Coronary stenoses

Gould KL, Lipscomb K, Hamilton GW. Physiologic basis for assessing critical coronary stenosis. Instantaneous flow response and regional distribution during coronary hyperemia as measures of coronary flow reserve. Am J Cardiol 1974 33 87-94... 

Gould KL. Collapsing coronary stenosis - a starling resistor. Int J Cardiol 1982 2 39-42... 

Demrow et al. (1995) used the Folts model of unstable coronary stenosis, which closely mimics ruptured atherosclerotic plaque, causing unstable angina, to examine the effects of grape juice on platelet function in vivo. In this model,... 

I 5 Willerson JT Yao SK, McNatt J, et al. Frequency and severity of cyclic flow alternations and platelet aggregation predict the severity of neointimal proliferation following experimental coronary stenosis and endothelial injury, Proc Natl Acad Sci USA 1991 88(23)40624-10628. 

Fuster V. Acute coronary syndromes the degree and morphology of coronary stenosis. J Am Coll Cardiol 2000 35(suppl B) 52B-54B. 

The direct or central effects of organic nitrates relieve ischemia by direct action on coronary vessels, improving myocardial oxygen supply. Direct vasodilator effects are exerted mostly on large conductance, rather than small resistance coronary vessels including intercoronary collateral vessels. Coronary stenosis dilatation is potentially a major component of the beneficial response. These mecha-... 

In addition to age, other factor s are associated with an inareased risk of AD. In developed countries, AD appears to be more common in v omen. Lack of education is a risk factor for senile dementia in China and Europe (Zhang et al., 1990 Schmand et al., 1997). Head daunra is also a risk factor for both sporadic (Mortimer et al., 1991) and familial AD (Guo et al., 2000). Silent myocardial infarcts and coronary stenosis triple the risk for AD (Aronson etal., 1990 Sparks etal., 1990), suggesting the importance of vascular risk factors. Other potential risk factors being studied include diabetes and hypertension (Ott et al., 1999 Peila et al., 2002 Qiu etal., 2005). As discussed below, a large number of genetic mutations are now associated with either early-onset AD or with increased risk of late-onset AD. 

Saini RK, Fulmor IE, Antonaccio MJ. Effect of tiapamil and nifedepine during critical coronary stenosis and in the presence of adrenergic beta-receptor blockade in anesthetized dogs. J Cardiovasc Pharmacol 1982 4(5) 770-6. 

Although myocardial depression has been described in healthy volunteers after the use of 40 or 50% nitrous oxide in oxygen, it is usually mild. It is likely that nitrous oxide can worsen myocardial ischemia in patients with critical coronary stenosis, although this may not be of clinical significance (3,4). 

Platelet aggregation plays an important role in the pathogenesis of acute coronary syndromes (ACS). Myocardial infarction is an ACS that occurs when atherosclerotic plaques embedded in artery walls rupture, leading to thrombus formation and coronary occlusion. Patients with high-risk coronary stenosis may need percutaneous coronary interventions (PCI) with or without stent placement to revascularize the arteries. 

Tousoulis D, Davies G, Tentolouris C, Crake T, Toutouzas P. 1997. Coronary stenosis dilation induced by L-arginine. Lancet 349 1812-13... 

Vittone F, Chait A, Morse JS, Fish B, Brown BG, Zhao XQ (2007) Niacin plus simvastatin reduces coronary stenosis progression among patients with metabolic syndrome despite a modest increase in insulin resistance a subgroup analysis of the HDL-Atherosclerosis Treatment Study (HATS). J Clin Lipidol 1 203-210... 

Patients with insignificant coronary stenosis (e.g., <50% diameter)... 

Data on the accumulation of 22 1 fatty acids in humans are also available from the work of Svaar who examined autopsy material from 54 hearts selected from Norwegian men, age 20 to 69, who had died suddenly from accidents (Svaar, 1982). These hearts were selected from a larger group on the basis of being without myocardial infarction, severe coronary stenosis, cardiac hypertrophy or valvular disease by macroscopical examination. No focal myocardial lesions were present. A mild to moderate lipidosis was found in 50% of the hearts but this was not correlated with the concentration of 22 1 which was present at less than 1% of the total lipids (Svaar,... 

White CW, Wright CB, Doty DB etal. (1984) Does visual interpretation of the coronary arteriogram predict the physiologic importance of a coronary stenosis N Engl J Med 310 819-824... 

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