Abstract:
BACKGROUND:Mechanisms favoring the occurrence of paroxysmal atrial fibrillation (PAF) are complex and poorly defined. This study was designed to analyze dynamic changes in autonomic tone preceding the onset of PAF in a large group of patients. METHODS AND RESULTS:Holter tapes from 77 unselected consecutive patients (63 men and 14 women aged 58+/-12 years) with PAF were analyzed. A total of 147 episodes of sustained AF (>30 minutes) were recorded and submitted to time-domain and frequency-domain heart rate variability analyses; 6 periods were studied using repeated measures ANOVA: the 24-hour period, the hour preceding PAF, and the 20 minutes before PAF divided into four 5-minute periods. In the time-domain analyses, a linear decrease in mean RR interval from 925+/-16 to 906+/-16 ms (P<0.0002) was observed before the onset of PAF, together with a significant increase in the standard deviation of NN intervals from 65+/-4 to 70+/-4 ms (P<0.02). In the frequency-domain analyses, a significant increase in high-frequency (HF, HF-NU) components was observed before PAF (P<0.001 and P<0.0001, respectively), together with a progressive decrease in low-frequency components (LF, LF-NU) (P<0.0001 and P<0.004, respectively). The low/high frequency ratio showed a linear increase until 10 minutes before PAF, followed by a sharp decrease immediately before PAF, suggesting a primary increase in adrenergic tone followed by a marked modulation toward vagal predominance. No difference was observed in these heart rate variability changes between patients with "lone" PAF and patients with structural heart disease. CONCLUSIONS:The occurrence of PAF greatly depends on variations of the autonomic tone, with a primary increase in adrenergic tone followed by an abrupt shift toward vagal predominance.
journal_name
Circulationjournal_title
Circulationauthors
Bettoni M,Zimmermann Mdoi
10.1161/01.cir.0000018443.44005.d8subject
Has Abstractpub_date
2002-06-11 00:00:00pages
2753-9issue
23eissn
0009-7322issn
1524-4539journal_volume
105pub_type
杂志文章相关文献
CIRCULATION文献大全abstract:BACKGROUND:Membrane contact sites are fundamental for transmission and translation of signals in multicellular organisms. The junctional membrane complexes in the cardiac dyads, where transverse (T) tubules are juxtaposed to the sarcoplasmic reticulum, are a prime example. T-tubule uncoupling and remodeling are well-kn...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.119.039751
更新日期:2019-07-02 00:00:00
abstract:BACKGROUND:A key component of reperfusion of myocardial infarction is an immediate inflammatory response, which enhances tissue repair. Matrix turnover is crucial to tissue repair, and matrix metalloproteinases (MMPs) are key enzymes involved in matrix degradation. The hypothesis tested is that one inflammation-based e...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.103.17.2181
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:The clinical profiles and outcomes of patients treated surgically for acute type B aortic dissection (ABAD) are often reported for those in small series or for those cared for at a single institution over a long time period, during which a continuous evolution in techniques has occurred. Accordingly, we soug...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.000620
更新日期:2006-07-04 00:00:00
abstract:BACKGROUND:Right ventricular function may be an important determinant of exercise capacity, peak oxygen consumption (VO2), and the ventilatory response to carbon dioxide production (VE/VCO2 relation) in patients with chronic heart failure (CHF). METHODS AND RESULTS:We studied the role of right ventricular function in ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.89.5.2062
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:Cardiac Na/K-ATPase (NKA) regulates intracellular Na ([Na](i)), which in turn affects intracellular Ca and thus contractility via Na/Ca exchange. Recent evidence shows that phosphorylation of the NKA-associated small transmembrane protein phospholemman (PLM) mediates beta-adrenergic-induced NKA stimulation. ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.754051
更新日期:2008-04-08 00:00:00
abstract:BACKGROUND:Reduced renal function is associated with a poorer prognosis and increased bleeding risk in patients with acute coronary syndromes and may therefore alter the risk-benefit ratio with antiplatelet therapies. In the Platelet Inhibition and Patient Outcomes (PLATO) trial, ticagrelor compared with clopidogrel re...
