Abstract:
OBJECTIVE:To date, few studies have evaluated asymptomatic patients with organic mitral regurgitation (MR). The goal of the present study was to assess the presence of independent predictive factors for progression of symptoms and/or left ventricular dysfunction (SLVSD) in this population. METHODS:We prospectively evaluated 128 consecutive patients (mean age 60 +/- 8 years, 68% men; ejection fraction 66 +/- 3%) who were asymptomatic, with severe organic MR. Mean follow-up was 29 +/- 12 months. The combined end point was SLVSD. Clinical and echocardiographic variables were evaluated. Follow-up data were also estimated considering the annualized rate (?) of the echocardiographic indices. RESULTS:Thirty-seven patients (29%) had SLVSD during follow-up. Cox regression model identified the effective regurgitant orifice area (EROA) >55 mm2 (risk ratio 6.3, 95% CI 2.3-8.1, P < .001) and end-systolic diameter >22 mm/m2 (risk ratio 4.5, 95% CI, 1.8-9.4, P < .02) as the only independent predictors of SLVSD. When the follow-up data were added, the ?EROA (>15 mm2/y) was independently associated with the end point. CONCLUSION:In asymptomatic patients with organic MR, the EROA and the end-systolic diameter are independent predictors of SLVSD and allow a better risk stratification in this group of patients. ANALYTICAL SUMMARY: The goal of this study was to determine the presence of independent predictors of symptomatic progression, and/or left ventricular dysfunction in asymptomatic patients with severe mitral regurgitation. We prospectively evaluated 128 consecutive patients (mean age 60 +/- 8 years, 68% male; ejection fraction 66 +/- 3%). During follow-up (mean 29 +/- 12 months). The end point occurred in 37 patients (29%). Multivariate analysis using Cox model identified the effective regurgitant orifice area (EROA) >55 mm2 (RR: 6.3; 95% CI: 2.3-8.1; P < .001) and an end-systolic diameter (ESD) >22 mm/m2 (RR: 4.5; 95%CI: 1.8-9.4; P < .02) as the only independent predictors of the end point. When the follow-up data were added, the annualized change rate of the EROA (>15 mm2/year) was independently associated with the end point. In asymptomatic patients with organic mitral regurgitation, the EROA and ESD at study entry were independent predictors of the combined end point and allowed a better risk stratification in this group of patients.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Krauss J,Pizarro R,Oberti PF,Falconi M,Cagide Adoi
10.1016/j.ahj.2006.01.015subject
Has Abstractpub_date
2006-11-01 00:00:00pages
1004.e1-8issue
5eissn
0002-8703issn
1097-6744pii
S0002-8703(06)00117-7journal_volume
152pub_type
杂志文章abstract:BACKGROUND/OBJECTIVES:The extent to which individual knowledge, preferences, and priorities explain lower use of invasive cardiac care among older vs. younger adults presenting with acute coronary syndrome (ACS) is unknown. We directly surveyed a group of patients to ascertain their preferences and priorities for invas...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2019.09.008
更新日期:2020-01-01 00:00:00
abstract:AIMS:The impact of estimated glomerular filtration rate (eGFR) on adverse events in patients with mechanical heart valves (MHVs) is unknown. We analyzed the independent association of eGFR and thromboembolism (TE), major bleeding, and mortality in patients with MHV in an observational cohort study. METHODS AND RESULTS...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2015.06.016
更新日期:2015-09-01 00:00:00
abstract:UNLABELLED:Antiarrhythmic agents enhance maintenance of sinus rhythm (SR) after direct current cardioversion (DCC) for atrial fibrillation but there are few comparative trials. BACKGROUND:The aims of the study were (1) to establish whether patients successfully cardioverted to SR are more likely to stay in SR over 6 m...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2005.09.009
更新日期:2006-04-01 00:00:00
abstract::Although Q wave and non-Q wave MI are often referred to as "transmural" and "nontransmural," there is no anatomic evidence to justify this distinction. Nevertheless, a distinction is important, because the two entities have a different prognosis. At the present time, between 25% and 35% of MIs are non-Q wave. They are...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(89)90629-7
