scholarly journals COMPARISON OF ESMOLOL, LABETALOL AND LIGNOCAINE FOR ATTENUATION OF SYMPATHOMIMETIC RESPONSES TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Dr. Ankit Kumar ◽  
Dr. Arun Kumar Kulshrestha
Keyword(s):  
Blood Pressure ◽  
Endotracheal Intubation ◽  
Stress Responses ◽  
Left Ventricular ◽  
Group Reduction ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
American Society ◽  
Group 1

INTRODUCTION: In some individual’s suffering from hypertension, coronary artery disease, cerebrovascular disease, myocardial infarction and thyrotoxicosis, these hemodynamic stress responses can turn into life-threatening conditions like left ventricular failure, myocardial ischemia, cerebral hemorrhage, and ruptured cerebral aneurysm. Different drugs like lidocaine, vasodilator agents inhibiting sympathoadrenal response, α-and β-adrenergic blockers, and opioids can be administered prior to tracheal intubation to prevent hemodynamic responses. But higher dose of lignocaine may lead to hypotension, bradycardia, and hypoxia in patients. Due to various effect of these drugs on hemodynamic changes in patients this study was carried out to evaluate the effects of IV esmolol, lignocaine, and labetalol for attenuation of hemodynamic response to laryngoscopy and intubation. MATERIAL AND METHODS: A total of 90 consecutive patients were included in the study and were grouped in to, lignocaine group, labetalol and esmolol group containing 30 patients each. Age group 21–65 years of either sex or American Society of Anesthesiologists (ASA) Grade I or II scheduled for various general surgical procedures under endotracheal anesthesia were included in this study. Patients excluded were pregnant and lactating women, morbid obesity, and hypertension. RESULTS: Mean Age in Group 1, group2 and group 3 was 40.38 ± 7.25, 43.8 ± 9.24 and 42.56 ± 8.71 respectively while weight was 62.41 ± 7.32, 63.63 ± 8.11 and 60.74 ± 6.92 respectively. There were 17 male and 13 female in group 1, 19 male and 11 female in group 2 and 16 male and 14 female in group 3. Attenuation of blood pressure was more in labetalol group. Reduction of heart rate in labetalol group was significant. It is seen that Labetalol was more effective at attenuation of diastolic blood pressure among all drugs. Mean arterial pressure was not much reduced lignocaine and esmolol group as compared to labetalol. CONCLUSION: Haemodynamic alterations are usually observed during laryngoscopy and endotracheal intubation. In our study it was found that as labetalol is a safe and effective drug, for attenuation of sympathomimetic response.

scholarly journals COMPARISON OF ESMOLOL, LABETALOL AND LIGNOCAINE FOR ATTENUATION OF SYMPATHOMIMETIC RESPONSES TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Dr. H. Kirankumar
Keyword(s):  
Blood Pressure ◽  
Endotracheal Intubation ◽  
Stress Responses ◽  
Left Ventricular ◽  
Group Reduction ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
American Society ◽  
Group 1

INTRODUCTION: In some individual’s suffering from hypertension, coronary artery disease, cerebrovascular disease, myocardial infarction and thyrotoxicosis, these hemodynamic stress responses can turn into life-threatening conditions like left ventricular failure, myocardial ischemia, cerebral hemorrhage, and ruptured cerebral aneurysm. Different drugs like lidocaine, vasodilator agents inhibiting sympathoadrenal response, α-and β-adrenergic blockers, and opioids can be administered prior to tracheal intubation to prevent hemodynamic responses. But higher dose of lignocaine may lead to hypotension, bradycardia, and hypoxia in patients. Due to various effect of these drugs on hemodynamic changes in patients this study was carried out to evaluate the effects of IV esmolol, lignocaine, and labetalol for attenuation of hemodynamic response to laryngoscopy and intubation. MATERIAL AND METHODS: A total of 90 consecutive patients were included in the study and were grouped in to, lignocaine group, labetalol and esmolol group containing 30 patients each. Age group 21–65 years of either sex or American Society of Anesthesiologists (ASA) Grade I or II scheduled for various general surgical procedures under endotracheal anesthesia were included in this study. Patients excluded were pregnant and lactating women, morbid obesity, and hypertension. RESULTS: Mean Age in Group 1, group2 and group 3 was 40.38 ± 7.25, 43.8 ± 9.24 and 42.56 ± 8.71 respectively while weight was 62.41 ± 7.32, 63.63 ± 8.11 and 60.74 ± 6.92 respectively. There were 17 male and 13 female in group 1, 19 male and 11 female in group 2 and 16 male and 14 female in group 3. Attenuation of blood pressure was more in labetalol group. Reduction of heart rate in labetalol group was significant. It is seen that Labetalol was more effective at attenuation of diastolic blood pressure among all drugs. Mean arterial pressure was not much reduced lignocaine and esmolol group as compared to labetalol. CONCLUSION: Haemodynamic alterations are usually observed during laryngoscopy and endotracheal intubation. In our study it was found that as labetalol is a safe and effective drug, for attenuation of sympathomimetic response.

