Arterial occlusion coronary

Indications for treatment with streptokinase include acute occlusion of arteries, deep vein thrombosis, and pulmonary embolism. Streptokinase therapy in coronary thrombosis, which is the usual cause of myocardial infarction (54,71,72), has proved to be valuable. In this frequently fatal condition, the enzyme is adrninistered intravenously at a dose of 1.5 million units over 60 min, or given by intracoronary infusion at a 20,000- to 50,000-unit bolus dose followed by 2000 to 4000 units/min for 60 min therapy must be instituted as soon as practicable after the diagnosis of heart attack is made. For deep vein thrombosis, pulmonary embolism, or arterial occlusion, streptokinase is infused at a loading dose of 250,000 units given over 30 min, followed by a maintenance dose of 100,000 units over a 60-min period. 

Many serious health problems result from abnormally located blood clots heart attacks (clots in coronary arteries), pulmonary embolism (clots in the lungs), and peripheral arterial occlusion and deep vein thrombosis (clots in the limbs). Each year heart attacks alone afflict over a million people in the United States, and almost half of them die as a result. 

Maroko, P.R., Kjeksus, J.K., Sobel, B.E., Watanabe, T., Covell, J.W., Ross, J., Jr and Braunwald, E. (1971). Factors influencing infarct size following experimental coronary artery occlusions. Circulation 43, 67-82. 

Acute coronary syndromes is a term that includes all clinical syndromes compatible with acute myocardial ischemia resulting from an imbalance between myocardial oxygen demand and supply.3 In contrast to stable angina, an ACS results primarily from diminished myocardial blood flow secondary to an occlusive or partially occlusive coronary artery thrombus. Acute coronary syndromes are classified according to electrocardiogram (ECG) changes into STE ACS (STE MI) or NSTE ACS (NSTE MI and unstable angina) (Fig. 5-1). An STE MI, formerly... 

The basic biology of chemokines and their receptors is well covered in Chapters 2 and 3 of this book, and we will focus hereafter upon the roles of individual chemokines and receptors in atherosclerosis. The largest amount of data on the roles of chemokines in cardiovascular disease (C VD) has been obtained from in vitro studies and murine models, which will be discussed in detail. In man, genetic polymorphisms in chemokine and chemokine-receptor genes have pointed to an important role for specific chemokines in various atherosclerotic diseases including coronary artery disease and carotid artery occlusive disease. For properties see Table 1. 

FIGURE 4.15 Two pH and two K+ planar sensors in the in-situ porcine heart preparation at midmyocar-dial depth (a) and the recorded fall in the pH and increase in K+ activity, respectively, during the course of coronary artery occlusion (b). (From [18].)... 

In contrast to stable angina, an ACS results primarily from diminished myocardial blood flow secondary to an occlusive or partially occlusive coronary artery thrombus. 

Masson, S., Masseroh, M., Fiordaliso, F., et al. (1999) Effects of a DA(2)/alpha(2) agonist and a beta(l)-blocker in combination with an ACE inhibitor on adrenergic activity and left ventricular remodeling in an experimental model of left ventricular dysfunction after coronary artery occlusion. J. Cardiovasc. Pharmacol. 34, 321-326. 

Heyndrickx GR, Millard RW, McRitchie RJ, Maroko PR, Vatner SF. Regional myocardial functional and electrophysiological alterations after brief coronary artery occlusion in conscious dogs. J Clin Invest 1975 56 978-985... 

Hill JL, Gettes LS. Effect of acute coronary artery occlusion on local myocardial extracellular K + activity in swine. Circulation 1980 61 768-778... 

In subsequent investigations, [ FIPFBG PET was used to image canine pheochromocytomas and to characterize the area at risk in a canine coronary artery occlusion model [180, 181]. 

C.R. Berry, P.K. Garg, T.R. DeGrado, P. Hellyer, W. Weber, S. Garg, B. Hansen, M.R. Zalutsky, R.E. Coleman, Para-[ F]fluorobenzylguanidine kinetics in a canine coronary artery occlusion model, J. Nucl. Cardiol. 3 (1996) 119-129. 

It is used in lysis of suspected occlusive coronary artery thrombi associated with evolving MI in adults. 

Rosen MR, Janse MJ, Myerburg RJ Arrhythmias induced by coronary artery occlusion What are the electrophysiological mechanisms in Hearse DJ, Manning AS, Janse MJ (eds) Life Threatening Arrhythmias during Ischemia and Infarction. New York, Raven Press, 1987, pp 11-48. 

Thrombus Formation. The thromboxanes, especially TXA2, cause platelet aggregations that result in blood clot formation.73 It is unclear whether excessive thrombus formation (as in deep vein thrombosis or coronary artery occlusion) is initiated by abnormal thromboxane production. Certainly, inhibition of thromboxane synthesis will help prevent platelet-induced thrombus formation in individuals who are prone to specific types of excessive blood clotting.84... 

Angina pectoris is typically associated with some degree of coronary artery occlusion. To help prevent further blockage of the coronary arteries, certain anticoagulant drugs can be administered so that a partially occluded artery does not become completely... 

Percutaneous coronary intervention (PCI) such as coronary angioplasty and stent implantation has become a worldwide routine strategy for coronary arterial occlusive diseases. Along with the recognition that thrombus formation is very likely to be involved in acute coronary syndrome (ACS), selection of the optimal anticoagulant is becoming essential to achieve reliable anticoagulation for successful PCI. 

Stent-based drug delivery as a treatment modality for occlusive coronary artery disease... 

El Gendi H, Violaris AG, Foale R, Sharma HS, Sheridan DJ. Endogenous, local, vascular endothelial growth factor production in patients with chronic total coronary artery occlusions further evidence for its role in angiogenesis. Heart 2002 87(2) 158-159. 

The most common reason for failure of a chronic total occlusion is inability to cross with aguidewire. The pathologic basis for this has been studied (15-17). Srivatsa et al, (15) evaluated the histologic correlates of angiographic total coronary artery occlusion in an autopsy series of 61 patients with... 

Histologic specimens of chronic coronary arterial occlusions with (A) large central neovascular channels (arrow) or (B) extensive media/adventitial collaterals. 

Holmes DR Jr, Vlietstra RE, Reeder GS, et al. Angioplasty in total coronary artery occlusion. JACC 1984 3 845-849. 

Bell MR, Berger PB, Bresnahan JE et al. Initial and long term outcome of354 patients after coronary balloon angioplasty of total coronary artery occlusion. Circulation 1992 85 1003-101 I. 

Fig. 13.1 Phosphorylated c-Ski expression in cytosolic fraction of cells in post-MI rat heart. In post-MI rat hearts with chronic large myocardial infarction, phosphorylated c-Ski expression was noted in the cytosol of cells populating the infarct scar (predominantly myofibroblasts) and the remnant heart (mixed cytosolic fraction from myocytes and nonmyocytes). Hearts were sampled at different times after surgical ligation of coronary artery occlusion and Western analysis was carried out to assess phosphorylated c-Ski expression. Trends in -fold protein expression (target band intensity corrected for loading) are shown in curves.

Shizukuda, Y., Iwamoto, T., Mallet, R.T., and Downey, H.F. 1993. Hypoxic preconditioning attenuates stunning caused by repeated coronary artery occlusion in dog heart. Cardiovas. Res. 27 559-564. 

Wolf, R.A. et al., Heparin inhibits bovine testicular hyaluronidase activity in myocardium of dogs with coronary artery occlusion, Am. J. Card., 53, 941, 1984. 

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