Abstract:
BACKGROUND:Patients surviving ventricular fibrillation (VF) or sustained ventricular tachycardia (VT) are at a high risk of death due to a recurrence of arrhythmia. The implantable cardioverter defibrillator (ICD) terminates VT or VF, but it is not known whether this device prolongs life in these patients compared with medical therapy with amiodarone. METHODS AND RESULTS:A total of 659 patients with resuscitated VF or VT or with unmonitored syncope were randomly assigned to treatment with the ICD or with amiodarone. The primary outcome measure was all-cause mortality, and the secondary outcome was arrhythmic death. A total of 328 patients were randomized to receive an ICD. A thoracotomy was done in 33, no ICD was implanted in 18, and the rest had a nonthoracotomy ICD. All 331 patients randomized to amiodarone received it initially. At 5 years, 85.4% of patients assigned to amiodarone were still receiving it at a mean dose of 255 mg/day, 28.1% of ICD patients were also receiving amiodarone, and 21.4% of amiodarone patients had received an ICD. A nonsignificant reduction in the risk of death was observed with the ICD, from 10.2% per year to 8.3% per year (19.7% relative risk reduction; 95% confidence interval, -7.7% to 40%; P=0.142). A nonsignificant reduction in the risk of arrhythmic death was observed, from 4.5% per year to 3.0% per year (32.8% relative risk reduction; 95% confidence interval, -7.2% to 57.8%; P=0.094). CONCLUSIONS:A 20% relative risk reduction occurred in all-cause mortality and a 33% reduction occurred in arrhythmic mortality with ICD therapy compared with amiodarone; this reduction did not reach statistical significance.
journal_name
Circulationjournal_title
Circulationauthors
Connolly SJ,Gent M,Roberts RS,Dorian P,Roy D,Sheldon RS,Mitchell LB,Green MS,Klein GJ,O'Brien Bdoi
10.1161/01.cir.101.11.1297subject
Has Abstractpub_date
2000-03-21 00:00:00pages
1297-302issue
11eissn
0009-7322issn
1524-4539journal_volume
101pub_type
临床试验,杂志文章,随机对照试验相关文献
CIRCULATION文献大全abstract:BACKGROUND:Studies on apolipoprotein E (apoE) alleles have reported an increased risk of coronary heart disease in patients with the apoE4 allele. Given the risk factor and histological similarities between coronary and calcific valvular heart disease (aortic stenosis [AS] and mitral annular calcification [MAC]), we po...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000097560.96431.3E
更新日期:2003-10-14 00:00:00
abstract:BACKGROUND:Epinephrine has been shown to impair pulmonary excretion of CO2 during resuscitation. This phenomenon was investigated in a rodent model of cardiac arrest and conventional resuscitation. METHODS AND RESULTS:The effects of racemic epinephrine were compared with the selective alpha 1-agonist methoxamine and w...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.84.5.2101
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:The mechanisms responsible for the association between advanced age and atherosclerotic diseases are not clear. Because atherosclerosis develops in response to local endothelial injuries, we investigated the effect of aging on vascular healing and reendothelialization. METHODS AND RESULTS:Endothelium denuda...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000050652.47145.4c
更新日期:2003-01-21 00:00:00
abstract:BACKGROUND:During ischemia, the intracellular calcium and inorganic phosphate (P(i)) concentrations rise and pH falls. We investigated the effects of these changes on force development in donor and failing human hearts to determine if altered contractile protein composition during heart failure changes the myocardial r...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc3501.095485
更新日期:2001-09-04 00:00:00
abstract:BACKGROUND:gp130, a signal transducer of the IL-6-related cytokines, is expressed ubiquitously, including in the heart. The activation of gp130 in cardiac myocytes was reported to induce myocardial hypertrophy. The downstream side of gp130 consists of two distinct pathways in cardiac myocytes, one a Janus kinase/signal...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.98.4.346
更新日期:1998-07-28 00:00:00
abstract:BACKGROUND:Glycoprotein (GP) IIb/IIIa inhibitors are beneficial in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS); their safe use in women, however, remains a concern. The contribution of dosing to the observed sex-related differences in bleeding is unknown. METHODS AND RESULTS:We explored ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.620815
更新日期:2006-09-26 00:00:00
abstract:BACKGROUND:Endothelins are recently characterized vasoconstrictor peptides. As chronic heart failure (CHF) is characterized by peripheral arteriolar and renal vasoconstriction, we have measured venous plasma endothelin-like immunoreactivity ("endothelin") in patients with this syndrome. METHODS AND RESULTS:Compared wi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.85.4.1374
