Abstract:
BACKGROUND:Maximal hyperaemia is paramount in the diagnosis of patients with coronary artery disease. However in these patients, enhanced alpha-adrenergic microvascular vasoconstriction may preclude adenosine to induce maximal hyperaemia. AIM:To assess the presence and the clinical relevance of residual microvascular resistance after administration of adenosine. METHODS AND RESULTS:Fractional flow reserve (FFR, calculated by coronary pressure measurements during adenosine-induced hyperaemia) was assessed in 85 patients with an intermediate coronary stenosis (mean diameter stenosis of 50+/-1%) and normal left ventricular function which were divided into the following three groups: (a) 33 patients before and after IC bolus of phentolamine, an alpha1-, alpha2-adrenergic blocker; (b) 32 patients before and after IC bolus of urapidil, a selective alpha1-adrenergic blocker; (c) 20 patients before and after IC bolus of saline. Since minimal luminal diameter remained unchanged before and after phentolamine (1.46+/-0.06 vs. 1.47+/-0.06 mm, ns), urapidil (1.46+/-0.06 vs. 1.39+/-0.08, ns), and saline (1.56+/-0.08 vs. 1.55+/-0.08, ns), changes in FFR reflects changes in microvascular resistance. Overall, phentolamine and urapidil induced a slight but significant decrease in FFR (phentolamine: 0.79+/-0.02 vs. 0.77+/-0.02, p<0.05; urapidil: 0.78+/-0.02 vs. 0.75+/-0.02, p<0.05). However, only 6 patients showed a change in FFR from > or = 0.75 to <0.75 and no patients showed a change in FFR from > or = 0.80 to <0.75 that could have influenced clinical decision making. Saline did not induce any change in FFR. Phentolamine and urapidil induced only transient and negligible haemodynamic changes in heart rate and blood pressure. CONCLUSIONS:The administration of alpha-adrenergic blockers in addition to adenosine unmasks a small, yet clinically irrelevant, degree of residual microvascular tone. The consequential changes in FFR values do not significantly affect clinical decision making.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Barbato E,Bartunek J,Aarnoudse W,Vanderheyden M,Staelens F,Wijns W,Heyndrickx GR,Pijls NH,De Bruyne Bdoi
10.1016/j.ehj.2004.09.003subject
Has Abstractpub_date
2004-11-01 00:00:00pages
2034-9issue
22eissn
0195-668Xissn
1522-9645pii
S0195-668X(04)00635-9journal_volume
25pub_type
杂志文章abstract::The early termination of clinical trials, for either benefit or harm, often generates undue enthusiasm or alarm. The enhanced publicity attending early termination of a trial promotes inappropriate interpretations because of the inherent difficulty of a prompt and comprehensive data review. Furthermore, the process of...
journal_title:European heart journal
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract:AIMS:Although dilated cardiomyopathy is the most frequent form of cardiomyopathy, its aetiology is still poorly understood. In about 20-30% of cases the disease is familial with a large predominance of autosomal dominant transmission. Ten different chromosomal loci have been described for autosomal dominant forms of di...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2000.2245
更新日期:2000-11-01 00:00:00
abstract::There is mounting evidence to support the influence of inflammation in the pathogenesis of atrial fibrillation (AF). Indeed, AF is associated with increased levels of known inflammatory markers, even after adjustment for confounding factors. The renin-angiotensin-aldosterone system (RAAS) appears to play a key role in...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehi645
更新日期:2006-01-01 00:00:00
abstract::The acute electrophysiologic effects of clinical doses of procainamide, lidocaine, metoprolol, digoxin and atropine upon the conduction of ventricular premature beats, were studied in 48 healthy volunteers. The conduction time of the first premature beat, induced 1 ms after the ventricular effective refractory period ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061755
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:Electrocardiographic abnormalities and premature ventricular contractions are common in athletes and are generally benign. However, the specific outcome of high-level endurance athletes with frequent and complex ventricular arrhythmias is unclear. Also, information on the predictive accuracy of different inv...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/s0195-668x(03)00282-3
更新日期:2003-08-01 00:00:00
abstract:AIMS:To evaluate the predictive value of high sensitivity (hs) C-reactive protein levels on long-term survival in patients with ST-elevation myocardial infarction (STEMI) treated with primary PCI. METHODS AND RESULTS:We conducted a retrospective analysis of 758 STEMI patients (from January 2003 to December 2005), with...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm338
更新日期:2008-05-01 00:00:00
abstract:AIMS:The cardiac extracellular matrix is highly involved in regulating inflammation, remodelling, and function of the heart. Whether matrix alterations relate to the degree of inflammation, fibrosis, and overall rejection in the human transplanted heart remained, until now, unknown. METHODS AND RESULTS:Expression of m...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehs375