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND:Little is known on the "very" long-term incidence of major adverse cardiac events (MACE), target-lesion revascularization (TLR), target-vessel revascularization and stent thrombosis after sirolimus-eluting stent (SES) implantation. We present the first study to provide a 10-year clinical follow-up in an unse...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.12.013
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Early lumen loss (ELL) may be detected in patients undergoing coronary interventions for in-stent restenosis. This phenomenon may contribute to recurrences. This prospective, randomized study was designed to determine if repeat stent implantation may prevent ELL in patients with in-stent restenosis. METHODS...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.ahj.2004.06.022
更新日期:2005-02-01 00:00:00
abstract::Interatrial septal aneurysm (IASA) has been detected with increasing frequency since the advent of two-dimensional echocardiography (2DE). In this study, we investigated the prevalence, characteristics, and predisposing factors in IASA formation in 724 infants, children, and adolescents undergoing 2DE. Among this grou...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90927-6
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:We evaluate a simple, bedside test that measures 1-minute heart rate variability in deep breathing as a predictor of death after myocardial infarction. METHODS:Bedside heart rate variability was assessed in 185 consecutive patients 5.1 +/- 2.5 days after a first myocardial infarction. Patients were instruct...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70242-5
更新日期:1999-07-01 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::It has been suggested that the myocardium is able to recruit endogenous protective mechanisms in response to repeated ischemia and reperfusion. We set out to study whether this is manifested in patients with coronary artery disease in the form of fewer signs of myocardial ischemia during the second of two successive e...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90272-0
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:To determine whether peripheral arterial disease is associated with high circulating levels of pro-inflammatory cytokines, independent of confounders. METHODS:Participants were 955 men and women aged 60 years and older representative of the population in 2 Italian communities (107 with peripheral arterial di...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2004.09.032
更新日期:2005-08-01 00:00:00
abstract::This study investigated the correlation between cardiac abnormalities and cytosine-thymine-guanine (CTG) trinucleotide repeat expansion in patients with myotonic dystrophy (MD). We studied 18 patients with the adult form of classical MD and 18 age-matched control subjects. In patients with MD, left ventricular systoli...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70137-6
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVES:Impedance monitoring has been proposed as a method to assess the adequacy of tissue heating during catheter ablation procedures. The purpose of this study was to evaluate the relation among initial impedance, fall in impedance, and electrode temperature during catheter ablation procedures. METHODS AND RESUL...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70130-9
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:The Total Occlusion Study of Canada (TOSCA) is a multicenter, randomized trial evaluating the effect of stenting with > =1 heparin-coated stent on long-term patency after percutaneous coronary intervention by balloon angioplasty of occluded coronary arteries. The purpose of the current study was to compare t...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mhj.2001.116960
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:The magnitude of benefit of cardiac resynchronization therapy (CRT) varies significantly among its recipients; approximately 30% of CRT patients do not report clinical improvement. Optimization of CRT pacing parameters can further improve cardiac function, both acutely and chronically. Echocardiographic opti...
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.2012.02.007
更新日期:2012-05-01 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::In a study of GTN absorption during exercise and high ambient temperature, 12 healthy volunteers carried 10 mg glyceryl trinitrate (GTN, nitroglycerin) transdermal patches for 6 hours during each of 3 days. During a control day the mean plasma GTN concentration ranged from 1.0 nmol/L (SD +/- 0.8 nmol/L) to 1.5 nmol/L ...
