Seminars in interventional cardiology : SIIC最新文献_第10页

The coronary artery as a living organ. 冠状动脉是一个活的器官。

Seminars in interventional cardiology : SIIC Pub Date : 1998-03-01

T F Lüscher

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Shear stress in atherosclerosis, and vascular remodelling. 动脉粥样硬化中的剪切应力和血管重构。

Seminars in interventional cardiology : SIIC Pub Date : 1998-03-01

R Krams, J J Wentzel, J A Oomen, J C Schuurbiers, I Andhyiswara, J Kloet, M Post, B de Smet, C Borst, C J Slager, P W Serruys

引用次数: 0

Positron emission tomography to assess the haemodynamics of the coronary circulation. 正电子发射断层扫描评估冠状动脉循环的血流动力学。

Seminars in interventional cardiology : SIIC Pub Date : 1998-03-01

P G Camici

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Functional assessment of collaterals in the human coronary circulation. 人类冠状动脉循环络的功能评价。

Seminars in interventional cardiology : SIIC Pub Date : 1998-03-01

C Seiler, M Fleisch, S F de Marchi, M Billinger, A Wahl, F R Eberli, A R Garachemani, B Meier

{"title":"Functional assessment of collaterals in the human coronary circulation.","authors":"C Seiler, M Fleisch, S F de Marchi, M Billinger, A Wahl, F R Eberli, A R Garachemani, B Meier","doi":"","DOIUrl":"","url":null,"abstract":"The coronary collateral circulation is an alternative source of blood supply to a myocardial area jeopardized by the failure of the stenotic or occluded vessel to provide enough blood flow to this region. Until recently, only qualitative or semiqualitative methods have been available for the assessment of the coronary collateral circulation in humans, such as the patient's history of walk-through angina pectoris, the registration of intracoronary ECG signs for myocardial ischaemia or angina pectoris during coronary occlusion, or coronary angiographic classification (score 0-3) of collaterals. Studies of coronary wedge pressure measurements distal of a balloon-occluded coronary artery and the recent advent of ultrathin pressure and Doppler angioplasty guidewires have made it possible to obtain pressure or flow velocity data in remote vascular areas and, thus, to calculate functional variables for coronary collateral flow. Those coronary occlusive pressure- and flow velocity-derived parameters express collateral flow as a fraction of antegrade coronary flow during vessel patency of the collateral-receiving vessel. They are both interchangeable, and they have been validated in comparison to 'traditional' methods and against each other. The possibility of accurately measuring coronary collateral flow indices in humans undergoing coronary balloon angioplasty opens areas of investigation of the pathogenesis, pathophysiology and therapeutic promotion of the collateral circulation previously reserved for exclusively experimental studies. The purpose of this article is to review several clinically available methods for the functional characterization of the coronary collateral circulation.","PeriodicalId":79534,"journal":{"name":"Seminars in interventional cardiology : SIIC","volume":"3 1","pages":"13-20"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20966169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Blood flow assessment with intravascular ultrasound catheters: the ideal tool for simultaneous assessment of the coronary haemodynamics and vessel wall? 血管内超声导管血流评估:同时评估冠状动脉血流动力学和血管壁的理想工具?