更新日期:1992-04-01 00:00:00
abstract:BACKGROUND:Lymphatic network and chemokine-mediated signals are essential for leukocyte traffic during the proximal steps of alloimmune response. We aimed to determine the role of lymphatic vessels and their principal growth signaling pathway, vascular endothelial growth factor (VEGF)-C/D/VEGFR-3, during acute and chro...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.109.910703
更新日期:2010-03-30 00:00:00
abstract::Patients undergoing carotid endarterectomy were pretreated with low-dose, oral beta carotene to determine whether the carotenoid content of plaque could be increased in vivo. Beta carotene-treated patients had a 50-fold increase in their plaque beta carotene level from 0.066 to 3.3 micrograms beta carotene/g plaque. M...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.78.2.338
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND:The CAPRICORN trial has shown that carvedilol improved outcome in patients with left ventricular dysfunction after acute myocardial infarction treated with ACE inhibitors. The aim of this substudy was to determine the effects of carvedilol on left ventricular remodeling in this patient group. METHODS AND RE...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1161/01.CIR.0000108928.25690.94
更新日期:2004-01-20 00:00:00
abstract::We evaluated high-energy phosphate (HEP) levels and the ability to perform work in rat hearts preserved by standard techniques (0.9% NaCl arrest and storage at 4 degrees C) and by continuous coronary perfusion at 22 degrees C, pH 7.25, and 55 mm Hg for 4 or 8 hr with Krebs-Henseleit buffer (KHB), modified Morgan's sol...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract::Heart potentials were recorded from the entire chest surface in 42 patients suffering from Wolff-Parkinson-White syndrome. We were able to identify six types of surface maps, according to the location of the potential maximum and minimum during the delta wave. For each of these types we suggested the most likely locat...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.54.2.251
更新日期:1976-08-01 00:00:00
abstract:BACKGROUND:Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used to treat cardiogenic shock. However, VA-ECMO might hamper myocardial recovery. The Impella unloads the left ventricle. This study aimed to evaluate whether left ventricular unloading in patients with cardiogenic shock treated wit...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.120.048792
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Tissue-type plasminogen activator (tPA) and urokinase-type plasminogen activator (uPA) are thought to play critical roles in vascular remodeling after injury, with tPA mediating intravascular clot lysis and uPA modulating cell migration within the vessel wall. In human vascular disease, however, thrombus org...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000031162.80988.2b
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Alteration of the circadian rhythm and increased vascular senescence are linked to cardiovascular disease. Per2, a circadian gene, is known to regulate endothelium-dependent vasomotion. However, the mechanism by which Per2 affects endothelial function is unknown. We hypothesize that endothelial dysfunction i...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.790469
更新日期:2008-11-18 00:00:00
abstract::For estimating left ventricular mass (LVM), ECG criteria for left ventricular hypertrophy (LVH) were selected from conventional 12-lead ECGs, orthogonal three-lead ECGs, and multiple-dipole ECGs (MDECG). The three cardiograms were recorded in 139 patients for whom the degree of LVH was independently determined from bi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.60.6.1350
更新日期:1979-12-01 00:00:00
abstract:BACKGROUND:Pulmonary hypertension induced by chronic hypoxia is characterized by thickening of pulmonary artery walls, elevated pulmonary vascular resistance, and right-heart failure. Prostacyclin analogues reduce pulmonary pressures in this condition; raising the possibility that cycloxygenase-2 (COX-2) modulates the ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000145613.01188.0B
更新日期:2004-10-26 00:00:00
abstract::We determined the pharmacokinetics, efficacy and therapeutic plasma concentration of encainide, a new antiarrhythmic drug that affects His-Purkinje conduction but not ventricular refractoriness. Nine patients with frequent and complex premature ventricular complexes were studied in a 3-day double-blind protocol. Each ...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.64.2.290
更新日期:1981-08-01 00:00:00
abstract::Acute cardiac rejection, syndrome X, and arterial hypertension can induce small vessel damage and, therefore, restriction of coronary reserve in the presence of normal epicardial coronary arteries. A characteristic response pattern to dipyridamole (DIP) infusion has been previously described in syndrome X and arterial...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.81.1.72
