CIRCULAT Study in Chronic Ischemic Heart Disease (20 Pat)
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Transcript of CIRCULAT Study in Chronic Ischemic Heart Disease (20 Pat)
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CIRCULAT Study in Chronic Ischemic
Heart Disease
Patrick J. Lynch, 2006
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Background: Endothelial Damage
NORMAL ARTERY ATHEROSCLEROTIC PLAQUENARROWED ARTERY
ENDOTHELIUM
SMOOTH MUSCLE
SMOOTH MUSCLECELLS
MACROPHAGESTRANSFORMED
INTO FOAM CELLSLIPIDS, CALCIUM
CELLULAR DEBRIS
FIBROUS CAP.
ENDOTHELIUMDAMAGE
ENDOTHELIALDYSFUNCTION
MECHANICALSTREESS
HYPERTENSION
VASOCONSTRICTION
PERIPHERALVASCULAR RESISTANCE
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Relevant Mortality Rates in Venezuela
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Chronic Ischemic Heart
Disease GSPECT Assessment
(Independant Lab)
Treadmill
Imaging
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Chronic Ischemic Heart
Disease GSPECT Assessment
(Independant Lab)
Assessment
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GSPECT Cardio-Diagnostic Imaging(Source: www.yale.edu/imaging/)
Annualized Cardiac Events Risk
Treatment Implications(majority of patients)
<1% risk of cardiac deathand MI
Risk factor modification (RFM) in addition to current regimen
Low risk of cardiac death; Intermediate risk of MI
Aggressive RFM/medicaltreatment
Intermediate-to-high riskof both cardiac death/MI
Catheterization (possiblerevascularization)/RFM
Normal Mildly Normal Moderately / Severely Abnormal
anterior
inferior
septal lat
anterior
inferior
base apex
apex
latseptal
base
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Chronic Ischemic Heart Disease treatment with complex herbal formulation Study
Roberto Guzmán, José Olalde, Francis Amendola, Oswaldo del Castillo
Results: Good response (17 out of 20 initial patients) to therapy was observed in 85% of the patients (p ≤ 6.104e-05; %=99.9999) as determined by Wilcoxon. No patient suffered adverse
events or died during the studied period.
*Results ranging between six months and one year; in first 20 out of 30 total Patients under study
One PatientDiffuse Captation
Lateral WallQualitative
20 Patients *
3 PatientsSame Perfusion Defect
Quantitative
One PatientDiffuse Captation
Inferior WallQualitative
15 PatientsPerfusion Defect
Quantitative
3 PatientsSame Captation
Lateral / Inferior WallQualitative
17 PatientsImprovement
15 Quant + 2 Qual+ + =
3 PatientsNo Improvement= =
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Study Aditional Hightlights (1)
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Study Aditional Hightlights (2)
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PD%: 40
29 APR 2009
16 SEP2009
PD%: Post–Effort Perfusion Damage Percentage
GSPECT Image
PD%: 35
Control
6 months
Chronic Ischemic Heart Disease Six month treatment study
Funtional Capacity Time (sec)
Total452
post-treatment
386Time (sec)
pre-treatment
66Increase (sec)
6 month treatment
Patient 1
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PD%: 45
13 MAY 2009
28 OCT2009
GSPECT Image
PD%: 30
Control
6 months
PD%: Post–Effort Perfusion Damage Percentage
7 JUL2010
PD%: 15
One year
Chronic Ischemic Heart Disease One year treatment study
Funtional Capacity Time (sec)
Patient unable to carry out the test due physical limitations
Patient 2
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GSPECT Image
PD%: 20
20 MAY 2009
28 OCT2009
PD%: 10
Control
6 months
PD%: Post–Effort Perfusion Damage Percentage
16 JUN2010
PD%: 10
One year
Chronic Ischemic Heart Disease One year treatment study
Funtional Capacity Time (sec)
Total442
post-treatment
366Time (sec)
pre-treatment
76Increase (sec)
6 month treatment
Patient 3
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GSPECT Image
PD%: 70
03 JUN 2009
11 NOV2009
PD%: 60
Control
6 months
PD%: Post–Effort Perfusion Damage Percentage
Chronic Ischemic Heart Disease Six month treatment study
Funtional Capacity Time (sec)
Total200
post-treatment
155Time (sec)
pre-treatment
45Increase (sec)
6 month treatment
Patient 4
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GSPECT Image
PD%: 30
06 MAY 2009
07 OCT2009
PD%: 25
Control
6 months
09 JUL2010
PD%: 0
One year
PD%: Post–Effort Perfusion Damage Percentage
Chronic Ischemic Heart Disease One year treatment study
Funtional Capacity Time (sec)
Total615
post-treatment
486Time (sec)
pre-treatment
81Increase (sec)
6 month treatment
48Increase (sec)
1 year treatment
Patient 5
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GSPECT Image
PD%: 30
06 MAY 2009
07 OCT2009
PD%: 20
Control
6 months
09 JUN2010
PD%: 20
One year
PD%: Post–Effort Perfusion Damage Percentage
Chronic Ischemic Heart Disease One year treatment study
Funtional Capacity Time (sec)
Total662
post-treatment
553Time (sec)
pre-treatment
88Increase (sec)
6 month treatment
14Increase (sec)
1 year treatment
Patient 6
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PD%: 15
29 APR 2009
16 SEP2009
PD%: Post–Effort Perfusion Damage Percentage
GSPECT Image
PD%: 15
