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 LL on FFR has not been adequately assessed. We sought to evaluate the effect of LL on FFR in patients with angiographically intermediate coronary artery disease. METHODS:We performed FFR measurements by pressure guidewire in 63 intermediate-grade lesions (63 patients) by visual assessment. Lesion length and percent diameter stenosis (%DS) at the lesion site were determined by performing off-line quantitative coronary angiography analysis. RESULTS:Overall, there was a moderate inverse correlation between FFR and %DS (r = -0.55, P < .001). In addition, there was a weak inverse correlation between LL and FFR (r = -0.31, P < .001). Using a receiver operating characteristic curve analysis, an LL > or = 10 mm was identified as the best cutoff value for predicting an FFR < 0.75 (sensitivity 95%, specificity 66%, positive predictive power 48%, and negative predictive power 97%). The correlation between FFR and %DS was significantly improved for LL > or = 10 mm, as compared with LL < 10 mm (r = -0.78, P < .001; r = 0.16, P = NS; respectively). Similar improvement with LL was also observed for intermediate lesions by quantitative coronary angiography (%DS 50%-70%; r = 0.19, P = NS for LL < 10 mm; r = -0.74, P < .001 for LL > or = 10 mm). CONCLUSIONS:This study demonstrates that LL differentially affects the correlation between the functional assessment (FFR) and the "anatomic" severity (%DS) of coronary lesions and suggests that LL has a significant impact on the physiological significance of intermediate-grade coronary lesions.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Brosh D,Higano ST,Lennon RJ,Holmes DR Jr,Lerman Adoi
10.1016/j.ahj.2004.09.007subject
Has Abstractpub_date
2005-08-01 00:00:00pages
338-43issue
2eissn
0002-8703issn
1097-6744pii
S0002-8703(04)00606-4journal_volume
150pub_type
杂志文章abstract::There are selective blocking agents (antagonists) for alpha receptors and beta receptors. These blocking agents prevent the response to injected agonists and neurogenically released norepinephrine. The principal cardiovascular response to alpha blockade is postural hypotension with reflexly induced cardiac stimulation...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80020-8
更新日期:1976-12-01 00:00:00
abstract::The effects and possible mechanisms of actions of indomethacin on systemic and coronary hemodynamics were studied in 17 patients with coronary artery disease. Group I patients (12) were given either indomethacin or placebo in the absence of prior cyclooxygenase inhibition and group II (five) were given indomethacin af...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(85)90149-8
更新日期:1985-08-01 00:00:00
abstract::To determine whether mitral valve annulus displacement (MVAD) can be used to assess septal contractility in patients with paradoxical septal motion, we assessed four atrioventricular regions (septum, lateral wall, anterior wall, and inferior wall) by MVAD in 80 consecutive patients. The patients were divided into five...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90062-9
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Furthermore, patients with T2DM and acute coronary syndrome (ACS) have a particularly high risk of CV events. The glucagon-like peptide 1 receptor agonist, lixisenatide, improves glyc...
