Abstract:
:Rapid assessment of patients presenting with acute chest pain is essential, in order to distinguish between those who have a life-threatening condition, such as myocardial infarction or unstable angina, and the substantial proportion who do not have an acute coronary syndrome. It is thus of vital importance that reliable techniques are available to facilitate rapid risk stratification, as an aid to both clinical diagnosis and management strategy decisions. Assessments based on clinical findings, electrocardiographic monitoring, symptom-limited exercise testing, and biochemical marker measurements, used either singly or in various combinations, can fulfill this role. The present paper reviews some of the recent data that demonstrate the value of these techniques. Very few studies allow conclusions to be drawn about optimal treatment strategies in relation to groups stratified according to prognostic markers, and the question of whether intense medical treatment or early invasive intervention is most beneficial is one that clinical trials have yet to address adequately. In the recently completed Fragmin and Fast Revascularization during InStability in Coronary artery disease (FRISC II) study, comparisons were made of clinical outcomes achieved with early invasive versus noninvasive (i.e., medical) management strategies, and with short-term versus prolonged anticoagulation with dalteparin sodium (Fragmin), in patients with unstable coronary artery disease. All study participants underwent symptom-limited exercise testing and provided blood sample for measurements of biochemical markers; continuous electrocardiography monitoring and echocardiography were also performed in a high proportion of patients. Data from the FRISC II trial thus shed further light on the issue of risk stratification and its use to determine optimal treatment strategies.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Husted SEdoi
10.1002/clc.4960231306subject
Has Abstractpub_date
2000-01-01 00:00:00pages
I18-22eissn
0160-9289issn
1932-8737journal_volume
23 Suppl 1pub_type
杂志文章,评审abstract:BACKGROUND:The finding of aortic regurgitation at a classical examination is a diastolic murmur. HYPOTHESIS:Aortic regurgitation is more likely to be associated with a systolic than with a diastolic murmur during routine screening by a noncardiologist physician. METHODS:In all, 243 asymptomatic patients (mean age 42 ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960270905
更新日期:2004-09-01 00:00:00
abstract::The purpose of this study was to examine signal-averaged electrocardiographic (SA-ECG) late potentials to predict ventricular arrhythmias during intrinsic cardiac rhythm and during ventricular pacing in children with complete heart block (CHB). Recordings of SA-ECG were obtained from eight patients (aged 3-18 years) w...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960170610
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:It is known that exercise-induced ST-segment elevation in lead V1 (V1-E) detects left anterior descending (LAD) stenosis. It was also postulated that ST elevation in aVR and simultaneous ST depression in V5 (aVR-E + V5-D) is a marker of ischemia due to significant stenosis of the LAD in patients with single-...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960260506
更新日期:2003-05-01 00:00:00
abstract::One of the most important roles for professional societies in medicine is assembling multiple stakeholders and experts to develop documents that can help guide and define policies and strategies for best medical care. Each year the Heart Rhythm Society (HRS) develops several consensus documents that address critical c...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.22666
更新日期:2017-03-01 00:00:00
abstract::Research protocols often utilize serial exercise testing to examine the efficacy of anti-ischemic therapies. These tests, however, are prone to multiple sources of bias. This investigation sought to determine the influence of varying precordial electrocardiographic (ECG) electrode placement on the detection of exercis...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960180409
更新日期:1995-04-01 00:00:00
abstract:BACKGROUND:Ventricular arrhythmias are the most common consequences of structural and functional heart diseases, but cases with no evident pathology are also observed. A parameter indicating asymptomatic circulatory failure could support decisions related to possible treatment of ventricular arrhythmias. HYPOTHESIS:Th...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20611
更新日期:2009-12-01 00:00:00
abstract::Two-dimensional and Doppler echocardiography have become extremely useful in the management of patients with acute myocardial infarction (AMI). Echocardiography is noninvasive, relatively inexpensive, and has no known biohazards. It offers unequaled information about cardiac anatomy and function. In the acute setting ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960150603
更新日期:1992-06-01 00:00:00
abstract::Dynamic cardiomyoplasty is a new surgical procedure proposed for treatment of the failing heart. Clinically, the latissimus dorsi muscle is raised as a pedicled flap and wrapped around the heart. The skeletal muscle is transformed to produce a myocardium-like fatigue-resistant muscle. It is stimulated to contract in s...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960121203
更新日期:1989-12-01 00:00:00
abstract::The use of contrast echocardiography (CE) in cardiovascular medicine has grown significantly over the last 15 years. Depending on the site of injection, contrast enhancement of the right- or left-sided cardiac chambers or myocardium now can be achieved. Contrast echocardiography can improve the evaluation of patients ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960201308
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:While depressed left ventricular ejection fraction is clearly associated with poor long-term outcome in heart failure (HF), the effect of ejection fraction on short-term outcomes and resource utilization following hospitalization for HF remains unclear. HYPOTHESIS:We evaluated the independent effect of depr...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960220306
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Acute changes in high-sensitivity troponin T (hs-TnT) are induced by myocardial ischemia during exercise stress testing, but there are no reports of pharmacological stress testing. HYPOTHESIS:The pattern of troponin release by myocardial ischemia-induced pharmacological stress testing differs according to t...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22392
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Small heart syndrome has previously been reported as neurocirculatory asthenia, associated with a small heart shadow on a chest roentgenogram. This is characterized as weakness or fatigue even after ordinary exertion, palpitation, dyspnea, and fainting, resembling patients with chronic fatigue syndrome (CFS)...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20227
