• Title/Summary/Keyword: Acute myocardial ischemia

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Troponin-Positive Non-Obstructive Coronary Arteries and Myocardial Infarction with Non-Obstructive Coronary Arteries: Definition, Etiologies, and Role of CT and MR Imaging

  • Seung Min Yoo;Sowon Jang;Jeong A Kim;Eun Ju Chun
    • Korean Journal of Radiology
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    • v.21 no.12
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    • pp.1305-1316
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    • 2020
  • In approximately 10% of patients with acute myocardial infarction (MI), angiography does not reveal an obstructive coronary stenosis. This is known as myocardial infarction with non-obstructive coronary arteries (MINOCA), which has complex and multifactorial causes. However, this term can be confusing and open to dual interpretation, because MINOCA is also used to describe patients with acute myocardial injury caused by ischemia-related myocardial necrosis. Therefore, with regards to this specific context of MINOCA, the generic term for MINOCA should be replaced with troponin-positive with non-obstructive coronary arteries (TpNOCA). The causes of TpNOCA can be subcategorized into epicardial coronary (causes of MINOCA), myocardial, and extracardiac disorders. Cardiac magnetic resonance imaging can confirm MI and differentiate various myocardial causes, while cardiac computed tomography is useful to diagnose the extracardiac causes.

Rupture of Papillary Muscle -Report of a Case- (유두근 파열 수술 치험 1례)

  • 박국양
    • Journal of Chest Surgery
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    • v.28 no.1
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    • pp.69-72
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    • 1995
  • A 69-year-old patient with rupture of anterolateral papillary muscle following non-Q-wave myocardial infarction is described. Transesophageal echocardiography was useful in making the diagnosis. Mitral valve replacement was performed 22 days after the onset of acute myocardial infarction. The patient was discharged in his good condition and coronary angiography is scheduled.

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Alteration in Magnesium Level in Acute Myocardial Infarction

  • T. Angeline;K. Ramadevi;Aruna, Rita-Mary;G. Mohan;Nirmala Jeyaraj
    • Animal cells and systems
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    • v.7 no.2
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    • pp.169-171
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    • 2003
  • Sodium, potassium, calcium, zinc and magnesium levels in the serum of 31 patients diagnosed as acute myocardial infarction were analyzed on admission (within 24 Hours) and after 48 hours. The results were compared with those of 26 age matched controls. No significant difference was observed in the mean sodium, potassium, calcium and zinc levels between the cases and controls. Compared to the controls, however, the variation in the level of magnesium is highly significant at the time of admission as well as after 48 hours. When the risk factors like diabetes mellitus, hypertension, smoking and alcohol were considered, it is found that there is no significant difference between the risk groups as well as between the patients. The alteration in magnesium level in acute myocardial infarction is independent of these risk factors. Within the first 24 hours, the significant decrease in serum magnesium (35-51% fall when compared with the control group), correlates with its entry into the cell following ischemia. From this hypomagnesemic state, it rises to 9-22 times after 48 hours. This hyper-magnesemia after 45 hours is probably due to the shift of magnesuim from the intracellular fluid compartment to the extracellular fluid compartment that follows cellular recovery. Therefore, including magnesium in the immediate management of acute myocardial infarction will be beneficial in the early recovery.

Role of Magnetocardiography in Emergency Room (응급실에서 심자도의 역할)

  • Kwon, H.;Kim, K.;Kim, J.M.;Lee, Y.H.;Kim, T.E.;Lim, H.K.;Park, Y.K.;Ko, Y.G.;Chung, N.
    • Progress in Superconductivity
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    • v.8 no.1
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    • pp.40-45
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    • 2006
  • In emergency rooms, patients with acute chest pain should be diagnosed as quickly as possible with higher diagnostic accuracy for an appropriate therapy to the patients with acute coronary syndrome or for avoiding unnecessary hospital admissions. At present, electrocardiography(ECG) and biochemical markers are generally used to detect myocardial infarction and coronary angiography is used as a gold standard to reveal the degree of narrowing of coronary artery. Magnetocardiography(MCG) has been proposed as a novel and non-invasive diagnostic tool fur the detection of cardiac electrical abnormality associated with myocardial ischemia. In this study, we examined whether the MCG can be used fur the detection of coronary artery disease(CAD) in patients, who were admitted to the emergency room with acute chest pain. MCG was recorded from 36 patients admitted to the emergency room with suspected acute coronary syndrome. The MCG recordings were obtained using a 64-channel SQUID MCG system in a magnetically shielded room. In result, presence of CAD could be found with a sensitivity of 88.2 % in patients with acute chest pain without 57 elevation in ECG, demonstrating a possible use in the emergency room to screen CAD patients.

