The effect of dipyridamole on megakaryocytopoiesis in regenerating and stationary populations of mouse bone marrow cells has been studied by heterotopic transplantation of the bone marrow using histological, electron microscopic and biochemical techniques. It is shown that drug administration induced destruction of megakaryocytes. In megakaryocytic cytoplasm giant lipid granules were found whose growth and number increase resulted in megakaryocytes kill. Gas-liquid chromatography was used to evaluate the effect of dipyridamole on distribution of lipid fatty acids of the stationary and regenerating populations of the bone marrow cells. A marked increase of the percentage of docosahexaenoic acid was found in lipids of the stationary population. Chronic dipyridamole administration caused an increase of percentage of myristic, palmitic oleic acids, and decrease of percentage of arachidonic and eicosapentaenoic acids in lipids of regenerating bone marrow cells population.
The effects of the dihydropyridine calcium antagonists, nifedipine, nitrendipine and FR 7534 on the transmural distribution of coronary blood flow (endo/epi) were compared to the structurally unrelated calcium antagonists, verapamil and diltiazem and to the non-calcium antagonist vasodilator drugs, chromonar and dipyridamole in anesthetized dogs. The increase in transmural blood flow produced by diltiazem, verapamil, chromonar and dipyridamole was equally distributed between subendocardium and subepicardium (no change in endo/epi). On the other hand, the increase in myocardial blood flow produced by the dihydropyridine calcium antagonists nifedipine, nitrendipine and FR 7534 was relatively selective for subepicardial regions resulting in a significant and dose-related decrease in endo/epi. This unusual effect of the dihydropyridine calcium antagonists to produce a redistribution of flow within normal myocardium was not shared by the non-dihydropyridine calcium antagonists or non-calcium antagonist vasodilators studied. The redistribution of flow was not related to changes in heart rate, aortic blood pressure or to the level of total coronary blood flow. Such an effect may be related to the distribution of dihydropyridine receptors across the left ventricular wall, antagonism of the action of adenosine, or changes in regional intramyocardial tissue pressure and extravascular resistance.
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Myocardial perfusion and ischemia scores obtained from myocardial perfusion scintigraphy (MPS) have strong independent prognostic value in elderly individuals without known coronary artery disease (CAD). Herein we aimed to assess their independent diagnostic value and accuracy for CAD while considering different thresholds of myocardial ischemia.
Predischarge stress testing identifies the long-term occurrence of soft ischemic events driving late revascularization after uncomplicated AMI.
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Atrophie blanche (livedo vasculitis) is a superficial thrombotic condition characterized by grouped and reticulated erythematous and purpuric macules, painful ulcers, and atrophic scars, and is usually found in middle-aged women. We describe an 8-year-old boy with atrophie blanche. Therapy with antiplatelet medications seemed to alleviate pain and decrease the ulceration.
persantine medication classification
To detect severe coronary artery disease in asymptomatic middle-aged diabetic patients exposed to coronary artery disease risk factors.
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Coronary artery disease is one of the leading causes of death in developed countries and one of the factors contributing to high mortality associated with noncardiac surgical procedures. This is the reason why is so important to correctly assess surgical risk in patients with ischemic heart disease. These patients can be evaluated by a simple clinic examination, electrocardiogram and chest X-ray. In asymptomatic patients or in patients with angina (Class I-II), normal electrocardiogram and chest X-ray, the operative risk is low. On the other hand, patients with severe heart failure (Class IV NYHA), unstable angina or acute myocardial infarction have a high surgical risk. The exercise stress testing must be performed in some cases in order to identify preoperative factors (electrocardiographic ischemic changes, low functional capacity) that might affect the development of cardiac events after noncardiac surgery. When not possible a thallium-dipyridamole scintigraphy should be considered. We discuss preoperative indications for coronary angiography and coronary revascularization. Coronary artery bypass surgery must be thought based on clinic severity, therapeutic results, left ventricular function and patient age, among other factors.