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND/HYPOTHESIS:SMARTWOMAN™ was designed to develop and assess the feasibility of a smartphone app to control cardiovascular risk factors in vulnerable diabetic women. METHODS:Fourteen African-American women with diabetes and without known cardiovascular disease were enrolled. A weight-scale, glucometer, sphygmo...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23124
更新日期:2019-02-01 00:00:00
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
更新日期:1998-05-01 00:00:00
abstract::The long-term survival rate following acute myocardial infarction (AMI) was studied in 358 patients in central Japan who were monitored for 8 to 20 years after discharge from hospital for AMI. Fifteen-year cardiac survival rates were 65% in males and 72% in females. In both sexes, the survival rate decreased with incr...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960120905
更新日期:1989-09-01 00:00:00
abstract::Recent investigations have indicated that chronic heart failure can be reversed with agents that inhibit the reninangiotensin-aldosterone or sympathetic nervous system, such as angiontensin-converting enzyme (ACE) inhibitors and beta blockers. A meta-analysis of clinical trials of ACE inhibition in chronic heart failu...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:Advanced age remains one of the principal determinants of mortality in patients with acute myocardial infarction (AMI). HYPOTHESIS:The aim of this study was to determine the in-hospital outcome of elderly (> 75 years) patients with AMI who were admitted to hospitals participating in the national MITRA (Maxi...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960231109
更新日期:2000-11-01 00:00:00
abstract::We report a patient who presented with new onset atrial fibrillation in the setting of inferior ST-segment elevation myocardial infarction (STEMI). Cardiac catheterization revealed proximal occlusion of the left circumflex artery. Balloon angioplasty and stenting restored flow to a large left atrial branch, with promp...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20573
更新日期:2010-12-01 00:00:00
abstract::The role of catecholamine in atrial natriuretic peptide (ANP) secretion and its secretory mechanism in normal humans is not well defined; therefore, we studied the relationship among ANP, catecholamine, and atrial pressures in 25 patients without cardiovascular disease and in 35 patients with chronic congestive heart ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960110402
更新日期:1988-04-01 00:00:00
abstract::Five multicenter, randomized, double-blind, placebo-controlled studies were conducted in France to compare the efficacy and safety of once-daily simvastatin treatment (10-40 mg/day) with conventional therapy with gemfibrozil 900 mg/day, ciprofibrate 100 mg/day, bezafibrate 400 mg/day, and fenofibrate 300 or 400 mg/day...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1002/clc.4960181107
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:Left ventricular ejection fraction (LVEF) has shown to predict outcomes in patients with heart failure (HF). Left ventricular recovery (LVR) has shown to improve prognosis. HYPOTHESIS:Guideline-directed medical therapy will predict LVR in patients with HF and reduced LVEF. METHODS:We studied 244 patients w...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22937
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Cardiac resynchronization therapy (CRT) is highly beneficial in patients with heart failure (HF) and left bundle branch block (LBBB); however, up to 30% of patients in this selected group are nonresponders. HYPOTHESIS:We hypothesized that clinical and echocardiographic variables can be used to develop a sim...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/clc.23058
更新日期:2018-10-01 00:00:00
abstract::Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial ischemia that could present as angina, acute myocardial infarction, or even sudden death. It occurs more commonly in women and it has been associated with autoimmune and collagen vascular diseases. The management and prognosis in these patient...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20540
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Early recurrence of atrial fibrillation (ERAF) after catheter ablation is common and has been thoroughly studied. However, very late recurrence of atrial fibrillation (VLRAF) is rarely researched, and its characteristics have not been determined. HYPOTHESIS:The aim of this study was to investigate the clini...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20340
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Internal cardioversion of atrial fibrillation with direct current energy has become an increasingly employed technique for patients who fail external cardioversion. HYPOTHESIS:The purpose of this study was to determine whether internal cardioversion could be avoided by careful attention to cardioversion tec...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960240716
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:In addition to the well-investigated proinflammatory cytokine expression, there is an ever increasing interest in the field of anti-inflammatory response to cardiopulmonary bypass (CPB). Evidence suggests that myocardium serves as an important source of cytokines during reperfusion and application of CPB. Th...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960290708
更新日期:2006-07-01 00:00:00
abstract::The impact of transient myocardial ischemia on left ventricular function was examined by digital subtraction left ventricular angiography. Contrast medium was injected into the right pulmonary artery before, at 60 seconds of balloon inflation, and 10 minutes after balloon deflation. A total of 69 patients completed th...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章
doi:10.1002/clc.4960140808
更新日期:1991-08-01 00:00:00
abstract::Embolism of a fragment of a central venous catheter is a serious clinical complication, especially when the fragment cannot be made visible by radiological methods. We report a case where such a fragment could only be localized by transesophageal echocardiography (TEE). With combined use of x-rays and TEE, the cathete...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960110614
更新日期:1988-06-01 00:00:00
abstract::A patient with reversible coronary artery spasm superimposed on fixed atherosclerotic coronary disease was treated with percutaneous transluminal angioplasty. The procedure successfully dilated the atherosclerotic lesion. However, 20 minutes later, the patient developed coronary artery spasm at the angioplasty site. S...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960061206
更新日期:1983-12-01 00:00:00
abstract::When evaluating patients with possible coronary artery disease, it is necessary to combine physiologic assessment (measurements of ischemia) with anatomic pathologic assessment (coronary angiography). Coronary angiography currently is the only way to assess the anatomic pathology of the coronary circulation with preci...
journal_title:Clinical cardiology
pub_type: 社论
doi:10.1002/clc.4960270202
更新日期:2004-02-01 00:00:00