Central haemodynamics and coronary artery blood flow after administration of pentoxifylline to patients with coronary artery disease. A preoperative study

Abstract Aims The transition from hypertension to heart failure (HF) remains poorly understood. We hypothesized that insufficient perfusion to match global metabolic demand, reflected by a low ratio of myocardial blood flow to global myocardial mass, may be a HF risk marker. Methods and results A retrospective cohort (n = 346) of patients with hypertension who underwent clinical positron emission tomography (PET) myocardial perfusion imaging for chest pain and/or dyspnoea at Brigham and Women’s Hospital (Boston, MA, USA) were studied. Patients without obstructive coronary artery disease by history or PET perfusion (summed stress score <3), HF, cardiomyopathy, or ejection fraction (EF) <40% were followed for HF hospitalization (primary outcome), all-cause death, and their composite. Myocardial blood flow, left ventricular (LV) mass, volumes, and EF were obtained from PET, and a ‘flow/mass ratio’ was determined as hyperaemic myocardial blood flow over LV mass indexed to body surface area. A lower flow/mass ratio was independently associated with larger end-diastolic (β = −0.44, P < 0.001) and end-systolic volume (β = −0.48, P < 0.001) and lower EF (β = 0.33, P < 0.001). A flow/mass ratio below the median was associated with an adjusted hazard ratio of 2.47 [95% confidence interval (CI) 1.24–4.93; P = 0.01] for HF hospitalization, 1.95 (95% CI 1.12–3.41; P = 0.02) for death, and 2.20 (95% CI 1.39–3.49; P < 0.001) for the composite. Conclusion An integrated physiological measure of insufficient myocardial perfusion to match global metabolic demand identifies subclinical hypertensive heart disease and elevated risk of HF and death in symptomatic patients with hypertension but without flow-limiting coronary artery disease.

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Influence of phospholipase A2 and paraoxonase activity on endothelial function changes in various forms of coronary artery disease

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.058 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

VI Maslovskyi ◽

IA Mezhiievska ◽

YV Maslovskyi

Keyword(s):

Coronary Artery Disease ◽

Blood Flow ◽

Coronary Artery ◽

Endothelial Function ◽

Phospholipase A2 ◽

Brachial Artery ◽

Vascular Disorders ◽

Paraoxonase Activity ◽

Artery Disease ◽

Phospholipase A2 Activity

Abstract Funding Acknowledgements Type of funding sources: None. High phospholipase A2 activity is associated with atherosclerotic disorders of the arteries, while paraoxonase activity decreases with increasing atherogenic plasma activity. The purpose is to study the relationship between the combined effect of phospholipase A2 and paraoxonase activity on vascular endothelial dysfunction in various forms of coronary artery disease. We examined 152 men 52.5 ± 0.8 years, including 53 - STEMI, 32 - NSTEMI, 67 - chronic chronic coronary syndromes (CCS). Methods. All patients were examined for endothelial function of the brachial artery with a test for reactive hyperemia and vasodilation with exogenous NO, as well as determination of phospholipase A2 activity and plasma paraoxonase activity. All studiies conform to the principles of the Declaration of Helsinki of the World Medical Association. Results. Dynamics evaluation of endothelial function indicates a significant increase in blood flow in the brachial artery after compression in the NSTEMI group, but a decrease in the STEMI group after vasodilation of exogenous NO. Analysis of phospholipase A2 activity and paraoxonase showed an increasing the first in STEMI group compared to NSTEMI one and CCS while decreasing the second in the corresponding groups (Tab. 1). The results of the study confirm the association of increased activity of phospholipase A2 with vascular disorders severity, the correction of which should be considered a priority in prospective studies. The fact of reducing the activity of paraoxonase should be considered in the correction treatment of vascular disorders. Tab. 1 CCS NSTEMI STEMI LSD criteria D% 7,48 ± 0,39 6,65 ± 0,54 6,77 ± 0,62 {1-2} V% 54,71 ± 1,01 51,13 ± 1,92 42,16 ± 3,29 p1 < 0,0001 p2 = 0,010 {3} / {1, 2} D% (NO) 10,35 ± 0,47 8,24 ± 0,96 10,28 ± 0,98 {1, 2} V% (NO) 55,60 ± 1,12 37,71 ± 3,72 p1 < 0,0001 28,12 ± 3,94 p1 < 0,0001 {1} / {2, 3} sPA2 1,12 ± 0,03 1,25 ± 0,04 p1 < 0,0001 1,34 ± 0,04 p1 < 0,0001 {1} / {2, 3} PAO 0,54 ± 0,01 0,50 ± 0,01 0,44 ± 0,01 p1 < 0,0001 p2 < 0,0001 {1} / {2,3} D% - diameter of brachial artery after compression. V% - blood flow velocity after compression. sPA2 -phospholipase A2. PAO - paraoxanase. p - reliability on Sheffe"s criteria.

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Assessment of the Effect of Coronary Occlusion on Aortic Valve Dynamics Using a Global 3D FSI Model

ASME 2012 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2012-80395 ◽

2012 ◽

Author(s):

Soroush Nobari ◽

Rosaire Mongrain ◽

Richard Leask ◽

Raymond Cartier

Keyword(s):

Coronary Artery Disease ◽

Blood Flow ◽

Coronary Artery ◽

Coronary Blood Flow ◽

Aortic Root ◽

Calcific Aortic Stenosis ◽

Mortality And Morbidity ◽

Valve Dynamics ◽

Artery Disease ◽

Aortic Stiffening

Coronary artery disease (CAD) is considered to be a major cause of mortality and morbidity in the developing world. It has recently been shown that aortic root pathologies such as aortic stiffening and calcific aortic stenosis can contribute to the initiation and progression of this disease by affecting coronary blood flow [1,2]. Such pathologies influence the distensibility of the aortic root and therefore the hemodynamics of the entire region. As a consequence the coronary blood flow and velocity profiles will be altered [3,4,5] which could accelerate the development of an existing coronary artery disease. However, it would be very interesting to see if an occluded coronary artery would have a mutual impact on valvular dynamics and aortic root pathologies. This bi-directionality could aggravate and contribute to the progression of both the coronary and aortic root pathology.

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