Abstract:
BACKGROUND:Carvedilol therapy during congestive heart failure demonstrated a good efficacy in mortality rate reduction and in improvement of left ventricular (LV) systolic performance. However, currently there is not any finding about the drug's effect on diastolic filling. The aim of this study was to evaluate the effects of beta-blocker treatment on LV diastolic function with an eco-pulsed Doppler ultrasound scanning examination at transmitral level in a group of patients who were affected by heart failure with a restrictive filling pattern. METHODS:We studied 27 patients with idiopathic or ischemic dilated cardiomyopathy with LV severe systolic disfunction (ejection fraction <35%). Fourteen patients were randomized to receive carvedilol treatment (carvedilol group), and 13 patients continued to receive standard therapy with angiotensin-converting enzyme inhibitors, diuretics, and vasodilators (placebo group). All patients underwent an echo-Doppler ultrasound scanning examination at the beginning of the study and after 4 and 12 months of treatment. RESULTS:In the carvedilol group, we found a progressive improvement of Doppler ultrasound scanning parameters after 4 months, with a significant increase of A wave (P <.005), deceleration time (DT; P <.02) and isovolumetric relaxation time (IVRT; P <.02). These improvements were confirmed after 1 year of follow-up, whereas patients in the placebo group did not shown any significant modifications. After 1 year, the differences in these groups were more significant for A wave (39 +/- 4 cm/sec carvedilol group vs 30 +/- 4 cm/sec placebo group; P <.0001), for E/A ratio (1.8 +/- 0.2 carvedilol group vs 2.6 +/- 0.5 placebo group; P <.0002), for DT 1(40 +/- 16 msec carvedilol group vs 112 +/- 13 msec placebo group; P <.001), and for IVRT (74 +/- 8 msec carvedilol group vs 57 +/- 7 mesc placebo group; P <.0002). These changes seem to happen before systolic and morphological modifications. CONCLUSION:Our results show that carvedilol therapy is a means of modifying parameters of diastolic filling favorably in patients with heart failure. These effects seem to be independent of those of systolic function. The improvement of systolic performance occurs after 1 year of treatment. The restrictive filling pattern, related to an unfavorable prognosis, changes toward pseudonormal or altered relaxation pattern during carvedilol therapy. Further investigations with a greater sample size will be necessary to confirm our findings.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Palazzuoli A,Carrera A,Calabria P,Puccetti L,Pastrorelli M,Pasqui AL,Auteri A,Bruni Fdoi
10.1016/s0002-8703(03)00525-8subject
Has Abstractpub_date
2004-01-01 00:00:00pages
E2issue
1eissn
0002-8703issn
1097-6744pii
aS0002870303005258journal_volume
147pub_type
临床试验,杂志文章,随机对照试验abstract:BACKGROUND:Few data are available on the temporal patterns of health resource utilization (HRU) and expenditures around paroxysmal supraventricular tachycardia (PSVT) diagnosis. This study assessed the longitudinal trends in HRU and expenditures in the 3 years preceding and subsequent to PSVT diagnosis. METHODS:Adult ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2020.12.012
更新日期:2021-01-15 00:00:00
abstract::Left ventricular (LV) adaptation to the hemodynamic load of pregnancy has been studied with load-sensitive ejection-phase indexes, but the results of these studies are conflicting. The aim of this study was to examine the effects of the hemodynamic load of pregnancy on the contractile state of the left ventricle by us...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70247-3
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) continues to be one of the most common cardiac problems, placing an expanding burden on the public health system. In several circumstances, AF can increase the risk of stroke and heart failure. Current pharmacologic treatment options are associated with the potential for significant ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.05.024
更新日期:2009-08-01 00:00:00
abstract:AIMS:Cardiac e-consults may be an effective way to deliver value-oriented outpatient cardiology care in an accountable care organization. Initial results of cardiac e-consults have demonstrated high satisfaction among both patients and referring providers, no known adverse events, and low rates of diagnostic testing. N...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2015.11.019
更新日期:2016-03-01 00:00:00
abstract::We tested whether overload of the two ventricles may be associated with a preponderance of interventricular septum in patients with high blood pressure. The rationale is that the septum is shared by the greater and lesser circulation and that in hypertension the latter shows the same qualitative hemodynamic alteration...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90626-6
更新日期:1988-08-01 00:00:00
abstract::Sixty-five patients with dilated cardiomyopathy were studied by means of 24-hour ECG monitoring. Ventricular arrhythmias were present in 62 (95.4%), of whom 52 (80%) showed a complex form (multiform ventricular extrasystoles, pairs, and ventricular tachycardia). Forty-one patients, presenting with complex ventricular ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90711-3
