Reperfusion revisited: beyond TIMI 3 flow.

Abstract:

:Therapy for acute myocardial infarction has advanced dramatically since the early 1980s with the use of early intravenous fibrinolytic therapy. Combining low-dose fibrinolysis and platelet lysis appears to provide an additional increase in infarct-related artery (IRA) patency, but the large-scale mortality reduction trials evaluating this strategy are just getting under way. Recently, considerable attention has shifted away from the epicardial arteries to the microvasculature. Contemporary evidence suggests that epicardial patency does not necessarily translate to actual perfusion at the myocardial level. Techniques to evaluate beyond thrombolysis in myocardial infarction (TIMI) epicardial flow are now available and validated. In addition, there are promising treatments for the prevention or alleviation of certain forms of microvascular obstruction. This review attempts to clarify the confusion surrounding epicardial flow and "myocardial malperfusion" and to provide some insight into the next direction in acute myocardial infarction therapeutics.

journal_name

Clin Cardiol

journal_title

Clinical cardiology

authors

Gassler JP,Topol EJ

doi

10.1002/clc.4960221605

subject

Has Abstract

pub_date

1999-08-01 00:00:00

pages

IV20-9

issue

8 Suppl

eissn

0160-9289

issn

1932-8737

journal_volume

22

pub_type

杂志文章,评审
  • Long-term management of atrial fibrillation.

    abstract::In the past decade, catheter ablation techniques and implantable devices have revolutionized the treatment of ventricular arrhythmias, junctional arrhythmias, and atrial flutter. For most patients presenting with atrial fibrillation (AF), the treatment available today is similar to that used a century ago, although no...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960200416

    authors: Gallagher MM,Camm AJ

    更新日期:1997-04-01 00:00:00

  • Incidence of sudden athletic deaths between 1985 and 1990 in Marion County, Indiana.

    abstract::Relatively little information is available concerning the incidence of sudden death in athletes in the United States. The present study provides annual incidence rates of sudden athletic deaths in Marion County, Indiana, home of Indianapolis, the "amateur sports capital of the world." The overall incidence was 0.04% (...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960151111

    authors: Waller BF,Hawley DA,Clark MA,Pless JE

    更新日期:1992-11-01 00:00:00

  • Percutaneous coronary interventions in nonagenarians: in-hospital mortality and outcome at one year follow-up.

    abstract:BACKGROUND:Limited information is available regarding outcome of very elderly patients referred for percutaneous coronary intervention (PCI). PURPOSE:This study aimed to assess acute and intermediate term clinical outcomes among nonagenarians. METHODS:The study included 32 consecutive nonagenarian patients undergoing...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.20596

    authors: Parikh R,Chennareddy S,Debari V,Hamdan A,Konlian D,Shamoon F,Bikkina M

    更新日期:2009-12-01 00:00:00

  • Prospective comparison of exercise digital subtraction and exercise first pass radionuclide ventriculography.

    abstract::In order to test the comparative sensitivities of first-pass radionuclide and digital subtraction ventriculography in detecting wall motion abnormalities during exercise, 29 patients referred for coronary angiography were submitted to both types of stress ventriculograms. Resting and exercise ventriculograms by both t...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960090906

    authors: Detrano R,Yiannikas J,Simpfendorfer C,Underwood DA,Salcedo EE,Rollins M

    更新日期:1986-09-01 00:00:00

  • Adjunctive low molecular weight heparin during fibrinolytic therapy in acute ST-segment elevation myocardial infarction: a meta-analysis of randomized control trials.

    abstract:BACKGROUND:Recent data suggests that low molecular weight heparins (LMWHs) may be superior to unfractionated heparin (UFH) as an adjunct to fibrinolytic therapy in patients with acute ST-segment elevation myocardial infarction (STEMI). HYPOTHESIS:We evaluated cardiac outcomes and the risk of major bleeding with LMWHs ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/clc.20432

    authors: Singh S,Bahekar A,Molnar J,Khosla S,Arora R

    更新日期:2009-07-01 00:00:00

  • Rationale and design of the Henry Ford Exercise Testing Project (the FIT project).

    abstract::Although physical fitness is a powerful prognostic marker in clinical medicine, most cardiovascular population-based studies do not have a direct measurement of cardiorespiratory fitness. In line with the call from the National Heart Lung and Blood Institute for innovative, low-cost, epidemiologic studies leveraging e...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.22302

    authors: Al-Mallah MH,Keteyian SJ,Brawner CA,Whelton S,Blaha MJ

    更新日期:2014-08-01 00:00:00

  • The ventriculophasic response revisited: analysis of clinical correlations using a new proposed definition derived in pacemaker patients.

