Coronary artery disease: Part 1. Epidemiology and diagnosis

Link, Nate

doi:10.1136/ewjm.174.4.257

Cited by 13 publications

(10 citation statements)

References 11 publications

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“…Coronary artery disease (CAD) is the leading cause of death in the industrialized world today [1,2]. As reduced myocardial perfusion during stress conditions is the first functional parameter to indicate coronary artery disease, there is demand for diagnostic procedures which allow reliable detection of myocardial hypoperfusion [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

High resolution myocardial magnetic resonance stress perfusion imaging at 3 T using a 1 M contrast agent

et al. 2009

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Section: Introductionmentioning

confidence: 99%

High resolution myocardial magnetic resonance stress perfusion imaging at 3 T using a 1 M contrast agent

et al. 2009

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“…involved in the etiology of coronary artery disease [1,2] . HMG-CoA reductase inhibitors (statins) are a family of drugs developed to reduce cholesterol levels [6,7] .…”

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Statins Decrease Serotonin-Induced Contractions in Coronary Arteries of Swine in vitro

Crespo

Quidgley²

2006

Pharmacology

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Recent evidence suggests that statins improve the status of patients with coronary artery disease not only by reducing cholesterol levels, but also by acting at the level of the endothelium-smooth muscle unit. Previous results from our laboratory showed that these drugs interact with the vascular wall by partially inhibiting calcium-dependent, agonist-induced contractions in rat aortas. To evaluate whether this effect is also extended to the coronary vasculature, we assessed the effect of statins on serotonin (5-HT) induced contractions of left and right coronary arteries of swine. Concentration-response curves for the 5-HT-induced contractions (from 0.1 nmol/l to 100 µmol/l) were calculated on rings from both coronaries in the presence and absence of either (5 µmol/l) pravastatin, mevastatin, simvastatin, lovastatin, or atorvastatin. After a 45-min incubation period, all statins significantly reduced the E_max for the 5-HT-induced contractions, ranging from 51.9 ± 1.9% (simvastatin) to 15.9 ± 2.0% (pravastatin) in the left coronary artery and from 48.8 ± 2.0% (simvastatin) to 17.8 ± 2.5% (pravastatin) in the right coronary artery. The EC₅₀ values for the 5-HT-induced contractions were 0.150 ± 0.005 µmol/l for the left coronary artery and 0.171 ± 0.010 µmol/l for the right coronary artery. These values significantly changed after incubation with statins, ranging from 1.240 ± 0.101 µmol/l (for simvastatin) to 0.081± 0.008 µmol/l (for pravastatin) in the left coronary artery and from 1.410 ± 0.075 µmol/l (for simvastatin) to 0.084 ± 0.008 µmol/l (for pravastatin) in the right coronary artery. This evidence supports the possibility that, beyond their lipid-lowering properties, statins may provide a beneficial effect in atherosclerotic patients by reducing the tone in the coronary vasculature, facilitating blood flow to the myocardium.

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“…CORONARY ARTERY DISEASE (CAD) is the leading cause of death in the United States and Western Europe (1,2). For the diagnosis of CAD, several techniques may be used to assess myocardial perfusion and coronary morphology.…”

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confidence: 99%

Multislice first‐pass myocardial perfusion imaging: Comparison of saturation recovery (SR)‐TrueFISP‐two‐dimensional (2D) and SR‐TurboFLASH‐2D pulse sequences

Fenchel

Helber

Simonetti

et al. 2004

Magnetic Resonance Imaging

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Purpose:To compare signal-to-noise ratio (SNR), contrastto-noise (CNR) ratio, and diagnostic accuracy of a newly developed saturation recovery (SR)-TrueFISP-two-dimensional (2D) sequence with an SR-TurboFLASH-2D sequence. Materials and Methods:In seven healthy subjects and nine patients with coronary artery disease (CAD), contrastenhanced perfusion imaging (with Gd-DTPA) was performed with SR-TrueFISP and SR-TurboFLASH sequences. Hypoperfused areas were assessed qualitatively (scale ϭ 0 -4). Furthermore, SNR and CNR were calculated and semiquantitative perfusion parameters were determined from signal intensity (SI) time curves. Standard of reference for patient studies was single-photon emission computer tomography (SPECT) and angiography. Results:The perception of perfusion deficits was superior in TrueFISP images (2.6 Ϯ 1.0) than in TurboFLASH (1.4 Ϯ 0.6) (P Ͻ 0.001). Phantom measurements yielded increased SNR (143 Ϯ 34%) and CNR (158 Ϯ 64%) values for True-FISP. In patient/volunteer studies SNR was 61% to 100% higher and signal enhancement was 110% to 115% higher with TrueFISP than with TurboFLASH. Qualitative and semiquantitative assessment of perfusion defects yielded higher sensitivities for detection of perfusion defects with TrueFISP (68% to 78%) than with TurboFLASH (44% to 59%). Conclusion:SR-TrueFISP-2D perfusion imaging provides superior SNR and CNR than TurboFLASH imaging. Moreover, the dynamic range of SIs was found to be higher with TrueFISP, resulting in an increased sensitivity for detection of perfusion defects.

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Coronary artery disease: Part 1. Epidemiology and diagnosis

Abstract: Coronary artery disease (CAD) is the leading cause of death in Americans, accounting for about 500,000 deaths every year. The annual incidence of myocardial infarction (MI) is about 1.5 million. As many as 2 million middle-aged men may have silent myocardial ischemia. (1)

Cited by 13 publications

References 11 publications

High resolution myocardial magnetic resonance stress perfusion imaging at 3 T using a 1 M contrast agent

High resolution myocardial magnetic resonance stress perfusion imaging at 3 T using a 1 M contrast agent

Statins Decrease Serotonin-Induced Contractions in Coronary Arteries of Swine in vitro

Multislice first‐pass myocardial perfusion imaging: Comparison of saturation recovery (SR)‐TrueFISP‐two‐dimensional (2D) and SR‐TurboFLASH‐2D pulse sequences

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