Imaging and diagnostic testing: diastolic dysfunction after coronary artery bypass grafting: a frequent finding of clinical significance not influenced by intravenous calcium.

Abstract:

BACKGROUND:Diastolic dysfunction is common immediately after coronary artery bypass surgery (CABG). The duration of this phenomenon is unknown. Intravenous calcium is frequently administered during separation from cardiopulmonary bypass (CPB). We sought to determine whether intravenous calcium influences perioperative diastolic function and whether diastolic dysfunction persists into the postoperative period. METHODS AND RESULTS:Patients undergoing first-time elective CABG (n = 29) were randomly assigned to receive intravenous calcium chloride (n = 13) or placebo (n = 16) during separation from CPB. Diastolic function was assessed by the pressure-area relation with transesophageal echocardiography and pulmonary capillary wedge pressure (PCWP) measured simultaneously. Left ventricular end-diastolic area (LVEDA) and Doppler indexes were measured at comparable PCWP (within 2 mm Hg) at baseline, after separation from CPB, after sternal closure, and 3 hours after surgery. After CABG, both groups had a significant decrease in LVEDA and mitral E-wave deceleration time that persisted at 3 hours. Because there were no significant differences between the calcium and control groups at any time point, the data for the entire study cohort was analyzed. The LVEDA decreased (stiffness increased) progressively from 16.9 +/- 3.4 cm2 at baseline to 15.8 +/- 2.9 cm2 after CPB, 14.9 +/- 2.5 cm2 after sternal closure, and 14.3 +/- 3.1 cm2 at 3 hours after surgery (P <.0001). The mitral E-wave deceleration time measured at the same time points was 168 +/- 47 ms, 136 +/- 25 ms, 137 +/- 36 ms, and 111 +/- 44 ms (P =.0001). CONCLUSIONS:An increase in left ventricular diastolic chamber stiffness is nearly universal after CABG, and it persists for at least 3 hours after surgery. An intravenous bolus of calcium chloride given during separation from CPB has no measurable negative effect on diastolic function. In the setting of increased chamber stiffness, the PCWP alone does not adequately reflect the volume status and effective preload of the left ventricle.

journal_name

Am Heart J

journal_title

American heart journal

authors

Ekery DL,Davidoff R,Orlandi QG,Apstein CS,Hesselvik JF,Shemin RJ,Shapira OM

doi

10.1016/S0002-8703(02)94786-1

subject

Has Abstract

pub_date

2003-05-01 00:00:00

pages

896-902

issue

5

eissn

0002-8703

issn

1097-6744

pii

S0002870302947861

journal_volume

145

pub_type

临床试验,杂志文章,随机对照试验
  • Coronary artery bypass grafting versus percutaneous coronary intervention for myocardial infarction complicated by cardiogenic shock.

    abstract:BACKGROUND:Myocardial infarction (MI) complicated by cardiogenic shock (CS) is associated with high mortality. Early coronary revascularization improves survival, but the optimal mode of revascularization remains uncertain. We sought to characterize practice patterns and outcomes of coronary artery bypass grafting (CAB...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/j.ahj.2020.01.020

    authors: Smilowitz NR,Alviar CL,Katz SD,Hochman JS

    更新日期:2020-08-01 00:00:00

  • Progression to left ventricular dilatation in patients with hypertrophic obstructive cardiomyopathy.

    abstract::Congestive heart failure with dilated left ventricle developed in two patients with symptomatic hypertrophic obstructive cardiomyopathy. Both patients previously underwent cardiac surgery for relief of their outflow obstruction. Alterations in structure and function of the left ventricle during their episode of cardia...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(79)90012-7

    authors: ten Cate FJ,Roelandt J

    更新日期:1979-06-01 00:00:00

  • Blood pressure and atrial natriuretic peptides correlate throughout the day.

