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Franca HH 《Arquivos brasileiros de cardiologia》2002,79(4):419-421
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The validity of coronary angioscope was discussed in several clinical settings in this article. First of all, although smooth coronary surface was observed by coronary angiography after the intervention of chronic total occlusion, protrusion or thrombus observed by angioscope occupied the arterial lumen and closed the vessel lumen. After implantation of the stent, lumen was widely opened. Serial angioscopic observation revealed that the neointima became thick and non-transparent until 6 months and then became thin and transparent by 3 years after stent implantation. These findings suggested the validity of angioscope in coronary intervention. Second, coronary angioscope revealed the morphologic and pathologic characteristics of culprit lesions in patients with acute coronary syndrome. The thrombus was observed on the yellow plaque in the culprit lesion. The thrombus formed directly over the plaque was mainly white and red thrombus might be formed after the blood flow was disturbed by the white thrombus formed by the platelet aggregation. These findings imply the importance of anti-platelet therapy after acute coronary syndromes. Finally, the angioscope can detect the minimal changes of the plaque formation, progression and rupture, that is, the entire process of the atherosclerosis. The early detection of yellow plaque might be able to intervent mechanically or pharmacologically to prevent its rupture. 相似文献
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Baim DS 《Current opinion in cardiology》1991,6(4):524-529
Coronary angioplasty has continued to undergo important developments, both in terms of the maturation of conventional balloon angioplasty, and the favorable preliminary results of a variety of novel adjunctive techniques. To the extent that these new techniques can address the residual limitations of conventional angioplasty--and thereby improve its success, safety, and durability--angioplasty is likely to become the dominant form of myocardial revascularization in the 1990s. To ensure that this tool is applied correctly, however, careful randomized trials must be performed to establish which medical, surgical, or catheter-based treatment represents the best approach to a given clinical situation. 相似文献
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Clark LT Ferdinand KC Flack JM Gavin JR Hall WD Kumanyika SK Reed JW Saunders E Valantine HA Watson K Wenger NK Wright JT 《Heart disease (Hagerstown, Md.)》2001,3(2):97-108
African Americans have the highest overall mortality rate from coronary heart disease (CHD) of any ethnic group in the United States, particularly out-of-hospital deaths, and especially at younger ages. Although all of the reasons for the excess CHD mortality among African Americans have not been elucidated, it is clear that there is a high prevalence of certain coronary risk factors, delay in the recognition and treatment of high-risk individuals, and limited access to cardiovascular care. The clinical spectrum of acute and chronic CHD in African Americans is similar to that in whites. However, African Americans have a higher risk of sudden cardiac death and present more often with unstable angina and non-Q-wave myocardial infarction than whites. African Americans have less obstructive coronary artery disease on angiography, but may have a similar or greater total burden of coronary atherosclerosis. Ethnic differences in the clinical manifestations of CHD may be explained largely by the inherent heterogeneity of the coronary syndromes, and the disproportionately high prevalence and severity of hypertension and type 2 diabetes in African Americans. Identification of high-risk individuals for vigorous risk factor modification-especially control of hypertension, regression of left ventricular hypertrophy, control of diabetes, treatment of dyslipidemia, and smoking cessation--is key for successful risk reduction. 相似文献
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Coronary heart disease in viscose rayon workers 总被引:1,自引:0,他引:1
R S Schilling 《American heart journal》1970,80(1):1-2
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Coronary heart disease in situs inversus totalis 总被引:1,自引:0,他引:1
In patients with dextrocardia as a part of situs inversus totalis, coronary heart disease may occur with similar frequency and manifestations as in the general population. Diagnostic problems arise from the altered cardiovisceral relation; when these are recognized, coronary heart disease can be defined by the usual criteria. The use of electrocardiographic and vectorcardiographic tracings with right-left reversal of all leads in patients with dextrocardia allows the recognition of abnormalities on the basis of standard criteria. Seven cases are reported, 1 followed up clinically and 6 studied at autopsy. 相似文献
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Coronary heart disease: genetic aspects 总被引:1,自引:0,他引:1
Morbidity and mortality differences between populations, between ethnic groups and between individuals are not satisfactorily explained by the variation of risk factors. Differences in genetic susceptibility might be responsible for a part of the unexplained variation of coronary heart disease (CHD) rates. Genetic factors are also significant in determining the level of risk factors in individuals. Ample evidence links genetic factors to the levels of serum cholesterol, blood pressure and diabetes. Marked sex differences in CHD mortality also indicate the role of heredity in the development of the disease. The male:female ratio varies widely between different countries, as well as between different ethnic groups. These variations are difficult to explain by variation in environmental and behavioral differences between males and females alone. The degree of atherosclerosis in males and females varies, depending on the anatomic location of the atherosclerosis. Inherited disorders of metabolism and the variability of anatomic patterns provide additional indications of the role of genetics. The data accumulated in the Israeli Ischemic Heart Disease Study over 15 years reveal an ethnic variation of risk factors coupled with remarkably larger variation in disease rates. Patterns of incidence assessed in the national mortality data of the Israeli study and in histologic findings in the coronary arteries of infants from different ethnic groups are compatible with a hypothesis that ethnic and sex differences in early structural changes of the coronary arteries partly determine the susceptibility of the latter to the development of atherosclerosis. In conclusion, findings from our studies and the review of the evidence from genetic epidemiologic investigations indicate a significant role of genetics in determining the degree, time course and severity of the atherosclerotic process and of the occurrence of symptomatic CHD. This important role of the genetic component is relevant to preventive strategies offered as tools for reducing the burden of CHD. Research into genetic determinants of both susceptibility to atherosclerosis or clinical manifestation of CHD and individual response to preventive measures should be encouraged. 相似文献
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