| 1. |
- Jung, Christian, et al.
(författare)
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Effects of Myocardial Postconditioning on the Recruitment of Endothelial Progenitor Cells.
- 2012
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Ingår i: Journal of Interventional Cardiology. - : Wiley. - 1540-8183 .- 0896-4327. ; 25:2, s. 103-110
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Tidskriftsartikel (refereegranskat)abstract
- Background: Ischemic postconditioning (PostC), brief repetitive cycles of ischemia and reperfusion during early reperfusion, is suggested to protect the myocardium in patients with stent thrombosis-elevation myocardial infarction (STEMI) by improved endothelial dysfunction and alteration of cytokine release. These mechanisms are also of importance for the recruitment of endothelial progenitor cells (EPC), an endogenous repair mechanism for re-endothelialization and neoangiogenesis. The aim of this study was to investigate the effect of PostC on recruitment of EPC. Methods: EPC were analyzed in 20 patients with STEMI randomized to receive four cycles of PostC following percutaneous coronary intervention (PCI) or conventional PCI. Different subpopulations of EPC were quantified immediately and on day 4 using flow cytometry. Myocardium at risk, and infarct size was determined by cardiovascular magnetic resonance. Results: There was no influence of PostC on the number of different EPC (CD34(+) , CD133(+) , CD34(+) CD133(+) , CD34(+) KDR(+) , CD34(-) CD133(+) KDR(+) , CD34(+) CD133(+) KDR(+) ). Left ventricular ejection fraction, myocardium at risk, and infarct size did not correlate to the mobilization of EPC. There was an inverse correlation between the symptom-to-balloon time and the mobilization of progenitor precursor cells (CD34(+) cells: R =-0.527, P = 0.02; CD133(+) cells: R =-0.624, P = 0.004; CD34(+) CD133(+) cells: R =-0.466, P = 0.04). Discussion: Ischemic PostC did not result in improved mobilization of EPC in STEMI patients. The recruitment of progenitor cells seems to be related to the duration of ischemia rather than the size of the ischemic myocardial area. More effort is needed to understand the changes of endothelial surface markers by PostC and their role in EPC recruitment and homing. (J Interven Cardiol 2012;**1-8).
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| 2. |
- Ryden, L
(författare)
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Hypertrophic obstructive cardiomyopathy
- 1996
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Ingår i: JOURNAL OF INTERVENTIONAL CARDIOLOGY. - : Wiley. - 0896-4327 .- 1540-8183. ; 9:4, s. 307-309
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 3. |
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| 4. |
- Ekenback, C, et al.
(författare)
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Changes in Index of Microcirculatory Resistance during PCI in the Left Anterior Descending Coronary Artery in Relation to Total Length of Implanted Stents
- 2019
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Ingår i: Journal of interventional cardiology. - : Hindawi Limited. - 1540-8183 .- 0896-4327. ; 2019, s. 1397895-
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To investigate the relationship between stent length and changes in microvascular resistance during PCI in stable coronary artery disease (CAD). Methods and Results. We measured fractional flow reserve (FFR), index of microcirculatory resistance (IMR), and coronary flow reserve (CFR) before and after stenting in 42 consecutive subjects with stable coronary artery undergoing PCI with stent in the LAD. Patients that had very long stent length (38–78 mm) had lower FFR before stenting than patients that had long (23–37 mm) and moderate (12–22 mm) stent length (0.59 (±0.16), 0.70 (±0.12), and 0.75 (±0.07); p=0.002). FFR improved after stenting and more so in subjects with very long stent length compared to long and moderate stent length (0.27 (s.d ± 16), 0.15 (s.d ± 0.12), and 0.12 (s.d ± 0.07); p for interaction = 0.013). Corrected IMR (IMRcorr) increased after stenting in subjects who had very long stent length, whereas IMRcorr was lower after stenting in subjects who had long or moderate stent length (4.6 (s.d. ± 10.7), −1.4 (s.d. ± 9,9), and −4.2 (s.d. ± 7.8); p for interaction = 0.009). Conclusions. Changes in IMR during PCI in the LAD in stable CAD seem to be related to total length of stents implanted, possibly influencing post-PCI FFR. Larger studies are needed to confirm the relationship.
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| 5. |
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| 6. |
- Malmberg, Stephen, et al.
(författare)
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Resting Full-Cycle Ratio versus Fractional Flow Reserve: A SWEDEHEART-Registry-Based Comparison of Two Physiological Indexes for Assessing Coronary Stenosis Severity
- 2023
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Ingår i: Journal of Interventional Cardiology. - : WILEY-HINDAWI. - 0896-4327 .- 1540-8183. ; 2023
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Tidskriftsartikel (refereegranskat)abstract
- The adenosine-requiring physiological index fractional flow reserve (FFR) is the gold-standard method for determining the significance of intermediate lesions, while the resting full-cycle ratio (RFR) is a novel nonhyperaemic index without the need for adenosine administration. The aim of this study was to investigate the degree of concordance between RFR and FFR in indicating the need for revascularisation in patients with intermediate coronary lesions. This was a retrospective, registry-based study utilising data from the SWEDEHEART registry. Patients treated at Ryhov County Hospital in Jonkoping, Sweden, between the 1(st) of January 2020 and the 30(th) of September 2021, were included. The degree of correlation and concordance between RFR and FFR was determined, both when used with a single cut-off (significant stenosis if RFR = 0.89) and with a hybrid approach (significant stenosis if RFR = 0.85, not significant if RFR & GE;0.94, and FFR measurement when RFR was in the grey zone 0.86-0.93). The study population consisted of 143 patients with 200 lesions. The overall correlation between FFR and RFR was significant (r = 0.715, R-2 = 0.511, p = 0.01). A strong correlation was seen for lesions in the left anterior descending artery (LAD) and the left circumflex artery (LCX) (r = 0.748 and 0.742, respectively, both p = 0.01), while the correlation in the right coronary artery (RCA) was moderate (r = 0.524, p = 0.01). The overall concordance between FFR and RFR using a single cut-off was 79.0%. With a hybrid cut-off approach, the degree of concordance was 91%, with no need of adenosine in 50.5% of the lesions. In conclusion, there was a strong correlation and a high degree of concordance between FFR and RFR in determining the significance of a stenosis. The use of a hybrid approach could improve the identification of physiologically significant stenoses while minimising the use of adenosine.