    abstract::Vessel dilator consisting of amino acids (a.a.) 31-67 and atrial natriuretic factor (ANF) composed of a.a. 99-126 of the 126 a.a. ANF prohormone circulate in humans and have potent vasodilatory properties. To determine whether these atrial natriuretic peptides are directly related to blood pressure in healthy normoten...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(95)90111-6

    authors: Sothern RB,Vesely DL,Kanabrocki EL,Bremner FW,Third JL,Boles MA,Nemchausky BM,Olwin JH,Scheving LE

    更新日期:1995-05-01 00:00:00

  • Myocardial infarction in young Indian patients: risk factors and coronary arteriographic profile.

    abstract::One hundred four patients (101 men, three women), under 40 years of age, with myocardial infarction (MI), underwent coronary arteriography. Eighty patients had significant obstructive coronary artery disease (CAD) (group 1), 23 had normal coronary arteries (group 2), and one patient had coronary ostial stenosis as a r...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(86)90680-0

    authors: Kaul U,Dogra B,Manchanda SC,Wasir HS,Rajani M,Bhatia ML

    更新日期:1986-07-01 00:00:00

  • Non-warfarin oral anticoagulant copayments and adherence in atrial fibrillation: A population-based cohort study.

    abstract:BACKGROUND:In patients with atrial fibrillation, incomplete adherence to anticoagulants increases risk of stroke. Non-warfarin oral anticoagulants (NOACs) are expensive; we evaluated whether higher copayments are associated with lower NOAC adherence. METHODS:Using a national claims database of commercially-insured pat...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/j.ahj.2020.12.010

    authors: Rome BN,Gagne JJ,Avorn J,Kesselheim AS

    更新日期:2021-01-14 00:00:00

  • A randomized trial of a 1-hour troponin T protocol in suspected acute coronary syndromes: Design of the Rapid Assessment of Possible ACS In the emergency Department with high sensitivity Troponin T (RAPID-TnT) study.

    abstract:BACKGROUND:Protocols incorporating high-sensitivity troponin to guide decision making in the disposition of patients with suspected acute coronary syndromes (ACS) in the emergency department have received a lot of attention. Traditionally, patients with chest pain have required long periods of observation in emergency ...

    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.2017.05.004

    authors: Papendick C,Blyth A,Seshadri A,Edmonds MJR,Briffa T,Cullen L,Quinn S,Karnon J,Chuang A,Nelson AJ,Horsfall M,Morton E,Chew DP

    更新日期:2017-08-01 00:00:00

  • The effects of cytochrome C on the extent of myocardial infarction and regional function of the ischemic myocardium.

    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

    authors: Zalewski A,Goldberg S,Krol R,Maroko PR

    更新日期:1987-01-01 00:00:00

  • Drug-eluting stents for the treatment of bifurcation lesions: a randomized comparison between paclitaxel and sirolimus stents.

    abstract:BACKGROUND:Drug-eluting stents have been shown to reduce restenosis in many types of lesions. The purpose of this article is to assess the efficacy of sirolimus- and paclitaxel-eluting stents in patients with bifurcation lesions. METHODS:Between June 2003 and October 2004, 205 patients were enrolled in a prospective r...

    journal_title:American heart journal

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ahj.2006.10.017

    authors: Pan M,Suárez de Lezo J,Medina A,Romero M,Delgado A,Segura J,Ojeda S,Mazuelos F,Hernandez E,Melian F,Pavlovic D,Esteban F,Herrador J

    更新日期:2007-01-01 00:00:00

  • Alcohol intake is not associated with subclinical coronary atherosclerosis.

    abstract:BACKGROUND:The inverse relation between alcohol intake and clinical coronary artery disease (CAD) is well established, although the mechanisms remain speculative. We studied the relation between alcohol intake and subclinical CAD to assess the possible role of alcohol in atherogenesis. METHODS:We conducted a prospecti...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/j.ahj.2004.05.023

    authors: Tofferi JK,Taylor AJ,Feuerstein IM,O'Malley PG

    更新日期:2004-11-01 00:00:00

  • Intraoperative assessment of left ventricular heterogeneity.

