- 著者
- Nihal Özdemir Cihangir Kaymaz Enver Daglar Osman Karakaya Murat Akçay Mehmet Özkan
- 出版者
- International Heart Journal Association
- 雑誌
- Japanese Heart Journal (ISSN:00214868)
- 巻号頁・発行日
- vol.43, no.5, pp.495-503, 2002 (Released:2002-10-24)
- 参考文献数
- 30
- 被引用文献数
- 9 9
The protective effect of severe mitral regurgitation (MR) against left atrial thrombus formation has been well documented. It was also proposed that severe MR may prevent thrombus formation within the left ventricle (LV) with systolic dysfunction. Therefore, we investigated whether ischemic MR prevents thrombus formation within the LV in patients with systolic dysfunction. The study population was comprised of 1313 patients (1133 males, 180 females, age 56±18) with ischaemic LV dysfunction documented by coronary angiography and left ventriculography. None of the patients had a history of chronic anticoagulation. Epicardial coronary arteries were normal in 91 patients, and single-vessel, two-vessel, and triple-vessel disease were detected in 328, 330, and 564 patients, respectively. Left ventricular thrombus and severe MR were detected in 191 (14.5%) and 125 (9.5%) patients, respectively. Overall incidence of LV thrombus was lower in patients with severe MR than in patients without severe MR (4% vs 15.6%, OR: 0.2, P<0.001). Severe MR compared with absence of severe MR was associated with a lower incidence of LV thrombus both in patients with ischemic dilated cardiomyopathy (6.8% vs 34.2%, OR: 0.19, P<0.001), and in patients with aneurysm (3% vs 18%, OR: 0.14, P<0.0001) involving anterolateral, septal and/or apical LV segments. A similar trend without statistical significance was also observed in patients with dyskinesia (4.7% vs 16%, OR: 0.26, P=0.1) related to anterolateral, septal and/or apical LV segments. However, MR had no impact on the incidence of LV thrombus in patients with aneurysm or dyskinesia related to posterior and/or inferior segments (3.7% vs 3%, OR: 1.2, P>0.05). In conclusion, severe MR seems to prevent LV mural thrombus formation in patients with ischemic dilated cardiomyopathy, and in patients with aneurysm related to anterolateral, septal, and/or apical LV segments. This relative risk reduction may be associated with diastolic volume overloading due to severe MR which may overcome stagnation and a procoagulant state within the LV with severe systolic dysfunction.
- 著者
- Osman Karakaya Abdulkadir Koçer Ali Metin Esen Ramazan Kargin Irfan Barutcu
- 出版者
- Tohoku University Medical Press
- 雑誌
- The Tohoku Journal of Experimental Medicine (ISSN:00408727)
- 巻号頁・発行日
- vol.225, no.1, pp.13-16, 2011 (Released:2011-08-11)
- 参考文献数
- 21
- 被引用文献数
- 4 8
Slow coronary flow (SCF) is characterized by delayed opacification of coronary arteries during coronary angiography and is associated with myocardial perfusion abnormalities, ischemia or myocardial infarction. We hypothesized that SCF could be a part of systemic circulatory abnormalities. Therefore, the present study was conducted to investigate whether cerebral blood flow velocity is altered in patients with SCF. The study included 16 patients suffering from chest pain with angiographically proven SCF and 16 subjects suffering from atypical chest pain with angiographically normal coronary flow. All study subjects were selected among those who undergone routine cardiac catheterization. SCF was defined based on thrombolysis in myocardial infarction frame count that reflects coronary artery flow. Thrombolysis in myocardial infarction frame count was significantly higher in patients with SCF than those with normal coronary flow. The average peak systolic, end diastolic and mean flow velocities of the middle cerebral artery were measured and recorded in both groups by transcranial Doppler ultrasonography. Baseline demographic properties were similar in both groups. Echocardiographic parameters were also similar in patients with SCF and those with normal coronary flow. In contrast, both right and left middle cerebral artery peak systolic, end diastolic and mean flow velocities were significantly lower in patients with SCF than those with normal coronary flow. We conclude that cerebral blood flow velocity is significantly lower in patients with SCF. SCF phenomenon may reflect a part of impaired systemic circulation.