journal_title:Circulation
pub_type: 杂志文章,随机对照试验
doi:10.1161/CIRCULATIONAHA.109.933796
更新日期:2010-09-14 00:00:00
abstract::Statins (HMG-CoA reductase inhibitors) are used widely for the treatment of hypercholesterolemia. They inhibit HMG-CoA reductase competitively, reduce LDL levels more than other cholesterol-lowering drugs, and lower triglyceride levels in hypertriglyceridemic patients. Statins are well tolerated and have an excellent ...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/01.cir.101.2.207
更新日期:2000-01-18 00:00:00
abstract:BACKGROUND:Since Mexican Americans have adverse patterns of risk factors for myocardial infarction relative to non-Hispanic whites, the incidence of myocardial infarction should be greater among Mexican Americans than among non-Hispanic whites. This expectation conflicts with reports generated from death certificate re...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.95.6.1433
更新日期:1997-03-18 00:00:00
abstract::Several conditions that contribute to drowning and near drowning must be considered in the treatment of near-drowned victims. Regardless of the cause, mechanical ventilation should begin as soon as possible and closed-chest cardiac massage should be administered when there is any question about the adequacy of cardiac...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1986-12-01 00:00:00
abstract:BACKGROUND:Increased expression of osteopontin (OPN), fibroblast growth factors (FGFs), and their type-1 receptor (FGFR-1) is associated with neointima formation and atherosclerosis. This study tested the hypothesis that ligand activation of FGFR-1 stimulates OPN expression in rat aortic smooth muscle cells (RASMCs), e...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000024113.26985.cc
更新日期:2002-08-13 00:00:00
abstract:BACKGROUND:Chagas heart disease is a frequent cause of morbidity and mortality in Latin America. Echocardiography provides useful diagnostic and prognostic information and is an important tool in the management of patients with Chagas disease. METHODS AND RESULTS:A search for relevant publications was obtained from ME...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/CIRCULATIONAHA.106.627323
更新日期:2007-03-06 00:00:00
abstract:BACKGROUND:To assess the reliability of pediatric echocardiographic measurements, we compared local measurements with those made at a central facility. METHODS AND RESULTS:The comparison was based on the first echocardiographic recording obtained on 735 children of HIV-infected mothers at 10 clinical sites focusing on...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1161/01.cir.104.3.310
更新日期:2001-07-17 00:00:00
abstract:BACKGROUND:Current methods of signal-averaged ECG analysis interrogate the terminal 40 msec of the QRS complex and/or the ST segment and have a low positive-predictive accuracy for detecting vulnerability to sustained ventricular tachycardia (VT). The extent to which abnormalities detected during these ECG intervals ar...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.86.6.1888
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:Previous studies have demonstrated that induction of heat shock protein (HSP) 72 by whole-body hyperthermia reduces infarct size in an in vivo model of ischemia and reperfusion. Furthermore, hearts obtained from transgenic mice that overexpress HSP72 demonstrate improved functional recovery and decreased inf...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.6.1408
更新日期:1996-09-15 00:00:00
abstract:BACKGROUND:Inotropic drugs are often used to treat acute, severe heart failure resulting from acute myocardial infarction and other unstable coronary artery syndromes. However, catecholamine inotropic agents may potentiate coronary thrombosis via a platelet alpha2-adrenergic mechanism, thus exacerbating the original pr...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.5.1647
更新日期:1997-09-02 00:00:00
abstract::These types of studies lay the foundation for understanding the human apolipoproteins at the genetic level. In addition, through a few specific examples, we have already shown evidence at the DNA level that lesions in apolipoprotein genes can play a role in human atherosclerosis. This work is in its infancy, but we ho...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.69.6.1190
更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:Endothelin (ET)-1 and norepinephrine (NE) are involved in myocardial ischemia/reperfusion injury. We investigated the role of ET-1 in ischemia/reperfusion-induced NE overflow and cardiac dysfunction using a selective ET(A) receptor antagonist (ABT-627), a selective ET(B) receptor antagonist (A-192621), and t...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000153351.86708.F7
更新日期:2005-01-25 00:00:00
abstract:BACKGROUND:In patients with acute minor ischemic stroke or high-risk transient ischemic attack enrolled in the POINT trial (Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke [POINT] Trial), the combination of clopidogrel and aspirin for 90 days reduced major ischemic events but increased major hemorrhag...