    abstract:BACKGROUND:The ventriculophasic response (VR) refers to shortening of atrial cycle length during heart block when a QRS complex is interposed between P waves. No formal quantitative definition has heretofore been proposed, nor have its potential clinical correlations been studied. HYPOTHESIS:We hypothesized that VR is...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.20998

    authors: Dadu RT,McPherson CA

    更新日期:2012-01-01 00:00:00

  • Thyroid function is associated with presence and severity of coronary atherosclerosis.

    abstract:BACKGROUND:Overt hypothyroidism has been found to be associated with cardiovascular disease. Moreover, subclinical hypothyroidism is a strong indicator of risk for aortic atherosclerosis and myocardial infarction. HYPOTHESIS:We hypothesized that variation of thyroid function within the normal range may influence the p...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960261205

    authors: Auer J,Berent R,Weber T,Lassnig E,Eber B

    更新日期:2003-12-01 00:00:00

  • Familial homozygous hypercholesterolemia: clinical and cardiovascular features in 18 patients.

    abstract::Homozygous familial hypercholesterolemia (HFH) is a very rare autosomal dominant disease characterized by accelerated severe atherosclerosis. We examined 18 patients from 9 families with HFH. The age range was 6-30 years (mean = 16 years). Male to female ratio was equal. All patients had huge, multiple tuberous xantho...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960120608

    authors: Brook GJ,Keidar S,Boulos M,Grenadier E,Wiener A,Shehada N,Markiewicz W,Benderli A,Aviram M

    更新日期:1989-06-01 00:00:00

  • The resting cardiokymogram: distribution of morphologies in normal patients and in patients with coronary heart disease.

    abstract::The cardiokymograph, a relatively new noninvasive device capable of recording anterior left ventricular segmental wall motion, was used to evaluate the frequency and type of wall motion abnormalities in 25 normal patients and in 109 patients with ischemic heart disease. Of the 25 patients with normal coronary arteries...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960030605

    authors: Tzivoni D,Diamond GA,Vas R,Silverberg RA,Forrester JS

    更新日期:1980-12-01 00:00:00

  • Importance of alpha 1-sympathetic activity for diurnal change in ischemic threshold in patients with stable angina.

    abstract:BACKGROUND:Although ischemic threshold reportedly is lower in the early morning than in the afternoon, the mechanisms that account for the diurnal change in minimal coronary vascular resistance in the potentially ischemic area are unknown. HYPOTHESIS:We hypothesized that calcium-channel blockers and alpha 1 blockers m...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960210512

    authors: Fujita M,Tanaka T,Nakae I,Tamaki S,Kihara Y,Nohara R,Sasayama S

    更新日期:1998-05-01 00:00:00

  • Development of a multi-institutional cohort to facilitate cardiovascular disease biomarker validation using existing biorepository samples linked to electronic health records.

    abstract:BACKGROUND:Emerging biomarkers for acute myocardial infarction (AMI) may enhance conventional risk-prediction algorithms if they are informative and associated with risk independently of established predictors. In this study, we constructed a cohort for testing emerging biomarkers for AMI in managed-care populations us...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,多中心研究

    doi:10.1002/clc.22146

    authors: Cross DS,McCarty CA,Steinhubl SR,Carey DJ,Erlich PM

    更新日期:2013-08-01 00:00:00

  • Cystatin C-based CKD-EPI equations and N-terminal pro-B-type natriuretic peptide for predicting outcomes in acutely decompensated heart failure.

    abstract:BACKGROUND:In patients with acute decompensated heart failure (ADHF), both natriuretic peptides and renal impairment predict adverse outcomes. Our aim was to evaluate the complementary prognosis role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and the newly developed Chronic Kidney Disease Epidemiology Col...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,多中心研究

    doi:10.1002/clc.22362

    authors: Flores-Blanco PJ,Manzano-Fernández S,Pérez-Calvo JI,Pastor-Pérez FJ,Ruiz-Ruiz FJ,Carrasco-Sánchez FJ,Morales-Rull JL,Pascual-Figal D,Galisteo-Almeda L,Januzzi JL

    更新日期:2015-02-01 00:00:00

  • Noninvasive evaluation of left ventricular performance by the shortest distance between mitral leaflets coaptation and interventricular septum at end-systole.

    abstract::We attempted to evaluate left ventricular performance from the shortest distance between the mitral leaflets coaptation and the interventricular septum at end-systole (MVC-IVS distance). The subjects were 37 patients with coronary artery disease (CAD) with prior myocardial infarction (MI), 8 with CAD without prior MI,...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960150908

    authors: Ohte N,Narita H,Hashimoto T,Takase R,Kobayashi K,Akita S,Fujinami T

    更新日期:1992-09-01 00:00:00

  • Impact of prior permanent pacemaker on long-term clinical outcomes of patients undergoing percutaneous coronary intervention.

