共查询到20条相似文献,搜索用时 468 毫秒
1.
Kenichi Sakakura Elena Ladich Qi Cheng Fumiyuki Otsuka Kazuyuki Yahagi David R. Fowler Frank D. Kolodgie Renu Virmani Michael Joner 《Journal of the American College of Cardiology》2014
Background
Although renal sympathetic denervation therapy has shown promising results in patients with resistant hypertension, the human anatomy of peri-arterial renal nerves is poorly understood.Objectives
The aim of our study was to investigate the anatomic distribution of peri-arterial sympathetic nerves around human renal arteries.Methods
Bilateral renal arteries were collected from human autopsy subjects, and peri-arterial renal nerve anatomy was examined by using morphometric software. The ratio of afferent to efferent nerve fibers was investigated by dual immunofluorescence staining using antibodies targeted for anti–tyrosine hydroxylase and anti–calcitonin gene–related peptide.Results
A total of 10,329 nerves were identified from 20 (12 hypertensive and 8 nonhypertensive) patients. The mean individual number of nerves in the proximal and middle segments was similar (39.6 ± 16.7 per section and 39.9 ± 1 3.9 per section), whereas the distal segment showed fewer nerves (33.6 ± 13.1 per section) (p = 0.01). Mean subject-specific nerve distance to arterial lumen was greatest in proximal segments (3.40 ± 0.78 mm), followed by middle segments (3.10 ± 0.69 mm), and least in distal segments (2.60 ± 0.77 mm) (p < 0.001). The mean number of nerves in the ventral region (11.0 ± 3.5 per section) was greater compared with the dorsal region (6.2 ± 3.0 per section) (p < 0.001). Efferent nerve fibers were predominant (tyrosine hydroxylase/calcitonin gene–related peptide ratio 25.1 ± 33.4; p < 0.0001). Nerve anatomy in hypertensive patients was not considerably different compared with nonhypertensive patients.Conclusions
The density of peri-arterial renal sympathetic nerve fibers is lower in distal segments and dorsal locations. There is a clear predominance of efferent nerve fibers, with decreasing prevalence of afferent nerves from proximal to distal peri-arterial and renal parenchyma. Understanding these anatomic patterns is important for refinement of renal denervation procedures. 相似文献2.
Jiun-Jr Wang J. Christopher Bouwmeester Israel Belenkie Nigel G. Shrive John V. Tyberg 《The Canadian journal of cardiology》2013
Background
Using the reservoir-wave approach, we studied wave propagation, reflection, and re-reflection in the canine aorta with administrations of sodium nitroprusside (NP) and methoxamine (Mtx).Methods
In 8 anaesthetized dogs, excess pressures were calculated from pressure and flow measurements at 4 locations along the aorta; wave intensity analysis was employed to identify wavefronts and the type of waves.Results
NP (intravenous; 14 μg/min) decreased mean aortic pressure from 80 ± 3 mm Hg to 48 ± 1 mm Hg; Mtx (intravenous; 10 μg/min) increased mean pressure from 80 ± 3 mm Hg to 104 ± 4 mm Hg. NP increased negative reflection near the kidneys (reflection coefficient: −0.33 vs −0.18; P < 0.01) and produced new negatively reflecting sites just beyond the arch and in the proximal femoral arteries, consistent with a vasodilating effects of nitrates on conducting arteries. Mtx negated negative reflection from near the kidneys (−0.02 vs −0.17; P < 0.01) and increased positive femoral reflection (0.38 vs 0.26; P < 0.01). The large reflected compression wave was re-reflected from the closed aortic valve to produce a prominent increase in middiastolic pressure in the distal aorta.Conclusions
The reservoir-wave approach explains decreasing diastolic pressure without positing waves that travel at near-infinite velocities and reveals the pressure changes that are uniquely due to wave motion. 相似文献3.