journal_title:Circulation
pub_type: 杂志文章,随机对照试验
doi:10.1161/CIRCULATIONAHA.119.040713
更新日期:2019-08-20 00:00:00
abstract:BACKGROUND:Extracorporeal circulation with circuits coated with surface-bound heparin has allowed reduced levels of systemic heparinization. Clinical benefits have included reduced postoperative bleeding and less homologous blood usage. However, the effects on the hemostatic and fibrinolytic systems have remained in pa...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.92.9.2579
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:The incidence of perinatal morbidity arising from birth hypoxia or asphyxia has not changed significantly in recent years despite marked improvements in labor management. Perinatal mortality in these circumstances may therefore reflect antenatal compromise and subsequent alteration of the fetal capacity to r...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000033827.48974.c8
更新日期:2002-10-22 00:00:00
abstract:BACKGROUND:Cardiac resynchronization therapy has emerged as an important therapy for advanced systolic heart failure. Among available cardiac resynchronization therapy pacing modes that restore ventricular synchrony, it is uncertain whether simultaneous biventricular (BiV), sequential BiV, or left ventricular (LV) paci...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.106.634444
更新日期:2007-04-24 00:00:00
abstract:BACKGROUND:Considerable controversy exists on the association between coffee consumption and cardiovascular disease (CVD) risk. A meta-analysis was performed to assess the dose-response relationship of long-term coffee consumption with CVD risk. METHODS AND RESULTS:PubMed and EMBASE were searched for prospective cohor...
journal_title:Circulation
pub_type: 杂志文章,meta分析,评审
doi:10.1161/CIRCULATIONAHA.113.005925
更新日期:2014-02-11 00:00:00
abstract:BACKGROUND:Early graft failure after the use of less satisfactory autologous grafts (30% of all vein grafts) is caused primarily by the following problems: (1) suitable autologous transplants are limited; (2) biotechnology has not yet been able to produce reliable graft substitutes that are legally and ethically approv...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:
更新日期:2001-09-18 00:00:00
abstract:BACKGROUND:A subgroup of patients with hypertrophic obstructive cardiomyopathy remain severely symptomatic despite optimal medical therapy. Septal myectomy reduces or eliminates left ventricular outflow obstruction and produces marked symptomatic improvement. With the recent advent of alternative methods for treatment ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.3.467
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:Intraoperative mapping studies suggest that an isthmus of myocardium between the mitral valve annulus and the border of inferior myocardial infarction may play a role in the genesis of ventricular tachycardia. We examined the frequency with which a slow conduction zone within the mitral isthmus was critical ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.12.3481
更新日期:1995-12-15 00:00:00
abstract:BACKGROUND:In the preterm newborn, a patent ductus arteriosus is in large part a result of the increased sensitivity of the immature ductus to prostaglandin E2 (PGE2). PGE2 acts through 3 G protein-coupled receptors (EP2, EP3, and EP4) that activate both adenyl cyclase and K(ATP) channels. We explored these pathways to...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000145159.16637.5D
更新日期:2004-10-19 00:00:00
abstract::Of 22 children with congenital complete heart block (CCHB) available for study, 14 (63.6%) were born to 11 mothers with clinical or laboratory evidence of connective tissue disease, primarily lupus erythematosus (LE). Seven mothers had both clinical and laboratory evidence of disease while four had only positive labor...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.56.1.82
更新日期:1977-07-01 00:00:00
abstract:BACKGROUND:It is not known whether progression of aortic arch (AA) atheroma is associated with vascular events in patients with stroke or transient ischemic attack (TIA). METHODS AND RESULTS:AA atheroma was detected on baseline transesophageal echocardiogram in 167 consecutive patients who had prevalent stroke or TIA....
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.671727
更新日期:2007-08-21 00:00:00
abstract:BACKGROUND:Atrial fibrillation is common in advanced heart failure, but its prognostic significance is controversial. METHODS AND RESULTS:We evaluated the relation of atrial rhythm to overall survival and sudden death in 390 consecutive advanced heart failure patients. Etiology of heart failure was coronary artery dis...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.84.1.40
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:Iron overload has an increasing worldwide prevalence and is associated with significant cardiovascular morbidity and mortality. Elevated iron levels in the myocardium lead to impaired systolic and diastolic function and elevated oxidative stress. Taurine accounts for 25% to 50% of the amino acid pool in myoc...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000124229.40424.80
更新日期:2004-04-20 00:00:00