scholarly journals Relationship of Body Fat and Left ventricular hypertrophy with the Risk of All-cause Death in Patients with Coronary Artery Disease

2021 ◽  
Author(s):  
Baotao Huang ◽  
Lu Yang ◽  
Bosen Yang ◽  
Fangyang Huang ◽  
Qianfeng Xiao ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Body Fat ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Lower Body ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Abstract Background and aimsLeft ventricular hypertrophy (LVH) is prevalent in obese individuals. Besides, both of LVH and obesity is associated with subclinical LV dysfunction. However, little is known about the interplay between body fat and LVH in relation to all-cause death in patients with coronary artery disease (CAD).MethodsIn this retrospective cohort study, a total of 2243 patients with angiographically proven CAD were included. Body fat and LV mass were calculated using formulas. Higher body fat was defined as the percentage of body fat was greater than 75th percentile. LVH was defined according to guidelines’ definition. Patients were divided into four groups: group 1, lower body fat and no LVH; group 2, lower body fat and LVH; group 3, higher body fat and no LVH; group 4, higher body fat and LVH. Cox-proportional hazard models were used to observe the interaction effect of body fat and LVH on all-cause death.ResultsOver 2.2 years, there were 120 deaths. Patients with higher body fat and no LVH (group 3) had similar risk of death (adjusted HR 1.83, 95%CI 1.00-3.38, P = 0.054) compared to the reference group (group 1), while patients with lower body fat and LVH (group 2) had the highest risk (adjusted HR 2.15, 95%CI 1.26–3.64, P = 0.005) of death. The results were robust after different degree of adjustment.ConclusionCertain amount of BF was not associated with increased risk of all-cause death in patients with CAD, even seems protective in those concomitant with LVH.

scholarly journals The Rate of Discordance between Syntax Score II and Cardiologist Decision as a Guide for Mode of Revascularization in Patients with Complex Coronary Artery Disease

2018 ◽  
Vol 59 (4) ◽  
pp. 285-290
Author(s):  
Hasan A. Farhan
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Clinical Judgment ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Clinical Decisions ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

