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1

Use of echocardiography for predicting myocardial viability in patients with reperfused anterior wall myocardial infarction  

Microsoft Academic Search

Dobutamine stress echocardiography (DSE), myocardial contrast echocardiography (MCE), and ultrasonic tissue characterization with integrated backscatter are useful methods for assessing myocardial viability in acute myocardial infarction. In this study, we compared the potential of 3 methods for predicting myocardial viability in 38 patients with reperfused anterior wall acute myocardial infarction. We performed MCE shortly after coronary reperfusion with an intracoronary

Katsuomi Iwakura; Hiroshi Ito; Nagahiro Nishikawa; Ken Sugimoto; Yasunori Shintani; Koichi Yamamoto; Yorihiko Higashino; Tohru Masuyama; Masatsugu Hori; Kenshi Fujii

2000-01-01

2

Temporal changes in regional end-diastolic wall thickness early after reperfusion in acute anterior myocardial infarction: Relation to myocardial viability and vascular damage  

Microsoft Academic Search

We investigated early temporal changes in end-diastolic wall thickness (EDWT) of the infarcted myocardium in 46 patients with reperfused anterior acute myocardial infarction in relation to myocardial viability. Two-dimensional echocardiography was performed on days 1 and 2 of acute myocardial infarction, and the EDWT of the anterior segment was measured in the short-axis view. Patients were divided into three groups

Hidemasa Oh; Hiroshi Ito; Katsuomi Iwakura; Tohru Masuyama; Shin Takiuchi; Atsushi Maruyama; Yorihiko Higashino; Kenshi Fujii; Junichi Azuma; Takazo Minamino

1996-01-01

3

Relationship between myocardial viability and the predischarge electrocardiographic pattern in patients with first anterior wall acute myocardial infarction  

Microsoft Academic Search

Background: The assessment of residual viability in the infarcted area after an acute myocardial infarction is relevant to subsequent management and prognosis. Objective: The aim of this study was to investigate the correlation between myocardial viability after an acute anterior myocardial infarction (AMI) as assessed by low dose dobutamine stress echocardiography (LDDSE) and the electrocardiographic patterns of ST segment and

Ramazan Atak; Hasan Turhan; Kubilay Senen; Mehmet Ileri; Ertan Yetkin; Cemal Ozbakir; Deniz Demirkan

2003-01-01

4

Left ventricular assist device implantation after acute anterior wall myocardial infarction and cardiogenic shock: A two-center study  

Microsoft Academic Search

Objective: Left ventricular assist device (LVAD) insertion after anterior wall myo- cardial infarction complicated by cardiogenic shock is an accepted modality of support in select patients. Results of primary revascularization for these patients are poor. We seek to determine the outcomes of patients with myocardial infarction and shock who undergo LVAD insertion alone versus surgical revascularization before LVAD insertion. Methods:

Nicholas C. Dang; Veli K. Topkara; Marzia Leacche; Ranjit John; John G. Byrne; Yoshifumi Naka

5

Acute Inferior Wall Myocardial Infarction due to Occlusion of the Wrapped Left Anterior Descending Coronary Artery  

PubMed Central

Acute occlusion of the left anterior descending coronary artery (LAD) generally results in ST segment elevations in precordial leads and reciprocal ST segment depression in inferior leads. The occurrence of isolated inferior myocardial infarction due to occlusion of LAD is very rare. We describe an isolated acute inferior myocardial infarction due to occlusion of a wrapped LAD at the apex which continues as the large posterior descending coronary artery (PDA) beyond the occlusion.

Sunil Roy, Thottuvelil Narayanan; Nagham, Jafar Saeed; Anil Kumar, Rajappan

2013-01-01

6

Intravenous nicorandil can preserve microvascular integrity and myocardial viability in patients with reperfused anterior wall myocardial infarction  

Microsoft Academic Search

OBJECTIVESWe assessed whether the intravenous administration of nicorandil, an adenosine triphosphate (ATP)-sensitive K+ channel opener, exerts beneficial effect on microvascular function and functional and clinical outcomes in patients with acute myocardial infarction (AMI).BACKGROUNDExperimental studies documented that ATP-sensitive K+ channel opener exerts cardioprotection after prolonged ischemia.METHODSWe randomly divided 81 patients with a first anterior AMI into two groups, nicorandil (n =

Hiroshi Ito; Yoshiaki Taniyama; Katsuomi Iwakura; Nagahiro Nishikawa; Tohru Masuyama; Tsunehiko Kuzuya; Masatsugu Hori; Yorihiko Higashino; Kenshi Fujii; Takazo Minamino

1999-01-01

7

Pseudosepsis after myocardial infarction. Unusual presentation of anterior wall rupture and left ventricular pseudoaneurysm.  

PubMed

Left ventricular pseudoaneurysm complicating myocardial infarction is extremely rare. A case of left ventricular anterolateral pseudoaneurysm with its initial presentation mimicking septic shock is reported. The need for urgent resection is stressed due to the high incidence of spontaneous rupture and death regardless of the age or the size of the pseudoaneurysm. PMID:3661592

McCriskin, J W; Baisden, C E; Spaccevento, L J; Breisblatt, W M

1987-09-01

8

Left ventricular rupture in an anterior wall acute myocardial infarction with severe intra-ventricular gradient.  

PubMed

We report the case of a 72-year-old man with ST-elevation acute myocardial infarction and severe intra-ventricular gradient (>40 mmHg), who died with left ventricular rupture (LVR). We postulate that severe intra-ventricular gradient detectable at admission may be related to subsequent LVR and proposed as a risk factor for LVR. PMID:22143246

Brunetti, Natale Daniele; Ieva, Riccardo; Correale, Michele; Di Martino, Luigi Flavio Massimiliano; De Gennaro, Luisa; Di Biase, Matteo

2012-02-01

9

Regional wall motion abnormality in apical ballooning syndrome (Takotsubo/stress cardiomyopathy): importance of biplane left ventriculography for differentiating from spontaneously aborted anterior myocardial infarction.  

PubMed

Understanding the precise distribution of the regional wall motion abnormality (RWMA) in apical ballooning syndrome (ABS) is important because the cardiomyopathy can mimic an acute anterior ST-elevation myocardial infarction (STEMI). The aim of the study was to quantify the severity and distribution of RWMA in ABS, compare it to anterior STEMI, and correlate with clinical features. RWMA (normal = 1, hypokinetic = 2, akinetic = 3) was quantified from the biplane left ventriculogram using a nine-segment model in 95 ABS and 17 anterior STEMI patients at the time of their presentation. Regional wall motion score index (RWMSI) was higher in ABS [2.1 (1.9, 2.1)] compared to anterior STEMI [2.0 (1.8, 2.0)], P = 0.024]. The region that most clearly differentiated ABS from anterior STEMI was the posterolateral segment (sensitivity 81% and specificity 100%) which was hypocontractile in 81% of ABS, but none of the STEMI patients (P < 0.001). RWMSI in ABS had a modest positive correlation with the troponin T levels (r = 0.23, P = 0.029). Patients with ABS with ST-segment elevation had the highest RWMSI [2.1(2.0, 2.2)], while those with non specific changes had the lowest [1.9 (1.8, 2.1)] (P = 0.007). In conclusion, patients with ABS have greater and more diffuse RWMA compared to anterior STEMI. The presence of systolic dysfunction in the posterolateral segment in the left anterior oblique projection of the left ventriculogram most accurately distinguishes ABS from an anterior STEMI highlighting the utility of biplane angiography for this purpose. The severity of RWMA correlates with the extent of troponin release and ECG abnormality. PMID:21688133

Patel, Sandeep M; Lennon, Ryan J; Prasad, Abhiram

2012-04-01

10

Early results of a novel technique for anterior vaginal wall prolapse repair: anterior vaginal wall darn  

PubMed Central

Background The aim of this study was to describe the results of a 1-year patient follow-up after anterior vaginal wall darn, a novel technique for the repair of anterior vaginal wall prolapse. Methods Fifty-five patients with anterior vaginal wall prolapse underwent anterior vaginal wall darn. The anterior vaginal wall was detached using sharp and blunt dissection via an incision beginning 1 cm proximal to the external meatus and extending to the vaginal apex. The space between the tissues that attach the lateral vaginal walls to the arcus tendineus fasciae pelvis was then darned. Cough Stress Test, Pelvic Organ Prolapse Quantification, seven-item Incontinence Impact Questionnaire, and six-item Urogenital Distress Inventory scores were performed 1-year postoperatively to evaluate recovery. Results One-year postoperatively, all patients were satisfied with the results of the procedure. No patient had vaginal mucosal erosion or any other complication. Conclusions One-year postoperative findings for patients in this series indicate that patients with stage II–III anterior vaginal wall prolapse were successfully treated with the anterior vaginal wall darn technique.

2014-01-01

11

Desmoid tumours of the anterior abdominal wall  

Microsoft Academic Search

Aims:To review the surgical management and outcomes for large desmoid tumours of the abdominal wall.Methods:Seven patients with large desmoid tumours of the anterior abdominal wall were treated by wide local excision and reconstruction with two layers of Marlex V mesh (Bard, Galway, Ireland).Results:No patient having initial surgery at this hospital has either a significant residual functional deficit or developed a

R. J. Sutton; J. M. Thomas

1999-01-01

12

Intraperitoneal haemorrhage from anterior abdominal wall varices.  

PubMed Central

Patients with oesophageal varices frequently present with gastrointestinal haemorrhage but bleeding from varices at other sites is rare. We present a patient with hepatitis C-induced cirrhosis and partial portal vein occlusion who developed spontaneous haemorrhage from anterior abdominal wall varices into the rectus abdominus muscle and peritoneal cavity. Images Figure 1

Hunt, J. B.; Appleyard, M.; Thursz, M.; Carey, P. D.; Guillou, P. J.; Thomas, H. C.

1993-01-01

13

Flap Coverage of Anterior Abdominal Wall Defects  

PubMed Central

Reconstruction of complex defects of the anterior abdomen is both challenging and technically demanding for reconstructive surgeons. Advancements in the use of pedicle and free tissue transfer along with the use of bioprosthetic and synthetic meshes have provided for novel approaches to these complex defects. Accordingly, detailed knowledge of abdominal wall and lower extremity anatomy in combination with insight into the design, implementation, and limitations of various flaps is essential to solve these complex clinical problems. Although these defects can be attributed to a myriad of etiologic factors, the objectives in abdominal wall reconstruction are consistent and include the restoration of abdominal wall integrity, protection of intraabdominal viscera, and the prevention of herniation. In this article, the authors review pertinent anatomy and the various local, regional, and distant flaps that can be utilized in the reconstruction of these complex clinical cases of the anterior abdomen.

Sacks, Justin M.; Broyles, Justin M.; Baumann, Donald P.

2012-01-01

14

A Novel Technique for Anterior Vaginal Wall Prolapse Repair: Anterior Vaginal Wall Darn  

PubMed Central

Aim. The aim of this study is to introduce a new technique, anterior vaginal wall darn (AVWD), which has not been used before to repair the anterior vaginal wall prolapse, a common problem among women. Materials and Methods. Forty-five women suffering from anterior vaginal wall prolapse were operated on with a new technique. The anterior vaginal wall was detached by sharp and blunt dissection via an incision beginning from the 1?cm proximal aspect of the external meatus extending to the vaginal apex, and the space between the tissues that attach the lateral walls of the vagina to the arcus tendineus fascia pelvis (ATFP) was then darned. Preoperation and early postoperation evaluations of the patients were conducted and summarized. Results. Data were collected six months after operation. Cough stress test (CST), Pelvic Organ Prolapse Quantification (POP-Q) evaluation, Incontinence Impact Questionnaire (IIQ-7), and Urogenital Distress Inventory (UDI-6) scores indicated recovery. According to the early postoperation results, all patients were satisfied with the operation. No vaginal mucosal erosion or any other complications were detected. Conclusion. In this initial series, our short-term results suggested that patients with grade II-III anterior vaginal wall prolapsus might be treated successfully with the AVWD method.

Kose, Osman; Saglam, Hasan S.; Kumsar, Sukru; Budak, Salih; Adsan, Oztug

2013-01-01

15

Significance of U wave polarities in previous anterior myocardial infarction  

SciTech Connect

The significance of the polarity of U waves in left precordial leads was evaluated in relation to myocardial perfusion (T1 201 myocardial scintigraphy) and left ventricular function (99m Tc radionuclide ventriculography) in 63 patients with clinical and electrocardiographic evidence of a previous anterior myocardial infarction. Patients were divided into three groups according to the polarity of the U waves: positive U waves, flat U waves, and negative U waves. Twelve matched patients served as normal controls. The following parameters were analyzed: (1) total number of abnormal Q waves; (2) total myocardial perfusion index and regional myocardial perfusion index; (3) global ejection fraction; (4) regional ejection fraction; and (5) number of diseased coronary arteries. The total myocardial perfusion index values were 43.9 {plus minus} 1.0 in controls, 40.8 {plus minus} 3.4 in the positive U wave group, 33.4 {plus minus} 3.5 in the flat U wave group, and 30.3 {plus minus} 4.4 in the patients with negative U waves. Global ejection fractions in these groups were, respectively, 63.9 {plus minus} 8.6%, 65.0 {plus minus} 11.8%, 53.6 {plus minus} 8.1%, and 36.5 {plus minus} 13.6%. The sensitivity of negative U waves suggesting a global ejection fraction of less than 45% was 91.6%, and the specificity was 82.1%. Therefore the size of myocardial infarction increased and left ventricular function decreased, in order, from patients with positive U waves, to those with flat U waves, to those with negative U waves, with statistically significant differences.

Kanemoto, N.; Imaoka, C.; Suzuki, Y. (Department of Internal Medicine, Tokai University School of Medicine, Kanagawa (Japan))

1991-04-01

16

Imaging electrical excitation inside the myocardial wall  

PubMed Central

Cardiac arrhythmias are often triggered by ectopic membrane depolarization originating deep inside the myocardial wall. Here we propose a new method utilizing a novel near-infrared voltage-sensitive fluorescent dye DI-4-ANBDQBS to determine the three-dimensional (3D) coordinates of the sources of such depolarization. We tested the method in live preparations of pig left and right ventricular myocardium (thickness 8-18 mm) and phantoms imitating the optical properties of myocardial tissue. The method utilizes an alternating transillumination approach that involves comparing pairs of simultaneously recorded broad-field epifluorescence and transillumination images produced at two alternating directions of illumination. Recordings were taken simultaneously by two CCD cameras facing the endocardial and epicardial surfaces of the heart at a frame rate up to 3 KHz. In live preparations, we were able to localize the origin of the depolarization wave with a precision of ±1.3mm in the transmural direction and 3 mm in the image plane. The accuracy of detection was independent of the depth of the source inside ventricular wall.

Mitrea, Bogdan G; Caldwell, Bryan J; Pertsov, Arkady M

2011-01-01

17

Index of microcirculatory resistance as predictor for microvascular functional recovery in patients with anterior myocardial infarction.  

PubMed

IMR is useful for assessing the microvascular dysfunction after primary percutaneous coronary intervention (PCI). It remains unknown whether index of microcirculatory resistance (IMR) reflects the functional outcome in patients with anterior myocardial infarction (AMI) with or without microvascular obstruction (MO).This study was performed to evaluate the clinical value of the IMR for assessing myocardial injury and predicting microvascular functional recovery in patients with AMI undergoing primary PCI. We enrolled 34 patients with first anterior AMI. After successful primary PCI, the mean distal coronary artery pressure (P(a)), coronary wedge pressure (P(cw)), mean aortic pressure (P(a)), mean transit time (T(mn)), and IMR (P(d)* hyperemic T(mn)) were measured. The presence and extent of MO were measured using cardiac magnetic resonance image (MRI). All patients underwent follow-up echocardiography after 6 months. We divided the patients into two groups according to the existence of MO (present; n = 16, absent; n = 18) on MRI. The extent of MO correlated with IMR (r = 0.754; P < 0.001), P(cw) (r = 0.404; P = 0.031), and P(cw)/P(d) of infarct-related arteries (r = 0.502; P = 0.016). The IMR was significantly correlated with the ?Regional wall motion score index (r = -0.61, P < 0.01) and ?Left ventricular ejection fraction (r = -0.52, P < 0.01), implying a higher IMR is associated with worse functional improvement. Therefore, Intracoronary wedge pressures and IMR, as parameters for specific and quantitative assessment of coronary microvascular dysfunction, are reliable on-site predictors of short-term myocardial viability and Left ventricle functional recovery in patients undergoing primary PCI for AMI. PMID:22969250

Yoo, Seung-Hoon; Yoo, Tae-Kyung; Lim, Hong-Seok; Kim, Mi-Young; Koh, Jong-Hoon

2012-09-01

18

Precordial ST-Segment Depression in Inferior Myocardial Infarction is Associated with Slow Flow in the Non-Culprit Left Anterior Descending Artery  

Microsoft Academic Search

Background: Anterior precordial ST-segment depression (APSTD) is common in the setting of inferior myocardial infarction (IMI). The presence of APSTD correlates with increased risk of adverse outcomes in patients with acute IMI as well as more myocardium at risk as assessed by sestamibi, larger infarcts, lower ejection fractions, and more severe wall motion abnormalities in the infarct region. The ECG

C. Michael Gibson; Michael Chen; Brad G. Angeja; Sabina A. Murphy; Susan J. Marble; Hal V. Barron; Christopher P. Cannon

2002-01-01

19

Assessment of left ventricular volume and mass by cine magnetic resonance imaging in patients with anterior myocardial infarction intra-observer and inter-observer variability on contour detection  

Microsoft Academic Search

Remodeling of the left ventricle after myocardial infarction can be documented by calculation of left ventricular volume and mass, using endocardial and epicardial tracings of multilevel multiphase short-axis cine magnetic resonance (MR) imaging series. We assessed left ventricular volume and mass from 8 slices and during 12 phases of the cardiac cycle in seven patients with an anterior wall myocardial

Niels A. A. Matheijssen; Leo H. B. Baur; Johan H. C. Reiber; Edo A. van der Velde; Paul R. M. van Dijkman; Rob J. van der Geest; Albert de Roos; Ernst E. van der Wall

1996-01-01

20

Contained Left Ventricular Free Wall Rupture following Myocardial Infarction  

PubMed Central

Rupture of the free wall of the left ventricle occurs in approximately 4% of patients with infarcts and accounts for approximately 20% of the total mortality of patients with myocardial infractions. Relatively few cases are diagnosed before death. Several distinct clinical forms of ventricular free wall rupture have been identified. Sudden rupture with massive hemorrhage into the pericardium is the most common form; in a third of the cases, the course is subacute with slow and sometimes repetitive hemorrhage into the pericardial cavity. Left ventricular pseudoaneurysms generally occur as a consequence of left ventricular free wall rupture covered by a portion of pericardium, in contrast to a true aneurysm, which is formed of myocardial tissue. Here, we report a case of contained left ventricular free wall rupture following myocardial infarction.

Shiyovich, Arthur; Nesher, Lior

2012-01-01

21

Myocardial Mycn is essential for mouse ventricular wall morphogenesis.  

PubMed

MYCN is a highly conserved transcription factor with multifaceted roles in development and disease. Mutations in MYCN are associated with Feingold syndrome, a developmental disorder characterized in part by congenital heart defects. Mouse models have helped elucidate MYCN functions; however its cardiac-specific roles during development remain unclear. We employed a Cre/loxp strategy to uncover the specific activities of MYCN in the developing mouse myocardium. Myocardial deletion of Mycn resulted in a thin-myocardial wall defect with dramatically reduced trabeculation. The mutant heart defects strongly resemble the phenotype caused by disruption of BMP10 and Neuregulin-1 (NRG1) signaling pathways, two central mediators of myocardial wall development. Our further examination showed that expression of MYCN is regulated by both BMP and NRG1 signaling. The thin-wall defect in mutant hearts is caused by a reduction in both cell proliferation and cell size. MYCN promotes cardiomyocyte proliferation through regulating expression of cell cycle regulators (including CCND1, CCND2, and ID2) and promotes cardiomyocyte growth through regulating expression of p70S6K. In addition, expression of multiple sarcomere proteins is altered in Mycn myocardial-inactivation embryos, indicating its essential role for proper cardiomyocyte differentiation. In summary, Mycn acts downstream of BMP and NRG1 cardiogenic signaling pathways to promote normal myocardial wall morphogenesis. PMID:23063798

Harmelink, Cristina; Peng, Yin; DeBenedittis, Paige; Chen, Hanying; Shou, Weinian; Jiao, Kai

2013-01-01

22

Prone decubitus: A solution to inferior wall attenuation in thallium-201 myocardial tomography  

SciTech Connect

We propose an efficient method to suppress inferior wall attenuation in /sup 201/TI 180 degrees myocardial tomography. We systematically performed redistribution studies in both supine and prone decubitus, assuming that the latter should result in shifting with respect to each other's cardiac structures and diaphragm as well as subphrenic organs possibly responsible for attenuation. The comparison of both studies in 25 normal subjects by visual interpretation and circumferential profiles analysis showed a complete suppression of significant attenuation in the inferior wall in prone studies. In addition and consequently, the standard deviation of activity in this area was markedly reduced and became close to its value in anterior and lateral walls. This simple technique now routinely performed in over 400 patients drastically improves specificity in the evaluation of inferior wall abnormalities by suppressing attenuation artifacts and, incidently, the effect of high individual variability in left phrenic and subphrenic anatomic configuration.

Esquerre, J.P.; Coca, F.J.; Martinez, S.J.; Guiraud, R.F.

1989-03-01

23

Hyperacute anterior myocardial infarction in a patient with dextrocardia and situs inversus.  

PubMed

Dextrocardia with situs inversus is an uncommon congenital condition in which the major visceral organs are reversed. The clinical diagnosis and electrocardiographic localization of myocardial infarctions in these patients remain a great challenge unless dextrocardia is recognized. A 50-year-old male with known dextrocardia and situs inversus presented with acute chest pain radiating to the right arm. The reversed normalized electrocardiogram showed acute anterior myocardial infarction and cardiac catheterization showed a proximal occlusion of the left anterior descending artery. He underwent coronary angioplasty with stenting, resulting in relief of chest pain and improvement in his clinical condition. PMID:22710589

Ciçek, Davran; Eldem, Olcay; Gökay, Seher; Müderriso?lu, Haldun

2012-03-01

24

Thallium-201 evidence that anterior ST segment depression during early acute inferior myocardial infarction reflects septal or posterolateral ischemic injury  

SciTech Connect

The pathogenesis of anterior (ANT) ST segment depression (ST decreasing) during acute inferior myocardial infarction (IMI) remains controversial. To evaluate the role of septal (S) or posterolateral (PL) ischemic injury (IS), resting thallium-201 (T1-201) scintigrams closely timed to ECG findings (mean 21+-21 minutes) were evaluated in 49 consecutive pts during the first 5 hrs of a first acute IMI. ANT ST decreasing (any lead V1-V4) of greater than or equal to 1.0 mm was considered significant. All 49 pts had inferior T1-201 defects. In all 38 pts with ANT ST decreasing, there was T1-201 evidence of PL and/or S IS. In 9 of 11 pts without ANT ST decreasing, IS was confined to the inferior wall. The magnitude of inferior lead ST segment elevation correlated well with ST decreasing in leads 1 and AVL (r=0.88) and poorly with ST decreasing in anterior leads (r=0.32, supporting the concept that in acute IMI, ST decreasing in 1 and AVL is a reciprocal electrical phenomenon, but that ANT ST decreasing has a different pathogenesis. Thus the authors conclude that anterior ST depression in acute inferior myocardial infarction is associated with additional septal and/or posterolateral ischemic injury and does not reflect a benign reciprocal electrical phenomenon.

Lew, A.; Weiss, T.; Maddahi, J.; Geft, I.; Shah, P.K.; Swan, H.J.C.; Ganz, W.; Berman, D.

1984-01-01

25

Assessment of myocardial viability using coronary zero flow pressure after successful angioplasty in patients with acute anterior myocardial infarction  

PubMed Central

Objectives: To investigate the relation between coronary flow reserve (CFR), coronary zero flow pressure (Pzf), and residual myocardial viability in patients with acute myocardial infarction. Designs: Prospective study. Setting: Primary care hospital. Patients: 27 consecutive patients with acute anterior myocardial infarction. Main outcome measures:18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) was used in 27 patients who underwent successful intervention within 12 hours of onset of a first acute anterior myocardial infarction. Within three days before discharge they had < 25% stenosis in the culprit lesion as determined by angiography 24 (3) days after acute myocardial infarction. Pzf and the slope index of the flow-pressure relation (SIFP) were calculated from the simultaneously recorded aortic pressure and coronary flow velocity signals at peak hyperaemia.%FDG was quantified by comparing FDG uptake in the infarct myocardium with FDG uptake in the normal myocardium. Results: There was a correlation between %FDG and CFR, where y = ?1.477x + 62.517, r = ?0.072 (NS). There was also a correlation between %FDG and SIFP, where y = ?0.975x + 60.542, r = ?0.045 (NS), and a significant correlation between %FDG and Pzf, where y = ?0.98x + 85.108, r = ?0.696 (p < 0.001). Conclusions: CFR does not correlate with FDG-PET at the time of postreperfusion evaluation of residual myocardial viability. The parameter that correlates best with residual myocardial viability is Pzf and this may be a useful index for predicting patient prognosis.

Shimada, K; Sakanoue, Y; Kobayashi, Y; Ehara, S; Hirose, M; Nakamura, Y; Fukuda, D; Yamagishi, H; Yoshiyama, M; Takeuchi, K; Yoshikawa, J

2003-01-01

26

Malignant Schwannoma of Anterior Abdominal Wall: Report of a Case  

PubMed Central

Malignant schwannoma of the anterior abdominal wall nerves is extremely rare. Malignant peripheral nerve sheath tumors (MPNST) represent approximately 10% of all soft tissue sarcomas and it is found in 4% of patients with neurofibromatosis 1. We present a case of malignant schwannoma in a 28-year-old female patient with neurofibromatosis 1. She presented with a painful mass in the right upper quadrant of her abdomen. The tumor location was in the abdominal wall in explorative laparatomy and malignant schwannoma was diagnosed in pathologic assessment. The tumor recurred in 3 months and computed tomography showed two masses in the right side of abdominopelvic cavity. Thereafter, second complete surgical resection was performed and pathologic finding was the same. In spite of administering chemotherapy after second surgery,the tumor recurred and magnetic resonance imaging finding showed a huge heterogeneously enhancing mass with adhesion to the inner side of the abdominal wall. The patient died because of acute respiratory failure due to multiple bilateral pulmonary metastases. Tumor location and rapid recurrence was unique in our patient. Keywords Malignant peripheral nerve sheath tumor; Malignant schwannoma; Abdominal wall

Khorgami, Zhamak; Nasiri, Shirzad; Rezakhanlu, Freshteh; Sodagari, Nassim

2009-01-01

27

Left ventricular remodeling in the elderly with acute anterior myocardial infarction treated with primary coronary intervention  

Microsoft Academic Search

We compared left ventricular (LV) remodeling following a first time acute anterior ST-elevation myocardial infarction (aSTEMI)\\u000a treated with primary coronary intervention (pPCI) in different age groups. A total of 116 patients, 61 aged <65 and 55 aged\\u000a ?65 years, who survived after a recent aSTEMI treated with pPCI, underwent dobutamine stress-echocardiography (DSE) and non-invasive\\u000a measurement of left anterior descending coronary artery

Francesca Innocenti; Francesca Caldi; Cinzia Meini; Chiara Agresti; Giorgio J. Baldereschi; Niccolò Marchionni; Giulio Masotti; Riccardo Pini

2010-01-01

28

Effects of distal protection on left ventricular function in acute anterior myocardial infarction: a Doppler echocardiographic study  

Microsoft Academic Search

Whether distal protection devices (DPDs) during percutaneous coronary intervention (PCI) can improve myocardial function in\\u000a patients with acute myocardial infarction (AMI) is still under debate. Using tissue Doppler imaging (TDI), we evaluate the\\u000a global and regional left ventricular systolic and diastolic functions in patients with anterior AMI using DPDs compared with\\u000a conventional PCI. Ninety-six patients with anterior AMI were randomly

Yun-Yan Duan; Hai-Bin Zhang; Li-Wen Liu; Xiao-Dong Zhou; Cheng-Xiang Li; Jun Li; Ting Zhu; Hai-Li Su; Yong-Sheng Zhu; Hong-Ling Li; Jun Zhang

2010-01-01

29

Ectopic ureter presenting as anterior wall vaginal prolapse.  

PubMed

The differential diagnoses for anterior wall vaginal prolapse (AWVP) include cystocele, enterocele, urethral diverticulum, and Gartner duct cyst. We present a case of a patient with a known solitary right kidney (congenital absence of a left kidney) presenting with lower urinary tract symptoms, absence of urinary incontinence, and feeling of bulge in the vagina. Physical examination revealed grade II AWVP. Because congenital solitary kidney can be associated with other possible genitourinary abnormalities, a pelvic magnetic resonance imaging was obtained. Magnetic resonance imaging demonstrated a tubular structure spanning the left retroperitoneum to the region of the AWVP. Urodynamics revealed an obstructive voiding pattern during pressure-flow phase. The combination of transvaginal and transabdominal surgical excision of the tubular structure resolved the patient's lower urinary tract and prolapse symptoms. Anatomically, her AWVP was corrected. Histopathologic examination of the tubular structure revealed presence of urothelium lining the lumen of the tubular structure consistent with a ureter. This case represents the rare situation in which an ectopic ureter presented as an AWVP. However, patients with congenital solitary kidney presenting with vaginal prolapse should raise the suspicion for other associated genitourinary anomalies, whether these anomalies are related to the prolapse or not. Cross-sectional imaging should be performed in these situations to delineate precise anatomy. PMID:24978091

Chai, Toby C; Davis, Rachel; Hawes, Lisa N; Twaddell, William S

2014-01-01

30

Unusual case of acute posteromedial papillary muscle rupture after acute anterior myocardial infarction.  

PubMed

Papillary muscle rupture is now a rare complication of acute myocardial infarction. Posteromedial papillary muscle rupture is more common than anterolateral papillary muscle rupture. The posteromedial papillary muscle is usually supplied from a branch of the right coronary artery. We present a case of posteromedial papillary muscle rupture due to an isolated left anterior descending artery lesion. This was diagnosed on the fifth day post infarction. The patient progressed to mitral valve replacement and coronary artery bypass grafting to the left anterior descending artery. We believe this unusual arterial supply to the posteromedial papillary muscle is due to an apex forming left anterior descending artery coupled with an apically located posteromedial papillary muscle. PMID:23948290

Cherian, P S; Clarke, A J B; Burstow, D J

2014-01-01

31

The efficacy of Marlex mesh in the repair of severe, recurrent vaginal prolapse of the anterior midvaginal wall  

Microsoft Academic Search

OBJECTIVE: The study assesses the efficacy and complications of Marlex mesh in repairing severe recurrent anterior vaginal wall prolapse. STUDY DESIGN: Twenty-four patients with two or more postsurgical recurrences of severe anterior vaginal wall prolapse were divided into control and treatment groups. Transvaginal repair was similar between groups except for reinforcement of the anterior vaginal wall with synthetic mesh. Two

Thomas M. Julian

1996-01-01

32

Evolution of myocardial ischemia and left ventricular function in patients with angina pectoris without myocardial infarction and total occlusion of the left anterior descending coronary artery and collaterals from other coronary arteries  

Microsoft Academic Search

Repeated episodes of myocardial ischemia might lead to progressive impairment of left ventricular (LV) function. This radionuclide study assessed myocardial ischemia and LV function several years after documented coronary occlusion without myocardial infarction. Over 5 years, 24 consecutive patients, who underwent cardiac catheterization for angina pectoris without myocardial infarction, had isolated total occlusion of the left anterior descending coronary artery

Y. Juilliere; Pierre Y. Marie; Nicolas Danchin; Gilles Karcher; Alain Bertrand; François Cherrier

1991-01-01

33

Right Ventricle Myocardial Performance Index Versus Simpson's Right Ventricle Ejection Fraction in Patients with Isolated Left Ventricle Anterior Myocardial Infarction  

PubMed Central

Introduction: Right ventricle (RV) dysfunction may be secondary to left ventricle (LV) dysfunction in patients of isolated left ventricle anterior myocardial infarction as a consequence of “Ventricular Interdependence”. As RV dysfunction is associated with high in-hospital morbidity and mortality, early recognization of RV dysfunction is warranted; but until today it remains a challenging task because of complex structure and asymmetric shape of RV. Aims and Objectives: Our aim in the present study was to compare Simpson's right ventricle ejection fraction (RVEF) with right ventricle myocardial performance index (RV-MPI) to predict RV function in patients with isolated left ventricle anterior myocardial infarction (LV-AMI). Materials and Methods: We conducted the present study at the Department of Cardiology of Jawahar Lal Nehru Medical College and Associate Group of Hospitals, Ajmer. The control group comprised of twenty five. Age, sex, BMI, pulse and blood pressure matched healthy subjects without history of heart disease, systemic hypertension, diabetes, any other systemic illness and with normal findings in resting and exercise ECG, Echocardiography and Coronary Angiography. Sub-group-1 consisted of 25 patients with hemodynamically significant stenosis of proximal left anterior descending artery (LAD) with patent first septal perforator (S1). Sub-group-2 was composed of s5 patients with hemodynamically significant stenosis of both LAD and left circumflex artery (LCx.). Both subgroups had fully patent right coronary artery (RCA) from proximal to distal end. Results: RV-MPI value determined using pulsed doppler echocardiography was 0.40 ± 0.19 in healthy subjects. However RV-MPI was increased in both subgroups of LV-AMI with significant increase in subgroup-2 (P < 0.005) as compared to subgroup-1 patients (P < 0.01). Simpson's RVEF was not significantly different between the groups (P > 0.05). Conclusion: The findings in this study demonstrate that RV-MPI is a more sensitive, non-geometric echocardiographic parameter than Simpson's RVEF in detecting early RV dysfunction. Early detection of RV dysfunction is important to reduce morbidity and mortality in these patients.

Maheshwari, Monika; Mittal, Sita Ram

2013-01-01

34

Surgical management of anterior vaginal wall prolapse: an evidencebased literature review  

Microsoft Academic Search

The aim of this review is to summarize the available literature on surgical management of anterior vaginal wall prolapse. A Medline search from 1966 to 2004 and a hand-search of conference proceedings of the International Continence Society and International Urogynecological Association from 2001 to 2004 were performed. The success rates for the anterior colporrhaphy vary widely between 37 and 100%.

C. Maher; K. Baessler

35

Surgical management of anterior vaginal wall prolapse: an evidencebased literature review  

Microsoft Academic Search

The aim of this review is to summarize the available literature on surgical management of anterior vaginal wall prolapse. A Medline search from 1966 to 2004 and a hand-search of conference proceedings of the International Continence Society and International Urogynecological Association from 2001 to 2004 were performed. The success rates for the anterior colporrhaphy vary widely between 37 and 100%.

Christopher Maher; Kaven Baessler

2006-01-01

36

Myocardial Perfusion in Patients With a Totally Occluded Left Anterior Descending Coronary Artery Reinjected by a Normal Right Coronary Artery: The Role of Collateral Circulation  

Microsoft Academic Search

In this article, myocardial perfusion in patients with a totally occluded left anterior descending artery reinjected by a normal right coronary artery is assessed using stress single photon emission computed tomography (SPECT). In all, 20 patients, with a totally occluded left anterior descending artery reinjected by normal right coronary artery, underwent myocardial single photon emission computed tomography imaging within 60

Elie Chammas; Ayman Hussein; Ghada Ballane; Antoine Helou; Ahmad Yatim; Walid Tarcha; Georges Ghanem

2008-01-01

37

Anterior Abdominal Wall Leiomyoma Arising De Novo in a Perimenopausal Woman  

PubMed Central

Extrauterine or extraintestinal leiomyomas are extremely uncommon especially in the pre-peritoneal area or within the anterior abdominal wall muscles. These tumors have been ascribed to intraoperative seeding during resection of a fibroid or a leiomyoma of gut, to exogenous hormone replacement therapy or a major derangement of glucose and/or lipid metabolism. So far, there is no published report of de novo origin of anterior abdominal wall pure leiomyoma in the literature. The author herein reports a case of perimenopausal multiparous woman without any listing of previous gynecological surgery or hormone therapy who presented with a large pre-peritoneal intramuscular leiomyoma of the anterior abdominal wall. The patient underwent complete primary resection with amelioration of her symptoms.

Al-Wadaani, Hamed A.

2012-01-01

38

Generation of Myocardial Wall Surface Meshes from Segmented MRI  

PubMed Central

This paper presents a novel method for the generation of myocardial wall surface meshes from segmented 3D MR images, which typically have strongly anisotropic voxels. The method maps a premeshed sphere to the surface of the segmented object. The mapping is defined by the gradient field of the solution of the Laplace equation between the sphere and the surface of the object. The same algorithm is independently used to generate the surface meshes of the epicardium and endocardium of the four cardiac chambers. The generated meshes are smooth despite the strong voxel anisotropy, which is not the case for the marching cubes and related methods. While the proposed method generates more regular mesh triangles than the marching cubes and allows for a complete control of the number of triangles, the generated meshes are still close to the ones obtained by the marching cubes. The method was tested on 3D short-axis cardiac MR images with strongly anisotropic voxels in the long-axis direction. For the five tested subjects, the average in-slice distance between the meshes generated by the proposed method and by the marching cubes was 0.4?mm.

Skrinjar, Oskar; Bistoquet, Arnaud

2009-01-01

39

Hypertrophic cardiomyopathy mimicking acute myocardial infarction: Diagnostic role of cardiac magnetic resonance  

Microsoft Academic Search

Rarely, hypertrophic cardiomyopathy can be associated with ST elevation on electrocardiogram.We report a rare case of anterior hypertrophic cardiomyopathy mimicking an acute myocardial infarction where the diagnosis of myocardial hypertrophy was made by cardiac magnetic resonance.The method was able to identify the myocardial hypertrophy located in basal segments of anterior wall respect to echocardiography.

Gianluca Di Bella; Oreste Bramanti; Mario Salvatore Russo; Alessandro Migliorato; Carmelo Anfuso; Fabio Minutoli; Francesco Arrigo; Sebastiano Coglitore

2008-01-01

40

Hypertrophic cardiomyopathy mimicking acute myocardial infarction: diagnostic role of cardiac magnetic resonance.  

PubMed

Rarely, hypertrophic cardiomyopathy can be associated with ST elevation on electrocardiogram. We report a rare case of anterior hypertrophic cardiomyopathy mimicking an acute myocardial infarction where the diagnosis of myocardial hypertrophy was made by cardiac magnetic resonance. The method was able to identify the myocardial hypertrophy located in basal segments of anterior wall respect to echocardiography. PMID:17368585

Di Bella, Gianluca; Bramanti, Oreste; Russo, Mario Salvatore; Migliorato, Alessandro; Anfuso, Carmelo; Minutoli, Fabio; Arrigo, Francesco; Coglitore, Sebastiano

2008-04-25

41

Concomitant surgical correction of severe stress urinary incontinence and anterior vaginal wall prolapse by anterior vaginal wall wrap: 18 months outcomes  

PubMed Central

Background: The aim of this study is to evaluate the outcome of an innovative, minimally invasive sling technique with autologous tissue in women with concomitant incontinence and anterior vaginal wall prolapse (AVWP). Materials and Methods: Fifty-six women with stress urinary incontinence (SUI) or mixed urinary incontinence and AVWP were randomly assigned into two groups: In Group A (26 patients), anterior colporrhaphy (Kelly placation) and sling placement using a strip of anterior vaginal wall were performed, and in Group B (30 patients), transvaginal mesh correction of AVWP and tension-free vaginal tape (TVT) insertion (retropubic – craniocaudal route) using polypropylene mesh were carried out. The patients were followed-up for over 18 months and were assessed objectively using a 48 h frequency-volume chart, a 48 h pad test and a standardized stress test. Related surgical complications and outcomes were recorded and compared. Results: Surgical cure rates for Group A and Group B at the first (3 days) and last (18 months) post-operative visits were 62% and 84%; and 54%, and 72%, respectively (P = 0.09 and 0.31). Complications occurred in 9 patients (44%) of Group B, but only 3 patients (12%) in Group A. Conclusion: Vaginal sling surgery using an anterior vaginal wall strip can improve SUI and in comparison with propylene mesh is associated with lower complication rates. Although, the surgical success rate of this technique is lower than T-Sling, larger studies with selected patients will help assess the suitable patients for this pelvic reconstructive surgery.

Zargham, Mahtab; Alizadeh, Farshid; Tadayyon, Farhad; Khorrami, Mohammad-Hatef; Nouri-Mahdavi, Kia; Gharaati, Mohammad Reza; Izadpanahi, Mohammad Hossein; Yazdani, Mohammad; Mazdak, Hamid

2013-01-01

42

Anterior Abdominal Wall Abscess Secondary to Subcutaneous Gallstones  

PubMed Central

Abdominal wall abscess secondary to spontaneous cholecystocutaneous gallstone fistulation is an uncommon presentation of a rare pathological process. Having been described relatively frequently in the 19th century, it is now much less common in the late 20th and early 21st century, probably due to earlier recognition of symptoms, better imaging and surgical treatment of biliary tract disease. Here we describe a report of a case with an unusual clinical presentation of the already rare pathological disease process of spontaneous cholecystocutaneous fistula.

Murphy, John A.; Vimalachandran, C. Dale; Howes, Nathan; Ghaneh, Paula

2008-01-01

43

Fistula between anterior rectum wall and seminal vesicles as a rare complication of low-anterior resection of the rectum  

PubMed Central

Laparoscopic surgery has become a frequently used modality for rectal tumour surgery. A fistula between the rectum and lower urinary tract is one of the possible complications, with rectovesical fistulas occurring most frequently. This case report presents a 66-year-old man who underwent a laparoscopic low-anterior resection of the rectum due to the presence of a polyp with a high risk of malignant transformation. At the time of discharge on the eleventh postoperative day, the patient returned to the hospital with a fever, scrotal swelling and pain in the right hemiscrotum. These symptoms began four hours after discharge from the hospital. There was no sign of faecaluria. The presence of gas in the urinary bladder was confirmed after catheter insertion. The patient was diagnosed with a fistula between the anterior wall of the rectum and seminal vesicles. The diagnosis was based on cystoscopy findings, X-ray and computed tomography irrigography. The condition was treated conservatively by suprapubic insertion of a catheter and antibiotics. The total length of the treatment, including management of subsequent complications, was 4 months. Twelve months after the complication developed, the patient is symptom free, without urinary tract infection recurrence, and is under the care of both surgery and urology clinics. We describe the clinical symptoms, possibilities of treatment and the result of treatment of this rare complication of rectum low-anterior resection, which has never been described in the literature before.

Krhut, Jan; Jonszta, Tomas; Nemec, David; Havranek, Ondrej; Martinek, Lubomir

2011-01-01

44

Tension–Free Vaginal Mesh Repair for Anterior Vaginal Wall Prolapse  

Microsoft Academic Search

Objectives: We determined the efficacy of the use of a tension free prolene mesh to correct a grade III anterior vaginal wall prolapse recurrence.Methods: Twelve women (mean age 65.6 years) with stress urinary incontinence (SUI) (4 type II and 1 type III) and bladder prolapse entered the study. After vaginal incision a pretailored polypropylene mesh was fixed to its four

Roberto Migliari; Michele De Angelis; Giuliana Madeddu; Tiziano Verdacchi

2000-01-01

45

Fatal Huge Left Free Wall Ventricular Rupture after Acute Posterior Myocardial Infarction  

PubMed Central

A 77-year-old man, with a recent history of an acute inferior myocardial infarction, was referred to our hospital with echocardiographic and clinical signs of left ventricular free wall rupture (LVFWR). The intraoperative finding demonstrated a huge double LVFWR. The inferoposterior wall was dramatically destroyed without any possibility to repair.

Ferro, Orazio; Paolini, Giovanni

2013-01-01

46

Pathophysiology of precordial ST-segment depression in inferior wall acute myocardial infarction: an echocardiographic appraisal.  

PubMed

Precordial ST-segment depression (PSD) in inferior wall acute myocardial infarction (IAMI), especially when maximal in leads V4-V6, has been shown to portend a higher rate of heart failure and mortality. To better understand the pathophysiology behind this phenomenon, we evaluated patients with a first IAMI by echocardiography 48-72 h after the acute event, using segmental scoring (0 = normal to 3 = dyskinesia) of left ventricle wall motion, and a dichotomous assessment of right ventricle involvement. Patients were categorized into 3 groups: I = no PSD (n = 14); II = maximal PSD in leads V1-V3 (n = 28); III = maximal PSD in leads V4-V6 (n = 8). As compared with group I, patients in groups II-III had more severe wall motion abnormalities in inferior segments (1.36 +/- 0.97 vs. 2.19 +/- 1.74, p = 0.04), and a similar trend for posterior and lateral segments (1 +/- 1.75 vs. 2 +/- 2.41, p = 0.11), translating into a worse total left ventricle score (2.36 +/- 2.34 vs. 4.25 +/- 4.05, p < 0.05). Frequency of right ventricle involvement was similar in patients with and without PSD (6 (43%) vs. 9 (25%), p = 0.37). Segmental scores for groups I, II, and III, respectively, were not different for inferior (1.36 +/- 1, 2.25 +/- 1.82 and 2 +/- 1.51, p = 0.24), posterior and lateral (1 +/- 1.75, 1.96 +/- 2.32 and 2.13 +/- 2.9, p = 0.38), and septal, anteroseptal and anterior segments (0 +/- 0, 0.04 +/- 0.19 and 0.13 +/- 0.35, p = 0.28). Right ventricle abnormalities occurred in 43, 21 and 38% of patients in groups I, II and III, respectively, p = 0.3. Thus, IAMI with PSD is associated with worse left ventricle wall motion. However, since patients with maximal PSD in leads V4-V6 do not have greater wall motion abnormalities or higher rate of right ventricle involvement, their poorer prognosis cannot be explained by worse systolic dysfunction. We propose that maximal PSD in leads V4-V6 reflects transient diffuse ischemia and altered diastolic distensibility due to extensive coronary artery disease, causing increased left ventricle end-diastolic pressure. PMID:9197431

Hasdai, D; Jabara, R; Sclarovsky, S; Imbar, S; Sagie, A

1997-01-01

47

Reconstruction with a patient-specific titanium implant after a wide anterior chest wall resection.  

PubMed

The reconstruction of full-thickness chest wall defects is a challenging problem for thoracic surgeons, particularly after a wide resection of the chest wall that includes the sternum. The location and the size of the defect play a major role when selecting the method of reconstruction, while acceptable cosmetic and functional results remain the primary goal. Improvements in preoperative imaging techniques and reconstruction materials have an important role when planning and performing a wide chest wall resection with a low morbidity rate. In this report, we describe the reconstruction of a wide anterior chest wall defect with a patient-specific custom-made titanium implant. An infected mammary tumour recurrence in a 62-year old female, located at the anterior chest wall including the sternum, was resected, followed by a large custom-made titanium implant. Latissimus dorsi flap and split-thickness graft were also used for covering the implant successfully. A titanium custom-made chest wall implant could be a viable alternative for patients who had large chest wall tumours. PMID:24227881

Turna, Akif; Kavakli, Kuthan; Sapmaz, Ersin; Arslan, Hakan; Caylak, Hasan; Gokce, Hasan Suat; Demirkaya, Ahmet

2014-02-01

48

Perineal approach for a gastrointestinal stromal tumor on the anterior wall of the lower rectum  

PubMed Central

Background Wide margins of resection and regional lymphadenectomy for GIST are not necessary. Several procedures for rectal GIST have been designed according to the location and size of the tumor to preserve the anal function and decrease the morbidity rate. Case presentation We report a 61-year-old-man with rectal bleeding. Proctologic examination revealed a small mass of approximately 2 cm in diameter on the anterior wall of the rectum at a distance of 4 cm from the anal verge. Histological examination of the biopsy sample via the rectum led to a diagnosis of GIST due to immunohistochemical positivity for C117 and CD34. Perineal resection was planned because abdominoperineal resection with sacrificing the sphincter function was excessive for this small tumor, and low anterior resection with the double stapling technique was difficult due to the lower position. A hemispheric incision was made from one mid-ischial tuberosity to the other with an apex of approximately 2 cm above the anus. The fascia band and muscles were successively transected in order to expose the anterior wall of the rectum, and excision of the tumor was performed. The postoperative course was uneventful, and the patient remained free from incontinence and recurrence. Conclusions This perineal approach for a GIST on the anterior wall of the rectum is one option for preserving the anal function and decreasing the morbidity rate.

2014-01-01

49

Management of Anterior Abdominal Wall Defect Using a Pedicled Tensor Fascia Lata Flap: A Case Report  

PubMed Central

Degloving injuries to anterior abdominal wall are rare due to the mechanism of injury. Pedicled tensor fascia lata is known to be a versatile flap with ability to reach the lower anterior abdomen. A 34-year-old man who was involved in a road traffic accident presented with degloving injury and defect at the left inguinal region, sigmoid colon injury, and scrotal bruises. At investigation, he was found to have pelvic fracture. The management consisted of colostomy and tensor fascia lata to cover the defect at reversal. Though he developed burst abdomen on fifth postoperative day, the flap healed with no complications.

Ojuka, K. D.; Nangole, F.; Ngugi, M.

2012-01-01

50

Electrocardiographic characterization of rhesus monkey model of ischemic myocardial infarction induced by left anterior descending artery ligation.  

PubMed

Myocardial infarction is a leading cause for morbidity and mortality in the modern society. Rhesus monkeys are excellent animal models for experimental and translational studies of cardiovascular diseases in humans. However, some detailed characterizations of cardiovascular disease, such as myocardial infarction, in Rhesus monkeys have not been available. The present study was undertaken to examine the progressive electrocardiographic changes in Rhesus monkeys after left anterior descending (LAD) artery ligation. Male Rhesus monkeys, aged 2-3 years and weighed 4.5-6.0 kg, were subjected to LAD ligation along with sham-operated controls. At 1 week, 1 month, and 6 months after the LAD ligation, ECG recording was performed to detect the progressive changes in ECG. In addition, cardiac magnetic resonance imaging (MRI) and echocardiography were applied to detect the myocardial infarction induced by LAD ligation, and histopathological examination was performed at the end of the experiment to measure the morphological changes. The results showed that QRS and ST-T changed significantly within 1 month after LAD ligation, but recovered to normal at the end of the experiment. The most significant change was a progressive QTc prolongation, which occurred corresponding to the development of myocardial infarction. Both cardiac MRI and echocardiography detected the myocardial infarction that was confirmed by the histopathological examination. This detailed characterization of ECG changes along with the development of myocardial infarction induced by LAD ligation thus demonstrated that the Rhesus monkey model of ischemic myocardial infarction would be an excellent surrogate for human myocardial infarction. This model would also provide an excellent tool for drug discovery and development for cardiac disease. PMID:21792668

Yang, Pingliang; Han, Pengfei; Hou, Jianglong; Zhang, Lizhi; Song, Haibo; Xie, Yuping; Chen, Yonglin; Xie, Huiqi; Gao, Fabao; Kang, Y James

2011-12-01

51

An alternative technique for anterior chest wall reconstruction: the sternal allograft transplantation  

PubMed Central

OBJECTIVES Sternal resection is indicated for a variety of pathological conditions, mainly neoplastic or related to sternotomy complications. Resection of the sternum generally leaves a large chest-wall defect, and reconstruction is thus the most difficult part of the operation. Correct stabilization of the anterior chest wall is very important to avoid secondary complications and respiratory failure. In the last few years, different technical solutions have been used to reconstruct the sternum. We describe our technique using a sternal allograft to reconstruct the anterior chest wall after partial or complete sternal resection. METHODS Between June 2010 and February 2012, four patients underwent sternectomy followed by anterior chest wall reconstruction using sternal allograft. The sternal allograft was harvested from a multitissue donor following Italian legislation for tissue donation. Three patients had neoplastic involvement of the sternum, and one had a complete sternal defect as a complication of a cardiac operation. RESULTS We had no operative mortality. Three patients underwent partial sternal transplantation, and one underwent total sternal replacement. We had no postoperative respiratory insufficiency, infections or mechanical failure of the reconstructions. The respiratory function was preserved in all patients. The follow-up period was free from complications related to the sternal allograft implantation. CONCLUSIONS The technique of sternal allograft transplantation is simple, reproducible and provides excellent functional and cosmetic results. Further studies including a larger number of patients are needed to understand the biology of the allograft and the long-term results of this technique.

Dell'Amore, Andrea; Cassanelli, Nicola; Dolci, Giampiero; Stella, Franco

2012-01-01

52

Cannabis-induced coronary artery thrombosis and acute anterior myocardial infarction in a young man.  

PubMed

Information concerning acute myocardial infarction after cannabis usage is limited and the actual mechanism of cannabis-induced myocardial infarction is not well known. In the report, we described a young man with an acute myocardial infarction and cannabis-induced coronary thrombosis. PMID:17097170

Tatli, Ersan; Yilmaztepe, Mustafa; Altun, Gurcan; Altun, Armagan

2007-09-01

53

Anterior Vaginal Wall Tenderness (AVWT) as a Physical Symptom in Chronic Pelvic Pain  

PubMed Central

Background and Objectives: Chronic pelvic pain is often difficult to diagnose and treat properly. Physicians called on to treat this problem may not be able to give a specific diagnosis. The aim of this study was to see whether the physical presence of anterior vaginal wall tenderness could help narrow down and elucidate diagnoses in a practice focusing on diagnosis and treatment of chronic pelvic pain. Methods: The study cohort comprised 284 patients with chronic pelvic pain limited to gynecologic and lower urinary problems. Histories, physical examinations, and endoscopic procedures were performed on each patient. An analysis of this information was conducted. Results: Of the chronic pelvic pain patients, 78% had endometriosis, 81% had interstitial cystitis, and 61% had both concurrently. The sensitivity of anterior vaginal wall tenderness (AVWT) in patients with interstitial cystitis was 95%, and in those with only endometriosis and no interstitial cystitis, the sensitivity was 17%. The positive predictive value for interstitial cystitis was 85%, and for endometriosis it was 67%. Conclusions: Examination of the anterior vaginal wall with an empty bladder at the initial examination can lead one to suspect interstitial cystitis and possibly either concomitant or singular endometriosis and allow the physician to approach the workup accordingly.

Paulson, Joseph N.

2011-01-01

54

Automated quantification of 3D regional myocardial wall thickening from gated Magnetic Resonance images  

PubMed Central

Purpose To develop 3D quantitative measures of regional myocardial wall motion and thickening using cardiac MRI and to validate them by comparison to standard visual scoring assessment. Materials and Methods 53 consecutive subjects with short-axis slices and mid-ventricular 2-chamber/4-chamber views were analyzed. After correction for breath-hold related misregistration, 3D myocardial boundaries were fitted to images, and edited by an imaging cardiologist. Myocardial thickness was quantified at end-diastole and end-systole by computing the 3D distances using Laplace’s equation. 3D thickening was represented using the standard 17-segment polar coordinates. 3D thickening was compared with 3D wall motion and with expert visual scores (6-point visual scoring of wall motion and wall thickening; 0=normal; 5=greatest abnormality) assigned by imaging cardiologists. Results Correlation between ejection fraction and thickening measurements was (r=0.84; p<0.001) compared to correlation between ejection fraction and motion measurements (r= 0.86; p<0.001). Good negative correlation between summed visual scores and global wall thickening and motion measurements were also obtained (rthick = -0.79; rmotion= -0.74). Additionally, overall good correlation between individual segmental visual scores with thickening/wall motion (rthick=-0.69; rmotion=-0.65) was observed (p<0.0001). Conclusion 3D quantitative regional thickening and wall motion measures obtained from MRI correlate strongly with expert clinical scoring.

Prasad, Mithun; Ramesh, Amit; Kavanagh, Paul; Tamarappoo, Balaji K.; Nakazato, Ryo; Gerlach, James; Cheng, Victor; Thomson, Louise E. J.; Berman, Daniel S.; Germano, Guido; Slomka, Piotr J.

2010-01-01

55

The anterior wall stripe of the left lower lobe bronchus on the lateral chest radiograph: CT correlative study.  

PubMed

We designed a study to determine whether thickening or effacement of the anterior wall stripe of the left lower lobe bronchus on the lateral chest radiograph implies adjacent disease, as it does for the posterior wall stripe of the right bronchus intermedius. The anterior wall stripe of the left lower lobe bronchus originates from the inferior anterior aspect of the end-on left bronchus and descends in a gentle posteriorly convex curve. The left lower lobe bronchus was identified on routine lateral chest films in 86 of 90 consecutive patients who also had chest CT. In those cases the anterior wall stripe was measured and categorized on chest films. On the CT scans, the length of the left lower lobe bronchus and its relationship to the left lower lobe artery and left upper lobe, lingular, and lower lobe veins were assessed. The presence of adjacent disease was noted. A complete anterior wall stripe was seen in 59 of 86 cases. It was effaced by anterior soft tissue in 15 of 86 cases; in 12 of 86 cases only the superior 0.5-1.5 cm was effaced. A normal anterior wall stripe was as thick as 12 mm in one case, but was 6 mm or less in 90%. Shapes other than linear were common. Anatomic variation accounted for nearly all of these findings. There was no focal abnormality in the 12 cases with partial effacement or in nine of the 15 cases with complete effacement; disease was significant in only two of these six. We concluded that thickening or effacement of the anterior wall stripe is an unreliable sign of disease. PMID:2104721

Lang, E V; Friedman, P J

1990-01-01

56

Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse  

PubMed Central

Introduction and hypothesis To estimate the risk of repeat surgery for recurrent prolapse or mesh removal after vaginal mesh versus native tissue repair for anterior vaginal wall prolapse. Methods We utilized longitudinal, adjudicated, healthcare claims from 2005 to 2010 to identify women ?18 years who underwent an anterior colporrhaphy (CPT 57420) with or without concurrent vaginal mesh (CPT 57267). The primary outcome was repeat surgery for anterior or apical prolapse or for mesh removal/revision; these outcomes were also analyzed separately. We utilized Kaplan–Meier curves to estimate the cumulative risk of each outcome after vaginal mesh versus native tissue repair. Cox proportional hazards models were used to estimate the hazard ratio (HR) for vaginal mesh versus native tissue repair, adjusted for age, concurrent hysterectomy, and concurrent or recent sling. Results We identified 27,809 anterior prolapse surgeries with 49,658 person-years of follow-up. Of those, 6,871 (24.7%) included vaginal mesh. The 5-year cumulative risk of any repeat surgery was significantly higher for vaginal mesh versus native tissue (15.2 % vs 9.8 %, p<0.0001) with a 5-year risk of mesh revision/removal of 5.9%. The 5-year risk of surgery for recurrent prolapse was similar between vaginal mesh and native tissue groups (10.4 % vs 9.3 %, p=0.70. The results of the adjusted Cox model were similar (HR 0.93, 95%CI: 0.83, 1.05). Conclusions The use of mesh for anterior prolapse was associated with an increased risk of any repeat surgery, which was driven by surgery for mesh removal. Native tissue and vaginal mesh surgery had similar 5-year risks for surgery for recurrent prolapse.

