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Journal articles on the topic 'Coronary artery haemodynamic'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

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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2

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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3

&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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4

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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6

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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7

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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8

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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9

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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10

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.

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11

Gulbaran, M., T. Cagatay, T. Gurmen, and P. Cagatay. "Right heart haemodynamic values and respiratory function test parameters in chronic smokers." Eastern Mediterranean Health Journal 10, no. 1-2 (March 17, 2004): 90–95. http://dx.doi.org/10.26719/2004.10.1-2.90.

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During coronary angiography in 24 chronic smokers with coronary heart disease, cardiac function measurements were taken and correlated with respiratory function tests. Fourteen patients had evidence of chronic obstructive pulmonary disease. Cardiac output had a direct correlation with vital capacity, forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], and velocity at 25% of FVC [V [max] 25]. Pulmonary artery resistance was inversely correlated with FEV1/FVC, while pulmonary artery oxygen saturation weakly correlated with FEV1 and V [max] 25. The pulmonary artery pressure had a weak correlation with the pulmonary artery resistance and an intermediate correlation with the right atrium and the right ventricular pressures. Early diagnosis and therapy of chronic obstructive pulmonary disease in smokers may be possible without using invasive methods

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12

Zohourian, Hajir, Rohit K. Bhandari, and Violeta Atanasoski McCormack. "Late perioperative native coronary artery spasm following bypass grafting in a patient with anomalous aortic origin of the coronary artery." BMJ Case Reports 12, no. 7 (July 9, 2019): e229748. http://dx.doi.org/10.1136/bcr-2019-229748.

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Native right coronary artery (RCA) spasm is a less frequent early complication of perioperative coronary artery bypass grafting. Late presentation at 6 days postoperation is scarce and its relationship with an anomalous coronary artery is unknown. The optimal management and prevention remains controversial. In the case presented, the patient’s anomalous left coronary artery originating from the right coronary cusp underwent ligation at its proximal segment at the time of bypass grafting. This ligation was preformed to prevent competitive flow. Six days postoperation, a refractory spasm of dominant native RCA occurred. The spasm resulted in right ventricular failure. Administration of intracoronary verapamil had a longer sustained vasodilatory effect and resolution of coronary spasm when compared with intracoronary nitroglycerine injection. An intra-aortic balloon pump, inotropic agents and low-dose nitroglycerine were used to maintain adequate haemodynamic support. Right ventricular systolic function recovery was noted within 2 days postintervention.

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13

Simakov, Sergey S., Timur M. Gamilov, Fuyou Liang, Daria G. Gognieva, Mariam K. Gappoeva, and Philipp Yu Kopylov. "Numerical evaluation of the effectiveness of coronary revascularization." Russian Journal of Numerical Analysis and Mathematical Modelling 36, no. 5 (November 1, 2021): 303–12. http://dx.doi.org/10.1515/rnam-2021-0025.

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Abstract In the present paper we construct the model of coronary flow which utilizes the patient’s CT data on both large CA and perfusion. We reconstruct large coronary vessels based on the CT data and extrude possibly invisible vessels from the branches of the left coronary artery so that every terminal point supply every of standardized zone of myocardium. We apply a previously developed and validated 1D model of haemodynamics. Utilizing the patient-specific CTP data for modifying outflow terminal resistance at rest and under stress conditions is the major novelty of the present work. From our results it follows that acceptable values of fractional flow reserve (FFR) after the stenotic treatment may produce false negative output. Therefore healthy FFR values may be observed after ineffective revascularization. We also conclude that microvascular perfusion impairment plays significant role in correct computational estimation of haemodynamic indices before stenotic treatment. The advantage of the presented approach is the availability of transmural perfusion ratio assessment in everyday practice.

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14

Matoq, Amr A., and Takeshi Tsuda. "Effective myocardial perfusion and concomitant haemodynamic status determine the clinical diversity of anomalous left coronary artery from the pulmonary artery." Cardiology in the Young 30, no. 3 (January 22, 2020): 362–68. http://dx.doi.org/10.1017/s1047951119003299.

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AbstractBackground:Anomalous left coronary artery from the pulmonary artery is a rare congenital heart disease (CHD) with diverse clinical presentations despite the same anatomy. Factors determining this heterogeneous presentation are not well understood.Method and Results:We retrospectively investigated 14 patients (12 females) who underwent surgical repair of anomalous left coronary artery from the pulmonary artery. These patients were divided into three groups based upon the severity of initial presentation: (1) severe, life-threatening condition (n = 5), (2) mild-to-moderate distress (n = 6), and (3) asymptomatic (n = 3). All patients presented with left ventricular dilation and retrograde flow in left coronary artery by echocardiogram. Eight patients in (1) and (2) presented with severe left ventricular dysfunction. All but one showed abnormal ECG consistent with myocardial ischemia or infarction. Asymptomatic patients had preserved left ventricular systolic function despite ischemic findings on ECG. In 13 patients after surgical repair, all but one normalised left ventricular geometry and systolic function, suggesting nearly full myocardial recovery upon improvement of myocardial perfusion; 8 patients had residual echogenic papillary muscle with variable degree of mitral regurgitation.ConclusionsEvidence of myocardial ischemic injury was present in all patients with anomalous left coronary artery from the pulmonary artery regardless of their initial presentation. Retrograde flow in left coronary artery, implying collateral vessel development from right coronary artery to left coronary artery, was noted in all patients, yet only few patients had preserved systolic function at the time of diagnosis. The balance between effective myocardial perfusion and a deleterious fistulous flow provided by these collaterals and the simultaneous haemodynamic status are what determine the clinical diversity of anomalous left coronary artery from the pulmonary artery.

