Abstract:
BACKGROUND:This multicenter trial was conducted to determine the efficacy and safety of pimobendan, an inotropic agent with calcium-sensitizing properties and activity as a phosphodiesterase inhibitor, in patients with heart failure. METHODS AND RESULTS:One hundred ninety-eight ambulatory patients with symptoms of moderate to severe heart failure despite therapy with digitalis and diuretics with or without a single vasodilator were randomly assigned to receive either placebo (n = 49) or pimobendan (n = 149) in a double-blind fashion for 12 weeks. A dose range of pimobendan was used including 2.5 (n = 49), 5 (n = 51), or 10 mg/day (n = 49). One hundred fifty-eight (80%) patients were taking a converting enzyme inhibitor (CEI) and 28 (14%) patients were taking a non-CEI vasodilator. At end point, the 5-mg dose of pimobendan significantly increase exercise duration compared with placebo (121.6 +/- 19.1 seconds, p less than 0.001), whereas the 10-mg dose produced an increase of borderline significance (81.1 +/- 19.5 seconds, p = 0.05). Peak VO2 was significantly increased by 2.23 +/- 0.58 ml/kg/min in the 5-mg group (p less than 0.01 versus placebo). Furthermore, quality of life measured with the Minnesota Living With Heart Failure Questionnaire improved by 8.5 +/- 2.3 units in the 5-mg group compared with 1.3 +/- 2.2 units in the placebo group (p less than 0.01). There were a total of 23 all-cause hospitalizations in the placebo group, which was significantly greater compared with 33 in the three groups treated with pimobendan (p less than 0.01). There were no significant differences between the placebo and pimobendan groups with respect to changes in ejection fraction and plasma norepinephrine measured at baseline and at the completion of the 12-week study, proarrhythmic effect, or the number of patients with a significant adjustment in background therapy. Eleven patients died, including three (6%) on placebo and eight (5%) on pimobendan (p = NS). Among all adverse events, headache tended to be more common in the pimobendan groups compared with placebo, with the incidence increasing with dose (p less than 0.05). CONCLUSIONS:These data demonstrate that pimobendan significantly increases exercise duration, peak VO2, and quality of life in patients with heart failure. Pimobendan appears to be useful adjunctive therapy when added to digitalis, diuretics, and vasodilators.
journal_name
Circulationjournal_title
Circulationauthors
Kubo SH,Gollub S,Bourge R,Rahko P,Cobb F,Jessup M,Brozena S,Brodsky M,Kirlin P,Shanes Jdoi
10.1161/01.cir.85.3.942subject
Has Abstract,Author List Incompletepub_date
1992-03-01 00:00:00pages
942-9issue
3eissn
0009-7322issn
1524-4539journal_volume
85pub_type
临床试验,杂志文章,多中心研究,随机对照试验相关文献
CIRCULATION文献大全abstract:BACKGROUND:AMP-activated protein kinase (AMPK) is a stress-activated protein kinase that works as a metabolic sensor of cellular ATP levels. Here, we investigated whether AMPK signaling has a role in the regulation of the angiotensin II (Ang II)-induced proliferation signal in rat vascular smooth muscle cells (VSMCs). ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000136025.96811.76
更新日期:2004-07-27 00:00:00
abstract:BACKGROUND:Both glucose-insulin-potassium (GIK) and tri-iodothyronine (T3) may improve cardiovascular performance after coronary artery surgery (CABG) but their effects have not been directly compared and the effects of combined treatment are unknown. METHODS AND RESULTS:In 2 consecutive randomized double-blind placeb...