Seminars in interventional cardiology : SIIC Pub Date : 1998-03-01

S G Carlier, E I Cespedes, W Li, F Mastik, A F Van Der Steen, N Bom, P W Serruys

{"title":"Blood flow assessment with intravascular ultrasound catheters: the ideal tool for simultaneous assessment of the coronary haemodynamics and vessel wall?","authors":"S G Carlier, E I Cespedes, W Li, F Mastik, A F Van Der Steen, N Bom, P W Serruys","doi":"","DOIUrl":"","url":null,"abstract":"We present the potentials of a novel method of intracoronary flow visualization and quantification that is based on conventional intravascular ultrasound (IVUS) imaging catheters. The quantification of flow is obtained from analysis of the rate of decorrelation of digitized radiofrequency ultrasound echo signals. Flow information is superimposed on the IVUS image using a colour scale. Integration of the blood velocity components normal to the scan plane permits calculation of the volume flow. Validation using IVUS and electromagnetic (EM) flowmeter recordings were obtained in vivo from instrumented pigs. IVUS flow (IVUS(f)) compared favourably to EM flow (EM(f)): IVUS(f)=1.0 EM(f)+5.72 cc/min, r2=0.98. Clinical results for the first five patients investigated are reported. A Doppler wire was used to measure the flow in four coronary arteries and one renal artery in baseline and hyperaemia conditions. IVUS flow and derived coronary flow reserve (CFR) demonstrated a very good agreement with the data derived from the combination of quantitative angiography and velocity when measured with the Doppler wire (DOP(f)): IVUS(f)=1.01 DOP(f)-20 cc/min, r2=0.90 and IVUS(cfr)=1.03 DOP(cfr)-0.03, r2=0.93. This demonstrates that simultaneous morphological and physiological assessment of coronary or peripheral arteries with one IVUS catheter is feasible. This method should be very useful for the evaluation of intermediate coronary stenoses or the results of revascularization procedures.","PeriodicalId":79534,"journal":{"name":"Seminars in interventional cardiology : SIIC","volume":"3 1","pages":"21-9"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20966170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Flow-dependent vasodilation in the coronary circulation: alterations in diseased states. 冠状动脉循环血流依赖性血管舒张:病变状态的改变。

Seminars in interventional cardiology : SIIC Pub Date : 1998-03-01

L Mandinov, P Kaufmann, W Maier, O M Hess

{"title":"Flow-dependent vasodilation in the coronary circulation: alterations in diseased states.","authors":"L Mandinov, P Kaufmann, W Maier, O M Hess","doi":"","DOIUrl":"","url":null,"abstract":"Flow-dependent vasodilation has been recognized to play an important role in the perfusion of the myocardium and the occurrence of myocardial ischaemia. In the past few years, the role of the endothelium in the regulation of coronary artery dimensions has gained a lot of attraction. Changes in coronary artery size are caused through the contraction and relaxation of the smooth musculature within the vessel wall. Vasoactive substances released from the endothelium play a crucial role in the regulation of vessel size and coronary vasomotor tone. During physiologic exercise, normal coronary arteries dilate, whereas stenotic arteries constrict. This abnormal behaviour of the stenotic artery has been associated with the occurrence of myocardial ischaemia, and has been thought to be either due to: endothelial dysfunction with reduced release or production of the endothelial derived relaxant factor (EDRF); an increased sympathetic stimulation during exercise; enhanced platelet aggregation with release of thromboxane A2 and serotonin; and/or a passive collapse of the disease-free vessel segment within the stenosis when blood-flow velocity increases during exercise. Thus, a diseased coronary endothelium may have a dramatic effect on the function of the coronary arteries, and may cause or contribute to the occurrence of myocardial ischaemia under high-demand situations, e.g. physical exercise or mental stress. Changes in flow-dependent vasodilation have been described in various disease states, e.g. hypercholesterolaemia, hypertension, diabetes mellitus, but also in valvular heart disease, heart failure and transplantation. Most of these alterations are due to functional changes of the endothelium, but vascular remodelling of the coronary arteries with thickening of the intima and an enlargement of the artery may affect these functional changes importantly.","PeriodicalId":79534,"journal":{"name":"Seminars in interventional cardiology : SIIC","volume":"3 1","pages":"5-12"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20966168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Measurement of flow velocity in the coronary circulation: requirements and pitfalls. 冠状动脉循环流速的测量:要求和缺陷。

Seminars in interventional cardiology : SIIC Pub Date : 1998-03-01

M Büchi, R Jenni

引用次数: 0

Internal atrial defibrillation: lessons learnt from experimental studies. 内部心房除颤:实验研究的经验教训。