F. Pasquet M. Chauffer L. Karkowski P. Debourdeau B. Mc Grégor M. Labeeuw M. Laville M. Pavic 《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》2010
Purpose
Granulomatous interstitial nephritis (GIN) are identified in 0.5 to 1,3% of all renal biopsies. Renal outcome and treatment modalities are not clearly established in the literature.Methods
We retrospectively analyzed a case series of 44 GIN identified among all renal biopsies performed between 1984 and 2005 in the Rhône-Alpes area.Results
The study population included 25 men and 19 women with a mean age of 56 years, and mean diagnostic delay was 11 months. Renal function was severely impaired (mean creatinine clearance 24 mL/min). Proteinuria was observed in 77% (mean value 0,9 g/24 h) of the patients and associated with microscopic hematuria and leukocyturia in 30% and 25%, respectively. The most common diagnosis was sarcoidosis (25%, n = 11), followed by drug-induced GIN (9%, n = 4), tuberculosis (6,8%, n=3), hemopathy-related paraneoplastic GIN (6,8%, n = 3), HIV infection (n = 1) and chronic renal allograft rejection (n = 1). In other patients, no aetiology was found (48%, n = 21). Severity of renal failure justified hemodialysis in 34% (n = 15) of the patients. Three patients underwent renal transplantation. Nonetheless, renal outcome was generally favorable: renal function improved in 41% (n = 18) and stabilized in 34% (n = 15) of patients.Conclusions
Sarcoidosis, drug-induced and infections represent the main causes of GIN. Histologic features are not specific enough to determine the aetiology. Corticosteroids is the gold standard in sarcoidosis, drug-induced, and idiopathic GIN. Treatment is etiologic in the other cases. 相似文献4.
Elisabetta M. Mariucci Luigi LovatoMarzia Rosati Luis M. PalenaMarco Bonvicini Rossella Fattori 《International journal of cardiology》2013
Objectives
Aim of this study was to assess vascular morphology and dimension of the entire aorta and branch vessels in MFS using thoracoabdominal MR angiography (MRA).Background
Evaluation of vascular involvement in Marfan Syndrome (MFS) is focused to the ascending aorta, which has the major risk of dissection/rupture.Methods
From March 2006 to January 2011, 64 patients (35 ± 13 years old) with MFS underwent echocardiography and MRA of thoracic and abdominal aorta. Measurements of ascending aorta, aortic arch, descending thoracic and abdominal aorta, and aortic branch vessels were assessed. In patients with aortic dissection only non dissected vessels were considered for measurements.Results
64 Marfan patients were divided into 2 groups: patients in natural history (group A, 55%) and patients previously submitted to aortic root and/or ascending aorta replacement because of severe aortic dilation or dissection (group B, 45%).Dilation of the descending aorta, mostly of the aortic isthmus, occurred in 18/53 patients (8/35 group A, 10/18 group B). Abdominal aorta resulted in the normal range in group A and in 16/18 patients of group B, while iliac vessels were dilated in 7/35 patients of group A and in 10/23 patients of group B. Four patients of group B presented isolated dilation of subclavian, celiac, mesenteric, or renal arteries.Conclusions
Vascular dilation beyond the aortic root is not uncommon in MFS. The systematic use of MRA provides a comprehensive evaluation of the entire arterial system. 相似文献5.
Adolfo Fontenla José A. García-Donaire Felipe Hernández Julián Segura Ricardo Salgado César Cerezo Luis M. Ruilope Fernando Arribas 《Revista espa?ola de cardiología》2013
Introduction and objectives
Resistant hypertension is a clinical problem because of its difficult management and increased morbidity and mortality. Catheter-based renal denervation has been demonstrated to improve control in these patients. The results of establishing a multidisciplinary unit for the implementation of renal denervation in the management of resistant hypertension are described.Methods
A team of nephrologists and cardiologists created a protocol for patient selection, intervention, and follow-up. One hundred and ninety-seven patients with poorly controlled essential hypertension, despite taking 3 or more drugs, were included. The ablation technique previously described was supported by a navigator based on rotational angiography. Blood pressure at baseline and after follow-up was compared using the Wilcoxon test for paired samples.Results
One hundred and eight patients (55%) with pseudo-resistant hypertension were excluded. The other 89 were given antialdosteronic drugs, to which 60 patients (30%) responded. The remaining 29 patients (15%) were candidates for denervation. Eleven patients, with blood pressure 164/99 mmHg and taking 4.4 antihypertensive drugs, were ablated. After 72 days of follow-up, systolic and diastolic blood pressure fell by 25 mmHg (P=.02) and 10 mmHg (P=.06), respectively. In 10 patients (91%) at least 1 drug was discontinued.Conclusions
Renal denervation performed by a multidisciplinary team led to an improvement in blood pressure similar to previous studies, with a greater reduction of antihypertensive drugs.Full English text available from:www.revespcardiol.org/en. 相似文献6.
