Abstract:
:High levels of endogenous plasma catecholamines in patients with severe congestive heart failure induce a down-regulation of the myocardial beta-adrenoreceptors and thus cause adrenoreceptor agonists, such as dobutamine, to be less effective in the treatment of these patients. Phosphodiesterase III inhibitors work independent of adrenoreceptor activity and plasma catecholamine levels; thus these agents are likely to be more effective in the treatment of severe heart failure. The present study compares both the initial and late hemodynamic effects of dobutamine and milrinone during sequentially administered 24-hour infusions. Twenty patients with severe heart failure (New York Heart Association class III, n = 4; New York Heart Association class IV, n = 16) were investigated. Dobutamine could be administered at the prescribed maximum dose of 15 micrograms/kg/min for 24 hours in only 15 of 20 patients. In three patients the dose was reduced or dobutamine infusion completely stopped because of a drug-related increase in heart rate greater than 140 beats/min. Another 2 of 20 patients showed no hemodynamic improvement over 3 hours at the maximum dose of 15 micrograms/kg/min. Dobutamine administration was also discontinued in these patients on account of the existing unfavorable hemodynamic condition, and therapy with intravenous milrinone was started. All 20 patients responded to milrinone without side effects, although comparison of the hemodynamic effects during a 24-hour infusion was possible in only 15 patients. The 15 patients studied over both observation periods experienced an increase in heart rate from 88.8 to 105.6 beats/min (+ 1 hour; p less than or equal to 0.001) when receiving dobutamine but had no increase with milrinone. Stroke volume increased during dobutamine infusion from 19.3 to 28.9 ml/m2 (+49.6%) after 1 hour and then fell continuously to 25.2 ml/m2 after 12 hours; during milrinone therapy, stroke volume increased from 18.8 to 31.2 ml/m2 (+66%; p less than or equal to 0.001) and remained at this level until the end of the infusion (30.2 ml/m2). Pulmonary capillary wedge pressure (PCWP) decreased (p less than or equal to 0.001) immediately during milrinone therapy from 26.5 to 16.2 mm Hg after 30 minutes and stabilized at 20.1 mm Hg after 24 hours. During dobutamine infusion PCWP showed a delayed decrease from 27.8 to 19.0 mm Hg after 6 hours and subsequently rose to 22.7 mm Hg after 24 hours.(ABSTRACT TRUNCATED AT 400 WORDS)
journal_name
Am Heart Jjournal_title
American heart journalauthors
Mager G,Klocke RK,Kux A,Höpp HW,Hilger HHdoi
10.1016/0002-8703(91)90834-5subject
Has Abstractpub_date
1991-06-01 00:00:00pages
1974-83issue
6 Pt 2eissn
0002-8703issn
1097-6744pii
0002-8703(91)90834-5journal_volume
121pub_type
临床试验,杂志文章abstract::Recent developments have provided a unique opportunity for the organization of regional ST-elevation myocardial infarction (STEMI) receiving center (SRC) networks. Because cumulative evidence has demonstrated that rapid primary percutaneous coronary intervention (PCI) is the most effective reperfusion strategy for acu...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2006.06.001
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Carvedilol therapy during congestive heart failure demonstrated a good efficacy in mortality rate reduction and in improvement of left ventricular (LV) systolic performance. However, currently there is not any finding about the drug's effect on diastolic filling. The aim of this study was to evaluate the eff...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(03)00525-8
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Many young investigators are interested in cardiovascular (CV) outcomes research; however, the current training experience of early investigators across the United States is uncertain. METHODS:From April to November 2014, we surveyed mentees and mentors of early-stage CV outcomes investigators across the Un...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2017.07.022
更新日期:2018-02-01 00:00:00
abstract::The prognostic significance of changes in the mode of induction of ventricular tachycardia (VT) noted during therapy was studied in 49 patients with sustained VT or ventricular fibrillation. Before treatment, all patients had inducible sustained VT by programmed stimulation (one to three extrastimuli) and frequent (gr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90189-x
更新日期:1987-11-01 00:00:00
