Abstract:
BACKGROUND:We evaluate a simple, bedside test that measures 1-minute heart rate variability in deep breathing as a predictor of death after myocardial infarction. METHODS:Bedside heart rate variability was assessed in 185 consecutive patients 5.1 +/- 2.5 days after a first myocardial infarction. Patients were instructed to take 6 deep respirations in 1 minute while changes in heart rate were measured and calculated by an electrocardiographic recorder. An abnormal test result was defined as a difference of less than 10 beats/min between the shortest and longest heart rate interval. RESULTS:Heart rate variability <10 beats/min was found in 65 patients (35%) and was significantly lower (P <.05) in women, patients >60 years of age, patients with diabetes, patients with congestive heart failure, and patients taking angiotensin-converting enzyme inhibitors. Mean follow-up period was 16 months. Ten patients died during follow-up: 9 of cardiac causes and 1 of stroke. Nine of these 10 patients had heart rate variability <10 beats/min (P =.004). The sensitivity and specificity of this test for cardiovascular mortality is 90.0% and 68.0%, respectively. The negative predictive value is 99.2% and the relative risk is 16.6. Heart rate variability <10 beats/min remained a significant predictor of death after adjusting for clinical, demographic, and left ventricular function with an odds ratio of 1.38 (95% confidence interval, 1.13-1.63). CONCLUSIONS:This simple, brief bedside deep breathing test of heart rate variability in patients after myocardial infarction appears to be a good predictor for all-cause mortality and sudden death. It may be used as a clinical test for risk stratification after myocardial infarction.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Katz A,Liberty IF,Porath A,Ovsyshcher I,Prystowsky ENdoi
10.1016/s0002-8703(99)70242-5subject
Has Abstractpub_date
1999-07-01 00:00:00pages
32-8issue
1 Pt 1eissn
0002-8703issn
1097-6744pii
S0002-8703(99)70242-5journal_volume
138pub_type
杂志文章abstract:BACKGROUND:Recent randomized clinical trials have suggested a benefit of an invasive management strategy in patients with acute coronary syndromes. However, the broader use and impact of the invasive management approach has not been established for patients with acute coronary syndromes beyond the relatively narrow pat...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1067/mhj.2002.122517
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:The outpatient prognostic assessment of coronary artery disease (CAD) by exercise electrocardiography has limitations, including the feasibility of the test and its low positive predictive value in several clinical conditions. In the current study we investigated the safety, feasibility, and prognostic value...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.113997
更新日期:2001-04-01 00:00:00
abstract::The novel oral anticoagulants (NOACs) have rapidly emerged as an alternative therapy to warfarin. Several recent phase 3 randomized control trials have demonstrated the efficacy and safety of the NOACs in the treatment for patients with nonvalvular atrial fibrillation. As the NOACs are incorporated in clinical practic...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2014.12.008
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:The recovery of left ventricular function (LVF) after revascularization takes time. alpha-Adrenergic blockade acutely improves coronary blood flow and LVF, whereas the effects of more prolonged alpha-adrenergic blockade on LVF recovery after stenting are unknown. METHODS:In 32 patients (age 58 +/- 12 y) wit...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.ahj.2003.08.005
更新日期:2004-02-01 00:00:00
abstract::In a double blind, placebo-controlled study, the efficacy of propafenone, a new antiarrhythmic drug was compared to that of disopyramide. Sixteen patients with frequent and complex premature ventricular contractions (PVCs) were studied by serial 24-hour ambulatory monitoring, while they were receiving propafenone, 300...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(85)90647-7
更新日期:1985-04-01 00:00:00
abstract::The effects of captopril (CPT), an oral angiotensin-converting enzyme (ACE) inhibitor, on systemic failure (CHF). In 15 patients, CPT decreased mean arterial pressure from 75 +/- 3 to 60 +/- 3 mm Hg associated with a 16% increase in cardiac output, a 24% reduction in systemic vascular resistance, and a 36% decrease in...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90052-7
更新日期:1982-11-01 00:00:00
abstract:BACKGROUND:Patients with left ventricular dysfunction who undergo coronary artery bypass graft (CABG) surgery frequently have late sudden cardiac death. The CABG Patch Trial is a prospective, randomized, multicenter clinical trial that randomized patients at high risk at the completion of CABG surgery to implantation o...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(97)80001-4
