre Deharo. "Rotational atherectomy through a coronary artery bypass graft after transcatheter aortic valve implantation: a case report." European Heart Journal - Case Reports 4, no. 5 (September 23, 2020): 1–5. http://dx.doi.org/10.1093/ehjcr/ytaa298.
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Abstract Background Aortic stenosis (AS) in the elderly is frequently associated with complex coronary artery disease. Rotational atherectomy (RA) in this clinical setting is challenging because coronary slow flow could lead to haemodynamic instability aggravated by the severe AS. Case summary We present the case of an 83-year-old woman with symptomatic severe AS, mildly decreased left ventricular ejection fraction and history of coronary artery bypass grafting with right internal mammary artery (RIMA) to the right coronary artery (RCA) and left internal mammary artery to the left anterior descending artery and further percutaneous coronary intervention (PCI) to the circumflex. First, we performed a transcatheter aortic valve implantation (TAVI) to treat the severe AS. Because of persistent symptoms despite good result, we then performed RA of the native RCA through the RIMA with a Guidezilla® guide extension catheter. Discussion A two-staged procedure of TAVI and PCI with RA of the RCA via RIMA was successfully performed. We decided to perform the PCI after the TAVI to allow a better haemodynamic tolerance of the complex coronary intervention. This procedure needs caution as the conduit is fragile and could be easily damaged during the RA. No data are available about feasibility and safety of RA through a native graft, but this could be a first step to consider it.
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Lee, E. J. E., T. L. Lee, M. Woo, W. K. Boey, A. Kumar, and C. N. Lee. "Haemodynamic Effects of Ketanserin following Coronary Artery Bypass Grafting." Anaesthesia and Intensive Care 19, no. 3 (August 1991): 351–56. http://dx.doi.org/10.1177/0310057x9101900307.
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PENSADO, A., N. MOLINS, and J. ALVAREZ. "HAEMODYNAMIC EFFECTS OF PROPOFOL DURING CORONARY ARTERY BYPASS SURGERY." British Journal of Anaesthesia 71, no. 4 (October 1993): 586–88. http://dx.doi.org/10.1093/bja/71.4.586.
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Ohayon, Paul, Anthony Matta, and Nicolas Boudou. "A case report of an iatrogenic coronary cameral fistula treated by retrograde percutaneous coronary intervention." European Heart Journal - Case Reports 4, no. 3 (May 3, 2020): 1–6. http://dx.doi.org/10.1093/ehjcr/ytaa094.
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Abstract Background Acquired coronary cameral fistula is an extremely rare condition that involves an abnormal communication between a coronary artery and a cardiac chamber. It usually occurs after chest trauma or cardiovascular interventions, such as percutaneous coronary intervention (PCI) and is associated with various outcomes, ranging from a stable status to haemodynamic instability. Acquired coronary cameral fistula frequently arises from the right coronary artery and drains generally into the right ventricle. Case summary We report the unusual case of a 56-year-old male patient referred to an invasive cardiology centre for a suspected left anterior descending (LAD) coronary–left ventricular (LV) fistula resulting from a primary PCI for an anterior ST-elevation myocardial infarction. Here, the confirmed LAD–LV fistula was successfully treated by retrograde PCI with covered stent implantation. Clinical and angiographic outcomes were favourable at 1-month follow-up. Discussion Coronary cameral fistula can be a severe complication of primary PCI. Various treatment strategies can be considered based on haemodynamic status and anatomical features. In the case described herein, the use of a retrograde approach led to permanent fistula closure and complete revascularization.
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Kalaycioǧlu, S., H. Soncul, V. Halit, L. Gökgöz, N. Akçora, M. Hayran, A. Yener, and A. Ersöz. "Effect of Right Atrial Appendicectomy on the Release of Atrial Natriuretic Peptide in Humans." Cardiovascular Surgery 1, no. 4 (August 1993): 426–31. http://dx.doi.org/10.1177/096721099300100424.
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The present study evaluated the effect of right atrial appendicectomy on the release of atrial natriuretic peptide (ANP) and subsequent changes in postoperative haemodynamics in 20 men undergoing coronary artery bypass graft surgery. The right atrial appendix was removed in ten patients and saved in ten. Serum ANP, sodium levels and urinary sodium excretion were measured before and on days 1, 7 and 30 after surgery. Haemodynamic parameters were monitored before surgery and on day 30. Serum ANP levels fell significantly in patients undergoing appendicectomy ( P < 0.05); haemodynamic parameters were unchanged. Hence, appendicectomy reduced serum ANP levels in the short term, though these tended to rise again with time; cardiac function was not affected by lowered levels of serum ANP. Consequently, saving the appendix in right atrial apendicectomy improves natriuresis and may decrease diuretic requirement.
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Djordjevic, Ilija, Oliver Liakopoulos, Mara Elskamp, Johanna Maier-Trauth, Stephen Gerfer, Thomas Mühlbauer, Ingo Slottosch, et al. "Concomitant Intra-Aortic Balloon Pumping Significantly Reduces Left Ventricular Pressure during Central Veno-Arterial Extracorporeal Membrane Oxygenation—Results from a Large Animal Model." Life 12, no. 11 (November 12, 2022): 1859. http://dx.doi.org/10.3390/life12111859.
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(1) Introduction: Simultaneous ECMO and IABP therapy is frequently used. Haemodynamic changes responsible for the success of the concomitant mechanical circulatory support system approach are rarely investigated. In a large-animal model, we analysed haemodynamic parameters before and during ECMO therapy, comparing central and peripheral ECMO circulation with and without simultaneous IABP support. (2) Methods: Thirty-three female pigs were divided into five groups: (1) SHAM, (2) (peripheral)ECMO(–)IABP, (3) (p)ECMO(+)IABP, (4) (central)ECMO(–)IABP, and (5) (c)ECMO(+)IABP. Pigs were cannulated in accordance with the group and supported with ECMO (±IABP) for 10 h. Systemic haemodynamics, cardiac index (CI), and coronary and carotid artery blood flow were determined before, directly after, and at five and ten hours on extracorporeal support. Systemic inflammation (IL-6; IL-10; TNFα; IFNγ), immune response (NETs; cf-DNA), and endothelial injury (ET-1) were also measured. (3) Results: IABP support during antegrade ECMO circulation led to a significant reduction of left ventricular pressure in comparison to retrograde flow in (p)ECMO(–)IABP and (p)ECMO(+)IABP. Blood flow in the left anterior coronary and carotid artery was not affected by extracorporeal circulation. (4) Conclusions: Concomitant central ECMO and IABP therapy leads to significant reduction of intracavitary cardiac pressure, reduces cardiac work, and might therefore contribute to improved recovery in ECMO patients.
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Jamshidi, Peiman, and Paul Erne. "Congenital Anomalies of the Coronary Arteries." European Cardiology Review 5, no. 1 (2009): 12. http://dx.doi.org/10.15420/ecr.2012.5.1.12.
