Publications by authors named "Beijk M"
Background: A coronary function test (CFT) is the recommended diagnostic test to identify coronary vasomotor dysfunction as a cause of symptoms in patients with angina and nonobstructive coronary arteries (ANOCA). Acetylcholine is the commonly used pharmacological agent for spasm provocation. We aimed to investigate an association between severity of symptoms and provocative acetylcholine dose.
View Article and Find Full Text PDFBackground: Concomitant coronary artery disease (CAD) is highly prevalent in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). The optimal treatment strategy for CAD is a topic of debate. An initial conservative strategy for CAD in patients undergoing TAVI may be favorable as multiple studies have failed to show an evident beneficial effect of percutaneous coronary intervention (PCI) on mortality after TAVI.
View Article and Find Full Text PDFPercutaneous Pulmonary Valve Implantation With Self-Expanding Valves for Carcinoid Heart Diseases.
Catheter Cardiovasc Interv
January 2025
Carcinoid heart disease is an important complication of neuroendocrine tumors that may lead to significant morbidity and mortality. Right-sided heart valve involvement with consequent valve dysfunction is one of the common manifestations. Patients often have multiple, significant comorbidities with advanced metastatic disease and, as such, may not be suitable for surgical valve replacement due to excessive risk.
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- The study evaluates how well epicardial vasomotion and coronary blood flow (CBF) alone can diagnose coronary endothelial dysfunction (CED) in patients with angina and non-obstructive coronary arteries.
- It involved 110 patients undergoing coronary function testing, finding that using epicardial diameter or CBF alone missed significant instances of CED diagnoses.
- The conclusion emphasizes that both parameters are necessary for a comprehensive diagnosis of CED to avoid missing cases related to microvascular and epicardial issues.
Article Synopsis
- Lipoprotein(a) [Lp(a)] is associated with increased risk for atherosclerotic cardiovascular disease (ASCVD), but there are gaps in its measurement among cardiologists according to current guidelines.
- The review presents four clinical cases showing the link between elevated Lp(a) levels and coronary artery disease (CAD), supported by consensus statements from leading heart organizations.
- Emphasizing routine Lp(a) measurement can help identify high-risk patients, guiding more aggressive treatment and tailored care in catheterization settings, while ongoing clinical trials explore Lp(a)-lowering therapies.
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- About 25% of the population has a patent foramen ovale (PFO), which is usually asymptomatic, but it can sometimes cause right-to-left shunt (RLS)-mediated hypoxaemia, a rare condition.
- In a case involving a 73-year-old woman, her oxygen levels significantly improved from 87% to 98% after undergoing percutaneous PFO closure due to her progressive difficulty breathing.
- While most PFOs don't cause problems, RLS-mediated hypoxaemia can occur even in older adults, and percutaneous closure is a safe and effective treatment that provides quick relief.
Coronary vasomotor dysfunction, an important underlying cause of angina and nonobstructive coronary arteries (ANOCA), encompassing coronary vasospasm, coronary endothelial dysfunction, and/or coronary microvascular dysfunction, is clinically assessed by invasive coronary function testing (ICFT). As ICFT imposes a high burden on patients and carries risks, developing noninvasive alternatives is important. We evaluated whether coronary vasomotor dysfunction is a component of systemic microvascular endothelial and smooth muscle dysfunction and can be detected using laser speckle contrast analysis (LASCA).
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- * A case study of four VSA patients revealed that all experienced significant coronary vasoconstriction during acetylcholine testing, but their ECGs differed between spontaneous episodes and induced spasms in three out of four cases.
- * The findings indicate that the ECG during spontaneous VSA episodes may not match those seen during acetylcholine-induced spasms, emphasizing the need for ECG monitoring during spontaneous angina to improve diagnosis
Article Synopsis
- Young patients with cryptogenic stroke and a patent foramen ovale (PFO) sometimes receive device closure to prevent future strokes, but about 25% may still have a residual right-to-left shunt after 6 months.
- In a study of 227 patients, it was found that at 6 months post-closure, 72.7% had no shunt, while the rest had varying degrees of residual shunt.
- By 12 months, many of these residual shunts had either diminished or closed completely, indicating that while residual shunts are common at 6 months, most are small and tend to close over time.
We present 2 patients with angina with no obstructive coronary artery disease and concomitant myocardial bridging. Despite maximal tolerated pharmacotherapy, symptoms remained. Invasive anatomical and hemodynamic assessment identified myocardial bridging as a contributing cause of angina.
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- The hyperaemic stenosis resistance (HSR) index is a new measure that combines pressure drop and blood flow to provide a better assessment of coronary artery disease severity compared to traditional methods like fractional flow reserve (FFR) and coronary flow reserve (CFR).
