Brugada Syndrome ; etiology ; physiopathology ; Coronary Artery Disease ; physiopathology ; Coronary Vasospasm ; physiopathology ; Electrocardiography ; Humans ; Male ; Middle Aged

Cardiomyopathy, Hypertrophic ; etiology ; pathology ; physiopathology ; Coronary Angiography ; Coronary Disease ; complications ; physiopathology ; Coronary Vessel Anomalies ; etiology ; pathology ; physiopathology ; Humans ; Myocardium ; pathology

OBJECTIVETo examine the relationship between coronary arterial remodeling and clinical presentation.

METHODSA total of 34 patients with acute (10 with recent myocardial infarction and 24 with unstable angina) and 26 with stable (8 with old myocardial infarction and 18 with stable angina) coronary syndrome underwent intravascular ultrasound (IVUS) before intervention. Target lesions were classified as soft or hard plaques. Quantitative measurements of cross-sectional area (CSA) of external elastic membrane (EEM), lumen and plaque were performed at the lesion site and at the proximal and distal reference sites. Remodeling index (RI) was expressed by the ratio of EEM CSA at the lesion site to the mean EEM CSA of both proximal and distal reference sites. Positive remodeling was defined as RI > 1.05 and negative remodeling as RI < 0.95.

RESULTSSoft plaque was observed more frequently in acute than in stable coronary syndrome (59% vs 31%), whereas hard plaque was more common in stable coronary syndrome (69% vs 41%) (P = 0.03). The EEM CSA (15.11 +/- 2.89 mm(2) vs 13.25 +/- 3.10 mm(2), P = 0.019) and plaque CSA (10.83 +/- 2.62 mm(2) vs 9.30 +/- 2.84 mm(2), P = 0.035) were significantly greater at target lesions in patients with acute rather than stable coronary syndrome, while lumen CSA and percent area stenosis were similar in both groups. RI was significantly higher (1.08 +/- 0.16 vs 0.95 +/- 0.14, P = 0.002) and positive remodeling was more frequent in acute coronary syndrome (53% vs 23%, P = 0.019), whereas negative remodeling was more common in stable coronary syndrome (58% vs 24%, P = 0.007).

CONCLUSIONSThe study indicates that clinical characteristics of patients with coronary artery disease depend largely upon underlying types of coronary arterial remodeling.

Aged ; Coronary Disease ; diagnostic imaging ; pathology ; physiopathology ; Coronary Vessels ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Ultrasonography

OBJECTIVETo compare graft patency in off-pump and conventional coronary artery bypass grafting by using the transit time flow meter in the treatment of triple vessel coronary artery disease.

METHODSBetween June 2000 and April 2001, 60 patients with triple vessel coronary artery disease underwent coronary artery bypass grafting. They were divided into two groups: off-pump and conventional coronary artery bypass. All completed grafts were tested intraoperatively using Transit Time Flow Measurement (TTFM). Preoperative and postoperative variables of the two groups were also compared.

RESULTSThere were no significant differences in sex, age, weight, acute or remote myocardial infarction, hypertension, diabetes and type of bypass grafts between the two groups. The number of bypass grafts and the assisted respiratory time of the off-pump coronary artery bypass grafting (OPCAB) group were significantly less than those of the conventional coronary artery bypass grafting (CCABG) group. The flow and pulsatile index (PI) of the left anterior descending artery bypass grafts and the right coronary artery bypass grafts were not significantly different between the OPCAB and CCABG groups. The flow of OM in the CCABG group with the multiple anastomosis site of sequential grafts was higher than that in the OPCAB group. Diffused narrow coronary artery bypass grafts in both groups had less flow.

CONCLUSIONNo significant differences in graft patency were observed in patients with triple vessel coronary artery disease who had undergone OPCAB or CCABG.

Aged ; Coronary Artery Bypass ; methods ; Coronary Circulation ; Coronary Disease ; physiopathology ; surgery ; Female ; Humans ; Male ; Middle Aged

Endothelial function plays a very important role in the process of erection. Erectile dysfunction (ED) and coronary artery disease (CAD) overlap in risk factors, aetiology and clinical outcomes. Endothelial dysfunction is considered to be their shared aetiological factor. There is growing evidence that patients presenting with ED should be investigated for CAD, even if with no symptoms of the problem. Earlier diagnosis of ED can facilitate prompt intervention, reduce long-term complications, especially the risk of CAD, and provide effective treatment for ED.
Arteriosclerosis ; physiopathology ; Coronary Artery Disease ; physiopathology ; Endothelium, Vascular ; physiology ; physiopathology ; Erectile Dysfunction ; physiopathology ; Humans ; Male ; Penis ; blood supply ; physiopathology

Acute Coronary Syndrome ; physiopathology ; Coronary Angiography ; Disease Progression ; Humans ; Myocardial Infarction ; classification ; physiopathology ; Plaque, Atherosclerotic ; diagnostic imaging ; physiopathology

Coronary Artery Disease ; physiopathology ; Fistula ; physiopathology ; Heart Ventricles ; Humans ; Iatrogenic Disease ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; adverse effects

Aged ; Anthracosis ; complications ; physiopathology ; Coronary Disease ; complications ; physiopathology ; Electrocardiography ; Humans ; Male ; Middle Aged ; Pulmonary Heart Disease ; complications ; physiopathology

Arteriosclerosis ; physiopathology ; Blood Pressure ; physiology ; Cardiovascular Diseases ; physiopathology ; Coronary Disease ; physiopathology ; Humans ; Hypertension ; physiopathology ; Predictive Value of Tests ; Pulse

BACKGROUNDFluid dynamic mechanisms attributed to coronary bifurcation lesions remain a subject of study. The present study aimed at investigating the hemodynamic change of wall shear stress (WSS) in patients with coronary bifurcation lesions treated by double kissing (DK) crush or one-stent with final kissing balloon inflation (FKBI).

METHODSEighty-one patients with bifurcation lesions treated by stenting who had 3-D model reconstruction were studied. The bifurcation vessels were divided into main vessel (MV), main branch (MB), side branch (SB), and polygon of confluence (POC). MB and SB were classified by internal- and lateral-subsegments, respectively.

RESULTSThe baseline magnitude of WSS in proximal MV, POC-MV, POC-MB, POC-SB and MB-internal segments increased significantly, compared to MB-lateral, SB-internal and SB-lateral. DK crush had the potential of uniformly reducing WSS, turbulent index and the WSS gradient. The WSS value at the POC-SB and SB in the one-stent group remained higher. The turbulent index and WSS gradient between the POC-SB minus the SB-lateral had equal predictive values for in-stent restenosis (ISR).

CONCLUSIONFluid dynamic results favor the use of DK crush over the one-stent technique.

Aged ; Angioplasty, Balloon, Coronary ; Coronary Artery Disease ; physiopathology ; therapy ; Female ; Hemodynamics ; physiology ; Humans ; Male ; Middle Aged