Funk, Michele Jonsson; Visco, Anthony G.; Weidner, Alison C.; Pate, Virginia

2013-01-01

57

Extent of regional wall motion abnormalities by gated spect in patients with Q-wave myocardial infarction  

Microsoft Academic Search

Background: Regional wall motion abnormalities (RWMA) on post stress gated SPECT enhance detection of myocardial ischemia. However, the extent of RWMA in patients (pts) with a prior electrocardiography (EKG) Q-wave myocardial infarction (Q-MI) on gated SPECT is not known. We studied this on post stress gated SPECT myocardial perfusion (MPI) studies in pts with a Q-MI by EKG.Methods: Thirty pts

J Mahenthiran; J. C Elliott; S Jacob; S Stricker; V. G Kalaria; S Sawada

2004-01-01

58

Associated influence of hypertension and heart rate greater than 80 beats per minute on mortality rate in patients with anterior wall STEMI  

PubMed Central

Acute myocardial infarction as a form of coronary heart disease is characterized by permanent damage/loss of anatomical and functional cardiac tissue. Diagnosis of STEMI includes data on anginal pain and persistent ST-segment elavation. According to the numerous epidemiological studies, arterial blood pressure and heart rate are offten increased especially during the first hours of pain due to domination of sympathetic response. We wanted to investigate the associated influence of heart rate greater than 80 beats per minute and hypertension on the mortality in patients with anterior wall STEMI. Research included 140 patients treated in Coronary Unit, Clinical Center Kragujevac form January 2001 to June 2006. Heart rate was calculated as the mean value of baseline and heart rate in the first 30 minutes after admission, recorded on monitor and electrocardiogram. Data for history of hypertension were collected and blood pressure levels were measured in a lying position after 5 minutes of rest, and classified according to the VII JNC recommendations as confirmation of hypertension. Collected data were analyzed in SPSS 13.0 for Windows. Heart rate greater than 80 bpm influences the hospital mortality. Systolic blood pressure levels were higher in the survivors, while for the diastolic there was no difference. History of hypertension was singled out as a significant predictor of mortality without difference between the respondents with heart rate greater and lower than 80 bpm in the survivors and fatal. Increased heart rate and hypertension at admission are significant predictors of mortality in patients with anterior wall STEMI.

Davidovic, Goran; Iric-Cupic, Violeta; Milanov, Srdjan

2013-01-01

59

Coronary spasm as the cause of myocardial ischaemia in a patient with anomalous origin of the left anterior descending artery from the proximal right coronary artery.  

PubMed

A 49-year-old woman developed angina at rest. A CT of the coronary artery revealed that the left anterior descending artery arose from the right coronary artery, and traversed between the aorta and pulmonary trunk. An exercise stress myocardial scintigraphy did not reproduce myocardial ischaemia or anginal symptoms. A coronary angiography did not show any atherosclerotic changes. Finally, an ergotamine provocation test for vasospasm revealed diffuse severe spasm in the right coronary artery and the left anterior descending artery. Surgical correction of the anomaly was deferred and the patient was managed with medications to control spasm with good clinical outcome. PMID:24920513

Nakazato, Jun; Hirata, Kazuhito; Wake, Minoru

2014-01-01

60

A new description of the anterior abdominal wall in man and mammals.  

PubMed Central

The ventral abdominal walls of 116 specimens (41 human and 75 from nine mammalian families) of various ages and both sexes were studied anatomically and histologically. In man, each abdominal aponeurosis was bilaminar, and each wall of the rectus sheath was trilaminar (plywood-like). The two layers of the internal oblique emerged, in part of its extent, superficial to the external oblique and also passed deep to the transversus abdominis. All the six aponeurotic layers were oblique and crossed the mid-line, forming the following digastric muscles: the two external obliques together, the two transversus abdominis muscles together, one internal oblique (anterior layer) with the opposite external oblique (posterior layer) and one internal oblique (posterior layer) with the opposite transversus abdominis (anterior layer). The linea alba might be considered less the insertion of the abdominal muscles, but rather the common area of decussation of their intermediate aponeuroses. In all mammals, the internal oblique aponeurosis passed either superficial to that of the external oblique or deep to that of the transversus. The transversus aponeurosis was always oblique and in all eutheria it split into two layers. All abdominal aponeuroses crossed the middle line forming digastric muscles between the two sides. The functional significance and surgical application of these findings are discussed. Images Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15

Rizk, N N

1980-01-01

61

Fournier's gangrene - delayed pedicle flap based upon the anterior abdominal wall.  

PubMed

Introduction: Fournier's gangrene is a poly-microbial necrotizing fasciitis that involves the perineum and/or external genitalia. Urgent surgical debridement is well recognized as essential acute treatment yet unique challenges arise for plastic surgical reconstruction to obtain a complete functional recovery. This case describes a successful delayed pedicle flap repair based upon the anterior abdominal wall. Case description: A 24 year old man was admitted to ICU ten days after elective circumcision with Fournier's gangrene. He underwent a number of surgical debridements, and was referred for plastic surgical management. He had penile reconstruction using a random pattern abdominal flap, which was performed as a three stage procedure including flap vascular delay technique. Discussion: Perineal and penile skin loss can be significant and is difficult to repair. Various techniques have been used to reconstruct lost tissue: skin grafts, transposition of the testes and spermatic cords to the thigh, flaps, and other types of pediculated myocutaneous flaps. Muscle flap reconstruction provides an environment that allows for complete regeneration of the urethral epithelium but is bulky and unsightly. Skin grafts contract and may produce painful and dysfunctional reconstructions. This novel technique produces a functional, and aesthetic reconstruction. Conclusion: Penile skin recovery following Fournier's gangrene recovery is problematic. This case demonstrates the functionality of a delayed flap repair using the anterior abdominal wall. PMID:25010310

Sliwinski, Ania; Kavanagh, Liam E; Bolton, Damien; Lawrentschuk, Nathan; Crock, John G

2014-01-01

62

Septal myocardial perfusion imaging with thallium-201 in the diagnosis of proximal left anterior descending coronary artery disease  

SciTech Connect

The use of myocardial perfusion imaging (MPI) to identify obstructive coronary disease of the left anterior descending coronary artery proximal to the first septal perforator (prox LAD) was studied in 60 patients. Perfusion of the septum and anteroapical areas with thallium-201 injected during exercise was compared to results of coronary arteriography. Septal MPI defect was found in 92.3% of patients with obstruction of the proximal LAD, 27.7% of patients with obstruction of LAD distal to first septal perforator, 0% in patients with obstructions involving right or circumflex arteries, and in 10.5% of patients without coronary disease. Anteroapical MPI defects were found with similar frequency in the three groups with obstructive coronary disease. Septal MPI defect had a sensitivity of 92.3% and specificity of 85.4% in the diagnosis of proximal LAD disease. Normal septal perfusion with thallium-201 virtually excluded proximal LAD disease.

Pichard, A.D.; Wiener, I.; Martinez, E.; Horowitz, S.; Patterson, R.; Meller, J.; Goldsmith, S.J.; Gorlin, R.; Herman, M.V.

1981-07-01

63

Automatic delineation of the myocardial wall from CT images via shape segmentation and variational region growing.  

PubMed

Prognosis and diagnosis of cardiac diseases frequently require quantitative evaluation of the ventricle volume, mass, and ejection fraction. The delineation of the myocardial wall is involved in all of these evaluations, which is a challenging task due to large variations in myocardial shapes and image quality. In this paper, we present an automatic method for extracting the myocardial wall of the left and right ventricles from cardiac CT images. In the method, the left and right ventricles are located sequentially, in which each ventricle is detected by first identifying the endocardium and then segmenting the epicardium. To this end, the endocardium is localized by utilizing its geometric features obtained on-line from a CT image. After that, a variational region-growing model is employed to extract the epicardium of the ventricles. In particular, the location of the endocardium of the left ventricle is determined via using an active contour model on the blood-pool surface. To localize the right ventricle, the active contour model is applied on a heart surface extracted based on the left ventricle segmentation result. The robustness and accuracy of the proposed approach is demonstrated by experimental results from 33 human and 12 pig CT images. PMID:23744658

Zhu, Liangjia; Gao, Yi; Appia, Vikram; Yezzi, Anthony; Arepalli, Chesnal; Faber, Tracy; Stillman, Arthur; Tannenbaum, Allen

2013-10-01

64

A murine model of myocardial ischemia-reperfusion injury through ligation of the left anterior descending artery  

PubMed Central

Acute or chronic myocardial infarction (MI) are cardiovascular events resulting in high morbidity and mortality. Establishing the pathological mechanisms at work during MI and developing effective therapeutic approaches requires methodology to reproducibly simulate the clinical incidence and reflect the pathophysiological changes associated with MI. Here, we describe a surgical method to induce MI in mouse models that can be used for short term ischemia-reperfusion (I/R) injury as well as permanent ligation. The major advantage of this method is to facilitate location of the left anterior descending artery (LAD) to allow for accurate ligation of this artery to induce ischemia in the left ventricle of the mouse heart. Accurate positioning of the ligature on the LAD increases reproducibility of infarct size and thus produces more reliable results. Greater precision in placement of the ligature will improve the standard surgical approaches to simulate MI in mice, thus reducing the number of experimental animals necessary for statistically relevant studies and improving our understanding of the mechanisms producing cardiac dysfunction following MI. This mouse model of MI is also useful for the preclinical testing of treatments targeting myocardial damage following MI.

Xu, Zhaobin; Alloush, Jenna; Beck, Eric; Weisleder, Noah

2014-01-01

65

Early diagnosis of right ventricular or posterior infarction associated with inferior wall left ventricular acute myocardial infarction  

Microsoft Academic Search

Right ventricular (RV) or posterior infarction associated with inferior wall left ventricular acute myocardial infarction (AMI) has important therapeutic and prognostic implications. However, RV and posterior chest leads in addition to the 12-lead electrocardiogram are required for accurate detection. Body surface mapping (BSM) has greater spatial sampling and may further improve inferior wall AMI classification. Consecutive patients with chest pain

Ian B. A Menown; James Allen; John McC Anderson; A. A. Jennifer Adgey

2000-01-01

66

Elective minimally invasive coronary artery bypass: Shunt or tournique occlusion? Assessment of a protective role of perioperative left anterior descending shunting on myocardial damage. A prospective randomized study  

PubMed Central

Background To determine impact of intraluminal-left anterior descending shunt to prevent myocardial damage in minimally invasive coronary artery bypass. Methods 38 patients were randomly assigned to external tournique occlusion (n?=?19) or intraluminal-left anterior descending shunt group (n?=?19). Blood samples for cardiac troponin T were collected at 30 minutes prior to, 6 and 24 hours after surgery. Results One patient in external tournique occlusion and two patients in intraluminal-left anterior descending shunt group were excluded from futher analysis due to preoperative cardiac troponin T level above the 99th-percentile. Postoperatively, each six patients in external tournique occlusion (33.3%) and intraluminal-left anterior descending shunt (35.3%) group were above the 99th-percentile. Two patients from each group (external tournique occlusion group 11.1% vs. intraluminal-left anterior descending shunt group 11.8%) had peak values above 10-% coeficient of variation cutoff (p?=?1). There were no significant differences in between both groups at all studied timepoints. Conclusion There was no protective effect of intraluminal shunting on myocardial damage compared to short-term tournique occlusion. It is upon the surgeon's discretion which method may preferrably be used to achieve a bloodless field in grafting of the non-occluded left anterior descending in minimally invasive coronary artery bypass.

2012-01-01

67

Decreases in Electrocardiographic R-Wave Amplitude and QT Interval Predict Myocardial Ischemic Infarction in Rhesus Monkeys with Left Anterior Descending Artery Ligation  

PubMed Central

Clinical studies have demonstrated the predictive values of changes in electrocardiographic (ECG) parameters for the preexisting myocardial ischemic infarction. However, a simple and early predictor for the subsequent development of myocardial infarction during the ischemic phase is of significant value for the identification of ischemic patients at high risk. The present study was undertaken by using non-human primate model of myocardial ischemic infarction to fulfill this gap. Twenty male Rhesus monkeys at age of 2–3 years old were subjected to left anterior descending artery ligation. This ligation was performed at varying position along the artery so that it produced varying sizes of myocardial infarction at the late stage. The ECG recording was undertaken before the surgical procedure, at 2 h after the ligation, and 8 weeks after the surgery for each animal. The correlation of the changes in the ECG waves in the early or the late stage with the myocardial infarction size was analyzed. The R wave depression and the QT shortening in the early ischemic stage were found to have an inverse correlation with the myocardial infarction size. At the late stage, the R wave depression, the QT prolongation, the QRS score, and the ST segment elevation were all closely correlated with the developed infarction size. The poor R wave progression was identified at both the early ischemic and the late infarction stages. Therefore, the present study using non-human primate model of myocardial ischemic infarction identified the decreases in the R wave and the QT interval as early predictors of myocardial infarction. Validation of these parameters in clinical studies would greatly help identifying patients with myocardial ischemia at high risk for the subsequent development of myocardial infarction.

Han, Pengfei; Xie, Yuping; Chen, Jianmin; Xiao, Ying; Kang, Y. James

2013-01-01

68

Giant pseudocyst of the anterior abdominal wall following mesh repair of incisional hernia: a rare complication managed laparoscopically.  

PubMed

Giant pseudocyst formation of the anterior abdominal wall, following on-lay polypropylene mesh repair for incisional hernia is an under reported complication. We report an unusual case of a 56-year-old female who underwent a polypropylene mesh repair of incisional hernia 2 years back. Subsequently she developed a giant pseudocyst of the anterior abdominal wall, which was occupying the whole of the abdomen from the xiphisternum to the pubic bone, and over both the flanks. Over a period of one year, the cyst had defied multiple attempts at aspiration. The patient underwent a laparoscopic drainage of the collection with piecemeal excision of the entire cyst wall. Histopathology of the cyst wall revealed necrotic material with intervening areas of hemorrhage. No epithelial lining was seen. There has been no recurrence in the two years of follow-up. Conclusion: giant pseudocyst of the anterior abdominal wall is a rare complication following mesh repair of an incisional hernia. Such pseudocysts can be managed successfully by laparoscopic procedures. PMID:16136392

Mehrotra, Prateek K; Ramachandran, C S; Goel, Deep; Arora, Vijay

2006-04-01

69

Finite Element Analysis of Ventricular Wall Motion and Intra-Ventricular Blood Flow in Heart with Myocardial Infarction  

NASA Astrophysics Data System (ADS)

To study the wall motion abnormality and characteristic flow distribution observed in the heart with myocardial infarction, we modified our finite element model of left ventricle and performed simulations at two different phases after the onset of the disease by applying characteristic material property to the infarcted region. The model could not only reproduce the hemodynamic change in myocardial infarction but also give mechanistic insight into the following complicating problems. 1) Stagnation of blood as the cause of clot formation 2) Extra energy wasted for the stretch of infarcted tissue. The effect of compensatory enhancement of the force generation in normal myocardial tissue is also discussed.

Watanabe, Hiroshi; Sugano, Takeshi; Sugiura, Seiryo; Hisada, Toshiaki

70

Speckle tracking analysis of the left ventricular anterior wall shows significantly decreased relative radial strain patterns in dystrophin deficient mice after 9 months of age  

PubMed Central

Background: Duchenne muscular dystrophy (DMD) is an inherited X-linked disorder with an incidence of 1 in 3,500 male births. Early treatment of DMD cardiomyopathy is under investigation and echocardiographic analysis of strain patterns may provide measures to better quantify early treatment outcomes. Methods: We compared cardiac function in 3, 9 and 12 month old dystrophin deficient mdx mice to wild type (C57BL10/J) using in vivo high frequency echocardiography (Vevo 770, VisualSonics, Inc., Toronto, CA) and 2D speckle tracking [Velocity Vector Imaging (VVI), Siemens Medical Solutions, Inc., Malvern, PA]. Mice were anesthetized with 1-2% inhaled isoflurane and images were obtained using a 30 MHz transducer in modified parasternal long and short axis views obtained at the level of the papillary muscles. Myocardial motion was analyzed using VVI in single-beat reconstructed images. Results: M-mode imaging showed significantly decreased shortening fraction in mdx mice compared to wild type at 12 months of age (SF% 26.6±3 vs. 32.2±2; p=0.002). Mdx mice showed significantly increased cardiac fibrosis at 12 months of age compared to controls (p<0.0001). Speckle tracking analysis of the left anterior mid ventricular wall segment showed significantly decreased relative radial strain in mdx mice at 9 and 12 months (4.5±1.3% vs. 8.4±0.7%; p=0.001). There were no significant differences in circumferential or longitudinal strain. Conclusion: Mdx mice show significantly decreased LV anterior mid wall radial strain with mild cardiomyopathy after 9 months of age compared to wild type. Speckle tracking analysis may provide novel outcome measures for preclinical cardiac drug treatment studies in DMD.

Spurney, Christopher; Yu, Qing; Nagaraju, Kannaboyina

2012-01-01

71

[The relationship between discrepant areas on 201TlCl/123I-BMIPP myocardial scintigraphy, local wall motion, and glucose metabolism in patients with myocardial infarction].  

PubMed

In order to clarify the significance of the discrepancy between myocardial blood flow and fatty acid metabolism on 201TlCl/123I-BMIPP SPECT after acute myocardial infarction, we examined 52 patients (278 segments) with their first acute myocardial infarction using two-dimensional echocardiography and FDG-PET. Patients with Tl/BMIPP discrepancy in the acute stage showed higher FDG accumulation than those without Tl/BMIPP discrepancy. In the chronic stage, however, there was no significant difference between both groups. Patients with Tl/BMIPP discrepancy in the chronic stage had lower wall motion scores than those without Tl/BMIPP discrepancy. Significant improvement of the wall motion score was recognized in patients who showed Tl/BMIPP discrepancy in the acute stage. Patients were classified into stenosis and non-stenosis groups by the presence of significant stenosis on coronary angiography in the chronic stage. In the stenosis group, the Tl/BMIPP discrepancy did not show much change from the acute to chronic stage, but there was a significant decrease in the non-stenosis group. It was concluded that 201TlCl/123I-BMIPP myocardial SPECT is useful for predicting future improvement of wall motion and determining the residual ischemia in the chronic stage based on the presence or absence of this discrepancy. PMID:9916402

Tanaka, A

1998-11-01

72

Non-invasive evaluation of myocardial reperfusion by transthoracic Doppler echocardiography and single-photon emission computed tomography in patients with anterior acute myocardial infarction  

PubMed Central

Background The study was designed to evaluate whether the preserved coronary flow reserve (CFR) 72 hours after reperfused acute myocardial infarction (AMI) is associated with less microvascular dysfunction and is predictive of left ventricular (LV) functional recovery and the final infarct size at follow-up. Methods In our study, CFR was assessed by transthoracic Doppler echocardiography (TDE) in 44 patients after the successful percutaneous coronary intervention during the acute AMI phase. CFR was correlated with contractile reserve assessed by low-dose dobutamine echocardiography and with the total perfusion defect measured by single-photon emission computed tomography 72 hours after reperfusion and at 5 months follow-up. The ROC analysis was performed to determine test sensitivity and specificity based on CFR. Categorical data were compared by an ?2 analysis, continuous variables were analysed with the independent Student's t test. In order to analyse correlation between CFR and the parameters of LV function and perfusion, the Pearson correlation analysis was conducted. The linear regression analysis was used to assess the relationship between CFR and myocardial contractility as well as the final infarct size. Results We estimated the CFR cut-off value of 1.75 as providing the maximal accuracy to distinguish between patients with preserved and impaired CFR during the acute AMI phase (sensitivity 91.7%, specificity 75%). Wall motion score index was better in the subgroup with preserved CFR as compared to the subgroup with reduced CFR: 1.74 (0.29) vs. 1.89 (0.17) (p < 0.001) during the acute phase and 1.47 (0.30) vs. 1.81 (0.20) (p < 0.001) at follow-up, respectively. LV ejection fraction was 47.78% (8.99) in preserved CFR group vs. 40.79% (7.25) in impaired CFR group (p = 0.007) 72 hours after reperfusion and 49.78% (8.70) vs. 40.36% (7.90) (p = 0.001) after 5 months at follow-up, respectively. The final infarct size was smaller in patients with preserved as compared to patients with reduced CFR: 5.26% (6.14) vs. 23.28% (12.19) (p < 0.001) at follow-up. Conclusion The early measurement of CFR by TDE can be of high value for the assessment of successful reperfusion in AMI and can be used to predict LV functional recovery, myocardial viability and the final infarct size.

2011-01-01

73

Evolution of myocardial ischemia and left ventricular function in patients with angina pectoris without myocardial infarction and total occlusion of the left anterior descending coronary artery and collaterals from other coronary arteries  

SciTech Connect

Repeated episodes of myocardial ischemia might lead to progressive impairment of left ventricular (LV) function. This radionuclide study assessed myocardial ischemia and LV function several years after documented coronary occlusion without myocardial infarction. Over 5 years, 24 consecutive patients, who underwent cardiac catheterization for angina pectoris without myocardial infarction, had isolated total occlusion of the left anterior descending coronary artery with well-developed collateral vessels. Five patients were successfully treated by coronary bypass grafting and 3 by coronary angioplasty. Among the 16 medically treated patients, 1 was lost to follow-up and 1 died (extracardiac death). The mean (+/- standard deviation) follow-up (14 patients) was 48 +/- 15 months. At follow-up, 8 patients still had clinical chest pain, 11 received antianginal therapy, 4 patients had no stress ischemia and the other 10 had greater than or equal to 1 sign of stress ischemia. All patients had a normal LV ejection fraction at rest (mean 60 +/- 3%; range 55 to 65%). Collateral circulation preserves LV function at the time of occlusion and, in some cases, prevents the development of myocardial ischemia; in patients with persisting myocardial ischemia after well-collateralized coronary occlusion, LV function is not impaired at long-term follow-up.

Juilliere, Y.; Marie, P.Y.; Danchin, N.; Karcher, G.; Bertrand, A.; Cherrier, F. (CHU Nancy-Brabois, Vandoeuvre-les-Nancy (France))

1991-07-01

74

Desmoid Tumors of the Anterior Abdominal Wall: Results from a Monocentric Surgical Experience and Review of the Literature  

Microsoft Academic Search

Background  Desmoid tumor, also known as aggressive fibromatosis, is a rare soft tissue tumor. For those cases localized in the anterior\\u000a abdominal wall, radical resection and reconstruction with a mesh is indicated. Because the rarity of the disease, randomized\\u000a trials are lacking, but in reported retrospective series, it is clear that although it is considered a benign lesion, local\\u000a recurrence is

Emilio Bertani; Antonio Chiappa; Alessandro Testori; Giovanni Mazzarol; Roberto Biffi; Stefano Martella; Ugo Pace; Javier Soteldo; Paolo Della Vigna; Rosalba Lembo; Bruno Andreoni

2009-01-01

75

Significance of location (anterior versus inferior) and type (Q-wave versus non-Q-wave) of acute myocardial infarction in patients undergoing percutaneous transluminal coronary angioplasty for postinfarction ischemia  

Microsoft Academic Search

Predictors of increased risk for recurrent cardiac events and death after acute myocardial infarction include postinfarction myocardial ischemia, anterior location of the infarct, and non-Q-wave versus Q-wave infarction. Although coronary angioplasty is performed in patients with postinfarction ischemia to alleviate symptoms, the outcome according to location and type of infarction and the effect on prevention of subsequent myocardial infarction and

Francine K. Welty; Murray A. Mittleman; Stanley M. Lewis; Robert W. Healy; Samuel J. Shubrooks; James E. Muller

1995-01-01

76

A 3-D Finite Element Model of Anterior Vaginal Wall Support to Evaluate Mechanisms Underlying Cystocele Formation  

PubMed Central

Objectives To develop a 3D computer model of the anterior vaginal wall and its supports, validate that model, and then use it to determine the combinations of muscle and connective tissue impairments that result in cystocele formation, as observed on dynamic magnetic resonance imaging (MRI). Methods A subject-specific 3D model of the anterior vaginal wall and its supports was developed based on MRI geometry from a healthy nulliparous woman. It included simplified representations of the anterior vaginal wall, levator muscle, cardinal and uterosacral ligaments, arcus tendineus fascia pelvis and levator ani, paravaginal attachments, and the posterior compartment. This model was then imported into ABAQUS™ and tissue properties were assigned from the literature. An iterative process was used to refine anatomical assumptions until convergence was obtained between model behavior under increases of abdominal pressure up to 168 cmH2O and deformations observed on dynamic MRI. Results Cystocele size was sensitive to abdominal pressure and impairment of connective tissue and muscle. Larger cystocele formed in the presence of impairments in muscular and apical connective tissue support compared to either support element alone. Apical impairment resulted in a larger cystocele than paravaginal impairment. Levator ani muscle impairment caused a larger urogenital hiatus size, longer length of the distal vagina exposed to a pressure differential, larger apical descent and resulted in a larger cystocele size. Conclusions Development of a cystocele requires a levator muscle impairment, an increase in abdominal pressure, and apical and paravaginal support defects.

Chen, Luyun; Ashton-Miller, James A.; DeLancey, John O.L.

2009-01-01

77

New electrocardiographic criteria for posterior wall acute myocardial ischemia validated by a percutaneous transluminal coronary angioplasty model of acute myocardial infarction  

Microsoft Academic Search

The standard 12-lead electrocardiogram (ECG) fails to detect ST-segment elevation in patients with posterior wall acute myocardial ischemia. However, additional posterior leads V7-9 provide limited additional diagnostic information to the standard 12-lead ECG when an ischemic criterion of 1-mm ST elevation is used. No study is available to delineate the ischemic criteria in the posterior electrocardiographic leads. Continuous 15-lead ECGs

Shu-Fen Wung; Barbara J Drew

2001-01-01

78

A prospective comparison of echocardiographic wall motion score index and radionuclide ejection fraction in predicting outcome following acute myocardial infarction  

Microsoft Academic Search

OBJECTIVETo characterise echocardiographic wall motion score index (WMSI) as a surrogate measure of left ventricular ejection fraction (EF) following acute myocardial infarction (AMI) and to compare its prognostic value with that of EF measured by radionuclide ventriculography (RNV).DESIGNA prospective study to compare baseline echocardiographic WMSI with RNV EF in consecutive patients thrombolysed for AMI, both performed on the same day

G I W Galasko; S Basu; A Lahiri; R Senior

2001-01-01

79

Measurement of myocardial wall thickening from PET/SPECT images: Comparison of two methods  

SciTech Connect

We compared two methods for measuring myocardial wall thickening from nuclear medicine perfusion scans. The first method uses the percent change in peak activity, and the second method models a profile measured across the myocardium. Mathematical simulations of the myocardium were used. In addition, images with PET or SPECT resolution were created from real MR images. Known amounts of noise were then added. The percent peak thickening (%PT) is nonlinear with true percent thickening, especially for PET resolutions [7 mm full width at half-maximum (FWHM)]. For the peak method, low levels of noise (10%) introduced an error of 8%PT for PET and of 16%PT for SPECT. Additional smoothing reduced these errors. For the fitted model, at 10% noise, the error in thickening was large: 2.3 mm for PET and 7.8 mm for SPECT. The fitted model works well only with good resolution and low noise (e.g., 7 mm FWHM and 10%). The peak method is also sensitive to noise, especially for poorer resolutions. Additional smoothing gives more reliable results for the peak method but not the fitted method. The peak method is therefore the more generally reliable, but even this method may only allow classification of myocardial thickening into broad categories. 13 refs., 4 figs., 2 tabs.

Bartlett, M.L.; Mok, D.; Dilsizian, V. [National Insitute of Health, Bethesda, MD (United States)] [and others] [National Insitute of Health, Bethesda, MD (United States); and others

1996-05-01

80

Reversal of segmental hypokinesis by coronary angioplasty in patients with unstable angina, persistent T wave inversion, and left anterior descending coronary artery stenosis. Additional evidence for myocardial stunning in humans  

SciTech Connect

To evaluate the significance of persistent negative T waves during severe ischemia, we prospectively studied 62 patients admitted for unstable angina without evidence of recent or ongoing myocardial infarction. A critical stenosis on the left anterior descending coronary artery (LAD), considered as the culprit lesion, was successfully treated by percutaneous transluminal coronary angioplasty (PTCA). The patients were divided into two groups according to the admission electrocardiogram: T NEG group (n = 32) had persistent negative T waves, and the T POS group (n = 30) had normal positive T waves on precordial leads. The two groups had similar baseline clinical, hemodynamic, and angiographic characteristics. All patients underwent a complete clinical and angiographic evaluation (coronary arteriography and left ventriculography) before undergoing PTCA and 8 +/- 3 months later. Left ventricular anterior wall motion was evaluated by the percent shortening of three areas (S1, S2, and S3) considered as LAD-related segments on left ventriculograms. Before PTCA, there was no significant difference in global ejection fraction between the two groups despite a significant depression in anterior mean percent area shortening in the T NEG compared with the T POS group (S1, 44 versus 54, p less than 0.01; S2, 39 versus 48, p less than 0.01; S3, 44 versus 50, NS). At repeated angiography, the anterior mean percent area shortening improved significantly in the T NEG group (S1, from 44 to 61, p less than 0.001; S2, from 39 to 58, p less than 0.001; S3, from 44 to 61, p less than 0.001).

Renkin, J.; Wijns, W.; Ladha, Z.; Col, J. (Univ. of Louvain Medical School, Brussels (Belgium))

1990-09-01

81

Report of Three Cases of Unusual Anterior Abdominal Wall Defects in Fallujah General Hospital During the Year 2010  

PubMed Central

Abdominal wall defects occur when the normal sequence of the gastro intestinal tract development is interrupted. Gastroschisis represents a herniation of abdominal contents through a paramedian full-thickness abdominal wall fusion defect without involving the umbilical cord. Evisceration usually only contains intestinal loops and has no surrounding membrane unlike omphalocoele. It is unusual for a newborn with gastroschisis to have other serious birth defects. Neonates with gastroschisis have better prognosis than those with omphalocele. Very rarely is gastroschisis associated with herniation of other organs, and their presence makes the prognosis worse. I report three cases of unusual anterior abdominal wall defects during the year 2010, each having specific associated abnormalities. One was stillborn, and the other two died shortly after delivery.

Alaani, Samira

2012-01-01

82

The spectrum of right ventricular involvement in inferior wall myocardial infarction: a clinical, hemodynamic and noninvasive study  

SciTech Connect

The clinical experience with 37 patients with acute transmural inferior wall myocardial infarction who were assessed for evidence of right ventricular involvement is reported. On the basis of currently accepted hemodynamic criteria, 29 patients (78%) had evidence suggestive of right ventricular infarction. However, only 5 (20%) of 25 patients demonstrated right ventricular uptake of technetium pyrophosphate on scintigraphy. Two-dimensional echocardiography or isotope nuclear angiography, or both, were performed in 32 patients; 20 studies (62%) showed evidence of right ventricular wall motion disturbance or dilation, or both. Twenty-one patients demonstrated a late inspiratory increase in the jugular venous pressure (Kussmaul's sign). The presence of this sign in the clinical setting of inferior wall myocardial infarction was predictive for right ventricular involvement in 81% of the patients in this study. It is suggested that right ventricular involvement in this clinical setting is common and includes not only infarction but also dysfunction without detectable infarction, which is likely on an ischemic basis.

Baigrie, R.S.; Haq, A.; Morgan, C.D.; Rakowski, H.; Drobac, M.; McLaughlin, P.

1983-06-01

83

Difference between Outcome of Left Circumflex Artery and Right Coronary Artery Related Acute Inferior Wall Myocardial Infarction in Patients Undergoing Adjunctive Angioplasty after Fibrinolysis  

PubMed Central

Introduction: Prognostic differences between anterior and inferior wall Myocardial Infarction (MI) has been extensively investigated, but there is limited information about similar comparison between inferior wall MI caused by right coronary artery (RCA) and left circumflex artery (LCX) occlusion. The aim of present study was to compare prognostic differences between LCX- and RCA-related acute inferior wall ST-segment elevation MI (STEMI) treated by routine adjunctive angioplasty after receiving thrombolytic therapy (TLT). Methods: Between March 2012 and June 2013 one hundred fifty consecutive patients with acute inferior wall STEMI were studied. Patients were divided into two groups according to the infarct related artery (LCX vs. RCA). All patients underwent routine adjunctive angioplasty after TLT during the index hospitalization and clinical characteristics and outcomes were compared. Results: RCA and LCX arteries were occluded in 97 (64.7%) and 53 (35.3%) of patients, respectively. Two groups were similar in baseline characteristics except multiple-vessel disease was more prevalent with LCX occlusion (p= 0.008). There was a higher cardiac enzyme release (p< 0.001), more significant mitral regurgitation (MR) (p= 0.015), and lower left ventricular ejection fraction (LVEF) (p= 0.01) in patients with LCX occlusion. Multivariate analysis showed cTn-I release, occurrence of MR, and lower LVEF as independent factors leading to poor outcome. Conclusions: There were higher cTn-I release, MR occurrence, and lower LVEF in LCX-related acute inferior wall STEMI, all associated with poor outcome. Therefore, patients with ECG finding in favour of LCX occlusion should be considered as high risk and an invasive approach should be planned.

Sohrabi, Bahram; Separham, Ahmad; Madadi, Reza; Toufan, Mehrnoush; Mohammadi, Nasibeh; Aslanabadi, Naser; Kazemi, Babak

2014-01-01

84

Abnormalities of early depolarization in patients with remote anterior myocardial infarction and ventricular septal hypoperfusion. Diagnosis of septal MI by BSM  

SciTech Connect

The authors conducted this study to find the difference in body surface isopotential maps in 46 patients with previous anterior infarction with and without septal involvement. Thallium-201 myocardial-perfusion imaging identified 25 patients with septal infarction (group P) and 21 without (group N). In contrast to group N, group P had a prominent minimum on the anterior chest during the early phases of the QRS. According to the results obtained, the following criteria for identifying patients with septal infarction (group P) were proposed (1). Criterion 1: The absolute value of the voltage of the minimum is equal to or greater than that of the maximum at 5 ms after the onset of the QRS; (2) Criterion 2: During the early portion of the QRS the voltage of the minimum reaches -0.10 mV at the same time or earlier than the maximum reaches 0.10 mV. Both criteria had higher sensitivities (100% and 100%), specificities (71.4% and 90.5%), and predictive accuracies (87.0% and 95.7%) than either Franklead vectorcardiograms or standard 12-lead electrocardiograms in the study population. Thus, body surface isopotential mapping is considered to be useful for the diagnosis of septal involvement in patients with previous anterior myocardial infarction.

Kubota, I.; Yamaki, M.; Ikeda, K.; Yamaguchi, I.; Tonooka, I.; Tsuiki, K.; Yasui, S. (Yamagata Univ. School of Medicine (Japan))

1990-10-01

85

Myocardial dysfunction in the periinfarct and remote regions following anterior infarction in rats quantified by 2D radial strain echocardiography: An observational cohort study  

PubMed Central

Background Heart failure from adverse ventricular remodeling follows myocardial infarction, but the contribution of periinfarct and remote myocardium to the development of cardiomyopathy remains poorly defined. 2D strain echocardiography (2DSE) is a novel and sensitive tool to measure regional myocardial mechanics. The aim is to quantify radial strain in infarcted (I), periinfarct (PI) and remote (R) myocardial regions acutely and chronically following anterior infarction in rats. Methods The left anterior coronary artery of male Sprague-Dawley rats (270–370 g) were occluded for 20–30 minutes and 2DSE was performed in the acute setting (n = 10; baseline and 60 minutes post-reperfusion) and in the chronic setting (n = 14; baseline, 1, 3 and 6 weeks). Using software, radial strain was measured in the mid-ventricle in short axis view. The ventricle was divided into 3 regions: I (anteroseptum, anterior and anterolateral), PI – (inferoseptum and inferolateral) and R – (inferior). Infarct size was measured using triphenyl tetrazolium chloride in the acute group. Results Following infarct, adverse remodeling occurred with progressive increase in left ventricular size, mass and reduced fractional shortening within 6 weeks. Radial strain decreased not only in the infarct but also in the periinfarct and remote regions acutely and chronically (I, PI, R, change vs. baseline, 60 minutes -32.7 ± 8.7, -17.4 ± 9.4, -13.5 ± 11.6%; 6 weeks -24.4 ± 8.2, -17.7 ± 8.3, -15.2 ± 8.4% respectively, all p < 0.05). Reduced radial strain in periinfarct and remote regions occurred despite minimal or absent necrosis (area of necrosis I, PI, R: 48.8 ± 23, 5.1 ± 6.6, 0 ± 0%, p < 0.001 vs. I). Conclusion Following left anterior coronary occlusion, radial strain decreased at 60 minutes and up to 6 weeks in the periinfarct and remote regions, similar to the reduction in the infarct region. This demonstrates early and chronic myopathic process in periinfarct and remote regions following myocardial infarction that may be an under recognized but important contributor to adverse left ventricular remodeling and progression to ischemic cardiomyopathy.

Migrino, Raymond Q; Zhu, Xiaoguang; Morker, Mineshkumar; Brahmbhatt, Tejas; Bright, Megan; Zhao, Ming

2008-01-01

86

Elasticity of the anterior abdominal wall and impact for reparation of incisional hernias using mesh implants  

Microsoft Academic Search

Summary.   Mesh implantation to repair incisional hernia involves extensive disturbance of the integrity of the abdominal wall. To define\\u000a the physiological requirements, we measured the elasticity of the abdominal wall of 14 anatomic samples. The complete abdominal\\u000a wall was excised and stretched at a strain of 0–24 N in horizontal, vertical and oblique (upper and lower abdomen) directions.\\u000a The resulting mean

K. Junge; U. Klinge; A. Prescher; P. Giboni; M. Niewiera; V. Schumpelick

2001-01-01

87

Planar positron imaging of rubidium-82 for myocardial infarction: A comparison with thallium-201 and regional wall motion  

SciTech Connect

Rubidium-82 (Rb-82) is a generator-produced, short half-life (76 seconds) positron emitting potassium analog. Using a mobile gamma camera equipped with a rotating tungsten collimator and high-energy shielding, we examined the use of Rb-82 in the coronary care unit and clinical laboratory for detection of perfusion defects due to myocardial infarction. We studied 31 subjects, 10 patients with acute myocardial infarction, 12 with remote myocardial infarction, and nine controls. Rb-82 images were compared with Tl-201 and regional wall motion for detection of infarct-related arteries. Of the 22 patients with myocardial infarction, 16 were identified with Rb-82 and Tl-201. In nine control subjects, eight were normal with each method. Correlation between Rb-82 and Tl-201 defect scores was excellent. Sensitivity and specificity for infarct-related arteries were similar for Rb-82, Tl-201, and wall motion imaging. Thus planar Rb-82 imaging can detect MI reliably in the coronary care unit and in the clinical laboratory.

Williams, K.A.; Ryan, J.W.; Resnekov, L.; Stark, V.; Peterson, E.L.; Gustafson, G.C.; Martin, W.B.; Freier, P.A.; Harper, P.V. (Univ. of Chicago Pritzker School of Medicine, IL (USA))

1989-09-01

88

Huge desmoid tumor of the anterior abdominal wall mimicking an intraabdominal mass in a postpartum woman: a case report  

PubMed Central

Desmoid tumors are benign neoplasms that most often arise from muscle aponeurosis and have been associated with both trauma and pregnancy. The etiology of desmoids has not been determined. We report the case of anterior abdominal wall desmoid tumor in a female patient with previous history of cesarean section. Preoperative ultrasound and computed tomography demonstrated a large mass mimicking a large hematoma or an intraabdominal mass. The tumor was removed by wide excision with safe margins. The abdominal wall defect was reconstructed with polypropylene mesh. Subsequent histology revealed a desmoid tumor. Desmoid tumors in females are often associated with pregnancy or occur post-partum. The reasons behind this association are unclear. The most common sites are in the abdominal muscles.

Trigui, Khaled; Bouassida, Mahdi; Kilani, Houda; Mighri, Mohamed Mongi; Sassi, Selim; Chebbi, Fathi; Touinsi, Hassen; Sassi, Sadok

2013-01-01

89

Huge desmoid tumor of the anterior abdominal wall mimicking an intraabdominal mass in a postpartum woman: a case report.  

PubMed

Desmoid tumors are benign neoplasms that most often arise from muscle aponeurosis and have been associated with both trauma and pregnancy. The etiology of desmoids has not been determined. We report the case of anterior abdominal wall desmoid tumor in a female patient with previous history of cesarean section. Preoperative ultrasound and computed tomography demonstrated a large mass mimicking a large hematoma or an intraabdominal mass. The tumor was removed by wide excision with safe margins. The abdominal wall defect was reconstructed with polypropylene mesh. Subsequent histology revealed a desmoid tumor. Desmoid tumors in females are often associated with pregnancy or occur post-partum. The reasons behind this association are unclear. The most common sites are in the abdominal muscles. PMID:23593530

Trigui, Khaled; Bouassida, Mahdi; Kilani, Houda; Mighri, Mohamed Mongi; Sassi, Selim; Chebbi, Fathi; Touinsi, Hassen; Sassi, Sadok

2013-01-01

90

Modified method of T-tube placement in cases of ruptured choledochal cyst having complete loss of anterior wall.  

PubMed

Survival rates for infants and children who have choledochal cyst with or without spontaneous rupture have improved dramatically in the past decades. Despite excellent long-term survival for patients with choledochal cyst who undergo elective surgery, many significant complications can occur in the patients being operated in emergency for rupture of the cyst. Spontaneous rupture of the cyst is one such problem resulting in considerable morbidity and mortality in these patients. Majority of surgeons manage these cases with T-tube external drainage. The conventional methods of T-tube placement for long period has remained simple as described in choledochotomies where there is no deficit of the walls of common bile duct (CBD). The present technique has been designed specially for the cases of ruptured choledochal cyst, where the wall of the CBD gets necrosed leaving behind a long gap between the two ends. In these cases, placement of T-tube with conventional method is not possible because there is no wall to suture together, and make the CBD water tight again to prevent leakage of bile. We found only two patients of spontaneous rupture of choledochal cyst with a long gap between two ends of CBD because of necrosed anterior wall. In both of these patients, it was not possible to put T-tube with traditional method and one would have to opt for primary definitive repair despite poor general condition of patients. PMID:21196660

Intezar, Ahmed; Jile, Rawat D; Sharma, Anshuman; Pandey, Anand; Wakhlu, Ashish; Kureel, Shiv N

2011-01-01

91

Extensive anterior chest wall ecchymosis as a sign of subacute type A aortic dissection  

PubMed Central

A 66-year old man was admitted to the hospital with chest and back pain and wide chest wall ecchymosis. His medical history revealed no chest trauma or resuscitation, but coronary angiography had been performed 20 days previously. Subacute type A aortic dissection was diagnosed. The likely cause of an ecchymosis located in this way, correlated with vasculature of thoracic wall, was thought to be progression of the dissection through the arterial branches feeding the chest wall. Perioperative observation confirmed the diagnosis and a hemiarch replacement was performed with a good outcome.

Yazici, Pinar; Oz, Kursad; Celik, Omer; Erek, Ersin

2012-01-01

92

Traumatic anterior abdominal wall hernia: A report of three rare cases  

PubMed Central

Traumatic abdominal wall hernia is a rare condition that can follow any blunt trauma. Associated intra-abdominal injuries are infrequent. In this study, we are reporting three cases, diagnosed as abdominal wall hernia associated with herniation of bowel loops due to blunt trauma. In one case, injury of the herniated bowel was seen. In western medical literature, only few cases have been reported especially with intra-abdominal injuries.

Singal, Rikki; Dalal, Usha; Dalal, Ashwani Kumar; Attri, Ashok Kumar; Gupta, Raman; Gupta, Anupama; Naredi, Bikash; Kenwar, Deepesh Benjamin; Gupta, Samita

2011-01-01

93

Electrocardiographic Characterization of Rhesus Monkey Model of Ischemic Myocardial Infarction Induced by Left Anterior Descending Artery Ligation  

Microsoft Academic Search

Myocardial infarction is a leading cause for morbidity and mortality in the modern society. Rhesus monkeys are excellent animal\\u000a models for experimental and translational studies of cardiovascular diseases in humans. However, some detailed characterizations\\u000a of cardiovascular disease, such as myocardial infarction, in Rhesus monkeys have not been available. The present study was\\u000a undertaken to examine the progressive electrocardiographic changes in

Pingliang Yang; Pengfei Han; Jianglong Hou; Lizhi Zhang; Haibo Song; Yuping Xie; Yonglin Chen; Huiqi Xie; Fabao Gao; Y. James Kang

94

Biceps sternalis: a Y-shaped muscle on the anterior chest wall  

PubMed Central

The sternalis muscle is an accessory muscle located in the anterior thoracic region, which is relatively unfamiliar to clinicians and surgeons. To date, no data from the Iranian population have been published. Here, a rare case of a sternalis muscle is presented. In addition, this anomalous muscle was observed along with other visceral and vascular anomalies. This case is unique and provides significant information to radiologists, angiologists and surgeons seeking to apply safer interventions. It is also imperative for better interpretation of mammographic images and in reconstructive surgery.

2013-01-01

95

The relationship between superior attachment points for anterior wall mesh operations and the upper vagina using a 3-dimensional magnetic resonance model in women with normal support  

PubMed Central

Objective We examined structural relationships between anterior mesh kit suspension points and the upper vagina in women with normal support. Study Design Eleven women with normal support underwent supine, multiplanar magnetic resonance pelvic imaging at rest and maximal Valsalva. Using 3-dimensional models generated from these images, anterior wall mesh kit anchoring points were identified along the arcus tendineus fascia pelvis. We then measured the percentage of anterior vagina above and posterior to superior suspension points. Results The anterior vagina extended above superior attachment points in 100% of women at rest and in 73% during Valsalva. It extended posterior to them in 82% and 100% (rest and Valsalva, respectively). The mean percentage of anterior vaginal length above superior anchoring sites was 40 ± 14% at rest and 29 ± 12% during Valsalva. Conclusion The upper vagina lies above and posterior to superior suspension points in the majority of women with normal support.

Larson, Kindra A.; Hsu, Yvonne; DeLancey, John O. L.

2010-01-01

96

[Ruptured aneurysm at the anomalous arterial wall of the distal anterior inferior cerebellar artery: a case report].  

PubMed

Distal anterior inferior cerebellar artery(AICA)aneurysms are rare, so its pathogenesis and treatment remain controversial. Here, we report the unique pathogenesis of a ruptured aneurysm in this area that was based on anomalous components as well as partial dissection of the arterial wall. A 61-year-old woman presented to our hospital with sudden headache and nausea. On admission, neurological examination revealed slight consciousness disturbance. Computed tomography(CT)of the head showed a clotted subarachnoid hemorrhage(SAH)that was dominant in the right cerebellopontine and prepontine cistern. Three-dimensional CT angiography detected an irregular fusiform aneurysm 4.5×3.2mm in size in the distal portion of the AICA. The patient underwent trapping without distal vascular reconstruction by the lateral suboccipital approach. After surgery, she experienced right hearing disturbance and ipsilateral facial palsy that were considered to be caused by vasogenic edema at the cerebellar peduncle that resulted from the initial SAH damage. Pathology revealed an aneurysmal wall with anomalous components and arterial dissection in the arterial wall. To our knowledge, only one article has reported the histological findings of a distal AICA aneurysm. Based on the pathology of this case, these findings may suggest a useful treatment strategy for this rare aneurysm. PMID:24388939

Hikichi, Kentaro; Ishikawa, Tatsuya; Moroi, Junta; Miyata, Hajime

2014-01-01

97

Acute Anterior ST-Elevation Myocardial Infarction and Electrical Storm Secondary to Nondominant Right Coronary Artery Occlusion  

PubMed Central

A 42-year-old man emergently presented with chest pain and anterior ST elevation. Refractory ventricular arrhythmias and shock developed rapidly. A coronary angiogram revealed the acute occlusion of a nondominant right coronary artery. After percutaneous coronary intervention, the anterior ST elevation and ventricular arrhythmias resolved. The electrocardiographic pattern was a result of isolated right ventricular infarction that in turn caused profound electrical and hemodynamic instability. We discuss the cause and pathophysiology of this patient's case, and we recommend that interventional and general cardiologists be aware that anterior ST elevation can be caused by the occlusion of a nondominant right coronary artery.

Brown, Michael; Bashir, Riyaz; O'Murchu, Brian

2014-01-01

98

Texture analysis improves level set segmentation of the anterior abdominal wall  

SciTech Connect

Purpose: The treatment of ventral hernias (VH) has been a challenging problem for medical care. Repair of these hernias is fraught with failure; recurrence rates ranging from 24% to 43% have been reported, even with the use of biocompatible mesh. Currently, computed tomography (CT) is used to guide intervention through expert, but qualitative, clinical judgments, notably, quantitative metrics based on image-processing are not used. The authors propose that image segmentation methods to capture the three-dimensional structure of the abdominal wall and its abnormalities will provide a foundation on which to measure geometric properties of hernias and surrounding tissues and, therefore, to optimize intervention.Methods: In this study with 20 clinically acquired CT scans on postoperative patients, the authors demonstrated a novel approach to geometric classification of the abdominal. The authors’ approach uses a texture analysis based on Gabor filters to extract feature vectors and follows a fuzzy c-means clustering method to estimate voxelwise probability memberships for eight clusters. The memberships estimated from the texture analysis are helpful to identify anatomical structures with inhomogeneous intensities. The membership was used to guide the level set evolution, as well as to derive an initial start close to the abdominal wall.Results: Segmentation results on abdominal walls were both quantitatively and qualitatively validated with surface errors based on manually labeled ground truth. Using texture, mean surface errors for the outer surface of the abdominal wall were less than 2 mm, with 91% of the outer surface less than 5 mm away from the manual tracings; errors were significantly greater (2–5 mm) for methods that did not use the texture.Conclusions: The authors’ approach establishes a baseline for characterizing the abdominal wall for improving VH care. Inherent texture patterns in CT scans are helpful to the tissue classification, and texture analysis can improve the level set segmentation around the abdominal region.

Xu, Zhoubing [Electrical Engineering, Vanderbilt University, Nashville, Tennessee 37235 (United States)] [Electrical Engineering, Vanderbilt University, Nashville, Tennessee 37235 (United States); Allen, Wade M. [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37235 (United States)] [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37235 (United States); Baucom, Rebeccah B.; Poulose, Benjamin K. [General Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37235 (United States)] [General Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37235 (United States); Landman, Bennett A. [Electrical Engineering, Vanderbilt University, Nashville, Tennessee 37235 and Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37235 (United States)] [Electrical Engineering, Vanderbilt University, Nashville, Tennessee 37235 and Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37235 (United States)

2013-12-15

99

Correlation Between NT-Pro BNP Levels and Left Ventricular Wall Stress, Sphericity Index and Extent of Myocardial Damage: A Magnetic Resonance Imaging Study  

Microsoft Academic Search

BackgroundTo determine the relationship between N-terminal pro-brain natriuretic peptide (NT-pro BNP) levels and left ventricular wall stress, sphericity index, function, and extent of myocardial damage in patients with coronary artery disease and abnormal left ventricular wall motion.

Rungroj Krittayaphong; Thananya Boonyasirinant; Pairash Saiviroonporn; Prajak Thanapiboonpol; Supaporn Nakyen; Suthipol Udompunturak

2008-01-01

100

Efficacy and Safety of "Tension-free" Placement of Gynemesh PS for the Treatment of Anterior Vaginal Wall Prolapse  

PubMed Central

Purpose To evaluate the efficacy and safety of the tension-free placement of a monofilament polypropylene mesh for the repair of an anterior vaginal wall prolapse (AVWP). Materials and Methods Women aged ? 30 years with an AVWP stage of II or greater were included. Forty-nine women underwent trans-vaginal repair using a Gynemesh™ PS. Forty-six women who had symptomatic stress urinary incontinence received a midurethral sling (MUS). At the 12-month follow-up, evaluations were made for changes in the Pelvic Organ Prolapse Quantification (POP-Q) stage and Pelvic Floor Distress Inventory. Cure was defined as a POP-Q stage of 0 and improvement as a stage of I. Complications were also evaluated. Results The cure rate was 71.4%, and the improvement rate was 18.4%. Obstructive/discomfort, irritative, and stress subscale scores of the Urinary Distress Inventory anterior and posterior subscale scores of the POP Distress Inventory and the obstructive subscale score of the Colo-Rectal-Anal Distress Inventory were significantly improved. Thirty-two of the 46 women (69.6%) who received MUS procedures reported no leakage after surgery. Complications were 2 cases of increased intraoperative bleeding and 1 case of vaginal erosion. Conclusions Trans-vaginal repair using a Gynemesh™ PS is a feasible and effective procedure for the treatment of AVWP with no significant complications.

Lee, Young-Suk; Han, Deok-Hyun; Lim, Soo-Hyun; Kim, Tae-Heon; Choo, Myung-Soo; Seo, Ju-Tae; Lee, Jeong-Zoo; Chung, Byung-Soo; Lee, Jeong-Gu

2010-01-01

101

Giant basal cell carcinoma of the anterior chest wall with bone invasion.  

PubMed

Giant basal cell carcinoma (BCC) of the chest wall is rare and poses challenges related to resection and reconstruction. A 69-year old man presented with giant BCC invading sternum. Wide resection and reconstruction with polymethylmethacrylate and mesh was performed. The soft tissue defect was covered with a pedicled omental flap and skin graft. He developed an infection requiring removal of the mesh construct; however, debridement and antibiotics cleared the infection. This case illustrates the locally aggressive nature of this disease and the need for tertiary-level care. PMID:24026857

Nystrom, Lukas M; Gibbs, C Parker; Singhal, Dhruv; Klodell, Charles T

2014-05-01

102

Improved detection of posterior myocardial wall ischemia with the 15-lead electrocardiogram  

Microsoft Academic Search

Background: A routine 12-lead electrocardiogram is commonly obtained to evaluate for possible acute myocardial infarction during the initial screening of patients with chest discomfort. Posterior myocardial infarction is commonly missed because it is not usually visible in the standard leads. In this study, we compared the sensitivity and specificity of posterior chest leads (V7, V8, and V9) and 12-lead electrocardiography

Kenneth Khaw; Abel E. Moreyra; Alan K. Tannenbaum; MaryHelen N. Hosler; Timothy J. Brewer; Jai B. Agarwal

1999-01-01

103

Cardiovascular magnetic resonance myocardial feature tracking detects quantitative wall motion during dobutamine stress  

Microsoft Academic Search

BACKGROUND: Dobutamine stress cardiovascular magnetic resonance (DS-CMR) is an established tool to assess hibernating myocardium and ischemia. Analysis is typically based on visual assessment with considerable operator dependency. CMR myocardial feature tracking (CMR-FT) is a recently introduced technique for tissue voxel motion tracking on standard steady-state free precession (SSFP) images to derive circumferential and radial myocardial mechanics.We sought to determine

A. Schuster; S. Kutty; A. Padiyath; V. Parish; P. Gribben; D. A. Danford; M. R. Makowski; B. Bigalke; P. B. J. Beerbaum; E. Nagel

2011-01-01

104

Usefulness of T wave inversion in leads with ST elevation on the presenting electrocardiogram to predict spontaneous reperfusion in patients with anterior ST elevation acute myocardial infarction.  

PubMed

Inversion of the T waves (T-) in electrocardiographic leads with ST-segment elevation after the initiation of reperfusion therapy is considered a sign of reperfusion. However, the significance of T- on presentation before the initiation of reperfusion therapy is unclear. The aim of this study was to assess whether T- on presentation predicts patency of the infarct-related artery in patients with acute ST-segment elevation myocardial infarctions (STEMIs) who undergo primary percutaneous interventions. The medical records, electrocardiograms, and angiographic findings of 209 consecutive patients who underwent emergent coronary angiography as part of primary percutaneous coronary intervention protocol activation for STEMI were reviewed. A total of 179 patients (86%) had positive T waves (T+), 16 (8%) had biphasic T waves (T+/-), and 14 (7%) had T-. Patency of the infarct-related artery (Thrombolysis In Myocardial Infarction [TIMI] flow grades 2 and 3) was seen in 64.3% of the patients in the T- group compared with only 31.2% in the T+/- group and 19.0% in the T+ group (p <0.001). Among patients with anterior STEMI, patency of the infarct-related artery was seen in all 7 patients in the T- group, compared with 50% of the 4 patients in the T+/- group and 10.1% of the 79 patients in the T+ group (p <0.001). There were no significant differences in TIMI flow grade among the groups in patients with nonanterior STEMIs (p = 0.985). In conclusion, T- in the leads with maximal ST-segment elevation on the presenting electrocardiogram was associated with higher prevalence of patency of the infarct-related artery before intervention (64.3%), especially in patients with anterior STEMIs (100%). PMID:24176061

Alsaab, Ayham; Hira, Ravi S; Alam, Mahboob; Elayda, Macarthur; Wilson, James M; Birnbaum, Y

2014-01-15

105

Changes in systolic and postsystolic wall thickening during acute coronary occlusion and reperfusion in closed-chest pigs: Implications for the assessment of regional myocardial function  

Microsoft Academic Search

The aim of the study was to characterize the impact of short-lived total coronary occlusions in closed-chest pigs on radial wall thickening within the “at-risk” myocardial segment by using gray-scale M-mode echocardiography. Twelve pigs underwent a series of 20-second total circumflex coronary artery occlusions with an angioplasty balloon. Myocardial thickening\\/thinning indexes were continuously monitored before ischemia, during ischemia, and on

Fadi Jamal; Monika Szilard; Tomasz Kukulski; Xiao-Shun Liu; Bart Bijnens; Frank Rademakers; Liv Hatle; Ivan De Scheerder; George R. Sutherland

2001-01-01

106

"Mushroom cloud": a giant left ventricular pseudoaneurysm after a myocardial infarction due to myocardial bridging - a case report  

PubMed Central

Left ventricular pseudoaneurysm is an uncommon complication after transmural myocardial infarction, occurring when a free wall rupture is contained by adhesions of the overlying pericardium preventing acute tamponade. In this report, an unusual case of a 61 year-old male with a giant apical left ventricular pseudoaneurysm after an unnoticed myocardial infarction is presented. On coronary angiogram myocardial bridging of the distal left anterior descending artery was judged to be the infarct related lesion. The echocardiographic diagnosis allowed for a timely surgical intervention which resulted in the patient's full recovery.

