The American Journal of Cardiology

2021

DOI: 10.1016/j.amjcard.2021.04.029

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Seattle Angina Pectoris Questionnaire and Canadian Cardiovascular Society Angina Categories in the Assessment of Total Coronary Atherosclerotic Burden

Welingson V.N. Guimarães

¹

,

Pedro Felipe Gomes Nicz

²

,

Héctor M. García‐García

³

et al.

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Cited by 4 publications

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“…A significant correlation was found between SAQ and angina classification. Nevertheless, SAQ is only applicable for evaluating patients' functional capacity and quality of life, rendering it unsuitable as a disease severity criterion [ 32 ]. Maeda et al employed SAQ to gauge children's postoperative quality of life after myocardial bridging myotomy, concluding that the procedure can alleviate symptoms unresponsive to medical therapy [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical strategies and outcomes for myocardial bridges coexisting with other cardiac conditions

Zhang,

Xu,

Wu

et al. 2023

Eur J Med Res

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Background Myocardial bridges are congenital coronary artery anomalies. There are still many controversies surrounding surgical treatment strategies for myocardial bridges combined with other heart disorders. The purpose of this study was to evaluate the surgical treatment strategies and outcomes in patients with these conditions. Methods Between March 2004 and October 2021, our institution witnessed 77 patients diagnosed with myocardial bridging who underwent surgical intervention. According to the myocardial bridge and combined heart disorder, four groups were identified: 1. isolated LAD supra-arterial myotomy group, 2. LAD CABG and(or not) myotomy group, 3. LAD supra-arterial myotomy and grafting of other branches group, and 4. LAD supra-arterial myotomy and other cardiac surgery group. The perioperative outcomes, symptoms, life quality, mortality, and major adverse cardiac events (MACEs) were analyzed. Results There were no deaths during hospitalization and no rethoractomy for postoperative bleeding or major adverse cardiac events (MACEs). The follow-up period ranged from 2 months to 199.2 months (55.61 ± 10.21) months, the 10-year cumulative survival rates for the four groups of patients were 95.0%, 100%, 100% and 74.1%, and the 10-year freedom rates from the MACEs were 83.9%, 92.0%, 87.5% and 76.2%, respectively. Conclusions Supra-arterial myotomy is preferred in patients with isolated myocardial bridge, and acceptable results can be achieved by choosing supra-arterial myotomy in combination with CABG or other cardiac surgery simultaneously for patients with myocardial bridges and other heart disorders.

“…A significant correlation was found between SAQ and angina classification. Nevertheless, SAQ is only applicable for evaluating patients' functional capacity and quality of life, rendering it unsuitable as a disease severity criterion [ 32 ]. Maeda et al employed SAQ to gauge children's postoperative quality of life after myocardial bridging myotomy, concluding that the procedure can alleviate symptoms unresponsive to medical therapy [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical strategies and outcomes for myocardial bridges coexisting with other cardiac conditions

Zhang,

Xu,

Wu

et al. 2023

Eur J Med Res

View full text Add to dashboard Cite

Background Myocardial bridges are congenital coronary artery anomalies. There are still many controversies surrounding surgical treatment strategies for myocardial bridges combined with other heart disorders. The purpose of this study was to evaluate the surgical treatment strategies and outcomes in patients with these conditions. Methods Between March 2004 and October 2021, our institution witnessed 77 patients diagnosed with myocardial bridging who underwent surgical intervention. According to the myocardial bridge and combined heart disorder, four groups were identified: 1. isolated LAD supra-arterial myotomy group, 2. LAD CABG and(or not) myotomy group, 3. LAD supra-arterial myotomy and grafting of other branches group, and 4. LAD supra-arterial myotomy and other cardiac surgery group. The perioperative outcomes, symptoms, life quality, mortality, and major adverse cardiac events (MACEs) were analyzed. Results There were no deaths during hospitalization and no rethoractomy for postoperative bleeding or major adverse cardiac events (MACEs). The follow-up period ranged from 2 months to 199.2 months (55.61 ± 10.21) months, the 10-year cumulative survival rates for the four groups of patients were 95.0%, 100%, 100% and 74.1%, and the 10-year freedom rates from the MACEs were 83.9%, 92.0%, 87.5% and 76.2%, respectively. Conclusions Supra-arterial myotomy is preferred in patients with isolated myocardial bridge, and acceptable results can be achieved by choosing supra-arterial myotomy in combination with CABG or other cardiac surgery simultaneously for patients with myocardial bridges and other heart disorders.

“…The CCS classification was used to assess the severity of angina pectoris based on the combination of physician’ s assessment and patient’ s self-reported symptoms. The SAQ is a 19-item questionnaire that measures five domains related to angina pectoris: angina frequency, angina stability, physical limitation, treatment satisfaction, and disease perception [ 23 ]. Each domain has a score from 0 to 100, with a higher score representing an improvement of angina pectoris.…”

Section: Methodsmentioning

confidence: 99%

Chronic remote ischemic conditioning treatment in patients with chronic stable angina (EARLY-MYO-CSA): a randomized, controlled proof-of-concept trial