I. Gallais Sérézal S. Le Jeune X. Belenfant R. Bakir O. Fain A. Mekinian N. Gambier L. Mouthon O. Steichen P. Blanche J.-J. Mourad R. Dhôte 《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》2014
Purpose
Idiopathic retroperitoneal fibrosis (IRF) is an inflammatory disorder, affecting the aorta and the surrounding vessels and tissues. The prognosis is mainly driven by the risks of chronic kidney disease and relapse. Our aim was to assess the prevalence of chronic kidney disease at follow-up.Methods
We retrospectively reviewed the medical records of patients diagnosed for IRF in Seine-Saint-Denis (France) between 1987 and 2011. We collected informations about presentation, radiologic findings and follow-up. Diagnosis of IRF was confirmed when all the following criteria were met: infiltration of the infrarenal aorta or iliac vessels, absence of aneurysmal dilation, lack of clinical suspicion of malignancy.Results
Thirty patients were identified, with a male/female ratio of 4.9. Mean age was 55 ± 13 years old. The mean creatinine clearance was 66 mL/min/1.73 m2 and the mean CRP was 45 ± 36 mg/L. In 24 (80%) patients, the location of IRF was periaortic and periiliac. Eleven patients (37%) underwent a diagnostic biopsy, and 14 (47%) required an ureteral procedure. A mean follow-up of 63 months was available for 29 patients: 69% relapsed, 7 developed chronic renal disease (24%), and one died of urinary sepsis. Older age (P = 0.023), diabetes (P = 0.007), and initial renal insufficiency (P = 0.05) were associated with a risk of chronic renal insufficiency.Conclusion
The high frequency of relapses and chronic renal disease emphasizes the need of close follow-up in patients diagnosed with IRF. 相似文献7.
Yingwei LiuNina Ghosh FRCPC Girish DwivediBenjamin J. Chow FRCPC FACC Robert A. deKempJean DaSilva PhD Ann GuoLinda Garrard BScN Rob S. BeanlandsTerrence D. Ruddy FRCPC FACC 《The Canadian journal of cardiology》2013
Background
It has been shown that 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is useful in identifying inflamed plaque in major arteries. This study evaluated the feasibility of inflamed plaque detection with routinely acquired cardiac FDG-PET viability studies in patients with severe coronary artery disease and left ventricular dysfunction.Methods
Clinically indicated myocardial viability scans using FDG and PET combined with computed tomography from 103 patients were retrospectively analyzed for FDG uptake in the proximal, ascending, and descending thoracic aorta. Aortic uptake was graded on the basis of peak and mean target-to-background ratio (TBR): grade 0, < 1; grade 1, 1.01-1.49; grade 2, 1.5-1.99; and grade 3, > 2.Results
Of the 103 patients, 71 (68.9%) had a history of myocardial infarction, 88 (85.4%) were on statins, and 70 (68%) were on angiotensin-converting enzyme (ACE) inhibitors. Increased FDG uptake (mean TBR grade 1-3) was seen in 79 of 103 patients (77%), and grade 3 aortic uptake based on peak TBR was found in 12 of 103 patients (12%).Conclusions
Detection of inflamed atherosclerotic plaque in the aorta with conventional FDG viability scans is feasible. The rate of very positive uptake in this population of ischemic heart disease patients is low, possibly reflecting aggressive secondary risk factor modification including statin and ACE inhibitor use. 相似文献8.
