Abstract:
BACKGROUND:Chronic heart failure is associated with impaired renal function, which may worsen during therapy. The incidence, predictors, and consequences of aggravated renal dysfunction (ARD) in patients undergoing intensive therapy for advanced chronic heart failure are unknown. METHODS:We reviewed the experience of 48 consecutive patients hospitalized for treatment of advanced chronic heart failure who underwent intravenous diuretic therapy with a weight loss of >/=2 kg. Evaluation included baseline renal function and echocardiography in all patients and hemodynamic measurements in 38 (79%) patients. RESULTS:ARD, defined as >/=25% increase in serum creatinine concentration to >/=2 mg/dL, developed in 10 (21%) patients. Patients with ARD developing were older (aged 58 +/- 16 years vs 51 +/- 13 years; P =.006) and had lower baseline creatinine clearance (49 +/- 21 mL/min vs 74 +/- 26 mL/min; P =.01) but had the same serum creatinine at baseline. They were more likely to have atrial fibrillation (70% vs 29%, P =.02) but did not have lower filling pressures, cardiac output, or estimated renal perfusion pressure. Length of stay was longer if ARD developed (median 17 vs 9 days, P =.02). Mortality rate after discharge was increased in the patients with ARD (relative risk 5.3, P =.002). CONCLUSIONS:In patients undergoing intensive treatment for heart failure, ARD is common and clinically significant. The relation among baseline factors, ARD, and worsened outcome may reflect complex cardiorenal interactions. Better understanding of the causes and prevention of ARD during heart failure therapy may in the future lead to better outcomes.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Weinfeld MS,Chertow GM,Stevenson LWdoi
10.1016/s0002-8703(99)70113-4subject
Has Abstractpub_date
1999-08-01 00:00:00pages
285-90issue
2 Pt 1eissn
0002-8703issn
1097-6744pii
S0002870399000174journal_volume
138pub_type
杂志文章abstract::The records of 64 patients with progressive systemic sclerosis (PSS) were reviewed. More than 100 items from the patient's history, physical examination, and laboratory tests were encoded. A two-tailed Gehan's test was used to evaluate the effect of each variable on patient survival. Variables significant at the 0.05 ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90525-3
更新日期:1985-07-01 00:00:00
abstract::It is unclear how agents designed to promote angiogenesis in the human heart affect the arteriographic appearance of the collateral circulation. Possible changes in collateral vessels include new collateral vessels arising from epicardial arteries, new branches emanating from existing collateral vessels, wider or long...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(99)70473-4
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Despite the common practice of clopidogrel loading for coronary stenting, the time dependence and degree of platelet inhibition after this therapy are not well defined. We sought to establish an optimal clopidogrel dosing regimen for sustained platelet inhibition in stented patients. METHODS AND RESULTS:Pla...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2003.109
更新日期:2003-02-01 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:BACKGROUND:Drug-eluting stents have been shown to reduce restenosis in many types of lesions. The purpose of this article is to assess the efficacy of sirolimus- and paclitaxel-eluting stents in patients with bifurcation lesions. METHODS:Between June 2003 and October 2004, 205 patients were enrolled in a prospective r...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2006.10.017
更新日期:2007-01-01 00:00:00
abstract::Head-up tilt provokes vasodepressor syncope in patients with this disorder but may also cause fainting in unaffected subjects. The aims of this study were to examine autonomic function and sequential changes in heart rate variability and plasma catecholamines during graded head-up tilt in patients with vasodepressor s...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70213-8
更新日期:1997-02-01 00:00:00
abstract::Since many patients with chest pain cannot exercise adequately, an alternative stress would be useful to evaluate coronary reserve. We studied the physiologic responses to epinephrine to assess its potential. We report on 39 patients with chest pain. Doses from 0.03 to 0.30 micrograms/kg/min were administered intraven...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90477-5
更新日期:1983-04-01 00:00:00
abstract:BACKGROUND:Decreased heart rate variability (HRV) is often assumed to be associated with mortality in all patients after myocardial infarction (MI), independent of clinical factors or time after MI. METHOD:HRV was determined from Holter tapes in the Cardiac Arrhythmia Suppression Trial (CAST). Patients were 71 +/- 120...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(03)00520-9
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:ISAR-REACT was a trial designed to evaluate whether the glycoprotein IIb/IIIa inhibitor abciximab is beneficial in patients undergoing elective percutaneous coronary intervention (PCI) with stent placement after pretreatment with a 600 mg loading dose of clopidogrel. Objective for the angiographic substudy w...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2005.08.002
更新日期:2006-06-01 00:00:00
abstract::The neurogenic component in the pathogenesis of essential hypertension has predominantly been analyzed with regard to the sympathetic part of the autonomous nervous system; the parasympathetic branch has largely been neglected. We investigated whether 54 normotensive (mean causal blood pressure [cBP]: 125 +/- 6/82 +/-...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90517-7
更新日期:1994-01-01 00:00:00
abstract::High levels of endogenous plasma catecholamines in patients with severe congestive heart failure induce a down-regulation of the myocardial beta-adrenoreceptors and thus cause adrenoreceptor agonists, such as dobutamine, to be less effective in the treatment of these patients. Phosphodiesterase III inhibitors work ind...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(91)90834-5
更新日期:1991-06-01 00:00:00
abstract::Intracoronary stents may potentially alleviate some of the problems associated with coronary angioplasty. Since the anatomy and physiology of swine coronary arteries closely resemble those of humans, the response to implantation of the Glanturco-Roubin, balloon-expandable, flexible stent was studied in this model. Add...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90506-d
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:Although the management of thoracic aortic aneurysms (TAAs) has improved significantly, patients presenting with aortic dissections, rupture, or other acute complications of TAAs continue to have high rates of morbidity and mortality. Accumulating data have indicated that many TAAs are due to underlying gene...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.10.005
