Classification, Diagnosis, and Treatment of Coronary Microvascular Dysfunction

Sucato, Vincenzo; Madaudo, Cristina; Galassi, Alfredo Ruggero

doi:10.3390/jcm11154610

Cited by 12 publications

(6 citation statements)

References 13 publications

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“…In addition, when these pressure points are explained using the gate control theory, which is also supported by the literature (5,11,(15)(16)(17), with continuous stimulus created by the pressure applied to each point for 2 min, large diameter fibers may have caused a decrease in the pain level of the patients by carrying the stimulus and closing the doors to painful stimuli (10,30). These results show that acupressure is effective in the control of pain, regardless of the point at which acupressure is applied, and that it can also help to reduce the risk of coronary microvascular dysfunction in patients (31)(32)(33). These results confirm our hypothesis that acupressure used in patients affects pain levels.…”

Section: The Effect Of Acupressure Application On Painmentioning

confidence: 69%

The effect of acupressure on pain level and hemodynamic parameters after coronary angiography: a randomized controlled study

Düzel

Yanık

Kanat

et al. 2023

Front. Cardiovasc. Med.

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BackgroundSubsequent to coronary angiography, procedures performed to prevent bleeding may cause pain in the patient. In this study, we aimed to determine the effect of acupressure on pain level and hemodynamic parameters in patients undergoing coronary angiography.MethodIn this prospective, a two-arm (1:1), randomized controlled trial was conducted, with 124 patients undergoing coronary angiography included. The randomly assigned study group (n = 62) received acupressure on the LI4 (on the dorsum of the hand, between the 1st and 2nd metacarpal bones), PC6 (three fingers above the wrist), and LI11 (at the lateral end of the transverse cubital crease) points for 15 min 2 h after angiography, while the control group (n = 62) received no acupressure. Data were collected using the visual pain scale (VAS) and hemodynamic parameters [systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), respiratory rate (RR), and peripheral oxygen saturation (SpO2)], monitoring form before, immediately after, and at 10, 20, and 30 min after acupressure.ResultsIn the study, it was found that patients had moderate pain after coronary angiography (study group: 5.02 ± 2.27; control group: 3.98 ± 1.82). When the groups were compared, it was found that the VAS score of the study group before angiography was significantly higher than that of the control group, but lower than the control group immediately after acupressure, and at 10, 20, and 30 min after acupressure. In addition, it was determined that acupressure was significantly higher in DBP and RR in the study group compared to the control group at 20 and 30 min; it was not effective in terms of SBP, HR, and SpO2 values.ConclusionThe results of the study indicated that patients reported moderate pain after coronary angiography, and that acupressure was effective in reducing the pain level, but affected only the DBP and RR hemodynamic parameters. Since the study was single-centered and followed for a short time, it is recommended to conduct new studies with a longer duration.

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Section: The Effect Of Acupressure Application On Painmentioning

confidence: 69%

The effect of acupressure on pain level and hemodynamic parameters after coronary angiography: a randomized controlled study

Düzel

Yanık

Kanat

et al. 2023

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

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“…Typical symptoms are angina, cold sweats, dizziness, extreme tiredness, palpitations, shortness of breath, nausea and weakness, and even erectile dysfunction. When atherosclerosis affects the coronary arteries, it can cause acute coronary syndromes, including myocardial infarction or chronic conditions, such as angina pectoris; both present as chest pain and discomfort caused by insufficient perfusion of the heart muscle due to ischemia [ 87 ]. Atherosclerosis involving cerebral vessels causes ischemic stroke or transient cerebral ischemic attack (TIA).…”

Section: Symptoms Of Atherosclerosismentioning

confidence: 99%

Discovering Inflammation in Atherosclerosis: Insights from Pathogenic Pathways to Clinical Practice

Madaudo,

Coppola,

Parlati

et al. 2024

IJMS

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This comprehensive review explores the various scenarios of atherosclerosis, a systemic and chronic arterial disease that underlies most cardiovascular disorders. Starting from an overview of its insidious development, often asymptomatic until it reaches advanced stages, the review delves into the pathophysiological evolution of atherosclerotic lesions, highlighting the central role of inflammation. Insights into clinical manifestations, including heart attacks and strokes, highlight the disease’s significant burden on global health. Emphasis is placed on carotid atherosclerosis, clarifying its epidemiology, clinical implications, and association with cognitive decline. Prevention strategies, lifestyle modifications, risk factor management, and nuanced antithrombotic treatment considerations are critical to managing cardiovascular complications, thus addressing a crucial aspect of cardiovascular health.

