Dysfonction microvasculaire et ischémie du myocarde [Microvascular dysfunction and myocardial ischemia]

Une lésion fonctionnelle ou structurale des artérioles intramurales influence le seuil ischémique du myocarde. Le diagnostic de dysfonction microvasculaire est retenu en présence d'une diminution du flux coronaire maximal et de coronaires angio-graphiquement normales ou presque normales. Un trouble de la microcirculation peut traduire une dysfonction endothéliale chez le sujet diabétique ou hyperlipidémique, ou une lésion structurale ou fonctionnelle dans le cadre de la cardiomyopathie hypertrophique, la sténose aortique ou l'hypertension artérielle. Après recanalisation de l'artère responsable d'un infarctus, la mesure de la fonction microcirculatoire permet d'estimer la qualité de la reperfusion myocardique. L'appréciation de la fonction microvasculaire est un enjeu majeur dans l'évaluation de l'ischémie du myocarde en l'absence de sténose coronaire. Functional or structural lesions in intramural arterioles influence the ischemic threshold of the myocardium. Microvascular dysfonction is evidenced by a decrease in coronary blood flow during maximum hyperemia in the presence of angiographically normal or near-normal coronary arteries. Microvascular dysfonction may reflect endothelial dysfonction in diabetic or hyperlipidemic patients, as well as structural and functional changes in patients with hypertrophic cardiomyopathy, aortic stenosis or hypertension. Assessing microvascular fonction after thrombolysis or primary angioplasty for acute myocardial infarction allows to estimate the quality of myocardial reperfusion. Assessing microvascular fonction is a major component of the evaluation of myocardial ischemia in the absence of coronary artery stenoses.

Agreed-upon procedures report on the City of Granger, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Granger, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Victor, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Victor, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Ely, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Ely, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Remsen, Iowa and the Remsen Municipal Utilities for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Remsen, Iowa and the Remsen Municipal Utilities for the period July 1, 2014 through June 30, 2015

Atorvastatin-loaded hydrogel affects the smooth muscle cells of human veins.

Intimal hyperplasia (IH) is the major cause of stenosis of vein grafts. Drugs such as statins prevent stenosis, but their systemic administration has limited effects. We developed a hyaluronic acid hydrogel matrix, which ensures a controlled release of atorvastatin (ATV) at the site of injury. The release kinetics demonstrated that 100% of ATV was released over 10 hours, independent of the loading concentration of the hydrogel. We investigated the effects of such a delivery on primary vascular smooth muscle cells isolated from human veins. ATV decreased the proliferation, migration, and passage of human smooth muscle cells (HSMCs) across a matrix barrier in a similar dose-dependent (5-10 µM) and time-dependent manner (24-72 hours), whether the drug was directly added to the culture medium or released from the hydrogel. Expression analysis of genes known to be involved in the development of IH demonstrated that the transcripts of both the gap junction protein connexin43 (Cx43) and plasminogen activator inhibitor-1 (PAI-1) were decreased after a 24-48-hour exposure to the hydrogel loaded with ATV, whereas the transcripts of the heme oxygenase (HO-1) and the inhibitor of tissue plasminogen activator were increased. At the protein level, Cx43, PAI-1, and metalloproteinase-9 expression were decreased, whereas HO-1 was upregulated in the presence of ATV. The data demonstrate that ATV released from a hydrogel has effects on HSMCs similar to the drug being freely dissolved in the environment.

Audit report on the City of Van Meter, Iowa for the year ended June 30, 2015

Audit report on the City of Van Meter, Iowa for the year ended June 30, 2015

Audit report on the City of Colo, Iowa for the year ended June 30, 2015

Audit report on the City of Colo, Iowa for the year ended June 30, 2015

Examination report on the City of Central City, Iowa for the period July 1, 2014 through June 30, 2015

Examination report on the City of Central City, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Wall Lake, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Wall Lake, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Bedford, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Bedford, Iowa for the period July 1, 2014 through June 30, 2015

Audit report on the City of Guthrie Center, Iowa for the year ended June 30, 2015

Audit report on the City of Guthrie Center, Iowa for the year ended June 30, 2015

Agreed-upon procedures report on the City of Manly, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Manly, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Lansing, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Lansing, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Monroe, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Monroe, Iowa for the period July 1, 2014 through June 30, 2015