Abstract:
BACKGROUND:Patients undergoing percutaneous coronary intervention (PCI) for unstable coronary syndromes have substantial emotional and spiritual distress that may promote procedural complications. Noetic (nonpharmacologic) therapies may reduce anxiety, pain and distress, enhance the efficacy of pharmacologic agents, or affect short- and long-term procedural outcomes. METHODS:The Monitoring and Actualization of Noetic Training (MANTRA) pilot study examined the feasibility of applying 4 noetic therapies-stress relaxation, imagery, touch therapy, and prayer-to patients in the setting of acute coronary interventions. Eligible patients had acute coronary syndromes and invasive angiography or PCI. Patients were randomized across 5 treatment groups: the 4 noetic and standard therapies. Questionnaires completed before PCI reflected patients' religious beliefs and anxiety. Index hospitalization end points included post-PCI ischemia, death, myocardial infarction, heart failure, and urgent revascularization. Mortality was followed up for 6 months after hospitalization. RESULTS:Of eligible patients, 88% gave informed consent. Of 150 patients enrolled, 120 were assigned to noetic therapy; 118 (98%) completed their therapeutic assignments. All clinical end points were available for 100% of patients. Results were not statistically significant for any outcomes comparisons. There was a 25% to 30% absolute reduction in adverse periprocedural outcomes in patients treated with any noetic therapy compared with standard therapy. The lowest absolute complication rates were observed in patients assigned to off-site prayer. All mortality by 6-month follow-up was in the noetic therapies group. In patients with questionnaire scores indicating a high level of spiritual belief, a high level of personal spiritual activity, a low level of community-based religious involvement, or a high level of anxiety, noetic therapies appeared to show greater reduction in absolute in-hospital complication rates compared with standard therapy. CONCLUSIONS:Acceptance of noetic adjuncts to invasive therapy for acute coronary syndromes was excellent, and logistics were feasible. No outcomes differences were significant; however, index hospitalization data consistently suggested a therapeutic benefit with noetic therapy. Of all noetic therapies, off-site intercessory prayer had the lowest short- and long-term absolute complication rates. Definitive demonstration of treatment effects of this magnitude would be feasible in a patient population about 4 times that of this pilot study. Absolute mortality differences make safety considerations a mandatory feature of future clinical trials in this area.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Krucoff MW,Crater SW,Green CL,Maas AC,Seskevich JE,Lane JD,Loeffler KA,Morris K,Bashore TM,Koenig HGdoi
10.1067/mhj.2001.119138subject
Has Abstractpub_date
2001-11-01 00:00:00pages
760-9issue
5eissn
0002-8703issn
1097-6744pii
S0002-8703(01)68915-4journal_volume
142pub_type
临床试验,杂志文章,随机对照试验abstract:BACKGROUND:Coronary heart disease (CHD) in women is strongly associated with estrogen deprivation. For example, risk for CHD increases dramatically after menopause. However, the role of hormone replacement therapy (HRT) in CHD prevention currently is unresolved. To better understand CHD in women, the precise mechanisms...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.121262
更新日期:2002-04-01 00:00:00
abstract::Pulsed Doppler echocardiographic studies of both right and left ventricular diastolic inflow patterns were performed in 10 full-term newborn infants and serially during the first month of life in 21 premature (28 to 35 weeks' gestation) infants with no clinical cardiorespiratory disease. Results of studies performed d...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90745-4
更新日期:1988-12-01 00:00:00
abstract::The effects of cytochrome C, an electron carrier in the process of oxidative phosphorylation, on infarct size and regional left ventricular function after a coronary artery occlusion were investigated. Thus, in 30 dogs, 1 minute after left anterior descending coronary artery occlusion, 99mTc-labeled albumin microspher...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90019-6
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Many chronic heart failure (CHF) patients have low vitamin D (VitD) and high plasma renin activity (PRA), which are both associated with poor prognosis. Vitamin D may inhibit renin transcription and lower PRA. We investigated whether vitamin D3 (VitD3) supplementation lowers PRA in CHF patients. METHODS AND...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2013.05.009
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus is an increasingly prevalent condition among heart failure (HF) patients. The long-term morbidity and mortality among patients with and without diabetes with HF with reduced (HFrEF), borderline (HFbEF), and preserved ejection fraction (HFpEF) are not well described. METHODS:Using the Get W...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2019.01.006
