Diagnosis of coronary artery disease by estimation of coronary sinus lactate.

Abstract

SUMMARY In an attempt to assess the value of coronary sinus lactate estimation before and during atrial pacing for the diagnosis of obstructive coronary artery disease, 70 patients with angina were investigated in this way and by selective coronary arteriography. Thirty-five had radiologically normal coronary arteries and 35 had coronary artery disease. When the change in coronary arteriovenous lactate difference was less than 0-09 mmol/l (0.8 mg/100 ml) between the control and the peak atrial pacing sample, the coronary arteries were normal except in one patient who had distal disease of a single vessel. When the change was greater than 0-22 mmol/l (2.0 mg/100 ml) coronary artery disease was always found, and when the change was greater than 0 39 mmol/l (3.5 mg/100 ml) there was always disease of two or three vessels. Unfortunately, the presence or absence of coronary artery disease could not be predicted when the change fell between 0 09 and 0-22 mmol/l (0.8 and 2-0 mg/100 ml). Estimation of coronary sinus lactate before and during atrial pacing can thus frequently distinguish patients with normal coronary arteries from those with coronary artery disease.

Cardiac release and kinetics of cytokines after elective bare metal coronary stenting

“…C-reactive protein and white blood cell count was measured in the baseline and 24 h peripheral venous samples. Myocardial ischemia was defined as a reduction of the cardiac lactate extraction [-10% or a frank cardiac lactate production [0% [22,23]. Per definition negative values stand for a lactate extraction, positive values for a lactate production: a ð ÞÀ c ð ÞÂ a ð Þ À1 Â À100 ð Þ¼cardiac lactate metabolism % ð Þ A 12-lead electrocardiogram was performed before, immediately after and 1, 2, 6, 12 and 24 h after the procedure.…”

Microvascular Angina: Assessment of Coronary Blood Flow, Flow Reserve, and Metabolism

“…Clinical judgment of typical anginal symptoms is commonly followed by electrocardiographic and perfusion imaging stress test findings consistent with ischemia. Metabolic evidence has been demonstrated by the accumulation of ischemically derived compounds in the coronary sinus, including lactate [35,36] and lipid peroxidation products [37]. Ischemic abnormalities of phosphorous metabolism can also be detected in the anterior wall with cardiac magnetic resonance (CMR) spectroscopy [38].…”

Human Plasma Metabolic Profiles of Coronary Heart Disease by Gas Chromatography-Mass Spectrometry with Monte Carlo Tree Approach

“…Moreover, lactate measurement in the critically ill has been traditionally used to stratify patients with a poor outcome (Valenza et al 2005). The estimation of coronary sinus lactate before and during atrial pacing can thus frequently distinguish patients with normal coronary arteries from those with coronary artery disease (Jackson et al 1978;Nielsen, Bagger, and Thomassen 1986). Valine is an essential amino acid; hence, it must be ingested, usually as a component of proteins.…”