Abstract:
AIMS:A substantial number of patients with dysfunctional but potentially viable myocardium cannot be accurately evaluated by transthoracic echocardiography due to a poor acoustic window. This study compares the diagnostic value of alternative functional imaging techniques, such as dobutamine-transoesophageal echocardiography (dobutamine-TEE) and dobutamine magnetic resonance imaging (dobutamine-MRI) for the detection of viable myocardium and the prediction of left ventricular functional recovery in patients with chronic coronary artery disease following successful revascularization procedures. METHODS AND RESULTS:Rest and low-dose (5, 10 microg dobutamine x min(-1) x kg(-1)) multiplane dobutamine-TEE and ultrafast cine-MRI studies were performed in 103 patients. Contractile recovery of an infarct region was predicted if a dobutamine contraction reserve could be assessed visually by TEE or MRI in > or =50% of infarct-related a- or dyskinetic segments. Revascularization of the infarct-related vessel was successful in 88 patients, and 4.9 +/- 0.7 months later 52 patients still had an angiographically controlled open target vessel. These patients underwent another rest MRI study to assess left ventricular functional recovery. A dobutamine contraction reserve was observed in 27/52 (52%) patients by TEE and in 26/52 (50%) patients by MRI. Functional improvement of the infarct region was diagnosed in 28/52 (54%) patients. The positive and negative predictive accuracy of dobutamine-TEE and dobutamine-MRI for the prediction of left ventricular functional recovery was not significantly different (85% vs 92%, ns and 80% vs 85%, ns). Diagnosis of a predominantly viable infarct region by TEE and MRI predicted a significant increase in left ventricular ejection fraction (TEE: 12 +/- 8% vs 2 +/- 7% P<0.001, MRI: 13 +/- 7% vs 2 +/- 7%, P<0.001) compared to infarct regions graded as scar. CONCLUSION:A qualitative visual analysis of TEE and MRI viability studies is highly accurate for the prediction of left ventricular functional recovery in patients with dysfunctional myocardium and proved to be a clinically valuable alternative if transthoracic dobutamine-echocardiography is unsuitable. To date, TEE is cardiologists' preferred choice for the assessment of myocardial viability but MRI may become significantly more attractive with increasing local availability and experience.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Baer FM,Theissen P,Crnac J,Schmidt M,Deutsch HJ,Sechtem U,Schicha H,Erdmann Edoi
10.1053/euhj.2000.1946subject
Has Abstractpub_date
2000-06-01 00:00:00pages
981-91issue
12eissn
0195-668Xissn
1522-9645pii
S0195668X00919468journal_volume
21pub_type
杂志文章abstract::Health economics is about spending limited resources wisely and, as with so many fields in medicine, combines science with art and ingenuity. In order to know whether money is well spent it is necessary to have some reference points to make comparisons. Many accepted cardiovascular interventions, such as revasculariza...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:
更新日期:1998-12-01 00:00:00
abstract:AIMS:To evaluate outcomes for left main coronary artery (LMCA) stenting and compare results between protected (left coronary grafted) and unprotected LMCA stenting in the current bare-metal stent era. METHODS:We reviewed outcomes among 142 consecutive patients who underwent protected or unprotected LMCA stenting since...
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abstract:AIMS:Nuclear receptors and their cofactors regulate key pathophysiological processes in atherosclerosis development. The transcriptional activity of these nuclear receptors is controlled by the nuclear receptor corepressors (NCOR), scaffolding proteins that form the basis of large corepressor complexes. Studies with pr...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehz667
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abstract:AIMS:The aims of the GISSI Prognosis Registry were to describe the diagnostic strategies initiated in acute myocardial infarction patients by a representative sample of Italian cardiological centres, and to determine which clinical or hospital characteristics were associated with the initiation of invasive diagnostic o...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1053/euhj.1998.1236
更新日期:1998-12-01 00:00:00
abstract:AIMS:Resuscitated cardiac arrest (CA), leading to harmful cardiovascular dysfunction and multiple organ failure, includes a whole-body hypoxia-reoxygenation phenomenon. Opening of the mitochondrial permeability transition pore (mPTP) appears to be a pivotal event in ischaemia-reperfusion injury. We hypothesized that ph...
journal_title:European heart journal
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doi:10.1093/eurheartj/ehq112
更新日期:2011-01-01 00:00:00
abstract::Contrary to most prospective epidemiologic studies, an earlier report from the British Regional Heart Study (BRHS) suggested that high density lipoprotein (HDL)-cholesterol in men aged 40-59 years was not a significant, independent, predictive risk factor for coronary heart disease (CHD), controlling for the composite...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/11.suppl_h.21
更新日期:1990-12-01 00:00:00
abstract::Hypertension induced in rats by suprarenal banding has a blood pressure elevating effect that is accompanied by the occurrence of cardiac hypertrophy and fibrosis. This phenomenon is already present at 2 weeks after banding and persists up to 1.5 years. The increase in cardiac weight is mostly due to the development o...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/16.suppl_c.33
更新日期:1995-05-01 00:00:00
abstract::A group of investigators met for two days in Santorini, Greece, to discuss progress in the field of identification and treatment of high risk/vulnerable atherosclerotic plaques and patients. Many differences in the manner in which terms are being utilized were noted. It was recognized that increased understanding of t...
journal_title:European heart journal
pub_type: 共识发展会议,杂志文章,评审
doi:10.1016/j.ehj.2004.01.002
更新日期:2004-06-01 00:00:00
abstract:AIMS:Calmodulinopathies are rare life-threatening arrhythmia syndromes which affect mostly young individuals and are, caused by mutations in any of the three genes (CALM 1-3) that encode identical calmodulin proteins. We established the International Calmodulinopathy Registry (ICalmR) to understand the natural history,...