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“…Whether Takotsubo syndrome and myocarditis are causes of MINOCA, as listed here, is still a matter of debate. Some authors in fact do not include these conditions among the causes of MINOCA, and others suggest a possible microvascular involvement that could explain the development of an acute coronary syndrome (ACS) [8][9][10]. This argument, of course, deserves closer examination, but it goes far beyond the scope of this document.…”

Section: Introductionmentioning

confidence: 99%

Role of Lipoprotein Ratios and Remnant Cholesterol in Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA)

Sucato,

Di Fazio,

Madaudo

et al. 2024

JCDD

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Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a clinical situation characterized by evidence of acute myocardial infarction (AMI)—according to the Fourth Universal Definition of Myocardial Infarction—with normal or near-normal coronary arteries on angiographic study (stenosis < 50%). This condition is extremely variable in etiology, pathogenic mechanisms, clinical manifestations, prognosis and consequently therapeutic approach. Objective: The objective of the study was the evaluation of remnant cholesterol (RC), monocyte/high-density lipoprotein cholesterol ratio (MHR), platelet/lymphocyte ratio (PLR) and various lipoprotein ratios in patients with MINOCA in order to establish their validity as predictors of this event. Materials and Methods: We included 114 patients hospitalized in the Intensive Coronary Care Unit (ICCU) and Hospital Wards of our Hospital Center from 2015 to 2019 who received a diagnosis of MINOCA compared to a control group of 110 patients without previous cardiovascular events. RC was calculated with the following formula: RC = total cholesterol (TC) − HDL-C − LDL-C. MHR was calculated by dividing the monocyte count in peripheral blood by high-density lipoprotein cholesterol (HDL-C) levels; PLR was obtained by dividing platelet count by lymphocyte count. We also calculated various lipoprotein ratios, like total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C), triglycerides/high-density lipoprotein cholesterol (TG/HDL-C), and non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol (non-HDL-C/HDL-C) ratios. Results: The MINOCA group had higher mean levels of RC (21.3 ± 10.6 vs. 13.2 ± 7.7 mg/dL), MHR (23 ± 0.009 vs. 18.5± 8.3) and PLR (179.8 ± 246.1 vs. 135 ± 64.7) than the control group. Only the mean values of all calculated lipoprotein ratios were lower in MINOCA patients. Statistical significance was achieved only in the RC evaluation. Conclusions: Higher levels of RC and MHR were found in patients with MINOCA. We also observed higher levels of PLR than in the control group. Only various lipoprotein ratios were lower, but this could reflect the extreme heterogeneity underlying the pathogenic mechanisms of MINOCA. In patients who receive a diagnosis of MINOCA with a baseline alteration of the lipid profile and higher levels of cholesterol at admission as well, the evaluation of these parameters could play an important role, providing more detailed information about their cardiometabolic risk.

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Classification, Diagnosis, and Treatment of Coronary Microvascular Dysfunction

Abstract: Coronary microvascular dysfunction represents a widespread disease which is highly disabling for the patient, who constantly presents angina [...]

Cited by 12 publications

References 13 publications

The effect of acupressure on pain level and hemodynamic parameters after coronary angiography: a randomized controlled study

The effect of acupressure on pain level and hemodynamic parameters after coronary angiography: a randomized controlled study

Discovering Inflammation in Atherosclerosis: Insights from Pathogenic Pathways to Clinical Practice

Role of Lipoprotein Ratios and Remnant Cholesterol in Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA)

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