Abstract:
BACKGROUND:The extent of the peri-infarct zone by magnetic resonance imaging (MRI) has been related to all-cause mortality in patients with coronary artery disease. This relationship may result from arrhythmogenesis in the infarct border. However, the relationship between tissue heterogeneity in the infarct periphery and arrhythmic substrate has not been investigated. In the present study, we quantify myocardial infarct heterogeneity by contrast-enhanced MRI and relate it to an electrophysiological marker of arrhythmic substrate in patients with left ventricular (LV) systolic dysfunction undergoing prophylactic implantable cardioverter defibrillator placement. METHODS AND RESULTS:Before implantable cardioverter defibrillator implantation for primary prevention of sudden cardiac death, 47 patients underwent cine and contrast-enhanced MRI to measure LV function, volumes, mass, and infarct size. A method for quantifying the heterogeneous infarct periphery and the denser infarct core is described. MRI indices were related to inducibility of sustained monomorphic ventricular tachycardia during electrophysiological or device testing. For the noninducible versus inducible patients, LV ejection fraction (30+/-10% versus 29+/-7%, P=0.79), LV end-diastolic volume (220+/-70 versus 228+/-57 mL, P=0.68), and infarct size by standard contrast-enhanced MRI definitions (P=NS) were similar. Quantification of tissue heterogeneity at the infarct periphery was strongly associated with inducibility for monomorphic ventricular tachycardia (noninducible versus inducible: 13+/-9 versus 19+/-8 g, P=0.015) and was the single significant factor in a stepwise logistic regression. CONCLUSIONS:Tissue heterogeneity is present and quantifiable within human infarcts. More extensive tissue heterogeneity correlates with increased ventricular irritability by programmed electrical stimulation. These findings support the hypothesis that anatomic tissue heterogeneity increases susceptibility to ventricular arrhythmias in patients with prior myocardial infarction and LV dysfunction.
journal_name
Circulationjournal_title
Circulationauthors
Schmidt A,Azevedo CF,Cheng A,Gupta SN,Bluemke DA,Foo TK,Gerstenblith G,Weiss RG,Marbán E,Tomaselli GF,Lima JA,Wu KCdoi
10.1161/CIRCULATIONAHA.106.653568subject
Has Abstractpub_date
2007-04-17 00:00:00pages
2006-14issue
15eissn
0009-7322issn
1524-4539pii
CIRCULATIONAHA.106.653568journal_volume
115pub_type
临床试验,杂志文章相关文献
CIRCULATION文献大全abstract:BACKGROUND:Reperfusion injury is insufficiently addressed in current clinical management of acute limb ischemia. Controlled reperfusion carries an enormous clinical potential and was tested in a new reality-driven rodent model. METHODS AND RESULTS:Acute hind-limb ischemia was induced in Wistar rats and maintained for ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.787754
更新日期:2008-11-04 00:00:00
abstract:BACKGROUND:Platelet activation plays a pivotal role in the pathogenesis of acute coronary disease. Monocytes are involved in the progression of atherosclerosis and are potent activators of blood coagulation through their ability to synthesize tissue factor (TF). The aim of this study was to compare markers of monocyte ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.90.4.1662
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:Adrenergic activation is thought to be an important determinant of outcome in subjects with chronic heart failure (CHF), but baseline or serial changes in adrenergic activity have not been previously investigated in a large patient sample treated with a powerful antiadrenergic agent. METHODS AND RESULTS:Sys...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1161/01.CIR.0000141297.50027.A4
更新日期:2004-09-14 00:00:00
abstract:BACKGROUND:Rapamycin (sirolimus)-eluting stents are associated with reduced restenosis rates in animal studies and initial human trials. The present study evaluated whether orally administered everolimus (a macrolide of the same family as sirolimus) inhibits in-stent neointimal growth in rabbit iliac arteries. METHODS...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000033973.06059.04
更新日期:2002-10-29 00:00:00