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Multiple variations of congenital anomalies of the coronary arteries exist that may occur in isolation or in association with other congenital anomalies. They can cause myocardial ischaemia. A rare but potentially lethal condition is the anomalous origin of the left coronary artery from the pulmonary artery. The most common haemodynamically significant coronary abnormalities are coronary artery fistulae. A left-toright shunt exists in more than 90% of cases. The origin of the left coronary artery from the proximal right coronary artery (RCA) or the right aortic sinus with subsequent passage between the aorta and the right ventricular outflow tract has been associated with sudden death during or shortly after exercise in young persons. High anterior origin of the RCA is commonly encountered but is of no haemodynamic significance. It is difficult to engage the ostium of the RCA selectively using conventional catheter manipulation. In this article we will discuss various types of congenital coronary anomaly, providing examples.
Dissertations / Theses on the topic "Coronary artery haemodynamic"
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Chaichana, Thanapong. "Haemodynamic evaluation of coronary artery plaques : prediction of coronary atherosclerosis and disease progression." Thesis, Curtin University, 2012. http://hdl.handle.net/20.500.11937/1233.
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Coronary artery disease is the leading cause of death in advanced countries. Coronary artery disease tends to develop at locations where disturbed flow patterns occur, such as the left coronary artery. Haemodynamic change is believed to play an important role in the pathogenesis of coronary artery disease. This study was conducted to analyse the haemodynamic variations in the left coronary artery, with normal and diseased conditions, based on idealised human left coronary artery models and realistic reconstructed left coronary geometries. Computational fluid dynamics analysis was performed, to replicate the actual physiological conditions that reflect the in vivo cardiac haemodynamics with high resolution CT images. The wall shear stress, wall shear stress gradient, velocity flow patterns, pressure gradient, wall pressure, wall pressure gradient, wall pressure stress gradient, were calculated though in idealised but near realistic left coronary geometries during the cardiac pulsatile cycles. This novel research was performed in four stages, with Stage 1 studying the correlation between bifurcation angle and subsequent haemodynamic effects; Stage 2 focused on the position of plaques in the left coronary artery and corresponding haemodynamic variations based on realistic models; Stage 3 investigated the impact of plaques on coronary side branches based on realistic models. Stage 4 analysed individual patients with the bifurcation stenosis based on CT images.Normal coronary artery geometries were generated to investigate the haemodynamic variations of various angulations of the left coronary artery, based on idealised and actual coronary artery models. Eight idealised left coronary artery models were generated, with inclusion of different coronary angulations, namely, 120°, 105°, 90°, 75°, 60°, 45°, 30° and 15°. Four realistic left coronary artery geometries were reconstructed, based on selected patient's data, with angulations ranging from wide angulations of 110° and 120° to narrow angulations of 73° and 58°. There were twelve left coronary artery models in total which consisted of left main stem, left anterior descending and left circumflex branches. Haemodynamic analysis showed that disturbed flow patterns were observed in both idealised and realistic left coronary geometries with wider angles. Wall pressure was found to reduce when the flow changed from the left main stem to the bifurcated locations. A low wall shear stress gradient was revealed at left main bifurcations in models with wide angulations. There is a direct correlation between coronary angulations and subsequent haemodynamic changes, based on realistic and idealised geometries.Diseased coronary geometry was used to study the haemodynamic changes surrounding the bifurcation plaques based on patient’s data. High resolution CT images of the coronary plaques were used to locate and generate the position of actual plaques, which was combined with the reconstructed left coronary disease geometry. Coronary plaques were replicated and located at the left main stem and the left anterior descending to produce at least 60% coronary stenosis. Computational fluid dynamic analysis was used to investigate the haemodynamic effects with and without the presence of coronary plaques. Our results revealed that the highest pressure gradients were observed in stenotic locations caused by the coronary plaques. Low flow velocity regions were found at post-stenotic locations in the left bifurcation, left anterior descending, and left circumflex. Wall shear stress at the plaque locations was similar between the non-Newtonian and Newtonian models, although more details were observed with non-Newtonian model. There is a direct correlation between coronary plaques and subsequent haemodynamic changes, based on the simulation of plaques in the realistic left coronary geometries.Coronary artery disease with their side branches was used to analyse the change of haemodynamic factors surrounding bifurcation plaques to characterise the effect of disturbed flow to their side branches. Coronary plaques were located at the left main bifurcation, which is composed of the left main stem and the left anterior descending to generate >50% narrowing of the coronary lumen. Haemodynamic parameters were compared in the left coronary artery models, with and without the presence of plaques. The analysis demonstrated that wall shear stress decreased while wall pressure stress gradient was increased in coronary side branches due to the presence of plaques. There is a direct relationship between coronary plaques and subsequent haemodynamic changes based on the bifurcation plaques located in the realistic coronary geometries.Patient-specific models with coronary disease were used to analyse the haemodynamic variations surrounding the stenotic locations. Three sample patients with left coronary artery disease were chosen based on CT data. Coronary plaques were shown at the left anterior descending and left circumflex branches with more than 50% lumen narrowing. Wall shear stress and blood flow changes in the left coronary artery disease were calculated during cardiac pulsatile cycles. Our results showed that wall shear stress was found to increase at the stenotic regions and decrease at pre- and post-plaque regions, while the disturbed flow regions was found at post-plaque location. There is a direct effect bifurcation plaque on the changes of blood flow and wall shear stress, based on the realistic coronary disease geometries.In summary, the results of this project show that coronary angulation is directly related to haemodynamic changes, resulting in the formation of atherosclerosis, leading to coronary artery disease. Presence of coronary plaques impacts the haemodynamic changes to both the left main coronary artery, and side branches. Computational fluid dynamic analysis of realistic normal and diseased coronary models improves our understanding of the pathogenesis of coronary artery disease. Further studies are needed to correlate the haemodynamic changes in the presence of plaques with clinical outcomes in patients with suspected coronary artery disease.
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Nijjer, Sukhjinder. "Development and application of a physiological tool to predict the haemodynamic impact of coronary artery stenting." Thesis, Imperial College London, 2015. http://hdl.handle.net/10044/1/33732.
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Coronary angioplasty is a commonly used therapy to remove stenoses in patients with chronic stable angina. Although a successful procedure, there remain both the short-term (stent thrombosis and vessel injury) and long-term risks (late stent thrombosis and significant in-stent restenosis) such that indiscriminate use of stenting can be deleterious. A considerable body of evidence suggests clinical outcomes are improved when stenting is performed using invasive coronary physiology; if stenoses cause ischaemia revascularisation is preferential to deferment, while non-ischaemic stenoses may be treated with medical therapy and observation. Successfully treated vessels are less likely to have major cardiovascular events and patient events are improved. However, there remains no good way of readily and practically predicting whether placing a stent will be successful with normalisation of abnormal coronary physiology. Furthermore, there remains no good parameter to delineate the length of a stenoses and the amount of stenting required to achieve an optimal haemodynamic result. The behaviour of coronary physiology after coronary intervention remains poorly described, particularly in the resting state. Furthermore, human coronary disease is often complex with many coronary stenoses present. This confounds our physiological assessment of a given stenosis and contributes to the poor utilisation of physiological technologies in the patients. In this thesis, I apply phasic assessment throughout the cardiac cycle to describe the behaviour of coronary physiology in humans who undergo assessment and intervention in the catheter laboratory. The behaviour of coronary pressure, flow velocity and resistance will be assessed. I will assess how these parameters change after coronary intervention to develop models of predicting the change in coronary flow and pressure. I will then apply these models to a novel approach that allows assessment of physiological stenosis length, the identification of haemodynamic impact imposed by a single stenosis in diffusely diseased and tandem stenoses. The aim is to produce a new clinical tool that can be readily used in the clinical assessment of challenging coronary disease.