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Coronary Artery Bypass Grafting in Patients with Acute Myocardial Infarction with an Abnormal Origin of the Right Coronary Artery (우관상동맥 이상기시를 동반한 급성 심근경색 환자에서의 관상동맥우회술)

  • Choi, Si-Young;Kim, Yong-Hwan;Suh, Jong-Hi
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.636-639
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    • 2008
  • An abnormal origin of the right coronary artery can be responsible for sudden death, myocardial ischemia, arrhythmia and syncope, and it may be associated with the accelerated development of atherosclerotic disease. The mechanisms of ischemia in the case of an abnormal origin of the right coronary artery are currently unclear and several surgical methods have been proposed to treat this malady. Multidetector Computed Tomography shows the course of the abnormal coronary artery, it helps to clarify the mechanism of the ischemia and it aids in choosing the best surgical approach. We report here on a case of acute myocardial infarction with an abnormal origin of the right coronary artery. Coronary artery bypass grafting was subsequently carried out to treat this patient.

Cardioprotective effect of ginsenoside Rb1 via regulating metabolomics profiling and AMP-activated protein kinase-dependent mitophagy

  • Hu, Jingui;Zhang, Ling;Fu, Fei;Lai, Qiong;Zhang, Lu;Liu, Tao;Yu, Boyang;Kou, Junping;Li, Fang
    • Journal of Ginseng Research
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    • v.46 no.2
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    • pp.255-265
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    • 2022
  • Background: Ginsenoside Rb1, a bioactive component isolated from the Panax ginseng, acts as a remedy to prevent myocardial injury. However, it is obscure whether the cardioprotective functions of Rb1 are related to the regulation of endogenous metabolites, and its potential molecular mechanism still needs further clarification, especially from a comprehensive metabolomics profiling perspective. Methods: The mice model of acute myocardial ischemia (AMI) and oxygen glucose deprivation (OGD)-induced cardiomyocytes injury were applied to explore the protective effect and mechanism of Rb1. Meanwhile, the comprehensive metabolomics profiling was conducted by high-performance liquid chromatography and quadrupole time-of-flight mass spectrometry (HPLC-Q/TOF-MS) and a tandem liquid chromatography and mass spectrometry (LC-MS). Results: Rb1 treatment profoundly reduced the infarct size and attenuated myocardial injury. The metabolic network map of 65 differential endogenous metabolites was constructed and provided a new inspiration for the treatment of AMI by Rb1, which was mainly associated with mitophagy. In vivo and in vitro experiments, Rb1 was found to improve mitochondrial morphology, mitochondrial function and promote mitophagy. Interestingly, the mitophagy inhibitor partly attenuated the cardioprotective effect of Rb1. Additionally, Rb1 markedly facilitated the phosphorylation of AMP-activated protein kinase α (AMPKα), and AMPK inhibition partially weakened the role of Rb1 in promoting mitophagy. Conclusions: Ginsenoside Rb1 protects acute myocardial ischemia injury through promoting mitophagy via AMPKα phosphorylation, which might lay the foundation for the further application of Rb1 in cardiovascular diseases.

Effect of Rosiglitazone on Myocardial Ischemia-Reperfusion Injury in Rat Heart

  • Ha, Ki-Chan
    • The Korean Journal of Physiology and Pharmacology
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    • v.10 no.4
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    • pp.181-186
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    • 2006
  • This study was undertaken to evaluate whether peroxisome proliferator-activated-receptor-gamma $(PPAR-{\gamma})$ agonist-rosiglitazone (ROSI) induces postischemic functional recovery in Langendorf heart model. Hearts isolated from normal rats were subjected to 20 min of normoxia or 25 min zero-flow ischemia followed by 50 min reperfusion. In this acute protocol, ROSI $(20\;{\mu}g/ml)$ administered 10 min before ischemia had no effect on hemodynamic cardiac function, but had protective effect on lipid peroxidation in in vitro experiments. In chronic protocol in which ROSI was given by daily gavage (4 mg/kg) for three consecutive days, ROSI could not prevent the hemodynamic alteration on cardiac performance, but has protective effect on the activity of superoxide dismutase (SOD). There was no significant difference in the contents of reduced glutathione (GSH) and catalase activity between ischemia-reperfusion (IR) and ROSI treated IR hearts. Although ROSI had no effect on hemodynamic factor, it had effect on antioxidant activity. Our results indicate that ROSI provides partial beneficial effects by inhibiting lipid peroxidation and/or recovering normal level of SOD activity in the ischemic reperfused heart.

