Abstract:
:The authors have previously shown that the resistance ratio (RR) is increased in patients with congestive heart failure (CHF), and that the patients with the highest RRs have an increased mortality. The authors hypothesized that CHF patients with the lowest maximum oxygen consumption and the most impaired Weber functional classification would have the highest RR. Eighty-four patients with chronic CHF underwent seated ergometric exercise to exhaustion. Hemodynamic and respiratory gas exchange parameters were measured at rest and peak exercise. Weber functional classifications (A through E) were determined from maximum oxygen consumptions, and patients were stratified to evaluate the RR. The RR increased progressively across Weber classifications at rest (A vs E; P < .001) and with maximum exercise (A vs E; P < .002). At rest, elevation in the RR was related to an increase in the pulmonary pressure gradient (A vs E; P < .002) secondary to increased mean pulmonary arterial pressures. With peak exercise, this elevation was secondary to a decrease in the systemic pressure gradient (A vs E; P < .001). Further analysis revealed that the progressive decrease in the systemic pressure gradient was due to progressively lower mean arterial pressures (A vs E; P < .001). Elevation of the RR, both at rest and peak exercise, predicts a more impaired exercise functional status in patients with chronic CHF. Increases in the RR at peak exercise were related to decreases in mean arterial pressure, most likely limiting perfusion to exercising skeletal muscle. The mechanism of poor exercise blood pressure response in these patients is unclear. Possible explanations include abnormal systemic baroreceptor function with inappropriate vascular adaptation, and a poor cardiac output response to a relative increase in right ventricular afterload in systemic vasodilation seen with exercise.
journal_name
J Card Failjournal_title
Journal of cardiac failureauthors
Mabee SW,Metra M,Reed DE,Dei Cas L,Cody RJdoi
10.1016/1071-9164(94)90005-1subject
Has Abstractpub_date
1994-10-01 00:00:00pages
27-33issue
1eissn
1071-9164issn
1532-8414pii
1071-9164(94)90005-1journal_volume
1pub_type
杂志文章abstract:BACKGROUND:The prognostic value of LA functional measures in heart failure patients with reduced ejection fraction (HFrEF) is unclear. Therefore, this study investigated the prognostic value of left atrial (LA) functional measures such as the left atrial emptying fraction (LAEF) and the minimal LA volume compared with ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2018.11.016
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:A wide variety of instruments have been used to assess the functional capabilities and health status of patients with chronic heart failure (HF), but it is not known how well these tests are correlated with one another, nor which one has the best association with measured exercise capacity. METHODS AND RESU...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2006.04.004
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Phosphodiesterase-5A inhibitors (PDE5i) are sometimes used in patients with advanced heart failure with reduced ejection fraction before heart transplant or left ventricular assist device implantation to decrease right ventricular (RV) afterload and mitigate the risk of right heart failure. Conflicting evide...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2020.11.007
更新日期:2020-11-21 00:00:00
abstract:BACKGROUND:Despite ample data from randomized clinical trials (RCTs), the management of advanced heart failure (HF) varies greatly. We examined the most common refractory questions arising in routine inpatient management of advanced HF. METHODS:From the inpatient HF service at 1 hospital, we prospectively recorded cli...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2003.10.006
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Sleep-disordered breathing (SDB) is common in patients with reduced ejection fraction (EF). However, little is known about the prevalence of SDB in a general heart failure population including patients with preserved EF (HFPEF). METHODS:We prospectively enrolled stable heart failure outpatients from our hea...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2011.01.013
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:There are no well validated patient-reported disease status instruments for acute heart failure (HF). We assessed the feasibility of using the Kansas City Cardiomyopathy Questionnaire (KCCQ) during acute heart failure hospitalization, and the association of acute changes with 30-day readmission. METHODS AND...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2013.11.010
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Little is known about guideline-directed pharmacotherapy use in patients with heart failure and reduced ejection fraction (HFrEF) discharged to skilled nursing facilities (SNFs). This study aimed to describe the use of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blocker (ARBs) and e...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2017.09.007
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Relative effectiveness of carvedilol and metoprolol succinate has never been compared in patients with heart failure (HF). METHODS AND RESULTS:From January 1998 to December 2008, 3,716 consecutive patients with ejection fraction (EF) ≤40%, initiated and maintained on carvedilol or metoprolol succinate, were...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2012.10.016
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Integrins are a large family of heterodimeric cell surface receptors that are present on all cells. These molecules link the extracellular matrix to the intracellular cytoskeleton and are multifunctional, playing roles in cell organization and differentiation, migration, alteration of gene expression, and ce...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,评审
doi:10.1054/jcaf.2002.129263
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:A greater understanding of how beliefs and perceptions inform LVAD placement refusals can help ensure that standards for informed decision making are met. We report on the factors that influence refusal and what accounts for changes in decliners' decision-making process when, and if, that occurs. METHOD AND...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2015.06.008
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:The present study examined the influence of rapid intravenous fluid loading (RFL) on airway structure and pulmonary vascular volumes using computed tomography imaging and the subsequent impact on pulmonary function in healthy adults (n = 16). METHODS AND RESULTS:Total lung capacity (DeltaTLC = -6%), forced ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2009.08.005
更新日期:2010-02-01 00:00:00
abstract::Simultaneous dysfunction of the heart and the kidney represents a distinct spectrum of disease states composed of complex clinical scenarios with adverse outcomes. Worsening renal function (WRF) in the setting of acute decompensated heart failure (ADHF) is one such clinical setup for which the underlying mechanisms ar...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,评审
doi:10.1016/j.cardfail.2014.09.005
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:This study was designed to examine the hemodynamic, renal, and hormonal effects of infusion of A-type natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in patients with congestive heart failure (CHF). METHODS AND RESULTS:We infused synthetic human ANP or BNP at a rate of 0.1 microgram/kg/ min i...