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:Technetium Tc 99m gated single photon emission computed tomography (SPECT) has become the cornerstone of noninvasive risk stratification in patients with ischemic heart disease, but its role in patients with heart failure is not as well established. STUDY DESIGN:This study is a substudy of the Heart Failure...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2007.03.045
更新日期:2007-07-01 00:00:00
abstract::Patients with impaired glucose tolerance (IGT) have increased risk for developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Lifestyle modification and medication can prevent or delay progression to diabetes (PD), but whether such interventions also reduce the risk of CVD has not been rigorously...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2008.05.017
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Endothelial progenitor cells (EPCs) are present in peripheral blood and can promote postnatal angiogenesis. The number and function of circulating EPCs are altered in diabetics. This study sought to investigate whether the number and functional properties of EPCs from patients with type II diabetes could be ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2006.07.029
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Patients with unstable angina (UA) and non-ST-elevation myocardial infarction (NSTEMI) remain at risk for death and cardiac ischemic events after being discharged from the hospital. METHODS:We examined whether the Thrombolysis In Myocardial Infarction (TIMI) risk score for UA/NSTEMI, ascertained at presenta...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mhj.2002.122870
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Enhanced external counterpulsation (EECP) reduces angina and extends time to exercise-induced ischemia in patients with symptomatic coronary disease. One- and two-center studies and a retrospective case series reported that EECP improves myocardial perfusion in stable angina pectoris. We sought to critically...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2005.01.054
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Several non-vitamin K antagonist oral anticoagulant (NOAC) alternatives to warfarin are available for stroke prevention in atrial fibrillation (AF). We aimed to describe the factors associated with selection of NOACs versus warfarin in patients with new onset AF. METHODS:The ORBIT-AF II study is a national,...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ahj.2017.03.024
更新日期:2017-07-01 00:00:00
abstract::CHD remains the leading cause of death in most developed countries; therefore, elucidation of risk factors and associated mechanisms for atherosclerosis and development of CHD has been a high priority. Data from the Framingham Heart Study and other large-scale epidemiologic studies have identified major risk factors a...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(96)90096-4
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Analysis of high-frequency QRS amplitudes (HF-QRS) may provide an additional diagnostic tool in patients with heart disease, but the basic properties of these waveforms have not been sufficiently investigated. This study describes the spatial, individual, and temporal variation at rest of HF-QRS recorded wit...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.101782
更新日期:2000-02-01 00:00:00
abstract::The stent delivery system (SDS) is a sheath-covered Palmaz-Schatz stent mounted on a 3.0, 3.5, or 4.0 mm compliant polyethylene balloon catheter; the balloon resists maximal inflation pressures of 5.7, 6.2, or 6.0 atm, respectively. It is postulated that these pressures are too low to obtain optimal stent deployment. ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90308-9
更新日期:1995-04-01 00:00:00
abstract::Coronary heart disease is the single largest cause of morbidity and mortality in the United States. The link between elevated low-density lipoprotein cholesterol (LDL-C) levels and coronary heart disease (CHD) has been clearly established. However, triglycerides (TG) are increasingly believed to be independently assoc...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2004.03.037
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND:Dilated and hypertrophic cardiomyopathies are primary myocardial diseases that cause considerable morbidity and mortality. Although these cardiomyopathies are clinically heterogeneous, genetic factors play an important role in their etiology and pathogenesis. The defects in the cardiac actin (ACTC) gene can ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.122514