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15

Saad Shaukat, Muhammad Hamza, Alexey Tatusov, Anthony Nappi, and Neil Yager. "Transient sinus arrest due to sinus node artery thrombus after revascularisation of the left circumflex artery." BMJ Case Reports 12, no. 2 (February 2019): e227878. http://dx.doi.org/10.1136/bcr-2018-227878.

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We present a case of sinus arrest and junctional escape rhythm from sinus node artery (SNA) thrombus in a 55-year-old man after revascularisation of right coronary and proximal circumflex arteries for infero-posterior wall ST-segement elevation myocardial infarction (STEMI). Sinus arrest from occlusion of the SNA is uncommon. The ensuing bradycardia may have haemodynamic consequences requiring temporary pacing but is almost always self-limited.

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16

Ding, Hao, Kun Shang, Zhenglong Chen, Lixing Shen, Meng Xu, Yu Zhou, Lingxi Zhao, Shixiong Xu, and Yanjun Zeng. "A haemodynamic model for heart–mural coronary artery–myocardial bridge." Journal of Medical Engineering & Technology 34, no. 1 (October 13, 2009): 29–34. http://dx.doi.org/10.3109/03091900903271638.

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17

Raumanns, J., A. Diegeler, J. Gummert, J. Ender, and A. Petry. "Haemodynamic changes in OPCAB procedures regarding different coronary artery anastomoses." European Journal of Anaesthesiology 18, Supplement 22 (July 2001): 25–26. http://dx.doi.org/10.1097/00003643-200107001-00055.

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18

Brune, Stephan, Ulrich Tebbe, Thomas Schmidt, Heinrich Kreuzer, H. P. Benn, and K. U. Seiler. "Haemodynamic Effects of Nebivolol in Patients with Coronary Artery Disease." Drug Investigation 3, S1 (January 1991): 64–68. http://dx.doi.org/10.1007/bf03258266.

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19

Silke, B., SP Verma, AV Zezulka, S. Sharma, G. Reynolds, NC Jackson, S. Guy, and SH Taylor. "Haemodynamic and radionuclide effects of amlodipine in coronary artery disease." British Journal of Clinical Pharmacology 29, no. 4 (April 1990): 437–45. http://dx.doi.org/10.1111/j.1365-2125.1990.tb03662.x.

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20

Stegehuis, Valérie E., Gilbert WM Wijntjens, Tadashi Murai, Jan J. Piek, and Tim P. van de Hoef. "Assessing the Haemodynamic Impact of Coronary Artery Stenoses: Intracoronary Flow Versus Pressure Measurements." European Cardiology Review 13, no. 1 (2018): 46. http://dx.doi.org/10.15420/ecr.2018:7:2.

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Fractional flow reserve (FFR)-guided percutaneous coronary intervention results in better long-term clinical outcomes compared with coronary angiography alone in intermediate stenoses in stable coronary artery disease (CAD). Coronary physiology measurements have emerged for clinical decision making in interventional cardiology, but the focus lies mainly on epicardial vessels rather than the impact of these stenoses on the myocardial microcirculation. The latter can be quantified by measuring the coronary flow reserve (CFR), a combined pressure and flow index with a strong ability to predict clinical outcomes in CAD. However, combined pressure-flow measurements show 30–40 % discordance despite similar diagnostic accuracy between FFR and CFR, which is explained by the effect of microvascular resistance on both indices. Both epicardial and microcirculatory involvement has been acknowledged in ischaemic heart disease, but clinical implementation remains difficult as it requires individual proficiency. The recent introduced pressure-only index instantaneous wave-free ratio, a resting adenosine-free stenosis assessment, led to a revival of interest in coronary physiology measurements. This review focuses on elaborating the coronary physiological parameters and potential of combined pressure-flow measurements in daily clinical practice.

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21

Lee, Ji Hyun, Asim Rizvi, Fay Y. Lin, James K. Min, Bríain ó. Hartaigh, and Donghee Han. "Fractional Flow Reserve Measurement by Computed Tomography: An Alternative to the Stress Test." Interventional Cardiology Review 11, no. 2 (2016): 105. http://dx.doi.org/10.15420/icr.2016:1:2.