Guo,

Zhao,

Yang

et al. 2023

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Background Chronic remote ischemic conditioning (CRIC) has been shown to improve myocardial ischemia in experimental animal studies; however, its effectiveness in patients with chronic stable angina (CSA) has not been investigated. We conducted a proof-of-concept study to investigate the efficacy and safety of a six-month CRIC treatment in patients with CSA. Methods The EARLY-MYO-CSA trial was a prospective, randomized, controlled trial evaluating the CRIC treatment in patients with CSA with persistent angina pectoris despite receiving ≥ 3-month guideline-recommended optimal medical therapy. The CRIC and control groups received CRIC (at 200 mmHg) or sham CRIC (at 60 mmHg) intervention for 6 months, respectively. The primary endpoint was the 6-month change of myocardial flow reserve (MFR) on single-photon emission computed tomography. The secondary endpoints were changes in rest and stress myocardial blood flow (MBF), angina severity according to the Canadian Cardiovascular Society (CCS) classification, the Seattle Angina Questionnaire (SAQ), and a 6-min walk test (6-MWT). Results Among 220 randomized CSA patients, 208 (105 in the CRIC group, and 103 in the control group) completed the treatment and endpoint assessments. The mean change in MFR was significantly greater in the CRIC group than in the control group (0.27 ± 0.38 vs. − 0.04 ± 0.25; P < 0.001). MFR increased from 1.33 ± 0.48 at baseline to 1.61 ± 0.53 (P < 0.001) in the CRIC group; however, a similar increase was not seen in the control group (1.35 ± 0.45 at baseline and 1.31 ± 0.44 at follow-up, P = 0.757). CRIC treatment, when compared with controls, demonstrated improvements in angina symptoms assessed by CCS classification (60.0% vs. 14.6%, P < 0.001), all SAQ dimensions scores (P < 0.001), and 6-MWT distances (440 [400–523] vs. 420 [330–475] m, P = 0.016). The incidence of major adverse cardiovascular events was similar between the groups. Conclusions CSA patients benefit from 6-month CRIC treatment with improvements in MFR, angina symptoms, and exercise performance. This treatment is well-tolerated and can be recommended for symptom relief in this clinical population. Trial registration [chictr.org.cn], identifier [ChiCTR2000038649].

“…When patients suffering from coronary heart disease, poor myocardial blood supply and excessive metabolites (such as lactic acid) accumulate in the myocardium and can't be transported away. These products can stimulate the heart's afferent sympathetic nerve into the brain, producing pain, so angina is caused by myocardial ischemia, which is an important symptom of coronary heart disease [19][20][21]. Currently commonly used drugs to improve ischemia and relieve symptoms include β-blockers, nitrates, calcium channel blockers, nicorandil and trimetazidine, so it is very important to select the appropriate drug [22,23].…”

Section: Comparison Of Incidence Of Adverse Reactions Between the Two...mentioning

confidence: 99%

Effects of Different Doses of Nitroglycerin Combined With Atenolol on Plasma Viscosity and Inflammatory Response in Patients With Angina Pectoris

2022

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In order to analyse the clinical efficacy and safety of high-dose nitroglycerin combined with atenolol in patients with angina pectoris, 120 patients were randomly divided into an experimental group (n = 60) and a control group (n = 60). The patients in the experimental group received high-dose nitroglycerin (0.5 mg nitroglycerin, three times a day, for 30 consecutive days) plus atenolol (6.25 mg twice a day) while the patients in the control group received low-dose nitroglycerin (0.2 mg nitroglycerin, three times a day, for 30 consecutive days) + atenolol (6.25 mg twice a day). The results showed that the left ventricular enddiastolic diameter (LVEDD), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) in the experimental group were significantly lower than those in the control group. The levels of TNF-α, IL-6 and plasma viscosity in the experimental group were significantly lower than those in the control group. The overall clinical response rate of the experimental group (90%) was significantly higher than that of the control group (71.67%). The incidence of adverse reactions in the experimental group (8.33%) was not significantly different from that in the control group (10%), indicating that high-dose nitroglycerin combined with atenolol could effectively reduce the serum inflammatory factor level and plasma viscosity in patients with angina pectoris compared with low-dose nitroglycerin, and the therapeutic effect on patients was more significant, without increasing adverse drug reactions, with high clinical safety. RezumatPentru a analiza eficacitatea clinică și siguranța nitroglicerinei în doză mare combinată cu atenolol la pacienții cu angină pectorală, 120 de pacienți au fost împărțiți aleatoriu într-un grup experimental (n = 60) și un grup control (n = 60). Pacienții din grupul experimental au primit nitroglicerină în doză mare (0,5 mg nitroglicerină, de trei ori pe zi, timp de 30 de zile consecutiv) plus atenolol (6,25 mg de două ori pe zi), în timp ce pacienții din grupul control au primit doze mici nitroglicerină (0,2 mg nitroglicerină, de trei ori pe zi, timp de 30 de zile consecutiv) + atenolol (6,25 mg de două ori pe zi). Rezultatele au arătat că diametrul și fracția de ejecție a ventriculului stâng în grupul experimental au fost semnificativ mai mici decât cele din grupul de control. Nivelurile de TNF-α, IL-6 și vâscozitatea plasmei în grupul experimental au fost semnificativ mai mici decât cele din grupul de control. Rata generală de răspuns clinic a grupului experimental (90%) a fost semnificativ mai mare decât cea a grupului control (71,67%). Incidența reacțiilor adverse în grupul experimental (8,33%) nu a fost semnificativ diferită față de cea din grupul control (10%), ceea ce indică faptul că nitroglicerina în doză mare combinată cu atenolol ar putea reduce nivelul factorului inflamator seric și vâscozitatea plasmatică la pacienții cu angină pectorală comparativ cu nitroglicerină în doză mică, cu efecte terapeutice mai însemnate și siguranță clinică ri...

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