Gomes, Renata; Andrade, Maria Joao; Santos, Miguel; Lima, Sonia; Gouveia, Raquel A; Ferreira, Manuel M; Silva, Jose Aniceto

2009-01-01

107

MRI evaluation of tibial tunnel wall cortical bone formation after platelet-rich plasma applied during anterior cruciate ligament reconstruction  

PubMed Central

Background After anterior cruciate ligament (ACL) reconstruction, formation of cortical sclerotic bone encircling the femoral and tibial tunnel is a part of intratunnel graft healing. During the physiological cascades of soft tissue healing and bone growth, cellular and hormonal factors play an important role. The purpose of this study was to non-invasively but quantitatively assess the effect of intraoperatively applied platelet-rich plasma (PRP) on the formation of cortical bone encircling the tibial tunnel. Patients and methods In fifty patients, standard arthroscopic ACL reconstructions were performed. The PRP group (n = 25) received a local application of PRP while the control group (n = 25) did not receive PRP. The proximal tibial tunnel was examined by MRI in the paraxial plane where the portion of the tibial tunnel wall circumference consisting of sclerotic cortical bone was assessed with testing occurring at one, two and a half and six months after surgery. Results At one month after surgery, differences between the groups in the amount of cortical sclerotic bone encircling the tunnel were not significant (p = 0.928). At two and a half months, the sclerotic portion of the tunnel wall in the PRP group (36.2%) was significantly larger than in the control (22.5%) group (p = 0.004). At six months, the portion of sclerotic bone in the PRP group (67.1%) was also significantly larger than in the control (53.5%) group (p = 0.003). Conclusions Enhanced cortical bone formation encircling the tibial tunnel at 2.5 and 6 months after ACL graft reconstruction results from locally applied platelet-rich plasma.

Rupreht, Mitja; Vogrin, Matjaz; Hussein, Mohsen

2013-01-01

108

Normal values of regional and global myocardial wall motion in young and elderly individuals using navigator gated tissue phase mapping.  

PubMed

The purpose of this study was to evaluate normal values for regional and global myocardial wall motion parameters in young and elderly individuals, as detected by navigator gated high temporal resolution tissue phase mapping. Radial, longitudinal and circumferential ventricular wall motion, as well as ventricular torsion and longitudinal strain rates, were assessed in two age groups of volunteers, 23 ± 3 (n = 14) and 66 ± 7 years old (n = 9), respectively. All subjects were healthy, non-smokers without known cardiac disease. An increased global left ventricular (LV) torsion rate (peak systolic torsion rate 20.6 ± 2.0 versus 14.5 ± 1.0°/s/cm, peak diastolic torsion rate -25.2 ± 1.8 versus -14.1 ± 1.3°/s/cm) and a decrease in longitudinal LV motion (peak systolic values at mid-ventricle 5.9 ± 0.5 versus 8.5 ± 0.8 cm/s, peak diastolic values -10.7 ± 0.7 versus -15.2 ± 0.9 cm/s) in the older age group were the most prominent findings. Lower peak diastolic radial velocities with a longer time-to-peak values, most pronounced at the apex, are consistent with reduced diastolic function with ageing. Lower peak clockwise and counter-clockwise velocities at all LV levels revealed limitations in resting LV rotational motions in the older group. Significant changes in the undulating pattern of the rotational motions of the left ventricle were also observed. The results demonstrate distinct changes in regional and global myocardial wall motion in elderly individuals. Increased LV torsion rate and reduced LV longitudinal motion were particularly prominent in the older group. These parameters may have a role in the assessment of global LV contractility and help differentiate age-related changes from cardiac disease. PMID:23604860

Codreanu, Ion; Pegg, Tammy J; Selvanayagam, Joseph B; Robson, Matthew D; Rider, Oliver J; Dasanu, Constantin A; Jung, Bernd A; Taggart, David P; Golding, Stephen J; Clarke, Kieran; Holloway, Cameron J

2014-02-01

109

Echocardiographic assessment of right ventricular function in inferior wall myocardial infarction and angiographic correlation to proximal right coronary artery stenosis  

PubMed Central

Background Presence of right ventricular (RV) infarction imposes a higher risk of adverse events in inferior wall myocardial infarction (IWMI). In this study, we attempted to correlate various indices of RV function assessed by echocardiography with presence of a proximal right coronary artery (RCA) stenosis in patients with first episode of acute IWMI. Methods In a prospective study, patients with first episode of acute IWMI underwent echocardiographic assessment within 24 h of symptom onset and indices of RV function viz. RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), myocardial performance index (MPI) and tissue Doppler velocities from RV free wall were measured. Patients who underwent coronary angiogram (CAG) within one month and they were classified into group 1 and group 2 based on the presence or absence, respectively, of a significant proximal RCA stenosis. Results There were 90 patients with first episode of IWMI of which 67 patients underwent CAG. There was significant difference between group 1 (n = 26) and group 2 (n = 41) in TAPSE (13.5 ± 1.3 vs 21.3 ± 1.7, p < 0.001), MPI by tissue Doppler (0.87 ± 0.1 vs 0.55 ± 0.2, p < 0.001) and in tissue Doppler systolic velocity from RV free wall (S? 9.8 ± 1.1 vs 15.0 ± 1.5, p < 0.001). There was a good interobserver correlation for TAPSE, MPI by TDI, and S? velocity. TAPSE ? 16 (sensitivity 93%, specificity 100%), MPI-TDI ? 0.69 (sensitivity 94.7%, specificity 93.5%), S ? 12.3 (sensitivity 90.3%, specificity 94.3%) were useful in predicting presence of proximal RCA stenosis. Conclusion RV function indices like TAPSE, MPI-TDI and S? velocity are useful in predicting proximal RCA stenosis in first episode of acute IWMI.

Rajesh, Gopalan Nair; Raju, Deepak; Nandan, Deepak; Haridasan, Vellani; Vinayakumar, Desabandhu; Muneer, Kader; Sajeev, C.G.; Babu, Kadangot; Krishnan, M.N.

2013-01-01

110

Electrocardiographic diagnosis of remote posterior wall myocardial infarction using unipolar posterior lead V9  

SciTech Connect

The accuracy of four electrocardiographic criteria for diagnosing remote posterior myocardial infarction was assessed prospectively in 369 patients undergoing exercise treadmill testing with thallium scintigraphy. Criteria included the following: (1) R-wave width greater than or equal to 0.04 s and R-wave greater than or equal to S-wave in V1; (2) R-wave greater than or equal to S-wave in V2; (3) T-wave voltage in V2 minus V6 greater than or equal to 0.38 mV (T-wave index); (4) Q-wave greater than or equal to 0.04 s in left paraspinal lead V9. Twenty-seven patients (7.3 percent) met thallium criteria for posterior myocardial infarction, defined as a persistent perfusion defect in the posterobase of the left ventricle. Sensitivities for the four criteria ranged from 4 to 56 percent, and specificities ranged from 64 to 99 percent. Posterior paraspinal lead V9 provided the best overall predictive accuracy (94 percent), positive predictive value (58 percent), and ability to differentiate patients with and without posterior myocardial infarction of any single criterion (p less than .0001). Combining the T-wave index with lead V9 further enhanced the diagnostic yield: the sensitivity for detecting posterior infarction by at least one of these criteria was 78 percent, and when both criteria were positive, specificity was 98.5 percent. It is concluded that a single, unipolar posterior lead in the V9 position is superior to standard 12-lead electrocardiographic criteria in diagnosing remote posterior myocardial infarction, and that combining V9 with the T-wave index maximizes the diagnostic yield.

Rich, M.W.; Imburgia, M.; King, T.R.; Fischer, K.C.; Kovach, K.L. (Jewish Hospital Washington University Medical Center, St. Louis (USA))

1989-09-01

111

Sexual function and health-related quality of life following anterior vaginal wall surgery for stress urinary incontinence and pelvic organ prolapse  

Microsoft Academic Search

To assess female sexual function (FSF) and health-related quality of life (HRQOL) following anterior vaginal wall surgeries for stress urinary incontinence (SUI) and pelvic organ prolapse (POP). The retrospective study consisted of 116 patients. Chinese translations of the modified Lemack Questionnaire (not validated) and Pelvic Floor Distress Inventory—Short Form 20 were used to assess FSF and HRQOL, 3 months pre-operatively

T Shen; L-J Song; Y-M Xu; B-J Gu; L-H Lu; F Li

2011-01-01

112

A Predictive Factor in Overactive Bladder Symptoms Improvement after Combined Anterior Vaginal Wall Prolapse Repair: A Pilot Study  

PubMed Central

Purpose We aimed to determine whether a preoperative urodynamic parameter is a valuable predictor for the persistence of OAB symptoms after the AVP repair. Materials and Methods 65 OAB patients with concomitant POP-Q stage III, IV anterior vaginal wall prolapse underwent a surgical repair were involved. All the patients were subjected to a preoperative urodynamic study, for whom the OABSS on questionnaire were preoperatively recorded. We firstly analyzed the correlation between the BOOI and the OABSS, then randomly divided patients into two groups: the group A (high PdetQmax, BOOI?20) and the group B (low PdetQmax, BOOI<20). In each group, the OABSS was repeatedly measured post-operatively and the change were analyzed. Results 31 patients were classified as the group A and 34 patients were classified as the group B. The group B showed significant decrease of symptom score in daytime frequency (p<0.01), urgency (p=0.04), urge incontinence (p=0.03), nocturnal frequency (p=0.01) and total score (p=0.01). The group A showed no significant decrease of symptom score in daytime frequency (p=0.42), urgency (p=0.61), urge incontinence (p=0.3), total score (p=0.15) except nocturnal frequency (p=0.01). Conclusions A preoperative pressure-flow study can be a valuable tool in predicting the OAB symptoms change after the combined AVP repair. While the AVP repair leads to the improvement of OAB symptoms generally, some patients with a higher preoperative PdetQmax are still in need of the additional medical treatment.

Lee, Dong Min; Ryu, Young Woo; Lee, Yong Taec; Ahn, Seung Hyun; Han, June Hyun

2012-01-01

113

Changes in systolic and postsystolic wall thickening during acute coronary occlusion and reperfusion in closed-chest pigs: Implications for the assessment of regional myocardial function.  

PubMed

The aim of the study was to characterize the impact of short-lived total coronary occlusions in closed-chest pigs on radial wall thickening within the "at-risk" myocardial segment by using gray-scale M-mode echocardiography. Twelve pigs underwent a series of 20-second total circumflex coronary artery occlusions with an angioplasty balloon. Myocardial thickening/thinning indexes were continuously monitored before ischemia, during ischemia, and on reperfusion by high-resolution M-mode recordings of the posterior wall obtained from parasternal views. The timing of regional events was compared with global systolic time intervals derived from the color Doppler myocardial imaging velocity data. Each occlusion induced a rapid decrease in end-systolic thickening (epsilon(ES)), closely paralleled by an increase in postsystolic thickening in the ischemic segment. After 20 seconds of ischemia, epsilon(ES) decreased by -86% and postsystolic thickening increased by +100%, whereas maximal thickening decreased only by -34% in comparison with preocclusion values. All wall thickening parameters returned to baseline after 15 seconds of reperfusion. During acute total ischemia in a closed-chest animal model, the changes in regional myocardial function were best characterized by the combined analysis of systolic and postsystolic thickening abnormalities and by their respective timings relative to global cardiac events markers. PMID:11447414

Jamal, F; Szilard, M; Kukulski, T; Liu, X S; D'hooge, J; Bijnens, B; Rademakers, F; Hatle, L; Descheerder, I; Sutherland, G R

2001-07-01

114

Estimation of left ventricular myocardial elasticity and viscosity by a thick-walled spherical model.  

PubMed

The authors measured the transfer function (TF) of the left ventricle (LV) in an isolated canine preparation. Here TF indicates the ratio of induced vibration in LV to input vibration when an external mechanical oscillation is applied. TF had a single peak the frequency of which changed from 40 Hz to 80 Hz when LV pressure (LVP) increased from 6 mm Hg to 96 mm Hg. A mathematical model was formulated to estimate the viscoelasticity of the spherical shell. This model was constructed of the material points, elastic components which connected all the material points, and viscous components placed in series with elastic components. Theoretical TF can be computed if the viscoelastic values are given. The value of viscoelasticity at which the theoretical TF best fitted the experimental TF was considered to be the viscoelasticity of the model. The validity of this approach was verified using a silicone spherical shell. The estimated myocardial elasticity was 40 kPa when LVP was 6 mm Hg, 160-170 kPa when LVP was 96 mm Hg and was approximately proportional to LVP, whereas viscosity showed small change. The inclination of elasticity was consistent with previous reports. These results proved that myocardial elasticity can be estimated by analysing the transfer function of the left ventricle. PMID:8231293

Tani, J; Yamamoto, H; Honda, H; Ootomo, K; Koiwa, Y; Takagi, T; Kikuchi, J; Hoshi, N; Takishima, T

1993-07-01

115

[Practical value of Frank's leads in electrocardiographic diagnosis of myocardial infarction].  

PubMed

Authors' own modification of Frank's leads is discussed. Potentials from these leads are recorded simultaneously with routine ECG. Frank's leads are used to increase possibility to diagnose myocardial infarction. Proposed leads in x, y, z, axis of Frank system enable to differentiate pathological QS wave in chest V1-V3 leads between myocardial infarction of the anterior wall and detectable intraventricular potentials in patients with emphysema. A lack of physiologic Q wave in "z+"-lead always indicates anterior wall infarction. Pronounced Q wave of "infarctional" character in y-lead x-lead--in the lesions to the lateral wall. Pathologies present in the posterior wall infarction while from cal Q wave from "z+"-lead facilitates diagnosis of the posterior wall infarction. PMID:2216942

Petelenz, T; Knosa?a, P; Zaorski, K

116

Serial thallium-201 myocardial imaging after dipyridamole infusion: diagnostic utility in detecting coronary stenoses and relationship to regional wall motion  

SciTech Connect

After a 4-minute i.v. dipyridamole infusion, 0.14 mg/kg/min, serial thallium-201 scans were obtained in 60 patients undergoing cardia catheterization. Forty patients had significant (greater than or equal to50% stenosis) coronary artery disease (CAD), and 20 patients had normal coronary arteries or trivial lesions. The images were graded qualitatively for thallium activity by three observers. Sensitivity was 93% (37 of 40) and specificity was 80% (16 of 20). The sensitivity and specificity of the thallium-201 study were not affected by the extent of CAD, the presence of Q waves, or propranolol therapy. Twenty-seven of 37 patients who had initial defects (73%) had complete thallium redistribution of one or more defects. Patient-by-patient anlaysis using a regression model of all patients showed that the fate of a segmental thallium defect predicted abnormal wall motion by angiography better than ECG Q waves. The presence of propranolol therapy or collaterals did not significantly affect the thallium redistribution results. It is concluded that qualitative interpretation by multiple observers of thallium images after dipyridamole infusion is a highly sensitive and specific test for CAD. After dipyridamole, as with exercise stress, the extent of thallium redistribution is related to the degree of myocardial wall motion abnormality.

Leppo, J.; Boucher, C.A.; Okada, R.D.; Newell, J.B.; Strauss, H.W.; Pohost, G.M.

1982-09-01

117

Radionuclide imaging of myocardial infarction using Tc-99m TBI  

SciTech Connect

The cationic complex Tc-99m t-butylisonitrile (TBI) concentrates in the myocardial tissue of several animal species. Its myocardial distribution is proportional to blood flow both in zones of ischemia and in normal myocardium at rest. Planar, tomographic, and gated myocardial images have been obtained using Tc-99m TBI in the human. The authors investigated the potential application of Tc-99m TBI imaging to detect and localize myocardial infarction. Four subjects without clinical evidence of cardiovascular disease and five patients with ECG evidence of previous myocardial infarction were studied. Tc-99m TBI (10mCi) was injected intravenously with the patient in a resting state with planar imaging in the anterior, 30 and 70 degree LAO projections beginning one hr after injection. The distribution of the tracer was homogeneous throughout the left ventricular wall in the normal subjects. Regional perfusion defects were present in 4/5 of the patients with myocardial infarction. Location of the defects corresponded to the location of the infarct using ECG criteria (2 inferoposterior and 2 anterior). The patient in whom the Tc-99m TBI image appeared normal had sustained a subendocardial myocardial infarct which could not be localized by ECG; the other 4 pts had transmural infarcts. Anterior and 30 degree LAO images were of excellent quality in all cases; there was overlap of the liver on the inferior wall of the left ventricle on the 70 degree LAO views. The authors conclude that accurate perfusion imaging may be possible using Tc-99m TBI in patients with transmural myocardial infarction.

Holman, B.L.; Campbell, S.; Kirshenbaum, J.M.; Lister-James, J.; Jones, A.G.; Davison, A.; Antman, E.

1985-05-01

118

[Marked 99mTc-PYP myocardial accumulation immediately after reperfusion in a patient with acute myocardial infarction].  

PubMed

We reported a case of a 72-year-old man with chest pain. An electrocardiogram showed ST segment elevation in I, II, III, aVL, aVF and V1-6 leads. 99mTc-tetrofosmin myocardial SPECT showed defect in the anterior, septal, apical and inferior walls. Coronary angiography showed 99% stenosis of the proximal right coronary artery and total occlusion of the midsegment of the left anterior descending coronary artery. Therefore, direct PTCA was performed for each lesion to achieve reperfusion. We didnt's see reperfusion injury during PTCA of the left coronary artery. On the other side, we saw severe reperfusion injury, such as slow-flow, arrhythmia and falling blood pressure during PTCA of the right coronary artery. After four hours, 99mTc-PYP myocardial SPECT showed marked uptake in the apical and inferior walls, and mild uptake in the anterior and posterior walls. After three days, severely-reduced uptake of 99mTc-PYP in the apex was noted, and mild uptake in the mid-portion of the anterior wall and the mid-portion of the inferior wall. Though reperfusion injury was seen, three was mild myocardial uptake of 99mTc-PYP in the area of the right coronary artery. On the other side, despite no reperfusion injury, there showed marked uptake during the acute phase and defect during the subacute phase in the area of the left coronary artery. Wall motion of the left ventricle was normal in the area of the right coronary artery and akinesis was seen on the left. These findings suggest that 99mTc-tetrofosmin and 99mTc-PYP myocardial SPECT are useful for visualization of reperfusion injury during the acute phase and for estimation of function during the chronic phase, better even than electrocardiogram or coronary angiography. PMID:12701202

Adachi, Yoshihiko; Ito, Kazuki; Nishikawa, Susumu; Yuba, Tatsuya; Tsubakimoto, Yoshinori; Takata, Hiroki; Kato, Shuji; Azuma, Akihiro; Sugihara, Hiroki; Nakagawa, Masao

2003-02-01

119

Relation between angiotensin-converting enzyme I\\/D gene polymorphism and pulse pressure in patients with a first anterior acute myocardial infarction ‹lk kez anteriyor akut miyokard infarktüslü hastalarda anjiyotensin dönüfltürücü enzim I\\/D gen polimorfizmi ile nab›z bas›nc› aras›ndaki iliflki  

Microsoft Academic Search

Objective: Evidence shows that an elevated pulse pressure (PP) may lead to an increased risk of cardiovascular morbidity and mortality. The aim of the present study was to determine the effects of polymorphism of the angiotensin-converting enzyme (ACE) gene on the PP after a first anterior acute myocardial infarction (AMI). Methods: Overall 116 patients with a first anterior AMI were

Önder Öztürk; Ünal Öztürk

120

Dyspareunia and chronic pelvic pain after polypropylene mesh augmentation for transvaginal repair of anterior vaginal wall prolapse  

Microsoft Academic Search

Synthetic mesh augmentations for pelvic floor reconstructive surgeries are increasing in usage and popularity. Many studies\\u000a are focusing on the anatomical success rates of transvaginal anterior compartment repairs with synthetic mesh, with minimal\\u000a attention on its postoperative complications. We present a case report on a 59-year-old postmenopausal woman who underwent\\u000a an anterior repair with 6×4-cm polypropylene mesh. Postoperatively, she developed

Lawrence L. Lin; Alexandra L. Haessler; Matt H. Ho; Lance H. Betson; Red M. Alinsod; Narender N. Bhatia

2007-01-01

121

[Prediction of improvement of left ventricular wall motion in patients with myocardial infarction--by using 99mTc-tetrofosmin and 123I-BMIPP myocardial SPECT at subacute phase].  

PubMed

The relationship between myocardial perfusion, fatty acid metabolism, and cardiac functional recovery were investigated by using single photon emission computed tomography (SPECT) with 99mTc-1,2-bis[bis(2-ethoxyethyl)phosphino]ethane (tetrofosmin: TF) and lodine-123-beta-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) in patients with myocardial infarction. We examined myocardial SPECT in 18 patients with acute myocardial infarction (AMI) underwent successful reperfusion therapy within 24 hours from onset. TF myocardial SPECT (early and delayed images) and BMIPP (early image) SPECT were performed 2 weeks after onset of AMI, and regional TF and BMIPP defect scores of the infarct area were scored visually by a 4-point system. There was a significant correlation between the defect score of the TF delayed image, BMIPP image and SD/chord (indicator of regional wall motion abnormalities on left ventriculograms) at subacute phase (TF: r = -0.592, p = 0.011, BMIPP: r = -0.643, p = 0.004). Good correlations were also found between the defect score of the TF delayed image, the BMIPP image and the SD/chord at chronic phase (TF: r = -0.491, p = 0.037, BMIPP: r = -0.599, p = 0.007). Furthermore, there was a significant correlation between the improvement of SD/chord (acute to chronic phase) and the degree of reverse redistribution score of TF (r = 0.735, p = 0.022), and discordance score between TF and BMIPP (r = 0.691, p = 0.037). In conclusion, resting BMIPP and TF myocardial SPECT performed in patients with subacute phase AMI were shown to be useful in predicting improvement of left ventricular function at chronic phase. PMID:10965649

Akimoto, N

2000-07-01

122

Comparison of real-time coherent contrast imaging to dipyridamole thallium-201 single-photon emission computed tomography for assessment of myocardial perfusion and left ventricular wall motion  

Microsoft Academic Search

Real-time coherent contrast imaging (CCI) echocardiography has the ability to evaluate wall motion and myocardial perfusion simultaneously, but its clinical applicability in the diagnosis of coronary artery disease (CAD) remains to be determined. This study examines the level of agreement between real-time CCI echocardiography and thallium-201 single-photon emission computed tomography (SPECT) following stress vasodilation. Forty-two patients with known or suspected

Mohamed A Oraby; Janet Hays; Fathi A Maklady; Ahmed A El-Hawary; Liberty O Yaneza; Miguel Zabalgoitia

2002-01-01

123

Bone single photon emission computed tomography with computed tomography disclosing chronic uterine perforation with intrauterine device migration into the anterior wall of the bladder: a case report  

PubMed Central

Introduction Extraosseous uptake of 99mTc-hydroxymethylene diphosphonate is a common situation of variable clinical relevance. Case presentation A 52-year-old Caucasian woman presented to our department for breast cancer staging. A 99mTc-hydroxymethylene diphosphonate bone scan was performed and showed focal pelvic hyperfixation that disclosed intrauterine device migration into the anterior wall of the bladder on single photon emission computed tomography with computed tomography. Conclusion This observation confirms the major role of single photon emission computed tomography with computed tomography in achieving an exact diagnosis.

2013-01-01

124

[A case of cervical and mediastinal lymph nodes tuberculosis, tuberculous pleurisy, spinal caries and cold abscess in the anterior chest wall].  

PubMed

A 61-year-old woman with schizophrenia that had been treated in a psychiatric hospital was admitted to our hospital because of subileus and back pain. Though subileus was improved, she had a sudden attack of fever 7 days later and developed right pleural effusion, a cold abscess in the anterior chest wall and swelling of a thumb-sized right cervical lymph node which broke through the skin. We made a diagnosis of cervical and mediastinal lymph nodes tuberculosis, tuberculous pleurisy, spinal caries and cold abscess in the anterior chest wall due to the biopsy findings of the specimen taken from the cervical lymph node, examination of pleural effusion, chest CT, bacteriological examination of the cold abscess and spinal MRI. We started chemotherapy with the antituberculous drugs (HRSZ) and symptoms except back pain improved. She complained of paresis of the both lower extremities, which completely paralyzed 8 months later in spite of continued chemotherapy. Thereafter her paralysis was gradually improved and she was able to walk by herself after 12 months chemotherapy. PMID:15354732

Iwata, Yasuhiro; Ishimatsu, Akiko; Hamada, Minako; Emori, Mikiko; Ikedo, Yukari; Wakamatsu, Kentaro; Nagata, Nobuhiko; Kajiki, Akira; Harada, Yasuko; Harada, Susumu; Kitahara, Yoshinari

2004-07-01

125

Biliary peritonitis caused by a leaking T-tube fistula disconnected at the point of contact with the anterior abdominal wall: a case report  

PubMed Central

Introduction Operations on the common bile duct may lead to potentially serious complications such as biliary peritonitis. T-tube insertion is performed to reduce the risk of this occurring postoperatively. Biliary leakage at the point of insertion into the common bile duct, or along the fistula, can sometimes occur after T-tube removal and this has been reported extensively in the literature. We report a case where the site at which the T-tube fistula leaked proved to be the point of contact between the fistula and the anterior abdominal wall, a previously unreported complication. Case presentation A 36-year-old sub-Saharan African woman presented with gallstone-induced pancreatitis and, once her symptoms settled, laparoscopic cholecystectomy was performed, common bile duct stones were removed and a T-tube was inserted. Three weeks later, T-tube removal led to biliary peritonitis due to the disconnection of the T-tube fistula which was recannulated laparoscopically using a Latex drain. Conclusion This case highlights a previously unreported mechanism for bile leak following T-tube removal caused by detachment of a fistula tract at its contact point with the anterior abdominal wall. Hepatobiliary surgeons should be aware of this mechanism of biliary leakage and the use of laparoscopy to recannulate the fistula.

Nikolic, Marko; Karthikesalingam, Alan; Nachimuthu, Senthil; Tang, Tjun Y; Harris, Adrian M

2008-01-01

126

Cardiac anaphylaxis: a case of acute ST-segment elevation myocardial infarction after IM epinephrine for anaphylactic shock.  

PubMed

A 62-year-old male smoker with no other comorbidities presented to emergency department with systemic anaphylaxis, due to oral diclofenac for toothache. He developed acute anterior wall myocardial infarction following IM epinephrine 1 mg 1:1000. Primary percutaneous coronary intervention was done, which showed a thrombus in the mid left anterior descending artery with no evidence of obstructive coronary artery disease after thrombus aspiration. PMID:23706578

Tummala, Karthik; Maniyal, Vijay K; Chandrashekaran, Rajiv; Mathew, Navin; Ganeshwala, Gaurav

2013-07-01

127

Acute myocardial infarction with normal coronary arteries in a case of polyarteritis nodosa: possible role of coronary artery spasm  

Microsoft Academic Search

A 20 year old man with no previous history of heart disease presented with acute left ventricular failure following extensive anterior wall myocardial infarction. Selective angiography revealed multiple aneurysms in the renal, mesenteric and hepatic arteries with an infarct in the lower pole of the right kidney. These findings, along with the presence of circulating hepatitis B surface antigen favoured

R. M. Rajani; B. V. Dalvi; S. A. DSilva; Y. Y. Lokhandwala; P. A. Kale

1991-01-01

128

Relation of global and regional left ventricular function to tomographic thallium-201 myocardial perfusion in patients with prior myocardial infarction  

SciTech Connect

To determine the relation between regional myocardial perfusion and regional wall motion in humans, tomographic thallium-201 imaging and two-dimensional echocardiography at rest were performed on the same day in 83 patients 4 to 12 weeks after myocardial infarction. Myocardial perfusion and wall motion were assessed independently in five left ventricular regions (total 415 regions). Regional myocardial perfusion was quantitated as a percent of the region infarcted (range 0 to 100%) using a previously validated method. Wall motion was graded on a four point scale as 1 = normal (n = 266 regions), 2 = hypokinesia (n = 64), 3 = akinesia (n = 70), 4 = dyskinesia (n = 13) or not evaluable (n = 2). Regional wall motion correlated directly with the severity of the perfusion deficit (r = 0.68, p less than 0.0001). Among normally contracting regions, the mean perfusion defect score was only 2 +/- 4. Increasingly severe wall motion abnormalities were associated with larger perfusion defect scores (hypokinesia = 6 +/- 5, akinesia = 11 +/- 7 and dyskinesia = 18 +/- 5, all p less than 0.01 versus normal. Among regions with normal wall motion, only 3% had a perfusion defect score greater than or equal to 10. Conversely, among 68 regions with a large (greater than or equal to 10) perfusion defect, only 13% had normal motion whereas 87% had abnormal wall motion. The relation between perfusion and wall motion noted for the entire cohort was also present in subgroups of patients with anterior or inferior infarction. In patients with prior myocardial infarction, the severity of the tomographic thallium perfusion defect correlates directly with echocardiographically defined wall motion abnormalities, both globally and regionally.

Stratton, J.R.; Speck, S.M.; Caldwell, J.H.; Martin, G.V.; Cerqueira, M.; Maynard, C.; Davis, K.B.; Kennedy, J.W.; Ritchie, J.L.

1988-07-01

129

Fully automated wall motion and thickening scoring system for myocardial perfusion SPECT: method development and validation in large population  

PubMed Central

Background Objective assessment of wall motion (M) and thickening (T) will aid in diagnosis of Coronary Artery Disease (CAD) from myocardial perfusion SPECT (MPS). We aimed to develop and validate an improved fully automated M/T segmental scoring system for MPS. Methods 100 normal gated stress/rest Tc-99m sestamibi MPS scans from patients with low-likelihood of CAD (LLk) were used to derive the regional normal M/T ranges. A new automatic algorithm incorporated regional dependence on the global contractility in polar map coordinates by linear regression analysis and automatically derived 17-segment M (scale 0–5) and T (scale 0–3) scores. We validated this new method in 630 consecutive Tc-99m stress MPS studies in patients with suspected CAD and available correlating angiography, and an additional 241 LLk studies. Two independent observers with 12 and 30 years of experience in nuclear cardiology, blinded to clinical and angiographic data, scored M/T in 17-segments for all 971 studies. Results Computation time was < 1 sec per case. In the angiography group, there was a high correlation between the summed scores (averaged for 2 observers) and automatic scores with r=0.91 (slope=1.02, offset=0.2; p < 0.0001) for M and r=0.88 (slope=1.06, offset=0.28 for T; p < 0.0001). Weighted kappa was 0.63 for M and 0.57 for T, with expected agreement of 89% (M) and 91% (T) in individual segments (n=10710). Weighted kappa between 2 experts was 0.45 for M and 0.52 for T. The normalcy rate in LLk cases was 96% for automated M and 99% for T (summed score < 3). Detection of the angiographically significant disease by automated motion or thickening scoring was better than or equivalent to individual expert observer scoring, and better than the previous automated system. Conclusions Fully automated scoring of MPS regional ventricular function can be performed rapidly, is highly correlated with expert visual scoring, can outperform individual experienced observers in the detection of CAD by wall thickening from MPS, and avoids inter-observer variability.

Slomka, Piotr J.; Berman, Daniel S.; Xu, Yuan; Kavanagh, Paul; Hayes, Sean W.; Dorbala, Sharmila; Fish, Mathews; Germano, Guido

2012-01-01

130

[The use of the Export Catheter device in a patient with acute myocardial infarction for thrombotic occlusion of the venous graft on the left anterior descending coronary artery: a case report].  

PubMed

Coronary angioplasty, eventually followed by stent implantation, represents the gold standard of acute myocardial infarction (AMI) treatment. Optimal reperfusion implies both patency of the infarct-related artery and a good myocardial microrevascularization with normal tissue reperfusion. The so called no-reflow phenomenon mainly occurs in the presence of highly thrombotic lesions, especially during primary angioplasty and it represents a negative prognostic factor of the outcome of AMI patients treated with angioplasty. A 77-year-old high-risk male patient, previous coronary artery bypass graft with the saphenous vein graft to the left anterior descending coronary artery for post-AMI angina in 1984, aided by 118 ambulance for anterior AMI was admitted to our cath-lab for primary coronary angioplasty. During the transport he was given aspirin i.v. 300 mg, heparin 5000 IU and abciximab (9.4 ml bolus plus infusion for 12 hours). The time of treatment (from symptom onset to first inflation) was about 90 min. Coronary angiography showed a massive thrombus occlusion of the vein graft with TIMI 0 distal flow. We employed the Export Catheter for mechanical aspiration of the occluding thrombus. The procedure was completed with direct stent implantation with good angiographic outcome. The use of thrombus aspiration and protection devices (filters or occlusive balloons) associated or not with the use of glycoprotein IIb/IIIa receptor blockers, has reduced the risk of distal embolization and of no-reflow phenomenon. PMID:16013434

Romano, Michele; Buffoli, Francesca; Lettieri, Corrado; Rosiello, Renato; Aroldi, Marco; Kuwornu, Helène; Tomasi, Luca; Baccaglioni, Nicola; Zanini, Roberto

2005-06-01

131

The Association of Abnormal Ventricular Wall Motion and Increased Dispersion of Repolarization in Humans is Independent of the Presence of Myocardial Infarction  

PubMed Central

Abnormal ventricular wall motion is a strong clinical predictor of sudden, arrhythmic, cardiac death. Dispersion in repolarization is a prerequisite for the initiation of re-entrant arrhythmia. We hypothesize that regionally decreased wall motion is associated with heterogeneity of repolarization. We measured local activation times, activation-recovery intervals (ARIs, surrogate for action potential duration), and repolarization times using a multielectrode grid at nine segments on the left ventricular epicardium in 23 patients undergoing coronary artery surgery. Regional wall motion was simultaneously assessed using intraoperative transesophageal echocardiography. Three groups were discriminated: (1) Patients with normal wall motion (n?=?11), (2) Patients with one or more hypokinetic segments (n?=?6), (3) Patients with one or more akinetic or dyskinetic segments (n?=?6). The average ARI was similar in all groups (251?±?3.7?ms, ±SEM). Dispersion of ARIs between the nine segments was significantly increased in the hypokinetic (84?±?7.4?ms, p?myocardial infarction. Repolarization heterogeneity occurred primarily in the normally contracting regions of the hearts with abnormal wall motion. An almost maximal increased dispersion of repolarization was observed when there was only a single hypokinetic segment. We conclude that inhomogeneous wall motion abnormality of even moderate severity is associated with increased repolarization inhomogeneity, independent from the presence of infarction.

Opthof, Tobias; Sutton, Peter; Coronel, Ruben; Wright, Susan; Kallis, Panny; Taggart, Peter

2012-01-01

132

Sexual function and health-related quality of life following anterior vaginal wall surgery for stress urinary incontinence and pelvic organ prolapse.  

PubMed

To assess female sexual function (FSF) and health-related quality of life (HRQOL) following anterior vaginal wall surgeries for stress urinary incontinence (SUI) and pelvic organ prolapse (POP). The retrospective study consisted of 116 patients. Chinese translations of the modified Lemack Questionnaire (not validated) and Pelvic Floor Distress Inventory-Short Form 20 were used to assess FSF and HRQOL, 3 months pre-operatively and 12-24 months (mean 16.8 months) post-operatively. Sixty-one (52.6%, 29 in SUI group and 32 in POP group) of patients were sexually active before and after the operation. Overall, 12 (19.7%, six in SUI group and six in POP group) reported an improvement in overall intercourse satisfaction, 21 (34.4%, 8 in the SUI and 13 in the POP group) were decreased and 28 (45.9%, 15 in SUI group and 13 in POP group) were unchanged. Incidence of coital incontinence decreased significantly in SUI group. Frequency of intercourse decreased, vaginal dryness and pain due to it and asymptomatic vaginal narrowing increased significantly, following the surgery in POP group. There were no statistically significant differences in the frequency of intercourse in SUI group, patients' perception of intercourse, frequency of orgasm and the importance of sex life in both groups. Partner discomfort remained unchanged. HRQOL improved significantly after the operation in both groups. There was no association between HRQOL and FSF in the post-operative period. In most patients, overall FSF did not impaired. All trans-anterior vaginal wall surgery positively impacted on the patients' HRQOL. A prospective study with validated questionnaire is necessary in future. PMID:21654811

Shen, T; Song, L-J; Xu, Y-M; Gu, B-J; Lu, L-H; Li, F

2011-01-01

133

[A 59 year-old patient with acute anterolateral myocardial infarction, complicated by cardiogenic shock, with chest wall deformity caused by Heine-Medin disease].  

PubMed

We report a case of a 59 year-old patient in a condition of acute myocardial infarction with ST elevation, in a cardiogenic shock, with multiple cardiac arrests in mechanism of ventricular fibrillation with a significant chest wall deformity caused by Heine-Medin disease in childhood. To our knowledge, this is the first case report of a patient in critical condition with a considerable pectus deformity after poliomyelitis who needed to undergo cardiovascular angioplasty. Although severe patient's condition and numerous difficulties during percutaneous coronary intervention, therapy was successful. PMID:22430421

Arazi?ska, Agata; Kr?cki, Rados?aw; Kasprzak, Jaros?aw D

2012-01-01

134

Comparison of maximal elastance and systolic wall thickening using arterial tonometry and gated myocardial SPECT in patients undergoing coronary artery bypass grafting  

Microsoft Academic Search

Myocardial SPECT using 99mTc-sestamibi, 99mTc-tetrofosmin, 201Thallium is widely used in nuclear cardiology. Left ventricular systolic wall thickening (SWT) by SPECT and regional maximal elastance (rEmax) using arterial tonometry were compared.rEmax was calculated from time–pressure and time–volume curves. In normal heart, improvement of SWT was 4.1±11%, while 6.0±16% in dilated heart. Improvement of rEmax was 0.67±1.0mmHg\\/mL in normal heart and 0.32±0.7mmHg\\/mL

Won Jun Kang; Dong Soo Lee; Byeong Il Lee; Jin Chul Paeng; Jae Sung Lee; June-Key Chung; Myung Chul Lee

2009-01-01

135

Evaluation of myocardial viability after myocardial infarction with intravenous real-time myocardial contrast echocardiography  

Microsoft Academic Search

Summary  The myocardial viability after myocardial infarction was evaluated by intravenous myocardial contrast echocardiography. Intravenous\\u000a real-time myocardial contrast echocardiography was performed on 18 patients with myocardial infarction before coronary revascularization.\\u000a Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using\\u000a 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Viable myocardium was defined by

Weihui Shentu; Youbin Deng; Runqing Huang; Peng Li; Xiang Wei; Haoyi Yang; Yun Zhang; Li Xiong; Fen Yu; Yuhan Wu

2008-01-01

136

Incremental Value of Strain Rate Analysis as an Adjunct to Wall-Motion Scoring for Assessment of Myocardial Viability by Dobutamine Echocardiography A Follow-Up Study After Revascularization  

Microsoft Academic Search

Background—Assessment of myocardial viability based on wall-motion scoring (WMS) during dobutamine echocardi- ography (DbE) is difficult and subjective. Strain-rate imaging (SRI) is quantitative, but its incremental value over WMS for prediction of functional recovery after revascularization is unclear. Methods and Results—DbE and SRI were performed in 55 stable patients (mean age, 6410 years; mean ejection fraction, 368%) with previous myocardial

Lizelle Hanekom; Carly Jenkins; Leanne Jeffries; Colin Case; Julie Mundy; Carmel Hawley; Thomas H. Marwick

137

Acute Myocardial Infarction in Rats  

PubMed Central

With heart failure leading the cause of death in the USA (Hunt), biomedical research is fundamental to advance medical treatments for cardiovascular diseases. Animal models that mimic human cardiac disease, such as myocardial infarction (MI) and ischemia-reperfusion (IR) that induces heart failure as well as pressure-overload (transverse aortic constriction) that induces cardiac hypertrophy and heart failure (Goldman and Tarnavski), are useful models to study cardiovascular disease. In particular, myocardial ischemia (MI) is a leading cause for cardiovascular morbidity and mortality despite controlling certain risk factors such as arteriosclerosis and treatments via surgical intervention (Thygesen). Furthermore, an acute loss of the myocardium following myocardial ischemia (MI) results in increased loading conditions that induces ventricular remodeling of the infarcted border zone and the remote non-infarcted myocardium. Myocyte apoptosis, necrosis and the resultant increased hemodynamic load activate multiple biochemical intracellular signaling that initiates LV dilatation, hypertrophy, ventricular shape distortion, and collagen scar formation. This pathological remodeling and failure to normalize the increased wall stresses results in progressive dilatation, recruitment of the border zone myocardium into the scar, and eventually deterioration in myocardial contractile function (i.e. heart failure). The progression of LV dysfunction and heart failure in rats is similar to that observed in patients who sustain a large myocardial infarction, survive and subsequently develops heart failure (Goldman). The acute myocardial infarction (AMI) model in rats has been used to mimic human cardiovascular disease; specifically used to study cardiac signaling mechanisms associated with heart failure as well as to assess the contribution of therapeutic strategies for the treatment of heart failure. The method described in this report is the rat model of acute myocardial infarction (AMI). This model is also referred to as an acute ischemic cardiomyopathy or ischemia followed by reperfusion (IR); which is induced by an acute 30-minute period of ischemia by ligation of the left anterior descending artery (LAD) followed by reperfusion of the tissue by releasing the LAD ligation (Vasilyev and McConnell). This protocol will focus on assessment of the infarct size and the area-at-risk (AAR) by Evan's blue dye and triphenyl tetrazolium chloride (TTC) following 4-hours of reperfusion; additional comments toward the evaluation of cardiac function and remodeling by modifying the duration of reperfusion, is also presented. Overall, this AMI rat animal model is useful for studying the consequence of a myocardial infarction on cardiac pathophysiological and physiological function.

Wu, Yewen; Yin, Xing; Wijaya, Cori; Huang, Ming-He; McConnell, Bradley K.

2011-01-01

138

How do hypertrophic cardiomyopathy mutations affect myocardial function in carriers with normal wall thickness? Assessment with cardiovascular magnetic resonance  

Microsoft Academic Search

BACKGROUND: Clinical data on myocardial function in HCM mutation carriers (carriers) is sparse but suggests that subtle functional abnormalities can be measured with tissue Doppler imaging before the development of overt hypertrophy. We aimed to confirm the presence of functional abnormalities using cardiovascular magnetic resonance (CMR), and to investigate if sensitive functional assessment could be employed to identify carriers. RESULTS:

Tjeerd Germans; Iris K Rüssel; Marco JW Götte; Marieke D Spreeuwenberg; Pieter A Doevendans; Yigal M Pinto; Rob J van der Geest; Jolanda van der Velden; Arthur AM Wilde; Albert C van Rossum

2010-01-01

139

Biphasic thallium 201 SPECT-imaging for the noninvasive diagnosis of myocardial perfusion abnormalities in a child with Kawasaki disease--a case report  

SciTech Connect

The mucocutaneous lymph node syndrome (Kawasaki disease) is of increasing importance for the pediatric cardiologist, for coronary aneurysms with the potential of thrombosis and subsequent stenosis can develop in the course of the disease. The authors report a 2 1/2-year-old female child in whom, fourteen months after the acute phase of Kawasaki disease, myocardial infarction occurred. Biphasic thallium 201 SPECT-imaging using dipyridamole depicted anterior wall ischemia and inferolateral infarction. This case demonstrates that noninvasive vasodilation-redistribution thallium 201 SPECT-imaging has the potential to predict reversible myocardial perfusion defects and myocardial necrosis, even in small infants with Kawasaki disease.

Hausdorf, G.; Nienaber, C.A.; Spielman, R.P.

1988-02-01

140

Placental growth factor increases regional myocardial blood flow and contractile function in chronic myocardial ischemia.  

PubMed

Placental growth factor (PlGF) has a distinct biological phenotype with a predominant proangiogenic role in disease without affecting quiescent vessels in healthy organs. We tested whether systemic administration of recombinant human (rh)PlGF improves regional myocardial blood flow (MBF) and systolic function recovery in a porcine chronic myocardial ischemia model. We implanted a flow-limiting stent in the proximal left anterior descending coronary artery and measured systemic hemodynamics, regional myocardial function using MRI, and blood flow using colored microspheres 4 wk later. Animals were then randomized in a blinded way to receive an infusion of rhPlGF (15 ?g·kg(-1)·day(-1), n = 9) or PBS (control; n = 10) for 2 wk. At 8 wk, myocardial perfusion and function were reassessed. Infusion of rhPlGF transiently increased PlGF serum levels >30-fold (1,153 ± 180 vs. 33 ± 18 pg/ml at baseline, P < 0.001) without affecting systemic hemodynamics. From 4 to 8 wk, rhPlGF increased regional MBF from 0.46 ± 0.11 to 0.85 ± 0.16 ml·min(-1)·g(-1), with a concomitant increase in systolic wall thickening from 11 ± 3% to 26 ± 5% in the ischemic area. In control animals, no significant changes from 4 to 8 wk were observed (MBF: 0.45 ± 0.07 to 0.49 ± 0.08 ml·min(-1)·g(-1) and systolic wall thickening: 14 ± 4% to 18 ± 1%). rhPlGF-induced functional improvement was accompanied by increased myocardial neovascularization, enhanced glycogen utilization, and reduced oxidative stress and cardiomyocyte apoptosis in the ischemic zone. In conclusion, systemic rhPlGF infusion significantly enhances regional blood flow and contractile function of the chronic ischemic myocardium without adverse effects. PlGF protein infusion may represent an attractive therapeutic strategy to increase myocardial perfusion and energetics in chronic ischemic cardiomyopathy. PMID:23316060

Liu, Xiaoshun; Claus, Piet; Wu, Ming; Reyns, Geert; Verhamme, Peter; Pokreisz, Peter; Vandenwijngaert, Sara; Dubois, Christophe; Vanhaecke, Johan; Verbeken, Erik; Bogaert, Jan; Janssens, Stefan

2013-03-15

141

Early-phase myocardial infarction: Evaluation by MR imaging  

SciTech Connect

In vivo gated magnetic resonance (MR) imaging was performed in 12 dogs immediately after occlusion of the left anterior descending coronary artery and serially up to 5 hours and again between 4 and 14 days. This was done to evaluate the appearance of acute myocardial infarcts and to determine how soon after coronary artery occlusion MR imaging can demonstrate the site of acute myocardial ischemia. In nine dogs with postmortem evidence of myocardial infarction, regional increase of signal intensity of the myocardium was present by 3 hours after coronary occlusion and conformed to the site of myocardial infarct found at autopsy. The signal intensity on T2-weighted images of the infarcted on T2-weighted images of the infarcted myocardium was significantly greater than that of normal myocardium at 3, 4, and 5 hours after occlusion. The T2 (spin-spin) relaxation time was significantly prolonged in the region of myocardial infarct at 3, 4, and 5 hours post-occlusion compared with normal myocardium. Myocardial wall thinning and increased intracavitary flow signal were found in six dogs with comparable pre- and postocclusion images in late systole.

Tscholakoff, D.; Higgins, C.B.; McNamara, M.T.; Derugin, N.

1986-06-01

142

Assessment of Myocardial Viability in Chronic Coronary Artery Disease Using Technetium99m Sestamibi SPECT  

Microsoft Academic Search

Objectives. The value of 99mTc-sestamibi (2-methoxy-isobutyl isonitrile [MIBI]) as a viability tracer was investigated in patients undergoing coronary artery bypass graft surgery.Background. Initial studies claim that rest MIBI single-photon emission computed tomographic (SPECT) studies can be used to assess myocardial viability.Methods. Thirty patients with a severely stenosed left anterior descending coronary artery and wall motion abnormalities were prospectively included. The

Alex F Maes; Willem Flameng; Johan L Nuyts; Frans van de Werf; Jannie J Ausma; Paul Sergeant; Luc A Mortelmans

1997-01-01

143

Relation between the location of the infarcted area in body surface isopotential mapping and the location of myocardial infarction in vectorcardiography  

SciTech Connect

In order to examine whether our method of determining the location of the infarcted area in body surface isopotential mapping (MAP) is adequate for clinical use, a comparison was made between the location of the infarcted area using MAP and the location of myocardial infarction using vectorcardiography (VCG). The percentage of agreement between MAP and VCG in the retrospective study was 91.7% in the anterior wall, 76.7% in the lateral wall, 93.3% in the inferior wall and 73.3% in the posterior wall. The reason for the disagreement between these two methods was investigated, and criteria for determining the infarcted area using MAP and vectorcardiographic criteria for myocardial infarction were partly corrected in anterior, lateral and (high) posterior infarction to increase the clinical accuracy of both methods. Consequently, the percentage of agreement in the four walls ranged from 83.7% to 87.9%, and the diagnostic value of MAP for the infarcted area was not inferior but was more sensitive than that of VCG except in anterior infarction. In the prospective study, the same result was obtained. Secondly, in order to establish the superiority of MAP or VCG, the sensitivity and specificity of MAP and VCG to SCG (thallium-201) were calculated. Except in the anterior wall, the sensitivity of MAP to SCG was higher than that of VCG to SCG, especially in the lateral and posterior walls. Accordingly, it is suggested that MAP is the method of choice in determining the infarcted area in clinical cases.

Suzuki, K.; Toyama, S.; Yoshino, K.; Fudemoto, Y.

1984-01-01

144

Coronary artery flow velocity profile measured by transthoracic Doppler echocardiography predicts myocardial viability after acute myocardial infarction  

Microsoft Academic Search

Objective: To study whether flow velocity profile in the left anterior descending coronary artery (LAD) measured by transthoracic Doppler echocardiography (TTDE) predicts myocardial viability after reperfused anterior acute myocardial infarction (AMI).Patients and methods: 15 patients who had their first anterior ST elevation AMI and were successfully reperfused by coronary angioplasty and five controls without coronary artery disease were selected. Blood

Antti Saraste; Juha W Koskenvuo; Markku Saraste; Jussi Pa?rkka?; Jyri Toikka; Alexandru Naum; Heikki Ukkonen; Juhani Knuuti; Juhani Airaksinen; Jaakko Hartiala

2007-01-01

145

Relation of left ventricular perfusion and wall motion with metabolic activity in persistent defects on thallium-201 tomography in healed myocardial infarction  

SciTech Connect

Myocardial viability in persistent thallium (TI)-201 defect is a controversial subject. To assess metabolic activity in segments with persistent defect, stress TI-201 tomography and positron emission tomography using nitrogen-13 ammonia and fluorine-18 2-fluoro-deoxyglucose (FDG) were performed in 28 patients with healed myocardial infarction. The segments with TI-201 perfusion defect in electrocardiogram-determined infarcted areas were selected for assessment. Stress perfusion defect was detected in 61 segments by TI-201 tomography. Twenty-two patients (36%) showed transient defects with redistribution (group 1) and 39 showed persistent defects (group 2). Increase in FDG uptake was observed in 95% in group 1. Among group 2 patients, 15 segments (38%) showed an increase in FDG uptake (group 2A) while the remaining 24 (62%) did not have an increased uptake (group 2B). The decrease in nitrogen-13 ammonia perfusion was more severe in group 2B (-23 +/- 7%) than in group 2A (-13 +/- 9%) (p less than 0.005) and group 1 (-10 +/- 4%) (p less than 0.001). In addition, wall motion scores tended to be lower in group 2B (0.21 +/- 0.71), compared with group 2A (0.67 +/- 0.70) (p = 0.05) and group 1 (0.77 +/- 0.60) (p less than 0.01). These data indicate that metabolic viability was observed in approximately 40% of the segments with persistent TI-201 defect. Preservation of regional perfusion and wall motion in these areas was similar to that in areas with transient TI-201 defect.

Tamaki, N.; Yonekura, Y.; Yamashita, K.; Senda, M.; Saji, H.; Hashimoto, T.; Fudo, T.; Kambara, H.; Kawai, C.; Ban, T.

1988-08-01

146

Serial /sup 201/Tl myocardial imaging after dipyridamole infusion: diagnostic utility in detecting coronary stenoses and relationship to regional wall motion  

SciTech Connect

After a 4-minute i.v. dipyridamole infusion, 0.14 mg/kg/min, serial /sup 201/Tl scans were obtained in 60 patients undergoing cardiac catheterization. Forty patients had significant (greater than or equal to 50% stenosis) coronary artery disease (CAD), and 20 patients had normal coronary arteries or trivial lesions. The images were graded qualitatively for thallium activity by three observers. Sensitivity was 93% (37 of 40) and specificity was 80% (16 of 20). The sensitivity and specificity of the /sup 201/Tl study were not affected by the extent of CAD, the presence of Q waves, or propranolol therapy. Twenty-seven of 37 patients who had initial defects (73%) had complete thallium redistribution of one or more defects. Patient-by-patient analysis using a regression model of all patients showed that the fate of a segmental thallium defect predicted abnormal wall motion by angiography better than ECG Q waves. The presence of propranolol therapy or collaterals did not significantly affect the thallium redistribution results. We conclude that qualitative interpretation by multiple observers of thallium images after dipyridamole infusion is a highly sensitive and specific test for CAD. After dipyridamole, as with exercise stress, the extent of thallium redistribution is related to the degree of myocardial wall motion abnormality.

Leppo, J.; Boucher, C.A.; Okada, R.D.; Newell, J.B.; Strauss, H.W.; Pohost, G.M.

1982-09-01

147

Cardiogenic shock accompanied by dynamic left ventricular outflow tract obstruction and myocardial bridging after transient complete atrioventricular block mimicking ST-elevation myocardial infarction: a case report  

PubMed Central

Background Dynamic left ventricular outflow tract obstruction with or without mitral regurgitation is typically observed in hypertrophic cardiomyopathy, but is also occasionally seen without left ventricular hypertrophy. In this report, we present a case of cardiogenic shock that mimics ST-elevation myocardial infarction, due to dynamic left ventricular outflow tract obstruction with transient mitral regurgitation and myocardial bridging after transient complete atrioventricular block. Case presentation A 65-year-old man with hypertension presented himself at the emergency department with syncope after chest pain. His initial electrocardiography showed inferior ST elevation with profound precordial ST depression and transient complete atrioventricular block. Due to sustained hypotension, an intra-aortic balloon pump was applied. His coronary angiography revealed almost normal right coronary artery and left circumflex artery and only a severe myocardial bridge in the mid-segment of his left anterior descending artery. Instead, severe mitral regurgitation was found without regional wall motion abnormality both in the left ventriculography and the portable echocardiography. However the severe mitral regurgitation completely disappeared in follow up echocardiography the day after. The pressure gradient across the left ventricular outflow tract was measured at 8.95 mmHg during the resting state, and was increased to 38.95 mmHg during the Valsalva state. Conclusions The patient presented with a case of cardiogenic shock that mimicked ST-elevation myocardial infarction due to dynamic left ventricular outflow tract obstruction combined with myocardial bridging in the mid-left anterior descending artery.

2013-01-01

148

In Hypertrophic Cardiomyopathy Reduction of Relative Resting Myocardial Blood Flow Is Related to Late Enhancement, T2-Signal and LV Wall Thickness  

PubMed Central

Objectives To quantify resting myocardial blood flow (MBF) in the left ventricular (LV) wall of HCM patients and to determine the relationship to important parameters of disease: LV wall thickness, late gadolinium enhancement (LGE), T2-signal abnormalities (dark and bright signal), LV outflow tract obstruction and age. Materials and Methods Seventy patients with proven HCM underwent cardiac MRI. Absolute and relative resting MBF were calculated from cardiac perfusion MRI by using the Fermi function model. The relationship between relative MBF and LV wall thickness, T2-signal abnormalities (T2 dark and T2 bright signal), LGE, age and LV outflow gradient as determined by echocardiography was determined using simple and multiple linear regression analysis. Categories of reduced and elevated perfusion in relation to non- or mildly affected reference segments were defined, and T2-signal characteristics and extent as well as pattern of LGE were examined. Statistical testing included linear and logistic regression analysis, unpaired t-test, odds ratios, and Fisher’s exact test. Results 804 segments in 70 patients were included in the analysis. In a simple linear regression model LV wall thickness (p<0.001), extent of LGE (p<0.001), presence of edema, defined as focal T2 bright signal (p<0.001), T2 dark signal (p<0.001) and age (p?=?0.032) correlated inversely with relative resting MBF. The LV outflow gradient did not show any effect on resting perfusion (p?=?0.901). Multiple linear regression analysis revealed that LGE (p<0.001), edema (p?=?0.026) and T2 dark signal (p?=?0.019) were independent predictors of relative resting MBF. Segments with reduced resting perfusion demonstrated different LGE patterns compared to segments with elevated resting perfusion. Conclusion In HCM resting MBF is significantly reduced depending on LV wall thickness, extent of LGE, focal T2 signal abnormalities and age. Furthermore, different patterns of perfusion in HCM patients have been defined, which may represent different stages of disease.

Hueper, Katja; Zapf, Antonia; Skrok, Jan; Pinheiro, Aurelio; Goldstein, Thomas A.; Zheng, Jie; Zimmerman, Stefan L.; Kamel, Ihab R.; Abraham, Roselle; Wacker, Frank; Bluemke, David A.; Abraham, Theodore; Vogel-Claussen, Jens

2012-01-01

149

Transient disappearance of Q waves of previous myocardial infarction due to exercise-induced ischemia of the contralateral noninfarcted myocardium.  