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Recent advances in computed tomographic technology have contributed towards improving coronary computed tomography angiography (CCTA) in determining the severity of coronary artery disease anatomically. Although the viability of CCTA has most often been confined to anatomical assessment, recent development has enabled evaluation of the haemodynamic significance of coronary artery disease. In light of this, CCTA-derived fractional flow reserve (FFRCT), a novel imaging modality, now permits the physiological assessment of coronary artery disease. To date, several studies have documented the diagnostic performance of FFRCT, and more trials are being performed that will further substantiate this technique. The present paper provides an overview and discussion of the available evidence for FFRCT in the clinical setting as well as potential future directions of FFRCT.

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22

Osawa, Takumi, Yuta Ito, and Tomomi Koizumi. "Rare case of congenital coronary artery fistula coexistent and coalesced with aortopulmonary fistula." BMJ Case Reports 14, no. 7 (July 2021): e244035. http://dx.doi.org/10.1136/bcr-2021-244035.

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Coronary artery fistula (CAF) is an uncommon congenital heart disease. Furthermore, aortopulmonary fistula is a rare congenital heart disease of adult onset. We report the case of a 79-year-old man who presented with chest pain. ECG-gated cardiac CT and coronary artery angiography revealed an anomalous vessel arising from the right coronary cusp and a CAF from the left coronary descending artery. These fistulas coalesced and drained into the same portion of the pulmonary artery. Haemodynamic studies revealed that the estimated systemic-to-pulmonary flow ratio was 1.18. The mean pulmonary pressure was 14 mm Hg. We decided against surgical intervention due to his advanced age and lack of heart failure symptoms. The patient did not have any worsening heart failure and chest pain on follow-up. This was a rare case of CAF coexistent and coalesced with an aortopulmonary fistula.

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23

LANGENBERG, Chris J., Henk G. PIETERSEN, Gijs GESKES, Anton J. M. WAGENMAKERS, Simon DE LANGE, Hubert J. SCHOUTEN, and Peter B. SOETERS. "The effect of glutamate infusion on cardiac performance is independent of changes in metabolism in patients undergoing routine coronary artery bypass surgery." Clinical Science 101, no. 6 (October 26, 2001): 573–80. http://dx.doi.org/10.1042/cs1010573.

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In a double-blind randomized placebo-controlled study, the effects of intravenous glutamate infusion on myocardial haemodynamics and metabolism were studied in 22 patients undergoing routine coronary artery bypass graft (CABG) surgery. Immediately after aortic cross-clamp release, an intravenous infusion of a solution of glutamate (125mmolċl-1) at a rate of 1.5mlċh-1ċkg-1 was given over 1h to 11 patients (G group). The other 11 patients received a placebo infusion (0.9% NaCl) (P group). Haemodynamic functions and rates of exchange of glucose, non-esterified fatty acids and lactic acid over the heart were measured before sternotomy (T1), 40min after cross-clamp release (T2) and 4h after cross-clamp release (T3). At T2, decreases were seen in comparison with T1 in systemic vascular resistance index, and increases were seen in cardiac index and coronary sinus flow. All of these changes were greater in the G group than in the P group (P < 0.05). Myocardial glutamate consumption increased 2-fold after glutamate administration. No significant changes were observed in the myocardial utilization of glucose, lactate or non-esterified fatty acids between the P and the G groups at T1, T2 or T3. These data show that an intravenous glutamate infusion after routine CABG surgery significantly improved cardiac haemodynamic performance without direct effects on cardiac substrate metabolism. This suggests that a reduction of the afterload via a peripheral vasodilatory effect is the main mechanism leading to the observed changes in haemodynamics. Earlier claims that patients with post-operative cardiac failure show metabolic benefits from the glutamate infusion do not seem to apply to patients undergoing routine CABG surgery.

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Rahman, Md Hamidur, Bhabesh Chandra Mondal, Niaz Ahmed, Md Sirajul Islam, and ZA Faruquee. "Haemodynamic Response After induction of Anaesthesia in Patients undergoing Coronary Artery Bypass Grafting Surgery of Poor Left ventricular Function. A comparison between Thiopental / fentanyl and Etomidate / fentanyl." BIRDEM Medical Journal 3, no. 1 (November 24, 2013): 23–26. http://dx.doi.org/10.3329/birdem.v3i1.17123.

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Objective: To compare the haemodynamic effect of thiopental/fentanyl with etomidate/fentanyl during anaesthetic induction in patients with coronary artery disease with poor left ventricular function (ejection fraction < 45%). Design: A retrospective randomized trial. Setting: Ibrahim Cardiac Hospital and Research Institute. Participants: Twenty patients with coronary artery disease of poor left ventricular function (ejection fraction<45%) scheduled for elective coronary artery bypass surgery. Interventions: Patients were allocated randomly to receive either thiopental/fentanyl or etomidate/fentanyl for induction. Measurement & Main Results: Haemodynamic response (heart rate, mean arterial pressure) were recorded at 1 minute interval starting from induction till five minutes after intubations. The reduction of mean arterial pressure was greater in patients who received thiopental/fentanyl induction (maximal decrease 32%) in comparison to etomidate/fentanyl induction (maximal decrease12%) [P<0.05 which is statistically significant]. The changes of heart rate were insignificant between the groups (reduction of heart rate 8% versus 7%). Conclusion: Etomidate/ fentanyl induction reduces less blood pressure in comparison to thiopental/fentanyl induction in patients of poor left ventricular function but changes of heart rate were insignificant in between the groups. Birdem Med J 2013; 3(1): 23-26 DOI: http://dx.doi.org/10.3329/birdem.v3i1.17123

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Thompson, W. Reid. "Stress echocardiography in paediatrics: implications for the evaluation of anomalous aortic origin of the coronary arteries." Cardiology in the Young 25, no. 8 (December 2015): 1524–30. http://dx.doi.org/10.1017/s1047951115002012.

