Abstract:
BACKGROUND:Mild and moderate functional ischemic mitral insufficiency present at the time of surgical revascularization present clinical uncertainty. It is unclear whether the relatively poor outcomes in this cohort are dependent on valvular function or related to left ventricular dysfunction. The purpose of this study was to examine the early and late outcomes in patients with less-than-severe functional ischemic mitral insufficiency at the time of isolated coronary artery bypass grafting (CABG). METHODS AND RESULTS:From 1996 through 2004, 2242 consecutive patients undergoing isolated CABG were identified as having none to moderate mitral regurgitation (MR) and no valve leaflet pathology. All of the patients at this single institution routinely had an intraoperative transesophageal echocardiography, prospectively quantified MR, and ejection fraction (EF). The New York State Cardiac Surgery Reporting System infrastructure was used to prospectively collect in-hospital patient variables and outcomes. Social Security Death Benefit Index was used to determine long-term survival. Odds ratio and significance (P value) are presented for each determined risk factor. There were 841 patients (37.5%) with no MR, 1137 (50.7%) with mild MR, and 264 (11.8%) with moderate MR. The patients with moderate MR were more likely to be older, female, and have more renal disease, previous MI, congestive heart failure, previous cardiac surgery, and lower EFs. Hospital mortality was independently and significantly associated with renal disease, decreasing EF, increasing age, previous cardiac operation, and cerebral vascular disease. Multivariable analysis revealed decreased survival with increasing age, previous operation, congestive heart failure, diabetes, nonelective operation, decreasing EF, and the presence of moderate MR (expbeta = 1.49; P=0.007) and mild MR (expbeta = 1.34; P=0.033). CONCLUSIONS:Independent of ventricular function, mild and moderate functional mitral insufficiency are associated with significantly decreased survival in patients undergoing CABG. Whether correction of moderate functional MR at the time of CABG improves outcome still needs to be determined.
journal_name
Circulationjournal_title
Circulationauthors
Grossi EA,Crooke GA,DiGiorgi PL,Schwartz CF,Jorde U,Applebaum RM,Ribakove GH,Galloway AC,Grau JB,Colvin SBdoi
10.1161/CIRCULATIONAHA.105.001230subject
Has Abstractpub_date
2006-07-04 00:00:00pages
I573-6issue
1 Suppleissn
0009-7322issn
1524-4539pii
114/1_suppl/I-573journal_volume
114pub_type
杂志文章相关文献
CIRCULATION文献大全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:Antiplatelet agents presently used in the secondary prevention of cardiovascular disease fail to prevent the majority of cases of recurrent stroke and systemic embolization. An evaluation of the efficacy of new agents is hampered by a lack of in vivo models in humans. Asymptomatic cerebral embolic signals (E...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.98.14.1372
更新日期:1998-10-06 00:00:00
abstract:BACKGROUND:The possible contribution of endothelin-1, a potent endothelium-derived vasoconstrictor peptide, to neurohumoral compensation for hemodynamic stress was examined in nine normal volunteers and six patients with severe congestive heart failure. METHODS AND RESULTS:Plasma levels of endothelin-1 were measured w...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.85.2.510
更新日期:1992-02-01 00:00:00
abstract::Composite graft replacement of the ascending aorta and aortic valve was performed in 78 patients over an 8 1/2-year period. Degenerative lesions of the aortic root in Marfan's syndrome (annuloaortic ectasia) was the indication for operation in 56 cases; the other 22 patients had other causes of aortic root dilatation ...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1982-08-01 00:00:00
abstract:BACKGROUND:Memory is a diverse biological phenomenon whose importance in the ventricle has been demonstrated. We hypothesized its occurrence in the atrium, contributing to the modulation of cardiac rhythm. METHODS AND RESULTS:We analyzed P and Ta waves in conscious chronically instrumented dogs with complete heart blo...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.103.3.455
更新日期:2001-01-23 00:00:00
abstract::We examined the cardiopulmonary effects of maximum bicycle ergometer exercise in seven patients with implanted Intermedics Nova MR pacemakers for three types of pacing in a randomized sequence: VVI or AAI at 70 beats/min (SSI 70), rate-adaptive temperature-controlled pacing with the implanted Nova MR, and rate-adaptiv...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1988-11-01 00:00:00
abstract::Serial electrophysiologic testing of multiple drugs was performed in 21 patients with recurrent atrioventricular (AV) nodal reentrant paroxysmal supraventricular tachycardia (PSVT). All patients had reproducible sustained PSVT induced before drug administration. Serial daily PSVT induction was attempted after administ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.62.6.1341
更新日期:1980-12-01 00:00:00
abstract:BACKGROUND:Conventional x-ray angiography frequently underestimates the true burden of atherosclerosis. Although intravascular ultrasound allows for imaging of coronary plaque, this invasive technique is inappropriate for screening or serial examinations. We therefore sought to develop a noninvasive free-breathing MR t...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.102.21.2582
更新日期:2000-11-21 00:00:00
abstract:BACKGROUND:Two phase III trials of enoxaparin for unstable angina/non-Q-wave myocardial infarction have shown it to be superior to unfractionated heparin for preventing a composite of death and cardiac ischemic events. A prospectively planned meta-analysis was performed to provide a more precise estimate of the effects...