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Hoole, Stephen P. "Investigation of the clinical application, mechanism and haemodynamic effects of remote ischaemic preconditioning in patients with coronary artery disease." Thesis, University of Oxford, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.510434.
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Hadjiloizou, Nearchos. "The effect of regional ventricular dysfunction on coronary artery haemodynamics." Thesis, Imperial College London, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.516134.
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Trevelyan, Jasper. "Renin-angiotensin system blockade and coronary artery bypass surgery : effect of ACE inhibition vs. ATâ‚ receptor blockade on haemodynamics, myocardial protection, cytokines and the endothelium in coronary artery bypass grafting with cardio-pulmonary byp." Thesis, University of Warwick, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269090.
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Hussain, A. "The role of A3 adenosine receptors in protecting the myocardium from ischaemia/reperfusion injury." Thesis, Coventry University, 2009. http://curve.coventry.ac.uk/open/items/678ba5ca-5a6f-dbfc-b915-1d7117f8201c/1.
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Activation of A3 adenosine receptors has been shown to protect the myocardium from ischaemia reperfusion injury in a number of animal models. The PI3K - AKT and MEK1/2 - ERK1/2 cell survival pathways have been shown to play a critical role in regulating myocardial ischaemia reperfusion injury. In this study we investigated whether the A3 adenosine receptor agonist 2-CL-IB-MECA protects the myocardium from ischaemia reperfusion injury, when administered at reperfusion or post reperfusion and whether the protection involved the PI3K – AKT or MEK 1/2 – ERK1/2 cell survival pathways. In the Langendorff model of ischaemia reperfusion injury isolated perfused rat hearts underwent 35 minutes of ischaemia and 120 minutes of reperfusion. Administration of 2-CL-IB-MECA (1nM) at reperfusion significantly decreased infarct size to risk ratio compared to non-treated ischeamic reperfused control hearts. This protection was abolished in the presence of the PI3K inhibitor Wortmannin or MEK1/2 inhibitor UO126. Western blot analysis determined that administration of 2-CL-IB-MECA (1 nM) upregulated ERK1/2 phosphorylation. In the adult rat cardiac myocyte model of hypoxia/reoxygenation cells underwent 6 hours of hypoxia and 18 hours of reoxygenation. Administration of 2-CL-IB-MECA (1 nM) at the onset of reoxygenation significantly decreased cellular apoptosis and necrosis. Administration of 2-CL-IB-MECA (1nM) in the presence of the Wortmannin or UO126 significantly reversed this anti-apoptotic effect and anti-necrotic effect. Our data further showed that 2-CL-IB-MECA protects myocytes subjected to hypoxia/reoxygenation injury via decreasing cleaved-caspase 3 activity that was abolished in presence of the PI3K inhibitor but not in the presence of the MEK1/2 inhibitor UO126. Administration of 2-CL-IB-MECA (100nM) at the onset of reperfusion also significantly decreased infarct size to risk ratio in the ischaemic reperfused rat heart compared to controls that was reversed in the presence of Wortmannin or Rapamycin. This protection was associated with an increase in PI3K-AKT / p70S6K / BAD phosphorylation. 2-CL-IB-MECA (100nM) administered at reoxygenation also significantly protected adult rat cardiac myocytes from hypoxia/reoxygenation injury 28 in an anti-apoptotic and anti-necrotic manner. This anti-apoptotic/necrotic effect of 2-CL-IB-MECA was abolished in the presence Wortmannin. Furthermore, that this protection afforded by 2-CL-IB-MECA (100nM) when administered at reoxygenation was associated with a decrease in cleaved caspase 3 activity that was abolished in the presence of the Wortmannin Interestingly, postponing the administration of 2-CL-IB-MECA to 15 or 30 minutes after the onset of reperfusion significantly protected the isolated perfused rat heart from ischaemia reperfusion injury in a Wortmannin and UO126 sensitive manner. This protection was associated with an increase in AKT and ERK1/2 phosphorylation. Administration of the A3 agonist 2-CL-IB-MECA 15 or 30 minutes after the onset of reoxygenation significantly protected isolated adult rat cardiac myocytes subjected to 6 hours of hypoxia and 18 hours of reoxygenation from injury in an anti-apoptotic/necrotic manner. This anti-apoptotic was abolished upon PI3K inhibition with Wortmannin or MEK1/2 inhibition with UO126. The anti-necrotic effect of 2-CL-IB-MECA when administered 15 or 30 minutes post-reperfusion was not abolished in the presence of the inhibitors. Delaying the administration of 2-CL-IB-MECA to 15 or 30 minutes after reoxygenation was associated with a decrease in cleaved-caspase 3 activity that was abolished in the presence of Wortmannin but not in the presence of the MEK 1/2inhibitor UO126. Collectively, we have demonstrated for the first time that administration of 2-CL-IB-MECA at the onset of reperfusion protects the ischaemic reperfused rat myocardium from lethal ischaemia reperfusion injury in a PI3K and MEK1/2 sensitive manner. Delaying the administration of 2-CL-IB-MECA to 15 or 30 minutes after the onset of reperfusion of reoxygenation also significantly protects the isolated perfused rat heart from ischaemia reperfusion injury and the adult rat cardiac myocyte from hypoxia/reoxygenation injury in an anti apoptotic / necrotic manner. Furthermore, that this protection is associated with recruitment of the PI3K-AKT and MEK1/2 – ERK1/2 cell survival pathways.
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Dean, Sadie. "3-Nitrotyrosine as an indicator of the disease state claudication." Thesis, Coventry University, 2009. http://curve.coventry.ac.uk/open/items/efca9970-2fc8-3fe5-9d2e-cde5cd2f79b0/1.
