Abstract:
BACKGROUND:In patients with symptoms of heart failure, elevations in B-type natriuretic peptide (BNP) accurately identify ventricular dysfunction. However, BNP levels are not specific for ventricular dysfunction in patients who do not have overt symptoms of heart failure, suggesting that other cardiac processes such as myocardial ischemia may also cause elevations in BNP. METHODS AND RESULTS:To determine whether BNP elevations are associated with myocardial ischemia, we measured plasma BNP levels before performing exercise treadmill testing with stress echocardiography in outpatients with stable coronary disease. Of the 355 participants, 113 (32%) had inducible ischemia. Compared with participants in the lowest BNP quartile (0 to 16.4 pg/mL), those in the highest quartile of BNP (> or =105 pg/mL) had double the risk of inducible ischemia (adjusted relative risk, 2.0; 95% CI, 1.2 to 2.6; P=0.008). The relation between elevated BNP levels and inducible ischemia was especially evident in the 206 participants who had a history of myocardial infarction (adjusted relative risk, 2.6; 95% CI, 1.5 to 3.7, P=0.002) and was absent in those without a history of myocardial infarction (adjusted relative risk, 1.0; 95% CI, 0.3 to 2.2; P=0.9). This association between BNP levels and inducible ischemia remained strong after adjustment for measures of systolic and diastolic dysfunction. CONCLUSIONS:Elevated levels of BNP are independently associated with inducible ischemia among outpatients with stable coronary disease, particularly among those with a history of myocardial infarction. The observed association between BNP levels and ischemia may explain why tests for BNP are not specific for ventricular dysfunction among patients with coronary disease.
journal_name
Circulationjournal_title
Circulationauthors
Bibbins-Domingo K,Ansari M,Schiller NB,Massie B,Whooley MAdoi
10.1161/01.CIR.0000103681.04726.9Csubject
Has Abstractpub_date
2003-12-16 00:00:00pages
2987-92issue
24eissn
0009-7322issn
1524-4539pii
01.CIR.0000103681.04726.9Cjournal_volume
108pub_type
杂志文章相关文献
CIRCULATION文献大全abstract:BACKGROUND:We previously demonstrated that reduced vagal activity and/or increased sympathetic activity identify post-myocardial infarction patients at high risk for cardiac mortality. Simple and inexpensive autonomic markers are necessary to perform autonomic screening in large populations. We tested our hypothesis th...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.545111
更新日期:2005-09-27 00:00:00
abstract:BACKGROUND:The acute effect of atrial fibrillation (AF) on the atrial effective refractory period (ERP) in humans is unknown. METHODS AND RESULTS:In 20 patients without structural heart disease, the atrial ERP was measured before and after pacing-induced AF at drive cycle lengths of 350 and 500 ms. Immediately after s...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.7.1600
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Bone marrow-derived cells have been shown to contribute to endothelial replacement after vascular injury. In vitro culture of peripheral blood mononuclear cells produces cells with phenotypic characteristics of endothelium. To test the hypothesis that delivery of autologous culture-modified mononuclear cells...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000089084.48655.49
更新日期:2003-09-23 00:00:00
abstract::Nineteen patients with chronic low output cardiac failure were studied before, during and after infusion of phentolamine in doses of 10, 20, 30 and 40 microgram/kg/min. Significant reduction of left- and right-sided pressures and increases in cardiac index and heart rate (HR) were present within 15 minutes of starting...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.58.1.157
更新日期:1978-07-01 00:00:00
abstract::Although the postoperative hemodynamic and echocardiographic features of idiopathic hypertrophic subaortic stenosis have been studied, the expected consistent postoperative thinning of the interventricular septum has not been reported. In this study, the short-term effects of septal myectomy were evaluated in 16 patie...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.58.5.850
更新日期:1978-11-01 00:00:00
abstract:BACKGROUND:Mesenchymal stem cells (MSCs) are bone marrow stromal cells that are in phase 1 clinical studies of cellular cardiomyoplasty. However, the electrophysiological effects of MSC transplantation have not been studied. Although improvement of ventricular function would represent a positive outcome of MSC transpla...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.593038
更新日期:2006-04-18 00:00:00