treatment decisions for percutaneous coronary intervention (PCI) and/or coronary artery bypass graft (CABG) in patients with complex coronary artery disease (CAD) and/or unprotected left main stem disease (ULMSD).Objectives: To assess the agreement between the clinical decisions of the cardiologist and the SS II recommendation regarding the revascularization strategies in patients with complex CAD and/or ULMSD.Patients and Methods: Prospective data from patients who presented to Baghdad Medical City Catheterization Labs for coronary angiography and were followed up between January 2014 and November 2015 were analyzed. For these patients, SS II was assessed by the two anatomical variables (SS and presence of ULMSD) and six clinical variables (age, creatinine clearance, left ventricular ejection fraction, sex, chronic obstructive pulmonary disease, and peripheral vascular disease) to predict 4-year mortality after revascularization with PCI and/or CABG. These scores were then compared with the clinical decisions of cardiologists. After 1 year of data collection, we followed up the patients by phone to assess their mortality status. Patients were categorized into three groups according the interventional procedures: Group 1 (for PCI), Group 2 (for CABG), and Group 3 (for PCI vs. CABG).Results: Two hundred patients were enrolled. Their mean age was 60.23 ± 9.836 years, and 157 (78.5%) were men. Depending on the clinical judgment of the cardiologist, 71 (35.5%) patients were referred for PCI (Group 1), 119 (59.5%) patients for CABG (Group 2), and the remaining 10 (5%) patients for PCI vs. CABG (Group 3). Based on an assessment of 4-year mortality by the SS II, CABG would have been the treatment of choice in 67 (33.5%) patients, PCI in 30 (15%) patients, and both the treatments in 103 (51.5%) patients. There was a concordance between the clinical decision of the cardiologist and SS II in 67 (33.5%) patients and discordance in 133 (66.5%) patients. Six patients died within 1 year, most of whom were from the discordant group.Conclusion: There was a statistically significant discordance between the SS II recommendation and clinical judgment of the interventional cardiologist. SS II proved to be a useful objective tool to assist experienced clinical judgment in determining appropriate revascularization strategy for CAD patients. المقدمة:درجة السنتاكس ٢ تعد طريقة ارشادية لاختيار طريقة العلاج في المرضى اللذين يعانون من امراض شرايين القلب التاجية المعقدة مع او بدون امراض الشريان الايسر الرئيسي غير المحمي. الهدف: لتقييم نسبة عدم التوافق بين القرار السريري لاختصاصي القلبية وتوصيات درجة السنتاكس ٢ بالنسبة لخطة العلاج في المرضى المصابين بآمراض شرايين القلب التاجية المعقدة مع او بدون امراض الشريان الايسر الرئيسي غير المحمي.                        طرائق البحث: يتم جمع معلومات المرضى اللذين يخضعون لاجراء القسطرة التشخيصية لشرايين القلب في صالات القسطرة في مدينة الطب وتتم متابعة المرضى ايضا وتكون مدة الدراسة للفترة من شهر كانون الثاني لسنة ٢٠١٤م الى شهر تشرين الثاني لسنة ٢٠١٥م وخلال هذه الفترة يتم تقييم المرضى عن طريق درجة السنتاكس ٢ وست متغيرات سريرية للتنبؤ بآحتمالية حدوث الوفاة خلال الاربع سنوات بعد عودة التوعي ومقارنتها مع القرار السريري لاختصاصي القلبية. ثم بعد مرور سنة على جمع الداتا، نقوم بمتابعة حالة المرضى عن طريق الاتصال الهاتفي لمعرفة إذا حدثت حالات الوفاة. يتم تقسيم المرضى الى ٣ مجاميع، المجموعة الاولى والتي تخضع للتداخل القسطاري، المجموعة الثانية والتي تخضع لعملية جراحية لزرع شرايين القلب، والمجموعة الثالثة والتي لديها احتمالية للخضوع للقسطرة او للعملية الجراحية.     النتائج: تم اشراك مئتا مريض في الدراسة، معدل العمر ٦٠.٢٣ ± ٩.٨٣٦سنة، ١٥٧ (٧٨.٥٪) من المرضى ذكور. بالاعتماد على القرار السريري لاختصاصي القلبية تم تحديد ٧١ (٣٥.٥٪) من المرضى للخضوع للتداخل القسطاري (المجموعة الاولى)، ١١٩ (٥٩.٥٪) من المرضى تم ارسالهم لاجراء عملية جراحية (المجموعة الثانية) وبقية المرضى ١٠ (٥٪) تم ادراجهم تحت احتمالية خضوعهم للتداخل القسطاري او العملية الجراحية. بالنسبة لتققيم حالة الوفاة للاربع سنوات بالاعتماد على درجة السنتاكس ٢، كانت النتيجة ان العلاج المفضل هو العمليات الجراحية وبنسبة ٣٣.٥٪، في حين ان نسبة المرضى الخاضعين للتداخل القسطاري كانت ١٥٪، وكانت النسبة متوازية بالنسبة للمرضى الخاضعين للعمليات الجراحية او التداخل القسطاري ٥١.٥٪. كان هنالك توافق بين القرار السريري لاختصاصي القلبية ودرجة السنتاكس ٢ وبنسبة ٣٣.٥٪، في حين ان نسبة عدم التوافق للمرضى كانت ٦٦.٥٪. خلال سنة واحدة توفي ستة مرضى ومعضمهم كانوا من مجموعة عدم التوافق.                  الاستنتاج: هذه الدراسة اظهرت عدم توافق هام بين توصيات درجة السنتاكس ٢ والقرار السريري لاختصاصي القلبية.

scholarly journals Relationship between the Deformation Properties of the Left Ventricle and the Severity of Coronary Atherosclerosis in Patients with Coronary Artery Disease

2021 ◽  
Vol 11 (2) ◽  
pp. 131-136
Author(s):  
F. Bekmetova ◽  
Kh. Fozilov ◽  
Sh. Doniyorov ◽  
R. Alieva ◽  
M. Mukhamedova ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diagnostic Value ◽  
Left Ventricular ◽  
Syntax Score ◽  
Deformation Properties ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

