Abstract 3351: The Coronary Suction Wave in Humans Is Not Diminished by Ischemia Induced Left Ventricular Diastolic Dysfunction.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Stephen P Hoole ◽  
Paul A White ◽  
Patrick M Heck ◽  
Sadia N Khan ◽  
Michael O’Sullivan ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Diastolic Dysfunction ◽  
Coronary Arteries ◽  
Cardiac Cycle ◽  
Left Ventricular ◽  
Balloon Occlusion ◽  
Lv Function ◽  
List Type ◽  
Ventricular Relaxation ◽  
Diastolic Left Ventricular Dysfunction

Background: A dominant suction wave due to ventricular relaxation has been postulated to contribute to normal coronary artery flow. We hypothesised that this wave would: be present in diseased coronary arteries, occur at the appropriate time in the cardiac cycle and be diminished following coronary artery balloon occlusion due to ischemia induced diastolic LV dysfunction. Methods: Simultaneous coronary pressure - velocity and LV pressure - volume were invasively recorded at baseline and after 1 minute coronary balloon occlusion, in 10 patients with single vessel coronary disease and normal LV function. Net coronary wave intensity (WI) = (dP/dt).(dU/dt) was calculated using MatLab software. Results: A dominant forward pushing wave and a backward suction wave (figure - shaded wave) were demonstrated in diseased coronary arteries. The suction wave occurred early in diastole, during active ventricular relaxation. Ischemia induced LV diastolic dysfunction was demonstrated after coronary artery occlusion (mean % Δ from baseline (SD): LV dP/dt min = −14.8 (13.8), p=0.008, LV Tau = +19.1(14.9), p = 0.011) but there was no significant change in suction WI (mean (SD): baseline = −1.35 (0.20) m −2 s −2 x10 5 , post-balloon occlusion −1.49(0.59) m −2 s −2 x10 5 , p =0.67). Conclusion: The coronary suction wave occurs in diseased coronary arteries at the appropriate time in the cardiac cycle but is not diminished by ischemia induced diastolic left ventricular dysfunction.

Abstract 3341: Human Coronary Collaterals Inversely Correlate with Indices of Ischemic Left Ventricular Diastolic Dysfunction during Coronary Balloon Occlusion.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Stephen P Hoole ◽  
Paul A White ◽  
Patrick M Heck ◽  
Michael O’Sullivan ◽  
Sarah C Clarke ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Diastolic Dysfunction ◽  
Diastolic Pressure ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Left Ventricular ◽  
Balloon Occlusion ◽  
Flow Index ◽  
Collateral Flow ◽  
Coronary Collaterals

Background: Coronary collaterals are thought to reduce myocardial ischemia during coronary artery occlusion. Coronary collaterals, defined angiographically, reduce end diastolic LV dilatation during coronary occlusion. However, counter to a role in reducing ischemia, they appear to be associated with an increase in LV end diastolic pressure. These changes may be explained if coronary collaterals act as an external LV scaffold. We aimed to re-evaluate this relationship by simultaneously measuring coronary collaterals and LV contractility quantitatively. Methods: Ten patients with normal LV function and single vessel coronary disease awaiting PCI were recruited. Collateral flow index, derived by pressure-wire measurement (CFI p = [P distal (occluded) − P venous ] / [P aorta − P venous ]) and change in LV end-diastolic pressure (LVEDP), volume (LVEDV) and Tau, measured by an LV cavity conductance catheter, were recorded simultaneously after 1 minute coronary balloon occlusion. A mean of 5 cardiac cycles was analyzed. Measurements were repeated after a recovery period of 30 minutes. Results: Percentage change in LVEDP and Tau inversely correlated with CFI p (ΔLVEDP vs. CFI p : y = −216.6x +63.4, r = 0.57, p=0.01; ΔTau vs. CFI p : y = −64.1x + 27.8, r = 0.47, p<0.05) (Figure ). There was also an inverse relationship between ΔLVEDV vs. CFI p (y = −8.4x + 1.5, r = 0.35, p = 0.15). Conclusion: Coronary collaterals inversely correlate with LV end diastolic stiffness and dilatation after 1 minute of coronary artery occlusion. This reflects a role in reducing ischemic LV diastolic dysfunction, by providing an alternative blood supply to the LV myocardium, rather than acting as an LV scaffold.