更新日期:2013-07-01 00:00:00
abstract:AIMS:The risk of gastrointestinal (GI) bleeding limits the use of antiplatelet and anticoagulant drugs. Risk factors for GI bleeding in post- myocardial infarction (MI) patients have not been well defined. We sought to identify risk factors for GI bleeding in patients following MI. METHODS AND RESULTS:The VALsartan In...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehp256
更新日期:2009-09-01 00:00:00
abstract:AIM:Elevated brain natriuretic peptide (BNP) and tumour marker antigen carbohydrate 125 (CA125) levels have shown to be associated with higher risk for adverse outcomes in patients with acute heart failure (AHF). Nevertheless, no attempt has been made to explore the utility of combining these two biomarkers. We sought ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehq142
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:In the acute phase of myocardial infarction (acute MI) marked endothelial damage occurs within the first 24h following thrombolysis with streptokinase. We investigated whether this is associated with a change in levels of vascular endothelial growth factor (VEGF, possibly marking angiogenesis) in the first 2...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2002.3312
更新日期:2002-10-01 00:00:00
abstract::Atrial fibrillation is a frequent cause of stroke; in the elderly, more than 20% of strokes are attributed to this common arrhythmia. Anticoagulation with warfarin reduces the risk of stroke by ∼60%; however, a large proportion of patients with atrial fibrillation do not receive this treatment because of relative/abso...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehr393
更新日期:2012-03-01 00:00:00
abstract:AIMS:Chronic kidney disease (CKD) was found to be an independent risk factor for all-cause mortality as well as adverse cardiovascular disease (CVD) events in high-risk populations. Findings from population-based studies are scarce and inconsistent. We investigated the gender-specific association of CKD with all-cause ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi880
更新日期:2006-05-01 00:00:00
abstract::The choice of oral anticoagulant (OAC) for patients with atrial fibrillation (AF) may be influenced by individual clinical features or by patterns of risk factors and comorbidities. We reviewed analyses of subgroups of patients from trials of vitamin K antagonists vs. non-vitamin K oral anticoagulants (NOACs) for stro...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehw069
更新日期:2017-03-21 00:00:00
abstract:AIMS:Efficacy of aspirin in primary prevention of cardiovascular disease (CVD) may be influenced by a common allele in guanylate cyclase GUCY1A3, which has been shown to modify platelet function and increase CVD risk. METHODS AND RESULTS:We investigated whether homozygotes of the GUCY1A3 rs7692387 risk (G) allele bene...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehz384
更新日期:2019-11-01 00:00:00
abstract::To assess possible clinical and angiographic factors associated with acute coronary events following PTCA, we performed quantitative angiography in 168 consecutive patients who had undergone successful angioplasty in a native vessel (94 for stable angina, 74 for unstable angina), and who were restudied (24 +/- 15 week...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061051
更新日期:1995-08-01 00:00:00
abstract:AIMS:Cardiomyopathy produces significant mortality in patients with Friedreich ataxia (FA), a genetic disorder that produces intra-mitochondrial iron accumulation. We sought to test the hypothesis that abnormal myocardial perfusion reserve and fibrosis represent early manifestations of cardiomyopathy. METHODS AND RESU...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehq443
更新日期:2011-03-01 00:00:00
abstract:AIMS:This study evaluated the predictive value of NT-proBNP for patients with diabetes mellitus and compared the prognostic aptitude of this neurohumoral marker to traditional markers of cardiovascular events. METHODS AND RESULTS:A prospective observational study was conducted in 631 diabetic patients. The composite e...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehn334
更新日期:2008-09-01 00:00:00
abstract:AIMS:To determine the sequence of critical cardiovascular events in the progression of heart failure, and whether aetiology or high-dose vs low-dose lisinopril affected these pathways. METHODS AND RESULTS:This was a post-hoc investigation of the ATLAS database, which comprised 3164 patients with chronic heart failure,...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2000.2570
更新日期:2001-09-01 00:00:00
abstract:AIM:Short-term psychological stress is associated with an immediate physiological response and may be associated with a transiently higher risk of cardiovascular events. The aim of this study was to determine whether brief episodes of anger trigger the onset of acute myocardial infarction (MI), acute coronary syndromes...