    abstract:BACKGROUND:The impact of permanent pacemaker (PPM) on long-term clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) has not been studied. HYPOTHESIS:PPM may increase heart failure (HF) burden on patients undergoing PCI. METHODS:We recruited consecutive patients undergoing PCI and carried...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.22645

    authors: Li YJ,Zhang WW,Yang XX,Li N,Qiu XB,Qu XK,Fang WY,Yang YQ,Li RG

    更新日期:2017-04-01 00:00:00

  • A critique of the new ST-segment criteria for the diagnosis of acute myocardial infarction in patients with left bundle-branch block.

    abstract:BACKGROUND:Recently, electrocardiogram (ECG) criteria have been proposed for the diagnosis of acute myocardial infarction (AMI) in the presence of left bundle-branch block (LBBB). However, clinical experience indicates that such ECG changes indicative of AMI are occasionally noted in clinically stable patients with LBB...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960241004

    authors: Madias JE,Sinha A,Ashtiani R,Agarwal H,Win M,Narayan VK

    更新日期:2001-10-01 00:00:00

  • Hyponatremia in acute decompensated heart failure: mechanisms, prognosis, and treatment options.

    abstract::Hyponatremia is common and is increasingly recognized as an independent prognostic marker that adversely affects morbidity and mortality in various disease states, including heart failure. In acute decompensated heart failure (ADHF), the degree of hyponatremia often parallels the severity of cardiac dysfunction and is...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.20822

    authors: Jao GT,Chiong JR

    更新日期:2010-11-01 00:00:00

  • N-terminal pro-brain natriuretic peptide and short-term mortality in acute aortic dissection: A meta-analysis.

    abstract:BACKGROUND:Acute aortic dissection (AAD) is a life-threatening medical emergency that requires immediate diagnosis and rapid treatment. There is a paucity of data on the role of biomarkers in risk stratification of patients with AAD. HYPOTHESIS:N-terminal pro-brain natriuretic peptide (NT-proBNP) is associated with sh...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.23436

    authors: Vrsalovic M,Vrsalovic Presecki A,Aboyans V

    更新日期:2020-11-01 00:00:00

  • Effects of intravenous dofetilide in patients with frequent premature ventricular contractions: a clinical trial.

    abstract:BACKGROUND:Although suppression of premature ventricular contractions (PVCs) is not a predictor of mortality over the long term, the extent of PVC suppression is an important characteristic of any antiarrhythmic drug. HYPOTHESIS:This study was undertaken to determine whether intravenous (i.v.) dofetilide has the abili...

    journal_title:Clinical cardiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1002/clc.4960230607

    authors: Pool PE,Singh SN,Friedrich T

    更新日期:2000-06-01 00:00:00

  • Advances in stroke prevention in atrial fibrillation: enhanced risk stratification combined with the newer oral anticoagulants.

    abstract::Patients with atrial fibrillation (AF) have an increased stroke risk compared with those in sinus rhythm, although the absolute risk for individual patients is modulated by the presence of various additional risk factors. Patient selection for oral anticoagulation for stroke prevention is based on risks of stroke and ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.22122

    authors: Verheugt FW

    更新日期:2013-06-01 00:00:00

  • Unexplained syncope: implications of age and gender on patient characteristics and evaluation, the diagnostic yield of an implantable loop recorder, and the subsequent treatment.

    abstract:BACKGROUND:Syncope is a common clinical problem with a variety of underlying mechanisms, some of which occur more frequently in 1 of the sexes or at a certain age. HYPOTHESIS:There may be clinically significant age- and gender-related differences in patients with unexplained syncope. METHODS:Five hundred seventy pati...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.22300

    authors: Edvardsson N,Garutti C,Rieger G,Linker NJ,PICTURE Study Investigators.

    更新日期:2014-10-01 00:00:00

  • Diagnostic accuracy of 2-D echocardiography for detection of exercise-induced wall motion abnormalities in patients with coronary artery disease: comparison to biplane cineventriculography.

    abstract::To determine the accuracy of two-dimensional echocardiography (2-D echo) for assessment of exercise-induced wall motion abnormalities in patients with coronary artery disease, the results of stress echocardiography were compared with exercise cineventriculography. In 56 consecutive patients, biplane cineventriculograp...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960110808

    authors: Voelker W,Jacksch R,Dittmann H,Karsch KR

    更新日期:1988-08-01 00:00:00

  • Sex-related differences in left ventricular diastolic function and arterial elastance during admission in patients with heart failure with preserved ejection fraction: The PURSUIT HFpEF study.

    abstract:BACKGROUND:We previously reported that an index of afterload-related left ventricular diastolic function, operant diastolic elastance (Ed)/effective arterial elastance (Ea) = E/e'/(0.9 × systolic blood pressure), was significantly higher in elderly hypertensive women. We aimed to determine sex-related differences in th...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,多中心研究

    doi:10.1002/clc.23073

    authors: Hoshida S,Watanabe T,Shinoda Y,Ikeoka K,Minamisaka T,Fukuoka H,Inui H,Ueno K,Suna S,Nakatani D,Hikoso S,Yamada T,Yasumura Y,Fuji H,Sakata Y,PURSUIT HFpEF Investigators.

