Document Detail


Obstructive coronary atherosclerosis and ischemic heart disease: an elusive link!
MedLine Citation:
PMID:  22954239     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In the current pathophysiological model of chronic ischemic heart disease (IHD), myocardial ischemia and exertional angina are caused by obstructive atherosclerotic plaque, and the clinical management of IHD is centered on the identification and removal of the stenosis. Although this approach has been in place for years, several lines of evidence, including poor prognostic impact, suggest that this direct relationship may present an oversimplified view of IHD. Indeed, a large number of studies have found that IHD can occur in the presence or absence of obstructive coronary artery disease and that atherosclerosis is just 1 element in a complex multifactorial pathophysiological process that includes inflammation, microvascular coronary dysfunction, endothelial dysfunction, thrombosis, and angiogenesis. Furthermore, the high recurrence rates underscore the fact that removing stenosis in patients with stable IHD does not address the underlying pathological mechanisms that lead to the progression of nonculprit lesions. The model proposed herein shifts the focus away from obstructive epicardial coronary atherosclerosis and centers it on the microvasculature and myocardial cell where the ischemia is taking place. If the myocardial cell is placed at the center of the model, all the potential pathological inputs can be considered, and strategies that protect the cardiomyocytes from ischemic damage, regardless of the causative mechanism, can be developed.
Authors:
Mario Marzilli; C Noel Bairey Merz; William E Boden; Robert O Bonow; Paola G Capozza; William M Chilian; Anthony N DeMaria; Giacinta Guarini; Alda Huqi; Doralisa Morrone; Manesh R Patel; William S Weintraub
Related Documents :
10482149 - Baroreflex and non-baroreflex modulation of vagal cardiac control after myocardial infa...
3949 - Pattern of enzyme activity following acute myocardial infarction with special reference...
9420739 - Should all patients undergo cardiac catheterization after a myocardial infarction?
17269209 - Pathogenesis of acute myocardial infarction in young male adults with or without obesity.
15262039 - Levels of soluble adhesion molecules in various clinical presentations of coronary athe...
6174269 - Myocardial contractility, haemodynamics, and metabolism in acute myocardial infarction....
10347349 - Methodologic drift in the assessment of timi grade 3 flow and its implications with res...
21656649 - Left main coronary artery stenting after cardiac arrest in an infant with william's syn...
23842759 - Transapical access closure: the ta plug device.
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  60     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-07     Completed Date:  2012-11-13     Revised Date:  2013-02-27    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  951-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Cardiothoracic Department, Division of Cardiology, University Hospital of Pisa, Italy. Mario.marzilli@med.unipi.it
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Atherosclerosis / complications*
Coronary Disease / complications*
Coronary Stenosis / complications
Humans
Myocardial Ischemia / classification,  etiology*
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2013 Jan 22;61(3):388   [PMID:  23328616 ]
J Am Coll Cardiol. 2013 Jan 22;61(3):387-8   [PMID:  23328614 ]
J Am Coll Cardiol. 2012 Sep 11;60(11):957-9   [PMID:  22954240 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Supervised Chemical Pattern Recognition in Almond (Prunus dulcis) Portuguese PDO Cultivars: a PCA an...
Next Document:  Dioxin-like Potency of OH- and MeO Analogues of PBDEs' the Potential Risk through Consumption of Fis...