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991.
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Florim Cuculi Giovanni Luigi De Maria Pascal Meier Erica Dall'Armellina Alberto R. de Caterina Keith M. Channon Bernard D. Prendergast Robin C. Choudhury John C. Forfar Rajesh K. Kharbanda Adrian P. Banning 《Journal of the American College of Cardiology》2014
Background
Invasive assessment of coronary physiology (IACP) offers important prognostic insights in ST-segment elevation myocardial infarction (STEMI) but the dynamics of coronary recovery are poorly understood.Objectives
This study sought to examine the evolution of coronary flow reserve (CFR), index of microcirculatory resistance (IMR), ratio of distal coronary pressure (Pd) to mean aortic pressure (Pa), and fractional flow reserve (FFR) in patients undergoing primary percutaneous coronary intervention (PPCI).Methods
82 patients with STEMI underwent IACP at PPCI. Repeat IACP was performed in 61 patients (74%) at day 1 and in 46 patients (56%) at 6 months. Contrast-enhanced cardiac magnetic resonance imaging (CMR) was performed in 45 patients (55%) at day 1 and in 41 patients (50%) at 6 months. Changes in IACP were compared between patients with and without microvascular obstruction (MVO) on CMR.Results
MVO was present in 21 of 45 patients (47%). Patients with MVO had lower CFR at PPCI and day 1 (p < 0.05) and a trend toward higher IMR values (p = 0.07). At 6 months, CFR and IMR were not significantly different between the groups. Baseline flow and Pd/Pa remained stable over time but FFR reduced significantly between PPCI and 6 months (p = 0.008); this reduction was mainly observed in patients with MVO (p = 0.006) but not in those without MVO (p = 0.21).Conclusions
In PPCI-treated patients with STEMI, coronary microcirculation begins to recover within 24 h and recovery progresses further by 6 months. FFR significantly reduces from baseline to 6 months. The presence of MVO indicates a highly dysfunctional microcirculation. 相似文献993.
Pedro Gabriel Melo de Barros e Silva Otavio Berwanger Elizabete Silva dos Santos Antnio Carlos Sobral Sousa Margaret Assad Cavalcante Pedro Beraldo de Andrade Fernando Carvalho Neuenschwander Hugo Vargas Filho Jorge Ilha Guimares Jadelson Andrade Angelo Amato Vincenzo de Paola Marcus Vinicius Bolivar Malachias Luiz Alberto Piva e Mattos Dalton Bertolim Precoma Fernando Bacal Oscar Pereira Dutra 《Arquivos brasileiros de cardiologia》2020,114(6):995
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Mariasanta Napolitano Alberto Dolce Giuseppe Celenza Elvira Grandone Maria Grazia Perilli Sergio Siragusa Gaspare Carta Assunta Orecchioni Guglielmo Mariani 《Annals of hematology》2014,93(4):557-563
In women of fertile age, iron loss consequent to excessive menstrual discharge is by far the most frequent cause of iron-deficient anemia. However, the relationship between menstrual discharge and iron loss is poorly understood. In this prospective study, total menstrual and iron losses were assayed in a large cohort of non-anemic women and women with excessive menstrual blood losses (menorrhagia) in order to provide data useful for intervention. One hundred and five Caucasian women aged 20–45 years were recruited. Blood cell count and serum ferritin (SF) levels were determined in each case before menses. Menstrual fluid losses (MFL) were determined using a standardized pads’ weight method. Hematin concentration was assayed by a variant of the Alkaline Hematin Method from which iron concentration was calculated. Mean SF levels were 36.2 (range 8.6–100) ng/ml in healthy women and 6.4 (range 5–14) ng/ml in patients with menorrhagia. Median values of iron lost/cycle were 0.87 mg in healthy women and 5.2 mg in patients with menorrhagia (ranges 0.102–2.569 and 1.634–8.665 mg, respectively, p?<?0.001). In women with menorrhagia, iron lost/cycle strongly correlated (0.789, p?<?0.001) with MFL. In conclusion, healthy women with normal menses lose, on average, 1 mg iron/cycle. Average iron losses in patients with menorrhagia are, at least in our cohort, on average, five-to-six times higher than normal. Most women with menorrhagia had totally depleted iron stores. Indirect, quantitative evaluation of iron lost with menses may be useful to assess the risk of developing iron-deficient anemia in individual patients. 相似文献