Abstract：
BACKGROUND:We review our 10-year experience of mitral valve (MV) repair in comparison with MV replacement in the elderly for floppy mitral valves/mitral valve prolapse (FMV/MVP). The use of MV repair for this entity has not been fully utilized by surgeons. METHODS:Two hundred ninety-two consecutive patients aged > or = 70 years receiving mitral surgery for regurgitation due to FMV/MVP were reviewed from our prospective database between January 1, 1992, and December 31, 2002. Patients receiving concomitant coronary artery bypass grafting (CABG) were included. Two hundred eighteen patients underwent repairs and 74 replacements. Postoperative and long-term follow-up data were obtained. Mean follow-up time for survivors was 6.2 +/- 2.5 years for MV repair and 6.8 +/- 2.7 years for MV replacement. RESULTS:Patients with isolated MV repair showed lower inhospital mortality compared with MV replacement (0.7% vs 13.9%, P = .002) with reduced length of stay (8.7 +/- 7.6 vs 9.6 +/- 5.2 days, P = .049). There was improvement in 5-year mortality favoring repair versus replacement (81% +/- 3% vs 63% +/- 3%, P = .001). With concomitant CABG, there was minimal difference in survival up to 5 years. Freedom from valve replacement was 93.9% +/- 1.3% for MV repair and 98.2% +/- 0.4% for MV repair with CABG at 10 years. Mitral valve repair was an independent protector of long-term mortality within multivariate correlates (hazard ratio 0.43, 95% CI 0.19-0.97, P = .041). CONCLUSIONS:In elderly patients, MV repair reduced in-hospital mortality and length of stay and increased long-term survival. With concomitant CABG, survival was similar to replacement. The preferred option for elderly patients with FMV/MVP is MV repair, especially in those without coronary artery disease.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Gogbashian A,Sepic J,Soltesz EG,Nascimben L,Cohn LHdoi
10.1016/j.ahj.2005.07.003subject
Has Abstractpub_date
2006-06-01 00:00:00pages
1325-33issue
6eissn
0002-8703issn
1097-6744pii
S0002-8703(05)00721-0journal_volume
151pub_type
杂志文章abstract：:The purpose of this study was to delineate the clinical, ECG, and angiographic features of a large series of consecutive patients with angina at rest. Transient ST segment elevation during pain was observed in 219 patients (group I), while 220 patients showed ST segment depression during pain (group II). Group II pati...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(86)90545-4
更新日期：1986-01-01 00:00:00
abstract：OBJECTIVES:The study aimed to analyze the use of intensive lipid-lowering therapy (I-LLT) at discharge in a broad population of patients hospitalized with acute coronary syndrome (ACS). BACKGROUND:Early and intensive statin therapy in ACS has been shown to reduce cardiovascular morbidity and mortality. Utilization and...
journal_title：American heart journal
pub_type： 杂志文章,多中心研究
doi：10.1016/j.ahj.2010.12.014
更新日期：2011-02-01 00:00:00
abstract：:Epinephrine increases coronary blood flow but may not improve the balance between myocardial oxygen supply and demand during cardiopulmonary resuscitation (CPR). The objective of this study was to determine whether this balance can be improved by administering a relatively pure alpha-adrenergic vasoconstrictor, alone ...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(94)90120-1
更新日期：1994-02-01 00:00:00
abstract：BACKGROUND:Endothelin 1 is a potent endogenous vasoconstrictor neurohormone, and endothelin 1 plasma concentrations predict adverse outcomes in patients with acute heart failure (AHF). Tezosentan, an intravenous endothelin receptor antagonist, improved hemodynamics in patients with AHF; however, its effects on morbidit...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/j.ahj.2005.04.035
更新日期：2005-07-01 00:00:00
abstract：BACKGROUND:The CD40 receptor and its ligand (CD40L) are known to modulate both inflammation and thrombosis-2 processes important for the development and clinical expression of atherosclerosis. Circulating soluble CD40L (sCD40L) concentration predicts cardiovascular risk in selected patient samples. The purpose of this ...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/j.ahj.2008.06.041
更新日期：2008-11-01 00:00:00
abstract：:Giant cell arteritis is a disease of the elderly which is more common than previously recognized. It is important to be aware of this condition because treatment effectively relieves symptoms and prevents serious complications. The disease is suggested when an elderly patient complains of constitutional symptoms, head...
