A UNIQUE CASE OF MYOCARDIAL ISCHEMIA IN THE SETTING OF MULTIPLE CORONARY ARTERY MYCOTIC ANEURYSMS

SummaryIntestinal mucosa heparin (IMH) and beef lung heparin (BLH) were infused into dogs subjected to myocardial ischemia by intermittent coronary artery occlusions. The IMH was from a mixture of beef, sheep, and pig intestinal mucosa. Initial control occlusion and recovery was followed by a second occlusion with 60,000 units of IMH or BLH added. Electrocardiographic S-T segment elevations (ST) were measured acutely. There were no significant differences in ST in non-ischemic myocardium before occlusions or with occlusions. In ischemic myocardium, IMH significantly lowered control ST 84% in amount (t = 6.1 p <0.00005), and 76% in number (t = 11.6 p <0.00001). BLH lowered control ST a significant, lesser, 36% in amount (t = 3.6 p <0.008), and 35% in number (t = 3.2 p <0.01). The difference between IMH and BLH in ischemic myocardium was a significant 48% in amount (t = 4.0 p <0.0007), and 41% in number (t = 2.0 p <0.06). Myocardial adenosine triphosphate (ATP) levels were assayed after 90 min. ATP levels were 31% higher in both ischemic and non-ischemic myocardium in IMH-treated dogs than in BLH- treated. It was concluded that IMH and BLH are functionally different, and IMH was significantly more effective.

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A Giant Right Coronary Artery of Diffuse Ectasia Induced by a Right Ventricular Fistula

The Heart Surgery Forum ◽

10.1532/hsf.1349 ◽

2015 ◽

Vol 18 (6) ◽

pp. 253

Author(s):

Renyuan Li ◽

Yiming Ni ◽

Peng Teng ◽

Weidong Li

Keyword(s):

Coronary Artery ◽

Right Coronary Artery ◽

Artery Bypass ◽

Coronary Artery Fistula ◽

Rare Entity ◽

Fistula Closure ◽

Unique Case ◽

Coronary Ectasia ◽

The Right ◽

Giant Size

<p>Coronary artery fistula (CAF) is a rare entity. Sometimes it may associate with mild diffuse or segmental coronary ectasia. CAF with giant coronary artery is exceptionally rare. We present a unique case of a 49-year-old female patient with a giant right coronary artery of diffuse ectasia coexisting with a fistula draining into the right ventricle. To our best knowledge, CAF with diffuse coronary ectasia of such giant size has never been reported. The patient was treated successfully by resection of the dilated right coronary artery, fistula closure, and coronary artery bypass grafting.</p>

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Faculty Opinions recommendation of Dual-energy CT of the heart for diagnosing coronary artery stenosis and myocardial ischemia-initial experience.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1113133.569129 ◽

2008 ◽

Author(s):

Stephan Achenbach

Keyword(s):

Coronary Artery ◽

Myocardial Ischemia ◽

Coronary Artery Stenosis ◽

Dual Energy ◽

Artery Stenosis ◽

Dual Energy Ct ◽

Initial Experience

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Beta-Blockade in Intraseptal Anomalous Coronary Artery With Reversible Myocardial Ischemia

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135120954818 ◽

2021 ◽

Vol 12 (1) ◽

pp. 145-148

Author(s):

Tam T. Doan ◽

Athar M. Qureshi ◽

Shagun Sachdeva ◽

Cory V. Noel ◽

Dana Reaves-O’Neal ◽

...

Keyword(s):

Coronary Artery ◽

Myocardial Ischemia ◽

Dobutamine Stress ◽

Medical Intervention ◽

Beta Blockade ◽

Fractional Flow ◽

Flow Reserve ◽

Reversible Ischemia ◽

Improve Patient

Anomalous aortic origin of a left coronary artery (L-AAOCA) with an intraseptal course is a rare anomaly and can be associated with myocardial ischemia and sudden cardiac death. No surgical or medical intervention is known to improve patient outcomes. A 7-year-old boy with intraseptal L-AAOCA presented with nonexertional chest pain, syncope, and had reversible myocardial ischemia on provocative testing. The patient was started on β-blockade, following which his symptoms improved and resolved over a period of six years. A follow-up dobutamine stress magnetic resonance imaging no longer showed reversible ischemia, and cardiac catheterization with fractional flow reserve did not show coronary flow compromise.

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Endothelial β1 Integrin-Mediated Adaptation to Myocardial Ischemia

Thrombosis and Haemostasis ◽

10.1055/s-0040-1721505 ◽

2021 ◽

Author(s):

Carina Henning ◽

Anna Branopolski ◽

Paula Follert ◽

Oksana Lewandowska ◽

Aysel Ayhan ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Artery ◽

Myocardial Ischemia ◽

Cardiac Function ◽

Integrin Subunit ◽

Β1 Integrin ◽

Human Coronary Artery ◽

Tetrazolium Chloride ◽

Magnetic Resonance Imaging Mri ◽

Interfering Rna

Abstract Background Short episodes of myocardial ischemia can protect from myocardial infarction. However, the role of endothelial β1 integrin in these cardioprotective ischemic events is largely unknown. Objective In this study we investigated whether endothelial β1 integrin is required for cardiac adaptation to ischemia and protection from myocardial infarction. Methods Here we introduced transient and permanent left anterior descending artery (LAD) occlusions in mice. We inhibited β1 integrin by intravenous injection of function-blocking antibodies and tamoxifen-induced endothelial cell (EC)-specific deletion of Itgb1. Furthermore, human ITGB1 was silenced in primary human coronary artery ECs using small interfering RNA. We analyzed the numbers of proliferating ECs and arterioles by immunohistochemistry, determined infarct size by magnetic resonance imaging (MRI) and triphenyl tetrazolium chloride staining, and analyzed cardiac function by MRI and echocardiography. Results Transient LAD occlusions were found to increase EC proliferation and arteriole formation in the entire myocardium. These effects required β1 integrin on ECs, except for arteriole formation in the ischemic part of the myocardium. Furthermore, this integrin subunit was also relevant for basal and mechanically induced proliferation of human coronary artery ECs. Notably, β1 integrin was needed for cardioprotection induced by transient LAD occlusions, and the absence of endothelial β1 integrin resulted in impaired growth of blood vessels into the infarcted myocardium and reduced cardiac function after permanent LAD occlusion. Conclusion We showed that endothelial β1 integrin is required for adaptation of the heart to cardiac ischemia and protection from myocardial infarction.

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