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William C. Roberts - One of the best experts on this subject based on the ideXlab platform.

  • Degrees of Cross-Sectional-Area Luminal Narrowing of the Four Major Epicardial Coronary Arteries in Patients with Otherwise Functionally and Anatomically Normal Hearts.
    The American journal of cardiology, 2021
    Co-Authors: Ernest N. Arnett, William C. Roberts
    Abstract:

    ABSTRACT Described herein are necropsy findings in the 4 major (left main, left anterior descending, left circumflex, and right) Epicardial Coronary Arteries in 86 patients aged 10-70 years who never had symptoms of myocardial ischemia, and at autopsy had otherwise anatomically normal hearts. All 86 died of a non-cardiovascular condition. In each of these patients all 4 major Epicardial Coronary Arteries were excised intact from the heart, divided into 5-mm segments, and each segment prepared for histologic examination. The degrees of cross-sectional area (CSA) narrowing was determined from histologic examination of each 5-mm segment. The degree of narrowing in each 5 mm segment was divided into 4 categories: 0 – 25%, 26 – 50%, 51 – 75%, and 76 – 100%. Twelve patients (14%) had ≥1 artery narrowed >75% in CSA, a single artery in 9 patients, and 2 Arteries in each of 3 patients. In contrast to the relative infrequency of narrowing >75%, narrowing 51-75% was common, and was present in 36 (42%) of the 86 patients. Of the 258 major Coronary Arteries (excludes the left main) studied in the 86 patients, 15 (6%) were narrowed >75%, and 70 (24%) were narrowed 51 to 75% in CSA. Even mild narrowing (26 – 50%) of the left main Coronary artery (66 patients) was generally accompanied by 51 – 75% or greater narrowing of at least one of the other major Coronary Arteries. In conclusion, even hearts which have functioned normally and are otherwise anatomically normal, usually have some degree of atherosclerotic plaque in the major Epicardial Coronary Arteries.

  • degrees of cross sectional area luminal narrowing of the four major Epicardial Coronary Arteries in patients with otherwise functionally and anatomically normal hearts
    American Journal of Cardiology, 2021
    Co-Authors: Ernest N. Arnett, William C. Roberts
    Abstract:

    Described herein are necropsy findings in the 4 major (left main, left anterior descending, left circumflex, and right) Epicardial Coronary Arteries in 86 patients aged 10-70 years who never had symptoms of myocardial ischemia, and at autopsy had otherwise anatomically normal hearts. All 86 died of a non-cardiovascular condition. In each of these patients all 4 major Epicardial Coronary Arteries were excised intact from the heart, divided into 5-mm segments, and each segment prepared for histologic examination. The degrees of cross-sectional area (CSA) narrowingwere determined from histologic examination of each 5-mm segment. The degree of narrowing in each 5 mm segment was divided into 4 categories: 0% to 25%, 26% to 50%, 51% to 75%, and 76% to 100%. Twelve patients (14%) had ≥1 artery narrowed >75% in CSA, a single artery in 9 patients, and 2 Arteries in each of 3 patients. In contrast to the relative infrequency of narrowing >75%, narrowing 51-75% was common, and was present in 36 (42%) of the 86 patients. Of the 258 major Coronary Arteries (excludes the left main) studied in the 86 patients, 15 (6%) were narrowed >75%, and 70 (24%) were narrowed 51% to 75% in CSA. Even mild narrowing (26% to 50%) of the left main Coronary artery (66 patients) was generally accompanied by 51% to 75% or greater narrowing of at least one of the other major Coronary Arteries. In conclusion, even hearts which have functioned normally and are otherwise anatomically normal, usually have some degree of atherosclerotic plaque in the major Epicardial Coronary Arteries.