    abstract::To evaluate regional differences in thickness and systolic function of human myocardium perfused by angiographically normal coronary arteries in valvular and ischemic heart disease, we performed intraoperative epicardial M-mode mapping of ventriculographically normal wall regions (perfused by normal coronary arteries)...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(86)90273-5

    authors: Douglas PS,Reichek N,Franklin K,Muhammad A,Sutton MG,Harken A

    更新日期:1986-08-01 00:00:00

  • Contrast bidimensional echocardiography in the morphologic and functional postoperative evaluation of the Senning technique for complete transposition of the great vessels.

    abstract::Contrast bidimensional echocardiographic (2DE) studies were performed in eight patients with d-transposition of the great vessels in the postoperative period of the Senning technique. Contrast was injected into a peripheral vein of all patients, and into the arterial atrium in five in the postoperative period. The 2DE...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(84)90552-0

    authors: Pasalodos J,González V,Suárez de Lezo J,Concha M,Vallés F

    更新日期:1984-07-01 00:00:00

  • Superiority of visual versus computerized echocardiographic estimation of radionuclide left ventricular ejection fraction.

    abstract::An optimal method for determining left ventricular ejection fraction (LVEF) by echocardiography should be rapid, reliable, and widely applicable in order to be utilized routinely in a busy clinical laboratory. Most methods reported in the literature are reliable in selected, high-quality echocardiograms. Most require ...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(89)90018-5

    authors: Amico AF,Lichtenberg GS,Reisner SA,Stone CK,Schwartz RG,Meltzer RS

    更新日期:1989-12-01 00:00:00

  • How diuretics lower blood pressure.

    abstract::Thiazides produce an average loss of 2 L of extracellular fluid volume, of which about 300 ml is plasma volume, during the first 48 hours of administration, and this reduction is maintained without further loss for as long as the drug is given. Do thiazides lower blood pressure by volume depletion or by direct vasodil...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(83)90116-3

    authors: Freis ED

    更新日期:1983-07-01 00:00:00

  • Different expressivity of a ventricular essential myosin light chain gene Ala57Gly mutation in familial hypertrophic cardiomyopathy.

    abstract:BACKGROUND:Familial hypertrophic cardiomyopathy (HCM) is a clinically and genetically heterogeneous disease of the sarcomere. Molecular genetic studies have shown that familial HCM involves mutations in 8 different genes that encode proteins of the myofibrillar apparatus. METHODS:We thoroughly searched these genes to ...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1067/mhj.2001.112487

    authors: Lee W,Hwang TH,Kimura A,Park SW,Satoh M,Nishi H,Harada H,Toyama J,Park JE

    更新日期:2001-02-01 00:00:00

  • Relationship between pharmacokinetics and pharmacodynamics of molsidomine and its metabolites in humans.

    abstract::The pharmacokinetic properties and hemodynamic effect of molsidomine and its pharmacologically active metabolite SIN-1 were investigated in 13 healthy volunteers following single oral doses. Hemodynamic changes were measured by finger plethysmography (peripheral arterial resistance), impedance plethysmography (venous ...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(85)90671-4

    authors: Meinertz T,Brandstätter A,Trenk D,Jähnchen E,Ostrowski J,Gärtner W

    更新日期:1985-03-01 00:00:00

  • Influence of long-acting nitrate therapy on the risk of reinfarction, sudden death, and total mortality in survivors of acute myocardial infarction.

    abstract::The effects of 20 variables that might influence postmyocardial infarction prognosis were assessed retrospectively in 139 patients followed up for an average of 11 months after discharge from San Francisco General Hospital following an acute myocardial infarction. When these variables were analyzed with the use of mul...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(85)90501-0

    authors: Rapaport E

    更新日期:1985-07-01 00:00:00

  • Effects of exercise training on left ventricular volumes and function in patients with nonischemic cardiomyopathy: application of magnetic resonance myocardial tagging.