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3-nitrotyrosine (3NT), a stable end product arising from the interaction of proteins and reactive nitrogen species such as peroxynitrite, is produced during periods of oxidative stress. 3NT is, therefore, of interest as a potential biomarker in a variety of disease states where oxidative stress is known to be involved in the pathology, for example intermittent claudication. The aim of this thesis was to develop sensitive and specific immunoassays to assess the levels of 3NT in plasma samples from claudicants and to investigate the protein nitration profile. Clinical data and plasma samples were collected from claudicant (n=33) and control (n=6) subjects. Analysis of data confirmed the difficulty of using parameters such as ankle brachial index (ABI) in diagnosis, supporting the need for investigations into potential biomarkers. Development of indirect and competitive ELISAs using electrochemically nitrated bovine serum albumin as the standard revealed that the detection of 3NT was dependent on the antibody being able to access the 3NT-residues within the protein. Various denaturing conditions and different types of microtitre plate were utilised during development. Initially the presence of 3NT in claudicant or control whole plasma samples could only be detected using dot blot immunodetection. Affinity purification techniques for the fractionation of the plasma proteins were therefore applied. Subsequently, 3NT-containing plasma proteins were found to be present in all of the claudicant and control samples using the developed competitive ELISA. Proteomic analysis of the 3NT-affinity purified samples, using MALDI-MS and LC-ESI-MS/MS, confirmed the presence of human serum albumin, serotransferrin and apolipoprotein A1 and A2 precursors within those protein bands staining immunopositive for 3NT on SDS-PAGE gels. The identification of apolipoprotein A1 within 3NT-immunopositive bands confirms previous reports suggesting the oxidative modification of HDL may contribute to the link between inflammation and the pathology of atherosclerosis.
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Ooi, Eng Lee. "lschaemia With No Obstructive Coronary Artery Disease (INOCA): Insights Into Assessment and Obstructive Sleep Apnoea Association." Thesis, 2022. https://hdl.handle.net/2440/136020.
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The evolution of myocardial ischaemia started with clinicopathological correlation of typical angina symptoms, traditionally, with flow-limiting atherosclerotic coronary artery disease (CAD). Notwithstanding, ischaemia with no obstructive coronary artery disease (INOCA) is increasingly recognised as a separate phenomenon, that impacts cardiac-related morbidity and financial burden on health services.1-6 Obstructive sleep apnoea (OSA) is recognized to be a risk factor of cardiovascular disease through a number of postulated mechanisms that encompasses hemodynamic, autonomic and inflammatory disturbances.7-12 This thesis evaluates OSA as a risk factor of INOCA and explore the prospect of assessing INOCA non-invasively via advanced echocardiography. Literatures review in chapter 1 provide comprehensive understanding of CAD, including the latest definition of chronic coronary syndrome (CCS), basic mechanisms of coronary ischaemia, the prevalence, prognosis and diagnosis of INOCA, with emerging invasive coronary physiology assessment and potential non-invasive technology. The current evidence illustrating the potential commonality in mechanisms and association of OSA with INOCA, is explored. Chapter 2 focused on more detail, of the association between OSA and structural and functional CAD. OSA is independently associated with CAD. The pathogenesis of atherosclerosis remains complex and poorly understood. CPAP therapy has been linked with reduction in major adverse cardiovascular events in a recent meta-analysis, albeit pivotal randomised controlled trials failed to demonstrate its significance. INOCA, a relatively new entity, remains unexplored in its association with OSA nor the effects of CPAP therapy. In chapter 3, information of the prevalence and clinical predictors of OSA in patients with anginal symptoms who have undergone coronary angiogram in a South Australia registry is provided. This study shows INOCA to be an independent predictor of OSA; especially in those presenting with stable angina; in addition to established risk factors for OSA. In chapter 4, we examined the relationship of obstructive sleep apnoea in patients experiencing angina with no obstructive coronary artery disease, with invasive coronary physiology study as a pilot study. The next two chapters are aimed to determine the ability to evaluate INOCA noninvasively with advanced echocardiography, given the invasiveness of current diagnostic criteria requiring instrumentations of the apparently ‘normal’ coronary arteries. Chapter 5 demonstrates the importance of establishing the extent of myocardial ischaemia in the diagnosis, management and prognostication of coronary artery disease. Stress echocardiography modality is easily available, cost effective and radiation free. Myocardial ischaemia prediction, utilising non-invasive speckle tracking derived global longitudinal strain (GLS), providing a novel prospect.13,14 Chapter 6 provides a pilot study information on correlation between GLS derived contractile reserve (CR) and the invasive coronary microvascular measures, specifically coronary flow reserve (CFR) and hyperaemic microvascular resistance (HMR), in INOCA. This study found that there were more CR at 5mcg/kg/min of dobutamine infusion between normal and abnormal coronary haemodynamic indices which suggest hibernating myocardium contractility recruitment. This was not seen on the higher dose of dobutamine. However, the results were limited by small numbers and echocardiographic technique remain at the mercy of suitable image quality.Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 2022
Books on the topic "Coronary artery haemodynamic"
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Davierwala, Piroze M., and Friedrich W. Mohr. Coronary artery bypass graft surgery. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0048.
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The surgical management of acute coronary syndrome still remains a challenge for the cardiac surgeon. Although most patients can be managed by percutaneous coronary intervention, for patients with complex multivessel or left main coronary artery disease (high SYNTAX score), in whom percutaneous coronary intervention is not possible or is unsuccessful, urgent or emergent coronary artery bypass graft surgery is the only available option. It is very important for surgeons to determine the optimum timing of surgical intervention, which is usually based on the clinical presentation, coronary anatomy, and biomarkers. Surgeons should be conversant with the different operative techniques, whether off- or on-pump coronary artery bypass graft surgery, that would help in achieving the best possible outcomes in such situations. Early and late survival of patients depends not only on an efficiently executed operation, but also on the competency of the post-operative care delivered. Modern perioperative management is reinforced by the availability of a variety of mechanical cardiopulmonary assist devices, like the intra-aortic balloon pump, the extracorporeal membrane oxygenation, and an array of ventricular assist devices, which aid us in managing very sick patients presenting with cardiogenic shock. The results of coronary artery bypass graft surgery for acute coronary syndrome, as published in the literature, vary significantly, because of the heterogeneity of patient populations, operative timing, and haemodynamic status, making a comparison of surgical outcomes almost impossible. Only one randomized trial has been conducted to that effect, to date. A heart team approach, involving an interventional cardiologist and a cardiac surgeon, is mandatory to determine the best treatment strategy and achieve the best possible outcomes in patients with acute coronary syndrome.
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Davierwala, Piroze M., and Friedrich W. Mohr. Coronary artery bypass graft surgery. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0048_update_001.