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AbstractStress echocardiography in paediatrics is used to evaluate pre- and post-operative coronary artery conditions, as well as to gain haemodynamic information for a variety of diagnoses, although evidence regarding sensitivity, specificity, and predictive value is lacking. This review will consider the available literature with a focus on anomalous aortic origin of the coronary arteries and discuss a practical approach to test selection and use.

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Ramasamy, Anantharaman, Hannah Safi, James C. Moon , Mervyn Andiapen, Krishnaraj S. Rathod, Pal Maurovich-Horvat, Retesh Bajaj, et al. "Evaluation of the Efficacy of Computed Tomographic Coronary Angiography in Assessing Coronary Artery Morphology and Physiology: Rationale and Study Design." Cardiology 145, no. 5 (2020): 285–93. http://dx.doi.org/10.1159/000506537.

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Computed tomographic coronary angiography (CTCA) is a non-invasive imaging modality, which allows plaque burden and composition assessment and detection of plaque characteristics associated with increased vulnerability. In addition, CTCA-based coronary artery reconstruction enables local haemodynamic forces assessment, which regulate plaque formation and vascular inflammation and prediction of lesions that are prone to progress and cause events. However, the use of CTCA for vulnerable plaque detection in the clinical arena remains limited. To unlock the full potential of CTCA and enable its broad use, further work is needed to develop user-friendly processing tools that will allow fast and accurate analysis of CTCA, computational fluid dynamic modelling, and evaluation of the local haemodynamic forces. The present study aims to develop a seamless platform that will overcome the limitations of CTCA and enable fast and accurate evaluation of plaque morphology and physiology. We will analyse imaging data from 70 patients with coronary artery disease who will undergo state-of-the-art CTCA and near-infrared spectroscopy-intravascular ultrasound imaging and develop and train algorithms that will take advantage of the intravascular imaging data to optimise vessel segmentation and plaque characterisation. Furthermore, we will design an advanced module that will enable reconstruction of coronary artery anatomy from CTCA, blood flow simulation, shear stress estimation, and comprehensive visualisation of vessel pathophysiology. These advances are expected to facilitate the broad use of CTCA, not only for risk stratification but also for the evaluation of the effect of emerging therapies on plaque evolution.

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Haraldsen, Pernille, Doris Cunha-Goncalves, Carsten Metzsch, Lars Algotsson, Sandra Lindstedt, and Richard Ingemansson. "Sevoflurane provides better haemodynamic stability than propofol during right ventricular ischaemia–reperfusion." Interactive CardioVascular and Thoracic Surgery 30, no. 1 (October 3, 2019): 129–35. http://dx.doi.org/10.1093/icvts/ivz235.

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Abstract OBJECTIVES To assess whether sevoflurane provides better haemodynamic stability than propofol in acute right ventricular (RV) ischaemia–reperfusion. METHODS Open-chest pigs (mean ± standard deviation, 68.8 ± 4.2 kg) anaesthetized with sevoflurane (n = 6) or propofol (n = 6) underwent 60 min of RV free wall ischaemia and 150 min of reperfusion. Haemodynamic parameters and blood flow in the 3 major coronary arteries were continuously monitored. Biomarkers of cardiac ischaemia were analysed. RESULTS Mean arterial pressure and stroke volume decreased, whereas pulmonary vascular resistance increased equally in both groups. Heart rate increased 7.5% with propofol (P < 0.05) and 17% with sevoflurane (P < 0.05). At reperfusion, left atrial pressure and systemic vascular resistance decreased with sevoflurane. While RV stroke work (mmHg·ml) and cardiac output (l·min−1) decreased in the propofol group (4.2 ± 1.2 to 2.9 ± 1.7 and 2.65 ± 0.44 to 2.28 ± 0.56, respectively, P < 0.05 both), they recovered to baseline levels in the sevoflurane group (4.1 ± 1.5 to 4.0 ± 1.5 and 2.77 ± 0.6 to 2.6 ± 0.5, respectively, P > 0.05). Circumflex and left anterior descending coronary artery blood flow decreased in both groups. Right coronary artery blood flow (ml·min−1) decreased with propofol (38 ± 9 to 28 ± 9, P < 0.05), but not with sevoflurane (28 ± 11 to 28 ± 17, P > 0.05). Biomarkers of cardiac ischaemia increased in both groups. CONCLUSIONS Compared to propofol, sevoflurane-anaesthetized pigs showed higher RV stroke work, cardiac output and right coronary artery blood flow during reperfusion. These findings warrant a clinical trial of sevoflurane in RV ischaemia in humans.