journal_title:European heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1093/eurheartj/ehu033
更新日期:2014-06-01 00:00:00
abstract::It is now recognised after many years of speculation regarding the role of mammalian atria in the direct regulation of intravascular volume, that atrial myocites produce a peptide hormone that results in natriuresis and diuresis, under the condition of atrial distention. This atrial natriuretic factor (ANF) is secrete...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/9.suppl_h.29
更新日期:1988-06-01 00:00:00
abstract:AIMS:Surgery in patients with infective endocarditis (IE) can be elective (upon completion of antibiotic treatment) or urgent (before antibiotic treatment has ended) when the clinical course is unfavourable. However, urgent surgery for left-sided endocarditis is associated with high mortality. The aims of this study we...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehl315
更新日期:2007-01-01 00:00:00
abstract::In a prospective study, an elderly group of patients (n = 63, 47 male, 16 female, age 40-65 years) was examined before and after open-heart surgery under cardiopulmonary bypass: postoperatively, 19 patients (30%) showed no clinical neuropsychiatric symptoms, whereas in 35 patients (56%) mild or transient neurological ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.7.885
更新日期:1993-07-01 00:00:00
abstract:AIMS:Patients with acute coronary syndrome (ACS) in the Myocardial Ischaemia Reduction with Aggressive Cholesterol Lowering (MIRACL) study had diminished cardiovascular events after 16 weeks of treatment of atorvastatin 80 mg daily. We determined whether plasma lipoproteins at baseline and then at 6 weeks after randomi...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/eurheartj/ehi186
更新日期:2005-05-01 00:00:00
abstract::This report of an ESC Study Group reviews current knowledge on myocardial hibernation and relevant imaging techniques, and provides an algorithm for investigation and management when a patient presents with ischaemic left ventricular dysfunction. It covers the definitions of myocardial viability, stunning and hibernat...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ehj.2004.03.012
更新日期:2004-05-01 00:00:00
abstract::This study has compared the effect on heart rate control of the addition of pindolol 15 mg bd or verapamil 40 mg tds to maintenance digoxin therapy in 12 patients with chronic atrial fibrillation. The study was performed in a randomized cross-over fashion. Treatment effects were assessed by 24-h ambulatory electrocard...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/oxfordjournals.eurheartj.a059386
更新日期:1989-01-01 00:00:00
abstract:AIMS:Atrial fibrillation (AF) is the most frequent arrhythmia in humans. Rare familial forms exist. Recent evidence indicates a genetic susceptibility to common forms of AF. The alpha-subunit of the myocardial I(Kr)-channel, encoded by the KCNH2 gene, is crucial to ventricular and atrial repolarization. Patients with m...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm619
更新日期:2008-04-01 00:00:00
abstract:AIMS:To investigate the effects of secretory phospholipase A2 (sPLA(2)) inhibition on plasma lipoproteins. Secretory phospholipase A2 isoenzymes promote atherosclerosis by mechanisms that include lipoprotein modification, retention, and oxidation. METHODS AND RESULTS:Phospholipase Levels And Serological Markers of Ath...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehq374
更新日期:2011-04-01 00:00:00
abstract:AIMS:To perform a retrospective analysis of subgroups of patients enrolled into the European Myocardial Infarct Amiodarone Trial (EMIAT) in order to identify patients who might benefit from prophylactic amiodarone treatment and patients in whom amiodarone might be harmful. METHODS:Baseline characteristics of the 1486 ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1997.0823
更新日期:1998-01-01 00:00:00
abstract::Aortic stenosis is one of the most common forms of acquired valvular heart disease. The development of symptoms, namely syncope, angina, or heart failure, in patients with severe aortic stenosis predicts a high likelihood of mortality. Aortic valve replacement is the current standard of care. In truly asymptomatic pat...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehs190
更新日期:2012-10-01 00:00:00
abstract::Factors that exacerbate the risk of atherosclerotic plaque formation include cigarette smoking, hypertension, hypercholesterolaemia, sedentary lifestyle, and oestrogen deficiency. The potentially important role of oestrogen deficiency in this process is evidenced by the significant increase in cardiovascular risk obse...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/17.suppl_d.32
更新日期:1996-08-01 00:00:00