Cardiopulmonary exercise testing (CPET) is a well-accepted physiologic evaluation technique in patients diagnosed with heart failure and in patients presenting with unexplained dyspnea on exertion. Several variables obtained during CPET, including oxygen consumption relative to heart rate and work rate provide consistent, quantitative patterns of abnormal physiologic responses to graded exercise when left ventricular dysfunction is caused by myocardial ischemia. This concept report describes both the methodology and clinical application of CPET associated with myocardial ischemia. Initial evidence indicates left ventricular dysfunction induced by myocardial ischemia may be accurately detected by an abnormal CPET response. CPET testing may complement current noninvasive testing modalities that elicit inducible ischemia. It provides a physiologic quantification of the work rate, heart rate, and O(2) uptake at which myocardial ischemia develops. In conclusion, adding CPET with gas exchange measurements is likely to be of value in diagnosing and quantifying both overt and occult myocardial ischemia and its reversibility with treatment.
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http://dx.doi.org/10.1016/j.amjcard.2008.10.034 | DOI Listing |
J Integr Neurosci
December 2024
First Clinical Medical College, Shaanxi University of Chinese Medicine, 712046 Xianyang, Shaanxi, China.
The coexistence of anxiety or depression with coronary heart disease (CHD) is a significant clinical challenge in cardiovascular medicine. Recent studies have indicated that hypothalamic-pituitary-adrenal (HPA) axis activity could be a promising focus in understanding and addressing the development of treatments for comorbid CHD and anxiety or depression. The HPA axis helps to regulate the levels of inflammatory factors, thereby reducing oxidative stress damage, promoting platelet activation, and stabilizing gut microbiota, which enhance the survival and regeneration of neurons, endothelial cells, and other cell types, leading to neuroprotective and cardioprotective benefits.
View Article and Find Full Text PDFCJC Open
December 2024
Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
Background: Contemporary surgical approaches for aortic valve replacement (AVR) include full median sternotomy, hemi-sternotomy, and a right anterior mini thoracotomy (RAMT) approach. We report the midterm outcomes of RAMT for isolated AVR.
Methods: A retrospective study was conducted, reporting the midterm outcomes of patients who underwent isolated RAMT AVR.
CJC Open
December 2024
University of British Columbia, Vancouver, British Columbia, Canada.
Background: Myocardial infarction with no obstructive coronary arteries (MINOCA), and ischemia with no obstructive coronary arteries (INOCA), are female-predominant conditions; clinical trials are lacking to guide medical management for the common underlying vasomotor etiologies. Data on long-term outcomes of (M)INOCA patients following attendance at a women's heart centre (WHC) are lacking.
Methods: Women diagnosed with MINOCA (n = 51) or INOCA (n = 112) were prospectively followed for 3 years at the Leslie Diamond WHC (LDWHC) in Vancouver.
Front Cardiovasc Med
December 2024
Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Background: Coronary artery bypass grafting (CABG) surgery has been a widely accepted method for treating coronary artery disease. However, its postoperative complications can have a significant effect on long-term patient outcomes. A retrospective study was conducted to identify before and after surgery that contribute to postoperative stroke in patients undergoing CABG, and to develop predictive models and recommendations for single-factor thresholds.
View Article and Find Full Text PDFFront Cardiovasc Med
December 2024
Department of Cardiovascular Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Objective: This study compared the value of different systemic immune-inflammatory markers for evaluating coronary collateralization (CC) in patients with type 2 diabetes mellitus (T2DM) and chronic total occlusion (CTO).
Methods: Systemic immune-inflammation index (SII), systemic inflammation response index (SIRI) and pan-immune-inflammation value (PIV) were calculated at admission in 1409 T2DM patients with CTO. The degree of coronary collaterals was estimated using the Rentrop scoring system and categorized into poor (Rentrop score 0 or 1) or good (Rentrop score 2 or 3) CC.
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