lschaemic heart disease: Endothelial dysfunction of the non-infarct related, angiographically normal, coronary artery in patients with an acute myocardial infarction

Abstract

Endothelial dysfunction of the epicardial and resistance vessels was found in angiographically normal coronary arteries of patients with one-vessel disease in 75% of this population.

Coronary flow reserve of the angiographically normal left anterior descending coronary artery in patients with remote coronary artery disease

“…[1][2][3][4][5] Discordant results have been reported in patients without previous myocardial infarction, 6 -8 and it is unclear what the interaction is when the normal vessel is the left anterior descending (LAD) coronary artery. Recent advances in color Doppler technology have allowed imaging of the distal LAD 9,10 by transthoracic echocardiography, thereby opening the way to the noninvasive detection of recanalization in acute anterior myocardial infarction, 11 diagnosis of LAD disease by measurement of CFR, [12][13][14][15] and monitoring of changes in CFR after stenting.…”

Relevance of multivessel disease in the development of in-hospital refractory angina and myocardial infarction in patients with unstable angina

“…In addition, the latter would also be facilitated by the lower ischemic threshold associated with multivessel disease in patients with UA when compared with patients with single vessel disease [22]. In part, this hypothesis would be supported by the enhanced vasoconstrictive reactivity that has been shown in patients with acute coronary syndromes not only in the culprit lesions [23 -26] but also in lesions of non-culprit arteries [23,27] that might possibly be attributable to agents released from the culprit plaque [26]. A similar increased ''multivessel'' vasoconstrictive reactivity could account, also in part, for the higher rates of postinfarction angina and reinfarction documented in patients with multivessel disease with respect to those with single vessel disease [28].…”

Prevention of Ventricular Fibrillation, Acute Myocardial Infarction (Myocardial Necrosis), Heart Failure, and Mortality by Bretylium

“…[74][75][76][77][78][79][80][81][82][83][84][85][86][99][100][101][102] This report presents evidence and a new thesis defining a new entity, which should be called adrenergic heart disease (AdHD) to distinguish it from anatomic coronary artery disease (CAD), with which it is commonly confused. AdHD can be a direct cause of IsHD, separate from and occurring independently of obstructive CAD for which it is often mistaken [103][104][105][106][107][108][109][110][111][112][113][114][115][116][117][118] because they cause similar metabolic disturbances, 1,5-15 pathologic lesions, and dysfunctional cardiopathy. 1, Since IsHD usually (but not always) [103][104][105][106][107][108][109][110][111][112][113][114]…”

“…AdHD can be a direct cause of IsHD, separate from and occurring independently of obstructive CAD for which it is often mistaken [103][104][105][106][107][108][109][110][111][112][113][114][115][116][117][118] because they cause similar metabolic disturbances, 1,5-15 pathologic lesions, and dysfunctional cardiopathy. 1, Since IsHD usually (but not always) [103][104][105][106][107][108][109][110][111][112][113][114][115][116][117][118] occurs in parallel with CAD, it has been widely assumed that coronary obstruction is the sole and primary cause of IsHD. Focus in the 20th century was compulsively centered on the attractive but simplistic idea that coronary vascular obstruction by CAD and thrombosis obstructing coronary blood flow was the sole putative cause and effect basis for IsHD.…”

“…Focus in the 20th century was compulsively centered on the attractive but simplistic idea that coronary vascular obstruction by CAD and thrombosis obstructing coronary blood flow was the sole putative cause and effect basis for IsHD. The fact that they usually but do not necessarily coexist 15,[103][104][105][106][107][108][109][110][111][112][113][114][115][116][117][118] has obscured their parallel (but independent) responses to neurovascular sensitivity to adrenergic vasoconstrictor actions 15 and adrenergic hypermetabolic actions, [8][9][10][11][12] as well as interactions with lipid metabolism [119][120][121][122][123][124][125] that concomitantly cause both IsHD and CAD together with its complications like angina pectoris, myocardial infarction, arrhythmias, SCD, and pathologic adrenergic remodeling of the myocardium. 2,10,73,74,79 In fact, the US Food and Drug Administration recently approved a test to measure the enzyme lipoprotein-associated phospholipase A2 (Lp-PLA2), which is considered to be an early indicator of so-called CAD.…”