Coronary Angiography ; Coronary Artery Disease/epidemiology* ; Humans ; Non-alcoholic Fatty Liver Disease/epidemiology* ; Risk Factors

Background: Coronary artery disease (CAD) is the most common cardiovascular disease in developing countries. CAD also called coronary heart disease, is a condition in which plaque (plak) builds up inside the coronary arteries. These arteries supply your heart muscle with oxygen-rich blood. Objective: The purpose of the study was to investigate the characteristics and value of gated SPECT MPI with Technetium - 99m sestamibi using dipyridamole stress in diagnosis of CAD. Subjects and method: One hundred and forty - six suspected or known CAD patients, mean age 65.2 \xb1 9.11, underwent gated SPECT MPI with technetium - 99m sestamibi using dipyridamole stress. These patients was performed coronary angiography. Results: Of 146 patients, 33.6% had no adverse reaction to intravenous dipyridamole and no fatal adverse events (myocardial infarction, death ... ) was reported. The most common adverse reactions were headache (49.3%), chest pain (40.4%). Aminophyline was administrated to 25.7% of 146 patients and complete relief of symptoms in 91.3% of these patients. The sensitivity for detection of CAD was 95.2 % and the specificity and accuracy were 78.6% and 91.1 %. When excluded the patients with previous MI, these values were 88.9%; 80.0% and 85.7% respectively. Among the coronary branches, the sensitivity was highest in diagnosis of LAD and highest specificity was LCX lesions. Conclusions: The Technetium - 99m sestamibi gated SPECT using dipyridamole stress is a safety and valuable technique for the detection of CAD. \r\n', u' \r\n', u'
Coronary Artery Disease/epidemiology ; pathology ; Dipyridamole/ administration & ; dosage

China/epidemiology* ; Coronary Angiography ; Coronary Artery Disease/epidemiology* ; Cross-Sectional Studies ; Humans ; Risk Assessment ; Risk Factors

Arterio-Arterial Fistula ; epidemiology ; China ; epidemiology ; Coronary Angiography ; Coronary Artery Disease ; epidemiology ; Coronary Vessel Anomalies ; Humans ; Prevalence

No abstract available.
Calcium/*analysis ; Coronary Artery Disease/*epidemiology ; Coronary Vessels/*chemistry ; Female ; Humans ; Male ; Metabolic Syndrome X/*epidemiology ; Vascular Calcification/*epidemiology

OBJECTIVETo compare the long-term real-world outcomes of consecutive patients with unprotected left main coronary artery disease (ULMCA) underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and coronary artery bypass grafting (CABG).

METHODSConsecutive patients with ULMCA (defined as stenosis ≥ 50%) undergoing DES implantation or CABG between January 2003 to July 2009 in Beijing Anzhen Hospital were enrolled. The follow-up period extended through August 2013. The end points of the study were death, cardiac death, repeat revascularization, myocardial infarction (MI), stroke, the composite of cardiac death, MI or stroke and MACCE (major adverse cardiac and cerebrovascular events, the composite of cardiac death, MI, stroke or repeat revascularization).

RESULTSFrom January 2003 to July 2009, 922 ULMCA patients were enrolled in this study (465 PCI patients, and 457 CABG patients). The median follow-up was 7.1 years (interquartile range 5.3 to 8.2 years). The crude relative risk was as follows: overall death rate (13.0% (41/465) vs. 22.1% (72/457), P = 0.009), stroke rate (5.8% (11/465) vs. CABG 18.9% (46/457), P < 0.001) were significantly lower whereas the rate of repeat revascularization (32.3% (110/465) vs. CABG 19.2% (58/457), P < 0.001) was significantly higher in PCI group than in CABG group. MI rate was similar between PCI and CABG group (13.9% (33/465) vs. 6.7% (26/457), P = 0.196). MACCE rate was also similar between the 2 groups (42.9% (145/465) vs. 42.5% (142/457), P = 0.122). After multivariate adjusting, there was no significant difference in rates of death, MI and a composite of serious outcomes (cardiac death, MI, or stroke) between the 2 groups. Rates of MACCE were significantly higher in the PCI group (P = 0.009) due to increased rate of repeat revascularization (P < 0.001). However, stroke rate was still significantly higher in CABG group (P = 0.001) after multivariate adjusting.

CONCLUSIONDuring a follow-up up to 8.2 years, the survival rate is similar between the PCI and the CABG group in patients with ULMCA disease. The rate of repeat revascularization is significantly higher and stroke rate is significantly lower in the PCI group compared to CABG group.

Coronary Artery Bypass ; Coronary Artery Disease ; epidemiology ; therapy ; Drug-Eluting Stents ; Humans ; Myocardial Infarction ; epidemiology ; Percutaneous Coronary Intervention ; Stroke ; epidemiology ; Survival Rate ; Treatment Outcome