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There were changes in the duration of the monophasic action potential indicative of ischaemia--that is, shortening of duration of steady state action potential--in 18 of the 20 recordings from areas of abnormal perfusion. Peak changes were apparent eight minutes from the start of the dipyridamole infusion. Mean (SEM) values for duration of the action potential between control and peak effect at eight minutes were 276.5 (5.3) ms v 276.6 (5.4) for group 1 (NS), 289.6 (4.7) ms v 278.4 (4.9) ms for group 2 (p less than 0.001), and 269.6 (5.7) ms v 242.0 (4.4) for group 3 (p less than 0.0001). These changes were significantly different between the three groups (p less than 0.01). ST segment changes on the surface electrocardiogram were seen in only eight patients, all with areas of viable myocardium supplied by collateral vessels.
Chronic and intermittent ischemic vascular disorders represent a burgeoning clinical challenge. Previous studies have focused on the idea that therapeutic angiogenesis strategies could alleviate tissue ischemia; however, it is now appreciated that vascular disease is not simply limited to vascular wall cells but also influenced by simultaneously occurring inflammatory responses. Our laboratory has discovered that pharmacological treatment of permanent tissue ischemia with dipyridamole significantly augments ischemic tissue reperfusion, angiogenesis, and arteriogenesis over time. We have found that the beneficial effects of dipyridamole therapy are due to its ability to increase tissue nitric oxide bioavailability that corrects tissue redox imbalance. Importantly, we have also discovered that dipyridamole treatment invoking nitric oxide (NO) production significantly downregulates various innate immune response genes during chronic ischemic tissue injury. These findings demonstrate that dipyridamole-induced production of nitrite/NO significantly decreases inflammatory responses while increasing vascular growth in ischemic tissues.
A brief survey is given on the state of the art of qualitative and quantitative myocardial contrast echocardiography as well as on the contrast agents used. Exact qualitative assessment of coronary perfusion areas is possible. In addition, myocardial areas of collaterals of less than 100 microns in diameter can be visualized and measured that were not seen by routine coronary angiography. Quantitative analysis was done in 5 normal subjects and 16 patients with coronary artery disease before and after right ventricular stimulation (170 bpm over 75 s). While decay half time (T1/2) remained unchanged in normal subjects before and after pacing (7 +/- 4 s vs 7 +/- 5 s), it increased significantly from 5 +/- 1 to 16 +/- 1 s in patients with coronary stenoses between 50% and 75%. Stenotic area reduction greater than 75% had significant prolongations of T 1/2 = 12 +/- 7 s already at rest with further prolongation to 36 +/- 17 s (p less than 0.05) after pacing. Regional wall motion in these areas, however, was not significantly altered either in the fixed axis or floating axis system. Following dipyridamole hyperaemia (0.56 mg/kg i.v.), normal subjects showed a significant shortening of T 1/2 (6 +/- 2 vs 1.6 +/- 1; p less than 0.01; n = 5), while T 1/2 of patients with multiple vessel disease was prolonged from 9 +/- 6 to 15 +/- 6 s (p less than 0.01; n = 7). This prolongation was not uniform, since some myocardial areas were found to be hyperaemic after dipyridamole. One patient showed an opening of antegrade collaterals following dipyridamole. In first results myocardial contrast echocardiography proved capable of recognizing ischaemic and hyperaemic myocardium.(ABSTRACT TRUNCATED AT 250 WORDS)
Visual judgment of stenosis severity from cine-film or single-photon emission computed tomographic dipyridamole perfusion images was compared to assessment of stenosis severity as measured with digital quantitative coronary angiography. Thirty patients with angiographically verified single-vessel disease underwent dipyridamole thallium stress testing within 90 days of angiography.
We studied the clinical benefit of depth-dependent RR, nonuniform AC using a scanning line source, and scatter correction (photon energy recovery [PER]) compared with filtered backprojection alone. Eighty-two patients were included: 40 healthy volunteers with a low likelihood of coronary artery disease (control group) and 42 patients with proven right or circumflex coronary artery disease but without involvement of the left anterior descending artery. Among these 82 patients, the images of 33 were also processed with PER.