The purpose of this study was to assess the properties of left ventricular myocardial deformation in patients with coronary artery disease (CAD) with various degrees of coronary lesions. Methods and Results: The study included 74 patients with stable angina pectoris Class II-IV aged between 40 and 70 years. All patients underwent the following examinations: assessment of traditional risk factors, physical examination, general clinical and laboratory blood tests, 12-lead ECG, 24-hour ABPM, transthoracic echocardiography, two-dimensional speckle tracking echocardiography (STE), and coronary angiography (CAG). The SYNTAX score was calculated retrospectively according to the SYNTAX score algorithm. All patients were divided into 3 groups: Group 1 included 21 patients with a low SYNTAX score (0–22), for whom standard drug therapy was recommended; Group 2 included 28 patients with an intermediate SYNTAX score (23–32), to whom PCI was recommended; Group 3 included 25 patients with a high SYNTAX score (≥33), to whom CABG was recommended. Left ventricular ejection fraction (LVEF) obtained using the modified biplane Simpson's method was significantly lower in Group 3 than in Groups 1 and 2 (P=0.001); it should be noted that this indicator was within the normative values in Groups 1 and 2, and belonged to the gradation “mild dysfunction.” A more objective quantitative assessment of the contractile function of the LV myocardium was obtained by assessing the GLS and SR. The comparative analysis of the LV myocardial deformation properties in the three studied groups showed that in Group 3 the GLS and SR indicators were significantly lower than in Group 1 (P=0.000 and P=0.0020). Moreover, GLS (global longitudinal strain) and SR (strain rate) were significantly higher in Group 1 than in Group 2 (P=0.0001 and P=0.0133, respectively). GLS significantly correlated with LVEF (r=0.57; P<0.05), E/A (r=0.22; P<0.05), and SYNTAX score (r=-0.63; P<0.05). SR significantly correlated with LVEF (r=0.49; P<0.05) and SYNTAX score (r=-0.37; P<0.05) Conclusion: The results obtained indicate the diagnostic value of STE with the determination of GLS and SR in a comprehensive assessment of the severity of SAD. GLS and SR significantly correlate with the clinical course of the disease, as well as indicators of LV remodeling and LV diastolic dysfunction. STE analysis of GLS and SR has incremental diagnostic value over transthoracic echocardiography in predicting significant CAD.

scholarly journals Effect of clonidine and gabapentin as oral premedication on hemodynamic response to laryngoscopy and tracheal intubation

2018 ◽  
Vol 6 (12) ◽  
pp. 3819
Author(s):  
Prabhati R. Mishra ◽  
Manmaya Padhy ◽  
Rusikesh Satapathy ◽  
Monali Kar
Keyword(s):  
Blood Pressure ◽  
Endotracheal Intubation ◽  
Hemodynamic Response ◽  
Oral Clonidine ◽  
Arterial Blood ◽  
Induction Group ◽  
Group 3 ◽  
Group 2 ◽  
Oral Premedication ◽  
Group 1

Background: Laryngoscopy and endotracheal intubation causes stimulation of symphatho-adrenal system resulting in increase in blood pressure and heart rate. The present study compared oral clonidine, gabapentin and placebo premedication in attenuating haemodynamic response to laryngoscopy and endotracheal intubation.Methods: About 90 adult patients of ASA grade I and II patients in age group of 18-60 yrs, of either sex posted for surgery under general anaesthesia were randomly divided into three groups (30 patients in each group). The study drugs were given orally 90minutes before induction. Group 1 and Group 2 were pre treated with oral clonidine (0.2mg) and gabapentin (800mg) respectively and Group-3 received placebo. The HR, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were recorded before induction of anesthesia and 1, 3, 5, 10min after laryngoscopy and intubation.Results: It was found that both clonidine and gabapentin reduces HR, SBP, DBP, MAP than placebo group at lminute, 3minutes, 5minutes and 10minutes after intubation. But reduction is more with clonidine as compared to gabapentine and difference was statistically significant (P = <0.0001).Conclusions: Both oral clonidine and gabapentine attenuate hemodynamic response to laryngoscopy and endotracheal intubation but effect is better with clonidine than oral gabapentine.