abstract::Antiplatelet therapy is the current criterion standard for the treatment of patients undergoing percutaneous coronary intervention and patients who have acute coronary syndromes. Clopidogrel in combination with aspirin is the current standard of care for reducing cardiovascular events in these patients. However, patie...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2008.06.003
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:This study investigates whether pioglitazone reduces neointimal hyperplasia after coronary stenting in nondiabetic patients with metabolic syndrome (MS) using intravascular ultrasound (IVUS). Pioglitazone, a novel insulin-sensitizing thiazolidinedione, has been shown to reduce neointimal hyperplasia after co...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.02.022
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:The activated coagulation time (ACT) is a rapid measurement of a patient's level of heparin anticoagulation during cardiac catheterization. Patients receiving warfarin therapy occasionally are seen at the catheterization laboratory for emergent procedures. The effects of warfarin on ACT activity have not bee...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70223-6
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Treatment strategies, either invasive or noninvasive, for patients with unstable coronary artery disease still vary. There are no published studies comparing the strategies for health-related quality of life. METHODS:A total of 2457 patients with unstable coronary artery disease were randomized. We prospect...
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.2003.11.026
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Data derived from stress myocardial perfusion imaging (MPI) carry prognostic significance in young patients with hypertrophic cardiomyopathy (HCM), but there are limited data on the utility of stress MPI in patients with HCM who are older. This study examined the prognostic significance of stress MPI in an a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.02.050
更新日期:2006-02-01 00:00:00
abstract::To examine the recovery time of left atrial mechanical function after electrical cardioversion of atrial fibrillation, we recorded transmitral flow, pulmonary venous flow velocities, and interatrial septal motion during atrial systole within 24 hours (16 +/- 5 hours) and 10 days after cardioversion in 25 patients with...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90353-1
更新日期:1996-02-01 00:00:00
abstract::To assess relative capabilities of magnetic resonance (MR) imaging and two-dimensional echocardiography (2DE) for evaluating regional contractile dysfunction in the left ventricle after a myocardial infarction, results from 22 concurrent MR (orthogonal-transaxial, ECG-gated, multiphasic, single-spin echo) and 2DE exam...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90533-9
更新日期:1988-01-01 00:00:00
abstract::The aim of our study was to compare the outcome of patients with a first acute myocardial infarction (AMI) among three large cohorts of patients hospitalized between 1966 and 1992 in Israel, in view of changes in treatment facilities and investigation methods. Patients with a first AMI constituted 71% of all myocardia...
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:10.1016/0002-8703(95)90351-8
更新日期:1995-09-01 00:00:00
abstract::Potential antiarrhythmic effects of calcium (slow-channel)-blocking drugs ca be indirect or direct. The indirect effect would affect ischemia-induced arrhythmias by improving myocardial perfusion or decreasing myocardial oxygen consumption. The direct effect would affect the electrical activity of the sinoatrial (SA) ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90476-8
更新日期:1982-04-01 00:00:00
abstract:BACKGROUND:Studies document better survival in heart failure patients with decreased left ventricular ejection fraction (EF) and higher body mass index (BMI; kg/m(2)) compared to those with a lower BMI. However, it is unknown if this "obesity paradox" applies to heart failure patients with preserved EF or if it extends...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2009.10.026
更新日期:2010-01-01 00:00:00
abstract::We studied the effect of propranolol administration on risk assessment based on submaximal exercise testing performed early after myocardial infarction. A total of 70 patients with recent infarction underwent modified Bruce treadmill testing with simultaneous measurement of expired gases in the absence of antianginal ...