Coronary artery z score values in adolescent elite male soccer players

2020 ◽  
pp. 1-5
Author(s):  
Stephan Gerling ◽  
Tobias Pollinger ◽  
Markus Johann Dechant ◽  
Michael Melter ◽  
Werner Krutsch ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
High Intensity ◽  
Left Main Coronary Artery ◽  
Left Ventricular ◽  
Soccer Players ◽  
Z Score ◽  
Left Main ◽  
Luminal Diameter ◽  
The Mean

Abstract Background: With the increased training loads at very early ages in European elite youth soccer, there is an interest to analyse coronary artery remodelling due to high-intensity exercise. Design and methods: Prospective echocardiographic study in 259 adolescent elite male soccer players and 48 matched controls. Results: The mean age was 12.7 ± 0.63 years in soccer players and 12.6 ± 0.7 years in controls (p > 0.05). Soccer players had significant greater indexed left ventricular mass (93 ± 13 g/m2 versus 79 ± 12 g/m2, p = 0.001). Both coronary arteries origin could be identified in every participant. In soccer players, the mean diameter of the left main coronary artery was 3.67 mm (SD ± 0.59) and 2.61 mm (SD ± 0.48) for right main coronary artery. Controls showed smaller mean luminal diameter (left main coronary artery, p = 0.01; right main coronary artery, p = 0.025). In soccer players, a total of 91% (n = 196) and in controls a total of 94% (n = 45) showed left main coronary artery z scores within the normal range: −2.0 to 2.0. In right main coronary artery, a pattern of z score values distribution was comparable (soccer players 94%, n = 202 vs. controls 84%, n = 40). A subgroup of soccer players had supernormal z score values (>2.0 to 2.5) for left main coronary artery (9%, n = 19, p = 0.01) and right main coronary artery (6%, n = 10, p = 0.025), respectively. Conclusion: Elite soccer training in early adolescence may be a stimulus strong enough to develop increased coronary arteries diameters. In soccer players, a coronary artery z score >2.0–2.5 might reflect a physiologic response induced by multiannual high-intensity training.

Estimation of Left Ventricular Wall Stiffness by Analysis of Late Diastolic Pressure Components

2011 ◽  
Author(s):  
Casandra L. Niebel ◽  
Kelley C. Stewart ◽  
Takahiro Ohara ◽  
John J. Charonko ◽  
Pavlos P. Vlachos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Diastolic Pressure ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Ventricular Wall ◽  
Ventricular Relaxation ◽  
Wall Stiffness ◽  
Ventricular Diastolic Dysfunction

Left ventricular diastolic dysfunction (LVDD) is any abnormality in the filling of the left ventricle and is conventionally evaluated by analysis of the relaxation driven phase, or early diastole. LVDD has been shown to be a precursor to heart failure and the diagnosis and treatment for diastolic failure is less understood than for systolic failure. Diastole consists of two filling waves, early and late and is primarily dependent on ventricular relaxation and wall stiffness.

scholarly journals Three Vessel Coronary Cameral Fistulae Associated with New Onset Atrial Fibrillation and Angina Pectoris

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Murat Yuksel ◽  
Abdulkadir Yildiz ◽  
Mustafa Oylumlu ◽  
Nihat Polat ◽  
Halit Acet ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Left Ventricle ◽  
Coronary Arteries ◽  
Diastolic Pressure ◽  
Left Ventricular ◽  
Ventricular Rate ◽  
Fistula Formation ◽  
New Onset

Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamber or a great vessel which are reported in less than 0.1% of patients undergoing diagnostic coronary angiography. All three major coronary arteries are even less frequently involved in fistula formation as it is the case in our patient. A 68-year-old woman was admitted to cardiology clinic with complaints of exertional dyspnea and angina for two years and a new onset palpitation. Standard 12-lead electrocardiogram revealed atrial fibrillation (AF) with a ventricular rate of 114 beat/minute and accompanying T wave abnormalities and minimal ST-depression on lateral derivations. Transthoracic echocardiographic examination was normal except for diastolic dysfunction, minimally mitral regurgitation, and mild to moderate enlargement of the left atrium. Sinus rhythm was achieved by medical cardioversion with amiodarone infusion. Coronary angiography revealed diffuse and multiple coronary-left ventricle fistulas originating from the distal segments of both left and right coronary arterial systems without any stenosis in epicardial coronary arteries. The patient’s symptoms resolved almost completely with medical therapy. High volume shunts via coronary artery to left ventricular microfistulas may lead to increased volume overload and subsequent increase in end-diastolic pressure of the left ventricle and may cause left atrial enlargement.