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The surgical management of acute coronary syndrome still remains a challenge for the cardiac surgeon. Although most patients can be managed by percutaneous coronary intervention, for patients with complex multivessel or left main coronary artery disease (high SYNTAX score), in whom percutaneous coronary intervention is not possible or is unsuccessful, urgent or emergent coronary artery bypass graft surgery is the only available option. It is very important for surgeons to determine the optimum timing of surgical intervention, which is usually based on the clinical presentation, coronary anatomy, and biomarkers. Surgeons should be conversant with the different operative techniques, whether off- or on-pump coronary artery bypass graft surgery, that would help in achieving the best possible outcomes in such situations. Early and late survival of patients depends not only on an efficiently executed operation, but also on the competency of the post-operative care delivered. Modern perioperative management is reinforced by the availability of a variety of mechanical cardiopulmonary assist devices, like the intra-aortic balloon pump, the extracorporeal membrane oxygenation, and an array of ventricular assist devices, which aid us in managing very sick patients presenting with cardiogenic shock. The results of coronary artery bypass graft surgery for acute coronary syndrome, as published in the literature, vary significantly, because of the heterogeneity of patient populations, operative timing, and haemodynamic status, making a comparison of surgical outcomes almost impossible. Only one randomized trial has been conducted to that effect, to date. A heart team approach, involving an interventional cardiologist and a cardiac surgeon, is mandatory to determine the best treatment strategy and achieve the best possible outcomes in patients with acute coronary syndrome.
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Davierwala, Piroze M., and Friedrich W. Mohr. Coronary artery bypass graft surgery. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199687039.003.0048_update_002.
Full textAbstract:
The surgical management of acute coronary syndrome still remains a challenge for the cardiac surgeon. Although most patients can be managed by percutaneous coronary intervention, for patients with complex multivessel or left main coronary artery disease (high SYNTAX score), in whom percutaneous coronary intervention is not possible or is unsuccessful, urgent or emergent coronary artery bypass graft surgery is the only available option. It is very important for surgeons to determine the optimum timing of surgical intervention, which is usually based on the clinical presentation, coronary anatomy, and biomarkers. Surgeons should be conversant with the different operative techniques, whether off- or on-pump coronary artery bypass graft surgery, that would help in achieving the best possible outcomes in such situations. Early and late survival of patients depends not only on an efficiently executed operation, but also on the competency of the post-operative care delivered. Modern perioperative management is reinforced by the availability of a variety of mechanical cardiopulmonary assist devices, like the intra-aortic balloon pump, the extracorporeal membrane oxygenation, and an array of ventricular assist devices, which aid us in managing very sick patients presenting with cardiogenic shock. The results of coronary artery bypass graft surgery for acute coronary syndrome, as published in the literature, vary significantly, because of the heterogeneity of patient populations, operative timing, and haemodynamic status, making a comparison of surgical outcomes almost impossible. Only one randomized trial has been conducted to that effect, to date. A heart team approach, involving an interventional cardiologist and a cardiac surgeon, is mandatory to determine the best treatment strategy and achieve the best possible outcomes in patients with acute coronary syndrome.
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Davierwala, Piroze M., and Friedrich W. Mohr. Coronary artery bypass graft surgery. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0048_update_003.
Full textAbstract:
The surgical management of acute coronary syndrome still remains a challenge for the cardiac surgeon. Although most patients can be managed by percutaneous coronary intervention, for patients with complex multivessel or left main coronary artery disease (high SYNTAX score), in whom percutaneous coronary intervention is not possible or is unsuccessful, urgent or emergent coronary artery bypass graft surgery is the only available option. It is very important for surgeons to determine the optimum timing of surgical intervention, which is usually based on the clinical presentation, coronary anatomy, and biomarkers. Surgeons should be conversant with the different operative techniques, whether off- or on-pump coronary artery bypass graft surgery, that would help in achieving the best possible outcomes in such situations. Early and late survival of patients depends not only on an efficiently executed operation, but also on the competency of the post-operative care delivered. Modern perioperative management is reinforced by the availability of a variety of mechanical cardiopulmonary assist devices, like the intra-aortic balloon pump, the extracorporeal membrane oxygenation, and an array of ventricular assist devices, which aid us in managing very sick patients presenting with cardiogenic shock. The results of coronary artery bypass graft surgery for acute coronary syndrome, as published in the literature, vary significantly, because of the heterogeneity of patient populations, operative timing, and haemodynamic status, making a comparison of surgical outcomes almost impossible. Only one randomized trial has been conducted to that effect, to date. A heart team approach, involving an interventional cardiologist and a cardiac surgeon, is mandatory to determine the best treatment strategy and achieve the best possible outcomes in patients with acute coronary syndrome.
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Buechel, Ronny R., and Aju P. Pazhenkottil. Basic principles and technological state of the art: hybrid imaging. Edited by Philipp Kaufmann. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0121.
Full textAbstract:
The core principle of hybrid imaging is based on the fact that it provides information beyond that achievable with either data set alone. This is attained through the combination and fusion of two datasets by which both modalities synergistically contribute to image information. Hybrid imaging is, thus, more powerful than the sum of its parts, yielding improved sensitivity and specificity. While datasets for integration may be obtained by a variety of imaging modalities, its merits are intuitively best exploited when combining anatomical and functional imaging, particularly in the setting of evaluation of coronary artery disease (CAD) as this combination allows a comprehensive assessment with regard to presence or absence of coronary atherosclerosis, the extent and severity of coronary plaques, and the haemodynamic relevance of stenosis. In clinical practice, the combination of CT coronary angiography (CCTA) with myocardial perfusion studies obtained by single-photon emission computed tomography (SPECT) and by positron emission tomography (PET) has been well established. Recent literature also reports on the feasibility of combining CCTA with cardiac magnetic resonance imaging. Finally, recent advances in CCTA and SPECT imaging have led to a substantial reduction of radiation exposure, now allowing for comprehensive morphological and functional diagnostic work-up by cardiac hybrid SPECT/CCTA imaging at low radiation dose exposures ranging below 5 mSv.
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London, Gerard M. Cardiovascular complications in end-stage renal disease patients. Edited by Jonathan Himmelfarb. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0268.
Full textAbstract:
Cardiovascular complications are the predominant cause of death in patients with end-stage renal disease (ESRD). The high incidence of cardiovascular complications results from pathology present before ESRD (generalized atherosclerosis, diabetes, hypertension) and an additive effect of multiple factors including haemodynamic overload and metabolic and endocrine abnormalities more or less specific to uraemia or its treatment modalities. These disorders are usually associated and can exacerbate each other. While ischaemic heart disease is a frequent cause of cardiac death, heart failure and sudden death are the most frequent causes of death in ESRD. Cardiomyopathy of overload with development of left ventricular hypertrophy and fibrosis are the most characteristic alterations and major determinants of prognosis. Left ventricular hypertrophy may result in systolic and/or diastolic dysfunction and is a risk factor for arrhythmias, sudden death, heart failure, and myocardial ischaemia. Arterial disease, whether due to atherosclerosis or arteriosclerosis (or both), represents a major contributory factor to the cardiovascular complications. Arterial disease may result in ischaemic complications (ischaemic heart disease, peripheral artery diseases) or arterial stiffening with direct consequences on left ventricular afterload, decreased coronary perfusion, and microvascular abnormalities (inward remodelling and microvessel rarefaction).
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Hajhosseiny, Reza, Kaivan Khavandi, and David J. Goldsmith. Sudden cardiac death in chronic kidney disease. Edited by David J. Goldsmith. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0108.