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Sheridan, D. J., and W. Culling. "Acute Haemodynamic Effects of Felodipine in Patients with Coronary Artery Disease." Drugs 29, Supplement 2 (1985): 87. http://dx.doi.org/10.2165/00003495-198500292-00016.

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Hess, W., and C. Meyer. "Haemodynamic effects of nifedipine in patients undergoing coronary artery bypass surgery." Acta Anaesthesiologica Scandinavica 30, no. 8 (November 1986): 614–19. http://dx.doi.org/10.1111/j.1399-6576.1986.tb02486.x.

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30

Demeyere, R., W. Flameng, and T. B. TjandraMaga. "Haemodynamic effects of intravenous dilevalol in patients with coronary artery disease." Journal of Cardiothoracic Anesthesia 4, no. 6 (December 1990): 96. http://dx.doi.org/10.1016/0888-6296(90)90167-e.

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31

Hammarén, E., and M. Hynynen. "Haemodynamic effects of propofol infusion for sedation after coronary artery surgery." British Journal of Anaesthesia 75, no. 1 (July 1995): 47–50. http://dx.doi.org/10.1093/bja/75.1.47.

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32

Silke, B., MA Frais, P. Muller, SP Verma, G. Reynolds, and SH Taylor. "Haemodynamic dose-response effects of intravenous nisoldipine in coronary artery disease." British Journal of Clinical Pharmacology 20, no. 6 (December 1985): 675–80. http://dx.doi.org/10.1111/j.1365-2125.1985.tb05127.x.

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33

Côté, Dany, R. Martin, and J. P. Tétrault. "Haemodynamic interactions of muscle relaxants and sufentanil in coronary artery surgery." Canadian Journal of Anaesthesia 38, no. 3 (April 1991): 324–29. http://dx.doi.org/10.1007/bf03007622.

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34

Silke, B., D. J. M. Graham, S. P. Verma, G. Reynolds, M. A. Frais, J. R. Finlayson, and S. H. Taylor. "Pharmacokinetic, haemodynamic and radionuclide studies with nicardipine in coronary artery disease." European Journal of Clinical Pharmacology 29, no. 6 (1986): 651–57. http://dx.doi.org/10.1007/bf00615954.

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35

CHARLES, Christopher J., John M. ELLIOTT, M. Gary NICHOLLS, Miriam T. RADEMAKER, and Mark RICHARDS. "Myocardial infarction with and without reperfusion in sheep: early cardiac and neurohumoral changes." Clinical Science 98, no. 6 (May 10, 2000): 703–11. http://dx.doi.org/10.1042/cs0980703.

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There are few stable and reproducible large-animal models of chronic heart failure produced by ischaemic damage to the myocardium. Here we characterize a novel method of inducing myocardial damage in closed-chest sheep by catheter delivery of thrombogenic coils, and compare this with a newly described open-artery model of cardiac injury in sheep. Sham controls were compared with animals subjected to (a) 90 min of coronary artery occlusion/reperfusion by PTCA (percutaneous transluminal coronary angioplasty) balloon, and (b) permanent coronary artery occlusion induced by catheter delivery of thrombogenic coils (seven sheep/group). Both balloon occlusion/reperfusion and permanent coil occlusion resulted in well-defined anteroapical infarcts, as documented by ECG changes, significant rises in creatine kinase (both groups P < 0.001) and troponin-T (both groups P < 0.05), and post-mortem examination. Washout of enzymes was much more rapid in the reperfused group (P < 0.01). Infarction resulted in significant reductions in left ventricular (LV) ejection fraction (both groups P < 0.01) and regional wall abnormalities. Ejection fraction 7 days post-coil (21.3±4.2%) was significantly lower (P < 0.01) than that 7 days post-balloon (38.8±4.5%). Coil-induced infarction was associated with acutely reduced arterial pressure (P < 0.05), and increases in heart rate (P < 0.05), atrial pressures (P < 0.05), plasma brain natriuretic peptide levels (P < 0.05) and adrenaline levels (P < 0.05). Rises seen in plasma endothelin levels in sham controls were blunted in the coil group (P < 0.001). Haemodynamic changes were less marked in the balloon group. In conclusion, restriction of coronary artery occlusion to 90 min results in infarction, but less LV dysfunction with reduced early remodelling, compared with permanent occlusion. Acute changes in biochemical markers, haemodynamics, neurohormones and LV function confirm that these are excellent models of open- and closed-artery myocardial infarction leading to asymptomatic LV dysfunction.

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36

Chacon-Portillo, Martin A., Bishnu Dhakal, and Rajesh Janardhanan. "Bioprosthetic aortic valve haemodynamic deterioration secondary to a thrombus." BMJ Case Reports 13, no. 9 (September 2020): e233400. http://dx.doi.org/10.1136/bcr-2019-233400.