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Galectin-3, a β-galactoside binding lectin involved in important regulatory roles in adhesion, inflammation, immunity, and fibrosis, may be relevant to atrial fibrillation (AF) etiology. METHODS:We included 8,436 participants free of AF at baseline (1996-1998) and with measures of plasma galectin-3 from the...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2017.07.001
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Research has shown that vaccination with Streptococcus pneumoniae reduced the extent of atherosclerosis in experimental animal models. It is thought that phosphorylcholine lipid antigens in the S. pneumoniae cell wall induce the production of antibodies that cross-react with oxidized low-density lipoprotein,...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2016.04.003
更新日期:2016-07-01 00:00:00
abstract::The records of 64 patients with progressive systemic sclerosis (PSS) were reviewed. More than 100 items from the patient's history, physical examination, and laboratory tests were encoded. A two-tailed Gehan's test was used to evaluate the effect of each variable on patient survival. Variables significant at the 0.05 ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90525-3
更新日期:1985-07-01 00:00:00
abstract::The hemodynamic hallmark of hypertension is increased systemic vascular resistance, although this variable is usually not determined in hypertensive patients because it has generally required invasive procedures to measure cardiac output. Reliable, totally noninvasive methods are now available that measure cardiac out...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(88)90565-0
更新日期:1988-08-01 00:00:00
abstract::Head-up tilt provokes vasodepressor syncope in patients with this disorder but may also cause fainting in unaffected subjects. The aims of this study were to examine autonomic function and sequential changes in heart rate variability and plasma catecholamines during graded head-up tilt in patients with vasodepressor s...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70213-8
更新日期:1997-02-01 00:00:00
abstract::Postoperative atrial fibrillation/flutter (PoAF) commonly complicates cardiac surgery, occurring in 25% to 60% of patients. Postoperative atrial fibrillation/flutter is associated with significant morbidity, higher long-term mortality, and increased health care costs. Novel preventive therapies are clearly needed. In ...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2011.03.035
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Diastolic dysfunction induced by ischemia may alter transmitral blood flow, but this reflects global ventricular function, and pseudonormalization may occur with increased preload. Tissue Doppler may assess regional diastolic function and is relatively load-independent, but limited data exist regarding its a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.123836
更新日期:2002-09-01 00:00:00
abstract::Because of its unique ability to demonstrate the metabolic consequences of myocardial ischemia, positron emission tomography (PET) is extremely valuable in assessing myocardial viability. PET imaging can identify the myocardial segments that are likely to improve after revascularization and may be more sensitive and s...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(91)90803-p
更新日期:1991-07-01 00:00:00
abstract::There are many similarities between the clinical features of viral heart disease and of rheumatic carditis, as defined in the revised Jones criteria for the diagnosis of rheumatic fever. Because of this, it is likely that viral heart disease has been, and still is, diagnosed as rheumatic. This situation can be avoided...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80137-8
更新日期:1976-05-01 00:00:00
abstract::Body surface isopotential maps were recorded in 30 normal subjects and 32 patients with clinical evidence of old anterior myocardial infarction but without ECG findings of infarction. Position of the minimum in maps was compared at 5 msec intervals from the onset of QRS between the normal and infarction groups. A sign...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90463-0
更新日期:1984-10-01 00:00:00
abstract:BACKGROUND:Dilated and hypertrophic cardiomyopathies are primary myocardial diseases that cause considerable morbidity and mortality. Although these cardiomyopathies are clinically heterogeneous, genetic factors play an important role in their etiology and pathogenesis. The defects in the cardiac actin (ACTC) gene can ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.122514
更新日期:2002-06-01 00:00:00
abstract::This study uses echocardiography to characterize the pattern of left ventricular hypertrophy in a new hypertensive heart failure-prone rat strain designated SHHF/Mcc-cp (SHHF). M-mode echocardiograms of the left ventricle in nine 10- to 12-month old SHHF rats and nine age-matched spontaneously hypertensive rats (SHR) ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90081-0
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers effectively reduce blood pressure in patients with renovascular disease (RVD); yet, randomized cardiovascular prevention trials of these drugs typically exclude individuals with this condition. PATIENTS AND METHODS:We studied the ass...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.05.013