Abnormal Haemostasis and Blood Viscosity in Malignant Hypertension

1984 ◽  
Vol 52 (03) ◽  
pp. 253-255 ◽  
Author(s):  
C Isles ◽  
G D O Lowe ◽  
B M Rankin ◽  
C D Forbes ◽  
N Lucie ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Viscosity ◽  
Renal Damage ◽  
Antithrombin Iii ◽  
Plasma Viscosity ◽  
Malignant Hypertension ◽  
Fibrin Deposition ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

SummaryWe have previously shown abnormalities of haemostasis suggestive of intravascular coagulation in patients with malignant hypertension, a condition associated with retinopathy and renal fibrin deposition. To determine whether such abnormalities are specific to malignant hypertension, we have measured several haemostatic and haemorheological variables in 18 patients with malignant hypertension (Group 1), 18 matched healthy controls (Group 2), and 18 patients with non-malignant hypertension (Group 3) matched for renal pathology, blood pressure and serum creatinine with Group 1. Both Groups 1 and 3 had increased mean levels of fibrinogen, factor VIIIc, beta-thrombo- globulin, plasma viscosity and blood viscosity (corrected for haematocrit); and decreased mean levels of haematocrit, antithrombin III and platelet count. Mean levels of fast antiplasmin and alpha2-macroglobulin were elevated in Group 1 but not in Group 3. We conclude that most blood abnormalities are not specific to malignant hypertension; are also present in patients with non-malignant hypertension who have similar levels of blood pressure and renal damage; and might result from renal damage as well as promoting further renal damage by enhancing fibrin deposition. However increased levels of fibrinolytic inhibitors in malignant hypertension merit further investigation in relation to removal of renal fibrin.

Analysis of the quality of early diagnostics of cardiovascular diseases in students of educational institutions of Khabarovsk (according to the data of preventive examinations)

2020 ◽  
pp. 13-16
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Diseases ◽  
Sinus Tachycardia ◽  
Blood Pressure Level ◽  
Educational Institutions ◽  
Conduction Disturbances ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

To identify the prevalence of early pathology of cardiovascular diseases, a survey of 400 200 girls) in the age group 15 and 17 years old was conducted as a part of routine medical of the level of blood pressure (BP) was carried out, with the calculation of the average level pressure on the basis of three separate measurements estimated by percentile tables for a registration of a standard resting ECG in 12 leads. According to the results of the survey, into 3 groups: with an increase in blood pressure above 95 ‰ (group 1 – 16 people), which recorded in males (p<0,05); Group 2 (67 people) – adolescents with a normal blood pressure level and group 3 of adolescents with a decrease in blood pressure below 5 ‰ changes in the form of rhythm and conduction disturbances were noted in almost every a predominance of sinus tachycardia in the first group. In the third group of adolescents, form of ectopic rhythm and pacemaker migration were significantly more frequently only 78 % of adolescents were referred for consultation and in-depth examination by a pediatric cardiologist.

scholarly journals Hypertrophy of unaffected cardiomyocytes correlates with severity of cardiomyopathy in female patients with Fabry disease

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Cristina Chimenti ◽  
Romina Verardo ◽  
Andrea Frustaci
Keyword(s):  
Fabry Disease ◽  
Wall Thickness ◽  
Left Ventricular ◽  
Female Patients ◽  
Maximal Wall Thickness ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Aim To investigate the contribution of unaffected cardiomyocytes in Fabry disease cardiomyopathy. Findings Left ventricular (LV) endomyocardial biopsies from twenty-four females (mean age 53 ± 11 ys) with Fabry disease cardiomyopathy were studied. Diagnosis of FD was based on the presence of pathogenic GLA mutation, Patients were divided in four groups according with LV maximal wall thickness (MWT): group 1 MWT ≤ 10.5 mm, group 2 MWT 10.5–15 mm, group 3 MWT 16–20 mm, group 4 MWT > 20 mm. At histology mosaic of affected and unaffected cardiomyocytes was documented. Unaffected myocytes’ size ranged from normal to severe hypertrophy. Hypertrophy of unaffected cardiomyocytes correlated with severity of MWT (p < 0.0001, Sperman r 0,95). Hypertrophy of unaffected myocytes appear to concur to progression and severity of FDCM. It is likely a paracrine role from neighboring affected myocytes.

