Active clinical trials for "Coronary Artery Disease"

Patients planned for elective conventional coronary angiography will undergo CT coronary angiography (Dual Source CT) in order to assess the correlation of stenosis detection and therapeutic advice between conventional and CT coronary angiography. We hypothesize that their is a good correlation between conventional and CT coronary angiography for stenosis detection and therapeutic advice.

There is substantial, continuing, and unexplained rise in prescribing of proton pump inhibitors. It is unknown whether their use in practice has corresponded to their licensed indications. Although the indications for H2RA or PPI administration in the treatment of acid-related diseases and the prevention of gastric mucosal damage have been well defined in the medical literature, the perception of benefit from their use frequently tends to be extrapolated to all patients in general, leading to an excessive consumption of these drugs in general practice. To date, however, little has been published with regard to the overall use or misuse of these drugs in hospital populations in ischemic heart disease patients as a secondary prevention to Aspirin use. We will undertake a 6-months retrospective survey (about 1200 patients) to evaluate the use of acid-suppressive medications in the general internal medicine ward of Rambam Hospital. We will extract all records of prescribing of a proton pump inhibitor within Rambam Hospital computerized patients file program (Premetheuos) in period of half year, categorized and analyze them using statistical X2 test.

We will obtain data using multi-slice CT technology to detect subclinical coronary disease in the HIV population. Determination of subclinical cardiovascular disease using noninvasive technology and elucidation of the associated risk factors will help to guide targeted therapy to prevent cardiovascular events in this patient population. We will investigate the prevalence of coronary plaque lesions and coronary artery calcifications in men and women with HIV disease as determined by 64-row multidetector computed tomography (MDCT) and MDCT coronary angiography in comparison to age-matched control subjects without HIV infection. We hypothesize that evidence of coronary artery calcification and coronary plaque lesions as seen by MDCT will be present in individuals with HIV more than non-HIV control subjects of the same age. We also hypothesize the degree of atherosclerosis will be increased in HIV patients compared to control subjects. We will evaluate the metabolic and inflammatory factors associated with coronary artery disease in HIV-infected individuals. We hypothesize that traditional cardiac risk factors as well as metabolic and inflammatory changes associated with HIV and its treatment such as dyslipidemia, increased secretion of inflammatory markers, decreased adiponectin, increased insulin resistance and increased visceral fat may be associated with coronary artery disease in HIV-infected individuals.

The purpose of the study is to investigate the clinical and morphological characteristics of chronic subclinical inflammation in the myocardium in patients with decompensated heart failure with ischemic systolic dysfunction.

Cardiac output (CO) is a key variable when describing the cardiovascular system. Electrical cardiometry (EC) is a non-invasive method in measuring stroke volume and cardiac output. However, its accuracy has been inconsistent. Therefore Martin et al. have compared measurements with echocardiographic measurements and propose calibration with left ventricle outflow tract (LVOT)-measurements obtained from transthoracic echocardiography (TTE). This study was performed in pregnant women at term. Goal of this study is to validate their formula in non-pregnant outpatients undergoing echocardiography for cardiology work-up. Secondary aim is to perform a leg raising test and to compare changes in stroke volume observed with either EC or TTE.

In this study, the investigators will determine whether patients with documented atherosclerosis are characterized by specific epigenetic changes in circulating cells of the innate immune system, compared to patients without atherosclerosis.

This study is to evaluate the prevalence, plaque characteristics (plaque types, stenosis degree, remodeling) and predictors of coronary atherosclerosis in stroke patients with coronary CT angiography.

Macrophage migration inhibitory factor (MIF) is a pleiotropic cytokine that promote the inflammatory response.In animal studies, it has been found that MIF is released in the ischaemic heart, promoting glucose uptake and protecting the heart from ischaemia-reperfusion injury.The MIF concentration, influenced by age and myocardial ischemia, have different impact on myocardial functional recovery after ischemia.Therefore, the purpose of this experiment is to study the clinical significance of MIF in patients with coronary heart disease.

The iFRCT study is a prospective, multicenter study to evaluate the diagnostic performance of iFRCT with the use of ≥64-detector row CT scanners for the detection and exclusion of significant obstructive coronary artery disease, defined by invasive fractiona flow reserve (FFR) as the reference standard.

The electrocardiogram (ECG) is an important diagnostic procedure in medicine mainly to detect circulation disorders and problems of the spread of the electrical heart impulse. It is frequently the first measure in clinical practice when angina pectoris, acute myocardial infarction or an arrhythmia are suspected. The ECG is easy to perform, safe and cheap. Posture changes are known to cause alterations of the ECG [1]. Deviation of the electrical heart axis (EHA) [2], temporary changes of the QRS morphology and ST-segment alterations are of particular importance in view of diagnostic accuracy [3], [4]. In ambulatory ECG recordings ST-segment alterations for instance might mistakenly be interpreted as cardiac ischemia [5]. Artifacts could be minimized by the concurrent determination of the deviation of the electrical heart axis [6] [7]or by using posture detectors [8] helping to correlate ECG changes to posture changes. Due to the emergence of new computer based opportunities ambulatory ECG in the sense of home monitoring is an emerging market. Together with the superiority compared to the scalar ECG in detecting certain pathologies, like myocardial infarction and right ventricular hypertrophy, the VCG gained new interest in recent years [9]. Four ECG leads are sufficient to synthesize a standard 12-lead ECG from a VCG and vice versa with a transformation matrix [10] [11].The redirection of the spatial VCG after posture changes has been determined for the QRS loop with the Frank leads, which is the reference method for constructing the VCG [12][13]. 4 leads of an ambulatory ECG are sufficient to construct the VCG if arranged approximately in the position of three rectangular axes. Doctors are best trained to interpret standard 12 lead ECGs. With optimization of the leads of ambulatory (Holter) ECG towards the three rectangular axes, this might allow mathematical transformation into the standard 12 lead ECG. A precondition would be that the transformation matrix is independent of posture. To date, transformation matrix between Frank VCG and standard 12 lead ECG has only been calculated in resting ECGs [5]. This is the first study which investigates the transformation matrix in different postures. Additionally, the investigators will investigate for the first time prospectively for known artefacts of stress testing and ambulatory ECGs. Aim: Simultaneous prospective recording of the standard 12 lead ECG and the Frank-lead VCG in different postures is expected to add information on potential causes of artifacts of the ECG caused by posture changes. During continuous recording, the investigators will investigate the accuracy of the linear affine transformation with posture, the occurrence (dimension and duration) of ECG/ VCG morphology changes and ST-segment alterations, and VCG angle changes in dependence of posture changes in healthy young men. Hypothesis The investigators hypothesis is that the transformation matrix between Frank-Lead VCG and standard 12-lead ECG is posture dependent. Artefacts of the ECG due to posture changes are systematic. The knowledge of the systematics improves the diagnostic accuracy of ambulatory ECG and stress testing.