Abstract:
BACKGROUND:Circulating mediators, including thromboxane A2, the vasoconstrictor, platelet aggregant, and smooth muscle mitogen, may contribute to the progression of vascular narrowing in primary pulmonary hypertension (PPH). METHODS:To further understand the contribution of thromboxane and to provide novel therapy for PPH, we administered the potent orally active thromboxane synthetase inhibitor and thromboxane receptor antagonist terbogrel for 12 weeks to patients with New York Heart Association functional classification II and III PPH. The study had a multicenter randomized placebo-controlled design. The primary endpoint was a change in the distance walked during 6 minutes. The pharmacologic effects of terbogrel on thromboxane and prostacyclin metabolism also were studied. RESULTS:Although the planned enrollment was 135 patients, the study was halted after only 71 patients had been randomized because of the unforeseen side effect of leg pain, which occurred almost exclusively in patients with terbogrel treatment. Only 52 patients completed the 12-week study, and only 22 patients (31%) were fully compliant with the study medication. The leg pain confounded the primary endpoint of walking distance. On an intention-to-treat analysis, no improvements in 6-minute walk distance or in hemodynamics in patients with terbogrel treatment were seen. However, terbogrel was effective from a pharmacologic standpoint, reducing thromboxane metabolites by as much as 98% (P <.0001), with a modest but statistically insignificant (39%) rise in prostacyclin metabolites. CONCLUSION:Inhibition of thromboxane with an orally active agent is feasible in PPH, but the incidence of severe leg pain with terbogrel precludes its use in this disorder. Similar therapeutic efforts, with other thromboxane inhibitors, should be considered.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Langleben D,Christman BW,Barst RJ,Dias VC,Galiè N,Higenbottam TW,Kneussl M,Korducki L,Naeije R,Riedel A,Simonneau G,Hirsch AM,Rich S,Robbins IM,Oudiz R,McGoon MD,Badesch DB,Levy RD,Mehta S,Seeger W,Solèr Mdoi
10.1067/mhj.2002.121806subject
Has Abstractpub_date
2002-05-01 00:00:00pages
E4issue
5eissn
0002-8703issn
1097-6744pii
S0002870302839151journal_volume
143pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract::High levels of endogenous plasma catecholamines in patients with severe congestive heart failure induce a down-regulation of the myocardial beta-adrenoreceptors and thus cause adrenoreceptor agonists, such as dobutamine, to be less effective in the treatment of these patients. Phosphodiesterase III inhibitors work ind...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(91)90834-5
更新日期:1991-06-01 00:00:00
abstract::Plasma levels of endothelin-1 are elevated in patients with chronic heart failure; however, it is unknown whether changes in plasma endothelin-1 levels accurately reflect clinical response to therapy in these patients. To determine this, we measured plasma endothelin-1 in addition to functional, hemodynamic, and other...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(96)90363-4
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:This study was planned to evaluate the outcome of patients ≥80 years old undergoing isolated conventional aortic valve replacement (AVR). METHODS:Systematic review of the literature and meta-analysis of data on octogenarians and nonagenarians who underwent isolated AVR were performed. RESULTS:The literature...
journal_title:American heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ahj.2011.12.005
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:The optimal antiplatelet regimen in elective patients undergoing complex percutaneous coronary interventions (PCIs) is uncertain. We aimed to assess the impact of glycoprotein IIb/IIIa (GpIIb/IIIa) inhibition with eptifibatide in clinically stable subjects with diffuse coronary lesions. METHODS:Patients wit...