PubMed

The electrocardiogram (ECG) of a 40-year-old woman with an old inferolateral myocardial infarction revealed, in the course of an exercise treadmill/thallium test, gradual disappearance of infarctional Q waves, which reappeared gradually during recovery from exercise. The patient had evidence of exercise-induced myocardial ischemia both by the ECG and by thallium-201 perfusion scintigraphy involving several myocardial regions. The temporal association of transient disappearance of Q waves with the occurrence of reversible ischemia suggested that the latter was instrumental in producing this phenomenon, through a transient failure of the ischemic anterior wall to shift the initial depolarization forces away from the infarcted inferolateral territory. Further evidence for this concept was provided by the case of another patient, a 49-year-old man who also had an old inferolateral myocardial infarction and whose ECG in the course of an exercise treadmill/thallium test did not reveal any changes in the infarctional Q waves. In this patient, thallium images showed mild, reversible inferolateral myocardial ischemia but a well perfused anterior wall, which provided for early depolarization forces (thus Q waves) directed opposite to the region of infarcted myocardium. PMID:9141603

Madias, J E; Manyam, B; Khan, M; Singh, V; Tziros, C

1997-04-01

150

Precordial ST segment depression during acute inferior myocardial infarction: early thallium-201 scintigraphic evidence of adjacent posterolateral or inferoseptal involvement  

SciTech Connect

To investigate the myocardial perfusion correlates of precordial ST segment depression during acute inferior myocardial infarction, a rest thallium-201 scintigram and a closely timed 12 lead electrocardiogram were obtained within 6 hours of the onset of infarction in 44 patients admitted with their first acute inferior myocardial infarction. Thirty-six patients demonstrated precordial ST segment depression (group 1) and eight did not (group 2). A perfusion defect involving the inferior wall was present in all 44 patients. Additional perfusion defects of the adjacent posterolateral wall (n . 20), the ventricular septum (n . 9) or both (n . 6) were present in 35 of 36 patients from group 1 compared with only 1 of 8 patients from group 2 (p less than 0.001). There was no significant difference in the frequency of multivessel coronary artery disease or disease of the left anterior descending artery between group 1 and group 2 or between patients with and those without a thallium-201 perfusion defect involving the ventricular septum. Thus, precordial ST segment depression during an acute inferior myocardial infarction is associated with thallium-201 scintigraphic evidence of more extensive involvement of the adjacent posterolateral or inferoseptal myocardial segments, which probably reflects the extent and pattern of distribution of the artery of infarction, rather than the presence of coexistent multivessel coronary artery disease or disease of the left anterior descending artery.

Lew, A.S.; Weiss, A.T.; Shah, P.K.; Maddahi, J.; Peter, T.; Ganz, W.; Swan, H.J.; Berman, D.S.

1985-02-01

151

Outcome of treatment of anterior vaginal wall prolapse and stress urinary incontinence with transobturator tension-free vaginal mesh (prolift) and concomitant tension-free vaginal tape-obturator.  

PubMed

Objective. It is to assess the feasibility, effectiveness, and safety of transobturator tension-free vaginal mesh (Prolift) and concomitant tension-free vaginal tape-obturator (TVT-O) system as a treatment of female anterior vaginal wall prolapse associated with stress urinary incontinence (SUI). Patients and Methods. Between December 2006 and July 2007, 20 patients with anterior genital prolapse and voiding dysfunction were treated with the transobturator tension-free vaginal mesh (Prolift) and concomitant tension-free vaginal tape-obturator (TVT-O). Sixteen patients had stress urinary incontinence and 4 patients were considered at risk for development of de novo stress incontinence after the prolapse is repaired. All patients underwent a complete urodynamic assessment. All the patients underwent pelvic examination 4-6 weeks after the operation, and anatomical and functional outcomes were recorded. Results. Twenty cystocoeles were repaired: 6 grade II, 12 grade III, and 2 grade IV. There were no vessel or bladder injuries. Eighteen patients had optimal anatomic results and 2 patients had persistent asymptomatic stage I prolapse. Conclusion. These preliminary results suggest that Prolift system offers a safe and effective treatment for female anterior vaginal wall prolapse. However, a long-term followup is necessary in order to support the good result maintenance. PMID:19125198

Abou-Elela, Ashraf; Salah, Essam; Torky, Haitham; Azazy, Sameh

2009-01-01

152

Reduction in the level of cardiac cyclic GMP worsens contractile delay in myocardial stunning.  

PubMed

We tested the hypothesis that a reduction in the level of myocardial cyclic GMP would worsen the contractile delay associated with myocardial stunning. Two groups of 12 anesthetized open-chest New Zealand white rabbits were utilized. Myocardial stunning was produced by two 15-min occlusions of the left anterior descending coronary artery followed by 15 min of reperfusion. Either control vehicle (saline + 1% DMSO) or 1H-[1,2,4]oxadiazolo[4, 3-a]quinoxalin-1-one (ODQ 10(-4) M, a guanylate cyclase inhibitor) was topically applied to the left ventricular surface of the rabbit hearts. Left ventricular and aortic pressures along with wall thickness parameters were determined. Coronary blood flow (microspheres) and O(2) extraction (microspectrophotometry) were used to determine myocardial O(2) consumption. Myocardial stunning was observed in the control group through an increased delay in onset of wall thickening (46.2 +/- 7.3 vs 76.6 +/- 17.5 ms). There was no significant effect of stunning on the rate of wall thickening (21.8 +/- 9.5 vs 18.1 +/- 3.4 mm/s) or O(2) consumption (stun 4.6 +/- 0.6, control 4.8 +/- 0.4 ml O(2)/min/100 g). After treatment with ODQ 10(-4) M, both delay (43.9 +/- 9.6 vs 134.1 +/- 30.0 ms) and myocardial O(2) consumption (stun 5.9 +/- 0.6, control 5.9 +/- 0. 7) increased significantly compared to control. There was no significant change in the rate of wall thickening. We conclude that decreasing cyclic GMP worsens stunning by increasing delay in onset of wall thickening and increasing local O(2) costs in the stunned region. PMID:10864491

Patel, K N; Weiss, H R; Scholz, P M

2000-07-01

153

Myocardial contrast echocardiography after myocardial infarction.  

PubMed

Myocardial contrast echocardiography (MCE) enables direct assessment of the degree and adequacy of microvascular perfusion as well as the presence of wall motion abnormalities. MCE has the following benefits in patients with acute myocardial infarction (MI): 1) rapid and definite diagnosis of acute MI; 2) identification of patients who may benefit from prompt reperfusion therapy; 3) assessment of the efficacy of mechanical or pharmacologic intervention for an open infarct-related artery; 4) estimation of MI size early after reperfusion and residual myocardial viability; 5) identification of being at high risk for post-MI complications and left ventricular remodeling; and 6) assessment of myocardial viability and ischemia prior to hospital discharge. Therefore, MCE is an ideal tool for correct triaging of patients to revascularization and has both prognostic and therapeutic implications in patients with acute MI. PMID:22437372

Ito, Hiroshi

2012-06-01

154

Non-invasive coronary flow reserve is correlated with microvascular integrity and myocardial viability after primary angioplasty in acute myocardial infarction  

Microsoft Academic Search

Objective: To test whether preserved coronary flow reserve (CFR) two days after reperfused acute myocardial infarction (AMI) is associated with less microvascular dysfunction (“ no-reflow” phenomenon) and is predictive of myocardial viability.Design: 24 patients with anterior AMI underwent CFR assessment in the left anterior descending coronary artery (LAD) with transthoracic echocardiography and myocardial contrast echocardiography (MCE) 48 h after primary

R Montisci; L Chen; M Ruscazio; P Colonna; C Cadeddu; C Caiati; M Montisci; L Meloni; S Iliceto

2006-01-01

155

Survival following self-limited left ventricular free wall rupture during myocardial infarction. Management differences between patients with or without pseudoaneurysm formation.  

PubMed

The clinical, angiographic and therapeutic features of eight patients who developed a left ventricular pseudoaneurysm (PA) after an acute myocardial infarction (AMI) and those of 25 who did not develop this complication following a medically managed left ventricular free wall rupture (FWR) were compared. These 25 patients were treated with pericardiocentesis, extended rest and strict blood pressure control. Most patients with FWR or PA had a first AMI and absence of overt heart failure. Both groups had a comparable age, frequency of systemic hypertension and extent of coronary disease. Pericardial effusion (> or =10 mm) was documented in all patients with FWR and in two of the three with PA with this information. Twenty four patients with FWR were hospitalized within the first 48 h (96%) but only three of those with PA (37.5%, P<0.002). Moreover, in patients with PA, a FWR was not suspected during AMI and, as opposed to those with FWR, they did not undergo a strict blood pressure control or a restriction of physical activity following AMI. Also, beta blockers were administered to 15 patients with FWR (60%) but to only one with PA (11%, P<0.02). Our findings suggest that failure to recognise a self limited FWR during AMI and to provide adequate control of blood pressure and physical exercise during the acute phase and the early weeks postinfarction, are likely to favor development of PA. PMID:11461727

Figueras, J; Cortadellas, J; Domingo, E; Soler-Soler, J

2001-07-01

156

Intra-aneurysmal flow patterns and wall shear stresses calculated with computational flow dynamics in an anterior communicating artery aneurysm depend on knowledge of patient-specific inflow rates  

Microsoft Academic Search

Objective  To evaluate if knowledge of patient-specific inflow data in computational fluid dynamics simulations is required for the accurate\\u000a calculation of intra-aneurysmal flow patterns and wall shear stress in an aneurysm of the anterior communicating artery (AcomA).\\u000a \\u000a \\u000a \\u000a Materials and methods  3D digital subtraction angiography (3D-DSA) and phase contrast magnetic resonance (pcMRI) images were obtained in a 71-year\\u000a old patient with an unruptured

Christof Karmonik; Christopher Yen; Robert G. Grossman; Richard Klucznik; Goetz Benndorf

2009-01-01

157

Antioxidant enzymes attenuate myocardial stunning in the conscious dog  

SciTech Connect

Several studies have shown that postischemic myocardial dysfunction (myocardial stunning) is attenuated by antioxidants, implying a pathogenetic role of oxy-radicals in this phenomenon. However, since all these studies have been performed in open-chest preparations, artifacts due to anesthesia, trauma, and other nonphysiologic conditions cannot be excluded. Accordingly, chronically instrumented dogs underwent a 15-minute occlusion (o) of the left anterior descending artery followed by reperfusion. Dogs received i.v. either saline or superoxide dismutase (SOD) plus catalase (CAT) (16,000 U/kg and 55,000 U/kg, respectively, over 1 hour starting 15 minutes before O). Regional myocardial function was assessed as systolic wall thickening (WTh) using a pulsed Doppler probe. WTh after reperfusion was significantly greater in treated dogs, and this difference could not be ascribed to differences in collateral flow or hemodynamics. The authors conclude that SOD plus catalase attenuate myocardial stunning in the conscious dog, indicating that oxy-radicals play a pathogenetic role in this phenomenon under physiologic conditions.

Triana, J.F.; Unisa, A.; Bolli, R. (Baylor Coll. of Medicine, Houston, TX (United States))

1990-02-26

158

Treatment of Chronic Myocardial Ischemia: Rationale and Treatment Options  

Microsoft Academic Search

A rational approach to the treatment of chronic myocardial ischemia requires an appreciation of the pathophysiology of coronary artery disease and the treatment options available. Any factor that causes an imbalance between myocardial oxygen supply and demand can provoke ischemia. Myocardial oxygen requirements rise with increases in heart rate, contractility, or left ventricular wall stress. Myocardial oxygen supply is determined

Peter F. Cohn

1998-01-01

159

[Successful repair of combined ventricular septal rupture and free wall rupture (double rupture); report of a case].  

PubMed

We report a case of successful surgical repair of combined ventricular septal perforation and blowout free wall cardiac rupture(double rupture) after acute myocardial infarction. The patient was a 59-year old man, who suffered an extensive acute anterior myocardial infarction. Although emergent coronary angiogram and coronary intervention was performed, he collapsed in a state of electro-mechanical dissociation in the catheterization laboratory. He was resuscitated by percutaneous cardiopulmonary support system (PCPS) and transferred to the operation theater. Infarction exclusion using bovine pericardial patch was performed. He was weaned from PCPS on day 5 after surgery and discharged hospital on day 65 with good health. PMID:23381365

Takazawa, Ippei; Kawahito, Koji; Aizawa, Kei; Misawa, Yoshio

2013-02-01

160

Relation between ST segment elevation during dobutamine stress test and myocardial viability after a recent myocardial infarction.  

PubMed Central

OBJECTIVE: To assess the relation between ST segment elevation during the dobutamine stress test and late improvement of function after acute Q wave myocardial infarction. PATIENTS AND DESIGN: 70 patients were studied a mean (SD) 8 (3) days after acute myocardial infarction with high dose dobutamine-atropine stress echocardiography and a follow up echocardiogram at 85 (10) days. A score model based on 16 segments and four grades was used to assess left ventricular function. Functional improvement was defined as a reduction of wall motion score > or = 1 in > or = 1 segments at follow up. INTERVENTION: Myocardial revascularisation was performed in 23 patients (33%) before follow up studies. RESULTS: ST segment elevation occurred in 40 patients (57%). Late functional improvement occurred in 35 patients (50%). Functional improvement was more common in patients with ST segment elevation (68% v 30%, P < 0.005) and they had a higher mean (SD) number of improved segments at follow up (1.9 (2.2) v 0.5 (1.1), P < 0.005). The wall motion score index decreased between baseline and follow up in patients with ST segment elevation (1.54 (0.50) v 1.48 (0.43), P < 0.05) but not in patients without ST segment elevation (1.39 (0.60) v 1.45 (0.47)). The accuracy of ST segment elevation for the prediction of functional improvement was similar to that of low dose dobutamine echocardiography in patients with anterior infarction (80% v 83%) and in patients who underwent revascularisation (78% v 83% respectively). CONCLUSION: In patients with a recent Q wave myocardial infarction, dobutamine-induced ST segment elevation is a valuable marker of myocardial viability particularly when the test is performed without or with suboptimal echocardiographic imaging.

Elhendy, A.; Cornel, J. H.; Roelandt, J. R.; van Domburg, R. T.; Geleijnse, M. I.; Nierop, P. R.; Bax, J. J.; Sciarra, A.; Ibrahim, M. M.; el-Refaee, M.; el-Said, G. M.; Fioretti, P. M.

1997-01-01

161

Quantitative Evaluation of Left Ventricular Wall Motion in Patient with Coronary Artery Bypass Grafting Using Magnetic Resonance Tagging Technique  

NASA Astrophysics Data System (ADS)

Left ventricular wall motions during systole were investigated from a mechanical perspective by using a magnetic resonance tagging technique. Subjects were 7 patients with coronary artery bypass grafting (CABG). First, by analyzing strain in the left ventricular wall, cardiac contractility was evaluated in the patients with CABG. Next, by calculating displacement in the myocardial wall, paradoxical movements following CABG were quantitatively evaluated. Strain analysis showed local decreases in circumferential strain in 4 of 7 subjects. The results of displacement analysis clarified that following CABG, the degree of radial displacement was small in the septal wall and large in the lateral wall, and circumferential displacement towards the septal wall occurred in the anterior and posterior walls. Since this behavior was seen in both reduced and normal cardiac contractility groups, paradoxical movements in the present patients were not caused by reduced cardiac contractility, but rather by rigid-body motion of the entire heart.

Inaba, Tadashi; Nakano, Takahiro; Tsutsumi, Masakazu; Kawasaki, Shingo; Kinosada, Yasutomi; Tokuda, Masataka

162

[A case of "Takotsubo" cardiomyopathy observed with myocardial scintigraphy from the acute phase].  

PubMed

A 57-year-old woman was emergently admitted to our hospital because of chest oppression. On examination, blood pressure was 174/96 mmHg, pulse rate was 90/min and coarse crackle and third heart sound were audible. On laboratory data, the levels of LDH and CPK-MB were mildly elevated. Electrocardiogram (ECG) demonstrated elevation of the ST segment in leads I, aVL and V2-V5. 99mTc-tetrofosmin myocardial SPECT (TF) showed severely reduced uptake in the apex and anterior wall. Emergent coronary angiography (CAG) did not show any stenotic lesion. Left ventriculography (LVG), however, demonstrated akinesis of the apex, anterior, and inferior walls, and basal hyperkinesis. On the second hospital day, ECG demonstrated inverted T wave in leads I, aVL and V2-V5. 123I-BMIPP myocardial SPECT (BMIPP) and 123I-MIBG myocardial SPECT (MIBG) were performed on the second and fourth hospital days, respectively. These cardiac images showed severely reduced uptake equally. TF, BMIPP, and MIBG were re-examined on the eighth, tenth, and twelfth hospital days, respectively. MIBG, BMIPP, and TF showed reduced uptake in order of severity. On the fourteenth hospital day, CAG and LVG were re-examined. Coronary vasospasm provocation test was negative using ergonovine and acetylcholine, and LVG did not demonstrated any sign of asynergy. We considered that this case was "Takotsubo" cardiomyopathy and might be caused by microvascular spasm. PMID:12607239

Doue, Tomoki; Ito, Kazuki; Yuba, Tatsuya; Tanabe, Takuji; Adachi, Yoshihiko; Katoh, Shuji; Azuma, Akihiro; Sugihara, Hiroki; Nakagawa, Masao

2002-11-01

163

Infarct size as predictor of systolic functional recovery after myocardial infarction.  

PubMed

Background: The effects of modern therapy on functional recovery after acute myocardial infarction (AMI) are unknown. Objectives: To evaluate the predictors of systolic functional recovery after anterior wall AMI in patients undergoing modern therapy (reperfusion, aggressive platelet antiaggregant therapy, angiotensin-converting enzyme inhibitors and beta-blockers). Methods: A total of 94 consecutive patients with AMI with ST-segment elevation were enrolled. Echocardiograms were performed during the in-hospital phase and after 6 months. Systolic dysfunction was defined as ejection fraction value < 50%. Results: In the initial echocardiogram, 64% of patients had systolic dysfunction. Patients with ventricular dysfunction had greater infarct size, assessed by the measurement of total and isoenzyme MB creatine kinase enzymes, than patients without dysfunction. Additionally, 24.5% of patients that initially had systolic dysfunction showed recovery within 6 months after AMI. Patients who recovered ventricular function had smaller infarct sizes, but larger values of ejection fraction and E-wave deceleration time than patients without recovery. At the multivariate analysis, it can be observed that infarct size was the only independent predictor of functional recovery after 6 months of AMI when adjusted for age, gender, ejection fraction and E-wave deceleration time. Conclusion: In spite of aggressive treatment, systolic ventricular dysfunction remains a frequent event after the anterior wall myocardial infarction. Additionally, 25% of patients show functional recovery. Finally, infarct size was the only significant predictor of functional recovery after six months of acute myocardial infarction. PMID:25004416

Minicucci, Marcos F; Farah, Elaine; Fusco, Daniéliso R; Cogni, Ana Lúcia; Azevedo, Paula S; Okoshi, Katashi; Zanati, Silméia G; Matsubara, Beatriz B; Paiva, Sergio A R; Zornoff, Leonardo A M

2014-07-01

164

Infarct Size as Predictor of Systolic Functional Recovery after Myocardial Infarction  

PubMed Central

Background The effects of modern therapy on functional recovery after acute myocardial infarction (AMI) are unknown. Objectives To evaluate the predictors of systolic functional recovery after anterior wall AMI in patients undergoing modern therapy (reperfusion, aggressive platelet antiaggregant therapy, angiotensin-converting enzyme inhibitors and beta-blockers). Methods A total of 94 consecutive patients with AMI with ST-segment elevation were enrolled. Echocardiograms were performed during the in-hospital phase and after 6 months. Systolic dysfunction was defined as ejection fraction value < 50%. Results In the initial echocardiogram, 64% of patients had systolic dysfunction. Patients with ventricular dysfunction had greater infarct size, assessed by the measurement of total and isoenzyme MB creatine kinase enzymes, than patients without dysfunction. Additionally, 24.5% of patients that initially had systolic dysfunction showed recovery within 6 months after AMI. Patients who recovered ventricular function had smaller infarct sizes, but larger values of ejection fraction and E-wave deceleration time than patients without recovery. At the multivariate analysis, it can be observed that infarct size was the only independent predictor of functional recovery after 6 months of AMI when adjusted for age, gender, ejection fraction and E-wave deceleration time. Conclusion In spite of aggressive treatment, systolic ventricular dysfunction remains a frequent event after the anterior wall myocardial infarction. Additionally, 25% of patients show functional recovery. Finally, infarct size was the only significant predictor of functional recovery after six months of acute myocardial infarction.

Minicucci, Marcos F.; Farah, Elaine; Fusco, Danieliso R.; Cogni, Ana Lucia; Azevedo, Paula S.; Okoshi, Katashi; Zanati, Silmeia G.; Matsubara, Beatriz B.; Paiva, Sergio A. R.; Zornoff, Leonardo A. M.

2014-01-01

165

The effect of volume currents due to myocardial anisotropy on body surface potentials  

NASA Astrophysics Data System (ADS)

Changes in anterior and posterior body surface potential maps (BSPMs) due to myocardial anisotropy were examined using a highly heterogeneous finite element model of an adult male subject constructed from segmented magnetic resonance images. A total of 23 different tissue types were identified in the whole torso. The myocardial fibre orientations in the human heart wall were mapped from the fibre orientations of a canine heart which are available in the literature using deformable mapping techniques. The current and potential distributions in the whole torso were computed using dipolar sources in the septum, apical area, left ventricular wall or right ventricular wall. For each dipole x, y, z orientations were studied. An adaptive finite element solver was used to compute currents and potential distributions in the whole torso with an element size of 0.78 × 0.78 × 3 mm in the myocardium and larger elements in other parts of the torso. For each dipole position two cases were studied. In one case the myocardium was isotropic and in the other it was anisotropic. It was found that BSPMs showed a very notable difference between the isotropic and the anisotropic myocardium for all dipole positions with the largest difference for the apical dipoles. The correlation coefficients for the BSPMs between the isotropic and anisotropic cases ranged from 0.83 for an apical dipole to 0.99 for an RV wall dipole. These results suggest that myocardial fibre anisotropy plays an important role in determining the body surface potentials.

Ramon, Ceon; Schimpf, Paul; Wang, Yanqun; Haueisen, Jens; Ishimaru, Akira

2002-04-01

166

Relation of left ventricular perfusion and wall motion with metabolic activity in persistent defects on thallium-201 tomography in healed myocardial infarction  

Microsoft Academic Search

Myocardial viability in persistent thallium (TI)-201 defect is a controversial subject. To assess metabolic activity in segments with persistent defect, stress TI-201 tomography and positron emission tomography using nitrogen-13 ammonia and fluorine-18 2-fluoro-deoxyglucose (FDG) were performed in 28 patients with healed myocardial infarction. The segments with TI-201 perfusion defect in electrocardiogram-determined infarcted areas were selected for assessment. Stress perfusion defect

Nagara Tamaki; Yoshiharu Yonekura; Keiji Yamashita; Michio Senda; Hideo Saji; Tetsuo Hashimoto; Tetsuro Fudo; Hirofumi Kambara; Chuichi Kawai; Toshihiko Ban

1988-01-01

167

Triggers of acute myocardial infarction regarding its site  

Microsoft Academic Search

We have studied the incidence of possible triggers of the myocardial infarction regarding its site in 750 patients with anterior and 731 patients with inferior infarction. Infarctions occurred most frequently without recalling any triggering activity, especially in patients with anterior infarction (67 vs. 44%). Physical effort as the possible precipitator was also more frequent in anterior infarctions (22 vs. 16%).

Dinko Miri?; Davor Eterovi?; Lovel Giunio; Željko Duji?; Damir Fabijani?; Izet Hozo; Ante Kuzmani?; Ivo Boži?; Vikor ?uli?

1997-01-01

168

Anterior Cervical Arachnoid Cyst  

PubMed Central

This report is composed of two patients with anteriorly located cervical intradural arachnoid cyst and review of 24 cases in Englishlanguage literature. Both of our patients were in the first two decades of life with neck pain and motor weakness. With suspicious diagnosis of anterior arachnoid cyst surgery was carried out in both cases, though laminectomy in one and laminoplasty in the other. The cyst wall was widely fenestrated with subsequent subtotal excision of the cyst. Both cases had good long-term outcome. The review disclosed male predominance. 73% of the patients were diagnosed within the first two decades of life. Neck pain and motor weakness were the dominant signs and symptoms of this pathology. Magnetic resonance imaging showing a cerebrospinal fluid (CSF) containing cyst was the best mode of diagnosis. Wide cyst fenestration with waying CSF into subarachnoid cyst was the most appropriate and applied surgery with optimal outcome.

Sharifi, Give

2013-01-01

169

Biocement--a new material. Results of its experimental use for osseous repair of skull cap defects with lesions of the dura mater and liquorrhea, reconstruction of the anterior wall of the frontal sinuses and fixation of alloimplants.  

PubMed

A newly developed material, which we call biocement, consisting of bisphenol-a-glycidyl methacrylate ("epoxide methacrylate') as organic matrix and Bioceramic Battelle, Bioglass Hench and/or pentacalcium hydroxide triphosphate ("tri-calcium phosphate') powder as filling particles is presented. In an extension of previous experiments, various types of this biocement, containing different admixtures of particulate matter, were employed to test their usefulness in head surgery, in particular maxillo-facial reconstruction, on dogs and a rhesus monkey. Encouraging results were obtained with regard to (a) fixing a titanium alloimplant under some degree of mechanical stress; (b) covering a defect in the skull cap, including the closure of an artificially induced meningeal fistula with liquorrhea; and (c) reconstruction of defects in the anterior wall of frontal sinuses. Special emphasis is placed on direct contact between biocement and bone, interdigitations between these two, reactions of meningeal tissue, and regeneration of ciliated epithelium underneath fixed reimplants over the frontal sinus. PMID:6216717

Raveh, J; Stich, H; Schawalder, P; Ruchti, C; Cottier, H

1982-01-01

170

In vivo study of myocardial elastography under graded ischemia conditions  

NASA Astrophysics Data System (ADS)

The capability of currently available echocardiography-based strain estimation techniques to fully map myocardial abnormality at early stages of myocardial ischemia is yet to be investigated. In this study, myocardial elastography (ME), a radio-frequency (RF)-based strain imaging technique that maps the full 2D transmural angle-independent strain tensor in standard echocardiographic views at both high spatial and temporal resolution is presented. The objectives were to (1) evaluate the performance of ME on mapping the onset, extent and progression of myocardial ischemia at graded coronary constriction levels (from partial to complete coronary flow reduction), and (2) validate the accuracy of the strain estimates against sonomicrometry (SM) measurements. A non-survival canine ischemic model (n = 5) was performed by gradually constricting the left anterior descending (LAD) coronary blood flow from 0% (baseline blood flow) to 100% (zero blood flow) at 20% increments. An open-architecture ultrasound system was used to acquire RF echocardiograms in a standard full short-axis view at the frame rate of 211 fps, at least twice higher than what is typically used in conventional echocardiographic systems, using a previously developed, fully automated composite technique. Myocardial deformation was estimated by ME and validated against sonomicrometry. ME estimates and maps transmural (1) 2D displacements using RF cross-correlation and recorrelation; and (2) 2D polar (radial and circumferential) strains, derived from 2D (i.e. both lateral and axial) displacement components, at high accuracy. Full-view strain images were shown and found to reliably depict decreased myocardial function in the region at risk at increased levels of coronary flow reduction. The ME radial strain was deemed to be a more sensitive, quantitative, regional measure of myocardial ischemia as a result of coronary flow reduction when compared to the conventional wall motion score index and ejection fraction. Good agreement (0.22% strain bias, 95% limits of agreement) using Bland-Altman analysis and good correlation (r = 0.84) were found between the ME and SM measurements. These findings demonstrate for the first time that ME could map angle-independent strains to non-invasively detect, localize and characterize the early onset of myocardial ischemia, i.e. at 40%, and possibly as low as 20%, LAD flow reduction, which could be further associated with the severity of coronary stenosis.

Lee, Wei-Ning; Provost, Jean; Fujikura, Kana; Wang, Jie; Konofagou, Elisa E.

2011-02-01

171

Myocardial infarction accelerates atherosclerosis  

PubMed Central

SUMMARY During progression of atherosclerosis, myeloid cells destabilize lipid-rich plaque in the arterial wall and cause its rupture, thus triggering myocardial infarction and stroke. Survivors of acute coronary syndromes have a high risk of recurrent events for unknown reasons. Here we show that the systemic response to ischemic injury aggravates chronic atherosclerosis. After myocardial infarction or stroke, apoE?/? mice developed larger atherosclerotic lesions with a more advanced morphology. This disease acceleration persisted over many weeks and was associated with markedly increased monocyte recruitment. When seeking the source of surplus monocytes in plaque, we found that myocardial infarction liberated hematopoietic stem and progenitor cells from bone marrow niches via sympathetic nervous system signaling. The progenitors then seeded the spleen yielding a sustained boost in monocyte production. These observations provide new mechanistic insight into atherogenesis and provide a novel therapeutic opportunity to mitigate disease progression.

Dutta, Partha; Courties, Gabriel; Wei, Ying; Leuschner, Florian; Gorbatov, Rostic; Robbins, Clinton; Iwamoto, Yoshiko; Thompson, Brian; Carlson, Alicia L.; Heidt, Timo; Majmudar, Maulik D.; Lasitschka, Felix; Etzrodt, Martin; Waterman, Peter; Waring, Michael T.; Chicoine, Adam T.; van der Laan, Anja M.; Niessen, Hans W.M.; Piek, Jan J.; Rubin, Barry B.; Butany, Jagdish; Stone, James; Katus, Hugo A.; Murphy, Sabina A.; Morrow, David A.; Sabatine, Marc S.; Vinegoni, Claudio; Moskowitz, Michael A.; Pittet, Mikael J.; Libby, Peter; Lin, Charles P.; Swirski, Filip K.; Weissleder, Ralph; Nahrendorf, Matthias

2012-01-01

172

Myocardial infarction accelerates atherosclerosis.  

PubMed

During progression of atherosclerosis, myeloid cells destabilize lipid-rich plaques in the arterial wall and cause their rupture, thus triggering myocardial infarction and stroke. Survivors of acute coronary syndromes have a high risk of recurrent events for unknown reasons. Here we show that the systemic response to ischaemic injury aggravates chronic atherosclerosis. After myocardial infarction or stroke, Apoe-/- mice developed larger atherosclerotic lesions with a more advanced morphology. This disease acceleration persisted over many weeks and was associated with markedly increased monocyte recruitment. Seeking the source of surplus monocytes in plaques, we found that myocardial infarction liberated haematopoietic stem and progenitor cells from bone marrow niches via sympathetic nervous system signalling. The progenitors then seeded the spleen, yielding a sustained boost in monocyte production. These observations provide new mechanistic insight into atherogenesis and provide a novel therapeutic opportunity to mitigate disease progression. PMID:22763456

Dutta, Partha; Courties, Gabriel; Wei, Ying; Leuschner, Florian; Gorbatov, Rostic; Robbins, Clinton S; Iwamoto, Yoshiko; Thompson, Brian; Carlson, Alicia L; Heidt, Timo; Majmudar, Maulik D; Lasitschka, Felix; Etzrodt, Martin; Waterman, Peter; Waring, Michael T; Chicoine, Adam T; van der Laan, Anja M; Niessen, Hans W M; Piek, Jan J; Rubin, Barry B; Butany, Jagdish; Stone, James R; Katus, Hugo A; Murphy, Sabina A; Morrow, David A; Sabatine, Marc S; Vinegoni, Claudio; Moskowitz, Michael A; Pittet, Mikael J; Libby, Peter; Lin, Charles P; Swirski, Filip K; Weissleder, Ralph; Nahrendorf, Matthias

2012-07-19

173

AngioJet rheolytic thrombectomy for thrombotic myocardial injury in a 15-year-old cystic fibrosis patient during lung transplantation.  

PubMed

We report on an acute myocardial injury caused by thrombotic emboli during off-pump bilateral sequential lung transplantation in a 15-year-old female patient with end-stage cystic fibrosis. A few minutes after reperfusion of the right (second sequential) allograft, the patient developed hemodynamic collapse, including hypotension, acute akinesis of the anterior and lateral myocardial walls, and severe mitral regurgitation. Thrombus was noted within the left atrium and ventricle on intraoperative transesophageal echocardiogram. After emergent cannulation for cardiopulmonary bypass, the patient underwent left cardiac catheterization with AngioJet rheolytic thrombectomy and removal of the clot from the distal left anterior descending coronary artery. Reperfusion was established without the need for stent placement or further intervention. The patient required short-term life support with venoarterial extracorporeal membrane oxygenation. PMID:22579902

Hayes, Don; Schell, Randall M; Plunkett, Mark D; Gurley, John C; Hoopes, Charles W

2012-08-01

174

Improvement of Left Ventricular Function and Wall Motion Abnormalities after Recanalization of Total Occlusion of Left Anterior Descending Coronary Artery by Percutaneous Transluminal Coronary Angioplasty.  

PubMed

PTCA was performed in 262 consecutive patients (pts) with total LAD occlusion. TIMI 3 flow was established in 164 pts (success rate was 62.6%). After 4Ð6 months a follow-up angiography of 72 pts showed restenosis in 39 pts (restenosis rate was 54.2%). In 33 pts without restenosis there was a significant increase in ejection fraction (EF) (54.6 +/- 15 versus 59.8 +/- 18.1 before and after PTCA respectively, p = 0.02). Improvement of wall motion abnormalities (WMA) in 12 of 26 pts was observed. Anterolateral-apical (AL-A) aneurysm disappeared in 6 pts and limited to apex in 2 pts. AL-A hypokinesia in 3 and akinesia in 1 reversed to normal wall motion (NWM). There was not a significant change in EF in either of the groups of pts with reocclusion (24 pts) or restenosis (15 pts) (p > 0.05). However, AL-A aneurysm disappeared in 2 of 12 pts with WMA before PTCA although there was restenosis (but TIMI 3 flow) on follow-up coronary angiogram. In 3 pts with restenosis but not reocclusion AL-A hypokinesia, akinesia and apical dyskinesia returned to NWM. No significant changes were observed in the left ventricular end diastolic pressures (LVEDP) in both pt groups with or without improvement of WMA(p > 0.05). Filling fractions (FF) did not change in patients with or without restenosis. CONCLUSION: The observations in patients with successful total LAD occlusion angioplasty and no restenosis are as follows: 1) There was a significant increase in EF; 2) There was no significant decrease in LVEDP and no increase in FF; 3) The rate of improvement of WMA was 46.2%; 4) There was no relation between improvement of WMA and the age of occlusion, the grade of coronary collateral vessels and involvement of other coronary arteries. However, it has been emphasized that in 11 of 12 pts (91.6%) with improvement of WMA the age of occlusion was < 3 months, in 10 (83.3%) the grade of coronary collateral vessels was 2 or 3 and in 10 (83.3%) the other coronary arteries were normal. The improvement of WMA in 41.6% of pts. who had also subtotal restenosis but not reocclusion was observed. Finally in 72 pts with follow-up coronary angiography, the rate of improvement of wall motion was 23.5 %. PMID:10762934

Pamir; Oral; Omurlu; Erol; Kervancioglu; Akgun; Golbasi

1997-07-01

175

Quantification of diagnostic accuracy using nitrate enhanced Tc-99m sestamibi gated myocardial SPECT in assessing myocardial viability: prospective analysis.  

PubMed

The aim of this prospective study was to assess myocardial viability with nitrate-enhanced Tc-99m sestamibi gated single-photon emission computed tomography in patients with known coronary artery disease. We enrolled 48 consecutive patients (39 men, 9 women) aged 24-82 years, with coronary artery disease and history of myocardial infarction. A Tc-99m sestamibi study was conducted at rest as baseline, followed by a nitrate-enhanced study the next day. Of 960 segments analyzed, 244 of 480 in the left anterior descending coronary artery territory showed viability on the baseline study, and 276 were viable according to the nitrate-enhanced study. Similarly, of 192 right coronary segments analyzed, 148 showed viability on the baseline study compared to 153 on the nitrate study. Of 288 left circumflex territory segments analyzed, 206 showed viability on the baseline study compared to 241 on the nitrate study. The overall improvement of viability with the nitrate study was 12.04%. On the gated studies, the overall improvement with nitrate was 2.02%. The gated study also allowed grading of wall motion and thickness. It was concluded that nitrate-augmented Tc-99m sestamibi myocardial imaging significantly improved the detection of hibernating myocardium, with gated images further improving the accuracy of detection in borderline cases. PMID:22499958

Khan, Zahid Rahman; Syed, Aitizazuddin; Noor, Lubna; Shah, Syed Sadiq; Hafizullah, Mohammad

2012-04-01

176

Myocardial infarction in young adults-risk factors and pattern of coronary artery involvement  

PubMed Central

Background: Coronary artery disease (CAD) mostly occurs in persons older than 45 years of age. In India, CAD manifests almost a decade earlier than in Western countries. This study was done to study the risk factors and angiographic profile in young patients presenting with acute myocardial infarction (AMI). Patients and Methods: One hundred and twenty four consecutive patients presenting with AMI at less than 40 years of age were studied for risk factors. Coronary angiography was done in all. Results: Out of 124 patients, 123 were male. Mean age was 35.94 ± yrs. One hundred and eighteen had ST elevation myocardial infarction (MI) (95.16%) and six had non ST elevation MI (5.84%). Anterior wall MI was present in 88 patients (70.97%), inferior wall MI in 31 patients (25%) and lateral wall MI in five patients (4.03%). Seventy three patients (58.8%) were smoker, 55 were hypertensive (44.35%), 10 were diabetic (8.06%). Family history of CAD was present in 22 (17.7%) patients. Low High-density lipoprotein (HDL) was seen in 53 patients (42.7%), and high triglycerides in 60 patients (48.38%). Significant CAD was found in 88 (70.96%) patients, 13 (10.48%) had normal coronaries. Single vessel disease was seen in 57 patients, two-vessel disease in 15 patients and three-vessel disease in eight patients. Total 125 lesions were seen and left anterior descending (LAD) was the commonest vessel involved, with 78 lesions (62.4%). Conclusion: AMI in young almost exclusively occurs in male, and ST elevation MI is the main presentation. Anterior wall MI is most common, with LAD being involved in around 2/3 patients. Smoking, hypertension, low HDL and high triglycerides are the major risk factors.

Bhardwaj, Rajeev; Kandoria, Arvind; Sharma, Rajesh

2014-01-01

177

When heart goes "BOOM" to fast. Heart rate greater than 80 as mortality predictor in acute myocardial infarction  

PubMed Central

Many prospective studies established association between high heart rate and increased cardiovascular morbidity and mortality, independently of other risk factors. Heart rate over 80 beats per minute more often leads to atherosclerotic plaque disruption, the main step in developing acute coronary syndrome. Purpose was to investigate the incidence of higher heart rate levels in patients with anterior wall acute myocardial infarction with ST-segment elevation and the influence of heart rate on mortality. Research included 140 patients with anterior wall acute myocardial infarction with ST-segment elevation treated in Coronary Unit, Clinical Center Kragujevac in the period from January 2001-June 2006. Heart rate was calculated as the mean value of baseline and heart rate in the first 30 minutes after admission. Other risk factors were also followed to determine their connection with elevated heart rate. Results showed that the majority of patients survived (over 70%). In a total number of patients, more than 75% had a heart rate levels greater than 80 beats per minute. There was a significant difference in heart rate on addmision between survivors and patients who died, with a greater levels in patients with fatal outcome. Both, univariate and multivariate regression analysis singled out heart rate greater than 80 beats per minute as independent mortality predictor in these patients. Heart rate greater than 80 beats per minute is a major, independent risk factor for morbidity and important predictor of mortality in patients with acute myocardial infarction.

Davidovic, Goran; Iric-Cupic, Violeta; Milanov, Srdjan; Dimitijevic, Aleksandra; Petrovic-Janicijevic, Mirjana

2013-01-01

178

Myocardial Lipidomics  

PubMed Central

The development of electrospray ionization mass spectrometry has been critical for the analyses of lipidomes from subcellular organelles. The myocardial nuclear lipidome likely has a key role in the molecular regulation of gene expression. In fact, recent studies have suggested that specific phospholipid classes bind and regulate specific transcription factors. The dynamic regulation of the myocardial nuclear lipidome may be critical in mediating long-term pathological responses to stresses such as ischemia, tachycardia and hypertension. In this brief review, the preparation of myocardial nuclei is discussed, and the resulting nuclear lipidome from rat and rabbit are shown as examples. The rabbit myocardial nuclear lipidome contains relatively more plasmenylcholine/phosphatidylcholine molecular species in comparison to that ratio observed in the rat myocardial nuclear lipidome. The composition of the rat myocardial nuclear choline glycerophospholipid pool was relatively enriched with molecular species containing arachidonic acid and docosahexaenoic acid in comparison to that in the rabbit myocardial nuclear choline glycerophospholipid pool. While the ethanolamine glycerophospholipids of the rabbit myocardial nuclei are enriched with arachidonic acid and plasmalogens, the ethanolamine glycerophospholipid profile from rat myocardial nuclei show less plasmalogen and more species containing docosahexaenoic acid. Last, significant differences in the ethanolamine glycerophospholipid molecular species were observed in the rabbit heart lipidomes from the nucleus and the mitochondria. Quantitation of these lipid species in hearts subjected to pathophysiological stresses may provide important information on the role of the myocardial nuclear lipidome on long-term cardiac cell function.

Albert, Carolyn J.; Anbukumar, Dhanalakshmi S.; Monda, Julie K.; Eckelkamp, Joseph T.; Ford, David A.

2009-01-01

179

Assessment of myocardial viability by MR imaging  

Microsoft Academic Search

.   Diagnosis of myocardial viability after infarction focuses on the prediction of functional improvement of dysfunctional myocardium\\u000a after revascularization therapy. Magnetic resonance imaging provides different approaches for the detection of myocardial\\u000a viability. Measurement of end-diastolic wall thickness is easy to perform and has a high sensitivity, but a low specificity,\\u000a and can only be used 4 months after myocardial infarction due

Jörn J. W. Sandstede

2003-01-01

180

Kinetics and imaging of /sup 111/In-labeled autologous platelets in experimental myocardial infarction  

SciTech Connect

The kinetics of accumulation and the external imaging patterns of /sup 111/In-labeled platelets infused in a dog model of left anterior descending coronary artery occlusion with reperfusion were studied. The effects of infarct age and regional residual myocardial blood flow upon platelet accumulation were quantified, and the capacity of /sup 111/In platelets to image the experimental infarction was evaluated qualitatively. The endocardial accumulation of /sup 111/In platelets occurred primarily in infarct zones with residual blood flow less than 0.6 times normal and was maximal (24.98 +/- 2.76 times normal) in the lowest blood flow zone (less than 0.1 times normal). Indium-111 platelet accumulation in the epicardium occurred in the regions with blood flow less than 0.6 times normal and was maximal (17.83 +/- 1.20 times normal) in the lowest blood flow zone (less than 0.1 times normal). The maximal endocardial and epicardial platelet accumulation occurred 24 hours after reperfusion and was significantly decreased at 48 hours. In vivo cardiac images revealed discrete areas of increased myocardial radioactivity uptake in the anterior wall of dogs 24 hours after reperfusion. All images 48 hours after reperfusion were negative. Thus, in the experimental setting, /sup 111/In platelets allow quantification of platelet accumulation after myocardial infarction at a tissue level and provide a noninvasive means of in vivo imaging of reperfused infarcted myocardium.

Laws, K.H.; Clanton, J.A.; Starnes, V.A.; Lupinetti, F.M.; Collins, J.C.; Oates, J.A.; Hammon, J.W. Jr.

1983-01-01

181

Regional Myocardial Blood Flow and Ultrastructure Following Acute Temporary Ischemia.  

National Technical Information Service (NTIS)

The effect of reopening acutely occluded coronary arteries has on regional myocardial blood flow and ultrastructure was studied in open chest dogs. Temporary and permanent ischemia were produced in the same animal by ligating a branch of the left anterior...

H. Davis

1982-01-01

182

Relation of Opium Addiction with the Severity and Extension of Myocardial Infarction and Its Related Mortality  

PubMed Central

Background Despite some evidences about protective or triggering role of opium use in patients with coronary artery disease, the exact role of opium is still under question. The current study aimed to address the relation of opium dependence on the severity and extension of myocardial infarction (MI) and its related mortality. Methods The study population consisted of 460 consecutive patients (239 opium addicts and 221 non-addicts) with first acute MI. Study information was extracted from hospital recorded files as well as face to face interview. Findings In-hospital mortality in opium addicted patients was numerically lower than another group (5.4% versus 8.2%), but this difference was not statistically significant. Regarding types of MI, anterior wall MI was higher in non-addicted patients than addicts (36.4% versus 26.4%). Among patients with anterior wall MI, early mortality was significantly higher in non-addicted compared to addicted subjects (20.0% versus 7.9% P = 0.043). The main associated factors of in-hospital mortality due to acute MI in addicts were advanced age and family history of coronary artery disease and in non-addicts were advanced age and hypertension. Conclusion In current study total in-hospital mortality was not different between opium addicted and non-addicted groups but opium may reduce the occurrence of anterior wall MI and its related early mortality.

Dehghani, Farnaz; Masoomi, Mohammad; Haghdoost, Ali Akbar

2013-01-01

183

Evidence of myocardial scarring and microvascular obstruction on cardiac magnetic resonance imaging in a series of patients presenting with myocardial infarction without obstructed coronary arteries.  

PubMed

Patients with acute chest pain, electrocardiographic ST-elevation and significant elevation of cardiac troponin but without obstructive coronary artery disease represent a diagnostic and therapeutic dilemma. Cardiac magnetic resonance imaging (CMR) can elucidate underlying alternative causes of troponin elevation including detection of (minor) myocardial infarction (MI) by identifying myocardial scarring as delayed enhancement. Of 77 patients, who were admitted between March 2009 and December 2012 with electrocardiographic (ECG) and biochemical evidence of acute MI without obstructive coronary artery disease, 45 patients underwent CMR that showed in 11/77 (14 %) late gadolinium enhancement (LGE), compatible with myocardial scarring. We analyzed clinical, echocardiographic, and CMR data of these patients. Elevated troponin I levels were observed in all patients (median 1.3 ng/l, IQR 0.44-187) with median peak creatinine phosphokinase of 485 U/l (IQR 234-618). Echocardiographic wall motion abnormalities were detected in 8/11 (73 %) patients; in 75 % of these segments, ECG abnormalities were observed in corresponding leads. CMR detected LGE in the inferior (4/11), the inferolateral (5/11), the inferoseptal (2/11), the anterior (3/11), apical (3/11) and in the lateral segments (2/11). In addition, in all but two patients, these segments matched ECG abnormalities in corresponding leads. CMR identified microvascular obstruction in 4/11 (36 %) patients. Patients with clinical, ECG, and biochemical signs of acute MI but unobstructed coronary arteries may have CMR-detectable myocardial scars. Information on myocardial scarring may help to make the diagnosis and draw therapeutic consequences. This case series underlines the value of contrast-enhanced CMR for myocardial tissue characterization. PMID:24794293

Hermens, Jeannine A J M; van Es, Jan; von Birgelen, Clemens; Op den Akker, Jeroen W; Wagenaar, Lodewijk J

2014-08-01

184

Methylprednisolone treatment in acute myocardial infarction. Effect on regional and global myocardial function.  

PubMed

The effects of methylprednisolong treatment on acute myocardial ischemia were studied in nine closed chest dogs. After 1 hour of proximal occlusion of the left anterior descending coronary artery, an intravenous bolus injection (50 mg/kg body weight) of methylprednisolone was administered and its effects studied during an additional 2 hours of occlusion. After 2 hours of treatment the following significant mean alterations from levels after 1 hour of occlusion were noted: an increase of 16.7% in heart rate and decreases of 23% in left ventricular end-diastolic pressure, 32% in stroke volume, 14% in cardiac output and 37% in stroke work. Peak systolic pressure, maximal rate of rise of left ventricular pressure (dP/dt), left ventricular end-diastolic volume, systemic vascular resistance and coronary sinus blood flow changed less than 10%. Ejection fraction and regional cardiac wall motion were not improved. Metabolic dysfunction of the coronary-occluded myocardium, revealed by regional lactate as well as potassium derangements, persisted throughout the 2 hour treatment period. Comparison of these results with equivalent data from an untreated series of nine dogs with 3 hours of occlusion demonstrated no improvement in the treated series. Methylprednistone failed to restore regional cardiac metabolic and mechanical function, and treatment was associated with a further rise in S-T segment elevations. Administration of methylprednisolone after 1 hour of proximal left anterior descending coronary occlusion apparently does not reverse cardiac dysfunction in the first 2 hours of treatment. PMID:1258794

Osher, J; Lang, T W; Meerbaum, S; Hashimoto, K; Farcot, J C; Corday, E

1976-03-31

185

Myocardial bridges: morphological and functional aspects  

Microsoft Academic Search

OBJECTIVE--To assess the arrangement of myocardial bridges. DESIGN--A necropsy study of 90 consecutive hearts (56 male, 34 female). RESULTS--Myocardial bridges, either single or multiple, were seen in 50 (55.6%) of the 90 hearts. The left anterior descending artery was the most commonly affected artery. Thirty five of the 50 hearts which contained in total 41 muscle bridges were dissected further

A G Ferreira; S E Trotter; B König; L V Décourt; K Fox; E G Olsen

1991-01-01

186

Clinical, angiographic, hemodynamic, perfusional and functional changes after one-vessel left anterior descending coronary angioplasty  

SciTech Connect

Percutaneous transluminal coronary angioplasty (PTCA) was successfully performed in 20 patients with 1-vessel left anterior descending (LAD) coronary artery disease. Exercise capacity in terms of peak workload, heart rate and systolic blood pressure all increased significantly 1 week after PTCA. All patients had some decrease in stenosis size and gradient. All patients except 1 had an improvement in functional class. Eight of 12 patients with abnormal exercise electrocardiograms before PTCA had normal electrocardiograms after the procedure. Exercise thallium-201 (TI-201) myocardial perfusion images obtained in all 20 patients before and 1 week after PTCA were analyzed using a new computer method designed to quantitate regional myocardial TI-201 distribution, redistribution and clearance rate. Significant improvement in TI-201 activity was present in the anterior and septal segments of the left ventricle 1 week after PTCA. This increase in TI-201 uptake was associated with a significant reduction in the amount of TI-201 redistribution between initial and delayed postexercise images in the same regions. TI-201 clearance rate in the segments supplied by the dilated vessel also improved significantly. Abnormal TI-201 lung uptake was seen in 17 patients before and in 4 patients after PTCA. Exercise ejection fraction response and septal wall motion also improved after PTCA of the LAD stenosis in all 17 patients who had exercise radionuclide ventriculography.

Okada, R.D.; Lim, Y.L.; Boucher, C.A.; Pohost, G.M.; Chesler, D.A.; Block, P.C.

1985-02-01

187

Detection of myocardial ischaemia by transthoracic leads in ambulatory electrocardiographic monitoring  

PubMed Central

Objective—To determine the best sites for ambulatory monitoring leads to detect myocardial ischaemia. Patients—50 consecutive patients recovering from myocardial infarction. Six patients were excluded because of unsatisfactory recordings or baseline electrocardiographic abnormalities that influenced the diagnostic accuracy of ST segment depression. In 38 patients important ST segment changes were seen before the study recordings. Main outcome measure—Reproducibility of detecting the electrocardiographic ST segment changes with 12 bipolar leads alone or in combination. Results—The highest reproducibility rate was found in infarcts involving both the anterior and inferior left ventricular walls (80%). The reproducibility decreased as the extent of ventricular wall involvement decreased and was lowest in inferior infarcts (31%) (p < 0·001). For large infarcts the detection rate was almost equal for the 12 study leads, whereas disparity between leads increased as the infarct size decreased. The highest overall reproducibility was found in a transthoracic lead (V2, V9R) (76%). This lead was significantly better (p = 0·03) than lead CM5 (50%). When the transthoracic lead was combined with an inferior lead, the reproducibility increased (82%) and was significantly better than the combination of CM5 and an inferior lead (58%) (p = 0·02). Conclusions—Extensive ischaemic electrocardiographic changes are better detected than smaller ones and anterior infarcts better than inferior. A transthoracic lead (V2, V9R) was significantly better than CM5 both alone and when CM5 and the transthoracic lead were combined with an inferior lead.

Jespersen, Christian M; Rasmussen, Verner

1992-01-01

188

[Type IV dual left anterior descending coronary artery - a rare congenital coronary artery anomaly. A case report].  

PubMed

An extremely rare case of type IV dual left anterior descending coronary artery coexisting with myocardial bridging in a 50-year old Caucasian man with acute coronary syndrome is presented. Emergency cardiac catheterisation revealed no coronary atherosclerotic lesions. The potential causal relationship between the type IV dual left anterior descending coronary artery and myocardial ischaemia was discussed. We also summarised the current knowledge on the epidemiology and clinical significance of dual left anterior descending coronary artery in the adult population. PMID:20411463

Paradowski, Andrzej; Rostoff, Pawe?; Gajos, Grzegorz; Gackowski, Andrzej; Klimeczek, Piotr; Krupi?ski, Maciej; Pasowicz, Mieczys?aw; Piwowarska, Wies?awa

2010-03-01

189

Dynamic myocardial scintigraphy with 123 I-labeled free fatty acids in patients with myocardial infarction  

Microsoft Academic Search

We have already shown that myocardial imaging properties of radio-iodinated long-chain free fatty acids (123I-FFA) and thallium 201 (201Tl) are comparable in detecting areas of inadequate myocardial perfusion (van der Wall et al. 1980). Besides confirming our earlier observations, the present study tests the potential of 123I-FFA, hexadecenoic acid (123I-16-HA), and heptadecanoic acid (123I-17-HoA), in assessing regional myocardial metabolism in

E. E. Wall; W. den Hollander; G. A. K. Heidendal; G. Westera; P. A. Majid; J. P. Roos

1981-01-01

190

Vaginal wall fibroid.  

PubMed

Localization of leiomyomas in the vaginal wall is very rare. We report about a case of a vaginal leiomyoma in the anterior vaginal wall, preoperatively identified with sonography and CT. Surgical enucleation was performed. Surgical removal in these cases is safe and usually with minimal bleeding. PMID:18317784

Theodoridis, T D; Zepiridis, L; Chatzigeorgiou, K N; Papanicolaou, A; Bontis, J N

2008-09-01

191

Value and limitations of segmental analysis of stress thallium myocardial imaging for localization of coronary artery disease  

SciTech Connect

This study was done to determine the value of thallium-201 myocardial scintigraphic imaging (MSI) for identifying disease in the individual coronary arteries. Segmental analysis of rest and stress MSI was performed in 133 patients with ateriographically proved coronary artery disease (CAD). Certain scintigraphic segments were highly specific (97 to 100%) for the three major coronary arteries: anterior wall and septum for the left anterior descending (LAD) coronary artery; the inferior wall for the right coronary artery (RCA); and the proximal lateral wall for the circumflex (LCX) artery. Perfusion defects located in the anterolateral wall in the anterior view were highly specific for proximal disease in the LAD involving the major diagonal branches, but this was not true for septal defects. The apical segments were not specific for any of the three major vessels. Although MSI was abnormal in 89% of these patients with CAD, it was less sensitive for identifying individual vessel disease: 63% for LAD, 50% for RCA, and 21% for LCX disease (narrowings > = 50%). Sensitivity increased with the severity of stenosis, but even for 100% occlusions was only 87% for LAD, 58% for RCA and 38% for LCX. Sensitivity diminished as the number of vessels involved increased: with single-vessel disease, 80% of LAD, 54% of RAC and 33% of LCX lesions were detected, but in patients with triple-vessel disease, only 50% of LAD, 50% of RCA and 16% of LCX lesions were identified. Thus, although segmented analysis of MSI can identify disease in the individual coronary arteries with high specificity, only moderate sensitivity is achieved, reflecting the tendency of MSI to identify only the most severely ischemic area among several that may be present in a heart. Perfusion scintigrams display relative distributions rather than absolute values for myocardial blood flow.

Rigo, P.; Bailey, I.K.; Griffith, L.S.C.; Pitt, B.; Borow, R.D.; Wagner, H.N.; Becker, L.C.

1980-05-01

192

Preemptive heme oxygenase-1 gene delivery reveals reduced mortality and preservation of left ventricular function 1 yr after acute myocardial infarction.  

PubMed

We reported previously that predelivery of heme oxygenase-1 (HO-1) gene to the heart by adeno-associated virus-2 (AAV-2) markedly reduces ischemia and reperfusion (I/R)-induced myocardial injury. However, the effect of preemptive HO-1 gene delivery on long-term survival and prevention of postinfarction heart failure has not been determined. We assessed the effect of HO-1 gene delivery on long-term survival, myocardial function, and left ventricular (LV) remodeling 1 yr after myocardial infarction (MI) using echocardiographic imaging, pressure-volume (PV) analysis, and histomorphometric approaches. Two groups of Lewis rats were injected with 2 x 10(11) particles of AAV-LacZ (control) or AAV-human HO-1 (hHO-1) in the anterior-posterior apical region of the LV wall. Six weeks after gene transfer, animals were subjected to 30 min of ischemia by ligation of the left anterior descending artery followed by reperfusion. Echocardiographic measurements and PV analysis of LV function were obtained at 2 wk and 12 mo after I/R. One year after acute MI, mortality was markedly reduced in the HO-1-treated animals compared with the LacZ-treated animals. PV analysis demonstrated significantly enhanced LV developed pressure, elevated maximal dP/dt, and lower end-diastolic volume in the HO-1 animals compared with the LacZ animals. Echocardiography showed a larger apical anterior-to-posterior wall ratio in HO-1 animals compared with LacZ animals. Morphometric analysis revealed extensive myocardial scarring and fibrosis in the infarcted LV area of LacZ animals, which was reduced by 62% in HO-1 animals. These results suggest that preemptive HO-1 gene delivery may be useful as a therapeutic strategy to reduce post-MI LV remodeling and heart failure. PMID:17322421

Liu, Xiaoli; Simpson, Jeremy A; Brunt, Keith R; Ward, Christopher A; Hall, Sean R R; Kinobe, Robert T; Barrette, Valerie; Tse, M Yat; Pang, Stephen C; Pachori, Alok S; Dzau, Victor J; Ogunyankin, Kofo O; Melo, Luis G

2007-07-01

193

In vivo characterization of acute myocardial ischemia using photoacoustic imaging with a focused transducer  

NASA Astrophysics Data System (ADS)

We explore the feasibility of using photoacoustic imaging based on a focused transducer to characterizing acute myocardial ischemia at different stage. In this study, we blocked rat left anterior coronary descending artery (LAD) to induce the acute myocardial ischemia. The results show that the intensity and areas of photoacoustic images of myocardial decrease with the LAD time increasing, which suggests that photoacoustic imaging has a potential for diagnosis of acute myocardial ischemia.