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A 77-year-old man with a history of coronary artery bypass grafting and surgical aortic valve replacement for severe aortic stenosis 2 years prior presented with exertional chest pain and shortness of breath. The patient underwent a thorough initial evaluation including a transthoracic echocardiogram and coronary angiogram without significant findings. One month later the patient presented with worsened symptoms and a repeat echocardiogram showed an increased mean aortic valve gradient of 87 mm Hg. The patient had to undergo reoperation for a surgical aortic valve replacement and was found to have an aortic bioprosthetic valve thrombus. This case suggests a mismatch between the aortic prosthesis and the patient’s aortic root size.

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37

Jaworski, Radoslaw, Andrzej Kansy, Mariusz Birbach, Anna Brodzikowska-Pytel, Monika Kowalczyk-Domagala, Grazyna Brzezinska-Rajszys, and Bohdan Maruszewski. "Edwards Inspiris Resilia® valve for mitral replacement in an infant after mechanical valve failure." Cardiology in the Young 29, no. 2 (December 3, 2018): 219–21. http://dx.doi.org/10.1017/s1047951118001816.

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AbstractWe present the surgical implantation of the Edwards Inspiris Resilia® aortic valve in mitral position for mechanical mitral valve failure in a severely ill infant after valve replacement because of anomalous origin of the left coronary artery from the pulmonary artery. The biological valve was chosen because the child could not receive oral anticoagulation and was for several months on heparin infusion. The procedure was safely performed with good haemodynamic result.

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38

THOMAS, P., W. CULLING, H. SINGH, B. GRIFFITHS, and D. SHERIDAN. "Systemic and coronary haemodynamic effects of alpha adrenoceptor blockade in patients with coronary artery disease." Journal of Molecular and Cellular Cardiology 18 (1986): 100. http://dx.doi.org/10.1016/s0022-2828(86)80777-5.

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39

LAINCHBURY, J. G., M. G. NICHOLLS, E. A. ESPINER, H. IKRAM, T. G. YANDLE, and A. M. RICHARDS. "Regional plasma levels of cardiac peptides and their response to acute neutral endopeptidase inhibition in man." Clinical Science 95, no. 5 (November 1, 1998): 547–55. http://dx.doi.org/10.1042/cs0950547.

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1.The cardiac natriuretic peptides, atrial natriuretic peptide and brain natriuretic peptide, are degraded via clearance receptors and the enzyme neutral endopeptidase (EC 3.4.24.11). We studied the regional plasma concentrations of these peptides and their response to acute neutral endopeptidase inhibition in a consecutive series of patients with a broad spectrum of severity of cardiac dysfunction who were undergoing diagnostic right and left heart catheterization (24 patients, mean age 62.6 years). 2.Baseline blood samples were obtained for hormone analysis from femoral artery, femoral vein, renal vein, hepatic vein, superior vena cava, coronary sinus and pulmonary artery, and initial haemodynamic measurements were made. Twelve patients then received a neutral endopeptidase inhibitor (SCH 32615, 200 ;mg intravenously) and 12 received vehicle alone. The cardiac catheterization procedure was then completed and haemodynamic and hormone measurements were repeated. 3.Haemodynamic status was similar at baseline in both groups, and at repeated measurement (post-procedure after placebo or active drugs) haemodynamic variables were not significantly different from baseline values. Plasma levels of atrial and brain natriuretic peptides exhibited an arteriovenous increment (344% and 124% respectively) across the heart (femoral artery to coronary sinus) and decrement (by 28–54% and 9–16% respectively) across all other tissue beds (P< 0.05 for all) except the lung (no change). Final levels of atrial natriuretic peptide rose above initial levels at all sites in both groups (P< 0.05) except coronary sinus levels in the vehicle group (no change). The increase was consistently greater in the inhibitor group at all sites (P< 0.05 versus placebo). Levels of brain natriuretic peptide rose at all sites in the inhibitor group only (P< 0.05). The transcardiac step-up in atrial natriuretic peptide was markedly augmented after the administration of neutral endopeptidase inhibitor. Other tissue gradients were not significantly altered by neutral endopeptidase inhibitor. 4.Atrial and brain natriuretic peptides in plasma are degraded by a number of tissues, and respond differently to cardiac catheterization. Neutral endopeptidase has a significant role in determining plasma levels of natriuretic peptides, in part perhaps by influencing the amount of intact peptide reaching the circulation after secretion from the heart.

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40

Feng, Jiling, Nannan Wang, Yiliang Wang, Xiaoxian Tang, and Jie Yuan. "Haemodynamic mechanism of formation and distribution of coronary atherosclerosis: A lesion-specific model." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 234, no. 11 (August 4, 2020): 1187–96. http://dx.doi.org/10.1177/0954411920947972.