Abstract 1876: Functional Effect of Chronic Urotensin II Receptor Antagonist on L-Type Ca 2+ Current in Mouse Model of Progressive Heart Failure

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Peng Zhou ◽  
Heng-Jie Cheng ◽  
Michael Cross ◽  
Michael F Callahan ◽  
Bridget Brosnihan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Receptor Antagonist ◽  
Weight Ratio ◽  
Heart Association ◽  
Cell Voltage ◽  
Fold Increase ◽  
Left Ventricular ◽  
Lv Function ◽  
List Type ◽  
Urotensin Ii

Voltage-gated Ca 2+ channels play fundamental roles in the regulation of cardiac function by various neurotransmitters. Recently, we have shown that urotensin II (UII), a potent vasoconstrictor, inhibits L-type Ca 2+ current (I Ca,L ) and produces negative inotropic action. In heart failure (HF), the UII-mediated pathway is upregulated, suggesting a therapeutic value of UII receptor antagonist (UII-ANT) for HF. However, the role and mechanism of chronic UII-ANT in HF is unclear. We tested the hypothesis that chronic UII-ANT may improve cardiac I Ca,L , preventing β-adrenergic deregulation on I Ca,L and limit HF progression. We examined plasma levels of norepinephrine (NE), left ventricular (LV) function, and myocyte I Ca,L responses to isoproterenol (ISO) in 3 age-matched groups of mice: HF (n = 7), 2 months after ISO (150 mg/kg sq for 2 days); HF/UII-ANT (n = 11), 1 month after receiving ISO, then urantide, a potent UII-ANT (10 −5 M/kg/day, sq via implanted osmotic mini pump), given for 1 month; and Controls (n = 7). I Ca,L was measured using whole-cell voltage clamp technique. Compared with controls, ISO-treated mice progressed to HF with 4.7-fold increase in plasma NE (18975 vs 4066 pg/ml) and LV dilatation associated with increased myocyte length (ML, 155 vs120 μm) and heart-to-body weight ratio (H/BW, 7.6 vs 5.5 g/kg). Stroke volume (SV, 30.3 vs 61.4 μl) and ejection fraction (EF, 39% vs 60%) were decreased. Compared with normal myocytes, in HF myocytes, I Ca,L was reduced (50%, 3.7 ± 0.2 vs 7.4 ± 0.2 pA/pF), and I Ca,L response to β-AR stimulation (ISO, 10 −8 M) was attenuated (11% vs 35%) (p < 0.01). In HF/UII-ANT mice, plasma NE (5148 pg/ml), SV (57.9 μl), and EF (57%) returned close to control levels with retained normal ML (124 μm) and H/BW (5.9 g/kg). Moreover, compared with controls, in HF/UII-ANT mice, ISO caused similar increases in the peak I Ca,L (32% vs 35%). Chronic UII-ANT treatment normalizes LV L-type Ca 2+ channel basal function and β-adrenergic regulation, leading to regression of LV and myocyte dysfunction and remodeling in mice with ISO-induced HF. This research has received full or partial funding support from the American Heart Association, AHA National Center.

scholarly journals Surgical treatment of left ventricular wall rupture, regarded as a consequence of Takotsubo cardiomyopathy

2017 ◽  
Vol 5 ◽  
pp. 2050313X1668921 ◽  
Author(s):  
Taalaibek Kudaiberdiev ◽  
Irina Akhmedova ◽  
Gulzada Imanalieva ◽  
Ildar Abdildaev ◽  
Kilichbek Jooshev ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Angiography ◽  
Emotional Stress ◽  
Coronary Arteries ◽  
Takotsubo Cardiomyopathy ◽  
Laboratory Tests ◽  
Left Ventricular ◽  
Left Ventricular Aneurysm ◽  
Lv Function ◽  
Inferior Myocardial Infarction

Objective: We present the case of possible reverse type of TCM in a female patient presented with progressive left ventricular dysfunction and its rupture in pericardium. Methods: The detailed history, physical examination, laboratory tests, electrocardiography, serial echocardiography, coronary angiography with left ventriculography were performed to diagnose possible Takotsubo cardiomyopathy in 63-year old woman admitted to our center with complaints of dyspnea, lightheadedness, weakness and signs of hypotension and history of inferior myocardial infarction, acute left ventricular aneurysm, and effusive pericarditis and pleuritis, developed after emotional stress 5 months ago. Results: Clinical evaluation revealed unremarkable laboratory tests, normal troponin values, signs of old inferior myocardial infarction on electrocardiogram, and left ventricular (LV) dilatation and dysfunction, akinesia of LV infero-lateral wall with thinning and its rupture and blood shunting in pericardium. Her coronary angiography revealed normal coronary arteries. The diagnosis of pheochromocytoma was excluded. The patient underwent surgery under cardiopulmonary bypass with removal of LV pseudoaneurysm. The patient was discharged from hospital with improvement in NYHA class and LV function. Conclusion: Thus, in female postmenopausal patients presenting with acute myocardial infarction signs complicated by pericarditis, intact coronary arteries and LV dysfunction with emotional stress as triggering factor, reverse type of TCM should be considered and proper management applied to prevent development of life-threatening complications like LV rupture.

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