Abstract:
BACKGROUND:Today most patients with congenital heart disease survive childhood to be cared for by adult cardiologists. The number of physicians that should be trained to manage these lesions is unknown because we do not know the number of patients. METHODS:To answer this question, the expected numbers of infants with each major type of congenital heart defect born in each 5-year period since 1940 were estimated from birth rates and incidence. The numbers expected to survive with or without treatment were estimated from data on natural history and the results of treatment. Finally, lesions were categorized as simple, moderate, or complex, based on the amount of expertise in management needed for optimal patient care. RESULTS:From 1940 to 2002, about 1 million patients with simple lesions, and half that number each with moderate and complex lesions, were born in the United States. If all were treated, there would be 750,000 survivors with simple lesions, 400,000 with moderate lesions, and 180,000 with complex lesions; in addition, there would be 3,000,000 subjects alive with bicuspid aortic valves. Without treatment, the survival in each group would be 400,000, 220,000, and 30,000, respectively. The actual numbers surviving will be between these 2 sets of estimates. CONCLUSIONS:Survival of patients with congenital heart disease, treated or untreated, is expected to produce large numbers of adults with congenital disease, and it is likely that many more adult cardiologists will need to be trained to manage moderate and complex congenital lesions.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Hoffman JI,Kaplan S,Liberthson RRdoi
10.1016/j.ahj.2003.05.003subject
Has Abstractpub_date
2004-03-01 00:00:00pages
425-39issue
3eissn
0002-8703issn
1097-6744pii
S0002870303007294journal_volume
147pub_type
杂志文章abstract::To assess the effects of chronic left ventricular (LV) dysfunction on intravascular pulmonary blood volume (PBV) and extravascular lung water (EVLW) lung fluid volumes, 56 dogs were evaluated by means of double-indicator dilution techniques. PBV and EVLW were measured in seven control dogs, in eight dogs 4 hours after...
journal_title:American heart journal
pub_type: 杂志文章,收录出版
doi:10.1016/0002-8703(84)90421-6
更新日期:1984-09-01 00:00:00
abstract::The method for evaluating right ventricular and pulmonary artery systolic pressures by subtracting the systolic pressure gradient across the ventricular septal defect from the cuff systolic blood pressure is documented. To confirm the reliability and accuracy of this method, simultaneous continuous wave Doppler echoca...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90116-q
更新日期:1993-04-01 00:00:00
abstract::Intracoronary stents may potentially alleviate some of the problems associated with coronary angioplasty. Since the anatomy and physiology of swine coronary arteries closely resemble those of humans, the response to implantation of the Glanturco-Roubin, balloon-expandable, flexible stent was studied in this model. Add...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90506-d
更新日期:1991-09-01 00:00:00
abstract::Quantitation of coronary luminal diameter with a 20 MHz mechanically rotating intravascular ultrasound (IVUS) catheter was compared with orthogonal-view cineangiography by use of a semiautomated edge-detection algorithm in 48 patients undergoing coronary angioplasty. Quantitative comparison of 196 matched segments was...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90110-4
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:Fractional flow reserve (FFR) has become a gold standard in physiological assessment of coronary artery stenosis. An FFR < 0.75 is considered as a reliable physiological parameter indicating functionally significant lesion. Lesion length (LL) may affect the translesional hemodynamics. However, the effect of ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.09.007
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Aldosterone antagonist therapy is recommended for selected patients with heart failure and reduced ejection fraction. Adherence to therapy in the transition from hospital to home is not well understood. METHODS:We identified patients with heart failure and reduced ejection fraction who were ≥65 years old, e...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2013.03.007
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Optimal antithrombotic treatment after transcatheter aortic valve replacement (TAVR) is unknown and determined empirically. The direct factor Xa inhibitor rivaroxaban may potentially reduce TAVR-related thrombotic complications and premature valve failure. DESIGN:GALILEO is an international, randomized, ope...
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.2016.10.017
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) in the setting of heart failure (HF) is linked to embolic stroke and exacerbation of HF. The rate of new-onset AF in patients with left ventricular dysfunction and mild to moderate HF enrolled in the SoLVD trials was significantly lower with enalapril than with placebo (5.4% vs 24% o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.07.027
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Observational studies have shown apparently lower ischemic coronary disease risk in postmenopausal women receiving hormone replacement therapy (HRT). However, several recent studies have shown an increase in ischemic cardiac events when HRT is initiated in postmenopausal women with known coronary artery dise...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2004.10.028
更新日期:2005-09-01 00:00:00
abstract::Under electrophysiologic studies, 44 asymptomatic chagasic individuals were studied. The mean age was 39.9 years, with 26 being male. The surface ECG showed normal tracings in 12 patients, left anterior fascicular block in three, incomplete right bundle branch block in two, and right bundle branch block in 27 (isolate...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90206-5
更新日期:1983-08-01 00:00:00
abstract::The acute anatomic and valvular consequences of radiofrequency catheter ablation of accessory pathways were evaluated in 62 patients by means of serial echocardiographic examinations. Semiquantitative assessment of valvular incompetence and classification into one of four grades according to the width and the extensio...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90382-4
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:Despite the common practice of clopidogrel loading for coronary stenting, the time dependence and degree of platelet inhibition after this therapy are not well defined. We sought to establish an optimal clopidogrel dosing regimen for sustained platelet inhibition in stented patients. METHODS AND RESULTS:Pla...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2003.109
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Patients with diabetes have an increased incidence and severity of ischemic heart disease, which leads to an increased requirement for coronary revascularization. Comparative information regarding mode of revascularization--coronary artery bypass graft surgery surgery (CABG) or percutaneous coronary interven...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.07.001
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Recent studies suggest that smokers' coronary endothelial function is impaired because of increased oxidative stress, and their coronary flow velocity reserve (CFVR) is reduced. It is uncertain whether oral antioxidant vitamin C restores impaired CFVR in smokers. Recent technological advances in transthoraci...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.03.006
更新日期:2004-08-01 00:00:00
abstract::Current evidence suggests that the pathogenesis of atrial fibrillation (AF) is multifactorial. The observation that AF, once present, alters the electrophysiologic properties of the atrial myocardium causing self-perpetuation of the arrhythmia raised the importance of electrical remodeling in its pathogenesis. Althoug...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2008.10.009
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Most analyses of complications after percutaneous coronary intervention have been limited to angiographic predictors of abrupt closure. We sought to determine the relation between baseline clinical and angiographic characteristics and clinical ischemic events and whether treatment with the platelet glycoprot...