Full textAbstract:
Epidemiological data demonstrate the unique vulnerability of chronic kidney disease (CKD) subjects to cardiovascular disease, the most catastrophic being sudden cardiac death (SCD). In patients with declining kidney function there is a continuum of cardiovascular risk. In those individuals who survive to reach end-stage renal disease (ESRD), the risk of suffering a cardiac event is extremely high. Some of this risk is explained by the common risk factors and traditional cardiovascular events, namely atherosclerotic plaque fissure and rupture, but there is now evidence of a distinct ‘later CKD’ mechanism, notably arrhythmias. This appears particularly true in later stages of CKD and corresponds with the multifaceted range of myocardial and vascular insults operating. The physiological milieu of disordered vessel autoregulation, sequestered vasoprotective agents, loss of conduit and small artery elasticity/compliance, a stiffened and fibrotic myocardium, with calcified and diseased coronary arteries, all within an inflammatory environment, all contribute to arrhythmia generation. The final insult is changes in volume and electrolyte status. Risk stratification tools would be helpful in guiding clinicians to recognize those subjects likely to benefit from specific interventional strategies. These might include the novel, or emerging serum, haemodynamic, or electrocardiographic biomarkers in CKD. Current tools—such as those used for stratifying risk for SCD and determining the need for ICD implantation—are not valid in ESRD patients. Beta blockers appear likely to be generally advisable, blood pressure permitting, for patients with significant cardiomyopathy. Evidence for implantable cardiac defibrillators (ICD) is lacking. There is good reason to think that young dialysis patients at high risk of sudden death may benefit, but the risk/benefit ratio for older patients is less likely to be advantageous. These hypotheses need further investigation.
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Lameire, Norbert. Prevention of acute kidney injury. Edited by Norbert Lameire. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0225_update_001.
Full textAbstract:
This chapter describes the most important non-pharmacologic interventions in the prevention of acute kidney injury. Specific for bypass surgery is the choice between on- versus off-pump surgery in coronary artery bypass grafting. Other interventions include optimization and maintenance of oxygen delivery and of cardiovascular haemodynamics; careful selection of fluid therapy, particularly in septic shock and the postoperative period; possible application of preoperative remote ischaemic preconditioning; maintaining euglycaemia, and application of lung-protective artificial ventilation.
Book chapters on the topic "Coronary artery haemodynamic"
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Oh, Jae K. "Echocardiography and stress echocardiography for coronary artery disease." In State of the Art Surgical Coronary Revascularization, edited by David P. Taggart, John D. Puskas, and Mario Gaudino, 39–41. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198758785.003.0010.
Full textAbstract:
Echocardiography provides functional (systolic and diastolic), structural, and haemodynamic information about the heart at rest and with exercise using two- or three-dimensional Doppler, tissue Doppler, contrast, and strain imaging by transthoracic and transoesophageal approaches. These comprehensive imaging and haemodynamic data are essential in the diagnosis, management, and prognosis of patients with coronary artery disease. Moreover, echocardiography is frequently utilized intraoperatively during coronary artery bypass graft surgery and for clinical trials performed to establish optimal treatment strategies in coronary artery disease patients. These clinically indispensable roles that echocardiography plays in coronary artery disease are discussed in this chapter.
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Malik, Iqbal. "Carotid artery stenting." In Oxford Textbook of Interventional Cardiology, 698–722. Oxford University Press, 2010. http://dx.doi.org/10.1093/med/9780199569083.003.042.
Full textAbstract:
Stroke is the third leading cause of death in the developed world. Internal carotid artery (ICA) stenosis is a major correctable cause of ischaemic stroke, the risk being related to the degree of stenosis and the presence of recent symptoms. Carotid endarterectomy (CEA) has become the preferred method of treatment for patients with asymptomatic or symptomatic high-grade ICA stenosis, supplanting medical therapy alone. In coronary disease, the increasing use of percutaneous coronary intervention (PCI) has reduced the need for coronary artery bypass surgery (CABG). Unlike coronary stenting, where immediate relief of anginal symptoms can justify the procedure, carotid intervention is not usually done for haemodynamic or flow indications, but to reduce future emboli. For significant (greater than 50% angiographic) ICA stenosis, carotid artery stenting (CAS) is a reasonable alternative to CEA, but its true place is as yet undecided, and awaits the conclusion of several ongoing randomized trials.
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Chui, Jason, and John M. Murkin. "Postoperative management after coronary artery bypass graft surgery." In State of the Art Surgical Coronary Revascularization, edited by John M. Murkin and Gregory Fischer, 166–73. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198758785.003.0031.
Full textAbstract:
Postoperative management of patients following coronary artery bypass graft surgery is focused on fast-track recovery but can be challenging, and is often characterized by haemodynamic fluctuations that may require inotropic support, fluid compartment shifts, an increased bleeding tendency, and occasional surgical complications that require urgent re-exploration. This chapter focuses primarily on haemodynamic management and the attendant indications for and choices of pharmacological therapy, as well as considering the indications for continuance or initiation of longer-term medications. Other aspects of acute care such as bleeding and coagulopathy, respiratory support and ventilation and weaning protocols, sedation, and pain control are also important to ensure a smooth transition from acute care to hospital discharge.
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Lorusso, Roberto, Hadi Toeg, Simon Maltais, Scott DeRoo, and Koji Takeda. "Management and impact of preoperative, intraoperative, and postoperative cardiogenic shock/cardiac arrest in coronary artery bypass graft patients." In State of the Art Surgical Coronary Revascularization, edited by Joseph F. Sabik, Stuart J. Head, and Vipin Zamvar, 385–98. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198758785.003.0067.
Full textAbstract:
Cardiogenic shock and cardiac arrest due to acute coronary syndromes are almost exclusively approached, as first-line treatment, with percutaneous coronary intervention. In a few instances, however, coronary artery bypass grafting may be the procedure of choice or necessary in life-threatening scenarios based on the failure of percutaneous coronary intervention due to unfavourable/unsuitable anatomical features or for complications arising from percutaneous coronary intervention. Coronary artery bypass grafting in cardiogenic shock or cardiac arrest is frequently characterized by challenging and disadvantageous clinical and haemodynamic conditions.
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Krasniqi, Xhevdet, and Hajdin Çitaku. "Anomalous Origin of Coronary Arteries." In Vascular Biology - Selection of Mechanisms and Clinical Applications. IntechOpen, 2020. http://dx.doi.org/10.5772/intechopen.76912.