abstract::Cardiac allograft vasculopathy (CAV) remains a troublesome long-term complication of heart transplantation. It is manifested by a unique and unusually accelerated form of coronary disease affecting both intramural and epicardial coronary arteries and veins.CAV is characterized by vascular injury induced by a variety o...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/01.cir.96.6.2069
更新日期:1997-09-16 00:00:00
abstract:BACKGROUND:This study sought to evaluate the clinical impact of angiographic complete revascularization (CR) after drug-eluting stent implantation or coronary artery bypass graft surgery for multivessel coronary disease. METHODS AND RESULTS:A total of 1914 consecutive patients with multivessel coronary disease undergo...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.110.005041
更新日期:2011-05-31 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:Vascular endothelial growth factor (VEGF) is an endothelial cell-specific mitogen that is angiogenic in vitro and in vivo. It has been hypothesized that VEGF plays a role in myocardial collateral formation; however, the effects of VEGF on collateral flow to ischemic myocardium are unknown. METHODS AND RESUL...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.89.5.2183
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:Xenografts ultimately fail as a result of acute vascular rejection (AVR), a process characterized by intravascular thrombosis, fibrin deposition, and endothelial cell activation. METHODS AND RESULTS:We studied whether targeted deletion of Fgl-2, an inducible endothelial cell procoagulant, (Fgl-2-/-) in the ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.534271
更新日期:2005-07-12 00:00:00
abstract::Mitral pressure half-time (T1/2) is widely used as an independent measure of mitral valve area in patients undergoing percutaneous mitral valvotomy. However, fluid dynamics theory predicts T1/2 to be strongly dependent on chamber compliance and the peak transmitral gradient, which are variables that change dramaticall...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.78.4.980
更新日期:1988-10-01 00:00:00
abstract:BACKGROUND:Myocardial necrosis can occur during percutaneous coronary intervention (PCI) despite optimal adjunctive pharmacology and careful technique. We investigated the mechanisms of procedural infarction using angiographic analysis, intravascular ultrasound, and delayed-enhancement magnetic resonance imaging. METH...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/CIRCULATIONAHA.105.593210
更新日期:2006-08-15 00:00:00
abstract:BACKGROUND:The application of iloprost, a stable prostacyclin analogue, by inhalation has been shown to improve hemodynamic variables in patients with primary pulmonary hypertension. However, repetitive inhalations are required due to its short-term effects. One potential approach to prolong and increase the vasorelaxa...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/hc3601.096826
更新日期:2001-09-11 00:00:00
abstract:BACKGROUND:Chronic inhibition of endothelial nitric oxide (NO) synthesis by the administration of N:(omega)-nitro-L-arginine methyl ester (L-NAME) to rats induces early vascular inflammatory changes (monocyte infiltration into coronary vessels and monocyte chemoattractant protein-1 [MCP-1] expression) as well as subseq...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.18.2243
更新日期:2000-10-31 00:00:00
abstract:BACKGROUND:Cardiac-targeted expression of truncated K(v)4.2 subunit (K(v)4.2N) reduces transient outward current (I(to)) density, prolongs action potentials (APs), and enhances contractility in 3- to 4-week-old transgenic mice. By 13 to 15 weeks of age, these mice develop severely impaired cardiac function and signs of...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000014211.47830.4d
更新日期:2002-04-16 00:00:00
abstract:BACKGROUND:Cardiac growth and function may be modulated in part by trophic effects of neurohormones. Specifically, aldosterone has been shown to stimulate the growth of cardiac myocytes and the accumulation of cardiac extracellular matrix proteins. Moreover, a variant of the aldosterone synthase gene (a cytosine/thymid...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.99.17.2255
更新日期:1999-05-04 00:00:00
abstract:BACKGROUND:Cystathionine γ-lyase (CSE) produces H2S via enzymatic conversion of L-cysteine and plays a critical role in cardiovascular homeostasis. We investigated the effects of genetic modulation of CSE and exogenous H2S therapy in the setting of pressure overload-induced heart failure. METHODS AND RESULTS:Transvers...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.112.000855