Hypothermia Improves Outcomes of Cardiopulmonary Resuscitation After Cardiac Arrest In a Rat Model of Myocardial Infarction (심근경색에 의한 심정지 후 치료적 저체온증으로 호전된 쥐의 심폐소생술 모델)

  • Roh, Sang-Gyun;Kim, Jee-Hee;Moon, Tae-Young;Park, Jeong-Hyun
    • Proceedings of the KAIS Fall Conference
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    • 2011.12a
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    • pp.170-173
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    • 2011
  • Therapeutic hypothermia(TH) improves neurological outcomes and reduces mortality among survivors of out-of-hospital cardiac arrest. Animal and human studies have shown that TH results in improved salvage of the myocardium, reduced infarct size, reduced left ventricular remodeling and better long-term left ventricular function in settings of regional myocardial ischemia. This study is to investigate the effect of TH on post-resuscitation myocardial dysfunction and survival time after cardiac arrest and resuscitation in a rat model of myocardial infarction (MI). Thoracotomies were performed in 10 Male Sprague-Dawley rats weighing 450-550 g. MI was induced by ligation of the left anterior descending coronary artery (LAD). Ninety min after LAD ligation, ventricular fibrillation induction and subsequent cardiopulmonary resuscitation was performed before defibrillation attempts. Animals were randomized to two groups: a) Acute MI-Normothermia b) Acute MI-Hypothermia ($32^{\circ}C$ for 4 h). Myocardial functions, including cardiac output, left ventricular ejection fraction, and myocardial performance index were measured echocardiographically together with duration of survival. Ejection fraction, cardiac output and myocardial performance index were $54.74{\pm}9.16$, $89.00{\pm}8.89$, $1.30{\pm}0.09$ respectively and significantly better in the TH group than those of the normothermic group at the first 4 h after resuscitation($32.20{\pm}1.85$,$41.60{\pm}8.62$,$1.77{\pm}0.19$)(p=0.00). The survival time of the hypothermic group ($31.8{\pm}14.8$ h) was greater than that of the normothermic group($12.3{\pm}6.5$ h, p<0.05). This study suggested that TH attenuated post resuscitation myocardial dysfunction in acute MI and would be a potential strategy in post resuscitation care.

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Dendropanax morbifera Extract Protects Cardiomyocytes against Hypoxia/Reoxygenation Injury by Inhibition of Reactive Oxygen Species Generation and Calcium Perturbation

  • Lim, Leejin;Ju, Sujin;Song, Heesang
    • Natural Product Sciences
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    • v.25 no.2
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    • pp.136-142
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    • 2019
  • Ischemia/reperfusion-induced myocardial injury is the main cause of acute myocardial infarction. Dendropanax morbifera $L{\acute{e}}veille$ has been used in traditional medicines for the treatment of various diseases such as headache, infectious diseases, and general debility. However, the effect of extract from D. morbifera (EDM) on myocardial ischemic injury is still unknown. In this study, the effects of EDM on neonatal rat cardiomyocytes with hypoxia/reoxygenation (H/R) injury were investigated. The viability of cardiomyocytes with H (30 min)/R (1 h) decreased; however, treatment with EDM significantly inhibited H/R injury-induced cardiomyocyte death. Further, we observed that reactive oxygen species (ROS) generation and intracellular calcium concentration ($Ca^{2+}{_i}$) were significantly reduced in EDM-treated cardiomyocytes compared with that in H/R-injured positive control. In addition, western blotting results showed that EDM attenuated abnormal changes of RyR2 and SERCA2a genes in hypoxic cardiomyocytes. These results suggest that EDM ameliorates ROS generation and $Ca^{2+}{_i}$ homeostasis to prevent dysregulation of calcium regulatory proteins in the heart, thereby exerting cardioprotective effects and reducing hypoxia-induced cardiomyocyte damage, which verifies the potential use of EDM as a new therapeutic agent for the treatment of myocardial ischemic injury.

"Brain Stunning" Atypical Feature of tPA Thrombolysis Following Aneurysm Embolization

  • Park, Min-Woo;Yi, Hyeong-Joong;Gupta, Rishi;Horowitz, Michael B.
    • Journal of Korean Neurosurgical Society
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    • v.39 no.4
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    • pp.300-302
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    • 2006
  • "Stunning" represents prolonged contractile depression of any muscular component after alleviation of severe ischemia, as shown in reperfusion following acute myocardial ischemia or ischemic stroke. Clinically, it presents with no or delayed recovery past to thrombolytic therapy but its pathogenic mechanism is not fully uncovered yet. We describe a unique case of a 63-year-old woman, who was undertaken endovascular coiling for the aneurysms, deteriorated several hours later without known cause, and showed delayed clinical improvement over the next 3 days following thrombolysis. Immediate post-thrombolysis magnetic resonance imaging scan showed no apparent abnormality except for high signal intensity within the corresponding hemisphere. Reversible but delayed nature of " brain stunning" can be explained by these images and it seems to be caused by a certain type of reperfusion injury.