Control
6 months
Chronic Ischemic Heart Disease Six month treatment study
Funtional Capacity Time (sec)
Total609
post-treatment
555Time (sec)
pre-treatment
54Increase (sec)
6 month treatment
Patient 7
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PD%: 10
14 JUL 2009
11 NOV2009
GSPECT Image
PD%: 5
Control
6 months
28 JUL2010
PD%: 5
One year
PD%: Post–Effort Perfusion Damage Percentage
Chronic Ischemic Heart Disease One year treatment study
Funtional Capacity Time (sec)
Total491
post-treatment
433Time (sec)
pre-treatment
68Increase (sec)
6 month treatment
-10Decrease (sec) 1 year treatment
Patient 8
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PD%: 20
14 JUL 2009
11 NOV2009
PD%: 20
Control
6 months
04 AGO2010
PD%: 20
One year
PD%: Post–Effort Perfusion Damage Percentage
GSPECT ImageChronic Ischemic Heart Disease One year treatment study
Funtional Capacity Time (sec)
Total676
post-treatment
516Time (sec)
pre-treatment
132Increase (sec)
6 month treatment
28Increase (sec)
1 year treatment
Patient 9
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PD%: 60
13 MAY 2009
07 OCT2009
GSPECT Image
PD%: 35
Control
6 months
02 JUN2010
PD%: 20
One year
PD%: Post–Effort Perfusion Damage Percentage
Chronic Ischemic Heart Disease One year treatment study
Funtional Capacity Time (sec)
Total428
post-treatment
339Time (sec)
pre-treatment
89Increase (sec)
6 month treatment
Patient 10
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PD%: 25
12 AGO 2009
08 DEC2009
PD%: Post–Effort Perfusion Damage Percentage
GSPECT Image
PD%: 15
Control
6 months
Chronic Ischemic Heart Disease Six month treatment study
Funtional Capacity Time (sec)
Total373
post-treatment
323Time (sec)
pre-treatment
50Increase (sec)
6 month treatment
Patient 11
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PD%: 15
14 JUL 2009
02 DEC2009
GSPECT Image
PD%: 0
Control
6 months
04 AGO2010
PD%: 0
One year
PD%: Post–Effort Perfusion Damage Percentage
Chronic Ischemic Heart Disease One year treatment study
Funtional Capacity Time (sec)
Total570
post-treatment
432Time (sec)
pre-treatment
83Increase (sec)
6 month treatment
55Increase (sec)
1 year treatment
Patient 12
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PD%: 25
23 JUL 2009
02 DEC2009
PD%: Post–Effort Perfusion Damage Percentage
GSPECT Image
PD%: 20
Control
6 months
Chronic Ischemic Heart Disease Six month treatment study
Funtional Capacity Time (sec)
Patient unable to carry out the test due physical limitations
Patient 13
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GSPECT Image
PD%: 70
11 MAR 2010
15 SEP2010
PD%: 55
Control
6 months
PD%: Post–Effort Perfusion Damage Percentage
Chronic Ischemic Heart Disease Six month treatment study
Funtional Capacity Time (sec)
Total235
post-treatment
209Time (sec)
pre-treatment
26Increase (sec)
6 month treatment
Patient 14
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GSPECT Image
PD%: 95
04 MAR 2010
15 SEP2010
PD%: 90
Control
6 months
PD%: Post–Effort Perfusion Damage Percentage
Chronic Ischemic Heart Disease Six month treatment study
Funtional Capacity Time (sec)
Patient unable to carry out the test due physical limitations
Patient 15
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GSPECT Image
PD%: 35
10 MAR 2010
1 SEP2010
PD%: 35
Control
6 months
PD%: Post–Effort Perfusion Damage Percentage
Chronic Ischemic Heart Disease Six month treatment study
Funtional Capacity Time (sec)
Patient unable to carry out the test due physical limitations
Patient 16*
* Slight Qualitative Perfusion Improvement determined by diffuse radioisotope captation in lateral wall
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GSPECT Image
PD%: 50
17 MAR 2010
15 SEP2010
PD%: 35
Control
6 months
PD%: Post–Effort Perfusion Damage Percentage
Chronic Ischemic Heart Disease Six month treatment study
Funtional Capacity Time (sec)
Total254
post-treatment
333Time (sec)
pre-treatment
-79Decrease (sec)
6 month treatment
Patient 17
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GSPECT Image
PD%: 50
17 MAR 2010
06 SEP2010
PD%: 35
Control
6 months
PD%: Post–Effort Perfusion Damage Percentage
Chronic Ischemic Heart Disease Six month treatment study
Funtional Capacity Time (sec)
Total549
post-treatment
479Time (sec)
pre-treatment
70Increase (sec)
6 month treatment
Patient 18
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GSPECT Image
PD%: 45
03 MAR 2010
01 SEP2010
PD%: 45
Control
6 months
PD%: Post–Effort Perfusion Damage Percentage
Chronic Ischemic Heart Disease Six month treatment study
Funtional Capacity Time (sec)
Total620
post-treatment
610Time (sec)
pre-treatment
10Increase (sec)
6 month treatment
Patient 19*
* Important Qualitative Perfusion Improvement determined by diffuse radioisotope captation in inferior wall
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GSPECT Image
PD%: 15
10 MAR2010
15 SEP2010
PD%: 15
Control
6 months
PD%: Post–Effort Perfusion Damage Percentage
Chronic Ischemic Heart Disease Six month treatment study
Funtional Capacity Time (sec)
Patient unable to carry out the test due physical limitations
Patient 20