Abstract:
:The long-term efficacy of transdermal nitrate therapy, in particular the ability of a single patch to provide 24 h prophylaxis against angina, has been questioned. Two mechanisms have been suggested for this loss of effect: the development of pharmacological tolerance, and premature patch exhaustion. This study was designed to investigate this problem, and in particular to investigate the time course of treatment failure. It comprised a randomized, double-blind, cross-over comparison of transdermal glyceryl trinitrate and matching placebo transdermal patches. Significant treatment effects were demonstrated by several criteria for 8 h of continuous therapy, with some limited effect persisting for 15 h. Loss of effect began to develop very soon after treatment was initiated and progressed in a steady, linear fashion so that there was virtually no treatment effect after 24 h. In contrast, during intermittent therapy, treatment effects were maintained on the second day following a nitrate-free interval. Significant benefit was demonstrated for up to 32 h (i.e. 8 h of treatment on day 2). Both nitrate-free intervals (12 and 16 h) seemed to be equally effective in maintaining efficacy after 3 h of treatment on the second day, although this was still somewhat attenuated compared with day 1. These results confirm that loss of therapeutic efficacy of transdermal nitrate is due to the development of tolerance and not premature patch exhaustion. In contrast to previous studies, however, they suggest that tolerance can only partly be reversed by intermittent therapy and also that the onset of tolerance is so rapid that it is well established in less than a day's treatment.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
James MA,Papouchado M,Jones JVdoi
10.1093/eurheartj/12.12.1266subject
Has Abstractpub_date
1991-12-01 00:00:00pages
1266-72issue
12eissn
0195-668Xissn
1522-9645journal_volume
12pub_type
临床试验,杂志文章,随机对照试验abstract:AIMS:Characteristics of sudden cardiac arrest (SCA) during sports offers a novel (and unexplored) setting to assess factors associated with disparities in outcomes across regions. METHODS AND RESULTS:From a prospective 5-year community-based French registry concerning SCA during sports in 10-75 year-olds, we evaluated...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/eht282
更新日期:2013-12-01 00:00:00
abstract:AIMS:To investigate whether Atorvastatin (Ator) treatment improves the cardiac micro-environment that facilitates survival and differentiation of bone-marrow-derived mesenchymal stem cells (MSCs) implanted in the post-infarct myocardium. METHODS AND RESULTS:Myocardial infarction was created by coronary ligation and im...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehn167
更新日期:2008-06-01 00:00:00
abstract::In this study, two patterns of regional contract on of the left ventricle have been studied: endocardial motion and wall thickening, in order to check which of these was the most affected after myocardial infarction. The clinical relevance of this comparison was to assess which parameter of the regional contraction ab...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/oxfordjournals.eurheartj.a015069
更新日期:1996-09-01 00:00:00
abstract::Forty-one consecutive children with the Wolff-Parkinson-White (1-15 years: mean 8 years), 22 symptomatic [including 20 with supraventricular tachycardia (SVT) and one with ventricular fibrillation (VF) episode--Group A) and 19 asymptomatic (Group B)], underwent transoesophageal electrophysiological examination. The me...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060150
更新日期:1992-02-01 00:00:00
abstract::Antithrombotic therapy and invasive risk stratification in selected high-risk patients have improved outcomes from non-ST-segment elevation acute coronary syndromes (NSTE-ACS), but carry a risk of bleeding and blood transfusion. Although the true incidence of bleeding depends on the population studied (i.e. clinical t...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehm019
更新日期:2007-05-01 00:00:00
abstract::Left ventricular volume and ejection fraction were measured by 2-dimensional echocardiography from 2 orthogonal apical long axis views in 90 patients admitted with acute transmural myocardial infarction. Results were correlated with worst Killip class during hospital stay, enzymatic infarct size (peak CK-MB) and morta...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061638
更新日期:1984-03-01 00:00:00
abstract:AIMS:This study compares the functional outcome and cardiorespiratory response to exercise, in patients who have undergone arterial switch for transposition of the great arteries, with normal controls and patients who have undergone atrial switch operation. METHODS AND RESULTS:Fifteen patients who had undergone arteri...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2000.2425