journal_title:European heart journal
pub_type: 杂志文章
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061051
更新日期:1995-08-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi198
更新日期:2005-08-01 00:00:00
abstract:AIMS:Matrix metalloproteinase-1 (MMP-1), a proteolytic enzyme able to degrade types I and III collagens, is present in atherosclerotic lesions but absent from the normal blood vessel wall. The recent observation that, in a transgenic mouse model, MMP-1 gene expression slows the development and progression of atheroscle...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/s0195-668x(03)00385-3
更新日期:2003-09-01 00:00:00
abstract::The pathogenic T cell responsible for myocarditis following CVB3 infection differs between BALB/c and DBA/2 mice. Since these two strains are identical at the major histocompatibility (MHC) loci (both H-2d), our aim was to investigate the genetic basis for this difference in T cell immunity, as well as the tissue orig...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/12.suppl_d.108
更新日期:1991-08-01 00:00:00
abstract:AIMS:Evidence is accumulating that inflammation plays a role in the pathophysiology of heart failure. Lipoprotein-associated phospholipase A2 (Lp-PLA2) has pro-inflammatory properties. We investigated whether Lp-PLA2 activity is associated with heart failure. METHODS AND RESULTS:Lp-PLA2 activity was determined in a ra...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehl230
更新日期:2006-10-01 00:00:00
abstract::Stress echocardiography is an established method for the diagnosis and prognostic stratification of coronary artery disease. In the last few years, the tremendous technological and conceptual versatility of this technique has been increasingly applied in challenging diagnostic fields. Today, in the echocardiography la...
journal_title:European heart journal
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doi:10.1093/eurheartj/eht350
更新日期:2014-04-01 00:00:00
abstract:AIMS:Atrial fibrillation (AF) is associated with abnormal sarcoplasmic reticulum (SR) calcium release, which is promoted by adenosine A(2A) receptor (A(2A)R) activation. Here, we tested the hypothesis that abnormal calcium release in AF is linked to A(2A)R remodelling. METHODS AND RESULTS:Western blotting and quantita...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehq464
更新日期:2011-03-01 00:00:00
abstract:AIMS:The transversal distribution of coronary atherosclerotic plaques (AP) (myocardial vs pericardial) affects vessel remodelling. The aim of this study was to define the impact of transversal lesion distribution on vessel remodelling in proximal and distal coronary segments using a 3D intravascular ultrasound (IVUS) r...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/s0195-668x(02)00426-8
更新日期:2003-02-01 00:00:00
abstract:Aims:Congenital heart defects (CHD) affect almost 1% of all live born children and the number of adults with CHD is increasing. In families where CHD has occurred previously, estimates of recurrence risk, and the type of recurring malformation are important for counselling and clinical decision-making, but the recurren...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehx314
更新日期:2018-03-21 00:00:00
abstract::The optimal length of clopidogrel therapy in patients with acute coronary syndromes or in those who have undergone percutaneous coronary intervention (PCI) remains controversial. We therefore sought to determine the risk of both perioperative and premature discontinuation of clopidogrel. PubMed and EMBASE databases we...
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abstract::Atrial fibrillation is a common arrhythmia and one which may cause pilot incapacitation. In many cases there may be no more than one episode and there will be no organic heart disease. Prediction of the risk of recurrence is not possible. Atrial fibrillation in both paroxysmal and persistent forms should be disqualify...
journal_title:European heart journal
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doi:10.1093/eurheartj/5.suppl_a.89
更新日期:1984-03-01 00:00:00
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journal_title:European heart journal
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehy362
更新日期:2018-09-07 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/oxfordjournals.eurheartj.a015069
更新日期:1996-09-01 00:00:00
abstract:AIMS:Obstructive sleep apnoea (OSA) is highly prevalent in patients with chronic heart failure (CHF) and may contribute to CHF progression. We aimed to determine whether treatment of OSA with continuous positive airway pressure (CPAP) would improve subjective and objective measures of heart failure severity in patients...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehm131
更新日期:2007-05-01 00:00:00
abstract::An inventory has been made of the practice of angioplasty in 14 European countries from 1985 onwards. The numbers of procedures performed varied in 1985 from 3 to 186 per million inhabitants, in 1991 from 52 to 716. All countries showed a steady increase, but the highest performer. Belgium, achieved only 55% of the nu...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.3.391
更新日期:1993-03-01 00:00:00
abstract::It is now recognised after many years of speculation regarding the role of mammalian atria in the direct regulation of intravascular volume, that atrial myocites produce a peptide hormone that results in natriuresis and diuresis, under the condition of atrial distention. This atrial natriuretic factor (ANF) is secrete...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/9.suppl_h.29
更新日期:1988-06-01 00:00:00
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journal_title:European heart journal
pub_type: 临床试验,杂志文章
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更新日期:2005-08-01 00:00:00
abstract:AIMS:To evaluate the prevalence, clinical significance, and prognosis of latent Brugada syndrome (BrS) in patients with new-onset atrial fibrillation (AF) unmasked by class 1C antiarrhythmic drugs. METHODS AND RESULTS:Between January 2000 and June 2008, all consecutive patients with new-onset AF, who after flecainide ...
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pub_type: 杂志文章
doi:10.1093/eurheartj/ehp326
更新日期:2009-12-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059721
更新日期:1990-05-01 00:00:00
abstract::The purpose of this prospective study was to examine the incidence of exercise-induced ischaemia before and after angioplasty as well as 4 months later by exercise echocardiography, to evaluate the prognostic value of exercise echocardiography performed after angioplasty as regards the development of restenosis and to...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060841
更新日期:1995-12-01 00:00:00