Full textAbstract:
Coronary arteries supply the heart muscle with blood maintaining myocardial hemostasis and function. Coronary artery anomalies may persist after birth affecting cardiovascular system through haemodynamic impairment caused from shunting, ischaemia, especially in young children or adolescents and young adults. In patients undergoing coronary angiography the incidence of anomalous origination of the left coronary artery from right sinus is 0.15% and the right coronary artery from the left sinus is 0.92%. A recent classification of the coronary anomalies is based on anatomical considerations, recognizing three categories: anomalies of the origin and course, anomalies of the intrinsic coronary artery anatomy, and anomalies of the termination. In the setting of anomalous coronary artery from the opposite sinus, the proximal anomalous CA may run anterior to the pulmonary trunk (prepulmonic), posterior to the aorta (retroaortic), septal (subpulmonic), or between the pulmonary artery and the aorta itself (interarterial). Among them, only those with an interarterial aorta-pulmonary course are regarded as hidden conditions at risk of ischaemia and even sudden death. We presented two cases with anomalous origin of coronary arteries from opposite sinus, and two other cases with anomalous origin of left circumflex artery. The atherosclerotic coronary artery disease leads to the need of coronarography which can find out the presence of coronary artery anomalies. Anomalous origin of coronary artery that is present with atherosclerotic changes continues to exist as a challenge during treatment in interventional cardiology.
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Knuuti, Juhani, and Antti Saraste. "Non-invasive functional evaluation." In ESC CardioMed, edited by William Wijns, 1343–48. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0331.
Full textAbstract:
Imaging is useful to confirm the diagnosis of coronary artery disease and to guide therapy in patients with an intermediate pretest likelihood of disease. This chapter gives an overview of the indications, special features, and diagnostic performance of different functional imaging modalities in the detection of myocardial ischaemia. Computed tomography and invasive coronary angiography can visualize coronary stenosis at high resolution and reliably rule out the presence of significant coronary artery disease. However, evaluation of the haemodynamic significance of coronary artery disease is difficult based on anatomy alone. Therefore, demonstration of myocardial ischaemia with the use of stress echocardiography, single-photon emission tomography, positron emission tomography, and cardiovascular magnetic resonance imaging is important to identify patients who can benefit from revascularization.
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Davierwala, Piroze M., and Michael A. Borger. "Coronary artery bypass graft surgery." In The ESC Textbook of Intensive and Acute Cardiovascular Care, edited by Marco Tubaro, Pascal Vranckx, Eric Bonnefoy-Cudraz, Susanna Price, and Christiaan Vrints, 565–84. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198849346.003.0044.
Full textAbstract:
The surgical management of acute coronary syndrome still remains a challenge for the cardiac surgeon. Although most patients can be managed by percutaneous coronary intervention, for patients with complex multivessel or left main coronary artery disease (high SYNTAX score), in whom percutaneous coronary intervention is not possible or is unsuccessful, urgent or emergent coronary artery bypass graft surgery is the only available option. It is very important for surgeons to determine the optimum timing of surgical intervention, which is usually based on the clinical presentation, coronary anatomy, and biomarkers. Surgeons should be conversant with the different operative techniques, whether off- or on-pump coronary artery bypass graft surgery, that would help in achieving the best possible outcomes in such situations. Early and late survival of patients depends not only on an efficiently executed operation, but also on the competency of the post-operative care delivered. Modern perioperative management is reinforced by the availability of a variety of mechanical cardiopulmonary assist devices, like the intra-aortic balloon pump, the extracorporeal membrane oxygenation, and an array of ventricular assist devices, which aid us in managing very sick patients presenting with cardiogenic shock. The results of coronary artery bypass graft surgery for acute coronary syndrome, as published in the literature, vary significantly, because of the heterogeneity of patient populations, operative timing, and haemodynamic status, making a comparison of surgical outcomes almost impossible. Only one randomized trial has been conducted to that effect, to date. A heart team approach, involving an interventional cardiologist and a cardiac surgeon, is mandatory to determine the best treatment strategy and achieve the best possible outcomes in patients with acute coronary syndrome.
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Malik, Iqbal, and Mohamed Hamady. "Carotid artery stenting." In Oxford Textbook of Interventional Cardiology, edited by Simon Redwood, Nick Curzen, and Adrian Banning, 681–702. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198754152.003.0046.
Full textAbstract:
Stroke can be debilitating or fatal, and is the third leading cause of death in the developed world. Correctable risk factors include the standard cardiovascular conditions of diabetes mellitus, hypertension, smoking, and hyperlipidaemia. Atrial fibrillation has to be sought and the need for anticoagulation to reduce embolic risk assessed. Stenosis of the internal carotid artery (ICA) is a major correctable cause of ischaemic stroke, the risk being related to higher degree of narrowing and the presence of recent symptoms. Coronary stenting or coronary artery bypass surgery can be used for immediate relief of anginal symptoms or to improve prognosis with haemodynamically significant stenoses. Carotid intervention is not usually done for haemodynamic or flow indications, but to reduce future emboli. Carotid endarterectomy (CEA) has become the preferred method of invasive treatment for patients with asymptomatic or symptomatic high-grade ICA stenosis. However, for significant (>50% angiographic) ICA stenosis, carotid artery stenting is a reasonable alternative to CEA. Its true place is as yet undecided, and awaits the conclusion of further randomized trials.
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Bax, Jeroen J. "Coronary artery disease: from atherosclerosis to obstructive disease, inducible ischaemia, and the ischaemic cascade." In ESC CardioMed, edited by William Wijns, 1331–39. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0329.
Full textAbstract:
The inclusion or exclusion of coronary artery disease is important for patient management, both from a diagnostic and prognostic view, as well as from a therapeutic view. Various detection techniques are available, including invasive (coronary angiography) or non-invasive imaging techniques. The techniques can also be divided into anatomical imaging or functional imaging, where anatomical imaging detects coronary atherosclerosis and stenosis (invasive coronary angiography, but also non-invasive coronary angiography—performed with multidetector computed tomography), while functional imaging (nuclear imaging, stress echocardiography, and cardiovascular magnetic resonance) detects ischaemia: the haemodynamic consequences of the atherosclerosis/stenosis. The early phase of atherosclerotic coronary artery disease is often asymptomatic (and anatomical imaging can be used to detect/exclude coronary atherosclerosis), whereas with progression of atherosclerotic disease, symptoms occur related to myocardial ischaemia. Non-invasive imaging can facilitate in the detection of both early (asymptomatic) and more advanced (symptomatic, ischaemic) coronary artery disease. The pathophysiological cascade of cardiac abnormalities that occur once ischaemia is induced is referred to as the ischaemic cascade. The ischaemic cascade consists of chronological development of perfusion abnormalities, followed by diastolic dysfunction, then systolic dysfunction, and finally electrocardiographic abnormalities. In this chapter, the variety of the different non-invasive imaging techniques to assess the different phases of the non-ischaemic part and the ischaemic part (ischaemic cascade) of coronary artery disease are described.
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Montorsi, Piero. "Sex and the heart." In ESC CardioMed, edited by Charalambos Vlachopoulos, 1007–10. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0242.
Full textAbstract:
Since the identification of a link between erectile dysfunction and coronary artery disease and of the role of male sexual dysfunction as a marker of subclinical vascular disease, including coronary artery disease, sexual activity became a concern for both patients and physicians, regardless of the presence or not of a known cardiovascular disease. It is therefore fundamental for cardiologists (the most likely medical specialty involved with this disease) to understand the haemodynamic changes that occur during sexual intercourse in order to better counsel and treat their patients. Moreover, the advent of a powerful class of oral agents for the treatment of erectile dysfunction has made the importance of knowledge in this area even more apparent.