Objective: This study sought to investigate the impact of different obesity patterns on coronary microvascular function in male patients with non-obstructive coronary artery disease. Methods: We retrospectively analyzed clinical data of male patients diagnosed with suspected coronary microvascular dysfunction (CMD) in the First Hospital of Shanxi Medical University between December 2015 and August 2021. All patients underwent the one-day rest and stress ¹³N-ammonia positron emission tomography myocardial perfusion imaging. Overall obesity was defined by body mass index (BMI) ≥28 kg/m² and abdominal obesity was defined by waist circumference ≥90 cm. Hyperemic myocardial blood flow (MBF)<2.3 ml·min^-1·g^-1 or coronary flow reserve (CFR)<2.5 were referred as CMD. All patients were grouped based on their BMI and waist circumference. MBF, CFR, the incidence of CMD, hemodynamic parameters, and cardiac function were compared among the groups. Results: A total of 136 patients were included. According to BMI and waist circumference, patients were categorized into 3 groups: control group (n=45), simple abdominal obesity group (n=53) and compound obesity group (n=38). Resting MBF did not differ between groups (F=0.02,P=0.994). Compared with the control group, hyperemic MBF was significantly lower in the simple abdominal obesity and compound obesity groups ((2.82±0.64) ml·min^-1·g^-1, (2.44±0.85) ml·min^-1·g^-1 and (2.49±0.71) ml·min^-1·g^-1, both P<0.05, respectively). Hyperemic MBF was comparable among the groups of patients with obesity (P=0.772). CFR was significantly lower in the simle abdominal obesity group compared with the control group (2.87±0.99 vs. 3.32±0.62,P=0.012). Compared with the control group, CFR tended to be lower in the compound obesity group (3.02±0.91 vs. 3.32±0.62,P=0.117). The incidence of CMD was significantly higher in both the simple abdominal obesity and compound obesity groups than in the control group (62.3%, 52.6% vs. 22.2%, both P<0.01, respectively). Waist circumference was an independent risk factor for male CMD (OR=1.057, 95%CI: 1.013-1.103, P=0.011). Conclusions: In male patients with non-obstructive coronary artery disease, abdominal obesity is associated with decreased coronary microvascular function. Male patients with simple abdominal obesity face the highest risk of CMD.
Humans ; Male ; Coronary Artery Disease ; Coronary Circulation/physiology* ; Obesity, Abdominal ; Retrospective Studies ; Obesity/epidemiology* ; Hyperemia

China/epidemiology* ; Coronary Angiography ; Coronary Artery Disease/diagnosis* ; Humans ; Registries ; Risk Assessment ; Risk Factors

OBJECTIVE: The importance of central blood pressure evaluation for cardiovascular risk stratification has been emphasized. The aim of this study is to evaluate whether brachial blood pressure obtained by the oscillometric method accurately reflects central blood pressure. METHODS: The subjects consisted of 84 consecutive patients with suspected coronary artery disease who underwent cardiac catheterization. Central blood pressure was invasively measured in the origin of the left subclavian artery by using the fluid-filled system, and at the same time, brachial blood pressure in the left upper arm was measured by the oscillometric method. RESULTS: No significant difference was found between central systolic pressure and brachial systolic pressure (144.49+/-18.84 mmHg vs. 142.44+/-14.96 mmHg, P=0.063). Bland-Altman analysis accounted for only a small bias of +2.25 mmHg, and the limits of agreement were 24.15 mmHg and -19.65 mmHg. Central diastolic pressure was significantly lower than brachial diastolic pressure (75.80+/-8.74 mmHg vs. 86.70+/-10.48 mmHg, P<0.001). Bland-Altman analysis showed a significant bias of -5.45 mmHg, and the limits of agreement were 2.83 mmHg and -13.73 mmHg. CONCLUSION: These results indicate that central systolic pressure can be directly estimated from brachial systolic pressure using the noninvasive oscillometric method and observed biases seem to remain within the practical range. However, use of the brachial diastolic pressure and pulse pressure measured by the noninvasive oscillometric method is doubtful in clinical practice because of their large biases.
Arm ; Bias (Epidemiology) ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Artery Disease ; Humans ; Oscillometry ; Subclavian Artery

BACKGROUND: Peripheral venous pressure (PVP) was known to have significant correlation with central venous pressure (CVP) in patients with normal and abnormal cardiac function. The purpose of this study is to evaluate the possibility of PVP as a substitute of CVP for volume status monitoring. METHODS: 41 hypovolemic patients with pulmonary capillary wedge pressure (PCWP) below 10 mmHg, scheduled for elective coronary artery bypass graft were included. CVP and PVP were measured from proximal port of pulmonary artery (PA) catheter and antecubital vein, respectively. Each was connected to the same monitoring system by rigid tubes of same length. Measurements were performed as follows: after PA catheter insertion; after increasing PCWP above 10 mmHg by I.V. fluid infusion; and after anesthesia induction. Hemodynamic variables were recorded at end-expiration after stabilizing for 5 10 minutes. For statistical analysis, Bland and Altman plot was created. RESULTS: The overall mean bias between CVP and PVP was 0.7 mmHg (95% confidence interval, 1 0.5). Limits of agreement of mean bias was 2.1 3.6 mmHg. 118 out of 121 PVP measurements were within the ranges of CVP +/- 3 mmHg (98%). The direction of CVP change was predicted by PVP in 68%. However, larger changes of PVP (> or = 2 mmHg) predicted the changes of CVP with increased accuracy (90%). There were only 5 cases that CVP and PVP had changed in opposite direction. CONCLUSIONS: In conclusion, PVP has a potential to be a substitutional hemodynamic parameter of CVP.
Anesthesia ; Bias (Epidemiology) ; Catheters ; Central Venous Pressure* ; Coronary Artery Bypass ; Coronary Artery Disease* ; Coronary Vessels* ; Hemodynamics* ; Humans ; Hypovolemia* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Transplants ; Veins ; Venous Pressure*