The Experts below are selected from a list of 27 Experts worldwide ranked by ideXlab platform
G. Kober - One of the best experts on this subject based on the ideXlab platform.
-
Response of coronary arteries to nitrates, the EDRF-donor SIN-1, and calcium antagonists
Basic Research in Cardiology, 1991Co-Authors: W. Schulz, G. KoberAbstract:Intracoronary Drug Administration is an important tool to study coronary effects without interaction of systemic effects. The difficult methodological aspects and the results of clinical trials in which the effects of vasodilating Drugs were evaluated with respect to coronary dilatation are reviewed.
-
Response of coronary arteries to nitrates, the EDRF-donor SIN-1, and calcium antagonists.
Basic research in cardiology, 1991Co-Authors: W. Schulz, G. KoberAbstract:Intracoronary Drug Administration is an important tool to study coronary effects without interaction of systemic effects. The difficult methodological aspects and the results of clinical trials in which the effects of vasodilating Drugs were evaluated with respect to coronary dilatation are reviewed. Major (coronary substrate, study design) and minor (measuring devices, methods of evaluation) methodological problems make it difficult to precisely evaluate pharmacological effects such as dose-response relationship, duration of action, and selective responses, and to compare the effects of different Drugs. From a clinical point of view, knowledge of the maximal effect (EDmax) in coronary stenoses and the duration of action is essential. NO-donors tend to act stronger than CA-channel blockers which may be attributable to their different modes of action. Among those NO-donors investigated, SIN-1 showed stronger effects than nitroglycerin. Only with SIN-1 were maximal effects obviously achieved. The additional Administration of nitroglycerin or nisoldipine never led to a more prominent dilatation. In coronary stenoses, the underlying morphology causes a wider range of responses than is seen in normal segments: deendothelialized stenoses with high coronary tone show a larger dilatation, while fully sclerotic stenoses may not react.
W. Schulz - One of the best experts on this subject based on the ideXlab platform.
-
Response of coronary arteries to nitrates, the EDRF-donor SIN-1, and calcium antagonists
Basic Research in Cardiology, 1991Co-Authors: W. Schulz, G. KoberAbstract:Intracoronary Drug Administration is an important tool to study coronary effects without interaction of systemic effects. The difficult methodological aspects and the results of clinical trials in which the effects of vasodilating Drugs were evaluated with respect to coronary dilatation are reviewed.
-
Response of coronary arteries to nitrates, the EDRF-donor SIN-1, and calcium antagonists.
Basic research in cardiology, 1991Co-Authors: W. Schulz, G. KoberAbstract:Intracoronary Drug Administration is an important tool to study coronary effects without interaction of systemic effects. The difficult methodological aspects and the results of clinical trials in which the effects of vasodilating Drugs were evaluated with respect to coronary dilatation are reviewed. Major (coronary substrate, study design) and minor (measuring devices, methods of evaluation) methodological problems make it difficult to precisely evaluate pharmacological effects such as dose-response relationship, duration of action, and selective responses, and to compare the effects of different Drugs. From a clinical point of view, knowledge of the maximal effect (EDmax) in coronary stenoses and the duration of action is essential. NO-donors tend to act stronger than CA-channel blockers which may be attributable to their different modes of action. Among those NO-donors investigated, SIN-1 showed stronger effects than nitroglycerin. Only with SIN-1 were maximal effects obviously achieved. The additional Administration of nitroglycerin or nisoldipine never led to a more prominent dilatation. In coronary stenoses, the underlying morphology causes a wider range of responses than is seen in normal segments: deendothelialized stenoses with high coronary tone show a larger dilatation, while fully sclerotic stenoses may not react.
David E. Newby - One of the best experts on this subject based on the ideXlab platform.
-
Invasive assessment of the coronary circulation: intravascular ultrasound and Doppler
British Journal of Clinical Pharmacology, 2002Co-Authors: David E. NewbyAbstract:Advances in catheter-based technology have put many innovative techniques at the disposal of the clinical investigator. Intravascular ultrasound (IVUS), in particular, has facilitated the more detailed functional and morphological assessment of the coronary circulation, and will be the major focus of this review. Selective Intracoronary Drug infusion may be desirable for a number of reasons. When examining in vivo vascular responses, systemic Drug Administration causes concomitant effects on organs, such as the brain and kidney, and influences neurohumoral reflexes through changes in systemic haemodynamics. Intracoronary infusions have the advantage of assessing the heart and coronary circulation in relative isolation without invoking systemic effects. This is particularly important for the assessment of cardiac and coronary function which is heavily dependent on changes in the systemic vasculature and haemodynamics. In addition, relatively high doses can be administered locally which may be important for the desired physiological or therapeutic effect and may be further facilitated by the use of local Drug delivery systems. Finally, combining Intracoronary Drug Administration with coronary sinus catheterization and sampling can further extend the assessment of the coronary circulation to include additional aspects of cardiac metabolism and function. In addition to providing functional information, IVUS provides an invasive method of assessing arterial structure and morphology. Detailed and high-resolution examination of the proximal coronary vasculature is possible with precise and accurate definition of tissue planes [1, 2]. This permits the quantitative assessment of atherosclerotic burden and composition as well as enabling the assessment of systemic therapeutic interventions targeted at reducing atherosclerosis such as lipid-lowering therapy [3, 4].