Jose Gutierrez James Goldman Lawrence S. Honig Mitchell S.V. Elkind Susan Morgello Randolph S. Marshall 《Atherosclerosis》2014
Objective
It is hypothesized that outward remodeling in systemic arteries is a compensatory mechanism for lumen area preservation in the face of increasing arterial stenosis. Large brain arteries have also been studied, but it remains unproven if all assumptions about arterial remodeling can be replicated in the cerebral circulation.Methods
The sample included 196 autopsied subjects with a mean age of 55 years; 63 % were men, and 74 % non-Hispanic whites. From each of 1396 dissected cadaveric large arteries of the circle of Willis, the areas of the lumen, intima, media, and adventitia were measured. Internal elastic lamina (IEL) area was defined as the area encircled by this layer. Stenosis was calculated by dividing the plaque area by the IEL area and multiplying by 100.Results
Plotting stenosis against lumen area or stratified by arterial size showed no preservation of the lumen in the setting of growing stenosis. We could not find an association between greater IEL proportion and stenosis (B = 0.44, P = 0.86). Stratifying arteries by their size, we found that smaller arteries have greater lumen reduction at any degree of stenosis (B = −23.65, P ≤ 0.0001), and although larger arteries show a positive association between IEL proportion and stenosis, this was no longer significant after adjusting for covariates (B = 6.0, P = 0.13).Conclusions
We cannot confirm the hypothesis that large brain arteries undergo outward remodeling as an adaptive response to increasing degrees of stenosis. We found that the lumen decreases proportionally to the degree of stenosis. 相似文献9.
John J. Sim Jiaxiao Shi Csaba P. Kovesdy Kamyar Kalantar-Zadeh Steven J. Jacobsen 《Journal of the American College of Cardiology》2014
Background
Medical data or clinical guidelines have not adequately addressed the ideal blood pressure (BP) treatment targets for survival and renal outcome.Objectives
This study sought to evaluate ranges of treated BP in a large hypertension population and compare risk of mortality and end-stage renal disease (ESRD).Methods
A retrospective cohort study within the Kaiser Permanente Southern California health system was performed from January 1, 2006, to December 31, 2010. Treated hypertensive subjects ≥18 years of age were studied. Cox proportional hazards regression models were used to evaluate the risks (hazard ratios) for mortality and/or ESRD among different BP categories with and without stratification for diabetes mellitus and older age.Results
Among 398,419 treated hypertensive subjects (30% with diabetes mellitus), mortality occurred in 25,182 (6.3%) and ESRD in 4,957 (1.2%). Adjusted hazard ratios (95% confidence intervals [CI]) for composite mortality/ESRD in systolic BP <110, 110 to 119, 120 to 129, 140 to 149, 150 to 159, 160 to 169, and ≥170 compared with 130 to 139 mm Hg were 4.1 (95% CI: 3.8 to 1.3), 1.8 (95% CI: 1.7 to 1.9), 1.1 (95% CI: 1.1 to 1.1), 1.4 (95% CI: 1.4 to 1.5), 2.3 (95% CI: 2.2 to 2.5), 3.3 (95% CI: 3.0 to 3.6), and 4.9 (95% CI: 4.4 to 5.5) respectively. Diastolic BP 60 to 79 mm Hg were associated with the lowest risk. The nadir systolic and diastolic BP for the lowest risk was 137 and 71 mm Hg, respectively. Stratified analyses revealed that the diabetes mellitus population had a similar hazard ratio curve but a lower nadir at 131 and 69 mm Hg but age ≥70 had a higher nadir (140 and 70 mm Hg).Conclusions
Both higher and lower treated BP compared with 130 to 139 mm Hg systolic and 60 to 79 mm Hg diastolic ranges had worsened outcomes. Our study adds to the growing uncertainty about BP treatment targets. 相似文献10.
