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Peiman Jamshidi

Publications and source records attributed to Peiman Jamshidi.

4 recordsLinked to original sources
PubMed2004

Brachytherapy: potential therapy for refractory coronary spasm.

OBJECTIVES: We sought to demonstrate that brachytherapy reduces coronary spasm in refractory and highly symptomatic variant angina. BACKGROUND: In some patients with variant angina due to extensive vasoconstriction, intensive drug therapy fails to sufficiently relieve symptoms. METHODS: In 18 patients with frequent angina episodes despite triple anti-anginal therapy, coronary spasm was induced by intracoronary acetylcholine (ACh) infusion. Five patients had spasm in a second vessel. Intracoronary radiation (20 Gy) was applied to vasospastic segments using a beta-emitting ((32)P) wire source centered within a Galileo balloon. Parameters of vessel function before and after brachytherapy were investigated. RESULTS: Before brachytherapy, artery diameters decreased (p < 0.0001) from 2.8 +/- 0.4 mm to 1.0 +/- 0.4 mm for the first vessels and from 3.1 +/- 0.3 mm to 1.0 +/- 0.2 mm for the second vessels. After brachytherapy (143 +/- 106 and 80 +/- 52 days for first and second vessels, respectively), ACh-induced vasoconstriction was significantly reduced. The ACh-induced changes in artery diameter before and after brachytherapy were -1.5 +/- 0.5 mm and -0.5 +/- 0.3 mm (p < 0.0001) for the first vessels and -1.4 +/- 0.3 mm and -0.4 +/- 0.2 mm (p < 0.01) for the second vessels, respectively. In non-irradiated spastic vessels, ACh-induced vasoconstriction remained unchanged (e.g., -1.7 +/- 0.6 mm, -1.6 +/- 0.3 mm, and -1.5 +/- 0.5 mm for second vessels, at first investigation, first follow-up, and immediately before brachytherapy, respectively). Angina frequency decreased from 15.6 +/- 6.0 to 2.2 +/- 2.4 angina episodes/week (p < 0.001) in treated patients. CONCLUSIONS: Brachytherapy is a potential therapy in patients with highly symptomatic variant angina.

Adult↗
PubMedDate not supplied

Acoustic cardiographic parameters and their relationship to invasive hemodynamic measurements in patients with left ventricular systolic dysfunction.

Data obtained at cardiac catheterization were used to evaluate the utility of acoustic cardiographic data in assessing the hemodynamic abnormalities associated with left ventricular systolic dysfunction (LVSD). Thirty-seven patients (mean age, 62.6 years) underwent catheterization, and hemodynamic data were recorded. Acoustic cardiographic recordings were obtained using a system that records and algorithmically interprets diastolic heart sounds and parameters analogous to traditional systolic time intervals. Seventeen patients had LVSD (defined as ejection fraction <50%). The 17 patients with LVSD composed the cohort for analysis. There were strong associations between acoustic cardiographic parameters and left ventricular end-diastolic pressure, ejection fraction, and maximum contractility. Heart rate tended to influence the strength of these correlations. The authors conclude that acoustic cardiographic data can be used in the evaluation of patients with known or suspected LVSD, and specifically in the selection of patients for cardiac resynchronization therapy and the optimization of the settings of implanted resynchronization devices.

Acoustics↗