journal_title:Circulation
pub_type: 临床试验,杂志文章,meta分析,多中心研究
doi:10.1161/01.cir.100.15.1602
更新日期:1999-10-12 00:00:00
abstract:BACKGROUND:Transplantation of ex vivo expanded circulating endothelial progenitor cells (EPCs) from peripheral blood mononuclear cells improves the neovascularization after critical ischemia. However, the origin of the endothelial progenitor lineage and its characteristics have not yet been clearly defined. Therefore, ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000096483.29777.50
更新日期:2003-11-18 00:00:00
abstract:BACKGROUND:The endothelium acts as the sensor of shear stress and as the mediator of flow-induced changes in vessel tone and structure. The purpose of this study was to delineate the signal transduction pathway of flow-induced release of endothelium-derived relaxing factor (EDRF). METHODS AND RESULTS:We used a shear s...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.88.1.193
更新日期:1993-07-01 00:00:00
abstract::Inherited thoracic aortopathies denote a group of congenital conditions that predispose to disease of the thoracic aorta. Aortic wall weakness and abnormal aortic hemodynamic profiles predispose these patients to dilatation of the thoracic aorta, which is generally silent but can precipitate aortic dissection or ruptu...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.119.043756
更新日期:2020-05-12 00:00:00
abstract:BACKGROUND:The FRANCE-2 registry (French Aortic National Corevalve and Edwards) previously reported good early- and medium-term clinical and echocardiographic efficacy for transcatheter aortic valve replacement. We here report 5-year follow-up results from the registry. METHODS:The registry includes all consecutive pa...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.118.036866
更新日期:2018-12-04 00:00:00
abstract::Between 1972 and 1984, 100 consecutive neonates (less than or equal to 30 days old) underwent repair of coarctation of the aorta. Mean (+/- SD) age at operation was 12.0 +/- 8.0 days; mean weight was 3.1 +/- 0.5 kg. Simple coarctation was present in 29 patients (group I), 32 patients had additional ventricular septal ...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract::To define the role of portable two-dimensional echocardiography (2-D echo) in the immediate diagnosis of acute chest pain syndrome, 80 consecutive patients were studied. Adequate 2-D echo studies were obtained in 65 (81%). Thirty-three patients had clinical evidence of transmural or nontransmural acute myocardial infa...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.65.2.323
更新日期:1982-02-01 00:00:00
abstract::We assessed the effects of ethanol and autonomic blockade on left ventricular function in nine normal subjects, age 20--35 years, using M-mode echocardiography and systolic time intervals. On day 1, measurements were made of heart rate, mean velocity of circumferential fiber shortening, and left ventricular pre-ejecti...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.59.1.120
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND:The atrioventricular (AV) node is insensitive to changes in extracellular potassium concentration, [K+]o, because of the absence of the inward rectifier potassium current (IK1). However, we propose that in the presence of adenosine, elevated [K+]o should increase the adenosine-activated inward rectifier pota...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.99.2.312
更新日期:1999-01-19 00:00:00
abstract:BACKGROUND:The Bleeding Academic Research Consortium (BARC) has recently proposed a unified definition of bleeding in patients receiving antithrombotic therapy. We investigated the relationship between bleeding events as defined by BARC and 1-year mortality in patients undergoing percutaneous coronary intervention (PCI...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.111.060871
更新日期:2012-03-20 00:00:00
abstract::Isovolumic relaxation time (IVRT) and events of early transmitral flow measured by Doppler echocardiography were validated against the time constant of left ventricular relaxation (tau) in open-chest dogs. During increased inotropy (by isoproterenol infusion) at constant preload, enhancement of relaxation was indicate...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.81.1.260