journal_title:Journal of cardiac failure
pub_type: 临床试验,杂志文章
doi:10.1016/s1071-9164(96)80088-1
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:There are little data on the optimization of high-intensity aerobic interval exercise (HIIE) protocols in patients with chronic heart failure (CHF). Therefore, we compared acute cardiopulmonary responses to 4 different HIIE protocols to identify the optimal one. METHODS AND RESULTS:Twenty men with stable sy...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.cardfail.2011.10.010
更新日期:2012-02-01 00:00:00
abstract:INTRODUCTION:Orthotopic heart transplantation (OHT) is contraindicated in morbidly obese patients with end-stage heart failure (HF), for whom cardiac allograft is the only means for long-term survival. Bariatric surgery may allow them to achieve target body mass index (BMI) for OHT METHODS: From 4/2014 to 12/2018, 26 m...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2020.04.020
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Left ventricular assist devices (LVADs) are increasingly used to treat patients with refractory heart failure. Current-generation LVADs have major limitations, including the need for open chest surgery, limiting their widespread use. We hypothesized that the aortoatrial continuity could be used as a unique a...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2011.01.014
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Exercise training improves endothelium-dependent vasodilation in animals. This study was designed to determine whether forearm exercise training improves endothelium-dependent vasodilation in control subjects and patients with heart failure, a disease associated with abnormal endothelium-dependent vasodilati...
journal_title:Journal of cardiac failure
pub_type: 临床试验,杂志文章
doi:10.1016/s1071-9164(98)80006-7
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Guyana is a small developing country with a high burden of cardiovascular disease and extensive barriers to optimal care delivery. We investigated the effectiveness of a newly established multidisciplinary inpatient cardiology service in this setting. METHODS:We performed an interrupted time-series cohort s...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2018.07.002
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Heart failure with preserved ejection fraction (HFpEF) has been increasingly recognized as a leading cause of pulmonary hypertension (HFpEF-PH). It remains unknown how HFpEF-PH fares in relation to systolic HF (reduced ejection fraction)-induced PH (HFrEF-PH). Therefore, we sought to determine the long-term ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,多中心研究
doi:10.1016/j.cardfail.2014.05.003
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Drug-related negative outcomes (DNOs) are health problems that patients experience due to drug use or nonuse. Heart failure (HF) patients are at high risk of experiencing DNOs owing to polypharmacy, comorbidities, and age. METHODS AND RESULTS:Ninety-seven consecutive HF patients were enrolled and followed f...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2010.10.009
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Endothelin-1 (ET-1) is a potent vasoconstrictor peptide elaborated by many cell types. Plasma ET-1 levels are significantly augmented in patients and experimental animals with heart failure. Enhanced levels of ET-1 may contribute to myocardial depression and alterations in sympathetic nerve activity in the s...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/s1071-9164(00)00012-9
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Zinc is an essential cofactor for energy transfer and physiological heart function, has antioxidant properties, and is involved in multiple signaling pathways. We aimed to investigate the associations between serum zinc levels with prognosis, as well as underlying cardiac function and exercise capacity, in p...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2018.02.011
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Differentiating between constrictive pericarditis (CP) and restrictive cardiomyopathy (RCMP) is difficult because of similar clinical and hemodynamic presentation. Brain natriuretic peptide (BNP) has been reported a useful noninvasive biomarker to differentiate CP from RCMP; however, its utility in patients ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2007.05.001
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Wolff-Parkinson-White (WPW) has been associated with left ventricular noncompaction (LVNC) in children. Little is known about the prevalence of this association, clinical outcomes, and treatment options. METHODS:Retrospective review of subjects with LVNC. LVNC was defined by established criteria; those with...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2019.09.014
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:In chronic heart failure (HF), diuretic doses increase as the disease progresses, often after hospitalization for instability, and have been associated with worsening renal function and increased mortality. METHODS AND RESULTS:A prospective observational analysis of 183 patients in an advanced HF clinic stra...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2008.01.015
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Two recent literature-based meta-analyses revealed that restrictive filling pattern (RFP) was associated with a 4-fold increase in the risk of death in patients with heart failure (HF) and postacute myocardial infarction (AMI). This similar but unique analysis evaluated the link between RFP and morbidity. M...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,meta分析
doi:10.1016/j.cardfail.2007.01.010
更新日期:2007-06-01 00:00:00
abstract:AIMS:Augmented peripheral chemoreflex response is an important mechanism in the pathophysiology of chronic heart failure (CHF). This study characterizes prevalence and clinical predictors of this phenomenon in optimally managed male CHF patients, and seeks to describe the hemodynamic consequences of chemoreceptor hyper...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2013.03.013
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Fulminant myocarditis (FM) is a rare but life-threatening disease. Intravenous immunoglobulin (IVIG) is not recommended for acute or chronic myocarditis in Western nations owing to the lack of rigorous evidence, but it is widely used in other countries, including Japan. This nationwide retrospective cohort s...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2015.01.004
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Although beta-blockers were well-tolerated by heart failure (HF) patients in clinical trials, tolerability of these drugs in a general population of HF patients is not well-described. METHODS:We studied a total of 308 encounters with beta-blockers therapy in 268 ambulatory HF patients. Side effects and freq...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,多中心研究
doi:10.1054/jcaf.2003.34
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:The clinical consequences of prehospital delay in heart failure (HF) patients are unknown. This study explores the relationship between prehospital delay of HF patients and length of hospital stay, plasma values of brain natriuretic peptides (BNP) as well as the association of delay with all-cause mortality,...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.cardfail.2011.12.007
更新日期:2012-03-01 00:00:00