- This study analyzed data from 853 patients with chronic coronary syndromes to evaluate HSR's diagnostic and prognostic value, finding it to more accurately identify inducible ischaemia and predict long-term target vessel failure.
- The results suggest HSR can help determine which obstructed vessels may benefit from treatment, reinforcing its potential as a superior tool in clinical practice for managing coronary artery disease.
Background: Assessment of the pattern of the RV outflow tract Doppler provides insights into the hemodynamics of chronic thromboembolic pulmonary hypertension (CTEPH). We studied whether pre-operative assessment of timing of the pulmonary flow systolic notch by Doppler echocardiography is associated with long-term survival after pulmonary endarterectomy (PEA) for CTEPH.
Methods: Fifty-nine out of 61 consecutive CETPH patients (mean age 53 ± 14 years, 34% male) whom underwent PEA between June 2002 and June 2005 were studied.
Background: We present a case of a pregnant patient with recurrent angina, in which her symptoms were initially attributed to coronary artery spasm. However, during follow-up, she was diagnosed as having pheochromocytoma, a rare neuroendocrine tumour.
Case Summary: The 35-year-old patient was admitted to the hospital because of chest pain and elevated cardiac troponins after the use of MDMA.
Coronary endothelial dysfunction (CED) and coronary artery spasm (CAS) are causes of angina with no obstructive coronary arteries in patients. Both can be diagnosed by invasive coronary function testing (ICFT) using acetylcholine (ACh). This study aimed to evaluate the diagnostic yield of a 3-minute ACh infusion as compared with a 1-minute ACh bolus injection protocol in testing CED and CAS.
View Article and Find Full Text PDFImpact of coronary hyperemia on collateral flow correction of coronary microvascular resistance indices.
Am J Physiol Heart Circ Physiol
April 2024
Recently, a novel method to estimate wedge pressure (P)-corrected minimal microvascular resistance (MR) was introduced. However, this method has not been validated since, and there are some theoretical concerns regarding the impact of different physiological conditions on the derivation of P measurements. This study sought to validate the recently introduced method to estimate P-corrected MR in a Doppler-derived study population and to evaluate the impact of different physiological conditions on the P measurements and the derivation of P-corrected MR.
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- The microvascular resistance reserve (MRR) is a new index used to evaluate how well the coronary circulation can dilate, particularly in patients with coronary artery disease (CAD), and its assessment may require special considerations for women.
- This study aimed to evaluate how effective the MRR is for diagnosis and prognosis in women compared to men, using data from the ILIAS Registry.
- Results showed that MRR is a significant predictor of major adverse cardiac events (MACE) for both sexes, with similar correlations and cut-off values for predicting outcomes in women and men.
Article Synopsis
- This study evaluates the prognostic value of coronary pressure and flow parameters in patients who did not undergo revascularization due to borderline readings.
- It included 1,971 blood vessels, and found that abnormal pressure and flow metrics significantly predicted long-term risks of target vessel failure (TVF), myocardial infarction (MI), and cardiac death over five years.
- The study concluded that both resting and hyperemic conditions are important independent factors in predicting cardiac events, with their abnormal flow readings providing additional prognostic information.
Article Synopsis
- International guidelines recommend assessing frailty before Transcatheter Aortic Valve Implantation (TAVI), but there's no standard method to do so; this study used the Edmonton Frail Scale (EFS) to evaluate frailty status in patients.
- In a study of 357 TAVI patients, higher EFS scores (indicating greater frailty) were linked to longer hospital stays and increased mortality rates within 30 days to 4 years post-procedure.
- The findings suggest that the EFS is an effective tool for identifying frailty in TAVI patients and could guide clinical decisions to improve patient outcomes and reduce the risk of complications.
In the last decade, significant advancements have been made in the field of percutaneous coronary interventions (PCIs) with the development of new devices and drugs, the application of new technology and the utilization of artificial intelligence/machine learning, and new indications for revascularization [...
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- Patients with non-obstructive lipid-rich plaques (LRPs) are at a high risk for future health issues, prompting the exploration of a new treatment strategy involving a paclitaxel-eluting drug-coated balloon (PE-DCB).
- This pilot study focuses on assessing the safety and effectiveness of PE-DCB treatment on non-culprit LRPs, aiming to reduce the lipid core burden over a 9-month follow-up period through advanced imaging techniques (IVUS and NIRS).
- Outcomes will be measured based on changes in lipid core burden, clinical events, and various cardiac parameters, with ongoing follow-up extending to one year to evaluate long-term safety and effectiveness.
Background: Anginal symptoms in patients with non-obstructive coronary artery disease are frequently related to vasomotor disorders of the coronary circulation. Although frequently overlooked, a distinct diagnosis of different vasomotor disorders can be made by intracoronary function testing. Early detection and treatment seems beneficial, but little evidence is available for the medical treatment of these disorders.
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