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Endothelin 1 has been implicated in various human diseases, including atherosclerosis. In this study, we examined the expression and localization of endothelin-converting enzyme-1 (ECE-1), the final key enzyme of endothelin 1 processing, in rat carotid arteries after balloon injury and in human coronary athe...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.95.1.221
更新日期:1997-01-07 00:00:00
abstract:BACKGROUND:Albumin microbubbles that are used for contrast echocardiography persist within the myocardial microcirculation after ischemia/reperfusion (I-R). The mechanism responsible for this phenomenon is unknown. METHODS AND RESULTS:Intravital microscopy of the microcirculation of exteriorized cremaster muscle was p...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.101.6.668
更新日期:2000-02-15 00:00:00
abstract:BACKGROUND:Cardiac hypertrophy and subsequent heart failure triggered by chronic hypertension represent major challenges for cardiovascular research. Beyond neurohormonal and myocyte signaling pathways, growing evidence suggests inflammatory signaling pathways as therapeutically targetable contributors to this process....
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.112.001357
更新日期:2013-09-24 00:00:00
abstract:BACKGROUND:Phosphatidylserine-expressing microparticles circulate in blood with a short half-life of <10 minutes. We tested the role of an endothelium-derived phosphatidylserine-binding opsonin, developmental endothelial locus-1 (Del-1), in the uptake of platelet microparticles. METHODS AND RESULTS:Cultured human umbi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.111.068833
更新日期:2012-04-03 00:00:00
abstract:BACKGROUND:In the twin-to-twin transfusion syndrome (TTTS), pressure rather than volume overload is increasingly considered as a key factor in the pathogenesis of the cardiomyopathy of the recipient twin. If this is the case, cardiac dysfunction should be among the first signs observed with TTTS. The objective of this ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000146896.20317.59
更新日期:2004-11-09 00:00:00
abstract:BACKGROUND:Interleukin (IL)-6-related cytokines share gp130 as the signal-transducing protein. Downstream of gp130, two signal-transducing pathways have been recognized, the Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway and the Ras-mitogen-activated protein kinase (MAPK) pathway. To d...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.10.2626
更新日期:1996-11-15 00:00:00
abstract::Two patients with supraventricular parasystole (one atrioventricular and one auricular) are reported. In both patients, reentrant extrasystoles appeared to occur as the result of Mobitz type I second-degree entrance block. We believe that when a sinus impulse fell soon after the absolute refractory period of the pathw...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.65.1.208
更新日期:1982-01-01 00:00:00
abstract::Eleven consecutive patients with idiopathic dilated cardiomyopathy and spontaneous, sustained ventricular tachycardia (VT) of uniform morphology underwent programmed ventricular stimulation and serial antiarrhythmic drug testing. The mean ejection fraction was 30 +/- 6.4%. Sustained VT was induced by programmed electr...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.70.3.451
更新日期:1984-09-01 00:00:00
abstract::Current imaging modalities can provide only a qualitative or semiquantitative measure of the severity of aortic regurgitation. Ultrafast computed tomography (CT) has the capability of rapid imaging (17 frames/sec) coupled with high spatial resolution (1.5 mm2). Eight millimeter thick images can be acquired to interrog...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.76.3.728
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND:Patients with advanced heart failure have bioenergetic abnormalities of skeletal muscle metabolism during exercise. Using 31P magnetic resonance spectroscopy, we sought to determine whether skeletal metabolic responses to exercise are normalized by orthotopic cardiac transplantation. METHODS AND RESULTS:Fou...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.89.4.1624
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:Adipocyte-derived hormones may represent a mechanism linking insulin resistance to cardiovascular disease. In the present study, we evaluated the direct effects of resistin, a novel adipocyte-derived hormone, on endothelial activation. METHODS AND RESULTS:Endothelial cells (ECs) were incubated with human re...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000084503.91330.49
更新日期:2003-08-12 00:00:00