Hermann Blessberger Jürgen KammlerBarbara Wichert-Schmitt MD Clemens Steinwender MD 《Journal of electrocardiology》2013
Introduction
Left atrial catheter ablation (LACA) is routinely used in the management of recurrent atrial fibrillation.Case presentation
We report a patient suffering from vasospastic angina 2 months after a LACA procedure. Typical clinical symptoms, ST-segment changes during exercise test and successful treatment with nicorandil led to the diagnosis. According to our hypothesis, destruction of autonomic ganglia in the left atrium and resulting autonomic nerve tone imbalance might be the main determinants that have caused this phenomenon.Conclusion
Coronary spasms even weeks after LACA should draw attention to a possible association with the procedure. 相似文献11.
A. Jaïdane H. OuertaniA. Dorai C. ZouaouiH. Ibrahim B. Zidi 《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》2012
Introduction
Renal artery stenosis is rarely associated with Conn adenoma.Case report
We report a 27-year-old male patient who presented in 2001 with a severe high blood pressure associated with hypokaliemia. Radiologic investigations showed a left renal artery stenosis with agenesis of left kidney. A left nephrectomy was performed and blood pressure returned to normal with a single antihypertensive drug. Five years later, the patient again presented with severe high blood pressure. Laboratory studies revealed a low serum potassium level at 2.8 mmol/L associated with high urinary potassium excretion (84 mmol/24 h) and a very high aldosterone/renin ratio (> 462). Abdominal CT scan demonstrated a right adrenal mass. The patient underwent a right adrenalectomy (adenoma). Blood pressure returned to normal with a single antihypertensive. Serum potassium levels as well as aldosterone/renin ratio normalized.Conclusion
We discussed whether the association between these two entities is merely fortuitous or conversely based on a causal relationship. 相似文献12.
Background
The aim was to evaluate the accuracy, precision and feasibility of semi-automatic border detection software (AMS) in comparison to manual electronic calipers (EC) in the analysis of arterial images obtained with transcutaneous very-high resolution vascular ultrasound (VHRU, 25–55 MHz).Methods
100 images from central elastic and peripheral muscular arteries were obtained on two separate imaging occasions from 10 healthy subjects, and independently measured with AMS and EC.Results
No bias between AMS and EC was found. The intraobserver coefficients of variation (CV) for carotid lumen dimension (mean dimension 5.60 mm) was lower with AMS compared with EC (0.4 vs. 1.9%, p = 0.033; N = 20). No consistently significant differences in intra, inter or test-retest CVs were observed overall for muscular artery dimensions between AMS and EC. The intra CV for adventitial thickness (AT, mean 0.111 mm; 15.6 vs 24.8%, p = 0.011; N = 41) and inter CV for intima-media thickness (IMT, mean 0.219 mm; 14.3 vs. 21.2%, p = 0.001; N = 58) obtained with AMS in higher quality thin muscular artery images was lower compared with EC. The mean reading time was significantly lower with AMS compared with EC (71.5 s vs. 156.6 s, p < 0.001).Conclusion
AMS is accurate, precise, and feasible in the analysis of arterial images obtained with VHRU. Minor, although statistically significant, differences in the precision of AMS and EC-systems were found. The precision of AMS was superior for AT and IMT in higher quality images likely related to a decrease in the technical variability imposed by the observer. 相似文献13.