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:10.1053/hj.1999.v137.92521
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:Exercise training is recommended for chronic heart failure (HF) patients to improve functional status and reduce risk of adverse outcomes. Elevated plasma levels of amino-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), and cardiac troponin T (cTnT) are associ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2013.10.018
更新日期:2014-02-01 00:00:00
abstract::The hemodynamic effects of dopamine (DPM) and dobutamine (DBM) were compared in 13 patients with acute cardiogenic circulatory collapse. All patients presented with acute pump failure and inadequate systemic perfusion, and most were hypotensive. Nine patients had an acute myocardial infarction (AMI); the other four pa...
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)90562-2
更新日期:1982-06-01 00:00:00
abstract::Angiographic evidence of coronary dissection after angioplasty is found in 25% to 30% of cases. Although patients are usually asymptomatic, in a small percentage angioplasty-induced coronary dissection results in luminal impairment and ischemic complications. The present study was undertaken to identify factors respon...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(07)80008-1
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:This study assessed the feasibility of a 12-week program of exercise, with and without intramuscular testosterone supplementation, in male patients with chronic heart failure (CHF) and low testosterone status and collected preliminary data for key health outcomes. METHODS:Male patients with CHF (n = 41, age...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2012.09.016
更新日期:2012-12-01 00:00:00
abstract::To examine the relationship between the improvement of wall motion in infarcted regions after percutaneous transluminal coronary angioplasty (PTCA) and thallium-201 uptake in the delayed image of exercise thallium-201 scintigraphy before PTCA, 14 patients with anterior old myocardial infarction were studied. Exercise ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90053-c
更新日期:1993-01-01 00:00:00
abstract::The efficacy of chronic ambulatory captopril (CPT) therapy was evaluated over an 18-month period in 36 patients with refractory chronic congestive heart failure (CHF) by cardiac catheterization, treadmill exercise, nuclear scintigraphy, echocardiography, and symptomatology. Clinical improvement to New York Heart Assoc...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90043-6
更新日期:1982-11-01 00:00:00
abstract::The isovolumic relaxation time (IVRT) is an important noninvasive index of left ventricular diastolic function. Despite its widespread use, however, the IVRT has not been related analytically to invasive parameters of ventricular function. Establishing such a relationship would make the IVRT more useful by itself and ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90416-s
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Hypertrophic cardiomyopathy (HCM) is histopathologically characterized by myocyte hypertrophy, disarray, interstitial fibrosis, and small intramural coronary arteriole dysplasia, which contribute to disease progression. Longitudinal systolic and early diastolic strain rate (SR) measurements by speckle tracki...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.06.011
更新日期:2013-09-01 00:00:00
abstract::Echocardiography was performed on 26 patients with prosthetic Björk-Shiley aortic valves (BSAV). Technically satisfactory records were obtained in 22 patients. The systolic displacement of the valve disc varied from 1 to 1.8 cm. (mean, 1.4 cm.). Six patients developed valve dysfunction. Two patients had complete absen...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80215-3
更新日期:1976-03-01 00:00:00
abstract:BACKGROUND:We aimed to study the comparative safety and effectiveness of various antithrombotic treatment strategies among older adults with non-ST elevation myocardial infarction (NSTEMI) and atrial fibrillation (AF). METHODS:Using the CRUSADE registry linked to longitudinal Medicare claims data, we examined NSTEMI p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2012.01.017
更新日期:2012-04-01 00:00:00
abstract::Evaluation of mitral regurgitation is difficult whether invasive or noninvasive methods are used. The determination of the regurgitant volume itself cannot be done in clinical practice with reasonable accuracy. In six sheep with chronic mitral regurgitation, left ventricular and left atrial pressures were recorded wit...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90009-8
更新日期:1995-02-01 00:00:00
abstract::Electrophysiologic studies were prospectively performed in 91 consecutive patients referred for evaluation of sustained ventricular tachycardia or sudden cardiac death. Fifty-two patients had a history of sustained ventricular tachycardia and 39 patients had a history of sudden cardiac death. The identical stimulation...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90088-2
更新日期:1985-09-01 00:00:00
abstract:BACKGROUND:Plasma levels of brain natriuretic peptide (BNP) are increased in patients with left heart failure. In patients with severe pulmonary embolism (PE), primary right ventricular (RV) dysfunction is frequent. Little is known about BNP secretion in acute RV failure. METHODS:We prospectively studied 50 consecutiv...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(03)00528-3
更新日期:2004-01-01 00:00:00
abstract::A new shape-memory coil for transcatheter closure of the PDA was developed and evaluated in a dog PDA model. The coil is sensitive to temperature (composed of thermal shape-memory nickel-titanium). The coil was delivered to and implanted in the PDA model with a 5F catheter through the femoral artery. The PDA model was...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90189-1
更新日期:1996-05-01 00:00:00