The index of microcirculatory resistance predicts myocardial infarction related to percutaneous coronary intervention.

Background: Periprocedural myocardial infarction (MI) occurs in a significant proportion of patients undergoing percutaneous coronary intervention (PCI) and portends poor outcomes. Currently, no clinically applicable method predicts periprocedural MI in the cardiac catheterization laboratory before it occurs. We hypothesized that impaired baseline coronary microcirculatory reserve, which reduces the ability to tolerate ischemic insults, is a risk for periprocedural MI and that the index of microcirculatory resistance (IMR) measured during PCI can predict occurrence of periprocedural MI.

Doppler-derived pulmonary flow reserve detects pulmonary microvascular obstruction in high primates.

Background: Despite increasing evidence implicating the pulmonary microcirculation in the pathogenesis of lung conditions such as pulmonary vascular disease, there remain few methods for its evaluation in vivo. We recently demonstrated that the novel index of Doppler-derived pulmonary flow reserve (PFR(dopp)=maximal hyperaemic/basal pulmonary flow) could be reliably measured in high primates. Noting that the microvasculature is the chief regulator of pulmonary blood flow, we hypothesised that PFR(dopp) may detect microcirculatory loss.

The relationship between coronary stenosis severity and compression type coronary artery movement in acute myocardial infarction.

Background: Acute myocardial infarction is thought to occur at sites of minor coronary stenosis. Recent data challenge this and also propose a role for coronary artery movement (CAM) in plaque instability. We examined the relationship between coronary stenosis severity, CAM pattern, and infarct-related lesions (IRLs) in acute myocardial infarction.

Measurement of pulmonary flow reserve and pulmonary index of microcirculatory resistance for detection of pulmonary microvascular obstruction.

Background: The pulmonary microcirculation is the chief regulatory site for resistance in the pulmonary circuit. Despite pulmonary microvascular dysfunction being implicated in the pathogenesis of several pulmonary vascular conditions, there are currently no techniques for the specific assessment of pulmonary microvascular integrity in humans. Peak hyperemic flow assessment using thermodilution-derived mean transit-time (T(mn)) facilitate accurate coronary microcirculatory evaluation, but remain unvalidated in the lung circulation.

Development and validation of a time-dependent risk model for predicting mortality in infective endocarditis.

Aims: Existing risk models in infective endocarditis (IE) have not investigated whether the prognostic value of clinical parameters is time-dependent. We have explored the potential of time-dependent risk stratification to predict outcome in IE.

Methods And Results: We studied 273 patients admitted with IE to two centres (derivation cohort n=192, validation cohort n=81).

Measurement of pulmonary flow reserve in higher primates.

1. There are currently limited diagnostic methods for assessing the integrity of the pulmonary microvasculature. We hypothesized that a novel, invasively determined physiological index of 'pulmonary flow reserve' (PFR = maximal hyperaemic pulmonary blood flow divided by basal pulmonary flow) may facilitate microvascular assessment in the lung.

Efficacy and safety of 12-week treatment with fenofibrate 300 mg in Thai dyslipidemic patients.

Background: High levels of low density lipoprotein (LDL) cholesterol is a known major factor in atherosclerosis. In addition to LDL-cholesterol, an increase in the triglycerides-rich lipoprotein and a decrease in HDL-cholesterol increase the risk of coronary artery disease. Fenofibrate, a fibric acid derivative, is highly effective in reducing serum triglycerides and LDL-cholesterol and produces a modest increase in HDL-cholesterol.