Yuji Shimizu Shimpei Sato Jun Koyamatsu Hirotomo Yamanashi Mami Tamai Koichiro Kadota Kazuhiko Arima Hironori Yamasaki Noboru Takamura Kiyoshi Aoyagi Takahiro Maeda 《Atherosclerosis》2014
Objective
The influence of hyperuricemia on atherosclerosis is controversial. Subclinical carotid atherosclerosis can be defined in two ways in terms of mean and maximum carotid intima-media thickness (CIMT): one with mean CIMT ≥ 1.1 mm and the other with maximum CIMT ≥ 1.1 mm. However, no studies have been reported of the association between hyperuricemia and subclinical carotid atherosclerosis while taking the two different ways of classification into account.Methods
We conducted a cross-sectional study of 4133 subjects (1492 men and 2641 women) aged 30–89 years undergoing general health check-ups. For analysis of various associations, we calculated the multivariable odds ratios (ORs) for the two ways classifications of subclinical carotid atherosclerosis in relation to hyperuricemia.Results
Hyperuricemia-related renal impairment constitutes a significant marker for subclinical carotid atherosclerosis with mean CIMT ≥ 1.1 mm for both men and women, while hyperuricemia per se was found to be beneficially associated with risk of subclinical carotid atherosclerosis with maximum CIMT ≥ 1.1 mm for men. The classical cardiovascular risk factors without adjustment for glomerular filtration rate (GFR) of ORs for subclinical carotid atherosclerosis (mean CIMT ≥ 1.1 mm) and subclinical carotid atherosclerosis (maximum CIMT ≥ 1.1 mm) were 2.20(1.10–4.22) and 0.84(0.63–1.13) for men and 2.12(1.02–4.38) and 0.92(0.66–1.27) for women. After further adjustment for GFR, the corresponding values were 1.54(0.74–3.20) and 0.67(0.49–0.92) for men and 1.32(0.61–2.88) and 0.80(0.57–1.12) for women.Conclusion
Hyperuricemia-related renal impairment is a significant marker for subclinical carotid atherosclerosis for both men and women, while hyperuricemia per se may be inversely associated with subclinical carotid atherosclerosis for men as seen in a rural community-dwelling Japanese population. 相似文献14.
Objective
This study was designed to retrospectively investigate whether percutaneous transluminal angioplasty (PTA) is efficacious and safe for the treatment of atypical thromboangiitis obliterans (ATAO) in arteries with occlusion of long segments.Methods
From January 2011 to July 2013, 9 consecutive male patients with ATAO involving the external iliac and superficial femoral arteries were treated by PTA alone, without stent placement. Their mean age was 35 years (range, 24–47 years). Preoperative symptoms included severe claudication (n = 2), ischemic pain at rest (n = 4), and ischemic ulcers (n = 3). No any infrapopliteal interventions were performed besides the proximal intervention.Results
Technical success using PTA was achieved in 100% of cases with occluded arteries, and there were no periprocedural complications. Clinical improvement was observed postoperatively with a significant improvement in Rutherford categories (range, 2–3) and significantly increased ankle-brachial indexes, from 0.59 ± 0.14 to 0.91 ± 0.17 (p < 0.01). Ischemic ulcers in three patients healed 3–5 months postoperatively. No recurrent ischemic ulcer was observed, and no amputation was performed in these patients. At follow-up examination (average, 20.9 months), restenosis of the superficial femoral artery was diagnosed in only one patient who continued with a conservative medication regimen and refused additional interventional treatment because his physical symptoms were minor.Conclusion
PTA might be feasible and safe for the treatment of ATAO patients, and appears to provide positive clinical results at an average follow-up of 20.9 months. 相似文献15.
Jian-Jun Liu Sylvia Liu Nils G. Morgenthaler Melvin D.S. Wong Subramaniam Tavintharan Chee Fang Sum Su Chi Lim 《Atherosclerosis》2014
Objectives
To study the relationship between plasma soluble klotho (sKlotho) and pro-endothelin-1 (proET-1) in patients with type 2 diabetes (T2DM).Subjects and methods
In this cross-sectional study, we recruited 175 T2DM subjects and 56 non-diabetic controls. Plasma sKlotho, proET-1 and extracellular superoxide dismutase (SOD) were measured by ELISA and ILMA, respectively.Results
Plasma sKlotho level in patients with T2DM was lower compared to that in non-diabetic controls (416.8 ± 148.1 vs. 494.6 ± 134.3 pg/ml, p = 0.001) and showed significant interaction with diabetes status in its association with proET-1. Plasma sKlotho was inversely correlated with proET-1 in T2DM (Rho = −0.410, p < 0.0001) but not in non-diabetic controls (Rho = 0.091, p = 0.505). Multivariable linear regression models revealed that sKlotho was independently associated with proET-1 after adjustment for renal filtration function, albuminuria, diabetes duration, HbA1c, systolic and diastolic blood pressure.Conclusions
Plasma sKlotho was associated with proET-1 independent of renal function in patients with T2DM. 相似文献16.