journal_title：American heart journal
pub_type： 杂志文章,评审
doi：10.1016/0002-8703(80)90285-9
更新日期：1980-07-01 00:00:00
abstract：BACKGROUND:There are limited data regarding the clinical correlates and prognostic significance of echocardiographically defined mitral regurgitation (MR) early after acute myocardial infarction (MI). The current study addressed these issues. METHODS:Seven hundred thirty-seven patients with acute MI who underwent tran...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/j.ahj.2005.01.020
更新日期：2005-12-01 00:00:00
abstract：BACKGROUND:We assessed left atrial function in normal subjects and in patients with hypertrophic cardiomyopathy (HCM) by using Doppler echocardiography at the supine position and after sudden standing. METHODS AND RESULTS:Twenty-seven patients with hypertrophic obstructive cardiomyopathy (HOCM), 17 patients with HCM, ...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/s0002-8703(98)70153-x
更新日期：1998-12-01 00:00:00
abstract：:MAT is an uncommon arrhythmia most often seen in elderly patients with chronic pulmonary disease who are critically ill due to acute respiratory or cardiac decompensation. Its importance lies in the fact that it is commonly mistaken for AF, since both disorders are characterized by narrow ventricular complexes, irregu...
journal_title：American heart journal
pub_type： 杂志文章,评审
doi：10.1016/0002-8703(89)90275-5
更新日期：1989-09-01 00:00:00
abstract：BACKGROUND:Noninvasive methods are needed for the identification of women at highest risk for coronary artery disease (CAD) who might benefit most from aggressive preventive therapy. Identification of brachial artery atherosclerosis, which correlates with coronary artery atherosclerosis, may be useful to estimate or st...
journal_title：American heart journal
pub_type： 杂志文章,多中心研究
doi：10.1067/mhj.2002.121735
更新日期：2002-05-01 00:00:00
abstract：:The antiarrhythmic efficacy and safety of intravenous amiodarone were evaluated in 13 patients with recurrent sustained ventricular tachycardia. All patients had been refractory to at least three prior antiarrhythmic agents (mean, 3.3 per patient), and 11 had multiple direct current cardioversions. Intravenous amiodar...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(88)90523-6
更新日期：1988-01-01 00:00:00
abstract：BACKGROUND:Coronary calcium detected noninvasively is an attractive way to diagnose atherosclerosis before the development of symptoms. This study examines the prognostic value of coronary calcium in asymptomatic subjects with usual cardiovascular risk. METHODS AND RESULTS:In 425 asymptomatic subjects, 229 men (aged 4...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1067/mhj.2003.169
更新日期：2003-03-01 00:00:00
abstract：BACKGROUND:There is increasing evidence that transplantation of autologous stem cells improves cardiac function after acute myocardial infarction (AMI). For propagation of peripheral blood stem cells (PBSCs), application of granulocyte-colony stimulating factor (G-CSF) has been shown to be feasible, effective, and safe...
journal_title：American heart journal
pub_type： 临床试验,杂志文章
doi：10.1016/j.ahj.2006.03.012
更新日期：2006-06-01 00:00:00
abstract：:The conducting tissue of the heart was studied in 25 human cases of Chagas' myocarditis with a method which employs complete serial sections mounted on continuous transparent plastic tape. The pathological changes were correlated with electrocardiographic findings. The inflammation of the acute phase of Chagas' myocar...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(78)90362-9
更新日期：1978-03-01 00:00:00
abstract：BACKGROUND:Atrial fibrillation (AF) is associated with increased risk of death, thromboembolic complications, and a lowered quality of life. Despite this burden, pharmacologic agents for prevention of AF in patients who achieved normal sinus rhythm are of limited utility, mostly because of serious and frequent side eff...
journal_title：American heart journal
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ahj.2008.10.027
更新日期：2009-03-01 00:00:00
abstract：:To evaluate whether the identification of the different types of relations between premature ventricular contractions (PVCs) and the preceding sinus cycle length is capable of predicting the effect of beta-blockers on the PVCs themselves, 55 patients (43 men, 12 women, mean age 52.6 +/- 15.6 years) with different card...
journal_title：American heart journal
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-8703(96)90529-3
更新日期：1996-03-01 00:00:00
abstract：:The MAPHY Study was conducted to investigate whether metoprolol, a relatively beta 1-selective beta-blocker, given as initial antihypertensive treatment, would lower cardiovascular complications of high blood pressure to a greater extent than do thiazide diuretics as initial treatment at similar blood pressure control...