Li, Zhifang; Chen, Haiyu; Xie, Wengming; Li, Hui

2011-02-01

194

Scintigraphic assessment of sympathetic innervation after transmural versus nontransmural myocardial infarction  

SciTech Connect

To evaluate the feasibility of detecting denervated myocardium in the infarcted canine heart, the distribution of sympathetic nerve endings using I-123 metaiodobenzylguanidine (MIBG) was compared with the distribution of perfusion using thallium-201, with the aid of color-coded computer functional map in 16 dogs. Twelve dogs underwent myocardial infarction by injection of vinyl latex into the left anterior descending coronary artery (transmural myocardial infarction, n = 6), or ligation of the left anterior descending coronary artery (nontransmural myocardial infarction, n = 6). Four dogs served as sham-operated controls. Image patterns were compared with tissue norepinephrine content and with histofluorescence microscopic findings in biopsy specimens. Hearts with transmural infarction showed zones of absent MIBG and thallium, indicating scar. Adjacent and distal regions showed reduced MIBG but normal thallium uptake, indicating viable but denervated myocardium. Denervation distal to infarction was confirmed by reduced norepinephrine content and absence of nerve fluorescence. Nontransmural myocardial infarction showed zones of wall thinning with decreased thallium uptake and a greater reduction or absence of MIBG localized to the region of the infarct, with minimal extension of denervation beyond the infarct. Norepinephrine content was significantly reduced in the infarct zone, and nerve fluorescence was absent. These findings suggest that (1) MIBG imaging can detect viable and perfused but denervated myocardium after infarction; and (2) as opposed to the distal denervation produced by transmural infarction, nontransmural infarction may lead to regional ischemic damage of sympathetic nerves, but may spare subepicardial nerve trunks that course through the region of infarction to provide a source of innervation to distal areas of myocardium.

Dae, M.W.; Herre, J.M.; O'Connell, J.W.; Botvinick, E.H.; Newman, D.; Munoz, L. (University of California, San Francisco (USA))

1991-05-01

195

Stent implantation in acute myocardial infarction  

Microsoft Academic Search

Among 138 patients treated with coronary angioplasty during acute myocardial infarction (AMI), 35 (25%) had stent implantation. Mean age was 56 years and 83% were men. Mean onset of chest pain was 6.0 ± 5.3 hours, and previous thrombolytic therapy was given to 10 patients (29%). Infarct location was anterior in 19 (54%), inferior in 14 (40%), and lateral in

Elias Garcia-Cantu; Christian Spaulding; Thierry Corcos; Khaldoun Ben Hamda; Laurent Roussel; Xavier Favereau; Yves Guérin; Yann Chalet; Gérard Souffrant; François Guérin

1996-01-01

196

Nitroglycerine Induced Acute Myocardial Infarction in a Patient with Myocardial Bridging  

PubMed Central

Muscle overlying an intramyocardial segment of a coronary artery is termed a myocardial bridge. The intramyocardial segment, the tunneled artery, is compressed during systole. The condition is generally benign but may occasionally cause myocardial ischemia, infarction, arrhythmia, or sudden cardiac death. We present a case regarding a 52-year-old man with exercise-induced angina who was diagnosed with a myocardial bridge overlying the left anterior descending artery. He was initially treated with beta-blockers and later received coronary bypass graft surgery.

Rujic, Dragana; Veien, Karsten Tange

2014-01-01

197

Nitroglycerine induced acute myocardial infarction in a patient with myocardial bridging.  

PubMed

Muscle overlying an intramyocardial segment of a coronary artery is termed a myocardial bridge. The intramyocardial segment, the tunneled artery, is compressed during systole. The condition is generally benign but may occasionally cause myocardial ischemia, infarction, arrhythmia, or sudden cardiac death. We present a case regarding a 52-year-old man with exercise-induced angina who was diagnosed with a myocardial bridge overlying the left anterior descending artery. He was initially treated with beta-blockers and later received coronary bypass graft surgery. PMID:24826309

Rujic, Dragana; Nielsen, Mette Lundgren; Veien, Karsten Tange; Pareek, Manan

2014-01-01

198

Autologous Cardiomyotissue Implant Promotes Myocardial Regeneration, Decreases Infarct Size and Improves Left Ventricular Function  

PubMed Central

Background Cell therapy for myocardial infarction (MI) may be limited by poor cell survival and lack of transdifferentiation. We report a novel technique of implanting whole autologous myocardial tissue from preserved myocardial regions into infarcted regions. Methods and Results Fourteen rats were used to optimize cardiomyotissue size using peritoneal wall implantation (300?M identified as optimal size). Thirty-nine pigs were used to investigate cardiomyotissue implantation in MI induced by LAD balloon occlusion [10 animals died, male to female transplantation for tracking with ISH for Y chromosome, n=4 (2-donors and 2-MI animals), acute MI implant cohort at 1 hour, n=13, and healed MI implant at 2 weeks, n=12]. Assessment included echocardiography, MRI, hemodynamics, TTC staining, histological, and molecular analysis. Tracking studies demonstrated viable implants with donor cells interspersed in the adjacent myocardium with gap junctions and desmosomes. In the acute MI cohort, treated animals compared to controls had improved perfusion by MRI (1.2±0.01 vs. 0.86±0.05,p<0.01), decreased MI size (MRI:%LV:2.2±0.5 vs. 5.4±1.5,p=0.04, TTC: %Anterior wall: 10.3±4.6 vs. 28.9±5.8,p<0.03), improved contractility (+dP/dt:1235±215 vs. 817±817,p<0.05). In healed MI cohort, treated animals had less decline in EF between 2 and 4 week assessment (-3±4% vs. -13±-4%,p<0.05), less decline in +/-dP/dt, and smaller MI (TTC: 21±11% vs. 3±8%,p=0.006) than control animals. Infarcts in the treated animals contained more mdr-1+ cells and fewer c-kit+ cells with a trend for decreased expression of MMP-2 and increased expression of TIMP-2. Conclusion Autologous cardiomyotissue implanted in myocardial infarction area remains viable, exhibits electromechanical coupling, decreases infarct size and improves LV function.

Wykrzykowska, Joanna J.; Rosinberg, Audrey; Lee, Seung U.; Voisine, Pierre; Wu, Guifu; Appelbaum, Evan; Boodhwani, Munir; Sellke, Frank W.; Laham, Roger J.

2011-01-01

199

Agreement in human interpretation of analog thallium myocardial perfusion images  

SciTech Connect

To assess the agreement of human interpretation of analog thallium myocardial perfusion images, four experienced interpreters evaluated 100 images on two occasions using a form designed to limit reader variability. A high intraobserver agreement (agreement by same observer at separate times) of 89--93% was found when films were interpreted as normal or abnormal (a dichotomous decision). Interobserver agreement for a majority grouping of observers (three or four) was 75% for an abnormal and 68% for a normal interpretation. However, agreement ranged from 11--79% when interpreters were asked to read the anatomic location of defects. Posterior and lateral wall defects were interpreted with the least amount of agreement. These results indicate that caution must be taken when interpreting defect location. Using a scale of 1--10 to grade the severity of a defect, correlations of 0.82--0.86 were found when reading defects in the lateral and anterior projections. Higher correlations, from 0.86--0.94, were found in left anterior oblique views. Use of reporting forms with specific criteria, multiple observers at one occasion, and/or computer processing may improve agreement. A brief review of the agreement of cardiology testing procedures is also presented.

Atwood, J.E.; Jensen, D.; Froelicher, V.; Witztum, K.; Gerber, K.; Gilpin, E.; Ashburn, W.

1981-09-01

200

CONGENITAL ANTERIOR URETHROCUTANEOUS FISTULA  

Microsoft Academic Search

PurposeCongenital anterior urethrocutaneous fistula is a rare anomaly that may present in an isolated fashion or in association with other penile abnormalities, such as chordee or hypospadias. There have been 18 cases of congenital anterior urethrocutaneous fistula reported in the literature. We present 14 additional cases of congenital anterior urethrocutaneous fistula.

ANTHONY A. CALDAMONE; SHYH-CHYAN CHEN; JACK S. ELDER; MICHAEL L. RITCHEY; DAVID A. DIAMOND; MARTIN A. KOYLE

1999-01-01

201

Human progenitor cells derived from cardiac adipose tissue ameliorate myocardial infarction in rodents.  

PubMed

Myocardial infarction caused by vascular occlusion results in the formation of nonfunctional fibrous tissue. Cumulative evidence indicates that cell therapy modestly improves cardiac function; thus, novel cell sources with the potential to repair injured tissue are actively sought. Here, we identify and characterize a cell population of cardiac adipose tissue-derived progenitor cells (ATDPCs) from biopsies of human adult cardiac adipose tissue. Cardiac ATDPCs express a mesenchymal stem cell-like marker profile (strongly positive for CD105, CD44, CD166, CD29 and CD90) and have immunosuppressive capacity. Moreover, cardiac ATDPCs have an inherent cardiac-like phenotype and were able to express de novo myocardial and endothelial markers in vitro but not to differentiate into adipocytes. In addition, when cardiac ATDPCs were transplanted into injured myocardium in mouse and rat models of myocardial infarction, the engrafted cells expressed cardiac (troponin I, sarcomeric ?-actinin) and endothelial (CD31) markers, vascularization increased, and infarct size was reduced in mice and rats. Moreover, significant differences between control and cell-treated groups were found in fractional shortening and ejection fraction, and the anterior wall remained significantly thicker 30days after cardiac delivery of ATDPCs. Finally, cardiac ATDPCs secreted proangiogenic factors under in vitro hypoxic conditions, suggesting a paracrine effect to promote local vascularization. Our results indicate that the population of progenitor cells isolated from human cardiac adipose tissue (cardiac ATDPCs) may be valid candidates for future use in cell therapy to regenerate injured myocardium. PMID:20713059

Bayes-Genis, Antoni; Soler-Botija, Carolina; Farré, Jordi; Sepúlveda, Pilar; Raya, Angel; Roura, Santiago; Prat-Vidal, Cristina; Gálvez-Montón, Carolina; Montero, José Anastasio; Büscher, Dirk; Izpisúa Belmonte, Juan Carlos

2010-11-01

202

Transcatheter Embolization of a Coronary Fistula Originating from the Left Anterior Descending Artery by Using N-Butyl 2-Cyanoacrylate  

SciTech Connect

In this report, we describe a successful percutaneous transcatheter n-butyl 2-cyanoacrylate embolization of a coronary fistula originating from the left anterior descending artery in an adolescent with unexpected recurrent attacks of myocardial ischemia.

Karagoz, Tevfik; Celiker, Alpay [Hacettepe University, Faculty of Medicine, Section of Pediatric Cardiology (Turkey)], E-mail: alpayceliker@hotmail.com, E-mail: tkaraqoz@hacettepe.edu.tr; Cil, Barbaros; Cekirge, Saruhan [Hacettepe University, Faculty of Medicine, Department of Radiology (Turkey)

2004-11-15

203

Three-directional myocardial motion assessed using 3D phase contrast MRI.  

PubMed

Regional myocardial function is a complex entity consisting of motion in three dimensions (3D). Besides magnetic resonance imaging (MRI), no other noninvasive technique can give a true 3D description of cardiac motion. Using a time-resolved 3D phase contrast technique, three-dimensional image volumes containing myocardial velocity data in six normal volunteers were acquired. Coordinates and velocity information were extracted from nine points placed in different myocardial segments in the left ventricle (LV), and decomposed into longitudinal (V(L)), radial (V(R)), and circumferential (V(C)) velocity components. Our findings confirm a longitudinal apex-to-base gradient for the LV, with only a small motion of the apex. The mean velocity for V(L) for all the basal segments was higher compared to the midsegments during systole [3.5+/-1.2 vs. 2.5+/-1.7 cm/s (p<0.01)], early filling [-6.9+/-1.8 vs. -4.9+/-1.8 cm/s (p<0.001)], and during atrial contraction [-2.2+/-1.4 vs. -1.6+/-1.3 cm/s (p<0.05)]. A similar pattern was observed when comparing velocities from the midsegments to the apex. Radial velocity was higher during early filling in the midportion of the lateral [-4.9+/-2.7 vs. -3.2+/-1.6 cm/s (p<0.05)] wall compared to the basal segments, no difference was observed for the septal [-2.0+/-1.5 vs. -0.3+/-2.5 cm/s (p=0.15)], anterior [-5.8+/-3.3 vs. -4.0+/-1.7 cm/s (p=0.17)], and posterior [-2.3+/-2.1 vs. -2.5+/-1.0 cm/s (p=0.78)] walls. When observing the myocardial velocity in a single point and visualizing the movement of the main direction of the velocities in this point as vectors in velocity vector plots like planes, it is clear that myocardial movement is by no means one dimensional. In conclusion, our time-resolved 3D, phase contrast MRI technique makes it feasible to extract myocardial velocities from anywhere in the myocardium, including all three velocity components without the need for positioning any slices at the time of acquisition. PMID:15347127

Kvitting, John-Peder Escobar; Ebbers, Tino; Engvall, Jan; Sutherland, George R; Wranne, Bengt; Wigström, Lars

2004-01-01

204

Acute myocardial infarction following scorpion sting in a case with obstructive coronary artery disease.  

PubMed

The occurrence of an acute myocardial infarction (MI) following a scorpion sting has been very rarely reported in the previous literature. Possible pathogenetic mechanisms include severe hypotension due to hypovolaemic shock and coronary spasm with subsequent thrombosis of coronary vessels developed after the release of vasoactive, inflammatory and thrombogenic substances contained in the scorpion venom. All of the previously reported cases had normal coronary angiogram. We report a case of a 65-year-old woman who presented with severe scorpion sting and was treated with prazosin. But a few hours later, she developed acute anterior wall MI. Coronary angiogram revealed the presence of significant stenosis in coronary arteries. As acute MI owing to significant coronary artery disease can be evident after severe scorpion envenomation, so every case of acute coronary syndrome following scorpion sting needs early diagnosis, thorough cardiovascular evaluation and appropriate treatment. PMID:23715842

Patra, Soumya; Satish, K; Singla, Vivek; Ravindranath, K S

2013-01-01

205

Evaluation and simplified measurement of infarct size by myocardial contrast echocardiography in a rat model of myocardial infarction  

Microsoft Academic Search

To test the feasibility and accuracy of myocardial contrast echocardiography (MCE) for predicting infarct size (IS) in a rat\\u000a model of myocardial infarction (MI) and to compare a simplified single plane-based measurement of IS with the conventional\\u000a three plane-based approach. Fifty male SD rats underwent left anterior descending artery ligation and were evaluated by MCE\\u000a 8 h post MI. IS was

Xianghui Chen; Kai Cui; Jiancheng Xiu; Huanbing Lin; Yi Lao; Biying Zhou; Feixue Liang; Daogang Zha; Jianping Bin; Yili Liu

2009-01-01

206

Comparison of gated myocardial perfusion SPECT, echocardiography and equilibrium radionuclide ventriculography in the evaluation of left ventricle contractility.  

PubMed

Objectives: In this study, we investigated the reliability of gated myocardial perfusion single-photon emission computerized tomography (GSPECT) for the evaluation of left ventricle (LV) function. We compared left ventricle ejection fraction (LVEF) calculated with GSPECT with the values derived from planar equilibrium-gated radionuclide ventriculography (ERVG) and echocardiography (ECHO). Study design: Forty-eight patients with suspected coronary artery disease (CAD), who were referred for evaluation of myocardial perfusion and LV function and underwent two-day 99mTc-MIBI protocol GSPECT and ERVG, were examined retrospectively. LVEF was calculated with GSPECT Myometrix software, and wall motion and thickness were calculated with QGS analysis program. In the ERVG study, LVEF values were calculated using left anterior oblique images. In the GSPECT and ERVG study, wall motion was evaluated visually and scored. LVEF values and wall motion data measured with ECHO were noted. Results: For all cases, there was a significant correlation between LVEF values calculated by GSPECT and ERVG. Numerical LVEF values of 30 patients measured with ECHO showed no significant difference from the values measured with GSPECT. When 240 segments obtained from 48 patients were examined, the correlation between GSPECT and ERVG was 77.5% and between GSPECT and ECHO was 75.4% by visual wall motion analysis. Quantitatively calculated wall motion and thickness scores of segments visually defined as normokinetic were significantly higher than segments visually defined as having contraction defect. Conclusion: GSPECT can be used safely in clinical practice for the evaluation of LV function. Quantitatively calculated wall motion and thickness scores are promising methods to verify the visual evaluation. PMID:24899478

Hatipo?lu, Filiz; Burak, Zeynep; Omür, Ozgür

2014-06-01

207

Transient integral boundary layer method to calculate the translesional pressure drop and the fractional flow reserve in myocardial bridges  

PubMed Central

Background The pressure drop – flow relations in myocardial bridges and the assessment of vascular heart disease via fractional flow reserve (FFR) have motivated many researchers the last decades. The aim of this study is to simulate several clinical conditions present in myocardial bridges to determine the flow reserve and consequently the clinical relevance of the disease. From a fluid mechanical point of view the pathophysiological situation in myocardial bridges involves fluid flow in a time dependent flow geometry, caused by contracting cardiac muscles overlying an intramural segment of the coronary artery. These flows mostly involve flow separation and secondary motions, which are difficult to calculate and analyse. Methods Because a three dimensional simulation of the haemodynamic conditions in myocardial bridges in a network of coronary arteries is time-consuming, we present a boundary layer model for the calculation of the pressure drop and flow separation. The approach is based on the assumption that the flow can be sufficiently well described by the interaction of an inviscid core and a viscous boundary layer. Under the assumption that the idealised flow through a constriction is given by near-equilibrium velocity profiles of the Falkner-Skan-Cooke (FSC) family, the evolution of the boundary layer is obtained by the simultaneous solution of the Falkner-Skan equation and the transient von-Kármán integral momentum equation. Results The model was used to investigate the relative importance of several physical parameters present in myocardial bridges. Results have been obtained for steady and unsteady flow through vessels with 0 – 85% diameter stenosis. We compare two clinical relevant cases of a myocardial bridge in the middle segment of the left anterior descending coronary artery (LAD). The pressure derived FFR of fixed and dynamic lesions has shown that the flow is less affected in the dynamic case, because the distal pressure partially recovers during re-opening of the vessel in diastole. We have further calculated the wall shear stress (WSS) distributions in addition to the location and length of the flow reversal zones in dependence on the severity of the disease. Conclusion The described boundary layer method can be used to simulate frictional forces and wall shear stresses in the entrance region of vessels. Earlier models are supplemented by the viscous effects in a quasi three-dimensional vessel geometry with a prescribed wall motion. The results indicate that the translesional pressure drop and the mean FFR compares favourably to clinical findings in the literature. We have further shown that the mean FFR under the assumption of Hagen-Poiseuille flow is overestimated in developing flow conditions.

Bernhard, Stefan; Mohlenkamp, Stefan; Tilgner, Andreas

2006-01-01

208

Anomalous origin of the left coronary artery: angiographic and myocardial perfusion scintigraphic correlates  

Microsoft Academic Search

We studied a patient with an anomalous left coronary artery arising from the pulmonary artery by using conventional angiographic and myocardial imaging techniques. Myocardial imaging with radioactive 201thallium confirmed the significance of resting Q waves, and the defect in anterior perfusion coupled with the presence of thallium in the pulmonary outflow tract during exercise underscored the dynamic nature of the

M. W. Young; R. I. Hamby; B. Zaret

1981-01-01

209

Renin-angiotensin system and myocardial collagen matrix remodeling in hypertensive heart disease: in vivo and in vitro studies on collagen matrix regulation  

Microsoft Academic Search

The interstitial space of the myocardium is composed of nonmyocyte cells and a highly organized collagen network which serves to maintain the architecture and mechanical behavior of the myocardial walls. It is the myocardial collagen matrix that determines myocardial stiffness in the normal and structurally remodeled myocardium. In hypertensive heart disease, the heterogeneity in myocardial structure, created by the altered

C. G. Brilla; B. Maisch; K. T. Weber

1993-01-01

210

Efficacy of long-term anticoagulant treatment in subgroups of patients after myocardial infarction  

Microsoft Academic Search

OBJECTIVE--To investigate the efficacy of long term oral anticoagulant treatment in subgroups of patients after myocardial infarction. DESIGN--Analysis of the effect of anticoagulant treatment in subgroups of hospital survivors of myocardial infarction based upon age, gender, history of hypertension, previous myocardial infarction, smoking habits, diabetes mellitus, Killip class, anterior location of infarction, thrombolytic therapy, and use of beta blockers. SUBJECTS--Participants

P. F. van Bergen; J. W. Deckers; J. J. Jonker; R. T. van Domburg; A. J. Azar; A. Hofman

1995-01-01

211

Acute myocardial infarction during regadenoson myocardial perfusion imaging.  

PubMed

Pharmacologic stress testing uses vasodilators to provide objective evidence of myocardial ischemia. Adenosine and dipyridamole are nonselective adenosine receptor agonists that have been associated with myocardial infarction (MI) during intravenous infusion. Mechanisms postulated for this effect include coronary steal, transmural steal, global hypotension, and direct vasoconstriction. Regadenoson, a direct A2A agonist, was approved for use in stress testing in 2008. We describe a 68-year-old man who presented to our institution with typical angina, relieved by nitroglycerin. He did not have electrocardiogram (ECG) changes suggestive of myocardial pathology, and laboratory testing did not reveal a significant rise in troponin-I levels. To further assess the etiology of his symptoms, he underwent a pharmacologic stress test with regadenoson followed by technetium 99 m sestamibi. Six minutes after regadenoson infusion, the patient developed severe retrosternal chest pain accompanied by ST elevations on ECG. Sublingual nitroglycerin was administered that resolved both the pain and ECG changes. The patient subsequently underwent urgent coronary angiography and was found to have a 95% critical stenosis involving the left anterior descending artery. We conclude this case represents a MI secondary to coronary steal phenomenon induced by regadenoson infusion. Clinicians should be aware this adverse effect can occur despite the improved side-effect profile of regadenoson. Continuous monitoring of vital signs and the ECG with regular assessment of symptoms is imperative to identify this rare but potentially devastating adverse event. PMID:23471769

Shah, Sachil; Parra, David; Rosenstein, Robert S

2013-06-01

212

Early increase in myocardial perfusion after stem cell therapy in patients undergoing incomplete coronary artery bypass surgery.  

PubMed

Incomplete revascularization is associated with worse long-term outcomes. Autologous bone marrow cells (BMC) have recently been tested in patients with severe coronary artery disease. We tested the hypothesis that intramyocardial injection of autologous BMC increases myocardial perfusion in patients undergoing incomplete coronary artery bypass grafting (CABG). Twenty-one patients (19 men), 59?±?7 years old, with limiting angina and multivessel coronary artery disease (CAD), not amenable to complete CABG were enrolled. BMC were obtained prior to surgery, and the lymphomonocytic fraction separated by density gradient centrifugation. During surgery, 5 mL containing 2.1?±?1.3?×?108 BMC (CD34+?=?0.8?±?0.3%) were injected in the ischemic non-revascularized myocardium. Myocardial perfusion was assessed by magnetic resonance imaging (MRI) at baseline and 1 month after surgery. The increase in myocardial perfusion was compared between patients with <50% (group A, n?=?11) with that of patients with >50% (group B, n?=?10) of target vessels (stenosis???70%) successfully bypassed. Injected myocardial segments included the inferior (n?=?12), anterior (n?=?7), and lateral (n?=?2) walls. The number of treated vessels (2.3?±?0.8) was significantly smaller than the number of target vessels (4.2?±?1.0; P?myocardial perfusion in patients undergoing incomplete CABG, even in those with fewer target vessels successfully treated. This strategy may be an adjunctive therapy for patients suffering from a more advanced (diffuse) CAD not amenable for complete direct revascularization. PMID:21061106

Gowdak, Luís Henrique Wolff; Schettert, Isolmar Tadeu; Rochitte, Carlos Eduardo; Lisboa, Luiz Augusto Ferreira; Dallan, Luís Alberto Oliveira; César, Luiz Antônio Machado; de Oliveira, Sérgio Almeida; Krieger, José Eduardo

2011-02-01

213

Myocardial infarction in young people with normal coronary arteries  

PubMed Central

Myocardial infarction occurring in young people with angiographically normal coronary arteries is well described but the pathophysiology of this condition remains unknown. Coronary artery spasm in association with thrombus formation and minimal atheromatous disease or spontaneous coronary artery dissection are possible causes. Two young men presented with severe chest pain after acute alcohol intoxication and each sustained an extensive anterior myocardial infarction. Investigations including intravascular ultrasound showed no evidence of atherosclerotic coronary artery disease. Coronary artery spasm associated with acute alcohol intoxication as well as a prothrombotic state and endothelial damage related to cigarette smoking may be mechanisms leading to acute myocardial infarction in these cases. Acute myocardial infarction occurs in young persons with normal coronary arteries and the diagnosis should be considered in young patients presenting with severe chest pain, particularly those abusing cocaine or alcohol, so that reperfusion therapy can be initiated promptly.?? Keywords: myocardial infarction;  coronary vasospasm;  alcohol;  intravascular ultrasound

Williams, M; Restieaux, N; Low, C

1998-01-01

214

Anterior Akut Miyokard ?nfarktüslü Hastalarda Anjiyotensin Konverting Enzim (ACE) Gen Polimorfizminin Geli? Sol Ventrikül Diyastolik Dolu? Parametreleri Üzerindeki Etkisi  

Microsoft Academic Search

SUMMARY An insertion \\/ deletion (I\\/D) polymorphism exerts effects on left ventricular (LV) diastolic performance. The purpose of this study is to determine the effects of polymorphism of the ACE on LV diastolic filling parameters after a first anterior acute myocardial infarction (AMI). The subjects were 142 patients (115 men, 27 women, 59±12 years) with a first anterior AMI. Echocardiograms

Önder Öztürk; Ünal Öztürk; Nizamettin Toprak

215

Subacute cardiac rupture complicating myocardial infarction. A case report.  

PubMed

The authors have focused this study on the emergence of subacute ventricular free wall rupture in a seventy-six-year-old patient admitted to hospital for inferior acute myocardial infarction. After six days he showed clinical signs of bradycardia and hypotension evolving to electromechanical dissociation. Given an adequate pharmacologic therapy, the patient was submitted to echocardiography, which was believed to be consistent with myocardial rupture, showing a moderate to large pericardial effusion. Pericardiocentesis of 150 mL of bloody fluid resulted in a further improvement in his hemodynamics. The patient underwent cardiac surgery with repair of the myocardial rupture through a large diaphragmatic infarction by a Dacron polyester fiber graft and pacemaker placement. In conclusion the authors confirm the relevant role of clinical data such as persistent chest pain and hemodynamic instability and the value of echocardiography in identifying subacute myocardial free wall rupture after an episode of acute myocardial infarction. PMID:8595015

Rosato, G; Santomauro, M; Stanco, G; Petillo, F; Sauro, R; Chiariello, M; Spampinato, N; Rotiroti, D

1996-02-01

216

[Importance of the delayed 123I-BMIPP image for detecting myocardial metabolic abnormality induced by transient myocardial ischemia: a case of vasospastic angina].  

PubMed

We experienced a case of 64-year-old man with stunned myocardium caused by vasospasm. Without enzymatic evidence of an acute myocardial infarction, the patient developed a prolonged chest pain with ST elevation in the electrocardiogram in the midnight before the day of coronary angiography. Coronary angiogram revealed no significant stenosis and left ventriculography demonstrated akinesis in the apico-anteroseptal region. Although initial images of 123I-BMIPP myocardium SPECT showed no significant decrease of uptake, delayed images revealed marked decrease of tracer uptake in the apico-anteroseptal region in which left ventriculography showed abnormal wall motion. After 3 months of medication, left ventriculography disclosed a marked improvement, and coronary spasm was evoked in the proximal portion of left anterior descending artery after intracoronary ergonovine provocations. At the same time, both initial and delayed images of 123I-BMIPP myocardial SPECT showed no significant decrease of tracer uptake. This patients was considered as a noteworthy case to understand the kinetics and metabolism of 123I-BMIPP in stunned myocardium. PMID:9183146

Tanaka, K; Ito, K; Kinoshita, N; Nakagawa, M; Terada, K; Kajita, Y; Sugihara, H

1997-04-01

217

Case of a sigmoid colon cancer with metachronous metastases to the mesorectum and the abdominal wall  

PubMed Central

Backround Sigmoid colon cancer metachronous metastases commonly occur in the liver and lungs with sporadic reports also to the spleen, stomach, thyroid gland, abdominal wall and upper urinary tract. This is a rare case of metachronous metastases invading the mesorectum and the abdominal wall. Case presentation A 72-year-old female underwent sigmoidectomy for stage I (T2N0 M0) sigmoid colon cancer in May 2008. In June 2009, an abdominal computed tomography scan revealed a tumor 2 cm in size at the lower anterior mesorectum and a second mass 2 cm in size at the anterior abdominal wall midline. Total colonoscopy showed no mucosal lesion. The serum carcinoembryonic antigen level was normal. A biopsy of the mesorectum tumor showed similar histologic characteristics with the primary tumor. Since no other site of recurrence was identified, an abdominoperineal resection was attempted. During the operation and after the removal of the incision recurrence, sinus bradycardia and signs of myocardial ischemia were noticed. A loop transverse colostomy was immediately perfomed and the operation was terminated. Postoperative cardiologic examination revealed an acute myocardium infract. Chemo-radiation of the mesorectum tumor and re-evaluation for surgical excision was decided. Conclusion Metachronous metastasis of the mesorectum from sigmoid colon cancer is extremely rare. Although patterns of lymphatic spread from rectal cancer to sigmoid colon have recently been demonstrated, there is no evidence of metachronous mesorectum invasion from sigmoid colon cancer. This could be the issue for future trials.

2010-01-01

218

Increasing myocardial 123I-BMIPP uptake in non-ischemic area in a patient with acute myocardial ischemia.  

PubMed

The subject was a 65-year-old woman with chest pain. An electrocardiogram revealed T-wave-inversion in leads III, aVF, V1-V5. 99mTc-tetrofosmin myocardial SPECT showed mildly reduced uptake in the anteroseptal wall and the apex. These findings suggested acute myocardial ischemia. Coronary angiography did not show any stenotic lesions, but diffuse coronary ectasia was noted in three vessels. Coronary flow velocity was remarkably reduced on coronary angiography. Epicardial coronary spasm was not provoked by ergonovine loading test. Left ventriculography showed diffuse hypokinesis. 123I-BMIPP myocardial SPECT showed mildly reduced uptake in the anteroseptal wall and the apex on the early images. But 4-hour delayed images showed an increase of 8% in myocardial 123I-BMIPP uptake. We treated this patient with ticlopidine and nicorandil. After drug therapy her symptoms and left ventriculography improved. 123I-BMIPP myocardial SPECT findings on the early images improved, whereas delayed images showed a decrease of 28% in myocardial 123I-BMIPP uptake after two weeks and 36% after four weeks. These dynamic changes in 123I-BMIPP findings might be a reflection of myocardial fatty acid metabolism in patients with acute myocardial ischemia. Delayed 123I-BMIPP myocardial SPECT images are useful for the assessment of fatty acid metabolism. PMID:12593424

Nishikawa, Susumu; Ito, Kazuki; Takada, Hiroki; Tsubakimoto, Yoshinori; Yuba, Tatsuya; Adachi, Yoshihiko; Kato, Syuji; Azuma, Akihiro; Sugihara, Hiroki; Nakagawa, Masao

2002-12-01

219

Adolescent Anterior Knee Pain  

MedlinePLUS

... pain in the front and center of the knee (anterior knee pain) is common among active, healthy young people, ... not caused by any particular abnormality in the knee and does not mean that the knee will ...

220

Utility of technetium-t-butyl isonitrile (99mTc-TBI) myocardial imaging in coronary artery disease.  

PubMed

99mTc-t-butyl isonitrile is a useful agent for myocardial perfusion imaging. The superior physical advantages of technetium over 201thallium make larger doses possible for imaging. Accumulation in the myocardium is unidirectional in that once attached it does not leave the myocardium and hence two separate injections are needed for rest and stress imaging. High liver uptake frequently conceals the inferior wall and high early uptakes make immediate post-injection imaging almost impossible at least up to 45-60 min. This agent, however, was seen to accurately identify under-perfused areas and distinguish between ischaemia and infarct in our patients. Agreement with 201Tl and with GBP study of regional wall motion was excellent. While its individual sensitivity and specificity are quite high at 82.6 and 90.9%, in combined GBP studies the sensitivity rose to 93.4%. It is concluded that Tc-TBI is a valuable agent for myocardial perfusion scintigraphy, especially in a developing country like India where Tc-MIBI cannot be routinely used, since it is expensive, and where regular supplies of 201Tl are also not always feasible due to the high cost of importing. 99mTc-TBI can be made cheaply here and in a select population, notably in those with left anterior descending and circumflex coronary artery disease, it can provide valuable information. PMID:1522026

Nair, N; Nayak, U N; Ramanathan, P; Ramamoorthy, N; Sachdeva, S S

1992-08-01

221

Myocardial infarction with normal coronary arteries and factor XII deficiency  

Microsoft Academic Search

A 17 year old girl had a myocardial infarction. Three days later coronary angiography showed an occlusive thrombus in the circumflex and anterior descending arteries. The coronary arteries themselves appeared to be normal, and this was confirmed at repeat angiography three months later. Tests of haemostasis showed a deficiency of factor XII.

W J Penny; B T Colvin; N Brooks

1985-01-01

222

Effects of time required for reperfusion (thrombolysis or angioplasty, or both) and location of acute myocardial infarction on left ventricular functional reserve capacity several months later  

SciTech Connect

The purpose of this study was to determine whether reperfusion of acute myocardial infarction (AMI) by recombinant tissue-type plasminogen activator (rt-PA) or percutaneous transluminal coronary angioplasty, or both, would improve left ventricular (LV) function when it is measured several months later at rest or maximal bicycle exercise, or both. Radionuclide angiography was performed in 44 patients 5 months (range 6 weeks to 9 months) after AMI to assess function, and tomographic myocardial thallium-201 imaging was performed at maximal exercise and delayed rest to determine whether there was any evidence of myocardial ischemia. As expected, no patient had chest pain or redistribution of a thallium defect during the exercise test, because patients had undergone angioplasty (n = 28) or coronary bypass graft surgery (n = 5) where clinically indicated for revascularization. The LV ejection fraction was plotted as a function of the time elapsed between the onset of chest pain and the time when coronary angiography confirmed patency of the infarct-related artery (achieved in 91% of 44 patients by rt-PA (n = 31) or percutaneous transluminal coronary angioplasty (n = 9) ). Functional responses differed markedly between patients with anterior (n = 20) versus inferior (n = 24) wall AMI. LV ejection fraction during exercise correlated with time to reperfusion in patients with an anterior wall AMI (r = -0.58; standard error of the estimate = 11.9%; p less than 0.02) but not in patients with an inferior AMI (r = 0.10; standard error of the estimate = 13.1%); difference not significant.

Little, T.; Crenshaw, M.; Liberman, H.A.; Battey, L.L.; Warner, R.; Churchwell, A.L.; Eisner, R.L.; Morris, D.C.; Patterson, R.E. (Emory Univ., Atlanta, GA (USA))

1991-04-15

223

A new ST-segment elevation myocardial infarction equivalent pattern? Prominent T wave and J-point depression in the precordial leads associated with ST-segment elevation in lead aVr.  

PubMed

Certain acute coronary syndrome electrocardiographic (ECG) patterns, which do not include ST-segment elevation, are indicative of acute coronary syndrome caused by significant arterial occlusion; these patterns are, of course, associated with significant risk to the patient and mandate a rapid response from the health care team. One such high-risk ECG pattern includes the association of the prominent T wave and J-point depression producing ST-segment depression seen in the precordial leads coupled with ST-segment elevation in lead aVr. This ECG presentation is associated with significant left anterior descending artery obstruction. We report the case of a patient with this ECG presentation who progressed over a very short time to ST-segment elevation myocardial infarction of the anterior wall. PMID:24176590

Goebel, Mathew; Bledsoe, Joseph; Orford, James L; Mattu, Amal; Brady, William J

2014-03-01

224

Anterior ST depression with acute transmural inferior infarction due to posterior infarction. A vectorcardiographic and scintigraphic study  

SciTech Connect

The hypothesis that anterior ST segment depression represents concomitant posterior infarction was tested in 49 patients admitted with a first transmural inferior myocardial infarction. Anterior ST depression was defined as 0.1 mV or more ST depression in leads V1, V2 or V3 on an electrocardiogram recorded within 18 hours of infarction. Serial vectorcardiograms and technetium pyrophosphate scans were obtained. Eighty percent of the patients (39 of 49) had anterior ST depression. Of these 39 patients, 34% fulfilled vectorcardiographic criteria for posterior infarction, and 60% had pyrophosphate scanning evidence of posterior infarction. Early anterior ST depression was neither highly sensitive (84%) nor specific (20%) for the detection of posterior infarction as defined by pyrophosphate imaging. Of patients with persistent anterior ST depression (greater than 72 hours), 87% had posterior infarction detected by pyrophosphate scan. In patients with inferior myocardial infarction, vectorcardiographic evidence of posterior infarction correlated poorly with pyrophosphate imaging data. Right ventricular infarction was present on pyrophosphate imaging in 40% of patients with pyrophosphate changes of posterior infarction but without vectorcardiographic evidence of posterior infarction. It is concluded that: 1) the majority of patients with acute inferior myocardial infarction have anterior ST segment depression; 2) early anterior ST segment depression in such patients is not a specific marker for posterior infarction; and 3) standard vectorcardiographic criteria for transmural posterior infarction may be inaccurate in patients with concomitant transmural inferior myocardial infarction or right ventricular infarction, or both.

Mukharji, J.; Murray, S.; Lewis, S.E.; Croft, C.H.; Corbett, J.R.; Willerson, J.T.; Rude, R.E.

1984-07-01

225

Effect of Matrix Metalloproteinase Inhibition by Doxycycline on Myocardial Healing and Remodeling after Myocardial Infarction  

Microsoft Academic Search

Summary  The aim of conducting this study was to assess the clinical relevance of matrix metalloproteinase (MMP) inhibition by doxycycline,\\u000a an effective MMP inhibitor, in a rat model of extensive myocardial infarction (MI) and left ventricular (LV) dysfunction.\\u000a Rats (n = 22) were subjected to extensive anterior MI. Doxycycline (25 mg SC, daily) or saline (control) injections were started\\u000a for nine days thereafter. The

Ariel Tessone; Micah S. Feinberg; Israel M. Barbash; Reuven Reich; Radka Holbova; Michal Richmann; Yael Mardor; Jonathan Leor

2005-01-01

226

Myocyte injury along myofibers in left ventricular remodeling after myocardial infarction  

PubMed Central

Left ventricular (LV) remodeling following myocardial infarction (MI) is considered to contribute to cardiac dysfunction. Though myofiber organization is a key component of cardiac structure, functional and anatomical features of injured myofiber during LV remodeling have not been fully defined. We investigated myocyte injury after acute MI in a mouse model. Mice were subjected to surgical coronary occlusion/reperfusion by left anterior descending coronary artery (LAD) ligation and examined at 1 week and 4 weeks post-MI. Magnetic resonance imaging (MRI) analysis demonstrated a significant decrease in systolic regional wall thickening (WT) in the border and remote zones at 4 weeks post-MI compared to that at 1 week post-MI (?86% in border zone, P<0.05, and ?77% in remote zone, P<0.05). Histological assays demonstrated that a broad fibrotic scar extended from the initial infarct zone to the remote zone along midcircumferential myofibers. Of particular note was the fact that no fibrosis was found in longitudinal myofibers in the epi- and endomyocardium. This pattern of the scar formation coincided with the helical ventricular myocardial band (HVMB) model, introduced by Torrent-Guasp. MRI analysis demonstrated that the extension of the fibrotic scar along the band might account for the progression in cardiac dysfunction during LV remodeling.

Kusakari, Yoichiro; Xiao, Chun-Yang; Himes, Nathan; Kinsella, Stuart D.; Takahashi, Masaya; Rosenzweig, Anthony; Matsui, Takashi

2010-01-01

227

Myocardial Effects of Shock.  

National Technical Information Service (NTIS)

Background material for the original proposal indicated that one of the pathogenic considerations in shock was a specific humoral factor responsible for myocardial depression. This myocardial depression factor (MDH) was found to originate in ischemic gut;...

L. Williams

1973-01-01

228

Myocardial Infarction Research Unit.  

National Technical Information Service (NTIS)

Clinical and laboratory investigations are conducted to provide a better understanding and more effective treatment of myocardial infarction. Patients with acute myocardial infarction are carefully characterized by clinical, hemodynamic, electrophysiologi...

C. E. Rackley

1975-01-01

229

Effect of Iraqi missile war on incidence of acute myocardial infarction and sudden death in Israeli civilians.  

PubMed

The Iraqi missile attack on Israel provided a unique opportunity to study the effects of fright due to a perceived threat of annihilation on the incidence of acute myocardial infarction (MI) and sudden death among the civilian population. During the first days of the Gulf war we noted a sharp rise in the incidence of acute MI and sudden death in our area compared with five control periods. Patient population in the various study periods did not differ significantly in age, sex ratio, hospital mortality, or proportion of patients in whom the acute event was the first presentation of coronary disease. However, during the first period of the war there were more cases of anterior wall MI and more patients received thrombolytic therapy than during control periods. Despite the continuing missile threat, the incidence of acute MI reverted to normal after the initial phase of the Gulf war. PMID:1679475

Meisel, S R; Kutz, I; Dayan, K I; Pauzner, H; Chetboun, I; Arbel, Y; David, D

1991-09-14

230

Depression Increases Sympathetic Activity and Exacerbates Myocardial Remodeling after Myocardial Infarction: Evidence from an Animal Experiment  

PubMed Central

Depression is an independent risk factor for cardiovascular events and mortality in patients with myocardial infarction (MI). Excessive sympathetic activation and serious myocardial remodeling may contribute to this association. The aim of this study was to discuss the effect of depression on sympathetic activity and myocardial remodeling after MI. Wild-type (WT) rats were divided into a sham group (Sham), a myocardial infarction group (MI), a depression group (D), and a myocardial infarction plus depression group (MI+D). Compared with controls, the MI+D animals displayed depression-like behaviors and attenuated body weight gain. The evaluation of sympathetic activity showed an increased level in plasma concentrations of epinephrine and norepinephrine and higher expression of myocardial tyrosine hydroxylase in the MI+D group than the control groups (p<0.05 for all). Cardiac function and morphologic analyses revealed a decreased fractional shortening accompanied by increased left ventricular dimensions, thinning myocardium wall, and reduced collagen repair in the MI+D group compared with the MI group (p<0.05 for all). Frequent premature ventricular contractions, prolonged QT duration and ventricular repolarization duration, shorted effective refractory period, and increased susceptibility to ventricular arrhythmia were displayed in MI+D rats. These results indicate that sympathetic hyperactivation and exacerbated myocardial remodeling may be a plausible mechanism linking depression to an adverse prognosis after MI.

Liu, Tao; Yuan, Xiaoran; Ruan, Bing; Sun, Lifang; Tang, Yanhong; Yang, Bo; Hu, Dan; Huang, Congxin

2014-01-01

231

Depression increases sympathetic activity and exacerbates myocardial remodeling after myocardial infarction: evidence from an animal experiment.  

PubMed

Depression is an independent risk factor for cardiovascular events and mortality in patients with myocardial infarction (MI). Excessive sympathetic activation and serious myocardial remodeling may contribute to this association. The aim of this study was to discuss the effect of depression on sympathetic activity and myocardial remodeling after MI. Wild-type (WT) rats were divided into a sham group (Sham), a myocardial infarction group (MI), a depression group (D), and a myocardial infarction plus depression group (MI+D). Compared with controls, the MI+D animals displayed depression-like behaviors and attenuated body weight gain. The evaluation of sympathetic activity showed an increased level in plasma concentrations of epinephrine and norepinephrine and higher expression of myocardial tyrosine hydroxylase in the MI+D group than the control groups (p<0.05 for all). Cardiac function and morphologic analyses revealed a decreased fractional shortening accompanied by increased left ventricular dimensions, thinning myocardium wall, and reduced collagen repair in the MI+D group compared with the MI group (p<0.05 for all). Frequent premature ventricular contractions, prolonged QT duration and ventricular repolarization duration, shorted effective refractory period, and increased susceptibility to ventricular arrhythmia were displayed in MI+D rats. These results indicate that sympathetic hyperactivation and exacerbated myocardial remodeling may be a plausible mechanism linking depression to an adverse prognosis after MI. PMID:25036781

Shi, Shaobo; Liang, Jinjun; Liu, Tao; Yuan, Xiaoran; Ruan, Bing; Sun, Lifang; Tang, Yanhong; Yang, Bo; Hu, Dan; Huang, Congxin

2014-01-01

232

Quantitative evaluation of myocardial function by a volume-normalized map generated from relative blood flow  

NASA Astrophysics Data System (ADS)

Our study aimed to quantitatively evaluate blood flow in the left ventricle (LV) of apical hypertrophic cardiomyopathy (APH) by combining wall thickness obtained from cardiac magnetic resonance imaging (MRI) and myocardial perfusion from single-photon emission computed tomography (SPECT). In this study, we considered paired MRI and myocardial perfusion SPECT from ten patients with APH and ten normals. Myocardial walls were detected using a level set method, and blood flow per unit myocardial volume was calculated using 3D surface-based registration between the MRI and SPECT images. We defined relative blood flow based on the maximum in the whole myocardial region. Accuracies of wall detection and registration were around 2.50 mm and 2.95 mm, respectively. We finally created a bull's-eye map to evaluate wall thickness, blood flow (cardiac perfusion) and blood flow per unit myocardial volume. In patients with APH, their wall thicknesses were over 10 mm. Decreased blood flow per unit myocardial volume was detected in the cardiac apex by calculation using wall thickness from MRI and blood flow from SPECT. The relative unit blood flow of the APH group was 1/7 times that of the normals in the apex. This normalization by myocardial volume distinguishes cases of APH whose SPECT images resemble the distributions of normal cases.

Fukami, Tadanori; Sato, Hidenori; Wu, Jin; Lwin, Thet-Thet-; Yuasa, Tetsuya; Kawano, Satoru; Iida, Keiji; Akatsuka, Takao; Hontani, Hidekata; Takeda, Tohoru; Tamura, Masao; Yokota, Hiroshi

2007-07-01

233

Relation between white blood cell count and final infarct size in patients with ST-segment elevation acute myocardial infarction undergoing primary percutaneous coronary intervention (from the INFUSE AMI trial).  

PubMed

Although it has been shown that elevated white blood cell count (WBCc) on presentation is associated with an increased risk of cardiac mortality in patients with ST-segment elevation myocardial infarction (STEMI), the responsible mechanisms are unknown. We therefore sought to investigate whether elevated WBCc is associated with increased infarct size measured with cardiac magnetic resonance imaging 30 days after primary percutaneous coronary intervention in the Intracoronary Abciximab and Aspiration Thrombectomy in Patients With Large Anterior Myocardial Infarction trial. INFUSE AMI randomized patients with STEMI and proximal or mid-left anterior descending coronary artery occlusion to bolus intracoronary abciximab versus no abciximab and to manual aspiration versus no aspiration. WBCc at hospital admission was available in 407 of 452 randomized patients. Patients were stratified according to tertiles of WBCc. At 30 days, a significant stepwise increase in infarct size (percentage of total left ventricular mass) was apparent across tertiles of increasing WBCc (median [interquartile range] for tertiles I vs II vs III = 11.2% [3.8% to 19.6%] vs 17.5% [0.5% to 22.9%] vs 19.1% [13.7 to 26.0], respectively, p <0.0001). Absolute infarct mass in grams and abnormal wall motion score were also significantly increased across tertiles of WBC. By multivariate linear regression analysis, WBCc was an independent predictor of infarct size along with intracoronary abciximab randomization, age, time from symptom onset to first device, proximal left anterior descending location, and baseline TIMI flow of 0/1. In conclusion, in patients with anterior wall STEMI, an elevated admission WBCc is a powerful independent predictor of infarct size measured with cardiac magnetic resonance imaging 30 days after primary percutaneous coronary intervention. PMID:24063843

Palmerini, Tullio; Brener, Sorin J; Genereux, Philippe; Maehara, Akiko; Della Riva, Diego; Mariani, Andrea; Witzenbichler, Bernhard; Godlewski, Jacek; Parise, Helen; Dambrink, Jan-Henk E; Ochala, Andrzej; Fahy, Martin; Xu, Ke; Gibson, C Michael; Stone, Gregg W

2013-12-15

234

Acute myocardial infarction following honeybee sting.  

PubMed

The occurrence of acute myocardial infarction following a honeybee sting has been very rarely reported in the previous literature. Possible pathogenetic mechanisms include severe hypotension, rarely hypertension and coronary vasospasm with subsequent thrombosis of coronary vessels developed after the release of vasoactive, inflammatory and thrombogenic substances contained in the bee venom. This syndrome is also known as Kounis syndrome. We report a case of a 32-year-old man who presented with acute inferior wall myocardial infarction within 3 h of honeybee sting. He was treated with thrombolytic therapy. Coronary angiogram revealed normal coronary arteries. PMID:24729117

Puttegowda, Beeresh; Chikkabasavaiah, Nagamani; Basavappa, Ramesh; Khateeb, Syed Tanveer Akmal

2014-01-01

235

[Assessment of myocardial fatty acid metabolism in patients with vasospastic angina using 123I-BMIPP myocardial SPECT].  

PubMed

Myocardial perfusion and fatty acid metabolism may be unpaired in the patients of vasospastic angina (VSA), because abnormal regional wall motion of left ventricle has been shown in some cases of VSA without apparent history of myocardial infarction. To study the clinical utility of 123I-BMIPP scintigraphy in diagnosis of myocardial ischemia in VSA, both 123I-BMIPP (rest) and 201T1 (exercise) SPECT were performed in the 20 patients of VSA diagnosed by coronary angiography. Defect scores were calculated visually from the 17 segments of myocardial images and were compared with patient's anginal history, period from last attack, numbers of attack, left ventricular (LV) ejection fraction and severity of regional LV wall motion abnormality. 123I-BMIPP SPECT images showed decreased tracer uptake in 14 cases of 20 (70%) VSA patients. Exercise 201T1 SPECT images showed decreased tracer uptake in 3 cases of 20 (15%) of patients. Severity of regional LV wall motion abnormality was correlated with defect score of BMIPP. Though total defect score of BMIPP did not correlate with patient's anginal history, number of symptoms and LV ejection fraction, correlated inversely with period from last attack. It was suggested that 123I-BMIPP myocardial SPECT images in VSA patients showed "memories" of myocardial ischemic damages induced by vasospasm. In summary, 123I-BMIPP myocardial SPECT images could be a useful test for diagnosis and evaluation of VSA. PMID:8523832

Ito, K; Sugihara, H; Terada, K; Matsumoto, K; Taniguchi, Y; Ohtsuki, K; Miyazaki, H; Nakagawa, T; Azuma, A; Maeda, T

1995-10-01

236

Anterior mediastinal lymphangioma: pre- and postnatal sonographic findings.  

PubMed

Anterior mediastinal lymphangiomas are very rare in utero with only a few cases reported in literature. We present a case of anterior mediastinal lymphangioma that was diagnosed on prenatal sonography (US) at 22 weeks' gestation. It appeared as a well-defined, multi-septated anechoic mass, in the anterior mediastinum between the heart base and right chest wall. There was no solid component and no internal flow on color Doppler US. The pre- and postnatal US findings are correlated with prenatal MRI and postnatal CT findings. PMID:22811285

Adaletli, Ibrahim; Towbin, Alexander J; Ozbayrak, Mustafa; Madazli, Riza

2013-01-01

237

Propofol limits rat myocardial ischemia and reperfusion injury with an associated reduction in apoptotic cell death in vivo  

Microsoft Academic Search

Propofol, a rapidly acting, short duration, intravenous hypnotic anesthetic induction agent, is often used in clinical situations where myocardial ischemia\\/ reperfusion (I\\/R) injury is a threat. The aim of the present study was to evaluate the protective effect of propofol on myocardial I\\/R injury in rat due to apoptosis. Myocardial I\\/R injury were induced by occluding the left anterior descending

Yong Chun Jin; WooYeol Kim; Yu Mi Ha; Il Woo Shin; Ju Tae Sohn; Hye Jung Kim; Han Geuk Seo; Jea Heun Lee; Ki Churl Chang

2009-01-01

238

Association between Angiotensin II Type 1 Receptor Polymorphism and Sudden Cardiac Death in Myocardial Infarction  

PubMed Central

Objective. The renin-angiotensin system is involved in the pathogenesis of coronary artery disease and myocardial infarction (MI). Angiotensin II (Ang II) has many adverse effects such as vasoconstriction and vascular remodeling, and these actions are mediated by the angiotensin II type 1 receptor (AT1R). Patients and Methods. A total of 1376 patients were recruited from January 2010 to April 2012. The study group consisted of 749 patients with ACS (317 females and 432 males) and of 627 healthy controls. Results. The ACS patients demonstrated a lower proportion of AA genotypes and AC genotypes but higher proportions of CC genotypes than the control population. The AT1R CC genotype conferred a 2.76-fold higher risk of MI compared with the genotype AC and AA. In addition, the CC genotype was also associated with a 4.08 times higher risk of left anterior descending artery infarction and a 3.07 times higher risk of anterior wall infarction. We also found that the CC genotype was independently associated with sudden cardiac death. In Summary. This study demonstrated that the AT1R CC genotype is an independent risk factor for ACS incidence, and this genotype is associated with a greater ACS severity and greater risk of sudden cardiac death.

Kruzliak, Peter; Kovacova, Gabriela; Pechanova, Olga; Balogh, Stefan

2013-01-01

239

Anterior uveitis in children  

Microsoft Academic Search

In this prospective study of childhood uveitis, 75 children with anterior uveitis were analyzed to determine whether a relationship could be found between the occurrence of uveitis, its clinical features, and humoral immunity to retinal S-antigen. For the purposes of analysis, children were divided into acute (18 cases) and chronic (57 cases) categories, depending on the duration of ocular inflammation.

Risto J. Uusitalo; Hannu Uusitalo; Kaj Mahlberg

1991-01-01

240

Straight anterior instability  

Microsoft Academic Search

Purpose: Thirty-three patients with avulsions of the middle glenohumeral ligament repaired using arthroscopic techniques were evaluated to determine the mechanism of injury, physical examination findings, and efficiency of repair techniques in this patient cohort. Type of Study: In a retrospective consecutive case series, 33 patients with symptomatic anterior subluxation of the glenohumeral joint were found to have a history, physical

Felix H. Savoie; Lew Papendik; Larry D. Field; Christopher Jobe

2001-01-01

241

A Murine Closed-chest Model of Myocardial Ischemia and Reperfusion  

PubMed Central

Surgical trauma by thoracotomy in open-chest models of coronary ligation induces an immune response which modifies different mechanisms involved in ischemia and reperfusion. Immune response includes cytokine expression and release or secretion of endogenous ligands of innate immune receptors. Activation of innate immunity can potentially modulate infarct size. We have modified an existing murine closed-chest model using hanging weights which could be useful for studying myocardial pre- and postconditioning and the role of innate immunity in myocardial ischemia and reperfusion. This model allows animals to recover from surgical trauma before onset of myocardial ischemia. Volatile anesthetics have been intensely studied and their preconditioning effect for the ischemic heart is well known. However, this protective effect precludes its use in open chest models of coronary artery ligation. Thus, another advantage could be the use of the well controllable volatile anesthetics for instrumentation in a chronic closed-chest model, since their preconditioning effect lasts up to 72 hours. Chronic heart diseases with intermittent ischemia and multiple hit models are other possible applications of this model. For the chronic closed-chest model, intubated and ventilated mice undergo a lateral blunt thoracotomy via the 4th intercostal space. Following identification of the left anterior descending a ligature is passed underneath the vessel and both suture ends are threaded through an occluder. Then, both suture ends are passed through the chest wall, knotted to form a loop and left in the subcutaneous tissue. After chest closure and recovery for 5 days, mice are anesthetized again, chest skin is reopened and hanging weights are hooked up to the loop under ECG control. At the end of the ischemia/reperfusion protocol, hearts can be stained with TTC for infarct size assessment or undergo perfusion fixation to allow morphometric studies in addition to histology and immunohistochemistry.

Kim, Se-Chan; Boehm, Olaf; Meyer, Rainer; Hoeft, Andreas; Knufermann, Pascal; Baumgarten, Georg

2012-01-01

242

[Myocardial perfusion scintigraphy].  

