circulat study in chronic ischemic heart disease (20 pat)

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