-
Intracoronary infusions and the assessment of coronary blood flow in clinical studies.
Heart, 2000Co-Authors: David E. NewbyAbstract:Intracoronary Drug Administration may be desirable for a number of reasons and is used in therapeutic, diagnostic, interventional, and clinical research settings. One of the main indications for Intracoronary Drug Administration is in the assessment of coronary blood flow either as a guide to intervention or as a clinical research tool. There are many methods of assessing coronary blood flow including the use of the angiogram derived corrected TIMI (thrombolysis in myocardial infarction) frame count1 and the rate of decorrelation of the radiofrequency signal from intravascular ultrasound (IVUS) imaging catheters.2 However, the most direct and widely used method of assessing coronary blood flow is the Doppler flow wire—a piezoelectric cell mounted on the tip of a 0.014 inch guide wire.3 The Doppler flow wire measures coronary blood flow velocity and, in order to measure coronary blood flow, knowledge of the cross sectional area of the vessel is required. The latter is usually estimated using quantitative coronary angiography (QCA), which assumes circular or elliptical luminal geometry, although greater accuracy can be obtained by using IVUS imaging catheters. Indices such as coronary flow reserve—the ratio of maximal to basal hyperaemic flow velocity—can be used to assess the functional severity of coronary stenoses and the dynamic integrity of the microcirculation without determining luminal cross sectional area. However, fractional flow reserve, which is measured using a pressure wire (guide wire with ability to measure distal coronary artery pressure), is increasingly being used to determine the functional severity of coronary stenoses since it is more reproducible, lesion specific, and less dependent on systemic haemodynamic parameters.4-6 Clinical research studies assessing coronary vasomotor responses to Drug infusion have used endothelium dependent and independent vasodilators as well as agonists and antagonists of physiological mediators (table 1). The magnitude and variability of coronary responsiveness is highly …
Jiongbin Lu - One of the best experts on this subject based on the ideXlab platform.
-
Clinical effect of super-selective Intracoronary Administration on acute myocardial infarction patients
Chinese Journal of Geriatrics, 2015Co-Authors: Shaohui Su, Jianfeng Ye, Xiaoping He, Daqiang Li, Bin Xiong, Jiongbin LuAbstract:Objective To investigate the effect of super-selective Intracoronary Administration on acute myocardial in farction patients. Methods A total of 240 patients with ST-segment elevation myocardial infarction who received emergency percutaneous coronary intervention in our department from March 2012 to January 2014 were selected and divided into the intravenous Drug Administration group (n=77), the conventional Intracoronary Drug Administration group (n=81) and the super-selective Intracoronary Drug Administration group (n=82). Parameters, including the Thrombolysis in Myocardial Infarction (TIMI) classification, ST segment resolution after operation, peak values of creatine kinase MB (CK-MB) and troponin-I (cTn-I), left ventricular ejection fraction, left ventricular end-diastolic diameter (LVEDD), major adverse cardiovascular events and bleeding events, were compared between the groups. Results There were no significant differences in TIMI flow grade between the three groups (χ2=0.14, P=0.529). The percentage of patients with complete ST segment resolution after operation was higher in the super-selective Intracoronary Drug Administration group than in the intravenous Drug Administration and conventional Intracoronary Drug Administration groups (74.4% vs. 62.3%, 61.7%, χ2=8.24, P 0.05). Conclusions Super-selective Intracoronary Drug Administration can significantly enhance cardiac function and alleviate angina pectoris in patients with acute myocardial infarction, and should be a recommended method. Key words: Myocardial infarction; Angioplasty, transluminal, percutaneus coronary; Platelet glycoprotein GPⅡb-Ⅲa complex
Kiyoshi Yoshida - One of the best experts on this subject based on the ideXlab platform.
-
Long-term prognostic impact of the attenuated plaque in patients with acute coronary syndrome
Heart and Vessels, 2016Co-Authors: Hiroyuki Okura, Toru Kataoka, Minoru Yoshiyama, Junichi Yoshikawa, Kiyoshi YoshidaAbstract:Several intravascular ultrasound studies have reported that culprit lesion-attenuated plaque (AP) is related to slow flow/no reflow after percutaneous coronary intervention (PCI). Long-term prognostic impact of the AP is unknown. The aim of this study was to investigate acute and long-term clinical impact of the AP in patients with acute coronary syndrome (ACS). A total of 110 ACS patients who underwent successful PCI were enrolled. Acute and long-term clinical outcomes were compared between patients with AP (AP group: n = 73) and those without AP (non-AP group: n = 37). Long-term cardiac event was defined as a composite of death and ACS. Baseline characteristics in 2 groups were similar. AP was associated with higher TIMI frame count immediately after the first balloon inflation. After thrombectomy and Intracoronary Drug Administration, final TIMI frame count became similar between AP and non-AP group. Although AP was associated with higher incidence of fatal arrhythmia during hospitalization, in-hospital mortality did not differ between the 2 groups. During follow-up (median 6.2 years), cardiac event-free survival did not differ between the 2 groups. Despite the initial unfavorable effect on coronary reflow, presence of AP did not affect acute as well as long-term clinical outcome in patients with ACS.