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(86)90518-1
更新日期:1986-09-01 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::Twenty-six patients with Ebstein's anomaly were classified into three types according to their clinical features, heart catheterization data, angiocardiographic and anatomical findings which were obtained on surgery or autopsy. The hemodynamics in each type were discussed. 1. Tricuspid Stenosis Dominant Type. Eight pa...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90458-1
更新日期:1978-02-01 00:00:00
abstract::Two double-blind multicenter studies compared acebutolol with placebo (acebutolol, N = 121; placebo, N = 116) and with propranolol (acebutolol, N = 186; propranolol, N = 190) in essential hypertension. Acebutolol significantly reduced mean sitting diastolic blood pressure from 99.2 +/- 0.3 mm Hg at baseline to 89.1 +/...
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)90702-1
更新日期:1985-05-01 00:00:00
abstract::Short-term follow-up after percutaneous aortic balloon valvuloplasty shows a high incidence of restenosis. Yet a high percentage of patients with restenosis continue to show symptomatic improvement. Those with decreased left ventricular function originally tend to have a recurrence of symptoms. In this study Doppler-d...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)91028-y
更新日期:1992-05-01 00:00:00
abstract::A new radiopaque, highly flexible balloon-expandable tantalum stent was tested. Thirty-six of 40 stents were successfully deployed percutaneously in the coronary arteries of 31 dogs. The dogs were given aspirin before, intravenous heparin during, and aspirin alone after the procedure. One dog died at 24 hours because ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90992-5
更新日期:1992-10-01 00:00:00
abstract::Valve area and cardiac output were determined with magnetic resonance (MR) velocity mapping in 12 patients with aortic stenosis. Heart catheterization, Doppler echocardiography, and indicator dilution were performed for comparison. Left ventricle could be catheterized in only nine patients; in these cases, MR measured...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90669-z
更新日期:1993-11-01 00:00:00
abstract::The isovolumic relaxation time (IVRT) is an important noninvasive index of left ventricular diastolic function. Despite its widespread use, however, the IVRT has not been related analytically to invasive parameters of ventricular function. Establishing such a relationship would make the IVRT more useful by itself and ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90416-s
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Despite a higher prevalence of sudden cardiac death (SCD), black individuals are less likely than whites to have an implantable cardioverter defibrillator (ICD) implanted. Racial differences in ICD utilization is in part explained by higher refusal rates in black individuals. Decision support can assist with...
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.2019.10.011
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Despite clopidogrel therapy, patients undergoing percutaneous coronary intervention (PCI) with stenting are at risk of recurrent coronary events. This could be partly explained by a reduced efficacy of clopidogrel to inhibit platelet aggregation, an ex vivo defined phenomenon called clopidogrel nonresponsive...
journal_title:American heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ahj.2007.04.014
更新日期:2007-08-01 00:00:00
abstract::There are many similarities between the clinical features of viral heart disease and of rheumatic carditis, as defined in the revised Jones criteria for the diagnosis of rheumatic fever. Because of this, it is likely that viral heart disease has been, and still is, diagnosed as rheumatic. This situation can be avoided...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80137-8
更新日期:1976-05-01 00:00:00
abstract:BACKGROUND:It has been shown that transient increase in left ventricular stiffness, assessed by Doppler-derived early filling deceleration time, occurs during the first 24 to 48 hours after myocardial infarction but returns to normal within several days. It has been reported that hyperbaric oxygen treatment has a favor...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.ahj.2004.02.009
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Glycoprotein (GP) IIb/IIIa antagonists have become a mainstay for the treatment of acute coronary syndromes. Yet, they have rarely been evaluated under relevant pathophysiologic conditions, for example, high shear rates in the presence of physiologic calcium concentrations. We compared the efficacy of eptifi...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.ahj.2003.11.003
更新日期:2004-04-01 00:00:00
abstract::In a prospective clinical trial of 195 consecutive unselected patients with acute myocardial infarction (AMI), systematic blinded clinical and echocardiographic examinations were performed by two observers on day 5. The purpose was to define low-risk patients with regard to in-hospital and 2-month mortality and predic...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(92)90963-v
更新日期:1992-10-01 00:00:00