  • morphologic observations in the Epicardial Coronary Arteries and their surroundings late after cardiac transplantation allograft vascular disease
    American Journal of Cardiology, 1996
    Co-Authors: E. Arbustini, William C. Roberts
    Abstract:

    Conclusions from this review, based primarily on study of 39 cardiac allografts in place for >2 months, but also on a study of 37 grafts in place for vascular disease affects all layers of the Epicardial Coronary Arteries and usually the intramural Coronary Arteries in the outer one-half of the left ventricular wall; (2) the resulting intimal lesion is relatively uniform, consisting mainly of cellular and acellular fibrous tissue; it is diffuse, affecting all segments of the major and minor Epicardial Coronary Arteries; (3) the degree of resulting luminal narrowing is similar in most 5-mm Coronary segments, making Coronary angiography hazardous in reliably predicting accurately the degree of luminal narrowing; (4) the extensive adventitial fibrosis and the extensive fibrous tissue infiltration of the subEpicardial tissues probably inhibit dilation and remodeling of the Epicardial Coronary Arteries and indeed may constrict them; (5) luminal narrowing of the Epicardial Coronary Arteries after transplantation may be the consequence of both intraluminal lesions and exterior compression from the surrounding fibrous tissue; (6) intraluminal and intralesion thrombus is commonly observed as are multiluminal channels in Coronary plaques, suggesting that organization of thrombi plays some role in the progression of post-transplant Epicardial Coronary disease; (7) the Coronary lesions developing after cardiac transplantation are morphologically quite different in composition than those occurring in natural (nontransplantation) atherosclerosis; and (8) inflammatory cellular infiltrates are often extensive in the subEpicardial tissues and the infiltrates in this area may be extensive even when interstitial myocardial inflammatory infiltrates are minimal or absent.

  • Composition of atherosclerotic plaques in the Epicardial Coronary Arteries in juvenile (type I) diabetes mellitus.
    The American journal of cardiology, 1992
    Co-Authors: Susanne L. Mautner, Fengru Lin, William C. Roberts
    Abstract:

    Abstract The composition of atherosclerotic plaques in 331 five-mm segments of the 4 major (left main, left anterior descending, left circumflex, and right) Epicardial Coronary Arteries of 8 patients with juvenile (mean age at onset, 9 years; mean age at death, 29 years) diabetes mellitus was determined by computerized planimetric analysis. Analysis of all Coronary segments disclosed that the plaques consisted primarily of dense (53%) and cellular (38%) fibrous tissue. Pultaceous debris (7%), foam cells (1.2%) and calcific deposits (0.7%) occupied a small percentage of the plaques. Thus, 91% of the Coronary plaques in these young diabetic patients consisted of fibrous tissue and nearly all of the remaining 9% consisted of lipid deposits. Analysis of composition according to degrees of cross-sectional luminal narrowing revealed marked increases in dense fibrous tissue (from 31 to 74%), pultaceous debris (from 3 to 12%), and calcific deposits (from 0% to 3%) as the cross-sectional area narrowing increased from ≤ 25% to >75%. Compared with older patients with fatal Coronary artery disease, the patients with juvenile diabetes had more dense fibrous tissue and pultaceous debris and less calcific deposits.

  • morphologic comparison of frequency and types of acute lesions in the major Epicardial Coronary Arteries in unstable angina pectoris sudden Coronary death and acute myocardial infarction
    Journal of the American College of Cardiology, 1991
    Co-Authors: Amy H Kragel, David S Gertz, William C. Roberts
    Abstract:

    The frequency and type of acute lesions in the four major (right, left main, left anterior descending, left circumflex) Epicardial Coronary Arteries were examined at necropsy in 14 patients with unstable angina pectoris, 21 patients with sudden Coronary death and 32 patients with a fatal first acute myocardial infarction. None of the 67 patients had a grossly visible left ventricular scar (healed myocardial infarct) and only the group with acute myocardial infarction had left ventricular myocardial necrosis. Although the frequency of intraluminal thrombus was similar in patients with unstable angina (29%) and sudden death (29%) and significantly lower than in those with acute infarction (69%) (p = 0.02), the thrombus in the patients with unstable angina and sudden death consisted almost entirely of platelets and was nonocclusive, whereas the thrombus in the group with acute infarction consisted almost entirely of fibrin and was occlusive. The frequency of plaque rupture was insignificantly different in the groups with unstable angina (36%) and sudden death (19%), and was significantly lower than in the group with acute infarction (75%) (p = 0.02). The frequency of plaque hemorrhage was insignificantly different in the groups with unstable angina (64%) and sudden death (38%) and was significantly lower than in the group with acute infarction (90%) (p = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)

Anna Kalynych - One of the best experts on this subject based on the ideXlab platform.