abstract:BACKGROUND:Hypothermic hyperkalemic cardioplegia results in significant myocyte swelling and impaired contractility. These detrimental effects may be eliminated by the addition of an adenosine triphosphate-sensitive potassium (KATP) channel opener. This study evaluated the hypothesis that a KATP channel opener (diazoxi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.104.523746
更新日期:2005-08-30 00:00:00
abstract:BACKGROUND:We determined the intraclass correlation coefficients (ICC) of repeated measures of the mean levels and variability of RR and muscle sympathetic nerve activity (MSNA) in 7 normal subjects. We examined whether spontaneous fluctuations in RR and MSNA over repeated measurements were mirrored by changes in spect...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.12.4326
更新日期:1997-12-16 00:00:00
abstract::The key initiating process in atherogenesis is the subendothelial retention of apolipoprotein B-containing lipoproteins. Local biological responses to these retained lipoproteins, including a chronic and maladaptive macrophage- and T-cell-dominated inflammatory response, promote subsequent lesion development. The most...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/CIRCULATIONAHA.106.676890
更新日期:2007-10-16 00:00:00
abstract:BACKGROUND:Children awaiting heart transplantation have severe limitations in their ability to exercise. The purpose of this study was to assess exercise capacity after pediatric heart transplantation and to identify factors influencing exercise performance. METHODS AND RESULTS:Progressive cycle ergometry testing was ...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1993-11-01 00:00:00
abstract::Echocardiographic and hemodynamic data were measured in closed-chest dogs during graded cardiac tamponade (pericardial pressure 5, 10, and 15 mm Hg) before and after production of diffuse ischemic left ventricular dysfunction. Left ventricular dysfunction was produced by intracoronary injection of nonradioactive micro...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.82.4.1370
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND:Patients with bicuspid aortic valve (AV) stenosis were excluded from the pivotal evaluations of transcatheter AV replacement (TAVR) devices. We sought to evaluate the outcomes of TAVR in patients with bicuspid AV stenosis in comparison with those with tricuspid AV stenosis. METHODS:We used data from the Soc...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.119.040333
更新日期:2020-03-31 00:00:00
abstract:BACKGROUND:Alfieri edge-to-edge mitral repair has been used clinically with ring annuloplasty to correct ischemic mitral regurgitation (IMR), but its efficacy without concomitant ring annuloplasty has not been described in this setting. METHODS:Seventeen sheep underwent implantation of 9 radiopaque markers on the left...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000087943.76135.fd
更新日期:2003-09-09 00:00:00
abstract:BACKGROUND:The relations of plasma activated factor XII (FXIIa) concentration and a common polymorphism (C46T) of the factor XII gene with hemostatic status and risk of coronary heart disease (CHD) were examined by prospective surveillance. METHODS AND RESULTS:Genotyping for the C46T variant was performed in 2624 men ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.17.2058
更新日期:2000-10-24 00:00:00
abstract:BACKGROUND:Myocardial salvage is most likely to occur when thrombolytic therapy is administered within 4 to 6 hours of the onset of symptoms of myocardial infarction. The impact of delays within this early time period on final myocardial infarct size are unknown. The purpose of this study was to quantitate the relation...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.93.1.48
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Spectral analysis of heart rate (HR) variability (HRV) requires, as a rule, some level of stationarity and, as a result, is inadequate to quantify biological transients. A time-/frequency-domain method (TF) was developed to obtain an instant spectral power (SP) of HRV during tilt. METHODS AND RESULTS:HR was...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.96.10.3521
更新日期:1997-11-18 00:00:00
abstract:BACKGROUND:The cross-talk between vascular endothelial growth factor (VEGF)-A, angiopoietin (Ang), and VE-cadherin coregulates endothelial cell (EC) survival. Cardiac expression of VEGF-A but not its receptor KDR is blunted in dilated cardiomyopathy (DCM). Whether VE-cadherin/Ang function is affected in DCM is unknown....
