ABSTRACT
@#Alzheimer's disease(AD)is one of the most common causes of Dementia in the world, with symptoms often appearing years after the degenerative changes in the brain. Therefore, the early diagnosis of AD is difficult and the previous diagnostic methods are generally invasive. Considering that most patients with AD are accompanied by visual impairment, the retina can be regarded as a window into the brain. Recently, optical coherence tomography(OCTA)can be used for noninvasive and rapid assessment of structure within different vascular plexuses in the retina and choroid. This improves our understanding of neurological diseases, and more likely contributes to the early diagnosis of AD patients. This paper reviewed the relevant literatures on the application of OCTA in the study of neurological diseases, as well as the structure and function of the brain and retina in patients with AD.
ABSTRACT
We investigated the importance of comprehensive physiologic assessment about culprit vessel in STEMI in estimating long-term clinical outcomes after complete revascularization. Comprehensive physiologic assessment provides additional information about microvascular function in coronary artery disease. This assessment includes three indices, fractional flow reserve (FFR), index of microcirculatory resistance (IMR) and coronary flow reserve (CFR). We have performed the comprehensive physiologic assessment in culprit vessels after successful primary PCI in STEMI patients. Both cases were thrombotic total occlusion in mid right coronary artery with inferior wall STEMI, successfully revascularized with stent implantation after thrombus suction. However, in post PCI physiologic assessment, one case showed overt microvascular damage. CFR was 1.1, and IMR was 75U, which was defined as a combined criterion of low CFR (<2.0) and high IMR (≥25U) in culprit vessel, but the other case showed 2.2 in CFR and 24U in IMR, which suggested no overt microvascular damage. Moreover, we can validate these findings by cardiac MR after primary PCI. Previous studies presented that the presence of overt microvascular damage was significantly associated with worse clinical outcome in patients with coronary artery disease. We suggest that comprehensive physiologic evaluation provides important information about the degree of microvascular damage and long-term clinical outcomes after complete revascularization in culprit vessel in STEMI.
Subject(s)
Humans , Coronary Artery Disease , Coronary Vessels , Myocardial Infarction , Percutaneous Coronary Intervention , Stents , Suction , ThrombosisABSTRACT
Diabetes being considered as an epidemic, long term untreated complicated diabetes resulting in retinopathy will be a leading cause of blindness worldwide. Many cross-sectional studies reported a strong relationship between chronic hyperglycaemia and development, progression of retinopathy, however the underlying mechanism that cause retinal microvascular damage following prolonged hyperglycaemia, yet to be revealed. Continued research worldwide focuses on understanding the molecular basis with the ultimate goal to prevent diabetic retinopathy by developing newer therapeutic targets. This article reviews multiple biochemical pathways that are implicated in diabetic retinopathy. Recent advancement in the molecular basis of the disease as well as clinical trials undertaken to target these molecules in order to block the signalling cascade prevailing in diabetic retinopathy is also discussed. This review highlights the recent therapeutic targets to prevent the onset as well as the progress of retinopathy in diabetes.
ABSTRACT
Systemic sclerosis is a connective tissue disease characterized by alterations in microvascular structure and function. In these patients, numerous studies have demonstrated a relationship between capillary morphology and peripheral blood perfusion. Nailfold videocapillaroscopy reveals the peripheral microvascular morphology and thus allows classification and scoring of capillary abnormalities with respect to different microangiopathy patterns (early, active, and late). Laser Doppler flowmetry and laser speckle contrast analysis can be used to estimate cutaneous blood flow through microvessels and to assess and quantify blood perfusion at peripheral sites. These two methods are also used to identify changes in digital blood perfusion after the infusion of vasodilators.