Seminars in interventional cardiology : SIIC Pub Date : 1997-12-01

D Keane, L Zhou, H Garan

引用次数: 0

Catheter ablation for atrial fibrillation. 房颤的导管消融。

Seminars in interventional cardiology : SIIC Pub Date : 1997-12-01

D Keane, L Zhou, J Ruskin

{"title":"Catheter ablation for atrial fibrillation.","authors":"D Keane, L Zhou, J Ruskin","doi":"","DOIUrl":"","url":null,"abstract":"Catheter ablation for atrial fibrillation is based upon the critical mass of fibrillation hypothesis and aims to compartmentalize the atria by the creation of linear lesions, thereby reducing the amount of contiguous myocardium available for the propagation of multiple activation wavefronts. Early attempts at creating right atrial linear lesions with conventional catheter tip technology to treat patients with chronic and paroxysmal atrial fibrillation yielded disappointing results. Although more efficacious, the creation of extensive left atrial lesions has been associated with a high rate of thromboembolic stroke despite the administration of heparin and use of temperature feedback to control radiofrequency energy. Approaches to reduce the risk of stroke include: the creation of more continuous and effective right atrial lesions with linear array catheter technology and thereby reduce the requirement for left atrial ablation; the assessment of adjuvant pharmacological agents to inhibit platelet aggregation; guidance of radiofrequency energy delivery by intracardiac echo; assessment of transvenous cryotherapy as an alternative to radiofrequency energy in order to reduce endocardial disruption; and development of minimally invasive surgical approaches to left atrial epicardial ablation.","PeriodicalId":79534,"journal":{"name":"Seminars in interventional cardiology : SIIC","volume":"2 4","pages":"251-65"},"PeriodicalIF":0.0,"publicationDate":"1997-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20619688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Electrophysiology of atrial fibrillation and its prevention by coronary sinus pacing. 心房颤动的电生理及冠状窦起搏预防。

Seminars in interventional cardiology : SIIC Pub Date : 1997-12-01

P Papageorgiou, K Monahan, F Anselme, C Kirchhof, M E Josephson

{"title":"Electrophysiology of atrial fibrillation and its prevention by coronary sinus pacing.","authors":"P Papageorgiou, K Monahan, F Anselme, C Kirchhof, M E Josephson","doi":"","DOIUrl":"","url":null,"abstract":"Atrial fibrillation (AF) is a re-entrant rhythm, and patients with AF have intra-atrial conduction abnormalities as evidenced by prolonged P-wave duration, abnormal SAECG of P wave, fragmented atrial electrograms and greater intra-atrial conduction delays in response to APDs. Our previous work has proposed that intra-atrial conduction delays and dispersion of refractoriness during extrastimulus testing are site dependent; high right atrial (HRA) stimulation results in marked prolongation of intra-atrial conduction times and AF, whereas distal coronary sinus (CS) stimulation is associated with minimal conduction delays and absence of AF inducibility. Patients with AF induction during HRA stimulation also manifest non-uniform anisotropic conduction in the region of the posterior triangle of Koch. We postulated that if the posterior triangle of Koch is a critical area for re-entry that initiates AF, then prevention of early activation of the posterior triangle may prohibit AF induction by HRA APDs. Distal CS pacing pre-excites the posterior triangle in relation to HRA activation, therefore a subsequent HRA APD will activate the posterior triangle with a longer coupling interval. AF induction by HRA APDs following HRA pacing is prevented when same HRA APDs follow distal CS pacing. We propose that distal CS pacing eliminates the propensity of HRA extrasystoles to induce AF. This observation may have further clinical applicability in AF prevention.","PeriodicalId":79534,"journal":{"name":"Seminars in interventional cardiology : SIIC","volume":"2 4","pages":"227-32"},"PeriodicalIF":0.0,"publicationDate":"1997-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20620964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0