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:The objective of this study was to determine if depression is associated with worse disease-specific functional status in patients with coronary artery disease. The study was designed as a cross-sectional survey and 3-month longitudinal cohort. METHODS AND RESULTS:The study took place in outpatient clinics ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.106600
更新日期:2000-07-01 00:00:00
abstract::After injecting 125I- or 131I-labeled lipoproteins, plasma was subjected to discontinuous density gradient centrifugation, which separates low-density lipoproteins (LDL) into three subfractions. Analysis of changes in apolipoprotein B-specific activity with time showed that light LDL is normally the product of interme...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90623-5
更新日期:1987-02-01 00:00:00
abstract::To observe the stereoscopic structure and the motion of the prolapsing mitral valve and its regurgitant jet in comparison with the normal mitral valve, four-dimensional (or dynamic three-dimensional) echocardiography of mitral valve apparatus was obtained in 20 patients with mitral valve prolapse and 10 unaffected sub...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70257-6
更新日期:1997-01-01 00:00:00
abstract::The efficacy of mexiletine used alone, and in combination with a class Ia antiarrhythmic drug, was assessed in 159 previously drug-refractory patients with ventricular tachycardia (VT) during serial electrophysiologic studies and during long-term (5-year) clinical follow-up. Electrically-inducible ventricular tachycar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90482-6
更新日期:1988-02-01 00:00:00
abstract:BACKGROUND:Noninvasive estimation of pulmonary capillary wedge pressure (PCWP) with Doppler-derived mitral inflow pattern has been shown to correlate well with invasively measured PCWP; however, it has not yet been determined whether Doppler-derived mitral inflow pattern can be used to estimate PCWP accurately in heart...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70280-7
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:Larger studies evaluating the angiographic results of second-generation stents are scarce. The objectives of this study were to assess current standards of angiographic and clinical outcomes after implantation of the second-generation stainless steel stent, NIR (Medinol Ltd, Tel Aviv, Israel), and to compare...
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.2003.32
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Peroxisome proliferator-activated receptors (PPARs) regulate transcription of genes involved in glucose uptake, lipid metabolism, and inflammation. Aleglitazar is a potent dual PPAR agonist with insulin-sensitizing and glucose-lowering actions and favorable effects on lipid profiles and biomarkers of cardiov...
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.2013.05.013
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:This study examines how the dissemination of stenting and procedural shifts to high-volume facilities have affected short-term outcomes after percutaneous coronary intervention (PCI). METHODS:Discharge information from the 1994 and 1997 US Nationwide Inpatient Sample was used. Data from 1994 involved 84,036...
journal_title:American heart journal
pub_type: 杂志文章
doi:
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Despite advances in treatment of cardiogenic shock (CS), the incidence of this serious complication of acute ST-elevation myocardial infarction (STEMI) has stayed relatively constant, and rates of mortality, although somewhat improved in recent decades, remain dauntingly high. Although both percutaneous coro...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2009.10.035
更新日期:2010-01-01 00:00:00
abstract::An acute thrombus at the proximal border of a high-grade atherosclerotic obstruction is the usual cause of myocardial infarction. Although intracoronary thrombolysis is potentially an exciting new therapy for reducing the extent of myocardial infarction by lysing coronary clot, a number of major difficulties limit its...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(82)90267-8
更新日期:1982-10-01 00:00:00
abstract:BACKGROUND:The aim of the study was to describe the incidence and consequences of minor surgery after drug-eluting stent (DES) implantation. METHODS:The Evaluation of Drug-Eluting Stents and Ischemic Events (EVENT) Registry prospectively enrolled unselected patients undergoing percutaneous coronary intervention at 47 ...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2010.09.028
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:The treatment of cocaine-related acute coronary syndromes presents unique challenges. Although percutaneous coronary intervention in cocaine abusers appears to be safe in the short term, longer-term outcomes have not been reported. We postulated that cocaine use would be associated with increased risk for st...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.04.004
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Although age is the most important variable associated with death among patients with persistent ST-segment elevation, its impact on outcome among patients without persistent ST-segment elevation remains unknown. Moreover, the impact of age on the efficacy of antiplatelet therapy with eptifibatide is unknown...
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(00)90018-8
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:We evaluated ethnic differences in the 10-year risk of myocardial infarction or coronary death derived from Framingham risk equation and in a composite measure of emerging cardiovascular disease risk factors in women and whether statistical adjustments for educational attainment, geographic location, and lif...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.08.027
更新日期:2005-06-01 00:00:00
abstract::Left ventricular topography and diastolic and systolic functions were studied in 41 patients with essential hypertension (group 1) and 33 age-matched normal adults (group 2) by Doppler echocardiography. In group 1 54% had LV concentric hypertrophy, 19% had combined concentric hypertrophy and eccentric remodeling, and ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90560-6
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:Procoagulant stress responses may contribute to atherosclerosis development and acute coronary thrombosis. In the present study, we examined the role of beta2-adrenergic receptor function and plasma catecholamines in the stress-induced increase in the 2 hypercoagulability markers thrombin-antithrombin III (T...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.123146
更新日期:2002-07-01 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