Conference papers on the topic "Coronary artery haemodynamic"
1
Boutsianis, Evangelos, Thomas Frauenfelder, Hitendu Dave, Jurg Grunenfelder, Simon Wildermuth, Gregor Zund, Marko Turina, Dimos Poulikakos, and Yiannis Ventikos. "Cardiovascular Haemodynamic Simulations of Anatomically Accurate Coronaries." In ASME 2003 International Mechanical Engineering Congress and Exposition. ASMEDC, 2003. http://dx.doi.org/10.1115/imece2003-42728.
Full textAbstract:
The present study is devoted to the investigation of the pulsatile blood flow within the first few vessels of the Left Coronary Artery (LCA) vasculature of an anatomically accurate porcine coronary tree. Transient computational fluid dynamics simulations were performed under realistic pulsatile volume inflow boundary conditions. The numerical results have provided a comprehensive collection of information regarding the haemodynamics within the LCA and its major branches, namely the Left Anterior Descending (LAD) and the Left Circumflex (LCX) arteries. The underlying principle of developing computational techniques, which would eventually allow for the realistic simulation of the vascular haemodynamics of patients, lies on the capacity of such tools for predictive diagnostics and non-invasive, hence simulation-based, surgical planning.
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Chaichana, Thanapong, Zhonghua Sun, and James Jewkes. "Haemodynamic Effect of Coronary Angulations on Subsequent Development of Coronary Artery Disease: A Preliminary Study." In 2010 Sixth IEEE International Conference on E-Science Workshops. IEEE, 2010. http://dx.doi.org/10.1109/esciencew.2010.16.
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Soulis, J. V. "Computational haemodynamics of left coronary artery." In BIOMEDICINE 2003, edited by T. M. Farmakis, G. D. Giannoglou, O. Faltsi, D. Sofialidis, J. Josipovic, and G. E. Louridas. Southampton, UK: WIT Press, 2003. http://dx.doi.org/10.2495/bio030181.
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Patterson, Tiffany, Simone Rivolo, Daniel Burkhoff, Jan Schreuder, Natalia Briceno, Satpal Arri, Kal Asrress, et al. "14 Differential effects of exercise and nitrates on invasive haemodynamics in patients with coronary artery disease." In British Cardiovascular Intervention Society, Young Investigator Award Shortlisted Presentations, Royal College of Physicians of London, November 30 2017. BMJ Publishing Group Ltd and British Cardiovascular Society, 2018. http://dx.doi.org/10.1136/heartjnl-2018-bcis.14.
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Le Gouez, J. M. "Numerical Simulation of Non Newtonian Hemodynamics in Compliant Vessels." In ASME 2006 Pressure Vessels and Piping/ICPVT-11 Conference. ASMEDC, 2006. http://dx.doi.org/10.1115/pvp2006-icpvt-11-93801.
Full textAbstract:
The numerical simulation of hemodynamics is increasingly recognized as a valuable analysis tool for the bioengineering laboratories who design implantable vascular grafts, and it is thought to become in a not so far future a complement to the physician’s analysis for the choice of interventional methods to restore a proper irrigation in diseased arteries [1]. The detailed numerical results obtained from 3d unsteady simulations permit to verify the hypotheses formulated by physiologists concerning the evolution of arterial disease and to quantify the risks associated to medical intervention. These objectives require an accurate representation of the major physiological parameters, much more complex than that encountered in standard CFD analysis of pipe flows, which makes the computation of blood flows in compliant vessels extremely challenging to the CFD and CSM communities. A comprehensive methodology for the adaptation of existing numerical schemes to this advanced modelling issues was conducted, for the behaviour laws of the fluid and walls on the one hand, and for the unsteady boundary conditions on the other hand. The complex nature of the mathematical model formed by the coupled fluid and structural mechanics equations, completed by highly unsteady boundary conditions, led to a choice of fully time-implicit algorithms with problem matching subiterations. These algorithms are successfully applied to different 3D, unsteady haemodynamics problems in a coronary artery. The complex, patients’ dependent geometry of a stenosed artery was reconstructed in CAD format from medical imaging. The accuracy of the numerical procedure is discussed, and this methodology can open the way for the validation of physiological criteria for the design of medical apparatus and the choice of interventional methods adapted to each individual patient’s situation.
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García Mozos, Luis, Devonjit Saroya, Yannick Roelvink, Naël dos Santos D'Amore, Stefano Gabetti, Jorge Galván Lobo, Catarina Lobo, et al. "Artery in Microgravity (AIM): Assembly, integration, and testing for a student payload for the ISS." In Symposium on Space Educational Activities (SSAE). Universitat Politècnica de Catalunya, 2022. http://dx.doi.org/10.5821/conference-9788419184405.097.
Full textAbstract:
The Artery in Microgravity (AIM) project was the first experiment to be selected for the “Orbit Your Thesis!” programme of the European Space Agency Academy. It is a 2U cube experiment that will be operated in the International Commercial Experiment (ICE) Cubes facility onboard the International Space Station. The experiment is expected to be launched on SpaceX-25 in mid-2022. The project is being developed by an international group of students from ISAE-SUPAERO and Politecnico di Torino. The objective of the experiment is to study haemodynamics in the space environment applied to coronary heart disease. The outcomes of this testbench will contribute to understanding the effects of radiation and microgravity on the circulatory system of an astronaut, specifically the behaviour in long-term human spaceflight. It will also help to ascertain the feasibility of individuals suffering from this kind of disease going to space someday. The cornerstones of the experiment are two models of 3D-printed artificial arteries, in stenotic and stented conditions respectively. Blood-mimicking fluid composed of water and glycerol is circulated
through the arteries in a closed hydraulic loop, and a red dye is injected for flow visualisation. Drops of pressure and image analysis of the flow will be studied with the corresponding sensors and camera. The pH of the fluid will also be monitored to assess the effect of augmented radiation levels on the release of particles from the metallic stent. Some delays were experienced in the project due to the COVID-19 pandemic and to implement design improvements. Improvements were made to several aspects of the design including mechanics (e.g. remanufacturing the reservoir with surface treatment against corrosion, leak prevention measures), software (e.g. upgrading to Odroid-C4 and migrating the code to
Python), and electronics (e.g. several iterations of the interface PCB design). This iterative process of identifying areas of concern and designing and implementing solutions has resulted in many lessons learned. The paper will outline in detail Phase D – Qualification and Production of the AIM experiment cube, with special insight on the implementation of the improvements. Previously, at the Symposium on Space Educational Activities in 2019 in Leicester, the initial phases of the design and development of the cube were presented. This year, the final flight model and the results of validation testing before launching on SpaceX-25 are presented. Lessons learned throughout the course of the project are also highlighted for students embarking on their own space-related educational activities.