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000091085.12422.19
更新日期:2003-09-30 00:00:00
abstract:BACKGROUND:Insulin sensitivity and cardiovascular risk profile were examined in 20 healthy, nonobese, middle-aged men who were long-term users of nicotine-containing chewing gum and in 20 matched control subjects who did not use nicotine. METHODS AND RESULTS:Long-term use of nicotine-containing chewing gum was associa...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.5.878
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:Myocardial perfusion reserve can be noninvasively assessed with cardiovascular MR. In this study, the diagnostic accuracy of this technique for the detection of significant coronary artery stenosis was evaluated. METHODS AND RESULTS:In 15 patients with single-vessel coronary artery disease and 5 patients wi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.101.12.1379
更新日期:2000-03-28 00:00:00
abstract:BACKGROUND:Human salusins, related bioactive polypeptides with mitogenic effects on vascular smooth muscle cells and fibroblasts and roles in hemodynamic homeostasis, may be involved in the origin of coronary atherosclerosis. Macrophage foam cell formation, characterized by cholesterol ester accumulation, is modulated ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.712539
更新日期:2008-02-05 00:00:00
abstract:BACKGROUND:Erythropoietin (Epo) receptors (EpoRs) are expressed in the heart. We have recently demonstrated that the endogenous Epo-EpoR system plays an important protective role in myocardial ischemia in mice and humans. In the present study, we tested our hypothesis that the endogenous Epo-EpoR system in nonhematopoi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.659037
更新日期:2007-04-17 00:00:00
abstract:BACKGROUND:Hypoxia from birth in immature rabbits increases the tolerance of isolated hearts to ischemia compared with age-matched normoxic rabbits. We determined whether this increased tolerance to ischemia was due to an alteration in the ATP-sensitive potassium (KATP) channel and whether increased KATP channel activa...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.95.5.1278
更新日期:1997-03-04 00:00:00
abstract::In patients treated with sulfinpyrazone, an apparent reduction in the incidence of sudden death and presumed ventricular fibrillation has been reported. Using an intact animal model without microcirculatory thrombosis, we studied the effects of sulfinpyrazone on ischemic myocardium in 58 anesthetized dogs divided into...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.64.1.13
更新日期:1981-07-01 00:00:00
abstract:BACKGROUND:The mechanism of ECG changes and arrhythmogenesis in Brugada syndrome (BS) patients is unknown. METHODS AND RESULTS:A BS patient without clinically detected cardiac structural abnormalities underwent cardiac transplantation for intolerable numbers of implantable cardioverter/defibrillator discharges. The pa...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.532614
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Mutations in the cardiac sodium (Na) channel gene (SCN5A) give rise to the congenital long-QT syndrome (LQT3) and the Brugada syndrome. Na channel blockade by antiarrhythmic drugs improves the QT interval prolongation in LQT3 but worsens the Brugada syndrome ST-segment elevation. Although Na channel blockade...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc3501.093797
更新日期:2001-09-04 00:00:00
abstract::Four revolutions are transforming the cardiology of our day. The first is a social revolution. It has resulted in plummeting esteem for the medical profession reflecting disenchantment coupled with the rapid emergence of the recognition that health care is a right rather than a privilege. The second revolution, interv...
journal_title:Circulation
pub_type: 传,历史文章,杂志文章
doi:10.1161/01.cir.87.6.2047
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:Induction of matrix metalloproteinases (MMPs) contributes to adverse remodeling after myocardial infarction (MI). Whether a region- and type-specific distribution of MMPs occurs within the post-MI myocardium remained unknown. METHODS AND RESULTS:Ten sheep were instrumented with a sonomicrometry array to mea...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000068375.40887.FA
更新日期:2003-06-10 00:00:00
abstract:BACKGROUND:Subclinical inflammation is associated with an increased risk of heart failure and with adverse prognosis in patients with established heart failure. Yet, treatments specifically directed at reducing inflammation in patients with heart failure have not yet shown improved clinical outcomes. We tested the hypo...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.118.038010
更新日期:2019-03-05 00:00:00
abstract:BACKGROUND:Adrenomedullin (AM) is a vasodilating peptide involved in the regulation of circulatory homeostasis and in the pathophysiology of certain cardiovascular diseases. To determine the extent to which chronic AM overproduction affects circulatory physiology under normal and pathological conditions, we used a prep...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.101.19.2309
更新日期:2000-05-16 00:00:00
abstract:BACKGROUND:The TAXUS NIRx stent (Boston Scientific Corp) provides local delivery of paclitaxel via a slow-release polymer coating. The TAXUS I trial was the first in-human experience evaluating safety and feasibility of the TAXUS NIRx stent system compared with bare NIR stents (control) (Boston Scientific Corp) for tre...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1161/01.cir.0000047700.58683.a1
更新日期:2003-01-07 00:00:00
abstract:BACKGROUND:The majority of infrarenal abdominal aortic aneurysm (AAA) repairs in the United States are performed with endovascular methods. Baseline aortoiliac arterial anatomic characteristics are fundamental criteria for appropriate patient selection for endovascular aortic repair (EVAR) and key determinants of long-...
journal_title:Circulation
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.110.014902
更新日期:2011-06-21 00:00:00
abstract:BACKGROUND:Reduction in cardiovascular death and hospitalization for heart failure (HHF) was recently reported with the sodium-glucose cotransporter-2 inhibitor (SGLT-2i) empagliflozin in patients with type 2 diabetes mellitus who have atherosclerotic cardiovascular disease. We compared HHF and death in patients newly ...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.117.029190
更新日期:2017-07-18 00:00:00