PubMed

The aim of this review was to recall the relevance of the myocardial perfusion scintigraphy procedure in the diagnosis of coronary artery disease. Myocardial perfusion scintigraphy is undergone after treadmill exercise or pharmacological stress by infusion of Dipyridamole. Thallium-201, sestamibi-Tc99m and tetrofosmine-Tc99m are the most frequently used tracers. Gated single photon emission computed tomography provides a combined evaluation of both myocardial perfusion and function. Myocardial perfusion imaging is an accurate tool for the diagnosis of coronary artery disease with a high sensitivity 93% and good specificity 80%. Its prognostic value is now well established among patients with known coronary artery disease. In particular for risk stratification and patient management decisions. Thallium-201 SPECT is clinically accurate in assessing myocardial viability. As it is for assessment after myocardial revascularisation. Thus myocardial perfusion scintigraphy is a reliable and a cost-effective investigation for coronary artery disease. PMID:14534942

Hammami, Hatem; Ben Brahim, Habib; Mhiri, Aida; Letaief, Béchir; Kraeim, Tarek; Ben Slimene, M Faouzi

2003-06-01

243

Specificity of systolic anterior motion of anterior mitral leaflet for hypertrophic cardiomyopathy. Prevalence in large population of patients with other cardiac diseases.  

PubMed Central

The value of systolic anterior motion of the anterior mitral leaflet as a diagnostic marker for hypertrophic cardiomyopathy has been questioned because of its reported occurrence in other heart diseases. To determine the true specificity of systolic anterior motion for hypertrophic cardiomyopathy, 721 echocardiograms from patients with a wide variety of cardiac diseases were reviewed for its presence or absence under basal conditions. Systolic anterior motion of the anterior mitral leaflet was present in only 22 (3.0%) of the 721 patients, giving a specificity of 97 per cent. It was most common in patients with d-transposition of the great vessels (11 of 51, or 21%). With patients having transposition of the great vessels excluded from the analysis, the prevalence of systolic anterior motion of the anterior mitral leaflet was only 1.6 per cent (specificity 98%). Of note, eight of the 11 patients with systolic anterior motion of the anterior mitral leaflet and diseases other than transposition of the great vessels had disproportionate thickening of the ventricular septum, making it exceedingly rare in a patient population with normal septal-free wall thickness ratios (prevalence 0.4%; specificity 99%). Hence, while systolic anterior motion is not pathognomonic of hypertrophic cardiomyopathy, it was an uncommon finding in a large population of patients with a variety of cardiac diseases; when present in such patients systolic anterior motion of the anterior mitral leaflet is usually associated with disproportionate septal thickening. Images

Maron, B J; Gottdiener, J S; Perry, L W

1981-01-01

244

Effect of Wenxin Granule on Ventricular Remodeling and Myocardial Apoptosis in Rats with Myocardial Infarction  

PubMed Central

Aim. To determine the effect of a Chinese herbal compound named Wenxin Granule on ventricular remodeling and myocardial apoptosis in rats with myocardial infarction (MI). Methods. Male Sprague-Dawley (SD) rats were randomly divided into four groups: the control group, the model group, the metoprolol group, and the Wenxin Granule group (WXKL group) with sample size (n) of 7 rats in each group. An MI model was established in all rats by occlusion of the left anterior descending coronary artery (the control group was without occlusion). Wenxin Granule (1.35?g/kg/day), metoprolol (12?mg/kg/day), and distilled water (5?mL/kg/day for the control and model groups) were administered orally for 4 weeks. Ultrasonic echocardiography was used to examine cardiac structural and functional parameters. Myocardial histopathological changes were observed using haematoxylin and eosin (H&E) dyeing. Myocardial apoptosis was detected by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) staining. Serum angiotensin II (Ang II) concentration was measured using the enzyme-linked immunosorbent assay (ELISA). Results. It was found that Wenxin Granule could partially reverse ventricular remodeling, improve heart function, alleviate the histopathological damage, inhibit myocardial apoptosis, and reduce Ang II concentration in rats with MI. Conclusions. The results of the current study suggest that Wenxin Granule may be a potential alternative and complementary medicine for the treatment of MI.

Wu, Aiming; Zhai, Jianying; Zhang, Dongmei; Lou, Lixia; Zhu, Haiyan; Gao, Yonghong; Chai, Limin; Xing, Yanwei; Lv, Xiying; Zhu, Lingqun; Zhao, Mingjing; Wang, Shuoren

2013-01-01

245

[Coronary angioplasty for the recovery of myocardial function after acute myocardial infarction: mid- and long-term results].  

PubMed

Sixty-three patients with previous myocardial infarction and documented hypoperfused reversibly dysfunctional myocardium after 201thallium tomography and/or echo-dobutamine were candidates to coronary angioplasty. Patients were enrolled at four hospitals (Naples, Milan, Pisa and Varese) and evaluated by different study protocols, while endpoint (presence of myocardial viability and efficacy of coronary angioplasty to improve dysfunctional myocardium) was similar. Sixty-two patients underwent successful angioplasty, and early evaluation (between 1 and 3 months after procedure) showed the ability of either 201thallium tomography and/or dobutamine echocardiography, to identify hypoperfused reversibly dysfunctional myocardium. Ten patients underwent late (after 8 +/- 2 months) evaluation of both wall motion and myocardial perfusion showing a sustained improvement in 25/32 hypoakinetic myocardial segments. Our data confirm the efficacy of revascularization of hypoperfused dysfunctional myocardial segments by coronary angioplasty. Further studies are warranted to obtain a better patient stratification and to evaluate the long-term results. PMID:7634311

Piscione, F; Ceravolo, R; Indolfi, C; Perrone-Filardi, P; Prastaro, M; Focaccio, A; Pace, L; Vezzuto, P; Chiariello, M

1994-12-01

246

MR myocardial perfusion imaging.  

PubMed

Contrast material-enhanced myocardial perfusion imaging by using cardiac magnetic resonance (MR) imaging has, during the past decade, evolved into an accurate technique for diagnosing coronary artery disease, with excellent prognostic value. Advantages such as high spatial resolution; absence of ionizing radiation; and the ease of routine integration with an assessment of viability, wall motion, and cardiac anatomy are readily recognized. The need for training and technical expertise and the regulatory hurdles, which might prevent vendors from marketing cardiac MR perfusion imaging, may have hampered its progress. The current review considers both the technical developments and the clinical experience with cardiac MR perfusion imaging, which hopefully demonstrates that it has long passed the stage of a research technique. In fact, cardiac MR perfusion imaging is moving beyond traditional indications such as diagnosis of coronary disease to novel applications such as in congenital heart disease, where the imperatives of avoidance of ionizing radiation and achievement of high spatial resolution are of high priority. More wide use of cardiac MR perfusion imaging, and novel applications thereof, are aided by the progress in parallel imaging, high-field-strength cardiac MR imaging, and other technical advances discussed in this review. PMID:23431226

Coelho-Filho, Otavio R; Rickers, Carsten; Kwong, Raymond Y; Jerosch-Herold, Michael

2013-03-01

247

Preoperative evaluation of myocardial viability by thallium-201 imaging in patients with old myocardial infarction who underwent coronary revascularization  

Microsoft Academic Search

The myocardial uptake and redistribution in thallium scintigraphy and the regional wall motion by echocardiography were evaluated\\u000a by a semi-quantitative method in 42 patients who previously had myocardial infarction (50 target vessels) and underwent coronary\\u000a revascularization. The aim of this study was to elucidate the significance of the initial image, delayed image and redistribution\\u000a on thallium-201 scintigraphy for clinical diagnosis

Hitoshi Naruse; Mitsumasa Ohyanagi; Tadaaki Iwasaki; Takashi Miyamoto; Minoru Fukuchi

1992-01-01

248

Initial clinical outcomes of intracoronary infusion of autologous progenitor cells in patients with acute myocardial infarction  

PubMed Central

BACKGROUND: Myocardial infarction (MI) is an irreversible cardiomyocytes injury which begins after 15–20 minutes of coronary artery occlusion. The extent of infarction is modulated by a number of factors including collateral blood supplies, medications, and ischemic preconditioning. Although angioplasty and thrombolytic agents can relieve the cause of the infarction, the time from the occlusion onset to reperfusion determines the degree of irreversible myocardial injury. Experimental studies suggested that stem cells and progenitor cells derived from bone marrow can be used in the repair of cardiac tissue after acute MI. This study was designed to investigate the feasibility, safety and initial clinical outcome of intracoronary infusion of autologous progenitor cells in patients with acute MI. METHODS: Patients with a history of anterior MI and a left ventricular ejection fraction (LVEF) less than 35 % who were candidates for coronary angioplasty were randomly allocated in a 1:1 ratio to either control or bone marrow cell groups (each including 16 patients). Thallium scan and 17-segment echocardiography analysis for regional wall motion abnormality were performed before and 1 and 6 months after intracoronary infusion of bone marrow cells. The same tests were also conducted for the control group at identical time intervals. Quantitative variables were compared by independent t-test and paired t-test. Statistical significance was assumed at a value of P < 0.05. RESULTS: LVEF in the case and control groups increased to 39.37 ± 2.47% and 31.00 ± 1.87%, respectively (P = 0.069 and 0.1, respectively). Wall motion abnormality index (WMAI) decreased insignificantly in both groups. Perfusion defect scores (PDSs) decreased significantly in the case group. CONCLUSION: In this study, autologous mesenchymal stem cell transplantation by intracoronary catheter during angioplasty in patients with a history of severe LV dysfunction caused mild increases in LVEF.

Jazi, Seyed Mohammad Hashemi; Esfahani, Mohammad Hossein Nasr; Fesharaki, Mehrafarin; Moulavi, Fariba; Gharipour, Mojgan

2012-01-01

249

A minimally invasive method for induction of myocardial infarction in an animal model using tungsten spirals  

Microsoft Academic Search

Most animal models use surgical thoracotomy with ligation of a coronary artery to induce myocardial infarction. Incision of\\u000a the chest wall and myocardium affect remodeling after myocardial infarction. The aim of our study was to evaluate a new minimally\\u000a invasive technique for inducing acute myocardial infarction in pigs. To this end, coronary angiography using a 6-F cardiac\\u000a catheter was performed

Daniel Peukert; Michael Laule; Nicola Kaufels; Jörg Schnorr; Matthias Taupitz; Bernd Hamm; Marc Dewey

2009-01-01

250

Metabolic myocardial imaging with 123 I-labeled heptadecanoic acid in patients with angina pectoris  

Microsoft Academic Search

The potential value of 123I-heptadecanoic acid (123I-HoA) in myocardial scintigraphy has recently been assessed in patients with acute myocardial infarction (AMI) by studying regional myocardial metabolism (Van der Wall et al. 1981 a). To determine the metabolic behavior of 123I-HoA in patients with stable angina pectoris (AP) as well, 30 patients with AP were included in this study: 18 patients

E. E. Wall; G. A. K. Heidendal; W. Hollander; G. Westera; J. P. Roos

1981-01-01

251

The significance of the late fall in myocardial PCO2 and its relationship to myocardial pH after regional coronary occlusion in the dog.  

PubMed

After acute regional coronary occlusion, myocardial tissue PCO2, as measured by mass spectrometry, rises, reaches a peak, and then gradually falls. This late fall in myocardial tissue PCO2 could be due to (1) a gradual increase in tissue blood flow (and hence improved carbon dioxide washout), (2) a gradual consumption of tissue bicarbonate, (3) a gradual reduction in the production of carbon dioxide due to progressive cellular damage, or (4) an artifact caused by the continued presence of the mass spectrometer probe in the ischemic tissue. To determine which of these four mechanisms is responsible for the late fall in myocardial tissue PCO2, we subjected 27 anesthetized open-chest dogs to 3-hour occlusion of the left anterior descending coronary artery. Both myocardial tissue PCO2 and intramyocardial hydrogen ion concentration were measured in the myocardial segment supplied by the left anterior descending coronary artery. Ten dogs (group 1) were killed after the occlusion (occlusion I), and 11 dogs (group 2) underwent reocclusion (occlusion II) at the same site after a 45-minute period of reflow. Regional myocardial blood flow was measured periodically by the intramural injection of 127Xe. Changes in myocardial tissue PCO2 and hydrogen ion concentration were related to ultrastructural changes in the tissues adjacent to the myocardial tissue PCO2 probe. Regional myocardial blood flow remained unchanged throughout the 3-hour occlusion, ruling out increased carbon dioxide washout as a cause for its late fall. Tissue hydrogen ion concentration, as measured by a new lead glass electrode, correlated well with myocardial tissue PCO2, with the reduction in regional myocardial blood flow, and with ischemic damage assessed histologically. Myocardial hydrogen ion concentration also exhibited a late fall after the occlusion, from a peak of 199.8 +/- 27.8 nmol/liter to 91.9 +/- 12.1 nmol/liter (mean +/- SEM). This ruled out consumption of tissue bicarbonate as the cause for the late fall in myocardial tissue PCO2. Peak rise in myocardial tissue PCO2 after occlusion II (71.2 +/- 7.9 mm Hg) was significantly lower than peak myocardial tissue PCO2 after occlusion I (116.7 +/- 13.9 mm Hg, P less than 0.001). The difference between these latter two values, as well as the magnitude of fall in myocardial tissue PCO2 during occlusion I, related directly to the degree of histological damage observed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:3919963

Khuri, S F; Kloner, R A; Karaffa, S A; Marston, W; Taylor, A D; Lai, N C; Tow, D E; Barsamian, E M

1985-04-01

252

Myocardial ischemia with left ventricular outflow obstruction  

PubMed Central

We report an unusual case of a 32-year old man who was treated for a hypertrophic obstructive cardiomyopathy (HOCM) with a DDD pacing with short AV delay reduction in the past. Without prior notice the patient developed ventricular fibrillation and an invasive cardiac diagnostic was performed, which revealed a myocardial bridging around of the left anterior descending artery (LAD). We suspected ischemia that could be either related to LAD artery compression or perfusion abnormalities due to AV delay reduction with related to diastolic dysfunction.

Popov, Aron F; Bireta, Christian; Schmitto, Jan D; Zenker, Dieter; Friedrich, Martin; Coskun, Kasim O; Seipelt, Ralf; Hanekop, Gerd G; Schoendube, Friedrich A

2009-01-01

253

Simultaneous technetium-99m MIBI angiography and myocardial perfusion imaging  

SciTech Connect

Resting first-pass radionuclide angiography (FPRNA) was performed with the myocardial perfusion agent technetium-99m MIBI. In 27 patients, it was compared with technetium-99m diethylenetriamine pentaacetic acid FPRNA. A significant correlation was present in left (r = 0.93, p less than 0.001) as well as right (r = 0.92, p less than 0.001) ventricular ejection fraction measured with both radiopharmaceuticals. In 13 patients, MIBI derived segmental wall motion was compared with contrast ventriculography. A high correlation was present (p less than 0.001), and qualitative agreement was found in 38/52 segments. In 19 patients with myocardial infarction a significant correlation was present between MIBI segmental wall motion and perfusion scores (p less than 0.001). In ten patients with a history of myocardial infarction, 18 myocardial segments demonstrated diseased coronary vessels and impaired wall motion at contrast angiography. These segments were all identified by the MIBI wall motion and perfusion study. We conclude that MIBI is a promising agent for simultaneous evaluation of cardiac function and myocardial perfusion at rest.

Baillet, G.Y.; Mena, I.G.; Kuperus, J.H.; Robertson, J.M.; French, W.J.

1989-01-01

254

Management of ST elevation myocardial infarction in pregnancy.  

PubMed

A 33-year-old lady in the second trimester of pregnancy presented to the emergency department having suffered a cardiac arrest at home. An emergency caesarean section was performed in the resuscitation area. On return of spontaneous circulation, a 12-lead ECG showed anterior ST elevation myocardial infarction. She was transferred to our tertiary centre for an emergency coronary angiography and was successfully treated, making a full recovery. This case report examines the relatively rare entity of myocardial infarction in pregnancy and looks at the mechanisms underlying this. PMID:24114603

Constantine, Andrew Harry; Mozid, Abdul M; Aggarwal, Rajesh

2013-01-01

255

Stress thallium-201 myocardial scintigraphy for the detection of individual coronary arterial lesions in patients with and without previous myocardial infarction  

SciTech Connect

The value of stress thallium-201 scintigraphy for detecting individual coronary arterial stenoses was analyzed in 141 patients with angiographically proved coronary artery disease, 101 with and 40 without a previous myocardial infarction. In patients without infarction, the sensitivity for detecting greater than 50 percent narrowing in the left anterior descending, the right and the left circumflex coronary artery was 66, 53 and 24 percent, respectively. In those with a previous infarction, the sensitivity for demonstrating disease in the artery corresponding to the site of infarction was 100 percent for the left anterior descending, 79 percent for the right and 63 percent for the left circumflex coronary artery. In patients with a prior anterior infarction, concomitant right or left circumflex coronary arterial lesions were detected in only 1 of 12 cases, whereas in those with previous inferior or inferolateral infarction, the sensitivity for left anterior descending coronary artery disease was 69 percent. Because of the reasonably high sensitivity for detecting left anterior descending arterial disease, irrespective of the presence and location of previous infarction, myocardial scintigraphy was useful in identifying multivessel disease in patients with a previous inferior infarction. However, because of its relative insensitivity for right or left circumflex coronary artery disease, scintigraphy proved to be a poor predictor of multivessel disease in patients with a prior anterior infarction and in patients without previous myocardial infarction.

Rigo, P.; Bailey, I.K.; Griffith, L.S.; Pitt, B.; Wagner, H.N. Jr.; Becker, L.C.

1981-08-01

256

Effects of nerve growth factor on the action potential duration and repolarizing currents in a rabbit model of myocardial infarction  

PubMed Central

Objectives To investigate the effect of nerve growth factor (NGF) on the action potential and potassium currents of non-infarcted myocardium in the myocardial infarcted rabbit model. Methods Rabbits with occlusion of the left anterior descending coronary artery were prepared and allowed to recover for eight weeks (healed myocardial infarction, HMI). During ligation surgery of the left coronary artery, a polyethylene tube was placed near the left stellate ganglion in the subcutis of the neck for the purpose of administering NGF 400 U/d for eight weeks (HMI + NGF group). Cardiomyocytes were isolated from regions of the non-infarcted left ventricular wall and the action potentials and ion currents in these cells were recorded using whole-cell patch clamps. Results Compared with HMI and control cardiomyocytes, significant prolongation of APD50 or APD90 (Action potential duration (APD) measured at 50% and 90% of repolarization) in HMI + NGF cardiomyocytes was found. The results showed that the 4-aminopyridine sensitive transient outward potassium current (Ito), the rapidly activated omponent of delayed rectifier potassium current (IKr), the slowly activated component of delayed rectifier potassium current (IKs), and the L-type calcium current (ICaL) were significantly altered in NGF + HMI cardiomyocytes compared with HMI and control cells. Conclusions Our results suggest that NGF treatment significantly prolongs APD in HMI cardiomyocytes and that a decrease in outward potassium currents and an increase of inward Ca2+ current are likely the underlying mechanism of action.

Lan, Yun-Feng; Zhang, Jian-Cheng; Gao, Jin-Lao; Wang, Xue-Ping; Fang, Zhou; Fu, Yi-Cheng; Chen, Mei-Yan; Lin, Min; Xue, Qiao; Li, Yang

2013-01-01

257

Anomalous origin of the left coronary artery: angiographic and myocardial perfusion scintigraphic correlates  

SciTech Connect

We studied a patient with an anomalous left coronary artery arising from the pulmonary artery by using conventional angiographic and myocardial imaging techniques. Myocardial imaging with radioactive 201thallium confirmed the significance of resting Q waves, and the defect in anterior perfusion coupled with the presence of thallium in the pulmonary outflow tract during exercise underscored the dynamic nature of the ischemic response to exercise in this syndrome.

Young, M.W.; Hamby, R.I.; Zaret, B.

1981-04-01

258

Myocardial Elastography at Both High Temporal and Spatial Resolution for the Detection of Infarcts  

Microsoft Academic Search

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc.,

Jianwen Luo; Kana Fujikura; Shunichi Homma; Elisa E. Konofagou

2007-01-01

259

Cardiovascular magnetic resonance of acute myocardial infarction following traumatic coronary artery dissection.  

PubMed

Traumatic coronary artery dissection is a very rare cause of myocardial infarction. Occurrence of this condition late in the posttraumatic period is extremely uncommon. We present a case of a young patient with acute myocardial infarction 4 weeks after blunt chest trauma. Coronary angiography showed left anterior descending artery dissection as well as thrombus formation, and multiple small infarctions were shown by cardiovascular magnetic resonance. PMID:20686414

Mahmod, Masliza; Wage, Rick; Alpendurada, Francisco; Pennell, Dudley J

2013-09-01

260

Interventricular septal rupture after myocardial infarction despite early percutaneous coronary intervention.  

PubMed

Ventricular septal rupture (VSR) complicating acute myocardial infarction (AMI) is a serious clinical problem with high mortality rate due to cardiogenic shock or prolonged hemodynamic compromise. Despite multiple improvements in medical, interventional and surgical techniques, early and long-term prognosis after AMI related VSR still remain unpromising. We report a patient in whom an acute VSR was diagnosed 7 days after an anterior myocardial infarction treated with early primary percutaneous coronary intervention (pPCI). PMID:24765324

Cicek, Davran; Gökay, Seher; Saba, Tonguc; Sapmaz, Ismail; Muderrisoglu, Haldun

2011-07-01

261

Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction in a Young Female with Idiopathic Thrombocytopenic Purpura: A Case Report and Review  

PubMed Central

A 23-year-old female with the diagnosis of idiopathic thrombocytopenic purpura (ITP) was admitted to our hospital with severe chest pain. The electrocardiogram (ECG) revealed acute anterior myocardial infarction. She underwent an immediate cardiac catheterization. An occluded left anterior descending (LAD) was detected by coronary angiography. Reperfusion was performed successfully by angioplasty and stenting with optimal distal flow without any complications. In this report we discussed the management strategies of acute myocardial infarction (AMI) in a patient with ITP.

Yildiz, Ahmet; Coskun, Ugur; Batukan, Ozlem Esen; Keskin, Kudret

2010-01-01

262

"En masse" retraction of maxillary anterior teeth with anterior headgear.  

PubMed

In the treatment of the first premolar extraction cases with certain techniques, incisor retraction is realized after canine distalization. In maximum anchorage cases, retraction of anterior segments require more posterior anchorage. This treatment concept is still valid, however, the difficult anchorage control is considered a major drawback. The purpose of this study is to introduce our technique for the "en masse" retraction of maxillary anterior teeth after first premolar extraction and discuss its effects. The technique consists of the application of extraoral traction on canines, followed by banding of maxillary anterior teeth, to form them as a mass. Advantages of our mechanics are as follows: (1) Anterior headgear may have the advantage of retracting anterior teeth with minimum strain on posterior anchorage. (2) The adjustability of the outer bow in relation to the premaxilla's center of resistance, provides effective desired movements. (3) Intrusion and torque control are achieved in the course of anterior segment retraction. PMID:9387832

Güray, E; Orhan, M

1997-11-01

263

Pathological Views of Injured Myofibers After Myocardial Infarction in a 3D Reconstruction Obtained from Multiple Tissue Sections  

PubMed Central

Adverse left ventricular (LV) remodeling after acute myocardial infarction, characterized by LV dilatation and fibrosis, is a critical factor for prognosis in the subsequent development of heart failure. Though myofiber organization is a key component of cardiac structure, pathological views of injured myofibers during LV remodeling have not been characterized well. In our previous study using ischemia-reperfusion (I/R) injury models in mice, histological assays demonstrated the formation of a broad fibrotic scar extending from the initial infarct zone to a remote zone along mid-circumferential myofibers. However, the fibrosis was contained and did not extend into longitudinal myofibers within the internal and external aspects of the myocardium. We hypothesized that myocyte injury after I/R extends along myofibers but not coronary vessels. However, a histological analysis of tissue sections does not adequately indicate myofiber injury distribution throughout the entire heart. To address this, we investigated patterns of scar formation along myofibers using 3D images obtained from multiple tissue sections of the heart following I/R. Mice were subjected to surgical I/R (30 min-ischemia followed by reperfusion) injury by ligation of the left anterior descending coronary artery (LAD) and examined at 1 week after I/R. Each heart was fixed with 4% polyformaldehyde and cut serially into sections 5-µm thick from base to apex. In total, more than 100 sections were stained with Masson's trichome to identify regions of tissue fibrosis. Of those, 31 representative tissue sections were selected in equal distribution along the base to the apex. To generate the 3D model, digital images of the sections were outlined to highlight fibrotic areas, realigned for anatomic accuracy, and reconstructed using WinSurf v 1.0. The 3D model clearly delineates scar formation along myofibers beginning at the anterior wall of the base and extending inferiorly to the posterior wall of the apex. The pattern was consistent with distribution of the mid-circumferential myofibers. The data suggest that myocyte injury after temporal coronary ligation extends along myofibers rather than coronary vessels. Interestingly, recent clinical reports of patients with post-myocardial infarction evaluated with gadolinium-contrast MRI showed late enhancement of scar tissue limited only to the mid-myocardium in some cases. The same technique could be used to confirm the pattern of scar formation using autopsy samples. Computerized 3D images of histological assays are useful tools for visual analysis of myocardial architecture in I/R models and in the evolution of fibrosis in clinical settings.

Aoyagi, Hiroko; Aoyagi, Toshinori; Lozanoff, Scott; Matsui, Takashi

2013-01-01

264

Sustained effect of glucose-insulin-potassium on myocardial performance during regional ischemia. Role of free fatty acid and osmolality.  

PubMed Central

To evaluate the influence of glucose infusate administered with insulin and potassium on left ventricular function during 4 h of ischemia, as well as mechanism of action, four groups of intact anesthetized dogs were studied. Acute regional ischemia was induced with a balloon tip catheter in the left anterior descending artery and infusates were begun after 20 min of ischemia. A threefold increase of plasma glucose concentration was associated with improved left ventricular function during ischemia, compared to animals receiving isovolumic saline. There was a significant decline of left ventricular end-diastolic pressure associated with elevation of stroke volume and ejection fraction to control levels, as determined by indicator dilution. In a separate subgroup studied by cineangiography, shortening of the ischemic anterior wall, after an initial decline, was increased in response to glucose but there was no evidence of extension of injury. Ischemic tissue exhibited a smaller gain of water as well as Na+ per gram dry weight as compared to ischemic controls. On precordial electrocardiogram mapping there was a significant decrease in the sigmaST (sum of ST elevation) as well as NST (number of ST segment elevations), but the reduction of R wave amplitude was not different from controls. To further evaluate long-term effects, eight controls and six treated animals underwent myocardial ischemia and were sacrificed after 4 mo. Calculated area and weight of scar, as well as degree of wall thinning, were similar in both groups. The glucose-treated animals had a significant decrease of plasma FFA in contrast to controls which manifested a significant rise. To examine the postulate that the decrease in FFA was important to therapeutic action, a third group was infused with Intralipid (Cutter Laboratories, Inc., Berkeley, Calif.) and heparin, simultaneously with the glucose infusate, to effect an elevation of plasma FFA during ischemia. Changes in myocardial function and electrolyte composition, as well as precordial electrocardiogram mapping, were similar to that of animals receiving glucose alone. Because serum osmolality was increased approximately 40 mosmol during the glucose infusion, the potential role of hyperosmolality was assessed by infusion of 20% mannitol during acute ischemia in a fourth group. After a transient small increase, there was a moderate decline in function by 4 h, suggesting that the response to glucose is not dependent upon extracellular osmolality. Thus, it is concluded that during the initial hours after the onset of myocardial ischemia the glucose infusate improves ventricular performance without evidence of arrhythmia induction or intensification of ischemic injury. Evolution of irreversible necrosis appears to be delayed rather than prevented under the circumstances of this study.

Ahmed, S S; Lee, C H; Oldewurtel, H A; Regan, T J

1978-01-01

265

Detection of myocardial viability by low-dose dobutamine cine MR imaging  

Microsoft Academic Search

The purpose of this work was to test the diagnostic value of dobutamine stress magnetic resonance imaging (MRI) for predicting recovery of regional myocardial contractility after revascularization. Cardiac wall motion abnormalities are due to either non-viable and\\/or scarred, or viable, but hibernating, myocardial tissue. Dobutamine stress leads to increased systolic wall thickening only in viable myocardium. Twenty-five patients with akinetic

Joern J. W Sandstede; Gerald Bertsch; Meinrad Beer; Werner Kenn; Edgar Werner; Thomas Pabst; Claudia Lipke; Susanne Kretschmer; Stefan Neubauer; Dietbert Hahn

1999-01-01

266

QT dispersion variability and myocardial viability in acute myocardial infarction  

Microsoft Academic Search

The aim of this study was to evaluate QT dispersion in acute and sub-acute stages of myocardial infarction and clarify the relationship between QT dispersion and myocardial viability. We studied 95 patients with acute myocardial infarction. The QT dispersion values were compared to those of a control group of 50 healthy subjects. In the patients with acute myocardial infarction dispersion

F Gabrielli; L Balzotti; A Bandiera

1997-01-01

267

[Report of a case of lung cancer with metastasis to the myocardium which showed electrocardiographic findings similar to acute myocardial infarction and intramyocardial mass on echocardiography].  

PubMed

A 61-year-old man was admitted to our hospital with complaints of cough and left back and chest pain. He had suffered from left tuberculous pleurisy at the age of 20 years. Chest X-ray film and CT revealed atelectasis of the left lung, a left hilar mass and an irregular left atrial wall. Depressed P-Ta segment in the inferior limb and anterior chest leads and an abnormal P wave were found on ECG. Transbronchial lung biopsy showed squamous cell carcinoma. After radiation therapy, the patient complained of chest oppression. ECG revealed a normalized P-Ta segment deviation, markedly elevated ST segment in the inferior limb and lateral chest leads and a depressed ST segment in the anterior chest leads. These findings persisted until his death. An obscure appearance of the pericardium and an echogenic intramyocardial mass in the posteroinferior and lateral wall were evident by echocardiography. The patient died due to heart failure. Postmortem needle biopsy showed scattered intramyocardial tumor cell nests with keratinization. CPK, GOT and LDH were within normal limits throughout the course, but CPK-MB was slightly increased. Cardiac metastasis with an ECG appearance similar to that of acute myocardial infarction has been rarely reported. Our present case showed peculiar feature including 1) ECG findings similar to atrial and ventricular myocardial infarction, and 2) an echogenic intramyocardial mass and an ill-defined pericardium on echocardiography. These findings suggested direct invasion of squamous cell carcinoma of the lung to the ventricular myocardium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2740646

Dazai, Y; Katoh, I; Sueda, S; Katoh, T; Yoshida, R; Fujii, M; Kazatani, S

1989-04-01

268

Diagnostic significance of gadolinium-DTPA (diethylenetriamine penta-acetic acid) enhanced magnetic resonance imaging in thrombolytic treatment for acute myocardial infarction: its potential in assessing reperfusion  

Microsoft Academic Search

The diagnostic value of gadolinium-DTPA (diethylenetriamine penta-acetic acid) enhanced magnetic resonance imaging in patients treated by thrombolysis for acute myocardial infarction was assessed in 27 consecutive patients who had a first acute myocardial infarction (14 anterior, 13 inferior) and who underwent thrombolytic treatment and coronary arteriography within 4 hours of the onset of symptoms. Magnetic resonance imaging was performed 93

E E van der Wall; P R van Dijkman; A de Roos; J Doornbos; A van der Laarse; V Manger Cats; A E van Voorthuisen; N A Matheijssen; A V Bruschke

1990-01-01

269

[Coronary artery disease, myocardial perfusion and ventricular function in Q-wave and non-Q-wave myocardial infarcts].  

PubMed

Controversy remains in considering non-Q wave myocardial infarction (NQMI) a distinct pathophysiological entity of Q wave myocardial infarction (QMI). In order to analyze the severity of coronary artery disease, extension of myocardial scar or myocardial ischemia and ventricular function, 78 consecutive patients with QMI and 32 with NQMI, mean age 55.4 +/- 8.5, not submitted to thrombolytic therapy, were studied. Coronary angiography, exercise thallium scintigraphy and radionuclide ventriculography were performed in all at least within 3 months of a prior myocardial infarction. In the present study the occurrence of QMI was significantly more frequent in older patients than NQMI. There was no prevalence of occlusion either in the right, left circumflex or left anterior descending coronary arteries in both groups. Ejection fraction, degree of occlusion and presence of collateral circulation showed an equal prevalence in QMI and NQMI patients. A higher incidence of multivessel disease was found in NQMI that had less necrosis than QMI patients. The prevalence of exercise induced thallium-201 redistribution defects within the infarct zone was substantially higher and involved more scar segments in NQMI patients. Physiological and clinical consequences of coronary thrombosis depends on the size and the number of diseased arteries, the approach the pathophysiologic consequences of coronary disease in terms of fractal structure has been suggested. A pronounced heterogeneity in regional myocardial blood flow in a fractal branching arterial network may be responsible for the pathophysiologic differences of coronary thrombosis between Q-wave and non Q-wave infarction. PMID:9341032

Macieira-Coelho, E; Garcia-Alves, M; da Costa, B; Cantinho, G; Pedro, P; Dionisio, I; Gouveia, A; de Padua, F

1997-04-01

270

[Serial change of myocardial fatty acid metabolism in a case with severe myocardial ischemia].  

PubMed

A 66-year-old-man was admitted to our hospital because of chest pain on effort in October 1999. The initial images of 123I-BMIPP myocardial SPECT (BM) showed moderately decreased tracer uptake in the apex and the delayed images revealed redistribution in the apex. Coronary angiography revealed 99% stenosis in the proximal portion of the left anterior descending artery. Since sudden onset anaphylactic shock induced by contrast media developed, so percutaneous transluminal coronary angioplasty was not performed. The patient's symptoms were improved with medical treatment. On BM in March 2000, the initial images indicated slightly reduced uptake in the apico-anteroseptal region and the delayed images revealed mildly redistribution in the same area. BM in September 2000, the initial images showed moderately reduced uptake in the apico-anteroseptal region and the delayed images revealed high washout in the same area. The patient's symptoms markedly deferiorrated in March 2001, and BM initial images revealed slightly reduced uptake in the apico-anteroseptal region and the delayed images revealed redistribution in the same area again. During the clinical course, electrocardiography and 99mTc-tetrofosmin myocardial SPECT revealed no marked changes. We consider that 123I-BMIPP myocardial SPECT is useful in estimating myocardial ischemia. PMID:12058423

Yuba, Tatsuya; Ito, Kazuki; Tanabe, Takuji; Douue, Tomoki; Adachi, Yoshihiko; Katoh, Shuuji; Azuma, Akihiro; Sugihara, Hiroki; Nakagawa, Masao

2002-05-01

271

Prevalence of stress-induced myocardial stunning (Tako-Tsubo cardiomyopathy) among patients undergoing emergency coronary angiography for suspected acute myocardial infarction.  

PubMed

Stress-induced myocardial stunning is defined as a syndrome of acute chest pain, ST-T changes on the ECG and transient left ventricular apical wall motion abnormalities mimicking acute myocardial infarction but with surprisingly normal coronary angiography findings. The aim of this retrospective study is to assess the prevalence of stress-induced myocardial stunning among patients undergoing urgent coronary angiography for suspected acute myocardial infarction. During a four-year period (2002-2005), a total of 5876 patients underwent urgent coronary angiography for suspected acute myocardial infarction at three tertiary centers. Four patients fulfilled the diagnostic criteria for stress-induced myocardial stunning. Thus, the cath-lab prevalence of stress-induced myocardial stunning (i.e. among patients undergoing urgent coronary angiography for suspected acute myocardial infarction) was estimated as 1 per 1469 ST-elevation coronary angiograms (i.e. 0.07%) The estimated annual population incidence of this rare disorder was calculated as 0.00006%. Stress-induced myocardial stunning is an extremely rare syndrome among patients undergoing emergency coronary angiography for suspected acute myocardial infarction. PMID:17098304

Klinceva, Milka; Widimský, Petr; Pesl, Ladislav; Stásek, Josef; Tousek, Frantisek; Vambera, Milan; Bílková, Danuse

2007-09-01

272

Clinical Study of Myocardial Bridge  

Microsoft Academic Search

Background and Objectives:Myocardial bridge is a congenital coronary anomaly that causes myocardial ischemia by a milking effect. The general study of myocardial bridge is weak, therefore we retrospectively examined clinical records of cases of myocardial bridge. Materials and Method:This study included 36 bridge cases out of 1048 patients who underwent coronary angiography due to chest pain from Jan. 1993 to

Kil Hyun Cho; Jun Yong Jung; Jin Ho Song; Jong Cheol Ryu; Doo Il Kim; Dong Soo Kim

273

Correlation between symptomatology and site of acute myocardial infarction  

Microsoft Academic Search

Objective: We determined the occurrence of presenting symptoms in patients with different sites of acute myocardial infarction after controlling for age and conventional risk factors. Methods: Hospital-based study of patients hospitalized because of first anterior (n=731), inferior (n=719) and lateral (n=96) infarction in Clinical Hospital Split between 1990 and 1994. Data form about presenting symptoms and clinical profile was completed

Viktor ?uli?; Dinko Miri?; Davor Eterovi?

2001-01-01

274

Effect of Hyperinsulinemia on Myocardial Fluorine18FDG Uptake  

Microsoft Academic Search

This study was performed to evaluate the effect of insulin on myocardial kinetics of 18F-fluorodeoxyglucose(FDG)and glucose in patients with ischemie heart disease. Methods: Twelve male pa tients (age range 54-79 yr; mean age 69 ±8 yr) were studied during the fasting awake state. Patients with diabetes and previous myo cardial infarction of the left anterior descending vascular bed were excluded

Chin K. Ng; Robert Soufer; Patrick H. McNulty

275

[The usefulness of 123I-BMIPP myocardial SPECT in diagnosis for silent myocardial ischemia induced by vasospasm].  

PubMed

This study was designed to evaluate the clinical usefulness of 123I-BMIPP myocardial SPECT in patients with silent myocardial ischemia induced by vasospasm. Ultrasonic echocardiography (UCG), Holter electrocardiogram recording (Holter ECG), exercise 201Tl myocardial SPECT (EX-Tl) and rest 123I-BMIPP myocardial SPECT (BMIPP) were performed in 8 patients with asymptomatic vasospasm without history of myocardial infarction. The sensitivity of each modality in detecting coronary artery spasm was 37.5% (3 of 8 cases) for UCG, 37.5% (3 of 8 cases) in Holter ECG, 25.0% (2 of 8 cases) in Ex-Tl, 62.5% (5 of 8 cases) on initial BMIPP images and 75.0% (6 of 8 cases) on delayed BMIPP images. Severity of regional left ventricular wall motion abnormality in UCG correlated with the severity of regionally decreased tracer uptake in BMIPP. The washout rate of BMIPP was 18.7 +/- 2.4 in normal controls, 32.4 +/- 5.9 in asymptomatic vasospasm, and 38.2 +/- 4.0 in asymptomatic vasospasm with abnormal left ventricular wall motion. It was suggested that 123I-BMIPP myocardial SPECT might be useful for assessing asymptomatic vasospasm. PMID:10087765

Kawasaki, T; Ito, K; Okano, A; Nagata, K; Yoneyama, S; Sugihara, H; Katoh, S

1999-01-01

276

Bioengineered anterior cruciate ligament  

NASA Technical Reports Server (NTRS)

The present invention provides a method for producing an anterior cruciate ligament ex vivo. The method comprises seeding pluripotent stem cells in a three dimensional matrix, anchoring the seeded matrix by attachment to two anchors, and culturing the cells within the matrix under conditions appropriate for cell growth and regeneration, while subjecting the matrix to one or more mechanical forces via movement of one or both of the attached anchors. Bone marrow stromal cells are preferably used as the pluripotent cells in the method. Suitable matrix materials are materials to which cells can adhere, such as a gel made from collagen type I. Suitable anchor materials are materials to which the matrix can attach, such as Goinopra coral and also demineralized bone. Optimally, the mechanical forces to which the matrix is subjected mimic mechanical stimuli experienced by an anterior cruciate ligament in vivo. This is accomplished by delivering the appropriate combination of tension, compression, torsion, and shear, to the matrix. The bioengineered ligament which is produced by this method is characterized by a cellular orientation and/or matrix crimp pattern in the direction of the applied mechanical forces, and also by the production of collagen type I, collagen type III, and fibronectin proteins along the axis of mechanical load produced by the mechanical forces. Optimally, the ligament produced has fiber bundles which are arranged into a helical organization. The method for producing an anterior cruciate ligament can be adapted to produce a wide range of tissue types ex vivo by adapting the anchor size and attachment sites to reflect the size of the specific type of tissue to be produced, and also adapting the specific combination of forces applied, to mimic the mechanical stimuli experienced in vivo by the specific type of tissue to be produced. The methods of the present invention can be further modified to incorporate other stimuli experienced in vivo by the particular developing tissue, some examples of the stimuli being chemical stimuli, and electro-magnetic stimuli. Some examples of tissue which can be produced include other ligaments in the body (hand, wrist, elbow, knee), tendon, cartilage, bone, muscle, and blood vessels.

Altman, Gregory (Inventor); Kaplan, David (Inventor); Vunjak-Novakovic, Gordana (Inventor); Martin, Ivan (Inventor)

2001-01-01

277

Anterior radical debridement and anterior instrumentation in tuberculosis spondylitis  

Microsoft Academic Search

The conventional procedure in the treatment of vertebral tuberculosis is drainage of the abscess, curettage of the devitalized vertebra and application of an antituberculous chemotherapy regimen. Posterior instrumentation results are encouraging in the prevention or treatment of late kyphosis; however, a second-stage operation is needed. Recently, posterolateral or transpedicular drainage without anterior drainage or posterior instrumentation following anterior drainage in

?. Benli; Emre Acaro?lu; Serdar Akalin; Mahmut Ki?; Evrim Duman; Ahmet Ün

2003-01-01

278

[Anterior sacral meningomyelocele].  

PubMed

Anterior sacral meningomyelocele is the rarest and least known form of congenital myelocele. It is not manifested externally, it is usually not attended with changes in the neurologic status, and may be regarded as a presacral dermoid cyst. The authors observed 5 members of one family with similar clinical and X-ray signs of such herniations, in 2 they were verified. The presence of cystic structures in the cavity of the small pelvis in conjunction with a congenital defect in the bodies of the sacral vertebrae is an indication for conducting pneumomyelography so as to make a more precise diagnosis. A study of the hereditary and family history is a necessary trend in the examination of such patients because the disease may be of a familial character. PMID:919974

Solopaev, A A; Myl'nikov, P I; Gerber, Iu M; Riazantsev, P N

1977-01-01

279

Quantitative automated assessment of myocardial perfusion at cardiac catheterization.  

PubMed

Perfusion assessed in the cardiac catheterization laboratory predicts outcomes after myocardial infarction. The aim of this study was to investigate a novel method of assessing perfusion using digital subtraction angiography to generate a time-density curve (TDC) of myocardial blush, incorporating epicardial and myocardial perfusion. Seven pigs underwent temporary occlusion of the left anterior descending coronary artery for 60 minutes. Angiography was performed in the same projections before, during, and after occlusion. Perfusion parameters were obtained from the TDC and compared with Thrombolysis In Myocardial Infarction (TIMI) frame count and myocardial perfusion grade. In addition, safety and feasibility were tested in 8 patients after primary percutaneous coronary intervention. The contrast density differential between the proximal artery and the myocardium derived from the TDC correlated well with TIMI myocardial perfusion grade (R = 0.54, p <0.001). The arterial transit time derived from the TDC correlated with TIMI frame count (R = 0.435, p = 0.011). Using a cutoff of 2.4, the density/time ratio, a ratio of density differential to transit time, had sensitivity and specificity of 100% for coronary arterial occlusion. The positive and negative predictive values were 100%. The generation of a TDC was safe and feasible in 7 patients after acute myocardial infarctions, but the correlation between TDC-derived parameters and TIMI parameters did not reach statistical significance. In conclusion, this novel method of digital subtraction angiography with rapid, automated, quantitative assessment of myocardial perfusion in the cardiac catheterization laboratory correlates well with established angiographic measures of perfusion. Further studies to assess the prognostic value of this technique are warranted. PMID:18929697

Boyle, Andrew J; Schuleri, Karl H; Lienard, Jean; Vaillant, Regis; Chan, Michael Y; Zimmet, Jeffrey M; Mazhari, Ramesh; Centola, Marco; Feigenbaum, Gary; Dib, Joud; Kapur, Navin K; Hare, Joshua M; Resar, Jon R

2008-10-15

280

Ginkgo biloba extract postconditioning reduces myocardial ischemia reperfusion injury.  

PubMed

We examined the protective effects of Ginkgo biloba extract (EGb761) postconditioning on myocardial ischemia reperfusion injury in rabbits. Four groups of 8 white rabbits were allocated to: pseudo surgery group: the left coronary was lined without blocking for 160 min after thoracotomy; ischemia and reperfusion group (IR): the left anterior descending coronary artery was blocked for 40 min and reperfused for 120 min; ischemic postconditioning group: the left anterior descending artery was ligated for 40 min, reopened for 30 s and ligated for 30 s, repeated three times, and then reperfused for 120 min; EGb761 postconditioning group (E): 100 mg/kg EGb761 was injected into a vein while the left coronary artery was opened for 1 min. The reperfusion took 120 min. Internal carotid arterial blood in each group was collected for cTnI measurement at five times: 20 min before occlusion of the left coronary artery, 20 min after left coronary artery occlusion, 40 min after left coronary artery occlusion, 1 h after myocardial reperfusion, and 2 h after myocardial reperfusion. Superoxide dismutase (SOD), malondialdehyde (MDA) in the centrifuged blood and myocardial infarction area were measured at the end of reperfusion. We found that the serum cTnI concentrations in the E group during reperfusion decreased significantly compared with those in the IR group. The infarction area was significantly lower in the E group than that in the IR group. The SOD activity in the E group was increased compared with that in the IR group; the MDA content decreased significantly in the E group compared with that in the IR group. We conclude that G. biloba extract postconditioning had myocardial protection effects by reducing the generation of oxygen-free radicals and increasing the antioxidant capacity of the myocardial cells. PMID:24782084

Ran, K; Yang, D-L; Chang, Y-T; Duan, K-M; Ou, Y-W; Wang, H-P; Li, Z-J

2014-01-01

281

[Long-term behavior of echocardiography findings of the left ventricle following myocardial infarct].  

PubMed

110 patients at the age of 62.5 +/- 10.7 years were echocardiographically investigated by means of M-mode and section-picture on the 6th and 27th day as well as 3 and 12 months after the infarction. In all investigations patients with anterior wall infarctions showed lower systolic thickenings of the septum, disturbances of the kinetics of the anterior wall of higher degree and up to the 3rd month a compensatorily increased systolic thickening of the posterior wall. Up to the 1st year this was replaced by an increasing hypertrophy of the posterior wall. After a posterior wall infarction the systolic thickening of the posterior wall and the disturbance of the kinetics had less clear results so that compensation mechanisms in the anterior wall were not proved. PMID:3442073

Schaller, K

1987-11-15

282

Myocardial CellHypertrophy After Myocardial Infarction WithReperfusion inDogs  

Microsoft Academic Search

Background. Thepotential roleofmyocardial cell hypertrophy intheischemic zoneinthemechanism oflate recoveryofregional contractile function after myocardial infarction followed byreperfusion hasnot beenexamined. Methods andResults. Eight chronically instrumented, conscious dogs weresubjected to90-120 minutes ofcircumflex coronaryartery occlusion followed byreperfusion. Thethickness andfunction oftheanterior (AT)andposterior (PT)walls was measured byultrasonic gaugesatcontrol, during occlusion, andafter reperfusion. After3weeks, cross-sectional areasofsurviving cells were determined fromsubepicardial (epi), midwall (mid), andsubendocardial (endo) regions insixdogsandcompared

Masashi Kambayashi; Toshiro Miura; Byung-Hee Oh; Howard A. Rockman; BA GregParra

283

Myocardial stunning in hypertrophic cardiomyopathy: recovery predicted by single photon emission computed tomographic thallium-201 scintigraphy  

SciTech Connect

A young woman with hypertrophic cardiomyopathy confirmed by echocardiography and cardiac catheterization presented with chest pain and features of a large left ventricular aneurysm. The initial diagnosis was myocardial ischemia with either an evolving or an ancient myocardial infarction. Subsequently, verapamil therapy was associated with complete resolution of the extensive left ventricular wall motion abnormalities, normalization of left ventricular ejection fraction and a minimal myocardial infarction. Normal thallium uptake on single photon emission computed tomographic scintigraphy early in the hospital course predicted myocardial viability in the region of the aneurysm. Thus, orally administered verapamil may reverse spontaneous extensive myocardial ischemia in hypertrophic cardiomyopathy and possibly limit the extent of myocardial infarction in such circumstances.

Fine, D.G.; Clements, I.P.; Callahan, M.J.

1989-05-01

284

Photoacoustic microscopy of myocardial sheet architecture in unfixed and unstained mammalian hearts  

NASA Astrophysics Data System (ADS)

The laminar myocardial sheet architecture and its dynamic change play a key role in myocardial wall thickening. Histology, confocal optical microscopy (COM), and diffusion tensor MRI (DTI) have been used to unveil the structures and functions of the myocardial sheets. However, histology and COM require fixation, sectioning, and staining processes, which dehydrate and deform the sheet architecture. Although DTI can delineate sheet architecture nondestructively in viable hearts, it cannot provide cellular-level resolution. Here we show that photoacoustic microscopy (PAM), with high resolution (~1 ?m) and label-free detection, is appropriate for imaging 3D myocardial architecture. Perfused half-split mouse hearts were also imaged by PAM in vitro without fixation, dehydration, nor staining. The laminar myocardial sheet architecture was clearly visualized within a 0.15 mm depth range. Two populations of oppositely signed sheet angles were observed. Therefore, PAM promises to access dynamic changes of myocardial architectures in ex vivo perfused-viable hearts.

Zhang, Chi; Cheng, Ya-Jian; Yao, Da-Kang; Wickline, Samuel; Wang, Lihong V.

2012-02-01

285

Anterior chamber depth during hemodialysis  

PubMed Central

Background Exacerbation of chronic glaucoma or acute glaucoma is occasionally observed in patients undergoing hemodialysis (HD) because of anterior chamber depth changes during this therapy. Purpose To evaluate anterior chamber depth and axial length in patients during HD sessions. Methods A total of 67 eyes of 35 patients were prospectively enrolled. Axial length and anterior chamber depth were measured using ultrasonic biometry, and these measures were evaluated at three different times during HD sessions. Body weight and blood pressure pre- and post-HD were also measured. Results There was no difference in the axial length between the three measurements (P = 0.241). We observed a significantly decreased anterior chamber depth (P = 0.002) during HD sessions. Conclusion Our results support the idea that there is a change in anterior chamber depth in HD sessions.

Gracitelli, Carolina Pelegrini Barbosa; Stefanini, Francisco Rosa; Penha, Fernando; Goes, Miguel Angelo; Draibe, Sergio Antonio; Canziani, Maria Eugenia; Junior, Augusto Paranhos

2013-01-01

286

Wall Turbulence.  

National Technical Information Service (NTIS)

This research was aimed at understanding turbulence generated at a wall. The goals were to investigate the structure of turbulence in the viscous wall region, to understand how production of turbulence is related to measured structural parameters, to deve...

L. P. Purtell

1992-01-01

287

Cardioprotective effects of bosentan, a mixed endothelin type A and B receptor antagonist, during myocardial ischaemia and reperfusion in rats.  

PubMed

The present study evaluated the cardioprotective potential of bosentan, a mixed endothelin type A and B receptor antagonist, in the myocardial ischaemia-reperfusion model of myocardial infarction. Adult male wistar rats (175-225 g) were divided into three groups: sham operated, non-myocardial ischaemia-reperfusion (SHAM); saline-treated myocardial ischaemia-reperfusion control (CON); bosentan-treated myocardial ischaemia-reperfusion (BOS). All animals were anaesthetized and subjected to 40 min. occlusion of left anterior descending coronary artery followed by 120 min. of reperfusion. Saline or drug was administered to the CON or BOS group, respectively, 20 min. after the left anterior descending coronary artery occlusion. Haemodynamic parameters viz. systolic arterial pressure, diastolic arterial pressure and heart rate were recorded throughout the experimental period. Hearts were subsequently excised and processed for histopathological and infarct size evaluation and for biochemical estimation of cardiac specific enzyme creatine kinase-MB (CK-MB) and myocardial malondialdehyde, a lipid peroxidation marker. Myocardial ischaemic reperfusion resulted in severe myocardial injury, depression of haemodynamic function, significant increase in malondialdehyde levels and decline in CK-MB isoenzyme activity in the heart tissue. Administration of bosentan (3 mg/kg, intravenously) slightly improved haemodynamic effects, decreased myocardial oxygen consumption, significantly (P<0.01) attenuated the rise in malondialdehyde levels and loss of myocardial CK-MB isoenzyme activity compared to the CON group, whereas bosentan administration significantly reduced the percentage area of fiber loss and infarct area. It is therefore concluded that endothelin-1 may mediate myocardial damage produced by ischaemia and reperfusion and that dual blockade of endothelinA and endothelinB receptors may have potential as a mode of therapy for myocardial infarction. PMID:16700825

Singh, Arya Dharamvir; Amit, Saxena; Kumar, Ojha Shreesh; Rajan, Mittal; Mukesh, Nandave

2006-06-01

288

Effect of early enalapril therapy on left ventricular function and structure in acute myocardial infarction.  

PubMed

Infarct expansion starts within hours to days after transmural myocardial injury. Previous echocardiographic and left ventriculographic studies demonstrated that angiotensin-converting enzyme (ACE) inhibitor therapy limits left ventricular dilatation, particularly in patients with anterior wall acute myocardial infarction (AMI) or impaired left ventricular function. Forty-three patients with an acute Q-wave AMI were randomized within 24 hours of symptom onset to intravenous enalaprilat (1 mg) or placebo. Patients were then given corresponding oral therapy and followed for 1 month. Predrug and 1-month gated blood pool scans were obtained in 32 patients to evaluate changes in cardiac volumes and ejection fraction. Twenty-three patients underwent magnetic resonance imaging at 1 month to evaluate left ventricular infarct expansion. Blood pressure decreased at 6 hours but returned to baseline in both groups after 1 month of therapy. The change in cardiac volumes from baseline to 1 month differed between the placebo (end-diastolic volume +16 +/- 5 ml, end-systolic volume +8 +/- 6 ml), and enalapril (end-diastolic volume -8 +/- 9 ml and end-systolic volume -14 +/- 7 ml) groups (p < 0.05 vs placebo). Global and infarct zone ejection fractions improved significantly at 1 month in the enalapril group (+6 +/- 3% and 19 +/- 5%, respectively) but did not change over 1 month in the placebo group. Infarct segment length and infarct expansion index by magnetic resonance imaging were significantly less in those treated with enalapril, suggesting less infarct expansion in this group. Thus, early administration of enalaprilat to patients presenting with a first Q-wave AMI prevents cardiac dilatation and infarct expansion. PMID:7572651

Schulman, S P; Weiss, J L; Becker, L C; Guerci, A D; Shapiro, E P; Chandra, N C; Siu, C; Flaherty, J T; Coombs, V; Taube, J C

1995-10-15

289

Magnetic targeting enhances retrograde cell retention in a rat model of myocardial infarction  

PubMed Central

Introduction Retrograde coronary venous infusion is a promising delivery method for cellular cardiomyoplasty. Poor cell retention is the major obstacle to the establishment of this method as the preferred route for cell delivery. Here, we explored whether magnetic targeting could enhance retrograde cell retention in a rat model of myocardial infarction. Methods Rat mesenchymal stem cells were labeled with superparamagnetic oxide nanoparticles. The magnetic responsiveness of MSCs was observed while cells flowed through a tube that served as a model of blood vessels in a 0.6-Tesla magnetic field. In a Sprague–Dawley rat model of acute myocardial infarction, 1?×?106 magnetic mesenchymal stem cells were transjugularly injected into the left cardiac vein while a 0.6-Tesla magnet was placed above the heart. The cardiac retention of transplanted cells was assessed by using quantitative Y chromosome-specific polymerase chain reaction, cardiac magnetic resonance imaging, and optical imaging. Cardiac function was measured by using echocardiography, and histologic analyses of infarct morphology and angiogenesis were obtained. Results The flowing iron oxide-labeled mesenchymal stem cells were effectively attracted to the area where the magnet was positioned. Twenty-four hours after cellular retrocoronary delivery, magnetic targeting significantly increased the cardiac retention of transplanted cells by 2.73- to 2.87-fold. Histologic analyses showed that more transplanted cells were distributed in the anterior wall of the left ventricle. The enhanced cell engraftment persisted for at least 3 weeks, at which time, left ventricular remodeling was attenuated, and cardiac function benefit was improved. Conclusions These results suggest that magnetic targeting offers new perspectives for retrograde coronary venous delivery to enhance cell retention and subsequent functional benefit in heart diseases.

2013-01-01

290

[National myocardial infarction registry].  

