ABSTRACT
Both the latest European guidelines on chronic coronary syndromes and the American guidelines on chest pain have underlined the importance of noninvasive imaging to select patients to be referred to invasive angiography. Nevertheless, although coronary stenosis has long been considered the main determinant of inducible ischemia and symptoms, growing evidence has demonstrated the importance of other underlying mechanisms (e.g., vasospasm, microvascular disease, energetic inefficiency). The search for a pathophysiology-driven treatment of these patients has therefore emerged as an important objective of multimodality imaging, integrating "anatomical" and "functional" information. We here provide an up-to-date guide for the choice and the interpretation of the currently available noninvasive anatomical and/or functional tests, focusing on emerging techniques (e.g., coronary flow velocity reserve, stress-cardiac magnetic resonance, hybrid imaging, functional-coronary computed tomography angiography, etc.), which could provide deeper pathophysiological insights to refine diagnostic and therapeutic pathways in the next future.
Subject(s)
Coronary Artery Disease , Coronary Stenosis , Fractional Flow Reserve, Myocardial , Computed Tomography Angiography , Coronary Angiography/methods , Coronary Artery Disease/diagnosis , Fractional Flow Reserve, Myocardial/physiology , Humans , Predictive Value of Tests , SyndromeABSTRACT
The mobilization of endothelial progenitor cells (EPCs) into circulation from bone marrow is well known to be present in several clinical settings, including acute coronary syndrome, heart failure, diabetes and peripheral vascular disease. The aim of this review was to explore the current literature focusing on the great opportunity that EPCs can have in terms of regenerative medicine.
Subject(s)
Endothelial Progenitor Cells/physiology , Animals , Cardiovascular Diseases/physiopathology , Cell Separation , HumansABSTRACT
The Vortex Medical AngioVac Cannula was employed in a 71-year-old man with a renal neoplasm with occlusion of the inferior vena cava and involvement of the right atrial cavity. Due to the presence of diffuse metastases, surgery was not indicated, and the AngioVac system was employed to remove the free-floating mobile atrial mass, thus minimizing the risk of pulmonary embolism and as a bioptic tool to allow a correct histological diagnosis. This novel use of this system may be advantageous in other similar cases.