  • comparison of outcomes of percutaneous Coronary intervention of ostial versus nonostial narrowing of the major Epicardial Coronary Arteries
    American Journal of Cardiology, 2004
    Co-Authors: Kreton Mavromatis, Ziyad M B Ghazzal, Emir Veledar, Laura Diamandopoulos, William S Weintraub, John S Douglas, Anna Kalynych
    Abstract:

    Outcomes of percutaneous Coronary intervention (PCI) of the ostia of the major Epicardial Coronary Arteries in the modern era of stenting have not been clearly defined. We evaluated data from all PCIs performed from 1998 to 2001 in the proximal segments of the major Epicardial Coronary Arteries entered into a large cardiac database and compared ostial with nonostial PCI outcomes. Of 2,484 patients who underwent PCI of a proximal Coronary artery (left anterior descending, left circumflex, or right Coronary), 223 patients had ostial narrowing and 2,261 patients had proximal, nonostial narrowing. Baseline characteristics were similar between the 2 groups, except that patients with ostial narrowing tended to be older and have shorter narrowings than did patients with nonostial narrowings. Stenting occurred in 89% of all patients and was similar in patients with ostial or nonostial narrowings. Procedural success was the same for ostial and nonostial PCI (96% vs 95%, p = 0.95). One-year event-free survival rate was lower in patients who underwent ostial PCI (69% vs 80%, p = 0.0019), largely due to a greater need for repeat PCI (19% vs 10%, p <0.0001). Multivariate analysis showed that ostial location, age, angina class, and number of diseased vessels were independent predictors of the occurrence of cardiac events. PCI of ostial narrowings of the major Epicardial Coronary Arteries was relatively safe. However, at 1 year, patients who underwent ostial PCI had an increased rate of repeat revascularization compared with patients who underwent nonostial, proximal PCI.

  • Comparison of outcomes of percutaneous Coronary intervention of ostial versus nonostial narrowing of the major Epicardial Coronary Arteries
    The American journal of cardiology, 2004
    Co-Authors: Kreton Mavromatis, Ziyad M B Ghazzal, Emir Veledar, Laura Diamandopoulos, William S Weintraub, John S Douglas, Anna Kalynych
    Abstract:

    Outcomes of percutaneous Coronary intervention (PCI) of the ostia of the major Epicardial Coronary Arteries in the modern era of stenting have not been clearly defined. We evaluated data from all PCIs performed from 1998 to 2001 in the proximal segments of the major Epicardial Coronary Arteries entered into a large cardiac database and compared ostial with nonostial PCI outcomes. Of 2,484 patients who underwent PCI of a proximal Coronary artery (left anterior descending, left circumflex, or right Coronary), 223 patients had ostial narrowing and 2,261 patients had proximal, nonostial narrowing. Baseline characteristics were similar between the 2 groups, except that patients with ostial narrowing tended to be older and have shorter narrowings than did patients with nonostial narrowings. Stenting occurred in 89% of all patients and was similar in patients with ostial or nonostial narrowings. Procedural success was the same for ostial and nonostial PCI (96% vs 95%, p = 0.95). One-year event-free survival rate was lower in patients who underwent ostial PCI (69% vs 80%, p = 0.0019), largely due to a greater need for repeat PCI (19% vs 10%, p

A Robert - One of the best experts on this subject based on the ideXlab platform.

