Prediction of left ventricular contractile recovery using tissue Doppler strain and strain rate measurements at rest in patients undergoing percutaneous coronary intervention
Abstract The aim of the study was to assess the ability of tissue Doppler (TD) deformation analysis at rest to predict left ventricular contractile recovery in patients undergoing percutaneous coronary intervention (PCI). This prospective cohort enrolled 67 patients with segmental wall motion abnormality. Assessment of each segment was performed at rest and during low dose Dobutamine stress echocardiography (DSE) using a 4 point scoring system, TD peak systolic strain (PSS) and peak systolic strain rate (PSSR). The study followed up the patients for contractile improvement after 6 months of successful PCI by echocardiography. Of a 319 dysfunctional segments, 155 (49%) showed contractile recovery and 164 (51%) did not. PSS and PSSR at rest were significantly higher in recovered segments compared to segments without recovery (PSS: −7.27 ± 0.8 Vs. −6.14 ± 0.7%, P SSR: −0.34 ± 0.13 Vs. −0.24 ± 0.1/s. p
Authors: Gu D, Qu J, Zhang H, Zheng Z Abstract Coronary revascularization is the most important strategy for coronary artery disease. This review summarizes the current most prevalent approaches for coronary revascularization and discusses the evidence on the mechanisms, indications, techniques, and outcomes of these approaches. Targeting coronary thrombus, fibrinolysis is indicated for patients with diagnosed myocardial infarction and without high risk of severe hemorrhage. The development of fibrinolytic agents has improved the outcomes of ST-elevation myocardial infarction. Percutaneous coronary intervention has...
Authors: Vemmou E, Nikolakopoulos I, Brilakis ES PMID: 32234689 [PubMed - in process]
CONCLUSION: Current data imply that PCI for CCS does not improve outcomes in a large percentage of cases. A symptomatic benefit exists only in patients with frequent angina pectoris. The selection of CCS patients for PCI needs to be more strictly bound to the recommendations of current guidelines, particularly in Germany. PMID: 32234189 [PubMed - in process]
ConclusionCCB with ACE or CCB with ARB combination strategies are equally acceptable in hypertensive Korean patients regarding the occurrence of NODM.
Condition: Primary Percutaneous Coronary Intervention Intervention: Sponsor: Amany Edward Ramzy Completed
With the routine use of primary percutaneous coronary intervention (PCI) for ST-Elevation Myocardial Infarction (STEMI), the rate of short-term complications is low and the optimal length-of-stay in the Coronary Care Unit (CCU) following reperfusion is unknown. We hypothesized that the rate of complications would not differ between two groups of stable patients admitted to the CCU following primary-PCI for STEMI: i) those for whom a minimum 24-hour stay was enforced ( ≥24 h Standard Stay) and ii) those with no minimum length-of-stay (Physician-guided Stay).
Abstract As the incidence of diabetes and cardiovascular comorbidities continues to rise, driven by increased prevalence of obesity and an aging population, so does the demand for percutaneous coronary intervention (PCI) to restore cardiac blood flow. Renin-angiotensin-aldosterone system (RAAS) inhibitors are commonly prescribed to hypertensive diabetic patients to prevent diabetic nephropathy. However, evidence suggests that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) may increase the risk of contrast-induced acute kidney injury (CIAKI) following coronary angiography ...
Treatment with ticagrelor alone shows no increase in bleeding, MI, or stroke after percutaneous coronary intervention in the TWILIGHT trial subanalysis.Medscape Medical News
Conclusions: This analysis showed a significantly higher mortality risk in CAD patients with RA when compared to the control group. Congestive heart failure also significantly manifested more in CAD patients with co-existing RA. However, the risks all the other cardiovascular outcomes were similar in both groups. Nevertheless, due to the several limitations of this analysis, this hypothesis should be confirmed in forthcoming trials based on larger numbers of CAD patients with co-existing RA.
Stress echocardiography – MCQ – Answer Stress echocardiography is useful when – Correct answer: d) All of the above Hibernating myocardium is viable myocardium Low dose dobutamine infusion improves the contraction of hibernating myocardial segments which are chronically ischemic. Such patients may benefit from revascularization procedures like coronary artery bypass grafting or percutaneous coronary intervention. Back to question