更新日期:2001-06-01 00:00:00
abstract::The electrocardiographic patterns, observed during 24-h Holter monitoring, of 10 patients (mean age 35 +/- 22 years) with first and second degree A-V block due to dual A-V nodal pathways are reported. Recordings were selected according to the presence of: sudden and persistent prolongation of the PR interval: sudden n...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059904
更新日期:1991-03-01 00:00:00
abstract:AIMS:No-reflow after a primary percutaneous coronary intervention (PCI) is associated with a high incidence of left ventricular (LV) failure and a poor prognosis. Endothelin-1 (ET-1) is a potent endothelium-derived vasoconstrictor peptide and an important modulator of neutrophil function. Elevated systemic ET-1 levels ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehl119
更新日期:2006-08-01 00:00:00
abstract::Chronically ischaemic myocardium from patients with coronary heart disease was investigated by light and electron microscopy using tissue biopsies taken during cardiac surgery. Light microscopy showed a significantly increased amount of fibrotic material, cell size was variable. By electron microscopy, the most obviou...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/9.suppl_a.141
更新日期:1988-01-01 00:00:00
abstract::The fundamental abnormality in syndrome X (angina pectoris, ischaemia-like stress ECG despite angiographically normal coronary arteries) might be patchily distributed increased tone in pre-arteriolar coronary vessels with compensatory release of adenosine. The aim of this study was to confirm this hypothesis and to ex...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060780
更新日期:1995-11-01 00:00:00
abstract::Transthoracic echocardiography and continuous wave Doppler were prospectively performed in 132 out-patients with suspicion of pulmonary embolism, and who had no previous history of severe cardiac or pulmonary disease. Bedside echocardiography determined diagnosis other than pulmonary embolism in 55 patients. Further s...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a014946
更新日期:1996-05-01 00:00:00
abstract::Human cytomegalovirus (CMV) can persist in many organs after primary infection. Not only is it suspected to cause morbidity during reactivation in patients under immunosuppression, but it may also induce long-term latency by chronic disease, e.g. in the myocardium. Endomyocardial biopsies of 27 patients with active my...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/16.suppl_o.46
更新日期:1995-12-01 00:00:00
abstract:Aims:Bioresorbable scaffolds (BRS) provide short-term coronary artery scaffolding and drug delivery. Although prior trials showed a higher rate of device failure compared with conventional drug-eluting stents (DES), only a single trial investigated patients undergoing percutaneous coronary intervention (PCI) for acute ...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehy710
更新日期:2019-01-07 00:00:00
abstract:AIMS:To assess the long-term benefit-risk ratio of drug-eluting (DES) vs. bare-metal stents (BMS) relative to stent size. METHODS AND RESULTS:All 826 consecutive BASKET (BAsel Stent Kosten-Effektivitäts Trial) patients randomized 2:1 to DES vs. BMS were followed after 3 years. Data were analysed separately for patient...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehn516
更新日期:2009-01-01 00:00:00
abstract:AIMS:To evaluate the effects of cardiac resynchronization therapy (CRT) on long-term survival of patients without baseline left ventricular (LV) mechanical dyssynchrony. METHODS AND RESULTS:A total of 290 heart failure patients (age 67 ± 10 years, 77% males) without significant baseline LV dyssynchrony (<60 ms as asse...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehr468
更新日期:2012-04-01 00:00:00
abstract:Aims:Pulmonary hypertension (PH) and pulmonary vascular disease (PVD) are common and associated with adverse outcomes in heart failure with preserved ejection fraction (HFpEF). Little is known about the impact of PVD on the pathophysiology of exercise intolerance. Methods and results:Heart failure with preserved eject...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehy331
更新日期:2018-08-07 00:00:00
abstract:AIMS:We analysed the contemporary incidence, outcomes, and predictors of heart failure (HF) and/or left ventricular systolic dysfunction (LVSD) before discharge in patients with acute myocardial infarction (MI). The baseline presence of HF or LVSD, or its development during hospitalisation, increases short- and long-te...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ehj.2004.08.006
更新日期:2004-11-01 00:00:00
abstract::The aim of this study was to investigate the haemodynamic effects of amrinone in patients with pulmonary hypertension and impaired right ventricular function. Twelve patients with mitral stenosis (NYHA classification III and IV) took part in the study. The haemodynamic measurements were performed in the steady state u...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062142
