Time-stretched multi-hit 3D velocity map imaging of photoelectrons.

The 2D photoelectron velocity map imaging (VMI) technique is commonly employed in gas-phase molecular spectroscopy and dynamics investigations due to its ability to efficiently extract photoelectron spectra and angular distributions in a single experiment. However, the standard technique is limited to specific light-source polarization geometries. This has led to significant interest in the development of 3D VMI techniques, which are capable of measuring individual electron positions and arrival times, obtaining the full 3D distribution without the need for inversion, forward-convolution, or tomographic reconstruction approaches.

Iron deficiency anemia and cardiac mortality in patients with left ventricular systolic dysfunction undergoing coronary stenting.

Aim: The aim of this study was to assess cardiac mortality in patients with reduced ejection fraction (EF< or =45%) and anemia (Hb< or =12 g/dL) undergoing coronary stenting and to investigate whether iron-deficiency anemia influenced outcome when compared to non-anemic patients or patients with other types of anemia.

Methods: One hundred twenty consecutive patients undergoing percutaneous coronary intervention (PCI) between April 2003 and December 2005 were identified and followed for a median of 30 months. Patients were divided into 2 groups, anemic (Hb< or =12 g/dL) and non-anemic.

Safety of drug-eluting stents in patients with left ventricular dysfunction undergoing percutaneous coronary intervention.

Recent studies have reported a higher incidence of late stent thrombosis in patients undergoing drug-eluting stent (DES). Reduced left ventricular (LV) ejection fraction (EF) is considered a risk factor for this complication after both bare-metal stent (BMS) and DES implantation. Therefore, the aim of this study was to evaluate the safety of DES on long-term follow-up in patients with LV dysfunction undergoing percutaneous coronary intervention.

Relation of blood urea nitrogen to long-term mortality in patients with heart failure.

Patients with chronic kidney disease and heart failure (HF) have been shown to be at higher risk for major adverse cardiovascular events and death. Recent studies have demonstrated that blood urea nitrogen (BUN) might serve as a powerful predictor of mortality in acutely decompensated HF. The goal of this study was to determine the impact of BUN on long-term mortality in patients with stage B and C HF.

Percutaneous coronary stenting in patients with left ventricular systolic dysfunction: a systematic review and meta-analysis.

Aims: There is uncertainty on the clinical outcomes of percutaneous coronary intervention (PCI) in patients with left ventricular dysfunction (LVD). We thus performed a systematic review of studies reporting on PCI in LVD.

Methods And Results: Pertinent studies were searched in PubMed, and included if reporting on >/=30 patients, with ejection fraction < 50%, and prevalently (>60%) treated with stents.

Effect of statins and white blood cell count on mortality in patients with ischemic left ventricular dysfunction undergoing percutaneous coronary intervention.

Background: While morbidity and mortality were shown to be increased in the setting of an elevated white blood cell (WBC) count for patients with acute coronary syndrome, the impact of statin therapy on mortality for patients with an elevated WBC count is unknown in high-risk patients with coronary artery disease.

Hypothesis: The goal of this study was to determine whether statin therapy improved survival in patients with elevated WBC count undergoing percutaneous coronary intervention (PCI) with preexisting left ventricular (LV) dysfunction, a population at high risk for adverse outcomes.

Methods: We retrospectively evaluated consecutive patient procedures performed at our institution from 1996 through 1999.

Improved survival for stenting vs. balloon angioplasty for the treatment of coronary artery disease in patients with ischemic left ventricular dysfunction.

While earlier studies of balloon angioplasty (BA) in patients with left ventricular (LV) dysfunction suggested high late mortality, a study directly comparing coronary stenting and BA has not been performed. Since stenting provides a more durable revascularization, we sought to compare long-term survival in patients undergoing stenting vs BA in patients with decreased left ventricular ejection fractions (LVEF). We evaluated consecutive patient procedures performed in our institution from 1996 through 1999.