journal_title:Circulation
pub_type: 杂志文章,随机对照试验
doi:10.1161/CIRCULATIONAHA.105.000786
更新日期:2006-07-04 00:00:00
abstract:BACKGROUND:CD4+CD28null T cells are present in increased numbers in the peripheral blood of patients with acute coronary syndrome (ACS) compared with patients with chronic stable angina (CSA). The triggers of activation and expansion of these cells to date remain unclear. METHODS AND RESULTS:Twenty-one patients with A...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000118476.29352.2A
更新日期:2004-03-16 00:00:00
abstract:BACKGROUND:We developed a computer model to predict lysis rates of thrombi for intravenous thrombolytic regimens based on the convective/diffusive penetration of reacting and adsorbing fibrinolytic species from the circulation into the proximal face of a dissolving clot. METHODS AND RESULTS:Solution of a one-compartme...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.4.763
更新日期:1996-08-15 00:00:00
abstract:BACKGROUND:There are few comparative data regarding long-term nonfatal outcomes for women versus men after coronary artery bypass grafting (CABG). This study compares gender differences in cardiac events in a population of hospital survivors up to 11 years after isolated CABG surgery in Ontario, Canada. METHODS AND RE...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.576652
更新日期:2006-01-31 00:00:00
abstract:BACKGROUND:The outcome of aortic valve replacement in patients with severe aortic stenosis, low transvalvular gradient, and severe left ventricular dysfunction is not well known. METHODS AND RESULTS:Between 1985 and 1995, 52 patients with left ventricular ejection fraction (EF) < or =35% and aortic stenosis with trans...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.101.16.1940
更新日期:2000-04-25 00:00:00
abstract:BACKGROUND:We have reported that there is a limitation of exercise capacity in mice with defects in the expression of endothelial nitric oxide (NO) synthase, which is associated with a greater increase in whole-body oxygen consumption (VO2). We hypothesized that in states in which superoxide anion (O2-) is increased, e...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000159261.11520.63
更新日期:2005-03-29 00:00:00
abstract:BACKGROUND:The diagnosis of infective endocarditis (IE) in prosthetic valves and intracardiac devices is challenging because both the modified Duke criteria (DC) and echocardiography have limitations in this population. The added value of (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/computed ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.115.015316
更新日期:2015-09-22 00:00:00
abstract::We have previously shown that a brief episode of ischemia slows the rate of ATP depletion during subsequent ischemic episodes. Additionally, intermittent reperfusion may be beneficial to the myocardium by washing out catabolites that have accumulated during ischemia. Thus, we proposed that multiple brief ischemic epis...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.74.5.1124
更新日期:1986-11-01 00:00:00
abstract::Cardiovascular disease continues to be the leading cause of death among women in the United States. One of the barriers to improving cardiovascular disease outcomes in women is the lack of reliable, effective screening modalities. Breast arterial calcification has emerged as a potential risk stratification tool. Local...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.118.038092
更新日期:2019-02-19 00:00:00
abstract:BACKGROUND:Endothelial dysfunction is associated with atherosclerosis and may contribute to ischemic syndromes. We assessed the contribution of endothelium-derived nitric oxide (NO) and vasodilator prostanoids to resting blood flow, metabolic vasodilation, and flow reserve in the human coronary circulation. METHODS AN...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.100.19.1951
更新日期:1999-11-09 00:00:00
abstract:BACKGROUND:Very early (day 4) hospital discharge has recently been proposed for selected patients with acute myocardial infarction (MI). The purpose of this study was to determine the most useful factors for identifying acute MI patients treated with aggressive interventional therapy who could be safely discharged on d...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.83.4.1186
更新日期:1991-04-01 00:00:00
abstract::To determine the effects of coronary angioplasty on coronary flow reserve (CFR), we studied 32 patients before and immediately after single-vessel coronary angioplasty and 31 patients evaluated late after angioplasty (7.5 +/- 1.2 months, mean +/- SEM). The geometry (percent area stenosis and minimal cross-sectional ar...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.77.4.873
更新日期:1988-04-01 00:00:00
abstract:BACKGROUND:Television viewing time, the predominant leisure-time sedentary behavior, is associated with biomarkers of cardiometabolic risk, but its relationship with mortality has not been studied. We examined the associations of prolonged television viewing time with all-cause, cardiovascular disease (CVD), cancer, an...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.109.894824
更新日期:2010-01-26 00:00:00
abstract:BACKGROUND:Precise noninvasive evaluation of pulmonary artery (PA) morphology is extremely important for medical and surgical management of patients with cyanotic heart disease. In this study, the accuracy of two-dimensional echocardiography combined with color Doppler flow mapping to assess the size, stenosis, and atr...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.89.3.1306
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:Administration of protease inhibitors (PIs) to HIV-infected individuals has been associated with hyperlipidemia. In this study, we characterized the lipoprotein profile in subjects receiving ritonavir, indinavir, or nelfinavir, alone or in combination with saquinavir. METHODS AND RESULTS:Plasma lipoprotein ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.100.7.700
更新日期:1999-08-17 00:00:00
