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CIRCULAT Study in Chronic Ischemic Heart Disease (20 Pat)
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CIRCULAT Study in Chronic Ischemic
Heart Disease
Patrick J. Lynch, 2006
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
Relevant Mortality Rates in Venezuela
Chronic Ischemic Heart
Disease GSPECT Assessment
(Independant Lab)
Treadmill
Imaging
Chronic Ischemic Heart
Disease GSPECT Assessment
(Independant Lab)
Assessment
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
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= =
Study Aditional Hightlights (1)
Study Aditional Hightlights (2)
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