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)90112-3
更新日期：1988-07-01 00:00:00
abstract：:A new integrated method for quantitating temporal and spatial systolic wall motion heterogeneity was developed and applied in 15 normal subjects and 26 patients with previous myocardial infarction (MI). After frame by frame digitizing, right anterior oblique left cineventriculograms (LV) were analyzed with 90 spaced r...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(86)90465-5
更新日期：1986-10-01 00:00:00
abstract：:Four hundred and ninety-two patients with coronary artery disease underwent analysis of their electrocardiograms, coronary arteriograms, and ventriculograms. Significant Q-waves were correlated with critical coronary occlusions (greater than or equal 75 per cent obstruction) and ventricular contractility. It was found...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(75)90425-1
更新日期：1975-10-01 00:00:00
abstract：:One hundred thirty-three patients with dilated heart failure, 80 with coronary artery disease, and 53 with idiopathic dilated cardiomyopathy were followed for a mean of 29 months. Patients with ischemic heart disease had a worse prognosis than those classified as having idiopathic cardiomyopathy. Features from history...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/s0002-8703(05)80242-x
更新日期：1990-05-01 00:00:00
abstract：:The prevalence of heart failure (HF) is high and still on the rise. In 2004, an estimated 5.2 million adults in the United States carried the diagnosis of HF with a mortality rate of >19%. The incidence of HF is higher in individuals 65 years or older. As the US population grows older, the personal and economic costs ...
journal_title：American heart journal
pub_type： 杂志文章,评审
doi：10.1016/j.ahj.2009.04.007
更新日期：2009-06-01 00:00:00
abstract：BACKGROUND:Hepatocyte growth factor (HGF), a member of the endothelial-specific growth factors with the greatest mitogenic activity, may play a role in the protection and/or repair of vascular endothelial cells injured by atherosclerosis. As a result, plasma HGF concentration may increase in response to endothelial cel...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1067/mhj.2002.120151
更新日期：2002-02-01 00:00:00
abstract：:The effects of nadolol (N) and propranolol (P) were studied in atrial and ventricular tachyarrhythmias. Interpretation of the results should take into account the dependence of the arrhythmia on the sympathetic tone, and the drug effect on the sinus node frequency. The day/night ratio of the sinus rate is too sensitiv...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(84)90589-1
更新日期：1984-10-01 00:00:00
abstract：:We compared the pauses that followed the spontaneous termination of supraventricular tachyarrhythmias with the pauses that followed the cessation of atrial overdrive pacing in 21 patients. In 10 patients with abnormal sinus node function and in 11 patients with normal sinus node function we recorded the spontaneous te...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(83)90515-x
更新日期：1983-02-01 00:00:00
abstract：:Left circumflex coronary blood flow was increased significantly (20 per cent) during stimulation of somatic afferent fibers. The change in CBF was associated with significant increases in heart rate and arterial pressure and significant decrease in coronary vascular resistance. Controlling heart rate or preventing car...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(79)90318-1
更新日期：1979-07-01 00:00:00
abstract：:Left ventricular topography and diastolic and systolic functions were studied in 41 patients with essential hypertension (group 1) and 33 age-matched normal adults (group 2) by Doppler echocardiography. In group 1 54% had LV concentric hypertrophy, 19% had combined concentric hypertrophy and eccentric remodeling, and ...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(94)90560-6
更新日期：1994-04-01 00:00:00
abstract：BACKGROUND:This study examines how the dissemination of stenting and procedural shifts to high-volume facilities have affected short-term outcomes after percutaneous coronary intervention (PCI). METHODS:Discharge information from the 1994 and 1997 US Nationwide Inpatient Sample was used. Data from 1994 involved 84,036...
journal_title：American heart journal
pub_type： 杂志文章
doi：
更新日期：2002-08-01 00:00:00
abstract：BACKGROUND:The American Heart Association recommends women with congenital heart defects (CHD) receive contraceptive counseling early in their reproductive years, but little is known about contraceptive method use among women with CHD. We describe recent female sterilization and reversible prescription contraceptive me...
journal_title：American heart journal
pub_type： 杂志文章,多中心研究
doi：10.1016/j.ahj.2020.01.008
更新日期：2020-04-01 00:00:00
abstract：:Oxygen has long been assumed beneficial for all ill and injured patients. However, hyperoxia may be harmful and aggravate myocardial injury such as that caused by myocardial infarction. We aimed to investigate if hyperoxia increases myocardial injury following direct current cardioversion compared with room air. METH...
journal_title：American heart journal
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ahj.2017.10.006
更新日期：2018-02-01 00:00:00
abstract：:The effect of participation in cardiac rehabilitation on medical costs was determined by measuring hospitalization charges for cardiac admissions over a 3-year period in 580 post-coronary event patients (58% after coronary bypass surgery, 42% after myocardial infarction), of whom 230 entered a cardiac rehabilitation p...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(92)90696-s
更新日期：1992-04-01 00:00:00