    abstract:BACKGROUND:Exercise training is now an accepted component of the therapeutic regimen in patients with heart failure and underlying ischemia, but few data are available on the effects of training in patients with nonischemic dilated cardiomyopathy. METHODS:Twenty-four patients (mean age 55 +/- 9 years, mean ejection fr...

    journal_title:American heart journal

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1067/mhj.2002.124401

    authors: Myers J,Wagner D,Schertler T,Beer M,Luchinger R,Klein M,Rickli H,Muller P,Mayer K,Schwitter J,Dubach P

    更新日期:2002-10-01 00:00:00

  • Comparison of long-term outcomes between older Asian and white patients with non-ST-segment elevation myocardial infarction: findings from CRUSADE-CMS database.

    abstract:BACKGROUND:In the United States as well as globally, Asians are a growing proportion of patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI), yet little is known about their longitudinal outcomes. METHODS:We linked Centers for Medicare & Medicaid claims data to detailed clinical data for 37...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/j.ahj.2013.10.001

    authors: Xu W,Holmes DN,Becker RC,Roe MT,Peterson ED,Wang TY

    更新日期:2013-12-01 00:00:00

  • Exercise-induced alterations of signal-averaged electrocardiograms in marathon runners.

    abstract::Late potentials have been shown to predict malignant ventricular arrhythmias and sudden cardiac death. To determine whether prolonged, strenuous activity is associated with the development of ventricular late potentials, signal-averaged electrocardiography was performed on 30 marathon runners before, immediately after...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(89)90010-0

    authors: Smith GS,Vacek JL,Wilson DB,Hawkins JW,Boyer TA

    更新日期:1989-12-01 00:00:00

  • Hyponatremia in patients treated with lorcainide, a new antiarrhythmic drug.

    abstract::The effects of lorcainide, a new antiarrhythmic drug, on serum electrolytes and osmolality are described in a series of 33 patients with organic heart disease and complex ventricular arrhythmias treated with lorcainide. In eight patients, a mean decrease in serum Na+ of 8.25 +/- 3.2 mEq/L was observed after a single 2...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(84)90690-2

    authors: Somani P,Temesy-Armos PN,Leighton RF,Goodenday LS,Fraker TD Jr

    更新日期:1984-12-01 00:00:00

  • Amplitude of the first heart sound at rest and during exercise in normal subjects and in patients with coronary heart disease.

    abstract::The response of S1 amplitude to exercise stress was investigated in patients with coronary heart disease. Phonocardiograms were recorded at rest and during a multistage bicycle ergometer exercise test in a group of 22 patients with angina pectoris and documented coronary disease, and in a normal control group comprise...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(75)90461-5

    authors: Bergman ST Jr,Blomqvist CG

    更新日期:1975-12-01 00:00:00

  • Risk factors for acute and subacute stent thrombosis after high-pressure stent implantation: a study by intracoronary ultrasound.

    abstract:BACKGROUND:In the era of coronary stenting with high-pressure expansion, stent thrombosis remains a major life-threatening risk. Because of its superior imaging mode, intracoronary ultrasound could provide insight into potential risk factors for stent thrombosis. PATIENTS AND METHODS:In 215 patients with stent implant...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/s0002-8703(98)70097-3

    authors: Werner GS,Gastmann O,Ferrari M,Schuenemann S,Knies A,Diedrich J,Kreuzer H

    更新日期:1998-02-01 00:00:00

  • Rational and design of the INtentional COronary revascularization versus conservative therapy in patients undergOing successful peripheRAl arTEry revascularization due to critical limb ischemia trial (INCORPORATE trial).