PubMed

The authors delineate the circumstances of the creation of the National Myocardial Infarction Registry program. This web-based program started in January 1, 2010 as a "pilot" study with the voluntary participation of 12 centres. As a result of professional consensus, the number of participating institutions has continuously increased and, since March 1, 2013, data supply has become obligatory for hospitals treating patients with myocardial infarction. In December, 2013 a new modification of certain health and health insurance related acts such as Act XLVII/1997 regulated the operation of National Myocardial Infraction Registry. At present 65 institutions provide data regularly. The number of patients with myocardial infarction in the database was 24308 in January 1, 2014. The authors summarize the data which accumulated during almost four years of functioning of the National Myocardial Infarction Registry Program. The incidence of myocardial infarction was defined by reviewing the number of pre hospital and hospital cases in five districts of the capital and Szabolcs-Szatmár-Bereg County of Hungary. Reviewing the records patients with ST-elevation and non-ST-elevation myocardial infarction revealed that treatment of 91% of ST-elevation patients occurred in hospitals with cardiac catheterization laboratory, and 82% of patients had primary percutaneous coronary intervention. In-hospital, 30-day and 1-year mortality were defined for patients treated for both types of myocardial infarction. Based on national and international experience, the authors emphasize that professional characteristics of patient care can only be assessed using specific patient registries and these data are essential in the development of an efficient health-care system. Orv. Hetil., 2014, 155(19), 740-744. PMID:24796779

Jánosi, András; Ofner, Péter

2014-05-01

291

Dual left anterior descending coronary artery: a rare coronary anomaly Çift sol ön inen koroner arter: Nadir bir koroner anomali  

Microsoft Academic Search

Dual left anterior descending artery (LAD) originating from the left and right coronary arteries is an extremely rare congenital coronary artery anomaly. A 65-year-old male patient was admitted with inferior acute myocardial infarc- tion. Coronary angiography showed normal left main coro- nary artery, a short LAD artery terminating proximally after bifurcating a few diagonal branches, and total occlusion of the

Enbiya Aksakal; Mustafa Kemal Erol; Mecit Kantarc

292

Deep anterior lamellar Keratoplasty  

PubMed Central

Keratoconus is a disease causing increased steepening of the cornea resulted in irregular astigmatism. Treatment options are Glasses, Hard contact lenses, Cross linking, Intracorneal Segments insertion, Refractive surgery (Gilda et al., 2008), or Keratoplasty. Lamellar Keratoplasty (LKP) can be a better choice to manage cases of moderate and some cases of severe Keratoconus without deep scarring and severe thinning, also in cases of corneal scarring not involving the deeper layers of the cornea. LKP is a corneal graft technique consisting of transplantation of partial-thickness donor tissue, devoid of endothelium, Descemet membrane (DM), and rear stroma into a recipient healthy stromal bed after dissection of pathologic anterior stroma. However, deep lamellar Keratoplasty (DLKP) is a surgical method that completely removes pathologic corneal stroma tissue down to the DM, followed by transplantation of donor cornea without endothelium over the host bed. DLKP has a number of advantages over penetrating Keratoplasty (PKP). Because it does not violate the intraocular structures of the eye, it diminishes or eliminates the chance of postoperative glaucoma, cataract formation, retinal detachment, cystoids macular edema, expulsive choroidal hemorrhage and epithelial ingrowths. Furthermore, this procedure avoids the replacement of host endothelium with donor endothelium and thus precludes endothelial graft rejection, with comparable visual outcomes and low rate of chronic endothelial cell loss compared to PKP.

Al-Kharashi, Soliman A.; Al-Obailan, Majed M.; Almohaimeed, Mansour; Al-Torbak, Abdullah A.

2009-01-01

293

Sustained-Release Delivery of Prostacyclin Analogue Enhances Bone Marrow-Cell Recruitment and Yields Functional Benefits for Acute Myocardial Infarction in Mice  

PubMed Central

Background A prostacyclin analogue, ONO-1301, is reported to upregulate beneficial proteins, including stromal cell derived factor-1 (SDF-1). We hypothesized that the sustained-release delivery of ONO-1301 would enhance SDF-1 expression in the acute myocardial infarction (MI) heart and induce bone marrow cells (BMCs) to home to the myocardium, leading to improved cardiac function in mice. Methods and Results ONO-1301 significantly upregulated SDF-1 secretion by fibroblasts. BMC migration was greater to ONO-1301-stimulated than unstimulated conditioned medium. This increase was diminished by treating the BMCs with a CXCR4-neutralizing antibody or CXCR4 antagonist (AMD3100). Atelocollagen sheets containing a sustained-release form of ONO-1301 (n?=?33) or ONO-1301-free vehicle (n?=?48) were implanted on the left ventricular (LV) anterior wall immediately after permanent left-anterior descending artery occlusion in C57BL6/N mice (male, 8-weeks-old). The SDF-1 expression in the infarct border zone was significantly elevated for 1 month in the ONO-1301-treated group. BMC accumulation in the infarcted hearts, detected by in vivo imaging after intravenous injection of labeled BMCs, was enhanced in the ONO-1301-treated hearts. This increase was inhibited by AMD3100. The accumulated BMCs differentiated into capillary structures. The survival rates and cardiac function were significantly improved in the ONO-1301-treated group (fractional area change 23±1%; n?=?22) compared to the vehicle group (19±1%; n?=?20; P?=?0.004). LV anterior wall thinning, expansion of infarction, and fibrosis were lower in the ONO-1301-treated group. Conclusions Sustained-release delivery of ONO-1301 promoted BMC recruitment to the acute MI heart via SDF-1/CXCR4 signaling and restored cardiac performance, suggesting a novel mechanism for ONO-1301-mediated acute-MI heart repair.

Imanishi, Yukiko; Miyagawa, Shigeru; Fukushima, Satsuki; Ishimaru, Kazuhiko; Sougawa, Nagako; Saito, Atsuhiro; Sakai, Yoshiki; Sawa, Yoshiki

2013-01-01

294

Relationship between segmental thallium-201 uptake and regional myocardial blood flow in patients with coronary artery disease  

SciTech Connect

The relationship between the spatial distribution of thallium-201 in myocardial perfusion scintigrams and the distribution of left ventricular regional myocardial blood flow was examined in 25 patients undergoing coronary arteriography. Thallium-201 myocardial scintigrams were obtained after symptom-limited exercise and after a 4 hr delay. Regional myocardial blood flow was measured by the xenon-133 clearance method in patients at rest and during rapid atrial pacing to a double product comparable with that achieved during exercise stress testing. Patterns of regional thallium-201 activity and regional myocardial blood flow, recorded in similar left anterior oblique projections, were compared for left ventricular segments supplied by the left anterior descending (LAD) and left circumflex (CIRC) arteries. In 11 patients without significant lesions of the left coronary artery (group 1), thallium-201 was homogeneously distributed in the LAD and CIRC distributions in scintigrams taken during peak exercise; these scintigrams correspond to homogeneous regional myocardial blood flow in the LAD and CIRC regions during pacing-induced stress. In 14 patients with significant lesions of the left coronary artery (group 2), ratios of regional thallium-201 activity in the LAD and CIRC distributions of exercise scintigrams correlated well (r . .84) with ratios of regional myocardial blood flow measured during rapid pacing. Background subtraction altered the relationship between relative thallium-201 uptake and regional myocardial blood flow, causing overestimation of the magnitude of flow reduction on exercise scintigrams.

Nichols, A.B.; Weiss, M.B.; Sciacca, R.R.; Cannon, P.J.; Blood, D.K.

1983-08-01

295

Successful Medical Management of a Left Ventricular Thrombus and Aneurysm Following Failed Thrombolysis in Myocardial Infarction  

PubMed Central

We report the case of a patient with an extensive anterior myocardial infarction complicated by left ventricular systolic dysfunction, left ventricular apical thrombus and an apical left ventricular aneurysm following failed thrombolysis. We obtained serial two-dimensional echocardiograms at short intervals in the acute phase and also during the months of recovery and follow up. The patient was successfully and exclusively medically managed.

Oyedeji, Adebayo T; Lee, Christopher; Owojori, Olukolade O; Ajegbomogun, Olabanji J; Akintunde, Adeseye A

2013-01-01

296

Optimal temporal delivery of bone marrow mesenchymal stem cells in rats with myocardial infarction  

Microsoft Academic Search

Objective: This study was designed to determine the optimal time point for bone marrow mesenchymal stem cell (MSC) transplantation after myocardial infarction (MI). Methods: MSCs from donor rats were labeled with DAPI before transplantation. The animals underwent MI by ligation of left anterior descending coronary artery, and received intramyocardial injection of MSCs at 1h, 1 week and 2 weeks after

Xinyang Hu; Jianan Wang; Jie Chen; Ronghua Luo; Aina He; Xiaojie Xie; Jiahui Li

2007-01-01

297

Differential uptake of myocardial perfusion radiotracers in normal, infarcted, and acutely ischemic peri-infarction myocardium  

Microsoft Academic Search

m . 201 . Objectives: We measured the uptake of technetium-99m tetrofosmin Tc and thallium-201 Tl in areas of healed transmural myocardial infarction and in regions of acute peri-infarction ischemia. Methods: Anesthetised pigs with a 1-month old transmural . infarction elicited by permanent ligature of the left anterior descending LAD coronary artery below the first branch underwent one hour 99m

Juan Cinca; Amparo Garcia-Burillo; Ana Carreno; Juan Castell; Mark Warren; Jaume Candell-Riera; Ana Domingo; J. Soler-Soler

298

Hyperlipidemia with Hypoglycemia Reduces Myocardial Oxygen Utilization Efficiency but not Contractile Function During Coronary Hypoperfusion  

Microsoft Academic Search

This study was designed to determine changes in myocardial contractile function and fuel selection during moderate coronary hypoperfusion in the presence of elevated plasma free fatty acid (FFA) at normal and reduced blood glucose concentrations. Coronary perfusion pressure (CPP) was sequentially lowered from 100 to 60, 50, and 40 mmHg in the left anterior descending coronary artery (LAD) of anesthetized,

Bradley J Hart; Xiaoming Bian; Robert T Mallet; H Fred Downey

2000-01-01

299

Effect of propranolol on enzymatic and histochemical estimates of infarct size in experimental myocardial infarction  

Microsoft Academic Search

Summary Acute myocardial infarction was produced in anesthetized dogs by ligation of the left anterior descendens coronary artery. Propranolol (2 mg\\/kg i.v.) administered 4 hours post ligation was examined for its ability to reduce infarct size estimated by histochemical and enzymatic methods. There was a significant correlation between these two methods in their estimation of infarct size. Treatment with propranolol

G. J. Jesmok; D. C. Warltier; G. J. Gross; H. F. Hardman

1978-01-01

300

Anterior radical debridement and anterior instrumentation in tuberculosis spondylitis.  

PubMed

The conventional procedure in the treatment of vertebral tuberculosis is drainage of the abscess, curettage of the devitalized vertebra and application of an antituberculous chemotherapy regimen. Posterior instrumentation results are encouraging in the prevention or treatment of late kyphosis; however, a second-stage operation is needed. Recently, posterolateral or transpedicular drainage without anterior drainage or posterior instrumentation following anterior drainage in the same session has become the preferred treatment, in order that kyphotic deformity can be avoided. Information on the use of anterior instrumentation along with radical debridement and fusion is scarce. This study reports on the surgical results of 63 patients with Pott's disease who underwent anterior radical debridement with anterior fusion and anterior instrumentation (23 patients with Z-plate and 40 patients with CDH system). Average age at the time of operation was 46.8+/-13.4 years. Average duration of follow-up was 50.9+/-12.9 months. Local kyphosis was measured preoperatively, postoperatively and at the last follow-up visit as the angle between the upper and lower end plates of the collapsed vertebrae. Vertebral collapse, destruction, cold abscess, and canal compromise were assessed on magnetic resonance (MR) images. It was observed that the addition of anterior instrumentation increased the rate of correction of the kyphotic deformity (79.7+/-20.1%), and was effective in maintaining it, with an average loss of 1.1 degrees +/-1.7 degrees. Of the 25 patients (39.7%) with neurological symptoms, 20 (80%) had full and 4 (16%) partial recoveries. There were very few intraoperative and postoperative complications (major vessel complication: 3.2%; secondary non-specific infection: 3.2%). Disease reactivation was not seen with the employment of an aggressive chemotherapy regimen. It was concluded that anterior instrumentation is a safe and effective method in the treatment of tuberculosis spondylitis. PMID:12709862

Benli, I Teoman; Acaro?lu, Emre; Akalin, Serdar; Ki?, Mahmut; Duman, Evrim; Un, Ahmet

2003-04-01

301

Pharyngoesophageal diverticulum perforation 18 years after anterior cervical fixation.  

PubMed

Anterior cervical spinal surgery can lead to various complications. We hereby present a case of two rare complications combined-pharyngo-oesophageal diverticulum and its perforation after cervical plate dislodgement. A 53-year old male patient presented with progressive dysphagia 18 years after anterior cervical spinal fusion with tricortical bone graft and custom-made plate at the C6/7 level. Oesophagography revealed a pharyngo-oesophageal diverticulum in front of the cervical plate. It was confirmed by subsequent oesophagoscopy, which also demonstrated a 3-cm longitudinal defect at the posterior wall of the diverticulum. During surgical exploration of the patient's neck, the plate was removed, the diverticulum was completely mobilized and excised, the oesophageal wall manually sutured and a cricopharyngeal myotomy performed. An oesophageal suture line failure was suspected postoperatively, but was not confirmed during reoperation. A year later, the patient has no dysphagia or any other symptoms. PMID:24246672

Almre, Ingemar; Asser, Andres; Laisaar, Tanel

2014-02-01

302

Acute myocardial infarction associated with intravenous dipyridamole for rubidium-82 PET imaging  

SciTech Connect

This report describes the occurrence of chest pain and electrocardiographic features of acute myocardial infarction following intravenous dipyridamole-handgrip stress. Myocardial perfusion imaging (Rb-82 PET) demonstrated a stress-induced perfusion defect. Following failure to respond to medical therapy, urgent cardiac catheterization demonstrated total occlusion of the left anterior descending coronary artery. The vessel was revascularized, with limitation of myocardial damage evidenced by failure to develop anterior Q waves and only modest elevation of cardiac enzyme levels. Complications of intravenous dipyridamole stress are rare, this case constituting the first major problem in over 500 such procedures at this institution. However, this experience demonstrates the importance of vigilant observation during the performance of this technique.

Marwick, T.H.; Hollman, J. (Cleveland Clinic Foundation, OH (USA))

1990-03-01

303

ECG findings after myocardial infarction in children after Kawasaki disease  

SciTech Connect

Standard 12-lead ECGs were evaluated in 17 children with myocardial infarction and 78 children without myocardial infarction after Kawasaki disease; sensitivity and specificity of the ECG infarction criteria were determined. The presence or absence of myocardial infarction was determined from either clinical examination results (coronary angiography, ventriculography, and thallium-201 myocardial imaging) or autopsy findings. Of seven patients with inferior infarction, abnormally deep Q waves in lead II, III, or aVF were observed in six, but the duration was greater than 0.04 second in only one (14%). The sensitivity and specificity of inferior infarction criteria based on Q wave amplitude were 86% and 97%, respectively. Of eight patients with anterior infarction, seven (88%) had abnormally deep and wide (greater than or equal to 0.04 second) Q waves in anterior chest leads. The sensitivity and specificity of the infarction criteria based on the amplitude and duration of the Q wave were 75% and 99%, respectively. Of seven patients with lateral infarction, Q waves were observed in lead I, aVL, or both in four patients, and in all of these patients Q waves were wider than 0.04 second. In two patients with both inferior and anterior infarction, Q waves were observed only in leads II, III, and aVF; in only one patient were the Q waves wider than 0.04 second. Thus deep Q waves in lead II, III, or aVF that are not wider than 0.04 second may indicate inferior infarction in children. Q waves in lead I, aVL, and chest leads associated with anterolateral infarction are in most instances deep and wide.

Nakanishi, T.; Takao, A.; Kondoh, C.; Nakazawa, M.; Hiroe, M.; Matsumoto, Y.

1988-10-01

304

Effects of Nitroglycerin on Regional Myocardial Blood Flow in Coronary Artery Disease  

PubMed Central

Regional myocardial blood flow before and after sublingual nitroglycerin was measured in 10 patients with coronary artery disease. During thoracotomy, 133Xe was injected directly into the subepicardium in diseased regions of the anterior left ventricular wall, and washout rates were recorded with a scintillation counter. All disappearance curves were closely approximated by two exponential decays analyzed as two parallel flow systems by the compartmental method. The appearance of a double exponential decay pattern in diseased regions suggests that the slow phase was associated with collateral blood flow, although nonhomogeneous myocardium-to-blood partition coefficients for xenon cannot be excluded. Nitroglycerin increased the rapid phase flow in 9 of 10 patients and the slow flow in 7 of 10 patients. Average flow increased in 9 of the 10 patients (P < 0.01). Mean rapid phase flow in the control state was 110 ml/100 g per min and after nitroglycerin increased to 132 ml/100 g per min (P < 0.01); slow phase flow increased from 12 ml/100 g per min to 15 ml/100 g per min (P < 0.05). It is concluded that, under these conditions, nitroglycerin improves perfusion in regions of diseased myocardium in patients with coronary artery disease.

Horwitz, Lawrence D.; Gorlin, Richard; Taylor, Warren J.; Kemp, Harvey G.

1971-01-01

305

Transmural Myocardial Deformation in the Canine Left Ventricle Normal in Vivo Three-Dimensional Finite Strains  

Microsoft Academic Search

SUMMARY. To examine transmural finite deformation in the wall of the canine left ventricle, closely spaced columns of lead beads were implanted at a single site on the left ventricular free wall. The three-dimensional coordinates of these myocardial markers were obtained with high- speed biplane cineradiography. Any four noncoplanar markers forming small tetrahedral volumes («*0.1 cc) were used to calculate

Lewis K. Waldman; Y. C. Fung; James W. Covell

306

Early dilation of the infarcted segment in acute transmural myocardial infarction: role of infarct expansion in acute left ventricular enlargement.  

PubMed

Left ventricular enlargement after myocardial infarction is a poor prognostic sign, the mechanism of which has not been well defined. Early left ventricular dilation may be due to the Frank-Starling effect, which results in an increase in the length of uninfarcted segments in response to a reduction in contractile muscle mass. In contrast to this adaptive physiologic mechanism, left ventricular dilation may alternatively be caused by a pathologic process that stretches and thins the infarcted myocardial segment (that is, infarct expansion). To determine the relative contributions of these two mechanisms to left ventricular dilation after an initial transmural anterior myocardial infarction, two-dimensional echocardiograms were obtained from 27 patients within 72 hours of the onset of symptoms of myocardial infarction and from 13 healthy control subjects. In the minor-axis echocardiographic view at the level of the papillary muscles, anterior and posterior endocardial segment lengths at end-diastole were measured with a microprocessor-based graphic system. The papillary muscles were used as internal landmarks to demarcate the anterior and posterior segments. Anterior (infarcted) segment length in patients with myocardial infarction was 11.6 +/- 2.2 cm (mean +/- SD), whereas in control subjects, anterior segment length was 8.6 +/- 1.2 cm (p less than 0.001). Posterior (uninfarcted) segment length in the patients was not significantly different from posterior segment length in the control subjects (5.4 +/- 1.2 versus 5.3 +/- 1.0 cm, respectively). Measurable left ventricular dilation during the first 3 days after transmural anterior myocardial infarction is due to dilation of the infarcted segment and not of the normal uninfarcted segment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6234343

Erlebacher, J A; Weiss, J L; Weisfeldt, M L; Bulkley, B H

1984-08-01

307

Microdialysis separately monitors myocardial interstitial myoglobin during ischemia and reperfusion.  

PubMed

Direct monitoring of myoglobin efflux during ischemia and reperfusion has been limited because of inherent sample collection problems in the ischemic region. Recently, the cardiac dialysis technique has offered a powerful method for monitoring myocardial interstitial levels of low-molecular-weight compounds in the cardiac ischemic region. In the present study, we extended the molecular target to high-molecular-weight compounds by use of microdialysis probes with a high-molecular-mass cutoff and monitored myocardial interstitial myoglobin levels. A dialysis probe was implanted in the left ventricular free wall in anesthetized rabbits. The main coronary artery was occluded for 60 or 120 min. We examined the effects of myocardial ischemia and reperfusion on myocardial interstitial myoglobin levels. Interstitial myoglobin increased within 15 min of ischemia and continued to increase during 120 min of ischemia, whereas blood myoglobin increased at 45 min of ischemia. Lactate and myoglobin in the interstitial space increased during the same period. At 60 min of ischemia, reperfusion markedly accelerated interstitial myoglobin release. The interstitial myoglobin level was fivefold higher at 0-15 min of reperfusion than at 60-75 min of coronary occlusion. The dialysis technique permits earlier detection of myoglobin release and separately monitors myoglobin release during ischemia and reperfusion. Myocardial interstitial myoglobin levels can serve as an index of myocardial injury evoked by ischemia or reperfusion. PMID:15833797

Kitagawa, Hirotoshi; Yamazaki, Toji; Akiyama, Tsuyoshi; Sugimachi, Masaru; Sunagawa, Kenji; Mori, Hidezo

2005-08-01

308

Immunoscintigraphy for detecting acute myocardial infarction without electrocardiographic changes.  

PubMed Central

OBJECTIVE--To establish whether immunoscintigraphy with antibody to myosin may detect acute myocardial infarction without electrocardiographic changes. DESIGN--Prospective study of patients with suspected acute myocardial infarction or unstable angina with cardiac imaging with 111indium myosin antibody, estimation of cardiac enzyme concentrations, electrocardiography, 201thallium imaging, and radionuclide ventriculography. SETTING--Coronary care unit in a district general hospital. PATIENTS--119 Consecutive patients with suspected acute myocardial infarction or unstable angina. Patients with cardiomyopathy, myocarditis, valvular heart disease, myocardial infarction or cardiac surgery in the previous two weeks or with left bundle branch block and women of childbearing age were excluded. RESULTS--Of 75 patients with suspected acute myocardial infarction, seven had no diagnostic electrocardiographic changes despite normal conduction patterns. Immunoscintigraphy with myosin antibody disclosed necrosis in all seven patients, which was localised in regions supplied by diseased coronary arteries in all but one. Six patients had abnormal images on 201thallium imaging, and all seven had abnormal wall motion at the site of antibody uptake. One patient with minimal left main stem and right coronary artery atheroma had uptake of antibody at two discrete sites. CONCLUSIONS--Immunoscintigraphy with antibody to myosin confirms myocardial infarction in the absence of electrocardiographic changes and discloses the site of infarction. Images FIG 1 FIG 2

Jain, D; Lahiri, A; Raftery, E B

1990-01-01

309

Acute myocardial infarction in a 35-year-old man with coronary artery aneurysm most probably caused by Kawasaki disease  

PubMed Central

We present a 35-year-old man with history of Kawasaki disease who referred with myocardial infarction, and angiography, revealing aneurysm of left main and left anterior descending coronary arteries. The patient underwent percutaneous coronary intervention and thrombectomy and was discharged after 6 d. Coronary artery sequels of Kawasaki disease should be considered as one of the underlying causes of acute myocardial infarction in young adults.

Parsa, Saeed Alipour; Khaheshi, Isa; Paydary, Koosha; Haybar, Habib

2014-01-01

310

Ischemia-induced alterations in myocardial (Na+ + K+)-ATPase and cardiac glycoside binding.  

PubMed Central

The effects of ischemia on the canine myocardial (Na+ + K+)-ATPase complex were examined in terms of alterations in cardiac glycoside binding and enzymatic activity. Ability of the myocardial cell to bind tritiated ouabain in vivo was assessed after 1, 2, and 6 h of coronary occlusion followed by 45 min of reperfusion, and correlated with measurements of in vitro (Na+ + K+)-ATPase activity and in vitro [3H]ouabain binding after similar periods of ischemia. Regional blood flow alterations during occlusion and reperfusion were simultaneously determined utilizing 15 mum radioactive microspheres to determine the degree to which altered binding of ouabain might be flow related. Anterior wall infarction was produced in 34 dogs by snaring of confluent branches of the left coronary system. Epicardial electrograms delineated ischemic and border zone areas. Coronary reperfusion after 2 and 6 h of occlusion was associated with impaired reflow of blood and markedly impaired uptake of [3H]ouabain in ischemic myocardium. In both groups, in vivo [3H]ouabain binding by ischemic tissue was reduced out of proportion to the reduction in flow. Despite near-complete restoration of flow in seven dogs occluded for 1 h and reperfused, [3H]ouabain remained significantly reduced to 58 +/- 9% of nonischemic uptake in subendocardial layers of the central zone of ischemia. Thus, when coronary flow was restored to areas of myocardium rendered acutely ischemia for 1 or more hours, ischemic zones demonstrated progressively diminished ability to bind ouabain. To determine whether ischemia-induced alteration in myocardial (Na+ + K+)-ATPase might underlie these changes, (Na+ + K+)-ATPase activity and [3H]ouabain binding were measured in microsomal fractions from ischemic myocardium after 1, 2, and 6 h of coronary occlusion. In animals occluded for 6 h, (Na+ + K+)-ATPase activity was significantly reduced by 40% in epicardial and by 35% in endocardial layers compared with nonischemic myocardium. Comparable reductions in in vitro [3H]ouabain binding were also demonstrated. Reperfusion for 45 min after occlusion for 6 h resulted in no significant restoration of enzyme activity when compared to the nonreperfused animals. In six animals occluded for 2 h, a time at which myocardial creatine phosphokinase activity remains unchanged, (Na+ + K+)-ATPase activity was reduced by 25% compared with nonischemic enzyme activity. In five dogs occluded for 1 h, (Na+ + K+)-ATPase activity in ischemic myocardium was unchanged from control levels. We conclude that reduced regional myocardial blood flow, local alterations in cellular milieu, and altered glycoside-binding properties of (Na+ + K+)-ATPase all participate in the reduction of cardiac glycoside binding observed after reperfusion of ischemic myocardium. In addition, after 2 or more hours of severe ischemia, myocardial (Na+ + K+)-ATPase catalytic activity is significantly reduced despite incubation in the presence of optimal substrate concentrations. Images

Beller, G A; Conroy, J; Smith, T W

1976-01-01

311

Usefulness of MRI to Differentiate Between Temporary and Long-Term Coronary Artery Occlusion in a Minimally Invasive Model of Experimental Myocardial Infarction  

SciTech Connect

The surgical technique employed to determine an experimental ischemic damage is a major factor in the subsequent process of myocardial scar development. We set out to establish a minimally invasive porcine model of myocardial infarction using cardiac contrast-enhanced magnetic resonance imaging (ce-MRI) as the basic diagnostic tool. Twenty-seven domestic pigs were randomized to either temporary or permanent occlusion of the left anterior descending artery (LAD). Temporary occlusion was achieved by inflation of a percutaneous balloon in the left anterior descending artery directly beyond the second diagonal branch. Occlusion was maintained for 30 or 45 min, followed by reperfusion. Permanent occlusion was achieved via thrombin injection. Thirteen animals died peri- or postinterventionally due to arrhythmias. Fourteen animals survived the 30-min ischemia (four animals; group 1), the 45-min ischemia (six animals; group 2), or the permanent occlusion (4 animals; group 3). Coronary angiography and ce-MRI were performed 8 weeks after coronary occlusion to document the coronary flow grade and the size of myocardial scar tissue. The LAD was patent in all animals in groups 1 and 2, with normal TIMI flow; in group 3 animals, the LAD was totally occluded. Fibrosis of the left ventricle in group 1 (4.9 {+-} 4.4%; p = 0.008) and group 2 (9.4 {+-} 2.9%; p = 0.05) was significantly lower than in group 3 (14.5 {+-} 3.9%). Wall thickness of the ischemic area was significantly lower in group 3 versus group 1 and group 2 (2.9 {+-} 0.3, 5.9 {+-} 0.7, and 6.1 {+-} 0.7 mm; p = 0.005). The extent of late enhancement of the left ventricle was also significantly higher in group 3 (16.9 {+-} 2.1%) compared to group 1 (5.3 {+-} 5.4%; p = 0.003) and group 2 (9.7 {+-} 3.4%, p = 0.013). In conclusion, the present model of minimally invasive infarction coupled with ce-MRI may represent a useful alternative to the open chest model for studies of myocardial infarction and scar development.

Abegunewardene, Nico, E-mail: nico@uni-mainz.de; Vosseler, Markus; Gori, Tommaso [Johannes Gutenberg-University Mainz, Second Medical Clinic (Germany); Hoffmann, Nico [Johannes Gutenberg-University Mainz, Section of Medical Physics (Germany); Schmidt, Kai-Helge; Becker, Dietmar [Johannes Gutenberg-University Mainz, Second Medical Clinic (Germany); Kreitner, Karl-Friedrich [Johannes Gutenberg-University Mainz, Clinic for Radiology (Germany); Petersen, Steffen E. [John Radcliffe Hospital, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR) (United Kingdom); Schreiber, Laura M. [Johannes Gutenberg-University Mainz, Section of Medical Physics (Germany); Horstick, Georg; Muenzel, Thomas [Johannes Gutenberg-University Mainz, Second Medical Clinic (Germany)

2009-09-15

312

Leukocyte behavior in atherosclerosis, myocardial infarction, and heart failure  

PubMed Central

Cardiovascular diseases claim more lives worldwide than any other. Etiologically, the dominant trajectory involves atherosclerosis, a chronic inflammatory process of lipid-rich lesion growth in the vascular wall that can cause life-threatening myocardial infarction (MI). Those who survive MI can develop congestive heart failure, a chronic condition of inadequate pump activity that is frequently fatal. Leukocytes – white blood cells – are important participants at the various stages of cardiovascular disease progression and complication. This review will discuss leukocyte function in atherosclerosis, myocardial infarction, and heart failure.

Swirski, Filip K.; Nahrendorf, Matthias

2013-01-01

313

3D perfusion mapping in the intact mouse heart after myocardial infarction using myocardial contrast echocardiography  

NASA Astrophysics Data System (ADS)

An intact mouse model of surgically-induced myocardial infarction (MI) caused by permanent occlusion of the Left Anterior Descending (LAD) coronary artery was studied. Normal mice with no occlusion were also studied as controls. For each mouse, contrast enhanced ultrasound images of the heart were acquired in parallel cross-sections perpendicular to the sternum at millimeter increments. For accurate 3D reconstruction, ECG gating and a tri-axial adjustable micromanipulator were used for temporal and spatial registration. Ultrasound images at steady-state of blood refilling were color-coded in each slice to show relative perfusion. Myocardial perfusion defects and necrosis were also examined postmortem by staining with Phthalo blue and TTC red dyes. Good correlation (R>0.93) in perfused area size was observed between in vivo measurements and histological staining. A 3D multi-slice model and a 3D rendering of perfusion distribution were created and showed a promising match with postmortem results, lending further credence to its use as a more comprehensive and more reliable tool for in vivo assessment of myocardial perfusion than 2D tomographic analysis.

Li, Yinbo; Yang, Zequan; French, Brent A.; Hossack, John A.

2005-04-01

314

Bone marrow mesenchymal stem cells improve myocardial function in a swine model of acute myocardial infarction.  

PubMed

The aim of the current study was to confirm the effect and elucidate the mechanism of bone marrow mesenchymal stem cells (BMSCs) in acute myocardial infarction (AMI). AMI was induced in mini?swine by ligating the left anterior descending coronary artery, and BMSCs (1x107) were injected via a sterile microinjection into the ischemic area. Six months postoperatively, electrocardiograph?gated single photon emission computed tomography revealed that the myocardial filling defect was reduced and the left ventricular ejection fraction was improved in the BMSC group compared with the control group (P<0.05). Histopathological examination indicated that, in the BMSC treatment group, the percentage of survived myocardial tissue and the vessel density were increased, and the percentage of apoptosis was decreased compared with controls (P<0.05). Reverse transcription?polymerase chain reaction results indicated that the expression levels of multiple inflammatory factors were significantly upregulated in the BMSC group compared with levels in the control group (P<0.05). In conclusion, the present study demonstrated that BMSC injection significantly improved cardiac function and reduced infarct size in six months, indicating that this method may be valuable for future study in clinical trials. PMID:25060678

Zhao, Jing-Jie; Liu, Xiao-Cheng; Kong, Feng; Qi, Tong-Gang; Cheng, Guang-Hui; Wang, Jue; Sun, Chao; Luan, Yun

2014-09-01

315

Myocardial viability assessment in 18FDG PET/CT study (18FDG PET myocardial viability assessment).  

PubMed

Accurate identification of viable myocardium is crucial in patient qualification for medical or surgical treatment. Only persons with confirmed cardiac viability will benefit from revascularization procedures. It is also well known, that the amount of viable myocardium assessed preoperatively is the best indicator of long term cardiac event free survival after cardiac intervention.There are several diagnostic approaches used in current clinical practice for assessment of myocardial viability. Analysis of wall thickness or myocardial contraction, evaluation of cardiac perfusion or metabolism can be assessed using following modalities: Echocardiography, Cardiac Molecular Imaging techniques (PET, SPECT), Cardiovascular MR or Cardiovascular CT. The article describes the methods and problems of viability assessment in 18FDG PET study. PET imaging has proved its accuracy and reproducibility for myocardial ischemia and viability assessment. However this unique in its ability for showing the particular substrate metabolism technique has unfortunately some disadvantages: currently achieved PET resolution is 0.4 cm. However the combined devices multislice computed tomography scanners with PET (PET/CT) are now widely used in clinical practice. This combination allows for wider morphologic assessments: coronary calcium scoring and non-invasive coronary angiography may be added to myocardial perfusion/metabolic imaging if necessary. PMID:23047574

Kobylecka, Ma?gorzata; M?czewska, Joanna; Fronczewska-Wieniawska, Katarzyna; Mazurek, Tomasz; P?azi?ska, Maria Teresa; Królicki, Leszek

2012-01-01

316

Myocardial infarction in young patients  

Microsoft Academic Search

Myocardial infarction in persons under the age of 45 years accounts for 6% to 10% of all myocardial infarctions in the United States. In this age group, it is predominantly a disease of men. Important risk factors include a family history of myocardial infarction before age 55 years, hyperlipidemia, smoking, and obesity. Unlike older patients, approximately half of young patients

Lubna Choudhury; James D Marsh

1999-01-01

317

A randomised double-blind control study of early intracoronary autologous bone marrow cell infusion in acute myocardial infarction (REGENERATE-AMI)  

PubMed Central

Introduction Acute myocardial infarction (AMI) remains a major cause of mortality and morbidity worldwide despite the latest therapeutic advances designed to decrease myocardial injury. Preclinical and emerging clinical evidence show that the intracoronary injection of autologous bone marrow mononuclear cells (BMCs) following AMI leads to improvement in left ventricular ejection function (LVEF). In this clinical trial we will for the first time assess the effect of early (<24?h) infusion of autologous BMCs following AMI on cardiac function. Methods and analysis REGENERATE-AMI is a double-blind, randomised, multicentre, placebo-controlled trial to determine whether early (<24?h) intracoronary infusion of BMCs improves LVEF after AMI. The study will enrol 100 patients presenting with an anterior AMI demonstrating anterior regional wall motion abnormality. Patients will be randomised to receive intracoronary infusion of BMCs or placebo (0.9% saline). Primary endpoint will be change in LVEF at 1?year compared to baseline, measured by cardiac MRI. Secondary endpoints at 6?months include the change in global LVEF relative to baseline measured by quantitative left ventriculography and echocardiography, as well as major adverse cardiac events which is also measured at 1?year. Ethics and dissemination The study will be performed in agreement with the Declaration of Helsinki and is approved by local ethics committee (NRES Committee London West London: 07/Q0603/76). Trial registration http://clincialtrials.gov (NCT00765453). The results of the trial will be published according to the CONSORT statement and will be presented at conferences and reported in peer-reviewed journals.

Hamshere, Stephen; Choudhury, Tawfiq; Jones, Daniel A; Locca, Didier; Mills, Peter; Rothman, Martin; Knight, Charles; Parmar, Mahesh; Agrawal, Samir; Martin, John; Mathur, Anthony

2014-01-01

318

[Acute myocardial infarction after wasp sting without anaphylactic reaction].  

PubMed

Bites of hymenopterans (bees, wasps and hornets) are very frequent phenomena that can stir up allergical reactions in venom-susceptible patients but that seldom provoke acute myocardial infarction. In the literature we can find case reports of myocardial infarction after bites of hymenopterans, and preceded by an allergic reaction (sometimes with angiographic evidence of undamaged coronary arteries). The pathophysiological determinant seems to be related to the chemical composition of hymenopterans venom, basically made up by vasoactive and thrombogenic substances able to create vasospasm and coronary thrombosis. Our report refers to a 65-year-old male patient without prior cardiological and allergic events who, bitten by a sharm of three bees, complains of an acute large anterior myocardial infarction with angiographic evidence of thrombotic lesion of the proximal left anterior descending artery treated with direct stenting with procedural success, without showing allergical symptoms. The pathophysiological determinant seems to be related to the release of vasoactive amines and thrombogenic substances contained into the hymenopterans venom, the former able to produce vasospasm, the latter able to create diffuse thrombosis. The use of adrenaline itself to counteract the possible systemic allergic reaction appears to advise against the treatment of patients with cardiological symptoms or coronary artery disease and because of its strong vasoactive activity (it leads, in fact, to vasoconstriction) and thrombogenic effects. PMID:15875504

Bongo, Angelo Sante; Fornaro, Gianluigi; Sansa, Mara; Macciò, Sergio; Rognoni, Andrea

2005-03-01

319

Ventricular outflow tract obstruction, systolic anterior motion and acute mitral regurgitation in Tako-Tsubo syndrome  

Microsoft Academic Search

Tako-Tsubo syndrome is characterized by ECG changes mimicking acute myocardial infarction, left ventricular wall motion abnormalities in the apical region with preserved function of base, and normal coronary arteries. We report the cases of two old women, presenting apical akinesis, basal hyperkinesis, severe systolic dysfunction and severe mitral regurgitation (MR). Doppler echocardiography showed a left ventricular outflow tract obstruction (LVOTO),

Natale Daniele Brunetti; Riccardo Ieva; Giuseppe Rossi; Nunziatina Barone; Luisa De Gennaro; Pier Luigi Pellegrino; Giovanni Mavilio; Andrea Cuculo; Matteo Di Biase

2008-01-01

320

Myocardial perfusion SPECT in a case of retropulmonary looping of left coronary artery in a baby after arterial switch surgery.  

PubMed

Pediatric myocardial perfusion imaging (MPI) is not a routine investigation in an Indian setting due to under referrals and logistic problems. However, MPI is a frequently performed and established modality of investigation in adults for the identification of myocardial ischemia and viability. We report myocardial perfusion scintigraphy in a case of retropulmonary looping of left coronary artery in a baby after arterial switch surgery. Adenosine stress MPI revealed a large infarct involving anterior segment with moderate reversible ischemia of the lateral left ventricular segment. Coronary angiogram later confirmed left main coronary artery ostial occlusion with retrograde collateral supply from dilated right coronary artery. PMID:24761067

Padma, Subramanyam; Sundaram, Palaniswamy Shanmuga

2014-04-01

321

Myocardial infarction in a patient with sickle cell trait. Treatment dilemmas and imaging findings at follow-up.  

PubMed

Background: A 43-year-old woman with a 2-hour history of chest pain presented with an anterior infarction and was referred for primary percutaneous coronary intervention. Investigations: Physical examination, electrocardiography, laboratory tests, coronary angiography, abdominal angiography, cardiac CT, histology, immunohistochemistry, intravascular ultrasound. Diagnosis: ST-segment elevation anterior myocardial infarction. Management: Coronary angiography, antithrombotic therapy, statin, angiotensin-converting enzyme inhibitor, thrombectomy, coronary artery bypass graft surgery. PMID:19608492

van Mieghem, Carlos; Ramcharitar, Steve; Barlis, Peter; Oosterhuis, Wolter; Kik, Charles; de Feyter, Pim; Serruys, Patrick W

2008-03-01

322

Objective anterior cruciate ligament testing.  

PubMed

We examined subjects with the Stryker knee laxity tester as part of the clinical examination to determine its usefulness in evaluating the anterior cruciate ligament. We measured 123 athletes with no history of knee injury, as well as 30 patients with ACL injury proven by arthroscopy, and 11 injured patients with intact ACL at arthroscopy. We recorded anterior and posterior tibial displacement at 20 degrees of knee flexion and 20 lbs force in each direction. Anterior laxity and side to side difference correlated with ACL injury; posterior and total AP laxity did not. In normal subjects, mean anterior laxity was 2.5 mm. Only 8% of normal knees had anterior laxity of 5 mm or more. Ten percent of normal subjects had a side to side difference of 2 mm or more. In ACL tears, mean laxity was 8.1 mm, with 94% measuring 5 mm or more. Of the subjects, 89% with unilateral ACL injury had an increase of 2 mm or more on the injured side. Ten of ten acute ACL tears were detected by these criteria, with no false positives. In injured knees with intact ACL, measurements did not differ significantly from normal. We found the objective knee laxity measurement to be a useful complement to clinical knee examination. PMID:3960778

Boniface, R J; Fu, F H; Ilkhanipour, K

1986-03-01

323

Arthroscopic Augmentation With Subscapularis Tendon in Anterior Shoulder Instability With Capsulolabral Deficiency  

PubMed Central

The treatment of chronic shoulder instability with poor quality of the anterior capsulolabral tissue is still controversial. In these cases the Latarjet procedure is certainly more effective in preventing recurrence than an arthroscopic capsular repair. However, several studies have reported a variety of severe complications related to the Latarjet procedure because of the use of bone augmentation and hardware implantation; moreover, the arthroscopic version of the Latarjet procedure is technically difficult and potentially dangerous because of the proximity of neurovascular structures. The aim of this report is to describe an innovative arthroscopic technique consisting of an augmentation of the anterior capsulolabral tissue using the articular portion of the subscapularis tendon and knotless suture anchors paired with high-strength tape for its fixation to the anterior glenoid edge. In the absence of severe bone deficiency of the anterior glenoid edge, this procedure can minimize arthroscopic technique failures, restoring the anterior capsulolabral wall without any significant reduction of shoulder functionality.

Maiotti, Marco; Massoni, Carlo

2013-01-01

324

Thallium myocardial perfusion scans for the assessment of right ventricular hypertrophy in patients with cystic fibrosis. A comparison with other noninvasive techniques  

SciTech Connect

The incidence of right ventricular hypertrophy in 32 patients with cystic fibrosis was studied using thallium 201 (TI-201) myocardial perfusion scans, and compared with other noninvasive techniques including electrocardiography, vectorcardiography, and M-mode echocardiography. The patients (mean age, 17.3 yr; range, 7 to 33) had a wide range of clinical and pulmonary abnormalities (mean Shwachman-Kulczycki score, 66.6). In the total study group, TI-201 scans, like the vectorcardiograms and the M-mode echocardiograms, gave a surprisingly high proportion of positive predictions for right ventricular hypertrophy (RVH) (44%). The correlations with all other noninvasive methods were uniformly poor, so caution must be exercised in using this technique to predict early RVH in order to follow the natural history of cor pulmonale in cystic fibrosis. At the time of the study, 6 patients had clinical evidence of right ventricular failure, and in this disease setting must have had RVH. In 3 patients, RVH was confirmed at autopsy, and it was successfully predicted by TI-201 scans in 5 of the 6 patients. The false negative scan may have been due to regional myocardial ischemia secondary to severe right ventricular failure. In contrast, the vectorcardiogram, using Fowler's new criteria, made a successful prediction of RVH in all 6 patients, and the electro cardiogram in only 3. Although the M-mode echocardiogram was abnormal in all patients, it would have predicted RVH (with increased right ventricular anterior wall thickness) in only 1 patient. We concluded that TI-201 myocardial perfusion cans are good at confirming RVH in cases with established right ventricular failure, but have no advantage over vectorcardiographic assessments, which are logistically easier to perform and carry no radiation risks.

Newth, C.J.; Corey, M.L.; Fowler, R.S.; Gilday, D.L.; Gross, D.; Mitchell, I.

1981-01-01

325

A Novel Stress Echocardiography Pattern for Myocardial Bridge With Invasive Structural and Hemodynamic Correlation  

PubMed Central

Background Patients with a myocardial bridge (MB) and no significant obstructive coronary artery disease (CAD) may experience angina presumably from ischemia, but noninvasive assessment has been limited and the underlying mechanism poorly understood. This study seeks to correlate a novel exercise echocardiography (EE) finding for MBs with invasive structural and hemodynamic measurements. Methods and Results Eighteen patients with angina and an EE pattern of focal end?systolic to early?diastolic buckling in the septum with apical sparing were prospectively enrolled for invasive assessment. This included coronary angiography, left anterior descending artery (LAD) intravascular ultrasound (IVUS), and intracoronary pressure and Doppler measurements at rest and during dobutamine stress. All patients were found to have an LAD MB on IVUS. The ratios of diastolic intracoronary pressure divided by aortic pressure at rest (Pd/Pa) and during dobutamine stress (diastolic fractional flow reserve [dFFR]) and peak Doppler flow velocity recordings at rest and with stress were successfully performed in 14 patients. All had abnormal dFFR (?0.75) at stress within the bridge, distally or in both positions, and on average showed a more than doubling in peak Doppler flow velocity inside the MB at stress. Seventy?five percent of patients had normalization of dFFR distal to the MB, with partial pressure recovery and a decrease in peak Doppler flow velocity. Conclusions A distinctive septal wall motion abnormality with apical sparing on EE is associated with a documented MB by IVUS and a decreased dFFR. We posit that the septal wall motion abnormality on EE is due to dynamic ischemia local to the compressed segment of the LAD from the increase in velocity and decrease in perfusion pressure, consistent with the Venturi effect.

Lin, Shin; Tremmel, Jennifer A.; Yamada, Ryotaro; Rogers, Ian S.; Yong, Celina Mei; Turcott, Robert; McConnell, Michael V.; Dash, Rajesh; Schnittger, Ingela

2013-01-01

326

Reversibility by dipyridamole of thallium-201 myocardial scan defects in patients with sarcoidosis  

SciTech Connect

In order to clarify the significance of anginal pain and myocardial thallium-201 scan defects in cardiac sarcoidosis, the pharmacologic effect of dipyridamole on myocardial perfusion was assessed by planar thallium-201 myocardial scintigraphy in patients with sarcoidosis. Thallium-201 myocardial scintigraphy was performed at rest and after 0.56 mg/kg intravenous dipyridamole during four minutes in 16 patients with sarcoidosis. The myocardial scan (45-degree and 70-degree left anterior oblique, and anterior views) was divided into 15 segments. Results were evaluated by the number of segmental defects and with a global perfusion score (from 0 to 60) by a semi-quantitative index depending on the size and severity of myocardial thallium-201 defects. Thirteen of the 16 patients showed partial or total reversion of their thallium-201 defects on redistribution scanning either at rest or after dipyridamole. The mean (+/- SD) number of myocardial perfusion defects that were present in all the patients decreased from 5.31 +/- 1.78 at rest to 3.25 +/- 2.52 after redistribution (p less than 0.001) and to 2.19 +/- 2.10 after dipyridamole (p less than 0.001). The mean global perfusion score increased from 53.2 +/- 3.0 at rest to 56.2 +/- 2.9 after redistribution (p less than 0.001) and to 57.2 +/- 2.7 after dipyridamole (p less than 0.001). A significant correlation (r = 0.82, p less than 0.001) was found between the increase of global perfusion score on redistribution and after dipyridamole. The reversibility of myocardial scan defects is a common finding in sarcoidosis. It makes unlikely the role of scar fibrosis or extensive confluent granulomas as a mechanism for such defects. The effect of dipyridamole suggests the presence of reversible disorders lying at the coronary microvascular level.

Tellier, P.; Paycha, F.; Antony, I.; Nitenberg, A.; Valeyre, D.; Foult, J.M.; Battesti, J.P.

1988-08-01

327

Speckle tracking echocardiography: A new approach to myocardial function  

PubMed Central

Echocardiography is the most common diagnostic method for assessing cardiac function but some limitations affect this technique. Until now, visual assessment of wall motion and thickening has allowed only a subjective evaluation of myocardial function and requires long-term training. Recently, new echocardiographic techniques have been introduced to evaluate myocardial mechanics. Tissue Doppler imaging (TDI) technique is limited by angle-dependency such that only deformation along the ultrasound beam can be derived from velocities, while myocardium deforms simultaneously in three dimensions. Speckle tracking echocardiography (STE) is a more recent technique that provides a global approach to left ventricular myocardial mechanics, giving information about the three spatial dimensions of cardiac deformation. In this editorial, we describe the physical and pathophysiological concepts of STE, discussing the differences compared to TDI and underlining the pitfalls of this new technique.

Sitia, Simona; Tomasoni, Livio; Turiel, Maurizio

2010-01-01

328

Left Atrial Myxoma: A Rare Nonatherosclerotic Cause of Acute Myocardial Infarction  

PubMed Central

Myocardial infarction from coronary artery embolism is a very rare but potentially lethal sequel of left atrial myxoma. Most atrial myxomas causing myocardial infarction are diagnosed retrospectively after a 2D echocardiogram is performed for assessment of myocardial function after a myocardial infarction. We present a relatively healthy 53-year-old male with anterolateral wall myocardial infarction and 100% occlusion at the proximal part of the obtuse marginal branch of the circumflex coronary artery that was subsequently reperfused. A 2D echocardiogram performed two days later revealed a left atrial mass, which was successfully resected and proven to be a myxoma. No recurrence of the tumor was seen on follow-up after four months. An automatic implantable cardioverter defibrillator was placed for residual ischemic cardiomyopathy with clinical improvement.

Arcenas, Rey Francisco; Ali, Mir Ishtiaque

2013-01-01

329

Chyloretroperitoneum following anterior spinal surgery.  

PubMed

Injury to the lymphatic channels is a rare and relatively unknown complication of anterior approaches to the lumbar spine and can cause fluid to build up in the retroperitoneal space, resulting in a lymphocele. If they enlarge sufficiently, these collections of chyle in the abdomen can cause pain and bowel ischemia, and can compress nearby organs. The authors report 4 cases in which anterior approaches to the lumbar spine were complicated by a postoperative retroperitoneal chylous fluid collection. They describe the anatomy of the lymphatic system and pathophysiology of this disease entity, review the sparse literature on this subject, and recommend a treatment algorithm. Maintaining a high index of suspicion for this clinical entity in patients who have recently undergone an anterior approach to the thoracic or lumbar spine is vital to avoid delays in diagnosis and treatment. PMID:22978438

Hussain, Namath S; Hanscom, David; Oskouian, Rod J

2012-11-01

330

[Myocardial viability assessment].  

PubMed

The prognosis for patients with chronic coronary artery disease and severe left ventricular dysfunction is poor, despite advances in different therapies. The assessment of myocardial viability has become an important aspect of the diagnosis, prognosis and management of patients with ischemic cardiomyopathy. Patients with left ventricular dysfunction, with a substantial amount of severely ischemic myocardium are at highest risk, and are likely to benefit from coronary revascularization. Patients with predominantly scar tissue should be treated medically. Multiple imaging techniques have been developed to assess viable and nonviable myocardium by evaluating perfusion, cell membrane integrity, glucose metabolism, fibrosis and contractile reserve. PET FDG-F18, myocardial perfusion scintigraphy (with (201)Tl and (99m)Tc), dobutamine stress echocardiography and more recently magnetic resonance have been extensively evaluated for assessment of viability and prediction of clinical outcome after coronary revascularization. In general, nuclear imaging techniques have a higher sensitivity for the detection of viability, whereas techniques evaluating contractile reserve have higher specificity (with lower sensitivity). Magnetic resonance has a high diagnostic accuracy for assessment of the transmural extent of myocardial scar tissue. The aim of this article is to review the role of Nuclear Medicine in assessing myocardial viability and risk stratification in patients with advanced left ventricular dysfunction, and to compare it with other imaging modalities. PMID:22863509

Fernandes, Hélder; Sousa, Alexandra; Campos, José; Patrício, José; Oliveira, Patrícia; Vieira, Tiago; Oliveira, Ana; Faria, Teresa; Perez, Berta; Martins, Elisabete; Pereira, Jorge

2011-12-01

331

[Assessment of myocardial function and perfusion by MRI two days and four months after acute myocardial infarction revascularised by primary angioplasty].  

PubMed

The extent of gadolinium enhancement assessed by cardiac MRI is an accepted marker of myocardial necrosis. The correlation between late enhancement and other parameters of infarct size after myocardial infarction have previously been described. However, the prognostic value of the extent of late enhancement in terms of myocardial recovery remains controversial especially in revascularised infarcts analysed by early MRI. In order to clarify this question the authors compared the results of MRI at two days and four months after myocardial infarction benefiting from early revascularisation. Between July 2002 and November 2004, the authors included patients with myocardial infarction treated by primary angioplasty and examined by MRI (Siemens Symphony 1.5 T) at two days and three to five months after myocardial infarction. The left ventricular ejection fraction, volume, mass and wall thickness were measured. Perfusion at first passage (PP) and late enhancement were analysed after injection of 20 cc of gadolinium. An eight segment short axis model was used for PP and analysis of late enhancement. Each segment was assessed for transmural or subendocardial hypoperfusion for PP assessment and the wall thickness with late enhancement (1-25%, 26-50%, 51-75%, and 76-100%) was measured to calculate the percentage of myocardial mass showing late enhancement. Thirty-nine patients (thirty three men) were included. The average age was 59 +/- 10 years. TIMI III flow was obtained in all but one (TIMI II) patient. Cardiac MRI was performed 2.1 +/- 1.5 days and 4.6 +/- 1.7 months after myocardial infarction. The ejection fraction increased from 48.7 +/- 12.6% to 54.2 +/- 11.1%, p<0.05, and was related to infarct size (p<0.01). Forty-eight per cent of dysfunctional segments at the initial MRI improved their contractility and the extent of transmural late enhancement was inversely correlated with wall thickening at initial (p<0.01) and four month MRI (p<0.01). The PP improved significantly (regression from 9.5 +/- 8.2% to 2.8 +/- 4.1% of segments with abnormal myocardial perfusion, p<0.01). The late enhancement with respect to total myocardial mass decreased from 20.0 +/- 10.7% to 13.0 +/- 8.1%, p<0.01). Despite restoring TIMI III flow, early myocardial reperfusion is incomplete and improves in the medium term. The authors also observed a reduction in late enhancement at four months, indicating that the results immediately after myocardial infarction may overestimate the infarct size and that this sign does not represent necrotic tissue alone but also viable myocardium with a potential for recovery. PMID:18032999

Noël, B; Morice, M-C; Kokis, A; Garot, J; Dumas, P; Louvard, Y; Tavolaro, O; Lévy, M; Lefèvre, T

2007-09-01

332

Regional myocardial shape and dimensions of the working isolated canine left ventricle  

NASA Technical Reports Server (NTRS)

The extent to which the dynamic shape and dimensions of the isolated left ventricular myocardial wall differ throughout the myocardium and how these differences are characteristic of the anatomic location was demonstrated. The use of a biplane X-ray technique and a metabolically-supported isolated canine left ventricle preparation provided an angiographically ideal means of measuring mechanical dynamics of the myocardium while the intact left ventricular myocardial structure and electrical activation pattern retains most of the in situ ventricular characteristics.

Ritman, E. L.; Tsuiki, K.; Donald, D.; Wood, E. H.

1975-01-01

333

Combined low dose dipyridamole-dobutamine stress echocardiography to identify myocardial viability  

Microsoft Academic Search

Objectives. We sought to evaluate the effects of combined administration of infra-low dose dipyridamole and low dose dobutamine on assessment of myocardial viability.Background. Low dose pharmacologic stress echocardiography with either dobutamine or dipyridamolc infusion has been proposed for the recognition of myocardial viability.Methods. Thirty-four patients with rest wall motion dyssynergy by two-dimensional echocardiography and with angiographically proved coronary artery disease

Eugenio Picano; Miodrag Ostojic; Albert Varga; Rosa Sicari; Ana Djordjevic-Dikic; Ivana Nedeljkovic; Marco Torres

1996-01-01

334

Scaling of Myocardial Mass to Flow and Morphometry of Coronary Arteries  

PubMed Central

There is no doubt that scaling relations exist between myocardial mass and morphometry of coronary vasculature. The purpose of this study is to quantify several morphological (diameter, length, and volume) and functional (flow) parameters of the coronary arterial tree in relation to myocardial mass. Eight normal porcine hearts of 117-244 g (mean of 177.5±32.7) were used in this study. Various coronary sub-trees of the Left Anterior Descending (LAD), Right Coronary (RCA) and Left Circumflex (LCX) arteries were perfused at pressure of 100 mmHg with different colors of a polymer (Microfil) in order to obtain rubber casts of arterial trees corresponding to different regions of myocardial mass. Volume, diameter and cumulative length of coronary arteries were reconstructed from casts to analyze their relationship to the perfused myocardial mass. Volumetric flow was measured in relationship with perfused myocardial mass. Our results show that arterial volume is linearly related to regional myocardial mass, whereas the sum of coronary arterial branch lengths, vessel diameters and volumetric flow show an approximately 3/4, 3/8 and 3/4 power-law relationship, respectively, in relation to myocardial mass. These scaling laws suggest fundamental design principles underlying the structure-function relationship of the coronary arterial tree that may facilitate diagnosis and management of diffuse coronary artery disease.

Choy, Jenny Susana; Kassab, Ghassan S.

2009-01-01

335

Quantitative Texture Analysis and Transesophageal Echocardiography to Characterize the Acute Myocardial Contusion  

PubMed Central

Myocardial contusion (MC) is a common injury following blunt chest trauma without any specific symptoms. Several techniques such as electrocardiogram, estimation of myocardial band fraction of creatine phosphokinase, chest radiography and the scintiscanning missed efficiency to characterize the MC. Another technique based on transesophageal echocardiography [TEE] allows to visualize the structures of the heart with a good spatial resolution. We postulated that the quantitative texture analysis of regional image texture in two- dimensional [2D] TEE echocardiograms would be an accurate method to differentiate normal from abnormal myocardial wall. This preliminary experimental study demonstrated the feasibility of the proposed technique.

Amichi, Abdelaziz; Laugier, Pascal

2009-01-01

336

Wall Tension  

NSDL National Science Digital Library

This page of Hyperphysics, from Georgia State University, develops the relationship between tension, pressure, and radius in a balloon. The same ideas are then applied to the walls of spherical and cylindrical containers. Several links provide further information.

Nave, Carl R.

2007-11-15

337

Wall Turbulence.  

ERIC Educational Resources Information Center

This paper gives an account of research on the structure of turbulence close to a solid boundary. Included is a method to study the flow close to the wall of a pipe without interferring with it. (Author/JN)

Hanratty, Thomas J.

1980-01-01

338

Diagnostic value of image processing in myocardial scintigraphy  

SciTech Connect

The diagnostic value of stress myocardial analog scintigrams, and of five image-processing methods, was assessed by a decisional analysis in 96 patients undergoing coronary arteriography. The methods involved digitalization, nine-point binomial smoothing, background subtraction by linear interpolation, stationary filtering, and a combination of them. The difference between after-test probabilities of having the disease with a postive or a negative examination provided a discriminant index for different prevalences of the disease. Though the processing methods failed to improve the detection of a circumflex stenosis, the stationary filter significantly increased the diagnostic value for the detection of stenosis in a left anterior descending artery for a large range of prevalence, and in a right coronary artery at high prevalence. Thus, the filter seemed to provide a useful tool for enhancing the diagnostic value of myocardial scintigraphy.

Cinotti, L.; Meignan, M.; Usdin, J.P.; Vasile, N.; Castaigne, A.