更新日期:2013-03-12 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate the prevalence of skeletal muscle atrophy and its relation to exercise intolerance and abnormal muscle metabolism in patients with heart failure (HF). METHODS AND RESULTS:Peak VO2, percent ideal body weight (% IBW), 24-hour urine creatinine (Cr), and anthropometr...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.85.4.1364
更新日期:1992-04-01 00:00:00
abstract::Diseases that cause symptoms incompletely relieved by available modes of treatment stimulate search for new therapies. Chronic disease processes, in which interventions are palliative rather than curative provide a particular challenge in determining the value of therapeutic intervention. Management of patients with a...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND:Although there is a statistically significant association between modestly raised baseline plasma C-reactive protein (CRP) values and future cardiovascular events, the debate is still unsettled in regard to whether CRP plays a causal role in the pathogenesis of atherosclerosis. METHODS AND RESULTS:We genera...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.109.872796
更新日期:2009-11-24 00:00:00
abstract::The benefit of cholesterol-lowering therapy in the prevention of coronary heart disease (CHD) is well established. The secondary prevention Scandinavian Simvastatin Survival Study (4S) and the primary prevention West of Scotland Coronary Prevention Study (WOSCOPS) demonstrated that lipid lowering with a statin can dra...
journal_title:Circulation
pub_type:
doi:10.1161/01.cir.99.8.e1
更新日期:1999-03-02 00:00:00
abstract::We determined the efficacy, pharmacokinetics, and plasma concentration-response relationships of propafenone, a promising new antiarrhythmic drug. Thirteen patients with frequent and complex ventricular premature beats were studied after receiving four increasing doses, during drug washout and during a randomized doub...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.68.3.589
更新日期:1983-09-01 00:00:00
abstract:BACKGROUND:Patients with acute ischemic right ventricular dysfunction often develop hemodynamic compromise, yet most manifest spontaneous early clinical improvement and later recovery of global right ventricular performance. This study was designed to delineate the determinants of right ventricular performance followin...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.88.2.696
更新日期:1993-08-01 00:00:00
abstract::Cerebral neurons can tolerate at least 20 min of normothermic ischemic anoxia. Cerebral recovery from more than 5 min of cardiac arrest is hampered by complex secondary derangements of multiple organ systems after reperfusion. There is increasing support of our hypothesis that this "postresuscitation syndrome" include...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:
更新日期:1986-12-01 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:The composition of plaque is a major determinant of coronary-related clinical syndromes. Intravascular ultrasound (IVUS) elastography has proven to be a technique capable of reflecting the mechanical properties of phantom material and the femoral arterial wall. The aim of this study was to investigate the ca...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.6.617
更新日期:2000-08-08 00:00:00
abstract:BACKGROUND:Blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) has been used to measure T2* changes in skeletal muscle tissue of healthy volunteers. The BOLD effect is assumed to primarily reflect changes in blood oxygenation at the tissue level. We compared the calf muscle BOLD response of patien...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.605717
更新日期:2006-06-27 00:00:00
abstract:BACKGROUND:Healthy levels of lifestyle factors can reduce the risk of cardiovascular disease. However, except for smoking status, often considered a traditional risk factor, their effect on cardiovascular risk prediction is unclear. METHODS AND RESULTS:We used a case-cohort design of postmenopausal nonsmokers in the m...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.114.012069
更新日期:2014-10-21 00:00:00
abstract:BACKGROUND:Integrins are involved in structural remodeling and tissue repair. This study aimed to elucidate the role of the beta-integrins in cardiac remodeling after myocardial infarction (MI). METHODS AND RESULTS:The MI model was created by ligation of the left anterior descending coronary artery in rats. We detecte...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000051363.86009.3c
更新日期:2003-02-25 00:00:00