  • Flow-mediated vasodilator response to tachycardia of Epicardial Coronary Arteries is preserved in heart transplant recipients.
    Circulation, 1993
    Co-Authors: C Hanet, P Evrard, M Goenen, Luc-marie Jacquet, A Robert
    Abstract:

    BACKGROUND. Increasing blood flow through conduit Arteries induces vasodilation through endothelium-dependent mechanisms. In humans, flow-mediated dilation of angiographically normal Epicardial Coronary Arteries has been observed during tachycardia, this response being impaired in the presence of atherosclerosis. METHODS AND RESULTS. To evaluate whether the endothelium-dependent physiological vasodilatory response of Epicardial Coronary Arteries to tachycardia is preserved in heart transplant recipients, 22 patients with angiographically smooth Coronary Arteries were studied with quantitative angiography. A total of 14 patients had undergone cardiac transplantation more than 1 year (mean, 28 +/- 18 months) before the study, and 8 patients were nontransplant patients with atypical chest pain and normal exercise tests (control group). Angiograms of the left Coronary artery were obtained on 35-mm cinefilms at 3-minute intervals in basal conditions, during pacing-induced tachycardia (150 beats per minute), and after intraCoronary injection of 1.5 mg of isosorbide dinitrate. During tachycardia, the mean luminal diameter of the midsegment of the left anterior descending Coronary artery increased by 8.9 +/- 6.1% from 2.64 +/- 0.56 to 2.88 +/- 0.62 mm (P < .001) in transplant recipients and by 7.5 +/- 5.0% from 2.37 +/- 0.54 to 2.53 +/- 0.50 mm (P < .025) in the control group (transplant vs control patients, NS). A further Coronary dilation was observed in all patients after isosorbide dinitrate, up to 124.8 +/- 8.1% of basal lumen diameter in transplant recipients and up to 129.1 +/- 16.1% of basal diameter in the control group. CONCLUSIONS. The vasodilator response of Epicardial Coronary Arteries to tachycardia is preserved in heart transplant recipients. This suggests that the functional response of the endothelium to an increase in Coronary blood flow remains normal in these patients.

  • Flow-mediated vasodilator response to tachycardia of Epicardial Coronary Arteries is preserved in heart transplant recipients.
    Circulation, 1993
    Co-Authors: C Hanet, P Evrard, L Jacquet, M Goenen, A Robert
    Abstract:

    Increasing blood flow through conduit Arteries induces vasodilation through endothelium-dependent mechanisms. In humans, flow-mediated dilation of angiographically normal Epicardial Coronary Arteries has been observed during tachycardia, this response being impaired in the presence of atherosclerosis. To evaluate whether the endothelium-dependent physiological vasodilatory response of Epicardial Coronary Arteries to tachycardia is preserved in heart transplant recipients, 22 patients with angiographically smooth Coronary Arteries were studied with quantitative angiography. A total of 14 patients had undergone cardiac transplantation more than 1 year (mean, 28 +/- 18 months) before the study, and 8 patients were nontransplant patients with atypical chest pain and normal exercise tests (control group). Angiograms of the left Coronary artery were obtained on 35-mm cinefilms at 3-minute intervals in basal conditions, during pacing-induced tachycardia (150 beats per minute), and after intraCoronary injection of 1.5 mg of isosorbide dinitrate. During tachycardia, the mean luminal diameter of the midsegment of the left anterior descending Coronary artery increased by 8.9 +/- 6.1% from 2.64 +/- 0.56 to 2.88 +/- 0.62 mm (P < .001) in transplant recipients and by 7.5 +/- 5.0% from 2.37 +/- 0.54 to 2.53 +/- 0.50 mm (P < .025) in the control group (transplant vs control patients, NS). A further Coronary dilation was observed in all patients after isosorbide dinitrate, up to 124.8 +/- 8.1% of basal lumen diameter in transplant recipients and up to 129.1 +/- 16.1% of basal diameter in the control group. The vasodilator response of Epicardial Coronary Arteries to tachycardia is preserved in heart transplant recipients. This suggests that the functional response of the endothelium to an increase in Coronary blood flow remains normal in these patients.