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:The development of selective atrial antiarrhythmic agents is a current strategy for suppression of atrial fibrillation (AF). METHODS AND RESULTS:Whole-cell patch clamp techniques were used to evaluate inactivation of peak sodium channel current (I(Na)) in myocytes isolated from canine atria and ventricles. ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.704890
更新日期:2007-09-25 00:00:00
abstract:BACKGROUND:Endothelin-converting enzyme (ECE)-1 activates endothelin-1 (ET-1) and may thus contribute to the regulation of vascular tone and cell growth during atherosclerosis. METHODS AND RESULTS:To evaluate ECE-1 immunoreactivity concerning big ET-1/ET-1, we performed qualitative and quantitative immunohistochemistr...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc3301.094742
更新日期:2001-08-21 00:00:00
abstract:BACKGROUND:A warm-water bath (WWB) or sauna bath (SB) has generally been considered inappropriate for patients with severe congestive heart failure (CHF). However, a comprehensive investigation of the hemodynamic effects of thermal vasodilation in CHF has not been previously undertaken. METHODS AND RESULTS:To investig...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.91.10.2582
更新日期:1995-05-15 00:00:00
abstract::Mitochondria have emerged as a central factor in the pathogenesis and progression of heart failure, and other cardiovascular diseases, as well, but no therapies are available to treat mitochondrial dysfunction. The National Heart, Lung, and Blood Institute convened a group of leading experts in heart failure, cardiova...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/CIRCULATIONAHA.119.040551
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Thrombus formation within a coronary vessel is the acute precipitating event in most acute coronary syndromes. Recently, constitutive nitric oxide synthase (cNOS) has been identified in human platelets, and platelet-derived nitric oxide has been shown to inhibit platelet recruitment after aggregation. Howeve...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.98.15.1481
更新日期:1998-10-13 00:00:00
abstract::In previous studies from this laboratory, we found that approximately 30% of women with chest pain and normal coronary arteries demonstrated either a decrease in or a failure to increase radionuclide ejection fraction during exercise. To examine the hypothesis that this apparent abnormality in left ventricular functio...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.70.3.357
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:Patients with Brugada syndrome who were resuscitated from an episode of ventricular fibrillation are at high risk for recurrent sudden death. There is general agreement about the therapeutic strategy for these patients. Conversely, the prognosis and approach in patients with a diagnostic ECG but without a pr...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1161/01.CIR.0000104568.13957.4F
更新日期:2003-12-23 00:00:00
abstract:BACKGROUND:To explore roles of endogenous atrial natriuretic peptide (ANP) in blood pressure and volume regulation, we examined the effects of a newly developed ANP antagonist, HS-142-1 (HS) in deoxycorticosterone acetate (DOCA)-salt hypertensive rats. METHODS AND RESULTS:We examined 1) the effects of HS on ANP- or br...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.87.2.554
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND:DC shock catheter ablation for the treatment of ventricular tachycardia (VT) may induce VT episodes that disappear within days. METHODS AND RESULTS:A 30-J cathodal shock was delivered to the endocardial left ventricular wall in 15 closed-chest dogs. All dogs had VT during the first day after ablation. Eleve...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.84.1.267
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:In patients with mitral stenosis, reduced cardiac output or altered pulmonary hemodynamics may increase sympathetic nerve activity. However, the magnitude of the increase in sympathetic activity in such patients and the effect of valvuloplasty on this activity are unknown. METHODS AND RESULTS:We microneurog...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.10.3443
更新日期:1997-11-18 00:00:00
abstract:BACKGROUND:We tested the hypothesis that long-term administration of the specific angiotensin II subtype 1 (AT1)-receptor blocker BMS-186295 will regress hypertrophy and modify left ventricular angiotensin converting enzyme (ACE) expression in rats with ascending aortic stenosis. METHODS AND RESULTS:Six weeks after su...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.95.6.1592
更新日期:1997-03-18 00:00:00