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:The pectoral approach to implantation of cardioverter defibrillators (ICDs) has become a standard in defibrillator therapy because of reduced generator size, weight, and volume. But the size of these devices is still comparable to the size of the early conventional antibradycardia pacemakers that were associ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70270-4
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:Recent randomized clinical trials have suggested a benefit of an invasive management strategy in patients with acute coronary syndromes. However, the broader use and impact of the invasive management approach has not been established for patients with acute coronary syndromes beyond the relatively narrow pat...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1067/mhj.2002.122517
更新日期:2002-06-01 00:00:00
abstract::The antiarrhythmic effect of nadolol, a long-acting, nonselective beta antagonist without intrinsic sympathomimetic or membrane-stabilizing properties, was evaluated in 36 patients with ventricular dysrhythmias as determined by three baseline 24-hour Holter recordings at a time when subjects were receiving placebo. Na...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(84)90590-8
更新日期:1984-10-01 00:00:00
abstract::Release of thromboxane (TXA2) during acute myocardial infarction may be an important contributing factor in the genesis of ventricular fibrillation (VF). We assessed the effect of selective TXA2 inhibition on vulnerability to VF after total occlusion of the anterior descending coronary artery in chloralose-anesthetize...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90099-2
更新日期:1986-04-01 00:00:00
abstract:BACKGROUND:According to a recent meta-analysis, parathyroid hormone (PTH) excess is associated with increased cardiovascular disease (CVD) risk, but existing studies are limited. We examined in a prospective study the association of PTH with the incidence of CVD, taking into account vitamin D and other confounding vari...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2014.04.017
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Bleeding and blood transfusion are associated with increased morbidity and mortality among patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS); however, the economic consequences of these complications are not well defined. We sought to determine the relationship between bleeding, bloo...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.10.014
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Transradial approach (TRA) for cardiac catheterizations and interventions improves clinical outcomes compared with transfemoral access, and its use is increasing worldwide. However, there are limited data on successive use of same artery for repeat procedures. METHODS:Between May 2010 and May 2011, all cons...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2012.10.016
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:The long-term effects of smoking and smoking cessation on markers of cardiovascular disease (CVD) prognosis obtained during treadmill stress testing (TST) are unknown. The purpose of this study was to evaluate the long-term effects of smoking cessation and continued smoking on TST parameters that predict CVD...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2011.06.023
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Magnetic resonance imaging (MRI) can noninvasively assess changes in atherosclerotic plaque morphology and composition. The ORION trial assessed the effects of rosuvastatin on carotid plaque volume and composition. METHODS:The randomized, double-blind ORION trial used 1.5-T MRI to image carotid atherosclero...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2007.11.018
更新日期:2008-03-01 00:00:00
abstract::Increased intracellular calcium (calcium overload) is considered one of the factors that can initiate ventricular fibrillation. In addition, ventricular fibrillation itself can cause and possibly maintain calcium overload. The goal of this study was to determine whether the class IA antiarrhythmic agent procainamide c...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90453-0
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND:After the Mustard or Senning procedure, adults with transposition of the great arteries may have right ventricular failure and require consideration of new therapies. A 2-stage arterial switch operation (ASO) may be performed as an alternative to heart transplantation. This procedure is relatively successful...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2003.09.015
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Although more than one million patients in the United States have permanent pacemakers, little is known about their cause of death. We evaluated the cause of death in 404 patients who died in the Mode Selection Trial (MOST). METHODS:In MOST, patients received a dual-chamber pacemaker randomly programmed to ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/S0002-8703(03)00429-0
更新日期:2003-11-01 00:00:00