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Coronary arterial disease, as the most devastated cardiovascular disease, is caused by the atherosclerosis in the coronary arteries, which blocks the blood flow to the heart, resulting in the deficient supply of oxygen and nutrition to the heart, and eventually leading to heart failure. To date, haemodynamic mechanisms for atherosclerosis development are not fully understood although it is believed that the haemodynamic disturbance at the region of the arterial bifurcation, particular, bifurcation angle, plays an important role in the atherosclerosis development. In this study, two types of computational fluid dynamics models, lesion-specific and idealized models, combined with the computer tomography imaging techniques, are used to explore the mechanism of formation and distribution of the atherosclerosis around the bifurcation of left coronary artery and its association with the bifurcation angle. The lesion-specific model is used to characterize the effect of personalized features on the haemodynamic performance, while the idealized model is focusing on the effect of single factor, bifurcation angle, on the haemodynamic performance. The simulated results from both types of the models, combined with the clinical observation, revealed that the three key areas around the bifurcations are prone to formation of the atherosclerosis. Unlike the idealized models, lesion-specific modelling results did not show the significant correlation between the wall shear stress and bifurcation angle, although the mean value of the wall shear stress in smaller bifurcation angles (less than 90°) is higher than that with larger bifurcation angles (greater than 90°). In conclusion, lesion-specific computational fluid dynamics modelling is an efficient and convenient way to predict the haemodynamic performance around the bifurcation region, allowing the comprehensive information for the clinicians to predict the atherosclerosis development. The idealized models, which only focus on single parameter, may not provide the sufficient and reliable information for the clinical application. A novel multi-parameters modelling technique, therefore, is suggested to be developed in future, allowing the effects of many parameters on the haemodynamic performance to be evaluated.

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41

De Silva, Kalpa, and Divaka Perera. "Cannabis, Collaterals, and Coronary Occlusion." Case Reports in Cardiology 2011 (2011): 1–3. http://dx.doi.org/10.1155/2011/469850.

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A 51-year-old gentleman, who regularly smoked cannabis, presented with chest pain and diaphoresis. He was haemodynamically stable. ECG showed ST depression, inferiorly, and 1 mm ST elevation in lead aVR. Emergent coronary angiography showed thrombotic occlusion of the left main coronary artery (LMCA), the dominant RCA provided Rentrop grade II collaterals to the LAD. The LMCA was successfully reopened by deployment of a bare-metal stent. Animal heart models suggest that endogenous cannibinoids may cause ischaemic preconditioning. This case suggests that the severity of ischaemia, and hence ECG changes and haemodynamic consequences following an acute occlusion of the LMCA, can be ameliorated by coronary collateralisation and possibly by preconditioning of the myocardium.

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42

Lüscher, Thomas F. "Coronary artery disease: risk factors, haemodynamic significance, anatomic complexity, and platelet lipidome." European Heart Journal 38, no. 25 (July 1, 2017): 1939–42. http://dx.doi.org/10.1093/eurheartj/ehx364.

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43

HYNYNEN, M., T. SILTANEN, A. SAHLMAN, T. POHJASVAARA, W. MÜCK, and M. KASTE. "Continuous infusion of nimodipine during coronary artery surgery: haemodynamic and pharmacokinetic study †." British Journal of Anaesthesia 74, no. 5 (May 1995): 526–33. http://dx.doi.org/10.1093/bja/74.5.526.

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44

Meissner, A., M. Lins, G. Herrmann, and R. Simon. "Multiple coronary artery-left ventricular fistulae: haemodynamic quantification by intracoronary Doppler ultrasound." Heart 78, no. 1 (July 1, 1997): 91–93. http://dx.doi.org/10.1136/hrt.78.1.91.

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45

McCourt, K. C., P. Elliott, R. K. Mirakhur, T. J. McMurray, A. S. Phillips, and D. Cochrane. "Haemodynamic effects of rapacuronium in adults with coronary artery or valvular disease." British Journal of Anaesthesia 83, no. 5 (November 1999): 721–26. http://dx.doi.org/10.1093/bja/83.5.721.

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46

Beatch, G. N., and J. H. McNeill. "Ventricular arrhythmias following coronary artery occlusion in the streptozotocin diabetic rat." Canadian Journal of Physiology and Pharmacology 66, no. 3 (March 1, 1988): 312–17. http://dx.doi.org/10.1139/y88-053.

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The following investigation was designed to assess whether or not streptozotocin diabetes has an influence on the number and severity of ventricular arrhythmias following coronary artery occlusion in the conscious rat. In addition, electrocardiogram and haemodynamic data were compared between streptozotocin diabetic groups and control. Diabetes was induced in male Sprague–Dawley rats with streptozotocin (55 mg/kg iv) and left anterior descending coronary artery ligation was performed either 6 or 9 weeks later. Rats were allowed to recover from preparative surgery for 1 week prior to ligation. Streptozotocin diabetes (untreated or insulin controlled) appeared to have little influence on the variables tested. When exposed to equivalent degrees of ischaemia (the rat is a microangiopathy-resistant species), the streptozotocin diabetic rat heart was not appreciably more prone to arrhythmias of any type compared with control.

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47

Kam, Pca, L. Hines, and E. O'Connor. "Effects of cardiopulmonary bypass on systemic vascular resistance." Perfusion 11, no. 4 (July 1996): 346–50. http://dx.doi.org/10.1177/026765919601100408.

