3,075 research outputs found
Noninvasive detection of accelerated stenotic flow in the entire left anterior descending coronary artery provides insights into the causes of impaired coronary flow reserve
No full textReduced microvascular and myocardial damage in patients with acute myocardial infarction and preinfarction angina
No full textBackground After acute myocardial infarction, the presence of ischemic preconditioning as a result of preinfarction angina has a protective role, limiting necrosis extent and guaranteeing greater myocardial functional recovery. The rela- tionship between preinfarction angina, microvascular reflow, and myocardial function is poorly known. We hypothesized that after acute myocardial infarction patients with preinfarction angina have both microvascular integrity and myocardial function preservation.
Methods and Results In 51 patients with a first acute myocardial infarction, we noninvasively assessed micro- vascular perfusion and coronary flow reserve with intravenous myocardial contrast echocardiography and investigated myocardial contractile recovery with low-dose dobutamine and 90-day follow-up echocardiography. Typical angina was present in 25 patients and absent in 26 patients during the 7 days preceding the myocardial infarction. Compared with those patients without preinfarction angina, patients with preinfarction angina showed a greater microvascular reflow ex- tent and coronary flow reserve (respectively, 25.2% 22.8% vs 48.3% 23.3%, P .05, and 3.44 0.75 vs
1.95 0.67, P .0001), a better regional myocardial function, as expressed with wall motion score index in the risk area at dobutamine (1.67 0.61 vs 2.10 0.43, P .005) and at follow-up (1.72 0.56 vs 2.22 0.40, P .0001) echocardiogram, despite being similar in the first echocardiogram (2.60 0.28 vs 2.63 0.28, P not signifi- cant), and significantly less pronounced left ventricular dilation at follow-up.
Conclusion Presence of preinfarction angina, because of the preconditioning effect, reduces myocardial damage and favors myocardial viability, limiting left ventricular remodeling. This beneficial effect seems to be at least partly medi- ated by the more preserved microvascular integrity and functional vasodilation after acute myocardial infarctio
Quantification of left ventricular function with contrast-enhanced harmonic colour Doppler and a semiautomated boundary detection algorithm in technically difficult patients: feasibility, accuracy, and inter-observer variability
No full textAims: Patients with poor quality echocardiograms impede the application of available automatic boundary detection technologies. Tissue harmonic imaging and contrast media can allow optimal differentiation of left ventricular blood pool and tissue, making it possible to utilize automatic boundary detection software for automatic non-operator- dependent computation of left ventricular volumes. We integrated contrast-enhanced harmonic colour Doppler with a semiautomated boundary detection algorithm to explore the feasibility, accuracy and inter-observer vari- ability for left ventricular volume assessment in technically difficult patients.
Methods and results: Twenty-six patients with more than two segments not clearly visualized in tissue harmonic imaging were studied with contrast-enhanced harmonic colour Doppler using Levovist. Twenty patients (77%) achieved full left ventricular contrast filling without appar- ent blooming artefacts. Contrast-enhanced harmonic colour Doppler-automatic boundary detection was success- fully implemented in these 20 patients, despite three (15%) in which it was not possible to acquire more than three cardiac cycles’ values. Contrast-enhanced harmonic colour Doppler-automatic boundary detection measurements
agreed closely with the manually drawn data. Among the three independent readers in the three techniques, the best correlation, lowest SEE, smallest limits of agreement and inter-observer variability were obtained in contrast- enhanced harmonic colour Doppler-automatic boundary detection.
Conclusion: Contrast-enhanced harmonic colour Doppler-automatic boundary detection was feasible and accurate in estimation of left ventricular volume and func- tion in patients with poor acoustic windows. This technique significantly reduced inter-observer variability, thus im- proving reliability and confidence of investigators in left ventricular function assessment. Contrast-enhanced har- monic colour Doppler-automatic boundary detection may have great potential in clinical evaluation of left ventricular volume and function, especially when on-line software is available
REDUCED MICROVASCULAR AND MYOCARDIAL DAMAGE IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND PREINFARCTION ANGINA.
No full text- Marble slab with a Persian inscription of Jahāngīr dated AH 1027
No full textMarble slab with a Persian inscription of Jahāngīr dated AH 102
Intravenous adenosine during coronary flow reserve assessment: is 90-second infusion sufficient for maximal coronary vasodilatation?
No full textCoronary steal detected noninvasively by contrast-enhanced transthoracic harmonic color Doppler echocardiography
No full textEvaluation of microvascular reperfusion by ST segment resolution and coronary flow reserve after recanalized acute anterior myocardial infarction
No full textCoronary flow reserve is correlated with no-reflow phenomenon and has predictive value of myocardial viability in patients with reperfused acute anterior myocardial infarction
No full textA new reading for the Abbasid dinar in the name of caliph Al-Mu tamid Ala Allah (AH 256-279) minted in Al-Ma Suq 271 AH
No full textThe case of a dinar minted ill 271 AH recording the he Caliph
al-Mu'tainid 'ala Allah (256-279 AH), al-Mufawwatj ila Allah (256-278 H),
and an enigmatic mint place is discussed in the paper. The Author attempts to
offer a new reading of the toponym of the mint using literary sources. The love
story between al-Mu'tamid and a Bedouin girl, seems to unveil the identity of
the mysterious mint
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