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND:Nitroglycerin is known to augment vessel wall squeezing at the site with coronary-myocardial bridging (CMB). This study was designed to define the mechanism of nitroglycerin-induced augmentation of CMB in clinical settings. METHODS:We analyzed nitroglycerin reactivity at the site with CMB in 39 patients. Ma...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70123-7
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Platelets play an important role in the natural history of coronary artery disease. Enhanced platelet aggregation and receptor expression unquestionably occur after coronary stent implantation; however, the functional characteristics of platelets before stenting have not been fully elucidated. METHODS:Plate...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.116478
更新日期:2001-10-01 00:00:00
abstract::To determine whether the first postpacing interval after entrainment was affected by recording and pacing sites, overdrive atrial pacing was undertaken in 13 episodes of atrial flutter with a mean flutter cycle length (FCL) of 140 +/- 8 msec induced in seven dogs. Atrial flutter was induced by means of an anatomic obs...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90259-7
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:Strenuous exercise can be a major trigger for coronary thrombosis and it enhances platelet aggregation. METHODS:We evaluated the effect of antiplatelet therapy on shear stress-induced platelet aggregation (SIPA), in addition to agonist-induced aggregation, before and immediately after ergometer exercise in ...
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.2001.116485
更新日期:2001-08-01 00:00:00
abstract::The aim of our study was to compare the outcome of patients with a first acute myocardial infarction (AMI) among three large cohorts of patients hospitalized between 1966 and 1992 in Israel, in view of changes in treatment facilities and investigation methods. Patients with a first AMI constituted 71% of all myocardia...
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:10.1016/0002-8703(95)90351-8
更新日期:1995-09-01 00:00:00
abstract::This prospective study evaluated the accuracy of phase analysis of scintigraphic imaging in defining the site of earliest ventricular activation in pediatric patients with electrophysiologic disorders. Twenty patients (10.8 +/- 5.5 years) with preexcitation (n = 16) or ventricular tachycardia (VT) (n = 4) were indepen...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90015-2
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND:We investigated the role of the renin-angiotensin system in women with signs and symptoms of ischemia without obstructive coronary artery disease (CAD). Although microvascular dysfunction has been suggested to explain this syndrome and recently was found to predict adverse outcomes, the mechanisms and treatm...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2011.07.011
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Cardiac resynchronization therapy (CRT) improves outcomes, functional capacity and quality of life in patients with heart failure. Despite two decades of experience with CRT, the rate of non-response remains approximately 30%. CRT efficacy is impacted by pacing location, which is anatomically limited in conv...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2019.04.002
更新日期:2019-11-01 00:00:00
abstract::Hemodynamic and echocardiographic data from 33 consecutive patients undergoing cardiac transplantation were correlated with endomyocardial biopsy results to determine whether reversible restrictive hemodynamics accompany histologic evidence of transplant rejection. During the study period 251 biopsy specimens were obt...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90475-w
更新日期:1991-10-01 00:00:00
abstract::Magnetic resonance imaging (MRI) produces high-resolution images of great-vessel anatomy in pediatric patients. In this study seven patients, aged 6 to 27 months were evaluated by using gated MRI and two-dimensional echocardiography 4 to 26 months after arterial switch operation for D-transposition of the great arteri...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90486-3
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:P2Y12 receptor antagonist therapy is recommended in addition to ASA for up to 1 year after acute coronary syndrome to reduce ischemic events. In contrast, the benefit of long-term dual antiplatelet therapy beyond 1 year remains unclear. Ticagrelor is a potent, reversibly binding P2Y12 receptor-antagonist tha...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2013.12.020
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Heart rate recovery (HRR) is a marker of vagal tone that is associated with survival, but little is known about the effects of exercise training on HRR in patients with heart failure (HF). METHODS:Twenty-four patients with HF were randomized to a 2-month residential rehabilitation program or to usual care. ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.02.038
