Abstract:
:Dobutamine stress echocardiography (DSE) is a reliable cardiac risk stratifier that has widespread applicability because of its clinical accuracy and cost effectiveness. Dobutamine has positive inotropic and chronotropic effects and is commonly used in patients who cannot exercise or achieve an adequate heart rate response with exercise. Recently available long-term results from several independent clinical trials, combined with enhancements in image quality, have improved the ability to detect significant coronary artery disease and determine myocardial viability. Dobutamine stress echocardiography has an excellent safety profile with clinical results superior to regular exercise electrocardiography and comparable with exercise echocardiography and radionucleotide perfusion stress imaging. Low-dose dobutamine response can accurately predict dysfunctional yet viable myocardial regions that may improve with revascularization. Clinical studies are now available refining the common use of DSE preoperatively in female patients with valvular disease, as well as in the emergency department. Dobutamine stress echocardiography does have some limitations in discriminating particular regions of ischemia when multiple ventricular segments are involved and when the imaging is suboptimal. It can be applied using minimal additional resources in an otherwise functioning echocardiography laboratory and, with appropriate training, can result in clinical results comparable with those of large-scale multicenter trials. Ongoing improvements in technology and the development of new reagents such as myocardial contrast agents hold promise for further advancement in the near future.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Usher BW Jr,O'Brien TXdoi
10.1002/clc.4960230804subject
Has Abstractpub_date
2000-08-01 00:00:00pages
560-70issue
8eissn
0160-9289issn
1932-8737journal_volume
23pub_type
杂志文章,评审abstract:BACKGROUND:Acute coronary syndromes (ACS) are characterized by activation of systemic and local inflammatory mediators. The interrelation between these soluble inflammatory markers and their association with markers of myocardial necrosis have not been extensively studied. HYPOTHESIS:The study was undertaken to evalua...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960280405
更新日期:2005-04-01 00:00:00
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
更新日期:2009-07-01 00:00:00
abstract::More women than men die each year of cardiovascular disease, which remains the leading cause of death in the United States. Sex-specific factors, including pregnancy-related disorders, should be considered when assessing cardiovascular (CV) risk in women. Hypertensive disorders of pregnancy have been associated with C...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.21965
更新日期:2012-03-01 00:00:00
abstract::High dose-dobutamine (DOB) has been previously used as a pharmacological stress test to evaluate wall motion abnormalities. As a result, recent stress echocardiography with low-dose DOB has been reported to be valuable for investigating stunned myocardium after thrombolysis. However, echocardiography requires an opera...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960160604
更新日期:1993-06-01 00:00:00
abstract::There is scant information regarding the effect of exercise training begun soon after hospital discharge for myocardial infarction (MI) with respect to subsequent improvement in exercise tolerance, enhancement of regional myocardial perfusion, or left ventricular function. Accordingly, 19 post-MI patients (mean age 53...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960150105
更新日期:1992-01-01 00:00:00
abstract::The mechanism of inferior ST depression during percutaneous transluminal coronary angioplasty (PTCA) for the left anterior descending artery (LAD) was studied in 108 patients with isolated LAD lesion. In 49 patients (Group I) ST depression in inferior leads was observed, and 59 patients (Group II) showed no inferior S...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960110905
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND AND HYPOTHESIS:Genetic influence on development of athlete's heart is uncertain. This study investigated whether angiotensin-converting enzyme (ACE) gene polymorphism influenced development of athlete's heart. METHODS:Forty-three participants in a 100-km ultramarathon were classified on the basis of ACE gen...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960230814
更新日期:2000-08-01 00:00:00
abstract::This review describes 23 patients with aortic valve stenosis who underwent balloon valvuloplasty during life and had subsequent valve tissue examined at the time of aortic valve replacement or at necropsy. Of 23 stenotic aortic valves, 17 were examined within 30 days (early) after balloon dilation. Of these 94% had no...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960141113
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:This study investigated the impact on all-cause mortality of airflow limitation indicative of chronic obstructive pulmonary disease or restrictive spirometry pattern (RSP) in a stable systolic heart failure population. HYPOTHESIS:Decreased lung function indicates poor survival in heart failure. METHODS:Inc...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22802
更新日期:2017-11-01 00:00:00
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
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:Although women typically develop coronary artery disease several years after men, once they have symptomatic disease their thromboembolic complications are worse than in men. The mechanism mediating this gender difference in outcome after thromboembolic events is unknown. We previously studied platelet funct...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/clc.4960191106
更新日期:1996-11-01 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:BACKGROUND:In the transcatheter aortic valve replacement era, characterization of functional status in older adults with aortic stenosis (AS) is essential. Gait speed (GS) is emerging as a marker of frailty and predictor of outcomes in older adults undergoing cardiovascular intervention. The objective of this study was...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.21974
更新日期:2012-05-01 00:00:00
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
更新日期:2013-08-01 00:00:00
