scholarly journals Increased symmetric dimethylarginine, but not asymmetric dimethylarginine, concentrations are associated with transient myocardial ischemia and predict outcome

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092043
Author(s):  
Zsuzsanna Szabo ◽  
Eva Bartha ◽  
Lajos Nagy ◽  
Tihamer Molnar
Keyword(s):  
Myocardial Perfusion ◽  
Coronary Flow ◽  
Venous Blood ◽  
Elevated Serum ◽  
Perfusion Abnormality ◽  
Myocardial Perfusion Abnormality ◽  
Before And After ◽  
Risk Patients ◽  
Artery Disease

Objective Asymmetric and symmetric dimethylarginines (ADMA and SDMA) are endothelial dysfunction markers. ADMA inhibits synthesis of nitric oxide. We aimed to analyze both markers in patients with coronary artery disease (CAD) who were referred for stress/rest myocardial perfusion scintigraphy (MPS). Methods All patients underwent a 2-day dipyridamole (DP) stress/rest protocol. Thereafter, patients with transient myocardial perfusion abnormality were followed up and their coronary blood flow was quantitatively assessed. Venous blood was taken before and after DP stress to measure markers. Results Baseline ADMA and SDMA concentrations were significantly higher in patients with CAD compared with healthy subjects. Pre- and post-stress SDMA concentrations were significantly higher in patients with transient myocardial perfusion abnormality compared with those with negative MPS results. However, ADMA and L-arginine concentrations were not significantly different between the two groups. None of the markers were significantly different between patients with angiographically proven low coronary flow and those with normal coronary flow. Pre-stress SDMA concentrations were an independent predictor of cardiovascular mortality during a 8-year follow-up. Conclusions Elevated serum SDMA concentrations may be helpful for selecting high-risk patients with CAD if there is any doubt in interpreting MPS. SDMA concentrations may also predict cardiovascular outcome.

Effects of aging on coronary flow reserve in patients with no evidence of myocardial perfusion abnormality

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Ramandika ◽  
S Kurisu ◽  
K Nitta ◽  
T Hidaka ◽  
H Utsunomiya ◽  
...  
Keyword(s):  
Myocardial Perfusion ◽  
Flow Velocity ◽  
Coronary Flow Reserve ◽  
Coronary Flow ◽  
Perfusion Abnormality ◽  
Coronary Flow Velocity ◽  
Group Iii ◽  
Flow Reserve ◽  
Group I ◽  
Myocardial Perfusion Abnormality

Abstract Background Coronary flow reserve (CFR) reflects the functional capacity of microcirculation to adapt to blood demand during increased cardiac work. Purpose We tested the hypothesis that aging had impacts on coronary flow velocities and CFR in patients with no evidence of myocardial perfusion abnormality on single photon emission computed tomography (SPECT). Methods and results Seventy-six patients with no evidence of myocardial perfusion abnormality on SPECT undergoing transthoracic Doppler echocardiography were enrolled in this study. Patients were divided into three age groups: 17 patients aged <70 years (Group I), 38 patients aged 70–79 years (Group II), and 21 patients aged ≥80 years (Group III). Compared with Group I, CFR was significantly lower in Group II (P<0.01) and Group III (P<0.01). Multivariate analysis showed that female (P=0.03), cigarette smoking (P=0.004), hemoglobin level (P=0.001) and LV mass index (P=0.03) were determinants for resting coronary flow velocity. On the other hand, age (P=0.008), hemoglobin level (P<0.001) and LV mass index (P=0.04) were determinants for hyperemic coronary flow velocity. Age was only independent determinant for CFR (β=−0.48 P<0.001). Conclusions Our data suggested that aging impaired CFR in patients with no evidence of myocardial perfusion abnormality primarily due to the decrease in hyperemic coronary flow velocity. Comparison of coronary flow reserve amon Funding Acknowledgement Type of funding source: None

Effects of aging on coronary flow reserve in patients with no evidence of myocardial perfusion abnormality

2020 ◽  
Vol 35 (12) ◽  
pp. 1633-1639
Author(s):  
Erasta Ramandika ◽  
Satoshi Kurisu ◽  
Kazuhiro Nitta ◽  
Takayuki Hidaka ◽  
Hiroto Utsunomiya ◽  
...  
Keyword(s):  
Myocardial Perfusion ◽  
Coronary Flow Reserve ◽  
Coronary Flow ◽  
Perfusion Abnormality ◽  
Flow Reserve ◽  
Myocardial Perfusion Abnormality ◽  
Effects Of Aging

Simvastatin May Improve Myocardial Perfusion Abnormality in Slow Coronary Flow

Cardiology ◽  
2008 ◽  
Vol 110 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Mahmut Cakmak ◽  
Halil Tanriverdi ◽  
Nazmiye Cakmak ◽  
Harun Evrengul ◽  
Sebnem Cetemen ◽  
...  
Keyword(s):  
Myocardial Perfusion ◽  
Coronary Flow ◽  
Perfusion Abnormality ◽  
Slow Coronary Flow ◽  
Myocardial Perfusion Abnormality

scholarly journals Coronary risk of patients with valvular heart disease: prospective validation of CT-Valve Score