    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

    authors: Toth G,Brodmann M,Barbato E,Mangiacapra F,Schneller L,Orias V,Gil R,Bil J,Bartus S,Ruzsa Z

    更新日期:2019-08-01 00:00:00

  • Short-term outcomes after percutaneous coronary intervention: effects of stenting and institutional volume shifts.

    abstract:BACKGROUND:This study examines how the dissemination of stenting and procedural shifts to high-volume facilities have affected short-term outcomes after percutaneous coronary intervention (PCI). METHODS:Discharge information from the 1994 and 1997 US Nationwide Inpatient Sample was used. Data from 1994 involved 84,036...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:

    authors: Watanabe CT,Maynard C,Ritchie JL

    更新日期:2002-08-01 00:00:00

  • Rupture of interventricular septum in acute myocardial infarction.

    abstract::Three cases of rupture of the interventricular septum occurring coincident with acute inferior myocardial infarction are reported and the relevant literature is reviewed. One patient under-went successful surgical repair and, in addition, had an aneurysmectomy. Clues and pitfalls in diagnosis as well as the possible c...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/s0002-8703(76)80407-3

    authors: Longo EA,Cohen LS

    更新日期:1976-07-01 00:00:00

  • Outpatient dobutamine and dopamine infusions in the management of chronic heart failure: clinical experience in 21 patients.

    abstract::Dobutamine (and dopamine) are potent positive inotropic drugs which are frequently given to treat decompensated congestive heart failure. This study reports on the use of ambulatory dobutamine (and dopamine) infusions in 21 outpatients with advanced congestive heart failure. Each patient was initially hospitalized, an...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(87)90757-5

    authors: Applefeld MM,Newman KA,Sutton FJ,Reed WP,Roffman DS,Talesnick BS,Grove WR

    更新日期:1987-09-01 00:00:00

  • Pulsed wave tissue Doppler-derived myocardial performance index for the assessment of left ventricular thrombus formation risk after acute myocardial infarction.

    abstract:BACKGROUND:Assessment of left ventricular (LV) thrombosis risk after acute myocardial infarction (AMI) is important because of potential embolic sequelae that are reduced by oral anticoagulant agents. The goal of this study was to investigate whether early assessment of LV systolic and diastolic performance with pulsed...

    journal_title:American heart journal

    pub_type: 临床试验,杂志文章

    doi:10.1016/j.ahj.2004.05.025

    authors: Yilmaz R,Celik S,Baykan M,Orem C,Kasap H,Durmus I,Erdol C

    更新日期:2004-12-01 00:00:00

  • "Silent" myocardial ischemia during and after exercise testing in patients with coronary artery disease.

    abstract::Although many patients with coronary artery disease (CAD) have a positive exercise test without pain, the frequency and significance of this "silent" ischemia is unclear. Therefore, we studied 122 consecutive clinically stable patients with angiographically defined CAD (greater than 75 per cent luminal stenosis) and a...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(78)90234-x

    authors: Lindsey HE Jr,Cohn PF

    更新日期:1978-04-01 00:00:00

  • Mitochondrial defects in cardiomyopathy and neuromuscular disease.

    abstract::Over the past 11 years, a considerable body of evidence has accumulated implicating defects in the mitochondrial energy-generating pathway, oxidative phosphorylation, in a wide variety of degenerative diseases including myopathy and cardiomyopathy. Most classes of pathogenic mitochondrial DNA mutations affect the hear...

    journal_title:American heart journal

    pub_type: 杂志文章,评审

    doi:10.1067/mhj.2000.103934

    authors: Wallace DC

    更新日期:2000-02-01 00:00:00

  • Sequential changes in regional coronary flow during pacing-induced angina pectoris: coronary flow limitation precedes angina.

    abstract::To investigate the sequence of changes in regional myocardial perfusion which precedes stress-induced angina, we measured great cardiac vein flow (GCVF), draining the anterior left ventricle, during incremental atrial pacing in 10 patients with normal anterior perfusion (group I) and in 11 patients with greater than o...

    journal_title:American heart journal

    pub_type: 杂志文章

    doi:10.1016/0002-8703(84)90374-0

    authors: Wilson JR,Martin JL,Untereker WJ,Laskey W,Hirshfeld JW

    更新日期:1984-02-01 00:00:00