Room-Temperature Transition-Metal-Free One-Pot Synthesis of 3‑Aryl Imidazo[1,2‑<i>a</i>]pyridines via Iodo-hemiaminal Intermediate

A mild and efficient one-pot synthesis of 3-aryl imidazo­[1,2-<i>a</i>]­pyridines in up to 88% yield was developed. An adduct was formed after the simple mixing of 2-amino-4-methylpyridine, 2-phenylacetaldehyde, and <i>N</i>-iodosuccinimide in CH₂Cl₂, and the structure of the adduct was characterized by 2D NMR, IR, and high-resolution mass analysis. The adduct was readily cyclized by treatment with a saturated aqueous solution of NaHCO₃. The reactions proceeded to completion after several hours at room temperature

Clinical data, diagnostic findings, and outcomes in 17 patients with CPAF.

<p>Clinical data, diagnostic findings, and outcomes in 17 patients with CPAF.</p

Comparison of CCTA findings according to SPECT findings.

<p>Comparison of CCTA findings according to SPECT findings.</p

Flow diagram showing the incidence and severity stratification of perfusion abnormalities in 17 patients with CPAF.

<p>Flow diagram showing the incidence and severity stratification of perfusion abnormalities in 17 patients with CPAF.</p

Coronary-to-pulmonary artery fistula in adults: Evaluation with thallium-201 myocardial perfusion SPECT

<div><p>Objectives</p><p>With the increasing use of multi-detector CT, the number of detected cases with coronary-to-pulmonary artery fistula (CPAF) has increased. Several previous studies reported severe cases of angina, but no appropriate tests to evaluate myocardial perfusion for patients with CPAF have been established. We evaluated the hemodynamic characteristics of CPAF using thallium-201 (Tl-201) single photon emission computed tomography (SPECT).</p><p>Materials and methods</p><p>Tl-201 SPECT was performed in 17 patients with CPAF, but without evidence of coronary artery disease on coronary computed tomography angiography (CCTA) (age, 58.5±13.3 years; 8 men). Quantitative analysis of scintigraphic data was performed. Additionally, perfusion abnormalities were compared with CCTA findings. Medical records were obtained to define clinical data, diagnostic findings, symptoms, management, follow-up data, and major adverse cardiac events (MACE).</p><p>Results</p><p>Six patients (35.2%) showed perfusion abnormalities on SPECT studies and could be classified as follows: 3 patients, no reversible ischemia (3/17, 17.6%); 1 patient, mild ischemia (1/17, 5.8%); and 2 patients, moderate ischemia (2/17, 11.7%). During the follow-up, ten patients (58.8%) improved under medical management and 5 patients (29.4%) underwent surgical ligation for CPAF with symptomatic improvement in 4 patients. Seven patients performed follow-up myocardial perfusion SPECT, and symptomatic improvement correlated well with scintigraphic perfusion improvement in 6 patients No MACE was observed.</p><p>Clinical significance</p><p>Tl-201 myocardial perfusion SPECT might be useful for determining the hemodynamic status and for risk stratification in patients with CPAF.</p></div

Initial and post-therapeutic change of SSS and SDS by SPECT studies.

<p>Initial and post-therapeutic change of SSS and SDS by SPECT studies.</p

Comparison of patients according to SPECT findings.

<p>Comparison of patients according to SPECT findings.</p

A 52-year-old woman (patient #15) with CPAF who underwent surgical ligation.

<p>(A) Axial CCTA images show tortuous and dilated vessels around the main pulmonary artery and a high-density jet flow, which directly inserts into the main pulmonary artery (<i>arrow</i>). (B and C) These vessels originate from two different vessels: from the proximal left anterior descending artery (<i>arrow</i> in B) and from the proximal right coronary artery (<i>arrow</i> in C). (A) This vascular connection passes from the left side of the main pulmonary artery and forms an aneurysmal dilatation (<i>arrowhead</i> in A) before it enters the main pulmonary artery. (D) Stress and rest polar maps shows perfusion abnormality (SSS = 6) with moderate reversible ischemia (SDS = 6). (E) After surgical ligation, subsequent SPECT shows decreased extent of the perfusion abnormality (SSS = 2).</p