1
|
Nasiri-Partovi A, Shafiee A, Rahmani R. Intracoronary injection of nitroglycerine can prevent unnecessary percutaneous coronary intervention. BMC Cardiovasc Disord 2022; 22:416. [PMID: 36117160 PMCID: PMC9484227 DOI: 10.1186/s12872-022-02823-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 08/18/2022] [Indexed: 11/11/2022] Open
Abstract
Background Despite the recommendation of the current guidelines, intracoronary administration of nitroglycerine during coronary angiography is often neglected. We investigated the effect of intra-coronary nitroglycerin on the relief of coronary artery stenosis in the candidates for percutaneous coronary intervention (PCI). Methods We included patients with angina pectoris or myocardial infarction who were candidates for PCI. In the coronary angiography, the culprit vessel involved was evaluated, and bolus nitroglycerin at a dose of 25–200 mcg was injected into the affected coronary artery. A significant change in the percentage of coronary artery stenosis was considered a positive response, and these patients were then compared with patients who did not have a substantial change in the percentage of stenosis at the same time. Univariate analysis and then multivariate logistic regression analysis was performed to determine the predictors of response to intracoronary nitroglycerin. Results Among 360 patients, 27 (7.5%) responded to nitroglycerine, and 333 (92.5%) were non-responsive. The mean age of patients was 60.2 ± 11.6 years, ranging from 23 to 93 years, and 265 (73.6%) were men. The study groups were not significantly different in the baseline demographic characteristics. The presence of multivessel disease (Odds ratio (OR) = 16.26, 95% confidence interval (CI):2.07–127.6; P = 0.008) and stenosis in the left circumflex artery (OR = 3.62, 95% CI: 1.03–12.70; P = 0.044) were the independent predictors for nonresponse to nitroglycerine, leading to PCI. Conclusion In some cases, especially those without multivessel diseases, intracoronary nitroglycerine administration can efficiently relieve coronary stenosis and prevent unnecessary PCI.
Collapse
Affiliation(s)
- Amirhossein Nasiri-Partovi
- Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Dr. Gharib st, Keshavarz Blvd, Tehran, 1419733141, Iran
| | - Akbar Shafiee
- Department of Cardiovascular Research, Tehran Heart Center, Cardiovascular Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Rahmani
- Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Dr. Gharib st, Keshavarz Blvd, Tehran, 1419733141, Iran.
| |
Collapse
|
2
|
Sueda S, Sakaue T. Coincidence between spontaneous and inducible coronary spasm: acetylcholine test is clinically valued for diagnosing coronary spasm. Heart Vessels 2021; 36:749-755. [PMID: 33389065 DOI: 10.1007/s00380-020-01748-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/27/2020] [Indexed: 12/20/2022]
Abstract
There is no report regarding the correlation between spontaneous documented coronary spasm and acetylcholine (ACh)-inducible spasm. We retrospectively analyzed the coincidence between angiographical spontaneous coronary spasm and ACh-inducible spasm in the same patients. We recruited 28 patients with 30 angiographical spontaneous coronary spasm in 6009 patients with diagnostic and follow-up coronary arteriography from Jan 1991 and Mar 2019 in the cardiac catheterization laboratory. We could perform intracoronary ACh testing in 19 patients with 20 vessels. ACh was injected in incremental dose of 20/50/100 μg into the left coronary artery and 20/50/80 μg into the right coronary artery. Positive spasm was defined as > 90% stenosis and ischemic ECG changes. Angiographical documented spontaneous coronary spasm was observed in 0.47% (28/6009) of patients with diagnostic and follow-up coronary angiography. Intracoronary administration of ACh reproduced 15 spontaneous coronary spasm and no provoked spasm was observed in the remaining 5 vessels due to the administration of nitroglycerine or under medications. Spasm-provoked sites by ACh tests and ACh-inducible spasm configurations were almost similar to spontaneous spasm. Coincidence of provoked spasm site (93.3% vs. 6.7%, p < 0.001) and spasm configuration (93.3% vs. 6.7%, p < 0.001) was markedly higher than discordance. Intracoronary ACh testing can reproduce spontaneous coronary artery spasm in 75% of vessels with almost similar sites and same morphological characteristics irrespective of the administration of nitroglycerine or vasodilators. ACh test is a reliable method to document coronary artery spasm in the clinic.
