Alternative interventions for refractory angina

Sainsbury, Paul; Fisher, Michael; Silva, Ranil de

doi:10.1136/heartjnl-2015-308564

Cited by 29 publications

(13 citation statements)

References 96 publications

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“…These angina patients often have incomplete revascularisation with lesions or anatomy previously considered ‘unsuitable for intervention’ but now amenable to treatment by trained operators. A recent review article in Heart summarises non-pharmacological therapeutic approaches to patients with refractory angina including cognitive behavioural therapy (CBT), stellate ganglion nerve blockade, Transcutaneous Electrical Nerve Stimulation (TENS)/spinal cord stimulation and pain modulating antidepressants (eg, imipramine) 61. Of note, coronary sinus reducers deployed using a transcatheter venous system have shown early promise in clinical studies.…”

Section: Managementmentioning

confidence: 99%

Angina: contemporary diagnosis and management

Ford

Berry

2020

Heart

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Section: Managementmentioning

confidence: 99%

Angina: contemporary diagnosis and management

Ford

Berry

2020

Heart

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“…Angina Pectoris occurs due to imbalance between oxygen supply to the myocardium and its demand leading to myocardial necrosis. Myocardial ischemia and infraction following angina attacks are major causes of mortality in developing as well as developed countries, and is considered as a serious disease (Sainsbury, Fisher, & de Silva, ). Vasopressin is an antidiuretic hormone with vasoconstricting and cardio‐stimulant activities.…”

Section: Introductionmentioning

confidence: 99%

Mentha longifolia alleviates experimentally induced angina via decreasing cardiac load

2018

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Angina occurs due to imbalance between heart oxygen demand and supply and is associated with serious morbidity and mortality. Here, the possible antianginal effect of Mentha longifolia extract was studied in experimental model of angina. Aerial parts of M. longifolia were extracted, standardized, and given to rats three days before angina. Heart hemodynamics and conductivity were recorded by microtip catheter and surface electrodes. M. longifolia extract significantly alleviated the sustained decline in cardiac contractility after vasopressin exposure. However, M. longifolia did not affect the impaired cardiac dilation after vasopressin. Heart rate was significantly decreased after vasopressin exposure in rats treated with M. longifolia compared with untreated animals. In addition, M. longifolia produced more increase in systolic and diastolic durations after vasopressin exposure compared with untreated animals. Moreover, the plant extract alleviated the ST height changes during vasopressin injection. M. longifolia extract alleviates impaired cardiac function associated with angina through decreasing heart work. Practical applications The present study is the first to study the effect of M. longifolia in an experimental model of angina. M. longifolia alleviated the impaired cardiac contractility associated with angina exposure. The antianginal effect of M. longifolia could be through reducing cardiac load. This can be concluded from the decrease in heart rate and the systolic and diastolic cycles elongation after exposure to vasopressin in animals pretreated with M. longifolia. This helps in reducing the associated cardiac ischemia upon exposure to vasopressin as indicated by ST change. This could provide new directions in the management of the serious angina disease.

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“…[22][23][24] Angina Refractory to Conventional Therapy Another potential application of biological therapy is "no-option" angina, strictly defined as severe, life-limiting angina due to CAD, refractory to maximal medical therapy, and without surgical or percutaneous revascularization options. 25,26 Coronary insufficiency in these patients is attributed to coronary artery stenosis on angiography and/or microvascular dysfunction. 25,27 The incidence of nonrevascularizable angina in the United States is 50,000 to 200,000 patients/year, although it is difficult to estimate how many would meet the strict inclusion criteria used in clinical trials.…”

Section: Target Patient Populations and Current Therapeutic Gaps Advanced Hfmentioning

confidence: 99%

Clinical potential of angiogenic therapy and cellular reprogramming

2021

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Feature Editor Note-You're driving along the freeway during rush hour. You're running late and find yourself in bumper-to-bumper traffic. You have 3 options: (1) do nothing, suffer with anguish inside; (2) find productive ways to pass the time, like listen to a podcast or talk on the phone; or (3) get off on the next exit and find an alternative, roundabout path to your destination. Similarly, patients suffering from coronary artery disease can opt to do nothing; stop progression and treat their symptoms with medical therapy; or undergo revascularization either percutaneously or surgically.There are few options, however, for those who develop chronic coronary artery disease without suitable revascularization strategies. They have missed their exit and are stuck in this metaphorical traffic jam, with no radio and no cell phone. These patients may experience refractory angina or develop ischemic cardiomyopathy and heart failure. Exploring solutions to this increasingly widespread problem is imperative. Chronic heart failure is rising, while the number of organs available for transplantation remains limited. Similarly, bridge therapies such as ventricular assist devices are resource intensive and are typically only performed at select, high-volume institutions.

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Alternative interventions for refractory angina

Cited by 29 publications

References 96 publications

Angina: contemporary diagnosis and management

Angina: contemporary diagnosis and management

Mentha longifolia alleviates experimentally induced angina via decreasing cardiac load

Clinical potential of angiogenic therapy and cellular reprogramming

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