Utility of routine functional testing after percutaneous transluminal coronary angioplasty: results from the ROSETTA registry.

Background: There is little consensus regarding the use of functional testing after percutaneous transluminal coronary angioplasty (PTCA). Some physicians employ a routine functional testing strategy, and others employ a symptom-driven strategy.

Objective: To examine the effects of routine post-PTCA functional testing on the use of follow-up cardiac procedures and clinical events.

Six-month outcomes after single- and multi-lesion percutaneous coronary intervention: results from the ROSETTA registry.

Background: The American College of Cardiology/American Heart Association exercise testing guidelines suggest that routine functional testing may benefit patients at high risk of restenosis, such as those undergoing multi-lesion percutaneous coronary intervention (PCI).

Objectives: To compare the six-month post-PCI clinical and procedural outcomes in patients following single- and multi-lesion PCI, and to examine the use of routine functional testing (ie, in all patients) versus selective functional testing (ie, only in those with recurrent symptoms) following multi-lesion PCI.

Methods: Six-month outcomes among 562 patients after single-lesion PCI and 229 patients after multi-lesion PCI were examined.

Medical therapy in patients undergoing percutaneous coronary intervention: results from the ROSETTA registry.

Background: Previous studies have examined medication use among patients with coronary artery disease who have suffered an acute myocardial infarction (MI). However, little is known about medication use among patients with coronary artery disease who undergo percutaneous coronary intervention (PCI).

Objective: To examine the patterns of use of medical therapy among patients who undergo PCI; and to examine the determinants of medical therapy in these patients.

Comparison of event and procedure rates following percutaneous transluminal coronary angioplasty in patients with and without previous coronary artery bypass graft surgery [the ROSETTA (Routine versus Selective Exercise Treadmill Testing after Angioplasty) Registry].

To compare 6-month post-percutaneous transluminal coronary angioplasty (PTCA) outcomes and cardiac procedure use among patients with and without prior coronary artery bypass graft (CABG) surgery, we examined 791 patients who were enrolled in the Routine versus Selective Exercise Treadmill Testing after Angioplasty (ROSETTA) Registry. The ROSETTA Registry is a prospective, multicenter registry that examines the use of functional testing after successful PTCA. Most patients were men (76%, mean age 61 +/- 11 years) who underwent single-vessel PTCA (85%) with stent implantation (58%).

Use of routine functional testing after percutaneous transluminal coronary angioplasty: results from the ROSETTA Registry.

Background: The American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for exercise testing suggest that only selected groups of high-risk patients should undergo routine functional testing after percutaneous transluminal coronary angioplasty (PTCA) for the detection of restenosis.

Objectives: Our purpose was (1) to document the patterns of use of post-PTCA functional testing and (2) to determine whether the choice of functional testing strategy is related to clinical characteristics of patients or whether physicians use a similar strategy for all their patients.

Methods: The Routine Versus Selective Exercise Treadmill Testing After Angioplasty (ROSETTA) Registry is a prospective study examining the use of functional testing among 788 patients at 13 centers in 5 countries.

Therapeutic embolization for unusual latrogenic complications related to coronary revascularization.

Percutaneous therapeutic embolization may be an effective strategy to manage distal coronary perforations or inadvertent iatrogenic coronary arteriovenous fistula complicating revascularization procedures. We present two cases in which embolization techniques were used to manage these patients and avoid the need for surgical intervention.

Fluoroscopy and selective angiography of left ventricular assist system inflow cannula as a method of detecting cannula entrapment.

Left ventricular assist systems have become an important tool as a bridge to cardiac transplantation. Malfunction of these devices often leads to clinical and hemodynamic deterioration. One potential complication is the obstruction of the inflow cannula secondary to remodeling of the left ventricular cavity.

Absence of parasympathetic control of heart rate after human orthotopic cardiac transplantation.