Ernest N. Arnett - One of the best experts on this subject based on the ideXlab platform.

  • Degrees of Cross-Sectional-Area Luminal Narrowing of the Four Major Epicardial Coronary Arteries in Patients with Otherwise Functionally and Anatomically Normal Hearts.
    The American journal of cardiology, 2021
    Co-Authors: Ernest N. Arnett, William C. Roberts
    Abstract:

    ABSTRACT Described herein are necropsy findings in the 4 major (left main, left anterior descending, left circumflex, and right) Epicardial Coronary Arteries in 86 patients aged 10-70 years who never had symptoms of myocardial ischemia, and at autopsy had otherwise anatomically normal hearts. All 86 died of a non-cardiovascular condition. In each of these patients all 4 major Epicardial Coronary Arteries were excised intact from the heart, divided into 5-mm segments, and each segment prepared for histologic examination. The degrees of cross-sectional area (CSA) narrowing was determined from histologic examination of each 5-mm segment. The degree of narrowing in each 5 mm segment was divided into 4 categories: 0 – 25%, 26 – 50%, 51 – 75%, and 76 – 100%. Twelve patients (14%) had ≥1 artery narrowed >75% in CSA, a single artery in 9 patients, and 2 Arteries in each of 3 patients. In contrast to the relative infrequency of narrowing >75%, narrowing 51-75% was common, and was present in 36 (42%) of the 86 patients. Of the 258 major Coronary Arteries (excludes the left main) studied in the 86 patients, 15 (6%) were narrowed >75%, and 70 (24%) were narrowed 51 to 75% in CSA. Even mild narrowing (26 – 50%) of the left main Coronary artery (66 patients) was generally accompanied by 51 – 75% or greater narrowing of at least one of the other major Coronary Arteries. In conclusion, even hearts which have functioned normally and are otherwise anatomically normal, usually have some degree of atherosclerotic plaque in the major Epicardial Coronary Arteries.

  • degrees of cross sectional area luminal narrowing of the four major Epicardial Coronary Arteries in patients with otherwise functionally and anatomically normal hearts
    American Journal of Cardiology, 2021
    Co-Authors: Ernest N. Arnett, William C. Roberts
    Abstract:

    Described herein are necropsy findings in the 4 major (left main, left anterior descending, left circumflex, and right) Epicardial Coronary Arteries in 86 patients aged 10-70 years who never had symptoms of myocardial ischemia, and at autopsy had otherwise anatomically normal hearts. All 86 died of a non-cardiovascular condition. In each of these patients all 4 major Epicardial Coronary Arteries were excised intact from the heart, divided into 5-mm segments, and each segment prepared for histologic examination. The degrees of cross-sectional area (CSA) narrowingwere determined from histologic examination of each 5-mm segment. The degree of narrowing in each 5 mm segment was divided into 4 categories: 0% to 25%, 26% to 50%, 51% to 75%, and 76% to 100%. Twelve patients (14%) had ≥1 artery narrowed >75% in CSA, a single artery in 9 patients, and 2 Arteries in each of 3 patients. In contrast to the relative infrequency of narrowing >75%, narrowing 51-75% was common, and was present in 36 (42%) of the 86 patients. Of the 258 major Coronary Arteries (excludes the left main) studied in the 86 patients, 15 (6%) were narrowed >75%, and 70 (24%) were narrowed 51% to 75% in CSA. Even mild narrowing (26% to 50%) of the left main Coronary artery (66 patients) was generally accompanied by 51% to 75% or greater narrowing of at least one of the other major Coronary Arteries. In conclusion, even hearts which have functioned normally and are otherwise anatomically normal, usually have some degree of atherosclerotic plaque in the major Epicardial Coronary Arteries.

Kunio Hiwada - One of the best experts on this subject based on the ideXlab platform.