Costas Tsioufis Vasilios Papademetriou Kyriakos Dimitriadis Dimitris Tsiachris Costas Thomopoulos Euljoon Park Cary Hata Apostolos Papalois Christodoulos Stefanadis 《International journal of cardiology》2013
Objectives
We investigated the acute and chronic effects of catheter-based renal sympathetic denervation (RSD) on renal hemodynamics assessed by average peak velocity (APV), renal blood flow (RBF), renal flow reserve (RFR) and resistive index (RI).Background
Sympathetic overdrive is accompanied by impaired RBF, whereas there is no data on the effects of transcatheter RSD on renal hemodynamic balance.Methods
Before and post-RSD (acutely and after 1 month), in 9 farm swines we measured APV by a 0.014-inch Doppler flow wire placed in the stem of the renal artery under baseline and hyperemic conditions, induced by intrarenal dopamine (50 μg/kg). RFR was calculated as the ratio of hyperemic to basal peak velocity, and RI was estimated as (peak systolic velocity − end-diastolic velocity)/peak systolic velocity. RSD was achieved via the lumen of the main renal artery with a specifically designed catheter connected to a radiofrequency generator according to prespecified algorithm.Results
APV and RBF increased acutely post ablation in all animals, compared to APV and RBF before ablation (61.44 ± 32.6 vs 20.44 ± 6.38 cm/s, p < 0.001 and 407.4 ± 335.1 vs 161.1 ± 76.6 ml/min, p = 0.003; respectively), whereas RFR and RI were reduced (1.51 ± 0.59 vs 2.85 ± 1.33, p < 0.001 and 0.67 ± 0.07 vs 0.74 ± 0.07, p = 0.005; respectively). One month post ablation APV and RBF compared to APV and RBF before ablation remained significantly higher whereas RFR and RI remained lower as compared to baseline.Conclusions
Catheter-based RSD exerts acute and chronic effects on renal hemodynamics in a large animal model. If confirmed in humans RBF parameters may be used as direct markers of successful RSD. 相似文献17.
Roberto Mantovan Laurent Macle Giuseppe De Martino Jian Chen Carlos A. Morillo Paul Novak Vittorio Calzolari Yaariv Khaykin Peter G. Guerra Girish Nair Esteban G. Torrecilla Atul Verma 《The Canadian journal of cardiology》2013
Background
The Substrate and Trigger Ablation for Reduction of Atrial Fibrillation (STAR AF) trial compared 3 strategies for ablation of high-burden paroxysmal/persistent atrial fibrillation (AF): complex fractionated electrogram ablation (CFE), pulmonary vein isolation (PVI), or a combined approach (PVI with CFE). This subanalysis aimed to identify the effect on quality of life (QOL) conferred by ablation strategy, AF recurrence, and type of AF.Methods
The STAR AF study (n = 100) found 88%, 68%, and 38% freedom from AF > 30 seconds at 12 months for PVI with CFE, PVI, and CFE approaches, respectively (P = 0.001). QOL was measured before ablation and at 12 months after ablation using the Short-Form Health Survey (SF-36) scale. Transformed scores were calculated for each of the 8 subscales of the SF-36, and also converted to physical health and mental health component scores.Results
There was a significant improvement in physical health (24%) and mental health (19%) component scores from baseline to 12 months after ablation (P < 0.05 for both). Significant QOL improvements were seen for all 3 ablation strategies despite differences in outcome. QOL measurements also improved regardless of AF recurrence, except in patients with an AF burden in the highest quartile (median 27.2 hours per month). AF recurrence independently predicted aggregate QOL score.Conclusions
QOL after AF ablation improves regardless of procedural outcome. QOL scores were only negatively affected in patients with a high symptomatic burden of arrhythmia recurrence suggesting that significant reduction in AF burden can improve QOL without total elimination of AF. 相似文献18.