    更新日期:2018-12-01 00:00:00

  • Circadian rhythmic fractal scaling of heart rate variability in health and coronary artery disease.

    abstract:BACKGROUND:In clinical cardiology, heart rate variability is a putative index of autonomic cardiovascular function. Signs of reduced vagal activity are not only associated with an enhanced risk of sudden cardiac death, but such impaired heart rate variability became a new predictor of sudden cardiac death and other mor...

    journal_title:Clinical cardiology

    pub_type: 临床试验,杂志文章

    doi:10.1002/clc.4960200710

    authors: Otsuka K,Cornélissen G,Halberg F

    更新日期:1997-07-01 00:00:00

  • Preventive therapy in patients with insignificantly narrowed coronary arteries: evaluation of physician attitude and practice.

    abstract:BACKGROUND:Although the outcome of patients with angiographically insignificantly narrowed coronary arteries (INCA) is not clearly defined, such lesions can progress or rupture, thus causing cardiovascular morbidity. Preventive therapy with aspirin and lipid-lowering drugs therefore seems warranted in these patients. ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960270605

    authors: Henkin Y,Abuful A,Yosefi C,Elis A,Ilia R,Gidron Y

    更新日期:2004-06-01 00:00:00

  • Metabolic syndrome and concomitant diabetes mellitus are associated with higher risk of cardiovascular comorbidity in patients with primary glomerular diseases: A retrospective observational study.

    abstract:BACKGROUND:Metabolic syndrome (MS) and diabetes mellitus (DM) are risk factors for cardiovascular diseases in general population. However, there was a paucity of studies investigating their impact in primary glomerular diseases (PGD). HYPOTHESIS:MS and concomitant DM are associated with higher risk of cardiovascular c...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.23388

    authors: Xie Z,Li Z,Dong W,Chen Y,Li R,Wu Y,Lin T,Tao Y,Liang H,Wang W,Liu S,Ye Z,Shi W,Liang X

    更新日期:2020-09-01 00:00:00

  • Monocyte chemoattractant protein-1 and coronary artery disease.

    abstract::The designation of atherosclerosis as a chronic inflammatory process represents an exciting and logical paradigm shift for cardiologists. Monocyte chemoattractant protein-1 (MCP-1) plays an important role in the recruitment and activation of monocytes and thus in the development of atherosclerosis. Enhanced MCP-1 expr...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960250403

    authors: Ikeda U,Matsui K,Murakami Y,Shimada K

    更新日期:2002-04-01 00:00:00

  • Effect of remote ischemic preconditioning on electrophysiological and biomolecular parameters in nonvalvular paroxysmal atrial fibrillation (RIPPAF study): Rationale and study design of a randomized, controlled clinical trial.

    abstract::Remote ischemic preconditioning (RIPC) has been studied in models of different cardiovascular entities. Recently, a beneficial effect of RIPC on incidence of atrial fibrillation (AF) in postsurgical patients has been suggested. However, the potential impact of RIPC on electrophysiological- and thrombogenesis-related p...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1002/clc.22584

    authors: Kosiuk J,Milani R,Ueberham L,Uhe T,Stegmann C,Hindricks G,Bollmann A

    更新日期:2016-11-01 00:00:00

  • Impact of thallium-201 imaging on clinical assessment and management of patients with chest pain.

    abstract::The histories, rest, and exercise ECG results of 60 patients without myocardial infarction complaining of chest pain were submitted to 6 physicians (3 cardiologists and 3 noncardiologists) who were unaware of the angiographic findings. The physicians were requested to estimate the probability of coronary artery diseas...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960071207

    authors: Schmoliner R,Dudczak R,Kronik G,Mösslacher H,Zangeneh M,Pollak C,Schurz B,Schoberwalter A

    更新日期:1984-12-01 00:00:00

  • Electrocardiographic QRS duration reflects right ventricular remodeling in patients undergoing corrective surgery for isolated tricuspid regurgitation: a comparative study with cardiac magnetic resonance imaging.

    abstract:BACKGROUND:The role of electrocardiogram (ECG) is unclear for the longitudinal follow-up of patients who undergo corrective surgery for isolated severe tricuspid regurgitation (TR). HYPOTHESIS:This study sought to investigate the usefulness of changes in QRS duration of ECG after TR surgery in predicting right ventric...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.22030

    authors: Seo MK,Park EA,Kim HK,Lee W,Kim YJ,Kim KH,Kim KB,Sohn DW,Ahn H,Park JH

    更新日期:2012-11-01 00:00:00