Coronary artery disease
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Coronary artery disease · Jan 1996
Randomized Controlled Trial Clinical TrialImprovement of exercise-induced ischaemia and myocardial perfusion after aminophylline.
Previous studies have suggested that aminophylline improves exercise-induced ischaemia by preventing the redistribution of the coronary flow from ischaemic to non-ischaemic myocardium. The purpose of the study was to assess whether aminophylline improves myocardial perfusion in zones supplied by collateral circulation. ⋯ Aminophylline significantly delayed the time to onset of exercise-induced ischaemia and improved perfusion in zones supplied by collateral circulation. Aminophylline-like drugs may be useful in the treatment of selected patients with ischaemic heart disease.
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Coronary artery disease · Sep 1995
Extensive endarterectomy of the left anterior descending coronary artery combined with coronary artery bypass grafting.
Complete revascularization of a diffusely diseased left anterior descending (LAD) coronary artery can be accomplished by extensive endarterectomy in conjunction with coronary artery bypass grafting (CABG). The present study was designed to assess the safety of the procedure, and which techniques lead to the best short- and long-term results. ⋯ Complete revascularization of the diffusely diseased LAD coronary artery can be accomplished by adjunctive open endarterectomy with a degree of operative risk (mortality 9% and incidence of non-fatal myocardial infarction 7%). The immediate and medium-term results are improved when the IMA is used as a conduit, with or without additional venous patch. Independent risk factors for mortality were two-vessel endarterectomy, female sex and emergency operation. The long-term results revealed an overall survival rate of 92% and a cardiac event-free survival rate of 79% at 4 years, as well as excellent functional results.
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Coronary artery disease · Jul 1995
Rapid accurate diagnosis of acute myocardial infarction in patients with non-traumatic chest pain within 1 h of admission.
Accurate diagnosis of impending acute myocardial infarction (AMI) in patients presenting at an emergency department with acute chest pain is essential for proper triage and treatment. We have developed an algorithm for the early diagnosis of AMI. ⋯ The classification procedure obtained allows accurate rapid and early diagnosis of AMI and could therefore be a valuable diagnostic aid to physicians of emergency medicine.
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Coronary artery disease · Jan 1995
ReviewAssessment of myocardial perfusion in coronary artery disease using myocardial contrast echocardiography.
MCE has evolved over the past decade as a clinically useful technique for the assessment of myocardial perfusion in patients with coronary artery disease. At present, its applications are limited because of the necessity of injecting microbubbles directly into the arterial circulation. ⋯ The advent of ultrasound systems that provide a linear relationship between the tissue concentration of microbubbles and the video intensity will make the method truly quantitative. It is likely that MCE will replace nuclear cardiology for the assessment of myocardial dysfunction by the turn of the century in many patients with coronary artery disease.