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.2012.02.009
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) ablation is superior to pharmacologic therapy in achieving maintenance of normal sinus rhythm in selected patient populations. However, the procedure is resource intensive, and repeat ablations are sometimes required. We examined the predictors and trends of repeat ablation using a l...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2015.10.015
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:In the general population, obesity is associated with an increased risk of all-cause death. However, the importance of obesity in patients with established coronary heart disease is less well defined. METHODS:As part of the Determinants of Myocardial Infarction Onset Study, we performed a prospective cohort...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2003.12.015
更新日期:2004-05-01 00:00:00
abstract::M-mode echocardiograms were obtained in 48 patients with complete left bundle branch block (LBBB). Of these 48 patients, 28 had LBBB with normal frontal plane QRS axis (-20 degrees to +90 degrees, mean +/- SD 18 degrees +/- 34 degrees), and 20 had LBBB with a left axis deviation (LAD) (-30 degrees to -60 degrees, mean...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90010-2
更新日期:1982-10-01 00:00:00
abstract::Heart rate responses to three different procedures (amyl nitrite inhalation, standing up, and isoproterenol infusion), were studied before and during acute adrenergic beta blockade with intravenous propranolol in three normal and six hypertensive subjects. Propranolol decreased, but did not completely abolish, the hea...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90125-4
更新日期:1978-07-01 00:00:00
abstract:AIMS:Furosemide is commonly prescribed for symptom relief in heart failure (HF) patients. Although few data support the continuous use of loop diuretics in apparently euvolemic HF patients with mild symptoms, there is concern about safety of diuretic withdrawal in these patients. The ReBIC-1 trial was designed to evalu...
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.2017.08.012
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Contrast-induced acute kidney injury (CIAKI) is a frequent complication after infusion of contrast media in patients undergoing percutaneous coronary intervention. A wide range of CIAKI rates occurs after intervention between 3% and 30%, depending on the definition. The aim of this study was to identify whic...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.02.004
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:This study was designed to investigate the efficacy of alteplase double-bolus dosing compared with the front-loaded 90-minute infusion regimen in patients with acute myocardial infarction. Recent pilot studies have suggested that bolus dosing may provide improved efficacy in establishing early, complete, and...
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(98)70024-9
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Renal function significantly impacts morbidity and mortality after a percutaneous coronary intervention. Platelet glycoprotein (GP) IIb/IIIa inhibitors reduce ischemic complications during percutaneous coronary intervention; little is known of whether their safety and efficacy are influenced by renal functio...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2004.12.002
更新日期:2005-05-01 00:00:00
abstract::Critical limb ischemia is associated with excessively high risk for cardiovascular events, including myocardial infarction and death. Additionally, in this patient population non-invasive evaluation of coronary artery disease is limited due to (1) inability of exercise testing, (2) frequent occurrence of balanced isch...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2019.05.005
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Larger studies evaluating the angiographic results of second-generation stents are scarce. The objectives of this study were to assess current standards of angiographic and clinical outcomes after implantation of the second-generation stainless steel stent, NIR (Medinol Ltd, Tel Aviv, Israel), and to compare...
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:10.1067/mhj.2003.32
更新日期:2003-02-01 00:00:00
abstract::Pulmonary function was measured serially in two separate randomized trials of pindolol in the treatment of essential hypertension. Patients with overt obstructive airways disease were excluded. In study 1, 131 hypertensive patients were randomized to placebo (31) and 15 mg (33), 30 mg (33), and 60 mg (34) of pindolol....