abstract::The 2011 Update of the American Heart Association's Cardiovascular Disease Prevention Guideline for Women is designed to help women and their physicians understand cardiovascular Disease (CVD) risks and undertake practical steps that are most effective in preventing heart disease and stroke. Defining a woman's risk st...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.20940
更新日期:2011-09-01 00:00:00
abstract::At present, there is an exponential use of new interventional techniques whose proper role and value have not yet been defined. The intracoronary stent is just one example. There is no doubt that stents can be implanted with a high technical success rate associated with highly predictable immediate angiographic result...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960160503
更新日期:1993-05-01 00:00:00
abstract::Infusion of dobutamine in low and high doses in combination with echocardiography can be used for the assessment of myocardial viability and functional significance of coronary artery disease. Improvement of contractile function of hypokinetic or akinetic ventricular wall segment with low-dose dobutamine has a high pr...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960180506
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:Electronic health record systems (EHR) are expected to facilitate higher quality patient care; however, studies evaluating EHR effectiveness in improving care have yielded mixed results. HYPOTHESIS:Implementation of a performance improvement system in outpatient practices with EHR may better demonstrate the...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.21971
更新日期:2012-03-01 00:00:00
abstract::The short-term hemodynamic and possible arrhythmogenic effects of intravenous salbutamol at a dose of 30 or 60 micrograms/min were evaluated in 14 patients with severe chronic left ventricular dysfunction using equilibrium radionuclide angiocardiography and electrocardiographic monitoring. Salbutamol infusions at a do...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960130708
更新日期:1990-07-01 00:00:00
abstract::Thrombotic obstruction of aortic bioprostheses is rare. Few cases have been reported involving the use of the Carpentier-Edwards (CE) prosthesis, the Hancock bioprosthesis, or the Medtronic Intact porcine valve. Thrombolytic therapy for mechanical valve thrombosis has been used frequently even though it is known to ca...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960160215
更新日期:1993-02-01 00:00:00
abstract::Long-acting oral isosorbide dinitrate (ISDN) was replaced by Nitroderm TTS, and the utility of this drug in long-term treatment was assessed in 69 patients with angina pectoris. The frequency of attacks (p < 0.001) and the consumption of sublingual nitrate tablets (p < 0.01) were found to be significantly lower at 2 w...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1002/clc.4960170107
更新日期:1994-01-01 00:00:00
abstract::In addition to the role of the electrophysiological substrate, paroxysmal atrial fibrillation depends on the modulation of the atrial tissues by the autonomic nervous system. Experimentally, models of atrial fibrillation can be based on either adrenergic or vagal stimulations that provoke the arrhythmia by disturbing ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960130311
更新日期:1990-03-01 00:00:00
abstract::Aspirin is integral in the primary and secondary prevention of coronary artery disease and acute coronary syndrome. Given the high clinical importance of aspirin in the management of coronary artery disease, much attention has been directed towards the concept of "aspirin resistance." Unfortunately, the term aspirin r...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.22031
更新日期:2012-11-01 00:00:00
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
更新日期:2015-02-01 00:00:00
abstract::After reviewing these published studies, I think one can conclude that in the patient population with chronic and/or paroxysmal atrial fibrillation, warfarin is beneficial and the benefits outweigh the risks. However, it is important to point out that patients at high risk for embolic disease, for example, dilated car...
journal_title:Clinical cardiology
pub_type: 社论
doi:10.1002/clc.4960160703
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:The maximal negative dP/dt [max (-)dP/dt] and time constant (T) are useful indices for evaluating left ventricular (LV) relaxation, but they require invasive procedures. HYPOTHESIS:The purpose of this study was to obtain max (-)dP/dt and T using the continuous-wave Doppler aortic regurgitation velocity curv...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960190907
更新日期:1996-09-01 00:00:00
abstract::Endothelial dysfunction is increasingly recognized as an early event in the pathogenesis of cardiovascular disease. This observation is consistent with the growing appreciation of the role of endothelium in maintaining cardiovascular health. Endothelial dysfunction and coronary artery disease are both linked to hypert...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960211103
更新日期:1998-11-01 00:00:00
abstract::Marijuana is the most abused recreational drug in the United States. Cannabinoids, the active ingredients of marijuana, affect multiple organ systems in the human body. The pharmacologic effects of marijuana, based on stimulation of cannabinoid receptors CB1 and CB2, which are widely distributed in the cardiovascular ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.21962
更新日期:2012-06-01 00:00:00
abstract::The effect of intravenous bepridil, a new calcium antagonist with class I and III properties, was tested in 21 patients with sustained ventricular tachyarrhythmias refractory to a mean of five antiarrhythmic agents as assessed by programmed right ventricular stimulation. At control electrophysiologic study without ant...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960131209
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:The Reduction in ENdpoints with the Angiotensin Antagonist Losartan (RENAAL) study reported that losartan delayed the progression of renal disease in patients with type 2 diabetes and nephropathy. Diabetic or renally impaired patients are at high cardiovascular risk, a risk potentially increased in patients ...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章
doi:10.1002/clc.4960280307
更新日期:2005-03-01 00:00:00