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.2015.02.002
更新日期:2015-05-01 00:00:00
abstract::Guidelines published in 2001 recommended 1 regional adult congenital heart disease (ACHD) center per 3 to 10 million population. Our objective was to determine if published guidelines on the numbers of regional ACHD centers are sufficient to meet the needs of adults with congenital heart disease in the general populat...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2008.08.029
更新日期:2009-01-01 00:00:00
abstract::Although cardiovascular disease remains the leading cause of death in the United States, cardiovascular disease mortality has decreased steadily during the past 2 decades. This trend is largely attributable to improved detection and management of cardiovascular risk factors, in which the Framingham Heart Study has pla...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80050-x
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:We evaluated the influence of peak respiratory exchange ratio (pRER), as an index of effort adequacy, on peak VO2 prognostic reliability in patients with chronic heart failure (CHF) and reduced exercise capacity, whose peak VO2 may be underestimated because of poor patient motivation. METHODS:A cardiopulmon...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/S0002-8703(03)00100-5
更新日期:2003-06-01 00:00:00
abstract::To evaluate the stability of precordial ST-segment mapping techniques in assessing ischemic myocardial injury, we studied 28 patients with acute anterior myocardial infarction using a 49-lead electrocardiographic system (1 mV. = 10 mm.). The sum of ST elevations in millimeters was taken as an index of ischemic injury,...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80011-2
更新日期:1977-05-01 00:00:00
abstract::Clinical and experimental evidence suggest that sympathoadrenal activation contributes to mortality in patients with ischemic heart disease. To determine the level of sympathoadrenal activation in the very early phase of acute myocardial infarction (AMI) and to determine if location of infarction (anterior versus infe...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90408-7
更新日期:1981-07-01 00:00:00
abstract::The aortocaval fistula is a classic model of pure cardiac volume overload in rats. This model is characterized by dilation of the ventricular cavities and eccentric cardiac hypertrophy. There are also changes in peripheral arterial flow: high flow in the proximal part of the aorta, upstream of the shunt, and low flow ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90929-4
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:Despite advances in treatment of cardiogenic shock (CS), the incidence of this serious complication of acute ST-elevation myocardial infarction (STEMI) has stayed relatively constant, and rates of mortality, although somewhat improved in recent decades, remain dauntingly high. Although both percutaneous coro...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2009.10.035
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Moderate alcohol drinking and marine omega-3 fatty acids (omega3) have both been associated with low mortality from coronary heart disease (CHD). However, there is little data evaluating the interactions of wine ethanol drinking with omega3 in CHD patients. METHODS:The relationships between wine drinking an...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.08.009
更新日期:2008-01-01 00:00:00
abstract::To test the hypothesis that elevated plasma levels of natriuretic peptides may serve to identify patients with left ventricular (LV) dysfunction, we assessed the predictive diagnostic value of natriuretic peptide levels, in addition to clinical and electro-cardiographic risk factors, as noninvasive indicators of cardi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70079-6
更新日期:1997-09-01 00:00:00
abstract::Complex coronary morphologic abnormalities with thrombus and ulceration have been recognized in acute ischemic syndromes by angiography, angioscopy, and autopsy. However, in vivo histopathologic correlates of unstable ischemic syndromes have not been described. The purpose of this study was to characterize intracorona...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90612-2
更新日期:1994-09-01 00:00:00
abstract::In chronic heart failure (CHF) the contributing role of increased sympathetic activity and hemodynamic dysfunction in the genesis of ventricular arrhythmias has not been well established. To assess the relation between severe ventricular arrhythmias, hemodynamic impairment, and autonomic nervous system derangement, 14...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)80011-7
更新日期:1997-11-01 00:00:00
abstract::In 14 patients with severe congestive heart failure, the effects of captopril on the forearm circulation were evaluated with strain gauge plethysmography. Changes in plasma renin activity, angiotensin II, norepinephrine, epinephrine, bradykinin, prostaglandin E2, and 6-keto-prostaglandin F1 alpha concentrations were a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90662-5
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:Aortopulmonary collaterals (APCs) are frequently observed before and after the Fontan procedure. However, the mechanism of the development of APCs is unknown. We hypothesized that one or several antiangiogenic and/or angiogenic growth factors might play a role in the development of APCs. METHODS:Eighty-five...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.03.009