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| 7. |
- Saad, Mohammed, et al.
(författare)
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Bioresorbable Vascular Scaffolds in a Real-World Patient Population-Results From a Mid-Term Angiographic Follow-Up
- 2016
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Ingår i: Journal of Interventional Cardiology. - : Wiley. - 0896-4327 .- 1540-8183. ; 29:4, s. 341-347
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Tidskriftsartikel (refereegranskat)abstract
- AIM: We aimed to investigate the safety and efficacy of bioresorbable vascular scaffolds (BVS) in daily use in a real-world patient population.METHODS AND RESULTS: Between March 2013 and September 2014, 224 patients (233 lesions) were treated with BVS at a tertiary care center. Patients underwent follow-up coronary angiography 3-6 months after implantation. Clinical presentations were stable angina in 101 patients (45.1%), unstable angina in 47 (21.0%), NSTEMI in 38 (17.0%), and STEMI in 38 (17.0%) patients. Twenty-two patients (27 lesions) had chronic total occlusion (CTO). Procedural success was achieved in all patients. Two patients died in the follow-up period due to BVS thrombosis (0.9%). In-hospital death occurred in further 3 patients (1.3%) due to other causes not related to the BVS implantation. Total BVS thrombosis was 3.1% (7 patients) and there was only 1 case of relevant restenosis on angiographic follow-up. The overall incidence of major adverse cardiac events was 11 (4.9%).CONCLUSIONS: Mid-term follow-up after implantation of BVS suggests a satisfactory safety profile and low restenosis rate in routine daily practice involving a large range of complex lesions.
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| 8. |
- Santos-Pardo, I, et al.
(författare)
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Index of Microcirculatory Resistance Measured during Intracoronary Adenosine-Induced Hyperemia
- 2020
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Ingår i: Journal of interventional cardiology. - : Hindawi Limited. - 1540-8183 .- 0896-4327. ; 2020, s. 4829647-
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Tidskriftsartikel (refereegranskat)abstract
- Background. The index of microcirculatory resistance is an invasive measure of coronary microvascular function that has to be calculated during maximal hyperemia, classically achieved with intravenous adenosine (IV). The aim of this study was to evaluate the use of intracoronary (IC) adenosine for the calculation of IMR. Methods and Results. 31 patients with stable coronary artery disease were included in the study. Coronary pressure and thermodilution measurements were obtained at rest and during maximal hyperemia using a pressure-temperature sensor-tipped coronary guidewire. Duplicate measurements were performed using first IC and then IV adenosine. Dispersion of transit times was comparable for IC and IV adenosine. IMR values based on IC vs IV adenosine showed a high level of agreement and an intraclass correlation coefficient of 0.90. Applying an upper normal limit of 25, misclassification of IMR using IC adenosine was seen in just one patient in whom IC adenosine resulted in a lower value. A simplified procedure based on a single bolus dose of saline did not change the level of agreement or the rate of misclassification. Conclusions. We found an excellent agreement between IMR values measured during hyperemia induced by IC as compared to IV adenosine. The use of IC adenosine may facilitate invasive assessment of microvascular function and is potentially time- and cost-saving with less patient discomfort as compared to IV infusion. The trail is registered with NCT03369184.
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| 9. |
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| 10. |
- Biasco, Luigi, et al.
(författare)
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First-in-Man Experience with the ClearLumen Thrombectomy System as an Adjunctive Therapy in Primary Percutaneous Coronary Interventions
- 2016
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Ingår i: Journal of Interventional Cardiology. - : Wiley. - 0896-4327. ; 29:2, s. 155-161
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To describe the first-in-man experience with the ClearLumen Thrombectomy System (Walk Vascular, Irvine, CA) and report on its safety, feasibility and efficacy when used as an adjunctive therapy during primary PCI. Background Thrombus aspiration (TA) aims to improve microvascular perfusion but currently available devices are not optimal. Methods Prospective, single-centre, non-randomized, safety, and efficacy trial. Patients with acute STEMI were enrolled and the investigational device was used for thrombus aspiration. Safety was evaluated as the overall rate of device related complications while efficacy as the rate of successful device deployment and culprit vessel reperfusion. The composite endpoint based on the achievement of at least two of the following three criteria - TIMI flow 3 and/or myocardial blush grade ≥2 at completion of the case and ST-resolution >70% at 90 minutes after vessel reperfusion - was also evaluated. Results Over a 3 months period 20 patients were enrolled in the study. Culprit lesion was successfully reached with the investigational device in 19 patients (95%). The pre-specified combined endpoint was met in 16 out of 19 patients (84.2%). Three patients not meeting the combined end point had procedure related, non TA associated, adverse event. Only 2 minor procedural adverse event occurred after thrombus aspiration. Conclusions This first-in-man experience with the ClearLumen Thrombectomy System demonstrates initial promising results on safety and efficacy when used as an adjunctive therapy during primary PCI. (J Interven Cardiol 2016;29:155-161)
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