Comparison of the ATRIA, CHA2DS2-VASc, and Modified Scores ATRIA-HSV, CHA2DS2-VASc-HS, for the Prediction of Coronary Artery Disease Severity

Angiology ◽  
2021 ◽  
pp. 000331972199141
Author(s):  
Arafat Yildirim ◽  
Mehmet Kucukosmanoglu ◽  
Fethi Yavuz ◽  
Nermin Yildiz Koyunsever ◽  
Yusuf Cekici ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Vascular Disease ◽  
Operating Characteristics ◽  
Coronary Artery Disease Severity ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Many parameters included in the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke, vascular disease, age 65-74 years, sex category) scores also predict coronary artery disease (CAD). We modified the ATRIA score (ATRIA-HSV) by adding hyperlipidemia, smoking, and vascular disease and also male sex instead of female. We evaluated whether the CHA2DS2-VASc, CHA2DS2-VASc-HS, ATRIA, and ATRIA-HSV scores predict severe CAD. Consecutive patients with coronary angiography were prospectively included. A ≥50% stenosis in ≥1epicardial coronary artery (CA) was defined as severe CAD. Patient with normal CA (n = 210) were defined as group 1, with <50% CA stenosis (n = 178) as group 2, and with ≥50% stenosis (n = 297) as group 3. The mean ATRIA, ATRIA-HSV, CHA2DS2-VASc, and CHA2DS2VASc-HS scores increased from group 1 to group 3. A correlation was found between the Synergy between PCI with Taxus and Cardiac Surgery score and ATRIA ( r = 0.570), ATRIA-HSV ( r = 0.614), CHA2DS2-VASc ( r = 0.428), and CHA2DS2-VASc-HS ( r = 0.500) scores ( Ps < .005). Pairwise comparisons of receiver operating characteristics curves showed that ATRIA-HSV (>3 area under curve [AUC]: 0.874) and ATRIA (>3, AUC: 0.854) have a better performance than CHA2DS2-VASc (>1, AUC: 0.746) and CHA2DS2-VASc-HS (>2, AUC: 0.769). In conclusion, the ATRIA and ATRIA-HSV scores are simple and may be useful to predict severe CAD.

scholarly journals Intracoronary Injection of Autologous CD34+ Cells Improves One-Year Left Ventricular Systolic Function in Patients with Diffuse Coronary Artery Disease and Preserved Cardiac Performance—A Randomized, Open-Label, Controlled Phase II Clinical Trial

2020 ◽  
Vol 9 (4) ◽  
pp. 1043 ◽  
Author(s):  
Pei-Hsun Sung ◽  
Yi-Chen Li ◽  
Mel S. Lee ◽  
Hao-Yi Hsiao ◽  
Ming-Chun Ma ◽  
...  
Keyword(s):  
Systolic Function ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Diffuse Coronary Artery Disease ◽  
Cd34 Cells ◽  
Group 2 ◽  
Artery Disease ◽  
One Year ◽  
Lv Systolic Function ◽  
Group 1

This phase II randomized controlled trial tested whether intracoronary autologous CD34+ cell therapy could further improve left ventricular (LV) systolic function in patients with diffuse coronary artery disease (CAD) with relatively preserved LV ejection fraction (defined as LVEF >40%) unsuitable for coronary intervention. Between December 2013 and November 2017, 60 consecutive patients were randomly allocated into group 1 (CD34+ cells, 3.0 × 107/vessel/n = 30) and group 2 (optimal medical therapy; n = 30). All patients were followed for one year, and preclinical and clinical parameters were compared between two groups. Three-dimensional echocardiography demonstrated no significant difference in LVEF between groups 1 and 2 (54.9% vs. 51.0%, respectively, p = 0.295) at 12 months. However, compared with baseline, 12-month LVEF was significantly increased in group 1 (p < 0.001) but not in group 2 (p = 0.297). From baseline, there were gradual increases in LVEF in group 1 compared to those in group 2 at 1-month, 3-months, 6-months and 12 months (+1.6%, +2.2%, +2.9% and +4.6% in the group 1 vs. −1.6%, −1.5%, −1.4% and −0.9% in the group 2; all p < 0.05). Additionally, one-year angiogenesis (2.8 ± 0.9 vs. 1.3 ± 1.1), angina (0.4 ± 0.8 vs. 1.8 ± 0.9) and HF (0.7 ± 0.8 vs. 1.8 ± 0.6) scores were significantly improved in group 1 compared to those in group 2 (all p < 0.001). In conclusion, autologous CD34+ cell therapy gradually and effectively improved LV systolic function in patients with diffuse CAD and preserved LVEF who were non-candidates for coronary intervention (Trial registration: ISRCTN26002902 on the website of ISRCTN registry).

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