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Limited information is available about recent trends in the incidence and death rates from atrial fibrillation (AF) complicating acute myocardial infarction (AMI). The purpose of this study was to examine the impact and trends over time of AF complicating initial AMI. METHODS:We conducted a longitudinal stu...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1067/mhj.2002.120410
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:We aim to validate the diagnostic performance of the first fully automatic, electronic heart failure (HF) identification algorithm and evaluate the implementation of an HF Dashboard system with 2 components: real-time identification of decompensated HF admissions and accurate characterization of disease char...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.10.001
更新日期:2017-01-01 00:00:00
abstract::Fifteen cases of the sick-sinus syndrome in young Negroes are presented. The etiology was unknown in all cases; organic heart disease was absent. The very high default rate suggests that the prognosis may be grave. This disorder is by no means uncommon in young persons in tropical countries and the dangers of a mistak...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90078-2
更新日期:1975-03-01 00:00:00
abstract:BACKGROUND:Diabetic nephropathy is associated with increased cardiovascular events. Coronary atherosclerosis is responsible for many of these events, but other mechanisms such as impaired flow reserve may be involved. The purpose of this study was to define the prevalence and mechanism of abnormal coronary velocity res...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2003.07.029
更新日期:2004-06-01 00:00:00
abstract::Three cases of rupture of the interventricular septum occurring coincident with acute inferior myocardial infarction are reported and the relevant literature is reviewed. One patient under-went successful surgical repair and, in addition, had an aneurysmectomy. Clues and pitfalls in diagnosis as well as the possible c...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80407-3
更新日期:1976-07-01 00:00:00
abstract::Fingolimod, a sphingosine-1-phosphate receptor (S1PR) modulator, was the first oral disease-modifying therapy approved for relapsing forms of multiple sclerosis; it reduces autoreactive lymphocytes' egress from lymphoid tissues by down-regulating S1PRs. Sphingosine-1-phosphate signaling is implicated in a range of phy...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2014.06.028
更新日期:2014-11-01 00:00:00
abstract::Two elderly patients with coronary heart disease, chronic pulmonary disease, and complex atrial arrhythmias are presented. The suction electrode technique for right atrium monophasic action potential recording was used. This recording allows better analysis of the atrial arrhythmias and estimates the stability of foca...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90126-x
更新日期:1975-08-01 00:00:00
abstract::Late potentials have been shown to predict malignant ventricular arrhythmias and sudden cardiac death. To determine whether prolonged, strenuous activity is associated with the development of ventricular late potentials, signal-averaged electrocardiography was performed on 30 marathon runners before, immediately after...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90010-0
更新日期:1989-12-01 00:00:00
abstract:AIMS:Furosemide is commonly prescribed for symptom relief in heart failure (HF) patients. Although few data support the continuous use of loop diuretics in apparently euvolemic HF patients with mild symptoms, there is concern about safety of diuretic withdrawal in these patients. The ReBIC-1 trial was designed to evalu...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2017.08.012
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Circulating mediators, including thromboxane A2, the vasoconstrictor, platelet aggregant, and smooth muscle mitogen, may contribute to the progression of vascular narrowing in primary pulmonary hypertension (PPH). METHODS:To further understand the contribution of thromboxane and to provide novel therapy for...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mhj.2002.121806
更新日期:2002-05-01 00:00:00
abstract:INTRODUCTION:Despite known associations between obesity and cardiovascular disease, the relationship between obesity as reflected by body mass index (BMI) and angiographic coronary artery disease (CAD) is not fully understood. Moreover, this relationship has not been adequately defined in black patients, a group demons...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.12.009
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:According to a recent meta-analysis, parathyroid hormone (PTH) excess is associated with increased cardiovascular disease (CVD) risk, but existing studies are limited. We examined in a prospective study the association of PTH with the incidence of CVD, taking into account vitamin D and other confounding vari...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2014.04.017
更新日期:2014-09-01 00:00:00