Background: Partial reinnervation of cardiac sympathetic nerves has been observed after heart transplantation; we hypothesized that parasympathetic control to the heart after transplantation may return as well. To test this hypothesis, we examined heart rate responses produced by two cardiovascular reflexes whose efferent limbs are subserved by vagal fibers to the heart: (1) trigeminal reflex (simulated diving reflex) and (2) arterial baroreflex with phenylephrine injection.

Methods And Results: An "early" group (n=31, <24 months after transplantation) and a "late group" (n=27, >45 months after transplantation) were studied and compared with a control group with intact cardiac innervation (n=32) and a renal transplant group with similar transplant immunosuppressive regimen (n=11).

Evidence against reinnervation of cardiac vagal afferents after human orthotopic cardiac transplantation.

Background: Orthotopic cardiac transplantation results in total cardiac denervation. Recent studies in humans suggest that reinnervation of cardiac sympathetic nerves (cardiac efferents) may occur after cardiac transplantation. We hypothesized that reinnervation of cardiac afferents may occur as well.

Histopathologic correlates of unstable ischemic syndromes in patients undergoing directional coronary atherectomy: in vivo evidence of thrombosis, ulceration, and inflammation.

Complex coronary morphologic abnormalities with thrombus and ulceration have been recognized in acute ischemic syndromes by angiography, angioscopy, and autopsy. However, in vivo histopathologic correlates of unstable ischemic syndromes have not been described. The purpose of this study was to characterize intracoronary lesion morphologic abnormalities by analyzing specimens excised by directional atherectomy in patients with different ischemic syndromes.

Immediate results of interventional devices for coronary ostial narrowing with angina pectoris.

Angioplasty of aorto-ostial lesions has had suboptimal results. This study reports on the immediate results of new debulking devices (atherectomy, excimer laser) in the treatment of aorto-ostial disease. Thirty-one vessels (29 patients) with an ostial lesion treated with a new device (group I) were compared with 15 vessels (13 patients) with an ostial lesion treated with angioplasty alone during the preceding 24 months (group II).

Assessment of thallium scintigraphy and echocardiography during dobutamine infusion for the detection of coronary artery disease.

Dobutamine infusion was performed in 16 patients following cardiac catheterization, and non-invasive assessment was performed with thallium SPECT and echocardiography. Dobutamine thallium scintigraphy was abnormal in 93% of patients with significant coronary artery disease. In addition, individual epicardial vessel involvement was identified by a corresponding perfusion defect with 88% sensitivity and 93% specificity.

Long-term efficacy of triple-vessel angioplasty in patients with severe three-vessel coronary artery disease.

Between May 1982 and December 1988, a total of 103 patients underwent angioplasty of all three major coronary arteries at a single institution. Angiographic success was achieved in 334 of 352 vessels (95%) and in 441 of 460 lesions (96%). No patients required urgent bypass surgery, and none died during the procedure; six had non-Q wave infarctions.

Frequency and predictors of left ventricular segmental dysfunction in patients with recent rest angina.

The relation between coronary artery lesion morphology and associated segmental left ventricular (LV) dysfunction in patients with unstable angina is unclear. Fifty-two patients with angina occurring at rest who underwent cardiac catheterization within 3 days of the last episode of pain and had no enzymatic evidence for myocardial necrosis were evaluated. Coronary artery narrowings deemed responsible for the ischemic episodes were analyzed with regard to the artery involved, maximal diameter of the narrowing, presence of thrombus, and complex appearance.

A technique to access severely diseased arteries.

Cardiac catheterization performed in patients with severe peripheral vascular disease may represent a difficult technical challenge and is associated with a higher incidence of vascular complications. We describe a technique that uses angioplasty equipment to access severely diseased arteries. This technique allows a percutaneous transluminal coronary angioplasty (PTCA) guide wire to be steered across vascular lesions under direct visualization of the lumen and continuous pressure monitoring, potentially reducing the risk of vascular complications.