更新日期:2007-06-01 00:00:00
abstract::Ambulatory ECG recordings are routinely used to identify patients at increased risk of sudden cardiac death and to monitor changes in ventricular arrhythmias during antiarrhythmic drug therapy. The arrhythmia frequency established during the initial baseline has previously been reported to change during a second place...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(88)90139-1
更新日期:1988-10-01 00:00:00
abstract::Right ventricular myocardial infarction has been reported to occur exclusively in association with inferior left ventricular infarction. To determine the frequency of right ventricular myocardial infarction in association with anterior left ventricular myocardial infarction, all hearts with anterior myocardial infarct...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90004-4
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:In patients with chronic heart failure, the use of carvedilol therapy induces clinical and hemodynamic improvement. However, although the benefits of this beta-blocker have been established in patients with chronic heart failure, the mechanisms underlying them and the changes in left ventricular systolic fun...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-8703(00)90036-x
更新日期:2000-04-01 00:00:00
abstract:AIMS:In adults with coarctation of the aorta (CoA), hypertension (HTN) is a common long-term complication. We investigated the prevalence of HTN and analyzed factors associated with HTN. METHODS AND RESULTS:In the national register for congenital heart disease, 653 adults with repaired CoA were identified (mean age 36...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.07.012
更新日期:2016-11-01 00:00:00
abstract::We tested the efficacy of microwave-frequency energy for ablating atrial tachycardia in eight open-chest dogs. Five other dogs served as controls. Atrial tachycardia was induced by direct application of aconitine crystals to the epicardial atrial surface or by injection of aconitine solution (0.15 mg/ml) into the righ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90126-4
更新日期:1995-05-01 00:00:00
abstract::In over 30 years of surveillance of 2873 women, 574 developed initial clinical manifestations of CHD. A number of antecedent metabolic risk factors proved atherogenic, including blood lipids, glucose tolerance, uric acid, and menopause. Serum total cholesterol predicts as strongly in women as in men. The predictive po...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90511-4
更新日期:1987-08-01 00:00:00
abstract::Out of 156 patients with stable coronary heart disease randomized to either an exercise intervention group or a control group, 41 had complete gas analysis data. Continuous gas exchange data, including the ventilatory threshold, and selected heart rates were determined initially and at 1 year. The mean attendance for ...
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(85)90548-4
更新日期:1985-03-01 00:00:00
abstract:BACKGROUND:Stroke in patients with heart failure is associated with poor outcomes. Risk stratification schemes may improve clinical decision making in this patient population. This study investigated whether female sex is a risk factor for stroke in patients with heart failure in sinus rhythm. METHODS:This is a popula...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2014.12.004
更新日期:2015-03-01 00:00:00
abstract::To determine which method of surgical therapy might be optimal for patients with anomalous left coronary artery from the pulmonary artery (ALCAPA), a follow-up study was performed. Twenty-nine teenagers and adults who had ALCAPA diagnosed during life at age 13 years or older were identified mainly by literature search...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90248-5
更新日期:1979-10-01 00:00:00
abstract::Selective blockade of the angiotensin II AT1 receptor represents a novel mechanism for interrupting the renin-angiotensin system without altering the potential benefits of AT2 receptor stimulation. This selective inhibition produces none of the disadvantages associated with reduced bradykinin metabolism and angiotensi...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(99)70317-0
更新日期:1999-09-01 00:00:00
abstract::Hypertensive cardiovascular risk may be related primarily to vascular overload, the sum of three vascular abnormalities: increased arteriolar resistance, increased large-artery stiffness, and the effect of increased early pulse-wave reflection. A method for quantifying vascular overload as an index can be derived from...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90278-x
更新日期:1994-10-01 00:00:00
abstract::A prospective study examining the relationship between psychological distress and ventricular ectopy was conducted with 125 post-myocardial infarction patients equipped with a transtelephonic ECG monitor. Subjects were subsequently grouped according to the occurrence (n = 59) or nonoccurrence (n = 65) of ventricular a...
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(88)90246-3
更新日期:1988-07-01 00:00:00
abstract::The effects of intravenous adenosine and adenosine triphosphate (ATP) were studied in a double-blind randomized study during 68 episodes of supraventricular tachycardia in 39 patients. Adenosine restored sinus rhythm in 20 patients (25 of 27 episodes) and produced atrioventricular block to reveal atrial arrhythmias in...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(05)80022-5
更新日期:1990-02-01 00:00:00