abstract:BACKGROUND:Ultrafast computed tomography (CT), by acquiring images of the proximal coronary arteries, detects coronary calcifications and has been demonstrated to be highly sensitive for the detection of coronary artery disease in many small studies. The aim of this study was to determine the relationship between ultra...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1161/01.cir.93.5.898
更新日期:1996-03-01 00:00:00
abstract::Since the discovery that neuregulin-1 (NRG-1)/ErbB signaling is indispensable in cardiac development, evidence has shown that this system also plays a crucial role in the adult heart. In patients, an inhibitory ErbB2 antibody, trastuzumab, used in the treatment of mammary carcinomas, increases the risk for the develop...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/CIRCULATIONAHA.107.690487
更新日期:2007-08-21 00:00:00
abstract::Premature opening of the pulmonary valve (opening independent of atrial or ventricular systole) was originally described in a case of sinus of Valsalva rupture into the right atrium. Since that time we have observed five additional cases in which the pulmonary valve opened prematurely. Entities encountered included: 1...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.55.1.128
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:Gene-nutrient interactions affecting high-density lipoprotein cholesterol (HDL-C) concentrations may contribute to the interindividual variability of the cardiovascular disease risk associated with dietary fat intake. Hepatic lipase (HL) is a key determinant of HDL metabolism. Four polymorphisms in linkage d...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000036597.52291.c9
更新日期:2002-10-29 00:00:00
abstract:BACKGROUND:Fibrosis and progressive failure are prominent pathophysiological features of hearts after myocardial infarction (MI). We examined the effects of inhibiting transforming growth factor-beta (TGF-beta) signaling on post-MI cardiac fibrosis and ventricular remodeling and function. METHODS AND RESULTS:MI was in...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000165066.71481.8E
更新日期:2005-05-17 00:00:00
abstract::The endothelin (ET) system is comprised of 4 active ETs, with ET-1 being the predominant isoform in the cardiovascular system. Because of the potent vasoconstricting and mitogenic effects of ET-1 and its involvement in various cardiovascular diseases, blockade of the ET receptor has received considerable attention. ET...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/01.CIR.0000094397.19932.78
更新日期:2003-11-04 00:00:00
abstract::The relationship between the degree of obesity and the incidence of cardiovascular disease (CVD) was reexamined in the 5209 men and women of the original Framingham cohort. Recent observations of disease occurrence over 26 years indicate that obesity, measured by Metropolitan Relative Weight, was a significant indepen...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.67.5.968
更新日期:1983-05-01 00:00:00
abstract:BACKGROUND:Current studies have demonstrated that applying therapeutic hypothermia for 12 to 24 hours after resuscitation from cardiac arrest improves the outcomes of cardiopulmonary resuscitation. The present study investigated whether a shorter duration of therapeutic hypothermia induced quickly and early after resus...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.111.062257
更新日期:2012-01-03 00:00:00
abstract:BACKGROUND:We tested the hypothesis that long-term administration of the specific angiotensin II subtype 1 (AT1)-receptor blocker BMS-186295 will regress hypertrophy and modify left ventricular angiotensin converting enzyme (ACE) expression in rats with ascending aortic stenosis. METHODS AND RESULTS:Six weeks after su...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.95.6.1592
更新日期:1997-03-18 00:00:00
abstract:BACKGROUND:We conducted a 10-year follow-up of the 11 712 patients with acute myocardial infarction randomized in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto-1 study, the first large trial assessing thrombolytic therapy. METHODS AND RESULTS:Information on survival at 10 years was obtained for th...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.98.24.2659
更新日期:1998-12-15 00:00:00
abstract:BACKGROUND:Although c-Kit+ adult progenitor cells were initially reported to produce new cardiomyocytes in the heart, recent genetic evidence suggests that such events are exceedingly rare. However, to determine if these rare events represent true de novo cardiomyocyte formation, we deleted the necessary cardiogenic tr...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.118.033703
更新日期:2018-09-04 00:00:00
abstract:BACKGROUND:It is not clear why some plaque ruptures lead to acute coronary syndromes (ACS) but others do not. METHODS AND RESULTS:We analyzed 80 plaque ruptures in 74 patients and compared culprit lesions of ACS patients with nonculprit lesions of ACS patients and lesions of non-ACS patients; both culprit and nonculpr...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.CIR.0000097121.95451.39
更新日期:2003-11-18 00:00:00
abstract:BACKGROUND:Interleukin-8 (IL-8) secreted from endothelial cells is a powerful neutrophil chemoattractant and activator. We hypothesized that human endothelial cells deprived of oxygen would secrete IL-8, which might translate into elevated IL-8 production after cardiac ischemia. Furthermore, we hypothesized that corona...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.92.9.428
更新日期:1995-11-01 00:00:00
abstract::The formula for survival in resuscitation describes educational efficiency and local implementation as key determinants in survival after cardiac arrest. Current educational offerings in the form of standardized online and face-to-face courses are falling short, with providers demonstrating a decay of skills over time...
journal_title:Circulation
pub_type: 共识发展会议,杂志文章,评审
doi:10.1161/CIR.0000000000000583
更新日期:2018-08-07 00:00:00