Yaron Arbel Amir Sternfeld Adiel Barak Zvia Burgansky-Eliash Amir Halkin Shlomo Berliner Itzhak Herz Gad Keren Ardon Rubinstein Shmuel Banai Ariel Finkelstein 《Atherosclerosis》2014
Background
The “Slow Coronary Flow” (SCF) phenomenon in the presence of angiographically normal coronaries is attributed to microvascular and endothelial dysfunction. The microcirculation can be non-invasively assessed by measuring retinal blood flow velocity.The aim of the present study was to evaluate the efficacy of the “Retinal Functional Imager” (RFI) device as a noninvasive method of diagnosing patients with slow coronary flow.Methods
Coronary blood flow velocity assessed by corrected TIMI Frame Count and retinal arterioles blood flow assessed by RFI were measured in 28 consecutive patients with normal coronary arteries. The patients were divided into 2 groups: a slow coronary flow (SCF) and a normal coronary flow (NCF) groups.Results
Inverse correlation was found between retinal and coronary blood flows so that higher retinal arterial flow velocity was observed in the SCF group (3.8 ± 1.1 mm/s vs. 2.9 ± 0.61 mm/s, respectively, p = 0.022). RFI provided 73% sensitivity and 77% specificity for diagnosing SCF using ROC analysis. Additionally, patients with SCF had higher values of serum LDL cholesterol (104.7 ± 18.93 mg/dl vs. 81.55 ± 14.62 mg/dl in NCF, p = 0.005), Glucose (96.9 ± 23.0 mg/dl vs. 83.55 ± 9.7 mg/dl in NCF, p = 0.024), and lower percentage of statin consumption (40.0% vs. 76.9% in NCF, p = 0.049).Conclusions
Slow coronary blood flow can be non-invasively diagnosed with Retinal Functional Imager. Patients with normal coronary arteries and slow coronary blood flow have high retinal arteriolar blood flow. Early non-invasive diagnosis of SCF might help detect individuals who are at higher risk to develop coronary atherosclerosis, and to provide them with early preventive measures. 相似文献19.
H.F. Tbahriti A. Messaoudi A. Kaddous M. Bouchenak K. Mekki 《Annales de cardiologie et d'angeiologie》2014
Aim
To evaluate pro-inflammatory cytokines, homocysteinemia and markers of oxidative status in the course of chronic renal failure.Patients and methods
One hundred and two patients (male/female: 38/64; age: 45 ± 07 years) with chronic renal failure were divided into 4 groups according to the National Kidney Foundation classification. They included 28 primary stage renal failure patients, 28 moderate stage renal failure, 28 severe stage renal failure and 18 end stage renal failure. The inflammatory status was evaluated by the determination of pro-inflammatory cytokines (tumor necrosis factor-α, interleukin-1β, interleukin-6) and total homocysteine. Pro-oxidant status was assessed by assaying thiobarbituric acid reactive substances, hydroperoxides, and protein carbonyls. Antioxidant defence was performed by analysis of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase.Results
Inflammatory markers were elevated in the end stage renal failure group compared to the other groups (P < 0.001). Indeed, an increase in thiobarbituric acid reactive substances, hydroperoxides and protein carbonyls was noted in the end stage renal failure group in comparison with the other groups (P < 0.001), while the levels of antioxidants enzymes activity were decreased in the study population (P < 0.001).Conclusion
Impaired renal function is closely associated with the elevation of inflammatory markers leading to both increased markers of oxidative stress and decreased antioxidant defense. 相似文献20.
Tamar S. Polonsky Kiang Liu Lu Tian James Carr Timothy J. Carroll Jarett Berry Michael H. Criqui Luigi Ferrucci Jack M. Guralnik Melina R. Kibbe Christopher M. Kramer Feiyu Li Dongxiang Xu Xihao Zhao Chun Yuan Mary M. McDermott 《Atherosclerosis》2014