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During cardiopulmonary bypass (CPB), complex neuroendocrine responses occur and result in haemodynamic changes. Systemic vascular resistance (SVR) before, during, and after CPB was documented in patients undergoing coronary artery bypass surgery. Whilst the overall effect was an increased SVR, transient profound decreases in SVR at the commencement of CPB, during the rewarming phase, and immediately on weaning off CPB were demonstrated.

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48

Rampidis, Georgios, Vasileios Rafailidis, Konstantinos Kouskouras, Andjoli Davidhi, Angeliki Papachristodoulou, Athanasios Samaras, George Giannakoulas, Antonios Ziakas, Panagiotis Prassopoulos, and Haralambos Karvounis. "Relationship between Coronary Arterial Geometry and the Presence and Extend of Atherosclerotic Plaque Burden: A Review Discussing Methodology and Findings in the Era of Cardiac Computed Tomography Angiography." Diagnostics 12, no. 9 (September 9, 2022): 2178. http://dx.doi.org/10.3390/diagnostics12092178.

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Coronary artery disease (CAD) represents a modern pandemic associated with significant morbidity and mortality. The multi-faceted pathogenesis of this entity has long been investigated, highlighting the contribution of systemic factors such as hyperlipidemia and hypertension. Nevertheless, recent research has drawn attention to the importance of geometrical features of coronary vasculature on the complexity and vulnerability of coronary atherosclerosis. Various parameters have been investigated so far, including vessel-length, coronary artery volume index, cross-sectional area, curvature, and tortuosity, using primarily invasive coronary angiography (ICA) and recently non-invasive cardiac computed tomography angiography (CCTA). It is clear that there is correlation between geometrical parameters and both the haemodynamic alterations augmenting the atherosclerosis-prone environment and the extent of plaque burden. The purpose of this review is to discuss the currently available literature regarding this issue and propose a potential non-invasive imaging biomarker, the geometric risk score, which could be of importance to allow the early detection of individuals at increased risk of developing CAD.

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49

Wierzbicka, Magdalena, Maciej Kośmider, Agata Bielecka-Dąbrowa, and Jan Goch. "The meaning of early percutaneous coronary intervention in acute coronary syndrome with preserved ST elevation." Open Medicine 4, no. 3 (September 1, 2009): 265–71. http://dx.doi.org/10.2478/s11536-009-0042-5.

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AbstractTo determine if delaying the primary precutaneous coronary intervention (PCI) for >6 hours for acute coronary syndrome with preserved ST elevation (STE-ACS) affects the PCI angiography effectiveness and clinical prognosis. The PCI was performed: for 71% of patients <6h (group 1), for 29% of patients >6h from the beginning of pain (group 2). For 1% of patients from group 1 and 3.4% of patients from group 2, no passage has been opened in the artery after STE-ACS. In spite of opening the passage mechanically, the phenomenon of lack of tissue reflow occurred in 2.7% of patients from group 1 and 12% of patients from group 2. Dangerous ventricular arrhythmias occurred more frequently in patients from group 2, including VF, asystole, haemodynamic complications classed 4° according to the Killip-Kimball scale and death. In an univariate logistic regression analysis, the following risk factors for death during the hospital phase were identified: delayed PCI >6 hours, 4° haemodynamic complications according to the Killip-Kimball scale, LVEF <40%, FV, p-k III block, TIMI <3, and no-reflow. In a multivariate logistic regression analysis, 4° according to the Killip-Kimball scale turned out to be the only risk factor for death during the hospital phase. Delaying PCI during STE-ACS for >6 hours significantly lowers the statistical chance to recover both full permeability and effective tissue reflow in the artery responsible for STE-ACS, which is connected with a significantly higher risk of serious complications, as well as with 8.5% risk of death during the hospital phase. The most significant, independent factor determining the survival of patients with STE-ACS after PCI is lack of cardiogenic shock.

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50

Lee, YK, SW Na, YL Kwak, and SB Nam. "Effect of Pre-operative Angiotensinconverting Enzyme Inhibitors on Haemodynamic Parameters and Vasoconstrictor Requirements in Patients Undergoing Off-pump Coronary Artery Bypass Surgery." Journal of International Medical Research 33, no. 6 (November 2005): 693–702. http://dx.doi.org/10.1177/147323000503300612.

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The effects of pre-operative angiotensin-converting enzyme inhibitor (ACEI) treatment on haemodynamic status and vasoconstrictor requirements during off-pump coronary artery bypass surgery (OPCAB) were studied. Eighty patients selected for OPCAB were divided into those who had been treated with ACEIs for 4 weeks or more pre-operatively (ACEI group) (n = 43) and those who had not been treated with ACEIs (control group) (n = 37). Noradrenaline was infused during the operation when the mean systemic arterial pressure (SAP) fell below 60 mmHg. No significant differences in the haemodynamic parameters measured were detected between the two groups, except for cardiac output, which was found to be significantly greater in the control group. During anastomosis of the obtuse marginal branch of the left circumflex artery (OM), a significantly larger amount of noradrenaline was required by the ACEI group compared with the control group. In conclusion, pre-operative treatment with ACEIs significantly increased the amount of vasoconstrictor necessary to maintain the target SAP during OM anastomosis during OPCAB.

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