更新日期:2007-06-01 00:00:00
abstract::The addition of IAC to otherwise standard CPR provides for the application of external pressure over the abdomen in counterpoint to the rhythm of chest compression. Interposed abdominal compression is a simple manual technique that can supplement the use of adrenergic drugs to increase both coronary perfusion pressure...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(94)90132-5
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:To examine sex differences in pain and associated symptoms in patients with exercise-related ischemia, as well as the independence of these findings from other clinical factors. METHODS:Prospective study of 482 women and 425 men (mean age 58 years) undergoing exercise stress testing with myocardial perfusio...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.06.028
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:The long-term prognostic significance of early (<48 hours) ventricular fibrillation (VF) or sustained ventricular tachycardia (VT) in patients with an acute myocardial infarction remains controversial. Emerging data suggest that some of the benefit of renin-angiotensin-aldosterone system (RAAS) antagonism ma...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.05.023
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Although angiotensin-converting enzyme inhibitor attenuates ventricular enlargement, whether beta-blocker therapy induces regression of left ventricular remodeling is not known. The purpose of this study was to compare the effects of bisoprolol therapy with those of imidapril therapy on left ventricular remo...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1067/mhj.2000.110934
更新日期:2000-12-01 00:00:00
abstract::Calcium channel blockers and central alpha-agonists are among the classes of antihypertensive drugs that yield the most favorable overall effects on risk factors for hypertension-related end-organ damage. An open-label prospective trial in 42 patients with a mean baseline blood pressure of 144/102 mm Hg sought to asse...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(93)90707-g
更新日期:1993-10-01 00:00:00
abstract:BACKGROUND:The optimal antibiotic treatment length for infective endocarditis (IE) is uncertain. International guidelines recommend treatment duration of up to 6 weeks for patients with left-sided IE but are primarily based on historical data and expert opinion. Efficacies of modern therapies, fast recovery seen in man...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2020.05.012
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Recent data indicate that cardiac antibodies play an active role in the pathogenesis of dilated cardiomyopathy (DCM) and may contribute to cardiac dysfunction in patients with DCM. The present study investigated the influence of immunoadsorption with subsequent immunoglobulin G substitution (IA/IgG) on cardi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2010.01.012
更新日期:2010-05-01 00:00:00
abstract::In vitro studies have established that intravascular ultrasound is a reliable technique for accurate assessment of vascular anatomic structure and disease conditions before and after intervention. In addition, quantitative data from intravascular ultrasound studies correspond well with histologic findings, which serve...
journal_title:American heart journal
pub_type: 社论,评审
doi:10.1016/s0002-8703(96)90263-x
更新日期:1996-09-01 00:00:00
abstract::We compared the effects of IV digoxin (0.04 mg/kg) and nitroprusside (NP) (1.2 and 1.8 microgram/kg/min) on left ventricular (LV) performance in six preinstrumented conscious dogs with 3 and 6 hours after digoxin administration (serum level, 3.5 +/- 0.6 ng/ml), there were no changes in heart rate, LV systolic (LVSP) a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90335-0
更新日期:1982-04-01 00:00:00
abstract:BACKGROUND:Coronary artery disease in women appears 10 to 15 years later than in men. To test the hypothesis that the effects of estrogen may manifest themselves as histologic differences in coronary plaques, we examined the hearts of premenopausal and postmenopausal women who died suddenly from coronary artery disease...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.109946
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:Many young investigators are interested in cardiovascular (CV) outcomes research; however, the current training experience of early investigators across the United States is uncertain. METHODS:From April to November 2014, we surveyed mentees and mentors of early-stage CV outcomes investigators across the Un...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2017.07.022
更新日期:2018-02-01 00:00:00
abstract::Twelve cirrhotic patients with portal hypertension and esophageal varices were treated with nadolol for 1 month, and the effects on renal and hepatic hemodynamics and function were studied. A significant decrease in cardiac output, portohepatic gradient, and effective hepatic blood flow was found, whereas mean arteria...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90602-1
更新日期:1984-10-01 00:00:00