1983-09-01

339

Diagnostic value of image processing in myocardial scintigraphy  

SciTech Connect

The diagnostic value of stress myocardial analog scintigrams, and of five image-processing methods, was assessed by a decisional analysis in 96 patients undergoing coronary arteriography. The methods involved digitalization, nine-point binomial smoothing, background subtraction by linear interpolation, stationary filtering, and a combination of them. The difference between after-test probabilities of having the disease with a positive or a negative examination provided a discriminant index for different prevalences of the disease. Though the processing methods failed to improve the detection of a circumflex stenosis, the stationary filter significantly increased the diagnostic value for the detection of stenosis in a left anterior descending artery for a large range of prevalence, and in a right coronary artery at high prevalence. Thus, the filter seemed to provide a useful tool for enhancing the diagnostic value of myocardial scintigraphy.

Cinotti, L.; Meignan, M.; Usdin, J.P.; Vasile, N.; Castaigne, A.

1983-09-01

340

Eyelash in the anterior chamber.  

PubMed

We present the case of a patient who had surgery for cataract extraction by phacoemulsification method and that the first day after surgery one lash was found in the anterior chamber of the eye. The lash was removed the same day, the postoperative refraction being 1.0. Starting from this case, therapeutic attitude is presented in different intracameral foreign bodies. PMID:20361650

Vámosi, P; Horvath, Karin

2009-01-01

341

Imaging of Anterior Knee Pain  

Microsoft Academic Search

nterior knee pain (AKP) is a common complaint in primary care and orthopedic clinics. In fact, in the sports medicine clinic, up to 25% of patients with knee complaints have symptoms of anterior knee pain (1). Adolescent females and other young individuals are at particular risk for AKP. In these individuals, symptoms are usually related to increased use, fre- quently

Stephen R. Christian; M. Bret Anderson; Ronald Workman; William F. Conway; Thomas L. Pope

2006-01-01

342

Attachment of anterior tooth fragments  

Microsoft Academic Search

This investigation examined the relationships of tooth preparation and resin material types in repair of fractured anterior teeth by reattachment of fractured tooth fragments. A total of 44 extracted maxillary central incisors were tested. Statistical analysis revealed that no mechanical preparation of the enamel was as retentive as a 45°-circumferential bevel (p K.01). In addition, light-cured resin proved to be

Jeffrey A. Dean; Marjorie L. Swartz; David R. Avery

1986-01-01

343

Access related complications during anterior exposure of the lumbar spine  

PubMed Central

The new millennium has witnessed the emergence of minimally invasive, non-posterior based surgery of the lumbar spine, in particular via lateral based methodologies to discectomy and fusion. In contrast, and perhaps for a variety of reasons, anterior motion preservation (non-fusion) technologies are playing a comparatively lesser, though incompletely defined, role at present. Lateral based motion preservation technologies await definition of their eventual role in the armamentarium of minimally invasive surgical therapies of the lumbar spine. While injury to the major vascular structures remains the most serious and feared complication of the anterior approach, this occurrence has been nearly eliminated by the use of lateral based approaches for discectomy and fusion cephalad to L5-S1. Whether anterior or lateral based, non-posterior approaches to the lumbar spine share certain access related pitfalls and complications, including damage to the urologic and neurologic structures, as well as gastrointestinal and abdominal wall issues. This review will focus on the recognition, management and prevention of these anterior and lateral access related complications.

Fantini, Gary A; Pawar, Abhijit Y

2013-01-01

344

Diagnostic Ultrasound Induced Inertial Cavitation to Non-Invasively Restore Coronary and Microvascular Flow in Acute Myocardial Infarction  

PubMed Central

Ultrasound induced cavitation has been explored as a method of dissolving intravascular and microvascular thrombi in acute myocardial infarction. The purpose of this study was to determine the type of cavitation required for success, and whether longer pulse duration therapeutic impulses (sustaining the duration of cavitation) could restore both microvascular and epicardial flow with this technique. Accordingly, in 36 hyperlipidemic atherosclerotic pigs, thrombotic occlusions were induced in the mid-left anterior descending artery. Pigs were then randomized to either a) ½ dose tissue plasminogen activator (0.5 mg/kg) alone; or same dose plasminogen activator and an intravenous microbubble infusion with either b) guided high mechanical index short pulse (2.0 MI; 5 usec) therapeutic ultrasound impulses; or c) guided 1.0 mechanical index long pulse (20 usec) impulses. Passive cavitation detectors indicated the high mechanical index impulses (both long and short pulse duration) induced inertial cavitation within the microvasculature. Epicardial recanalization rates following randomized treatments were highest in pigs treated with the long pulse duration therapeutic impulses (83% versus 59% for short pulse, and 49% for tissue plasminogen activator alone; p<0.05). Even without epicardial recanalization, however, early microvascular recovery occurred with both short and long pulse therapeutic impulses (p<0.005 compared to tissue plasminogen activator alone), and wall thickening improved within the risk area only in pigs treated with ultrasound and microbubbles. We conclude that although short pulse duration guided therapeutic impulses from a diagnostic transducer transiently improve microvascular flow, long pulse duration therapeutic impulses produce sustained epicardial and microvascular re-flow in acute myocardial infarction.

Xie, Feng; Gao, Shunji; Wu, Juefei; Lof, John; Radio, Stanley; Vignon, Francois; Shi, William; Powers, Jeffry; Unger, Evan; Everbach, E. Carr; Liu, Jinjin; Porter, Thomas R.

2013-01-01

345

[Usefulness of 201Tl/123I-BMIPP myocardial SPECT to evaluate myocardial viability and area at risk in acute myocardial infarction--comparison with 201Tl/99mTc-PYP dual SPECT].  

PubMed

To evaluate the area at risk and the myocardial viability of acute myocardial infarction (AMI), we compared rest 123I-beta-methyl iodophenyl pentadecanoic acid (123I-BMIPP) and 201Tl myocardial SPECT with 201Tl/99mTc-PYP dual SPECT (D-SPECT) in 65 patients (mean age 64 +/- 11 years) with AMI. D-SPECT was performed in 3 to 5 days, 123I-BMIPP myocardial SPECT in 5 to 7 days, and left ventriculography on 1 month after onset of AMI. Furthermore, 201Tl/123I-BMIPP myocardial SPECT and left ventriculography were performed on 4 months after onset of AMI. The area which showed the reduced 123I-BMIPP uptake was larger than that showed the accumulation of 99mTc-PYP. The improvement of regional wall motion on 4 months after onset of AMI tended to be more closely correlated with the existence of discrepancy zone between 201Tl and 123I-BMIPP uptake than that of overlap zone between 201Tl and 99mTc-PYP uptake in acute period. We conclude that 201Tl/123I-BMIPP myocardial SPECT is more useful to evaluate the area at risk and myocardial viability of AMI than D-SPECT. PMID:9183144

Isobe, N; Toyama, T; Hoshizaki, H; Oshima, S; Taniguchi, K

1997-04-01

346

Orbital wall approach with preoperative orbital imaging for identification and retrieval of lost or transected extraocular muscles  

Microsoft Academic Search

Purpose: To report the results of an anterior approach along the orbital wall to recover a lost or transected extraocular muscle. Methods: This is a retrospective review of lost or transected muscles retrieved by an anterior orbitotomy approach to the adjacent orbital wall because they were unable to be recovered by a standard conjunctival approach. Magnetic resonance imaging or computed

Jerald P. Underdahl; Joseph L. Demer; Robert L. Goldberg; Arthur L. Rosenbaum

2001-01-01

347

Left ventricular regional wall curvedness and wall stress in patients with ischemic dilated cardiomyopathy  

PubMed Central

Geometric remodeling of the left ventricle (LV) after myocardial infarction is associated with changes in myocardial wall stress. The objective of this study was to determine the regional curvatures and wall stress based on three-dimensional (3-D) reconstructions of the LV using MRI. Ten patients with ischemic dilated cardiomyopathy (IDCM) and 10 normal subjects underwent MRI scan. The IDCM patients also underwent delayed gadolinium-enhancement imaging to delineate the extent of myocardial infarct. Regional curvedness, local radii of curvature, and wall thickness were calculated. The percent curvedness change between end diastole and end systole was also calculated. In normal heart, a short- and long-axis two-dimensional analysis showed a 41 ± 11% and 45 ± 12% increase of the mean of peak systolic wall stress between basal and apical sections, respectively. However, 3-D analysis showed no significant difference in peak systolic wall stress from basal and apical sections (P = 0.298, ANOVA). LV shape differed between IDCM patients and normal subjects in several ways: LV shape was more spherical (sphericity index = 0.62 ± 0.08 vs. 0.52 ± 0.06, P < 0.05), curvedness at end diastole (mean for 16 segments = 0.034 ± 0.0056 vs. 0.040 ± 0.0071 mm?1, P < 0.001) and end systole (mean for 16 segments = 0.037 ± 0.0068 vs. 0.067 ± 0.020 mm?1, P < 0.001) was affected by infarction, and peak systolic wall stress was significantly increased at each segment in IDCM patients. The 3-D quantification of regional wall stress by cardiac MRI provides more precise evaluation of cardiac mechanics. Identification of regional curvedness and wall stresses helps delineate the mechanisms of LV remodeling in IDCM and may help guide therapeutic LV restoration.

Zhong, Liang; Su, Yi; Yeo, Si-Yong; Tan, Ru-San; Ghista, Dhanjoo N.; Kassab, Ghassan

2009-01-01

348

Quantitative analysis of regional myocardial performance in coronary artery disease  

NASA Technical Reports Server (NTRS)

Findings from a group of subjects with significant coronary artery stenosis are given. A group of controls determined by use of a quantitative method for the study of regional myocardial performance based on the frame-by-frame analysis of biplane left ventricular angiograms are presented. Particular emphasis was placed upon the analysis of wall motion in terms of normalized segment dimensions, timing and velocity of contraction. The results were compared with the method of subjective assessment used clinically.

Stewart, D. K.; Dodge, H. T.; Frimer, M.

1975-01-01

349

Diagnosing CAD: additional markers from myocardial perfusion SPECT  

PubMed Central

Over the past decades, stress/rest myocardial perfusion SPECT (MPS) has been utilized as a standard modality for the diagnosis, risk stratification and prognostic assessment of coronary artery disease (CAD). In addition to the perfusion information, MPS can also provide functional information of the left ventricle, including volume, ejection fraction, wall motion and dyssynchrony. This article introduces the incremental value of these non-perfusion parameters as markers and prognosticators of CAD.

Hung, Guang-Uei

2013-01-01

350

Prednisone induced two-way myocardial development in a patient with systemic lupus erythematosus.  

PubMed

We present a series of echocardiography images to demonstrate the myocardial response to a high dose of prednisone. A young woman with systemic lupus erythematosus (SLE) associated with interventricular septal hypertrophy exhibited a high pressure gradient between the ascending aorta and left ventricular outflow tract as well as significant systolic anterior motion (SAM) and mitral regurgitation (MR) during high-dose prednisone treatment. However, the pressure gradient decreased dramatically and the MR disappeared rapidly when the dose of prednisone was reduced. To the best of our knowledge, this is the only adult case of myocardial hypertrophy that is assumed to be related to prednisone use. PMID:24789158

Jiang, Meng; Pu, Jun; Shen, Xue-Dong; He, Ben

2014-01-01

351

Effects of olprinone on myocardial ischemia-reperfusion injury in dogs.  

PubMed

We investigated the effect of olprinone on canine myocardial pump function and myocardial damage after ischemia-reperfusion injury. Three dogs of the experimental group were given olprinone (Olprinone group) and another 3 dogs were served as control (Intact group). All animals were occluded left anterior descending artery for 60 min, followed by 6 hr of reperfusion. In the experiment, hemodynamics, infarct area, creatine kinase and troponin-I were measured. Olprinone infusion induced significantly high cardiac output value and significantly low values in left ventricular end diastolic pressure and systemic vascular resistance index after reperfusion. Also, olprinone tend to attenuate the infarct area, creatine kinase and troponin-I. PMID:16953089

Setoyama, Kentaro; Kamimura, Ryozo; Fujiki, Makoto; Misumi, Kazuhiro; Miyahara, Kenkichi; Sakamoto, Hiroshi

2006-08-01

352

Myocardial infarct quantification in the dog by single photon emission computed tomography. [\\/sup 99m\\/Tc-pyrophosphate  

Microsoft Academic Search

Radionuclide techniques for sizing acute myocardial infarction have been hampered by the intrinsic limitations of the scintillation camera. Emission computed tomography can overcome these limitations. Single photon emission computed tomograms of the distribution of technetium-99m pyrophosphate in acute anterior and posterior infarcts were obtained in 16 dogs after death. Tomograms were also obtained in 10 dogs during life without gating.

J. W. Jr. Keyes; P. F. Leonard; S. L. Brody; D. J. Svetkoff; W. L. Rogers; B. R. Lucchesi

1978-01-01

353

Bucindolol, a beta blocker, decreased ventricular fibrillation and maintained mechanical function in a pig model of acute myocardial ischemia  

Microsoft Academic Search

Bucindolol is a new beta blocker with marked vasodilatory properties and intrinsic sympathomimetic activity. We tested its potential effect against ventricular fibrillation (VF), in a pig model of acute myocardial ischemia. Bucindolol 6 mg\\/kg IV was administered in two equally divided doses, the first 30 minutes prior to, and the second 10 minutes after, ligation of the anterior descending coronary

Cecilia A. Muller; Lionel H. Opie; Carlos A. Pineda; Max Peisach

1992-01-01

354

Therapeutic Angiogenesis and Myocardial Regeneration  

Microsoft Academic Search

Ischemic heart disease is the leading cause of morbidity and mortality in the Western world. The term “ischemic heart disease”\\u000a covers a broad spectrum of manifestations ranging from effort-induced angina without myocardial damage, through stages of\\u000a chronic myocardial ischemia with associated reversible impairment in ventricular function, to states of irreversible myocardial\\u000a injury and necrosis resulting in congestive heart failure (CHF).

G. Chad Hughes; Brian H. Annex

355

Regional Myocardial Blood Flow*  

PubMed Central

A method is described which measures the local effectiveness of the myocardial circulation, expressed as a clearance constant. Uniform clearance constants have been demonstrated in the normal canine and human myocardium. A distinct difference in clearance constants has been demonstrated between the normal canine myocardium and areas of naturally occurring disease. Heterogeneous clearance constants have been found in a majority of human subjects with coronary artery disease—the lowest rates being noted in areas of fibrous aneurysm.

Sullivan, Jay M.; Taylor, Warren J.; Elliott, William C.; Gorlin, Richard

1967-01-01

356

Myocardial gene therapy  

NASA Astrophysics Data System (ADS)

Gene therapy is proving likely to be a viable alternative to conventional therapies in coronary artery disease and heart failure. Phase 1 clinical trials indicate high levels of safety and clinical benefits with gene therapy using angiogenic growth factors in myocardial ischaemia. Although gene therapy for heart failure is still at the pre-clinical stage, experimental data indicate that therapeutic angiogenesis using short-term gene expression may elicit functional improvement in affected individuals.

Isner, Jeffrey M.

2002-01-01

357

Myocardial Tagging With SSFP  

PubMed Central

This work presents the first implementation of myocardial tagging with refocused steady-state free precession (SSFP) and magnetization preparation. The combination of myocardial tagging (a noninvasive method for quantitative measurement of regional and global cardiac function) with the high tissue signal-to-noise ratio (SNR) obtained with SSFP is shown to yield improvements in terms of the myocardium–tag contrast-to-noise ratio (CNR) and tag persistence when compared to the current standard fast gradient-echo (FGRE) tagging protocol. Myocardium–tag CNR and tag persistence were studied using numerical simulations as well as phantom and human experiments. Both quantities were found to decrease with increasing imaging flip angle (?) due to an increased tag decay rate and a decrease in myocardial steady-state signal. However, higher ? yielded better blood–myocardium contrast, indicating that optimal ? is dependent on the application: higher ? for better blood–myocardium boundary visualization, and lower ? for better tag persistence. SSFP tagging provided the same myocardium–tag CNR as FGRE tagging when acquired at four times the bandwidth and better tag– and blood–myocardium CNRs than FGRE tagging when acquired at equal or twice the receiver bandwidth (RBW). The increased acquisition efficiency of SSFP allowed decreases in breath-hold duration, or increases in temporal resolution, as compared to FGRE.

Herzka, Daniel A.; Guttman, Michael A.; McVeigh, Elliot R.

2007-01-01

358

Traumatic abdominal wall hernia  

PubMed Central

INTRODUCTION Traumatic abdominal wall hernia (TAWH) is a rare entity. Most cases occur in children, following an injury from the bicycle handle bar. In adults, it usually results from road traffic accidents (RTA). We present one of the largest reported cases of TAWH following RTA managed by delayed mesh repair. PRESENTATION OF CASE A 35 yr old obese male with RTA was diagnosed with TAWH with 19 cm × 15 cm defect in left flank. As there were no intra abdominal injuries and overlying skin was abraded, he was planned for elective repair after 6 months. On exploration a defect of 30 cm × 45 cm was found extending from midline anteriorly to 8 cm short of midline posteriorly in transverse axis and costal margin to iliac crest in craniocaudal axis. After restoration of bowel into abdominal cavity, primary closure or even approximation of muscular defect was not possible thus a mesh closure using 60 cm × 60 cm prolene mesh in subcutaneous plane was done. After 4 months follow up, patient is healthy and has no recurrence. DISCUSSION Emergent surgical management of TAWH is usually favoured due to high incidence of associated intra abdominal injuries. Delayed repair may be undertaken in selected cases. CONCLUSION TAWH, although rare, should be suspected in cases of RTA with abdominal wall swellings. With time, the hernia defect may enlarge and muscles may undergo atrophy making delayed repair difficult.

Yadav, Siddharth; Jain, Sunil K.; Arora, Jainendra K.; Sharma, Piyush; Sharma, Abhinav; Bhagwan, Jai; Goyal, Kaushal; Sahoo, Bhabani S.

2012-01-01

359

The effects of hypoxemia on myocardial blood flow during exercise.  

PubMed

We evaluated the adequacy of regional and transmural blood flow during exercise and rapid pacing after 1 wk of hypoxemia. Seven mature mongrel dogs were made hypoxemic (mean O2 saturation = 72.4%) by anastomosis of left pulmonary artery to left atrial appendage. Catheters were placed in the left atrium, right atrium, pulmonary artery, and aorta. Atrial and ventricular pacing wires were placed. An aortic flow probe was placed to measure cardiac output. Ten nonshunted dogs, similarly instrumented, served as controls. Recovery time was approximately 1 wk. Cardiac output, mean aortic pressure, and oxygen saturation were measured at rest, with ventricular pacing, atrial pacing, and with treadmill exercise. Ventricular and atrial pace and exercise were at a heart rate of 200. Right ventricular free wall, left ventricular free wall, and septal blood flow were measured with radionuclide-labeled microspheres. Cardiac output, left atrial blood pressure, and aortic blood pressure were similar between the two groups of dogs in all testing states. Myocardial blood flow was significantly higher in the right and left ventricular free wall in the hypoxemic animals during resting and exercise testing states. Myocardial oxygen delivery was similar between the two groups of animals. Pacing resulted in an increase in myocardial blood flow in the control animals but not the hypoxemic animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2704596

Paridon, S M; Bricker, J T; Dreyer, W J; Reardon, M; Smith, E O; Porter, C B; Michael, L; Fisher, D J

1989-03-01

360

Does Intraoperative Evaluation of Left Ventricular Contractile Reserve Predict Myocardial Viability? A Clinical Study Using Dobutamine Stress Echocardiography in Patients Undergoing Coronary Artery Bypass Graft Surgery  

Microsoft Academic Search

To determine the contractile reserve of the left ventricle dur- ing reperfusion as a predictor of myocardial viability in pa- tients undergoing coronary artery bypass graft surgery, we measured the response of left ventricular regional wall mo- tion and thickening by using dobutamine stress echocardi- ography (DSE) after myocardial revascularization. All pa- tients were monitored with radial and pulmonary arterial

Jancqueline M. Leung; Wayne H. Bellows; Darwin Pastor

2004-01-01

361

Analysis of First-Pass and Delayed Contrast-Enhancement Patterns of Dysfunctional Myocardium on MR Imaging: Use in the Prediction of Myocardial Viability  

Microsoft Academic Search

OBJECTIVE. The purpose of the study was to analyze first-pass and delayed contrast-en- hancement patterns of dysfunctional myocardial regions on MR imaging after injection of gado- pentetate dimeglumine to predict myocardial viability in patients with coronary artery disease. SUBJECTS AND METHODS. Twelve patients with wall motion abnormalities and re- lated coronary artery disease revealed by conventional coronary angiography underwent MR

Jörn J. W. Sandstede; Claudia Lipke; Meinrad Beer; Kerstin Harre; Thomas Pabst; Werner Kenn; Stefan Neubauer; Dietbert Hahn

2000-01-01

362

'Stucco' Walls  

NASA Technical Reports Server (NTRS)

This projected mosaic image, taken by the microscopic imager, an instrument located on the Mars Exploration Rover Opportunity 's instrument deployment device, or 'arm,' shows the partial clotting or cement-like properties of the sand-sized grains within the trench wall. The area in this image measures approximately 3 centimeters (1.2 inches) wide and 5 centimeters (2 inches) tall.(This image also appears as an inset on a separate image from the rover's navigation camera, showing the location of this particular spot within the trench wall.)

2004-01-01

363

Assessment of single vessel coronary artery disease: results of exercise electrocardiography, thallium-201 myocardial perfusion imaging and radionuclide angiography  

SciTech Connect

The sensitivity of the commonly used stress tests for the diagnosis of coronary artery disease was analyzed in 46 patients with significant occlusion (greater than or equal to 70% luminal diameter obstruction) of only one major coronary artery and no prior myocardial infarction. In all patients, thallium-201 perfusion imaging (both planar and seven-pinhole tomographic) and 12 lead electrocardiography were performed during the same graded treadmill exercise test and radionuclide angiography was performed during upright bicycle exercise. Exercise rate-pressure (double) product was 22,307 +/- 6,750 on the treadmill compared with 22,995 +/- 5,622 on the bicycle (p = NS). Exercise electrocardiograms were unequivocally abnormal in 24 patients (52%). Qualitative planar thallium images were abnormal in 42 patients (91%). Quantitative analysis of the tomographic thallium images were abnormal in 41 patients (89%). An exercise ejection fraction of less than 0.56 or a new wall motion abnormality was seen in 30 patients (65%). Results were similar for the right (n = 11) and left anterior descending (n = 28) coronary arteries while all tests but the planar thallium imaging showed a lower sensitivity for isolated circumflex artery disease (n = 7). The specificity of the tests was 72, 83, 89 and 72% for electrocardiography, planar thallium imaging, tomographic thallium imaging and radionuclide angiography, respectively. The results suggest that exercise thallium-201 perfusion imaging is the most sensitive noninvasive stress test for the diagnosis of single vessel coronary artery disease.

Port, S.C.; Oshima, M.; Ray, G.; McNamee, P.; Schmidt, D.H.

1985-07-01

364

Improved Biometry of the Anterior Eye Segment  

Microsoft Academic Search

In this paper, a method is presented to evaluate the true values of several optical parameters of the anterior eye segment. These are: the thicknesses of the cornea and lens, the depth of the anterior chamber and the anterior and posterior curvatures of the cornea and lens. First, a photo is taken of each patient’s eye with a Topcon SL-45

T. Kampfer; A. Wegener; V. Dragomirescu; O. Hockwin

1989-01-01

365

Injectable myocardial matrix as a scaffold for myocardial tissue engineering  

Microsoft Academic Search

Current injectable materials utilized in myocardial tissue engineering have been borrowed from other tissue engineering applications and have not been specifically designed for the myocardium. We have recently tested the feasibility of using an injectable form of myocardial extracellular matrix that would provide cardiac specific matrix cues as well as be amenable to minimally invasive delivery. We have demonstrated that

Jennifer M. Singelyn; Jessica A. DeQuach; Karen L. Christman

2009-01-01

366

Cryptotanshinone, a lipophilic compound of Salvia miltiorrriza root, inhibits TNF-?-induced expression of adhesion molecules in HUVEC and attenuates rat myocardial ischemia\\/reperfusion injury in vivo  

Microsoft Academic Search

The aim of the present study was to evaluate the protective effect of cryptotanshinone (CTS), one of active ingredients of Salvia miltiorrhiza root, on myocardial ischemia-reperfusion injury in rat due to inhibition of some inflammatory events that occur by NF-kB-activation during ischemia and reperfusion. Myocardial ischemia and reperfusion injury was induced by occluding the left anterior descending coronary artery for

Yong Chun Jin; Chun Wook Kim; Young Min Kim; Irina Tsoy Nizamutdinova; Yu Mi Ha; Hye Jung Kim; Han Geuk Seo; Kun Ho Son; Su Jin Jeon; Sam Sik Kang; Yeong Shik Kim; Sung-Chul Kam; Jea Heun Lee; Ki Churl Chang

2009-01-01

367

[Acute myocardial infarction after blunt polytrauma -- successful coronary intervention].  

PubMed

Acute myocardial infarction following blunt chest trauma is a well reported but rare finding. Especially in severely injured patients the optimal therapy of the myocardial infarction is not well established, since anticoagulants, platelet aggregation inhibitors or thrombolytics are frequently contraindicated under these conditions. We report a case of a 41-year-old man, who presented with an acute myocardial infarction in combination with a severe polytrauma (multiple rib fractures, hematothorax, pelvic bone fractures, multiple injuries of intestinal organs) after a motorcycle accident with a blunt chest and abdominal trauma. After surgical treatment of the injuries of the bones and the intestinal organs a coronary angiography was immediately performed. The left anterior descending and the circumflex coronary artery were occluded in the mid-portion of the vessels. Coronary recanalization by PTCA and the implantation of coronary stents were successful in both vessels. Despite of a non-optimal blood flow after recanalization and stenting in one vessel (LAD TIMI II flow after recanalization), and a non-optimal accompanying medical therapy, during and after intervention (intravenous heparin starting 8 hours after the coronary intervention and platelet inhibitors starting 4 days after the intervention) the coronary angiogram after 2 months documented both vessels patent without a reocclusion or a restenosis. The case report documents, that in traumatic myocardial infarctions the treating of both, the attending injuries and the myocardial ischemia, is feasible. Early coronary angiography and coronary interventions, with or without stent-implantation, are indicated, even in cases in which an adequate accompanying medical therapy with heparin and platelet inhibitors is contraindicated. PMID:12557122

Mauser, M; Schwenk, M; Schmelzeisen, H; Fleischmann, D; Fösel, T

2003-02-01

368

Wall Covering  

NASA Technical Reports Server (NTRS)

The attractive wall covering shown below is one of 132 styles in the Mirror Magic II line offered by The General Tire & Rubber Company, Akron, Ohio. The material is metallized plastic fabric, a spinoff from space programs. Wall coverings are one of many consumer applications of aluminized plastic film technology developed for NASA by a firm later bought by King-Seeley Thermos Company, Winchester, Massachusetts, which now produces the material. The original NASA use was in the Echo 1 passive communications satellite, a "space baloon" made of aluminized mylar; the high reflectivity of the metallized coating enabled relay of communications signals from one Earth station to another by "bouncing" them off the satellite. The reflectivity feature also made the material an extremely efficient insulator and it was subsequently widely used in the Apollo program for such purposes as temperature control of spacecraft components and insulation of tanks for fuels that must be maintained at very low temperatures. I Used as a wall covering, the aluminized material offers extra insulation, reflects light and I resists cracking. In addition to General Tire, King-Seeley also supplies wall covering material to Columbus Coated Fabrics Division of Borden, Incorporated, Columbus, Ohio, among others.

1978-01-01

369

Prevalence and prognostic value of left ventricular dysfunction in non-Q-wave myocardial infarction.  

PubMed

Forty-two consecutive patients with non-Q-wave acute myocardial infarction (AMI) and 40 consecutive patients with transmural AMI were comparatively examined by equilibrium gated radionuclide angiography (ERNA) to assess prevalence and prognostic value of left ventricular dysfunction in non-Q-wave AMI. Left ventricular ejection (LVEF) was generally preserved both in anterior and inferior non-Q-wave infarctions and sharply reduced only in anterior transmural infarctions. ERNA cannot assist in identifying any subgroup of patients with non-Q-wave AMI at risk of major complications other than left ventricular failure because they may develop such complications in spite of a normal LVEF. PMID:3628021

Palagi, B; Baroffio, R; Picozzi, R

1987-06-01

370

Identifying Early Changes in Myocardial Microstructure in Hypertensive Heart Disease  

PubMed Central

The transition from healthy myocardium to hypertensive heart disease is characterized by a series of poorly understood changes in myocardial tissue microstructure. Incremental alterations in the orientation and integrity of myocardial fibers can be assessed using advanced ultrasonic image analysis. We used a modified algorithm to investigate left ventricular myocardial microstructure based on analysis of the reflection intensity at the myocardial-pericardial interface on B-mode echocardiographic images. We evaluated the extent to which the novel algorithm can differentiate between normal myocardium and hypertensive heart disease in humans as well as in a mouse model of afterload resistance. The algorithm significantly differentiated between individuals with uncomplicated essential hypertension (N?=?30) and healthy controls (N?=?28), even after adjusting for age and sex (P?=?0.025). There was a trend in higher relative wall thickness in hypertensive individuals compared to controls (P?=?0.08), but no difference between groups in left ventricular mass (P?=?0.98) or total wall thickness (P?=?0.37). In mice, algorithm measurements (P?=?0.026) compared with left ventricular mass (P?=?0.053) more clearly differentiated between animal groups that underwent fixed aortic banding, temporary aortic banding, or sham procedure, on echocardiography at 7 weeks after surgery. Based on sonographic signal intensity analysis, a novel imaging algorithm provides an accessible, non-invasive measure that appears to differentiate normal left ventricular microstructure from myocardium exposed to chronic afterload stress. The algorithm may represent a particularly sensitive measure of the myocardial changes that occur early in the course of disease progression.

Hiremath, Pranoti; Bauer, Michael; Aguirre, Aaron D.; Cheng, Hui-Wen; Unno, Kazumasa; Patel, Ravi B.; Harvey, Bethany W.; Chang, Wei-Ting; Groarke, John D.; Liao, Ronglih; Cheng, Susan

2014-01-01

371

Vaginal Myomectomy for a Thirteen-Centimeter Anterior Myoma  

PubMed Central

Vaginal myomectomy is an uncommon but advantageous approach for large interstitial uterine fibroids. Myomectomy is performed via laparotomy and laparoscopy; however, in selected cases, vaginal myomectomy has been proven to be a safe and an effective surgical procedure. We report the case of a 38-year-old para one woman with complaints of chronic lower abdominal pain. Preoperative workup revealed a thirteen-centimeter interstitial uterine myoma in the anterior wall. Successful myomectomy was performed via the vaginal route. We will share the preoperative images, operative technique, and postoperative images.

Deval, Bruno; Rousset, Pascal

2013-01-01

372

Beta endorphin release in patients after spontaneous and provoked acute myocardial ischaemia.  

PubMed Central

BACKGROUND--In animal models of circulatory shock and heart failure concentrations of the endogenous opioid peptide beta endorphin are raised and opioid receptor blockade improves haemodynamic variables and survival. This study was performed to identify whether acute myocardial ischaemia provokes the release of beta endorphin in humans. METHODS--Observational study in a university cardiology centre. Serial measurements of beta endorphin made by specific radioimmunoassay were correlated with other clinical and neuroendocrine variables that were measured prospectively. Fifty five patients with acute myocardial ischaemia and 26 patients undergoing elective coronary angioplasty of the left anterior descending coronary artery were studied. RESULTS--beta endorphin concentrations were raised above the upper limit of normal in 31/42 (74%) patients with confirmed myocardial infarction, 3/13 (23%) patients with unstable angina, and 10/24 (42%) patients after coronary angioplasty. There was no evidence of myocardial release of beta endorphin. There were significant positive correlations between beta endorphin and the concentrations of adrenocorticotrophic hormone, cortisol, and arginine vasopressin. In patients with acute myocardial ischaemia there was a significant positive correlation between the peak concentrations of creatine kinase and beta endorphin but no correlation with visual analogue scores of the intensity of chest pain. The highest beta endorphin concentrations were seen in patients whose clinical course was complicated by the development of heart failure. CONCLUSIONS--beta endorphin release is a component of the neuroendocrine activation associated with myocardial ischaemia/infarction. Images

Oldroyd, K G; Harvey, K; Gray, C E; Beastall, G H; Cobbe, S M

1992-01-01

373

A Nonthoracotomy Myocardial Infarction Model in an Ovine Using Autologous Platelets  

PubMed Central

Objective. There is a paucity of a biological large animal model of myocardial infarction (MI). We hypothesized that, using autologous-aggregated platelets, we could create an ovine model that was reproducible and more closely mimicked the pathophysiology of MI. Methods. Mepacrine stained autologous platelets from male sheep (n = 7) were used to create a myocardial infarction via catheter injection into the mid-left anterior descending (LAD) coronary artery. Serial daily serum troponin measurements were taken and tissue harvested on post-embolization day three. Immunofluorescence microscopy was used to detect the mepacrine-stained platelet-induced thrombus, and histology performed to identify three distinct myocardial (infarct, peri-ischemic “border zone,” and remote) zones. Results. Serial serum troponin levels (?g/mL) measured 0.0 ± 0.0 at baseline and peaked at 297.4 ± 58.0 on post-embolization day 1, followed by 153.0 ± 38.8 on day 2 and 76.7 ± 19.8 on day 3. Staining confirmed distinct myocardial regions of inflammation and fibrosis as well as mepacrine-stained platelets as the cause of intravascular thrombosis. Conclusion. We report a reproducible, unique model of a biological myocardial infarction in a large animal model. This technique can be used to study acute, regional myocardial changes following a thrombotic injury.

Spata, Tyler; Bobek, Daniel; Whitson, Bryan A.; Parthasarathy, Sampath; Mohler, Peter J.; Higgins, Robert S. D.; Kilic, Ahmet

2013-01-01

374

Significance of 99mTc-Sestamibi myocardial scintigraphy after percutaneous coronary intervention in patients with acute myocardial infarction  

PubMed Central

Summary Background This study was designed to clarify the significance of washout rate (WR) determined from 99mTc-sestamibi myocardial scintigraphic images and the levels of cardiac enzymes in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Material/Methods A total of 56 consecutive patients with AMI (mean age 65.8±8.5 years), who underwent PCI on admission, were included. Cardiac enzyme, the MB isoenzyme of creatinine kinase (CK-MB), was measured every 3 h after admission. Two weeks after the onset of AMI, 99mTc-sestamibi myocardial scintigraphy was performed at early (30 min) and delayed (4 h) phases after tracer injection. The heart-to-mediastinum ratio (H/M) and WR were calculated from the planar images. Results PCI was performed at 9.4±6.0 h after the onset of AMI. In 26 patients the culprit lesion was located in the right coronary artery and in 24 patients it was located in the left anterior descending coronary artery. The peak CK-MB was 274.1±169.4 IU/L (13.5±3.9 h). The early and delayed H/Ms and WR of 99mTc-sestamibi were 2.74±0.58, 3.00±0.70, and 58.8±10.0%, respectively. The delayed H/M was significantly correlated with the peak CK-MB (r=?0.37, p=0.005). The WR of 99mTc-sestamibi was also significantly correlated with the peak CK-MB (r=?0.34, p=0.012). Conclusions These results suggest that the WR determined from 99mTc-sestamibi myocardial scintigraphic images reflects the extent of myocardial damage in AMI patients.

Akashi, Yoshihiro J.; Ashikaga, Kohei; Takano, Makoto; Izumo, Masaki; Ishibashi, Yuki; Kida, Keisuke; Yoneyama, Kihei; Suzuki, Kengo; Miyake, Fumihiko; Banach, Maciej

2011-01-01

375

Biomarkers in acute myocardial infarction  

Microsoft Academic Search

Myocardial infarction causes significant mortality and morbidity. Timely diagnosis allows clinicians to risk stratify their patients and select appropriate treatment. Biomarkers have been used to assist with timely diagnosis, while an increasing number of novel markers have been identified to predict outcome following an acute myocardial infarction or acute coronary syndrome. This may facilitate tailoring of appropriate therapy to high-risk

Daniel Chan; Leong L Ng

2010-01-01

376

Anatomical variations of anterior communicating artery.  

PubMed

Introduction: The Circle of Willis is a vascular network formed at the base of skull in the interpeduncular fossa. Its anterior part is formed by the anterior cerebral artery, from either side. Anterior communicating artery connects the right and left anterior cerebral arteries. Posteriorly, the basilar artery divides into right and left posterior cerebral arteries and each joins to ipsilateral internal carotid artery through a posterior communicating artery. Anterior communicating artery, an important component of circle of Willis, acts as collateral channel to stabilize blood flow. In the present study, anatomical variations in the anterior communicating artery were noted. Material and Methods: One hundred apparently normal formalin fixed brain specimens were collected from human cadavers. Normal anatomical pattern and variations of anterior communicating artery were studied. The anterior communicating arteries were then coloured, photographed, numbered and the abnormalities, if any, were noted. Result: Thity eight variant anterior communicating arteries were noted. The most common variation observed in the anterior communicating artery was its duplication in 10 subjects, followed by its absence in 8 subjects. Some variations like plexus formation, median artery were found in adults, because of persistence of embryonic pattern. Conclusion: Knowledge on variations in the anterior communicating artery is of clinical significance, as it is one of the components of circle of Willis which stabilizes cerebral blood flow when principle conduits fail. PMID:24551604

Kardile, Poorwa Baburao; Ughade, Jaideo Manohar; Pandit, Sudhir Vishnupant; Ughade, Manohar Namdeo

2013-12-01

377

Anatomical Variations of Anterior Communicating Artery  

PubMed Central

Introduction: The Circle of Willis is a vascular network formed at the base of skull in the interpeduncular fossa. Its anterior part is formed by the anterior cerebral artery, from either side. Anterior communicating artery connects the right and left anterior cerebral arteries. Posteriorly, the basilar artery divides into right and left posterior cerebral arteries and each joins to ipsilateral internal carotid artery through a posterior communicating artery. Anterior communicating artery, an important component of circle of Willis, acts as collateral channel to stabilize blood flow. In the present study, anatomical variations in the anterior communicating artery were noted. Material and Methods: One hundred apparently normal formalin fixed brain specimens were collected from human cadavers. Normal anatomical pattern and variations of anterior communicating artery were studied. The anterior communicating arteries were then coloured, photographed, numbered and the abnormalities, if any, were noted. Result: Thity eight variant anterior communicating arteries were noted. The most common variation observed in the anterior communicating artery was its duplication in 10 subjects, followed by its absence in 8 subjects. Some variations like plexus formation, median artery were found in adults, because of persistence of embryonic pattern. Conclusion: Knowledge on variations in the anterior communicating artery is of clinical significance, as it is one of the components of circle of Willis which stabilizes cerebral blood flow when principle conduits fail.

Kardile, Poorwa Baburao; Ughade, Jaideo Manohar; Pandit, Sudhir Vishnupant; Ughade, Manohar Namdeo

2013-01-01

378

Cardiac wall tracking using Doppler tissue imaging (DTI)  

Microsoft Academic Search

Doppler tissue imaging (DTI) is a new technique that provides image information on values of intramyocardial wall velocity. This specific capability makes easier the automatic myocardial boundary extraction and tracking task. We apply a variation on active contour models to an M-mode ultrasound image. This is in fact an image made from a time sequence of digitized 1D images. To

Laurent D. Cohen; Floris Pajany; Denis Pellerin; Colette Veyrat

1996-01-01

379

The clinical usefulness of electrocardiogram-gated Tc99 m methoxy-isobutyl-isonitrile images in the detection of basal wall motion abnormalities and reversibility of stress induced perfusion defects  

Microsoft Academic Search

Technetium-99 m methoxy-isobutyl-isonitrile (SESTAMIBI) has been recently introduced to trace regional myocardial perfusion. Beyond blood flow distribution, a quantitative index of regional myocardial wall motion from SESTAMIBI electrocardiogram (ECG)-gated images was obtained, according to the assumption that changes in the detected radioactivity reflect changes in myocardial wall thickness during the cardiac cycle. As a preliminary study, 20 patients with coronary

Paolo Marzullo; Claudio Marcassa; Gianmario Sambuceti; Oberdan Parodi; Antonio L'Abbate

1992-01-01

380

Reference values for fetal tissue velocity imaging and a new approach to evaluate fetal myocardial function  

PubMed Central

Objectives Myocardial function can be evaluated using color-coded tissue velocity imaging (TVI) to analyze the longitudinal myocardial velocity profile, and by expressing the motion of the atrioventricular plane during a cardiac cycle as coordinated events in the cardiac state diagram (CSD). The objective of this study was to establish gestational age specific reference values for fetal TVI measurements and to introduce the CSD as a potential aid in fetal myocardial evaluation. Methods TVI recordings from 125 healthy fetuses, at 18 to 42 weeks of gestation, were performed with the transducer perpendicular to the apex to provide a four-chamber view. The myocardial velocity data was extracted from the basal segment of septum as well as the left and right ventricular free wall for subsequent offline analysis. Results During a cardiac cycle the longitudinal peak velocities of septum increased with gestational age, as did the peak velocities of the left and right ventricular free wall, except for the peak velocity of post ejection. The duration of rapid filling and atrial contraction increased during pregnancy while the duration of post ejection decreased. The duration of pre ejection and ventricular ejection did not change significantly with gestational age. Conclusion Evaluating fetal systolic and diastolic performance using TVI together with CSD could contribute to increase the knowledge and understanding of fetal myocardial function and dysfunction. The pre and post ejection phases are the variables most likely to indicate fetuses with abnormal myocardial function.

2013-01-01

381

The role of capillary transit time heterogeneity in myocardial oxygenation and ischemic heart disease.  

PubMed

Ischemic heart disease (IHD) is characterized by an imbalance between oxygen supply and demand, most frequently caused by coronary artery disease (CAD) that reduces myocardial perfusion. In some patients, IHD is ascribed to microvascular dysfunction (MVD): microcirculatory disturbances that reduce myocardial perfusion at the level of myocardial pre-arterioles and arterioles. In a minority of cases, chest pain and reductions in myocardial flow reserve may even occur in patients without any other demonstrable systemic or cardiac disease. In this topical review, we address whether these findings might be caused by impaired myocardial oxygen extraction, caused by capillary flow disturbances further downstream. Myocardial blood flow (MBF) increases approximately linearly with oxygen utilization, but efficient oxygen extraction at high MBF values is known to depend on the parallel reduction of capillary transit time heterogeneity (CTH). Consequently, changes in capillary wall morphology or blood viscosity may impair myocardial oxygen extraction by preventing capillary flow homogenization. Indeed, a recent re-analysis of oxygen transport in tissue shows that elevated CTH can reduce tissue oxygenation by causing a functional shunt of oxygenated blood through the tissue. We review the combined effects of MBF, CTH, and tissue oxygen tension on myocardial oxygen supply. We show that as CTH increases, normal vasodilator responses must be attenuated in order to reduce the degree of functional shunting and improve blood-tissue oxygen concentration gradients to allow sufficient myocardial oxygenation. Theoretically, CTH can reach levels such that increased metabolic demands cannot be met, resulting in tissue hypoxia and angina in the absence of flow-limiting CAD or MVD. We discuss these predictions in the context of MVD, myocardial infarction, and reperfusion injury. PMID:24743925

Ostergaard, Leif; Kristiansen, Steen Buus; Angleys, Hugo; Frøkiær, Jørgen; Michael Hasenkam, J; Jespersen, Sune Nørhøj; Bøtker, Hans Erik

2014-05-01

382

A method for myocardial contraction force reconstruction for tissue viability assessment  

NASA Astrophysics Data System (ADS)

Myocardial infarction results in myocardial necrosis, usually caused by an imbalance in the oxygen supply and demand to myocardial tissue. To our knowledge there is no technique that can provide quantitative direct information concerning the intensity, extent and location of the infarction. Contraction forces generated by cardiac tissues represent a quantitative and direct measure of the myocardial functionality, since it is expected that infarcted tissue generate little or no contraction force. Our objective is to develop a biomechanics based reconstruction technique to image myocardial contraction forces, for the purpose of assessing the viability of cardiac tissues. This technique is designed to reconstruct the contraction forces by inverting myocardial tissue displacement data acquired throughout heart beat cycles using conventional imaging techniques. Recognizing that myocardial contraction force distribution is 3D, we assumed an axisymmetric myocardial geometry to demonstrate the concept. With this assumption, the inversion algorithm was developed and implemented in 2D space. As a preliminary analysis, a simulation involving a 2D representation of myocardial wall tissue was carried out. The tissue was modeled as a homogeneous material with isotropic and linear elastic material properties. Assuming an axisymmetric contraction force distribution, a finite element analysis was performed on the tissue model, and a 2D displacement field was generated. The developed inversion algorithm was then employed to reconstruct the force distribution, which was ultimately compared to the original force field. The reconstruction error, estimated as the difference between the two force fields and normalized by the magnitude of the reference distribution, averaged to +/-10%. Results demonstrate that our myocardial contraction force reconstruction algorithm is reasonably accurate and robust.

Linte, Cristian A.; Peters, Terry M.; Samani, Abbas

2006-03-01

383

Assessment of myocardial viability.  

PubMed

The prevalence of left ventricular (LV) dysfunction and resultant congestive heart failure is increasing. Patients with this condition are at high risk for cardiac death and usually have significant limitations in their lifestyles. Although there have been advances in medical therapy resulting in improved survival and well being, the best and most definitive therapy, when appropriate, is revascularization. In the setting of coronary artery disease, accounting for approximately two thirds of cases of congestive heart failure, LV dysfunction often is not the result of irreversible scar but rather caused by impairment in function and energy use of still viable-myocytes, with the opportunity for improved function if coronary blood flow is restored. Patients with LV dysfunction who have viable myocardium are the patients at highest risk because of the potential for ischemia but at the same time benefit most from revascularization. It is important to identify viable myocardium in these patients, and radionuclide myocardial scintigraphy is an excellent tool for this. Single-photon emission computed tomography perfusion scintigraphy, whether using thallium-201, Tc-99m sestamibi, or Tc-99m tetrofosmin, in stress and/or rest protocols, has consistently been shown to be an effective modality for identifying myocardial viability and guiding appropriate management. Metabolic imaging with positron emission tomography radiotracers frequently adds additional information and is a powerful tool for predicting which patients will have an improved outcome from revascularization, including some patients referred instead for cardiac transplantation. Other noninvasive modalities, such as stress echocardiography, also facilitate the assessment of myocardial viability, but there are advantages and disadvantages compared with the nuclear techniques. Nuclear imaging appears to require fewer viable cells for detection, resulting in a higher sensitivity but a lower specificity than stress echocardiography for predicting post-revascularization improvement of ventricular function. Nevertheless, it appears that LV functional improvement may not always be necessary for clinical improvement. Future directions include use of magnetic resonance imaging, as well as larger, multicenter trials of radionuclide techniques. The increasing population of patients with LV dysfunction, and the increased benefit afforded by newer therapies, will make assessment of myocardial viability even more essential for proper patient management. PMID:15645391

Travin, Mark I; Bergmann, Steven R

2005-01-01

384

Wandering ascaris coming out through the abdominal wall.  

PubMed

A rare case of ascaris coming out through the anterior abdominal wall is reported here. A 40-year-old female had undergone dilatation and curettage by a quack. On the second day she presented with presented with features of peritonitis. She was explored. Resection anastomosis of the ileum was done for multiple perforations of the ileum. Patient developed a fistula in the anterior abdominal wall which was draining bile-colored fluid. On the 12(th) postoperative day a 10-cm-long worm was seen coming out through the fistulous tract which was found to be Ascaris lumbricoids. Ascaris lumbricoids can lead to many complications ranging from worm colic to intestinal obstruction, volvulus, peritonitis, pancreatitis, cholangiohepatitis, liver abscess and many more. Worm has been reported to come out through mouth, nostrils, abdominal drains, T-tubes etc. But ascaris coming out through the anterior abdominal wall is very rare hence reported here. PMID:23930192

Wani, Mohd L; Rather, Ajaz A; Parray, Fazl Q; Ahangar, Abdul G; Bijli, Akram H; Irshad, Ifat; Nayeem-Ul-Hassan; Khan, Tahir S

2013-06-01

385

Wandering Ascaris Coming Out Through the Abdominal Wall  

PubMed Central

A rare case of ascaris coming out through the anterior abdominal wall is reported here. A 40-year-old female had undergone dilatation and curettage by a quack. On the second day she presented with presented with features of peritonitis. She was explored. Resection anastomosis of the ileum was done for multiple perforations of the ileum. Patient developed a fistula in the anterior abdominal wall which was draining bile-colored fluid. On the 12th postoperative day a 10-cm-long worm was seen coming out through the fistulous tract which was found to be Ascaris lumbricoids. Ascaris lumbricoids can lead to many complications ranging from worm colic to intestinal obstruction, volvulus, peritonitis, pancreatitis, cholangiohepatitis, liver abscess and many more. Worm has been reported to come out through mouth, nostrils, abdominal drains, T-tubes etc. But ascaris coming out through the anterior abdominal wall is very rare hence reported here.

Wani, Mohd L; Rather, Ajaz A.; Parray, Fazl Q.; Ahangar, Abdul G.; Bijli, Akram H.; Irshad, Ifat; Nayeem-Ul-Hassan; Khan, Tahir S.

2013-01-01

386

Prediction of Myocardial Viability by MRI  

Microsoft Academic Search

evascularization interventions in evolving myocardial infarctions have their rationale in the assumption that viable myocardial cells persist in the ischemically in- jured area. Consequently, intensive work has been directed over the past decade toward the development of noninvasive imaging methods to identify and quantify myocardial viability. See p 744 In this regard, the temporal pattern of myocardial contrast enhancement on

Charles B. Higgins

387

Evaluation of myocardial viability with contrast echocardiography  

Microsoft Academic Search

Identification of viable myocardium after acute myocardial infarction (MI) or in the setting of severe chronic ischemic heart disease has important clinical implications. Myocardial contrast echocardiography (MCE) has been used for the evaluation of myocardial viability by assessing myocardial perfusion and microvascular integrity. In acute MI, MCE can identify the no-reflow phenomenon after revascularization, which has significant implications regarding recovery

William A Zoghbi

2002-01-01

388

Microvascular Obstruction and Left Ventricular Remodeling Early After Acute Myocardial Infarction  

Microsoft Academic Search

Background—The presence of microvascular obstruction (MO) within infarcted regions may adversely influence left ventricular (LV) remodeling after acute myocardial infarction. This study examined whether the extent of MO directly alters the mechanical properties of the infarcted myocardium. Methods and Results—Seventeen dogs underwent 90 minutes of balloon occlusion of the left anterior descending coronary artery, followed by reperfusion. Gadolinium-enhanced perfusion MRI

Bernhard L. Gerber; Carlos E. Rochitte; Jacques A. Melin; Elliot R. McVeigh; David A. Bluemke; Katherine C. Wu; Lewis C. Becker; Joao A. C. Lima

2010-01-01

389

Repeated stunning precedes myocardial hibernation in progressive multiple coronary artery obstruction  

Microsoft Academic Search

OBJECTIVEThe aim of this study was to characterize a regional myocardial flow-function relationship in collateral dependent myocardium produced by multiple coronary artery obstruction.METHODSAmeroid constrictors were placed around the proximal right (RC) and circumflex (CX) coronary arteries and a silicon tubing cuff around the proximal LAD (left anterior descending artery) (luminal stenosis ±77%) in 18 dogs. Weekly two-dimensional echocardiography was performed

Bharati Shivalkar; Willem Flameng; Monika Szilard; Sorin Pislaru; Marcel Borgers; Johan Vanhaecke

1999-01-01

390

Effects of intravenous nitroglycerin on left ventricular function and ST segment changes in acute myocardial infarction  

Microsoft Academic Search

It has been shown previously that 30-minute infusions of intravenous nitroglycerin in patients with acute myocardial infarction are able to lower left ventricular filling pressure and improve left ventricular function while lowering mean arterial pressure by only 7 mmHg (0.9 kPa). A decrease in sigmaST in praecordial ST segment mapping studies during nitroglycerin infusion in patients with anterior infarction suggested

J T Flaherty; P C Come; M G Baird; J Rouleau; D R Taylor; M L Weisteldt; H L Greene; L C Becker; B Pitt

1976-01-01

391

Reactive thrombocytosis leading to acute myocardial infarction.  

PubMed

Thrombocytosis is defined as platelet count of > 600000. An elevated platelet count may be primarily (essential) or secondary (reactive). Acute myocardial infarction and other vaso-occlusive phenomenon are seen in less than 5% of the patients of reactive thrombocytosis. Here we report such a case. A 49 yr old lady presented with chest pain and had isolated right ventricular infarction that progressed to anteroseptal wall STEMI. Her platelet count was 11 lac; the triggering factor in this case was reactive thrombocytosis secondary to lower respiratory tract infection and iron-deficiency anaemia confirmed after investigations. The clinical diagnosis was confirmed through IL6 levels. The patient was managed aggressively in ICCU, she had an uneventful recovery and was discharged with a normal platelet count. PMID:24772734

Aundhakar, Swati C; Mahajan, Sanket K; Mane, Makarand B; Lakhotiya, Akshay N

2013-10-01

392

Highly automatic quantification of myocardial oedema in patients with acute myocardial infarction using bright blood T2-weighted CMR  

PubMed Central

Background T2-weighted cardiovascular magnetic resonance (CMR) is clinically-useful for imaging the ischemic area-at-risk and amount of salvageable myocardium in patients with acute myocardial infarction (MI). However, to date, quantification of oedema is user-defined and potentially subjective. Methods We describe a highly automatic framework for quantifying myocardial oedema from bright blood T2-weighted CMR in patients with acute MI. Our approach retains user input (i.e. clinical judgment) to confirm the presence of oedema on an image which is then subjected to an automatic analysis. The new method was tested on 25 consecutive acute MI patients who had a CMR within 48 hours of hospital admission. Left ventricular wall boundaries were delineated automatically by variational level set methods followed by automatic detection of myocardial oedema by fitting a Rayleigh-Gaussian mixture statistical model. These data were compared with results from manual segmentation of the left ventricular wall and oedema, the current standard approach. Results The mean perpendicular distances between automatically detected left ventricular boundaries and corresponding manual delineated boundaries were in the range of 1-2 mm. Dice similarity coefficients for agreement (0=no agreement, 1=perfect agreement) between manual delineation and automatic segmentation of the left ventricular wall boundaries and oedema regions were 0.86 and 0.74, respectively. Conclusion Compared to standard manual approaches, the new highly automatic method for estimating myocardial oedema is accurate and straightforward. It has potential as a generic software tool for physicians to use in clinical practice.

2013-01-01

393

Anterior cruciate ligament tunnel placement.  

PubMed

The purpose of this cadaveric study was to analyze variation in anterior cruciate ligament (ACL) tunnel placement between surgeons and the influence of preferred surgical technique and surgeon experience level using three-dimensional (3D) computed tomography (CT). In this study, 12 surgeons drilled ACL tunnels on six cadaveric knees each. Surgeons were divided by experience level and preferred surgical technique (two-incision [TI], medial portal [MP], and transtibial [TT]). ACL tunnel aperture locations were analyzed using 3D CT scans and compared with radiographic ACL footprint criteria. The femoral tunnel location from front to back within the notch demonstrated a range of means of 16% with the TI tunnels the furthest back. A range of means of only 5% was found for femoral tunnel low to high positions by technique. The anterior to posterior tibial tunnel measure demonstrated wider variation than the medial to lateral position. The mean tibial tunnel location drilled by TT surgeons was more posterior than surgeons using the other techniques. Overall, 82% of femoral tunnels and 78% of tibial tunnels met all radiographic measurement criteria. Slight (1-7%) differences in mean tunnel placement on the femur and tibia were found between experienced and new surgeons. The location of the femoral tunnel aperture in the front to back plane relative to the notch roof and the anterior to posterior position on the tibia were the most variable measures. Surgeon experience level did not appear to significantly affect tunnel location. This study provides background information that may be beneficial when evaluating multisurgeon and multicenter collaborative ACL studies. PMID:24414390

Wolf, Brian R; Ramme, Austin J; Britton, Carla L; Amendola, Annunziato

2014-08-01

394

Chest pain with myocardial ischemia in a child: should we think about coronary slow flow phenomenon?  

PubMed

The coronary slow flow phenomenon (CSFP) is an angiographic finding characterized by delayed opacification of epicardial coronary arteries in the absence of stenotic lesion. Herein, we present a 13-year-old boy with recurrent chest pain who was diagnosed with acute ST-segment elevation myocardial infarction associated with CSFP, which has not been reported previously in the pediatric age group. Coronary angiography revealed only the presence of slow flow in the left anterior descending (LAD) coronary artery. Myocardial perfusion scintigraphy revealed a reversible perfusion defect in the LAD territory, which regressed partially at rest and showed complete improvement after dipyridamole infusion. All the symptoms, electrocardiogram abnormalities and cardiac markers returned to normal after dipyridamole treatment during the follow-up. We conclude that CSFP should be kept in mind in the differential diagnosis of chest pain with myocardial ischemia in the pediatric age group. PMID:24164999

Kocaba?, Abdullah; Kardelen, F?rat; Akçurin, Gayaz; Ertu?, Halil

2013-10-01

395

Myocardial Bridge as a Structure of "Double-Edged Sword" for the Coronary Artery  

PubMed Central

Myocardial bridge (MB) is a chance anatomical structure, comprised of the myocardial tissue, with which the coronary artery running in epicardial adipose tissue is partly covered. It is predominantly present in the left anterior descending artery (LAD) and recognizable through imaging techniques as changes in blood flow within the LAD that arises from MB contraction at cardiac systole. Such changes in blood flow influence the pathophysiology of coronary circulation and atherosclerosis development, thus generating controversy as to whether MB predisposes individual to myocardial infarction (MI). However, recent histomorphometric studies have shown that the individual anatomic properties of MB, such as location, length and thickness, consistently play a critical role in the occurrence of MI. This review article comprehensively addresses the pathophysiological mechanisms of MI occurrence together with