更新日期:1986-09-01 00:00:00
abstract:AIMS:This study assessed the relationship between inflammatory mediators and indices of infarct size and left-ventricular (LV) remodelling following successful primary percutaneous coronary intervention (PCI) in patients with first time ST elevation myocardial infarction (MI). METHODS AND RESULTS:Forty-two patients ad...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehp070
更新日期:2009-05-01 00:00:00
abstract:AIMS:Growth differentiation factor 11 and/or its homologue growth differentiation factor 8 (GDF11/8) reverses age-related cardiac hypertrophy and vascular ageing in mice. We investigated whether GDF11/8 associates with cardiovascular outcomes, left ventricular hypertrophy (LVH), or age in humans. METHODS AND RESULTS:W...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehv385
更新日期:2015-12-21 00:00:00
abstract:AIMS:Growth-differentiation factor-15 (GDF-15) has emerged as a biomarker of increased mortality and recurrent myocardial infarction (MI) in patients diagnosed with non-ST-elevation acute coronary syndrome. We explored the usefulness of GDF-15 for early risk stratification in 479 unselected patients with acute chest pa...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehn339
更新日期:2008-10-01 00:00:00
abstract::The advent of platelet membrane glycoprotein (GP) IIb/IIIa inhibitors has changed the landscape of interventional cardiology. Given the commercial availability of abciximab and expected regulatory approvals for other receptor blockers, defining appropriate use of these agents in the interventional setting is mandated....
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:
更新日期:1998-04-01 00:00:00
abstract:AIMS:In end-stage heart failure, an alteration in the expression of the Na+-Ca2+ exchanger has been reported. Regulation of its expression is largely unknown. We sought to find out whether Na+-Ca2+ exchanger in human heart failure is regulated by sympathetic activation. In addition, since Na+-Ca2+-exchange is electroge...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2001.3044
更新日期:2002-07-01 00:00:00
abstract:AIMS:To evaluate the efficacy of atrial pacing in the suppression of early reinitiation of atrial fibrillation after successful internal cardioversion. METHODS AND RESULTS:The efficacy of atrial pacing in suppressing early reinitiation of atrial fibrillation was studied in 12 of 45 (29%) patients with early reinitiati...
journal_title:European heart journal
pub_type: 临床试验,杂志文章
doi:10.1053/euhj.1999.1991
更新日期:2000-07-01 00:00:00
abstract:Aims:Epidemiological studies strongly suggest a link between stress, depression, and cardiovascular diseases (CVDs); the mechanistic correlation, however, is poorly understood. A single-nucleotide polymorphism in the BDNF gene (BDNFVal66Met), associated with depression and anxiety, has been proposed as a genetic risk f...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehv655
更新日期:2017-05-07 00:00:00
abstract:AIMS:To investigate the effects of secretory phospholipase A2 (sPLA(2)) inhibition on plasma lipoproteins. Secretory phospholipase A2 isoenzymes promote atherosclerosis by mechanisms that include lipoprotein modification, retention, and oxidation. METHODS AND RESULTS:Phospholipase Levels And Serological Markers of Ath...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehq374
更新日期:2011-04-01 00:00:00
abstract::Contrary to most prospective epidemiologic studies, an earlier report from the British Regional Heart Study (BRHS) suggested that high density lipoprotein (HDL)-cholesterol in men aged 40-59 years was not a significant, independent, predictive risk factor for coronary heart disease (CHD), controlling for the composite...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/11.suppl_h.21
更新日期:1990-12-01 00:00:00
abstract::To determine the neurohormonal response to angiotensin-converting enzyme (ACE) inhibition after acute myocardial infarction, 36 patients presenting within 6 h of the onset of chest pain were studied in a single regional cardiology service. In this double-blind study, 13 patients were randomized to receive captopril, 1...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/oxfordjournals.eurheartj.a060995
更新日期:1995-06-01 00:00:00
abstract::One case of unruptured sinus of Valsalva aneurysm causing left coronary artery compression and lethal myocardial infarction in a 39-year old woman is described. In reviewing the literature, 15 previously published cases of sinus of Valsalva aneurysms disturbing coronary flow were found. It is concluded that the mechan...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061811
更新日期:1985-12-01 00:00:00