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001380
Author(s):  
Rasmus Bo Hasselbalch ◽  
Mia Marie Pries-Heje ◽  
Sarah Louise Kjølhede Holle ◽  
Thomas Engstrøm ◽  
Merete Heitmann ◽  
...  
Keyword(s):  
Heart Disease ◽  
Valvular Heart Disease ◽  
Primary Outcome ◽  
Multislice Ct ◽  
Cost Effective ◽  
University Hospital ◽  
Before And After ◽  
History Of ◽  
Artery Disease

ObjectiveTo prospectively validate the CT-Valve score, a new risk score designed to identify patients with valvular heart disease at a low risk of coronary artery disease (CAD) who could benefit from multislice CT (MSCT) first instead of coronary angiography (CAG).MethodsThis was a prospective cohort study of patients referred for valve surgery in the Capital Region of Denmark and Odense University Hospital from the 1 February 2015 to the 1 February 2017. MSCT was implemented for patients with a CT-Valve score ≤7 at the referring physician’s discretion. Patients with a history of CAD or chronic kidney disease were excluded. The primary outcome was the proportion of patients needing reevaluation with CAG after MSCT and risk of CAD among the patients determined to be low to intermediate risk.ResultsIn total, 1149 patients were included. The median score was 9 (IQR 3) and 339 (30%) had a score ≤7. MSCT was used for 117 patients. Of these 29 (25%) were reevaluated and 9 (7.7%) had CAD. Of the 222 patients with a score ≤7 that did not receive an MSCT, 14 (6%) had significant CAD. The estimated total cost of evaluation among patients with a score ≤7 before implementation was €132 093 compared with €79 073 after, a 40% reduction. Similarly, estimated total radiation before and after was 608 mSv and 362 mSv, a 41% reduction. Follow-up at a median of 32 months (18–48) showed no ischaemic events for patients receiving only MSCT.ConclusionThe CT-Valve score is a valid method for determining risk of CAD among patients with valvular heart disease. Using a score ≤7 as a cut-off for the use of MSCT is safe and cost-effective.

Abstract 683: Regression of Plaque Volume in One Arterial Bed is not Necessarily Associated with Similar Changes in Other Vessels

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Takayuki Suzuki ◽  
Takashi Nozawa ◽  
Mitsuo Sobajima ◽  
Takashi Ohori ◽  
Akira Matsuki ◽  
...  
Keyword(s):  
Population Based ◽  
Plaque Volume ◽  
Independent Variables ◽  
Before And After ◽  
Independent Variable ◽  
Artery Disease ◽  
Soft Plaque ◽  
Major Factors ◽  
Atherosclerotic Changes

Background: Population-based studies have shown good correlation between severity of atherosclerotic disease in one arterial bed and involvement of other vessels. However, in patients with coronary artery disease (CAD), it remains unclear whether atherosclerotic plaque in an artery might regress or progress in parallel with other vessels. Accordingly, the present study was performed in patients with CAD to compare changes in plaque volume (PV) between the left main (LMT) and right coronary arteries (RCA), thoracic descending aorta (TDA) and common carotid artery (CCA), and to clarify clinical factors and biomarkers which might affect changes in PV in each artery. Methods: Using 64-multislice computed tomography, PVs in each artery were determined before and after 2.0-year follow-up period in 52 patients with CAD (67.4±9.9yo). Based on our previous study using ultrasound, CCA-PV was determined at windows of 90–240HU and TDA-PV determined manually. Coronary soft plaque was determined at windows of 0–75HU. Plasma levels of hsCRP, matrix metalloproteinase (MMP)-9 and urinary 8-iso-prostaglandin F2 α (PGF) were determined at baseline. Results: At baseline, PVs of TDA were correlated with CCA-PV (r=0.38, p<0.02), but PVs of other arteries did not correlate to each other. Two-year later, PVs of LMT, RCA, TDA, and CCA were reduced in 41, 62, 27, and 39% of patients, respectively. Changes in LMT-PV were weakly related with those of TDA-PV (r=0.37, p=0.02) and RCA-PV (r=0.31, p=0.08), but there were no relation between other arteries. The multivariate analysis revealed that treatment with statin and low LDL-cholesterol (C, <100mg/dl) were independent variables regarding a reduction in DTA-PV, but, in LMT, only low LDL-C was independent variable. However, there were no independent variables in RCA or CCA. The ratio of soft PV to total PV was similar between LMT (45.2±7.1%) and RCA (45.7±4.9%) at baseline and was unchanged in the follow-up study. None of hsCRP, MMP-9 or PGF levels was related with PVs of any arteries at baseline and with changes in PVs. Conclusions: Regression of PV in one arterial bed dose not necessarily allow us to predict atherosclerotic changes in the other vessels. Major factors which affect changes in PV may not be homogeneous between arteries.

Sign in / Sign up

Export Citation Format

Share Document