Collapse
Affiliation(s)
- Shozo Sueda
- Department of Cardiology, Ehime Prefectural Niihama Hospital, Hongou 3 choume 1-1, Niihama, Ehime, 792-0042, Japan.
| | - Tomoki Sakaue
- Department of Cardiology, Yawatahama City General Hospital, Yawatahama, Japan
| |
Collapse
|
3
|
Adeel M, Tingting J, Hussain T, He X, Ahmad MA, Irshad MK, Shakoor N, Zhang P, Changjian X, Hao Y, Zhiyong Z, Javed R, Rui Y. Bioaccumulation of ytterbium oxide nanoparticles insinuate oxidative stress, inflammatory, and pathological lesions in ICR mice. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:32944-32953. [PMID: 32524406 DOI: 10.1007/s11356-020-09565-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
With the rapid development in nanoscience and nanotechnology, rare earth oxide nanomaterials (REO-NMs) have been increasingly used due to their unique physical and chemical characteristics. Despite the increasing applications of REO NPs, scarce information is available on their detrimental effects. In the current study, we investigate the toxic effect of ytterbium oxide nanoparticles (Yb2O3 NPs) in mouse model by using various techniques including inductively coupled plasma mass spectrometry (ICP-MS) analysis over 30 days of exposure. Furthermore, we elucidated lung lavage fluid of mice for biochemical and cytological analysis, and lung tissues for histopathology to interpret the NP side effects. We observed a significant concentration of Yb2O3 NPs accumulated in the lung, liver, kidney, and heart tissues. Similarly, increased bioaccumulation of Yb content was found in the olfactory bulb compared to other reigns of brain. The cytological analysis of bronchoalveolar lavage fluid (BALF) revealed a significant elevation in the percentage of neutrophils and lymphocytes. Biochemical analysis showed an instilled Yb2O3 NPs, showing signs of oxidative damage through up-regulation of 60-87% of MDA while down-regulation of 20-40% of GSH-PX and GSH content. The toxicity pattern was more evident from histopathological observations. These interpretations provide enough evidence of bioaccumulation of Yb2O3 NPs in mice tissues. Overall, our findings reveal that acute exposure of Yb2O3 NPs through intranasal inhalation may cause toxicity via oxidative stress, which leads to a chronic inflammatory response. Graphical abstract Graphical illustrations of experimental findings.
Collapse
Affiliation(s)
- Muhammad Adeel
- Beijing Key Laboratory of Farmland Soil Pollution Prevention and Remediation, College of Resources and Environmental Sciences, China Agricultural University, Beijing, 100193, China
| | - Jin Tingting
- Beijing Key Laboratory of Farmland Soil Pollution Prevention and Remediation, College of Resources and Environmental Sciences, China Agricultural University, Beijing, 100193, China
| | - Tariq Hussain
- Key Laboratory of Animal Epidemiology and Zoonosis, Ministry of Agriculture, National Animal Transmissible Spongiform Encephalopathy Laboratory, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Xiao He
- Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, Key Laboratory of Nuclear Analytical Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, People's Republic of China
| | - Muhammad Arslan Ahmad
- Key Lab of Eco-restoration of Regional Contaminated Environment, Ministry of Education, Shenyang University, Shenyang, 110044, People's Republic of China
- Department of Tissue Engineering, China Medical University, Shenyang, 110122, People's Republic of China
| | - Muhammad Kashif Irshad
- Beijing Key Laboratory of Farmland Soil Pollution Prevention and Remediation, College of Resources and Environmental Sciences, China Agricultural University, Beijing, 100193, China
| | - Noman Shakoor
- Beijing Key Laboratory of Farmland Soil Pollution Prevention and Remediation, College of Resources and Environmental Sciences, China Agricultural University, Beijing, 100193, China
| | - Peng Zhang
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Xie Changjian
- Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, Key Laboratory of Nuclear Analytical Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, People's Republic of China
| | - Yi Hao
- Beijing Key Laboratory of Farmland Soil Pollution Prevention and Remediation, College of Resources and Environmental Sciences, China Agricultural University, Beijing, 100193, China
| | - Zhang Zhiyong
- Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, Key Laboratory of Nuclear Analytical Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, People's Republic of China
| | - Rabia Javed
- Department of Tissue Engineering, China Medical University, Shenyang, 110122, People's Republic of China
| | - Yukui Rui
- Beijing Key Laboratory of Farmland Soil Pollution Prevention and Remediation, College of Resources and Environmental Sciences, China Agricultural University, Beijing, 100193, China.
| |
Collapse
|