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(82)90135-1
更新日期:1982-08-01 00:00:00
abstract::Anesthetized dogs were cooled to a core body temperature of 26 degree C. or maintained at a body temperature of 37 degree C. during periods of 5 and 10 hours of LAD coronary artery occlusion. Subsequent macroscopic dehydrogenase enzyme mapping showed that ischemic injury was 25 per cent less after 5 hours of coronary ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90010-8
更新日期:1978-12-01 00:00:00
abstract:BACKGROUND:Chronic heart failure is associated with impaired renal function, which may worsen during therapy. The incidence, predictors, and consequences of aggravated renal dysfunction (ARD) in patients undergoing intensive therapy for advanced chronic heart failure are unknown. METHODS:We reviewed the experience of ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70113-4
更新日期:1999-08-01 00:00:00
abstract::Quinidine binding was studied in 15 survivors of prehospital cardiac arrest and was compared to 18 normal individuals and 20 patients with coronary artery disease. The unbound quinidine fraction was 6.3 +/- 2.8% in the survivors of prehospital cardiac arrest, a value significantly lower than normal individuals (unboun...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90312-0
更新日期:1984-04-01 00:00:00
abstract::Valve area and cardiac output were determined with magnetic resonance (MR) velocity mapping in 12 patients with aortic stenosis. Heart catheterization, Doppler echocardiography, and indicator dilution were performed for comparison. Left ventricle could be catheterized in only nine patients; in these cases, MR measured...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90669-z
更新日期:1993-11-01 00:00:00
abstract::Free fatty acids (FFA), the predominant myocardial energy substrate, are present in increased quantities immediately following acute myocardial infarction (AMI) and may cause deleterious alterations in cardiac rhythm, oxygen consumption, and mechanical performance. In an attempt to suppress FFA and simultaneously incr...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-8703(76)80043-9
更新日期:1976-10-01 00:00:00
abstract:BACKGROUND:Women with X-chromosome monosomy or Turner syndrome (TS) are at increased risk for aortic dilation and dissection. To better understand the pathology and develop tools to monitor the risk of aortic disease, we investigated N-terminal pro-brain natriuretic peptide (BNP) (NT-proBNP) levels in women with TS and...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2012.06.021
更新日期:2012-09-01 00:00:00
abstract::Intravascular thrombus often occurs when the rupture or fissure of an atherosclerotic plaque exposes procoagulant elements lying below the plaque surface. This process of plaque rupture is the result both of passive mechanical forces and an active cell-mediated mechanism. Recently a number of investigators have develo...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1053/hj.1998.v135.90300
更新日期:1998-06-01 00:00:00
abstract::We compared the pauses that followed the spontaneous termination of supraventricular tachyarrhythmias with the pauses that followed the cessation of atrial overdrive pacing in 21 patients. In 10 patients with abnormal sinus node function and in 11 patients with normal sinus node function we recorded the spontaneous te...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90515-x
更新日期:1983-02-01 00:00:00
abstract::Percutaneous balloon mitral valvuloplasty has been shown to be an effective means of reducing mitral valve gradient and increasing mitral valve area in patients with mitral stenosis. Most techniques currently employed for performing this procedure involve delivery of one or two balloon valvuloplasty catheters through ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80279-0
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:The increasing burden of cardiovascular disease (CVD) in low- and middle-income countries is largely driven by the increasing prevalence of hypertension, diabetes, and tobacco use. We hypothesize that the utilization of community health workers (CHWs) to screen for and manage these 3 determinants of CVD in a...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2016.10.027
更新日期:2017-03-01 00:00:00
abstract::To study the left ventricular (LV) diastolic function in uncomplicated insulin-dependent diabetic patients without hypertension (n = 25) and comparable controls (n = 15), the effect of acute administration of nitroglycerin and nifedipine on cavity dimensions and transmitral flow pattern was investigated by Doppler ech...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90542-h
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND:In patients hospitalized with acutely decompensated heart failure, unresolved signs and symptoms of fluid overload have been consistently associated with poor outcomes. Regardless of dosing and type of administration, intravenous loop diuretics have not reduced heart failure events or mortality in patients w...
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.2015.05.019
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:The study aimed to compare the short-term costs and long-term cost-effectiveness of 2 antithrombotics, fondaparinux and enoxaparin, for non-ST-elevation acute coronary syndrome in the United States. METHODS:It was based on a large randomized trial of 20,078 patients Fifth Organization to Assess Strategies i...
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.2009.02.017
更新日期:2009-05-01 00:00:00
abstract::Abnormal interventricular septal motion is a frequent finding after cardiac surgery. However, the time course and underlying mechanisms are not well understood. Nineteen patients, mean age 54 years (range 20 to 82 years), were studied with intraoperative transesophageal echocardiography at five specific times: with th...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(07)80024-x
更新日期:1993-07-01 00:00:00
abstract::Our understanding of the pathogenesis of congestive heart failure (CHF) has improved remarkably in recent years. However, despite better knowledge and novel pharmaceutical strategies, this disease is still one of the most brutal killers in the Western world. The pathophysiology of CHF is complex, and much of our compr...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1067/mhj.2003.163
更新日期:2003-03-01 00:00:00