Acute and long-term outcome of directional coronary atherectomy for stable and unstable angina

The clinical efficacy and safety of directional coronary atherectomy for the treatment of stable and unstable angina were assessed in 82 patients with stable and 68 patients with unstable angina. Therefore, clinical and angiographic follow-up was obtained in a prospectively collected consecutive series of 150 atherectomy procedures. Restenosis was assessed clinically and by quantitative angiography. The overall clinical success rate of atherectomy for patients with unstable and stable angina was 88% and 91%, respectively. No significant differences were found for in-hospital event rates between the unstable and stable angina groups: death (1.5% vs 0%), myocardial infarction (10% vs 6%), and emergency bypass operation (3% vs 2%). These clinical events were related to the occurrence of abrupt occlusions (8.8% in patients with stable and 6.1% in those with unstable angina; p = NS). Clinical follow-up was achieved in 100% of the patients with stable and unstable angina at a mean interval of 923 and 903 days, respectively. Two-year survival rates were 96% and 97% in the populations with unstable and stable angina, respectively. There were no significant differences with respect to bypass surgery and angioplasty, but event-free survival at 2 years was significantly lower in the unstable (54%) than the stable (69%) angina group. Quantitative coronary angiography did not detect any difference in luminal renarrowing during the 6-month angiographic follow-up period. Although directional coronary atherectomy can be performed effectively in patients with unstable and stable angina, the long-term clinical outcome was less favorable in the unstable angina group.(ABSTRACT TRUNCATED AT 250 WORDS

Directional atherectomy: combining basic research and intervention

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Analysis of VNTR loci amplified by the polymerase chain reaction for investigating the origin of intimal smoth muscle cells in a coronary artery lesion developing after heart transplantation in man

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Coronary vasodilatory action of elgodipine in coronary artery disease

The effects of intravenous elgodipine, a new second-generation dihydropyridine calcium antagonist, on hemodynamics and coronary artery diameter were investigated in 15 patients undergoing cardiac catheterization for suspected coronary artery disease. Despite a significant decrease in systemic blood pressure, elgodipine infused at a rate of 1.5 micrograms/kg/min over a period of 10 minutes did not affect heart rate and left ventricular end-diastolic pressure. The contractile responses during isovolumic contraction showed a slight but significant increase in maximum velocity (56 +/- 10 to 60 +/- 10 seconds-1; p less than 0.005), whereas the time constant of early relaxation was shortened from 49 +/- 11 to 44 +/- 9 ms (p less than 0.05). Coronary sinus and great cardiac vein flow increased significantly by 15 and 26%, respectively. As mean aortic pressure decreased, a significant decrease in coronary sinus (-27%) and great cardiac vein (-28%) resistance was observed, while the calculated myocardial oxygen consumption remained unchanged. In all, 69 coronary segments (including 13 stenotic segments) were analyzed quantitatively using computer-assisted quantitative coronary angiography. A significant increase in mean coronary artery diameter (2.27 +/- 0.53 to 2.48 +/- 0.53 mm; p less than 0.000001), as well as in obstruction diameter, (1.08 +/- 0.29 to 1.36 +/- 0.32 mm; p less than 0.02), was observed. The results demonstrate that elgodipine, in the route and dose described, induces significant vasodilatation of both coronary resistance and epicardial conductance vessels, without adverse effects on heart rate, myocardial oxygen demand and contractile indexes

Histologic characteristics of tissue excised during directional coronary atherectomy in stable and unstable angina pectoris

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Ford's Procedure for Combining Multiple Sets of Partially Ordered Data

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66929/2/10.1177_001316447303300104.pd

Magnetic fields in cosmic particle acceleration sources

We review here some magnetic phenomena in astrophysical particle accelerators associated with collisionless shocks in supernova remnants, radio galaxies and clusters of galaxies. A specific feature is that the accelerated particles can play an important role in magnetic field evolution in the objects. We discuss a number of CR-driven, magnetic field amplification processes that are likely to operate when diffusive shock acceleration (DSA) becomes efficient and nonlinear. The turbulent magnetic fields produced by these processes determine the maximum energies of accelerated particles and result in specific features in the observed photon radiation of the sources. Equally important, magnetic field amplification by the CR currents and pressure anisotropies may affect the shocked gas temperatures and compression, both in the shock precursor and in the downstream flow, if the shock is an efficient CR accelerator. Strong fluctuations of the magnetic field on scales above the radiation formation length in the shock vicinity result in intermittent structures observable in synchrotron emission images. Resonant and non-resonant CR streaming instabilities in the shock precursor can generate mesoscale magnetic fields with scale-sizes comparable to supernova remnants and even superbubbles. This opens the possibility that magnetic fields in the earliest galaxies were produced by the first generation Population III supernova remnants and by clustered supernovae in star forming regions.Comment: 30 pages, Space Science Review

Search for direct production of charginos and neutralinos in events with three leptons and missing transverse momentum in √s = 7 TeV pp collisions with the ATLAS detector

A search for the direct production of charginos and neutralinos in final states with three electrons or muons and missing transverse momentum is presented. The analysis is based on 4.7 fb−1 of proton–proton collision data delivered by the Large Hadron Collider and recorded with the ATLAS detector. Observations are consistent with Standard Model expectations in three signal regions that are either depleted or enriched in Z-boson decays. Upper limits at 95% confidence level are set in R-parity conserving phenomenological minimal supersymmetric models and in simplified models, significantly extending previous results