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(91)90009-7
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND:Depressive symptoms in patients with heart failure (HF) are common and might be associated with inflammation. No studies have examined both the cross-sectional and prospective association between inflammation and depressive symptoms in patients with HF with adequate correction for disease severity. The aim o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.03.011
更新日期:2011-06-01 00:00:00
abstract::Atrial antitachycardia pacing was tested in 23 children and young adults. The majority of these patients had had operative repair of congenital cardiac defects and had both bradycardia and tachycardia. Pacemakers were usually implanted by the transvenous technique using bipolar leads. In each patient it was possible t...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90534-o
更新日期:1991-09-01 00:00:00
abstract::To assess the influence of viscosity and iodine concentration, three matched and standardized left coronary arteriograms were obtained in 20 patients using iopamidol (Isovue-370), ioversol (Optiray-320), and iohexol (Omnipaque-350). The order of contrast media was randomized and the administration of contrast was doub...
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(92)90760-s
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Serum levels of pregnancy-associated plasma protein-A (PAPP-A) have recently been linked to plaque instability and are increased in acute coronary syndromes. The relation between PAPP-A levels and coronary risk factors, namely blood lipids, has not been studied to date. We have therefore investigated whether...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/S0002-8703(03)00446-0
更新日期:2003-12-01 00:00:00
abstract::The objective of this investigation was to determine the prevalence and clinical associations of systolic anterior motion (SAM) of the mitral chordae (chordal SAM) in patients without evidence of hypertrophic cardiomyopathy. Although SAM of the mitral valve is thought to be a specific marker of hypertrophic obstructiv...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90282-3
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:Current guidelines (American College of Cardiology/American Heart Association) for percutaneous coronary intervention (PCI) limit the performance of elective cases to hospitals with the capability for cardiac surgery. The number of hospitals in the United States with this capability is limited, which restric...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.03.040
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Our purpose was to study the effects of atrial natriuretic peptide (ANP) on cardiorenal functions when it is used to manage patients with heart failure who are receiving an angiotensin-converting enzyme inhibitor (ACEi) or in acute saline solution loading. METHODS:Seventeen patients with mild to moderate he...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mhj.2001.112782
更新日期:2001-03-01 00:00:00
abstract::Pulsed Doppler echocardiographic studies of both right and left ventricular diastolic inflow patterns were performed in 10 full-term newborn infants and serially during the first month of life in 21 premature (28 to 35 weeks' gestation) infants with no clinical cardiorespiratory disease. Results of studies performed d...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90745-4
更新日期:1988-12-01 00:00:00
abstract::The clinical usefulness of cardiac imaging modalities that rely upon the detection of perfusion defects and wall motion disturbances requires conditions that provoke a heterogeneity of coronary flow and a myocardial oxygen imbalance, respectively. Traditionally, this has been achieved by exercise stress testing. Many ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(92)90614-2
更新日期:1992-08-01 00:00:00
abstract::To assess the effects of pacing-induced tachycardia on phasic coronary blood flow pattern and flow reserve of left anterior descending artery, we examined 16 patients with chest pain and angiographically normal coronary arteries by using an intravascular Doppler catheter with spectral analysis of the velocity signal. ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90661-0
更新日期:1994-03-01 00:00:00
abstract:AIM:The aim of the study was to assess and compare the safety of antiarrhythmic drugs (AADs) in an unselected real-world population of patients with atrial fibrillation (AF). METHODS AND RESULTS:This is a study of all patients with diagnosed AF in the Swedish Patient register who filled a prescription for sotalol, ami...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2018.06.018
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Standard gray-scale imaging (GSI), three-dimensional (3D) echocardiography has been shown to be superior to two-dimensional echocardiography in measuring left ventricular volume. However, the often relatively poor quality of transthoracic gray-scale data can limit the potential application of this technique....
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70061-4
更新日期:1998-06-01 00:00:00
abstract::This study prospectively assessed the electrophysiologic effects of parenteral magnesium sulfate administration on paroxysmal atrioventricular (AV) reentrant supraventricular tachycardia and the efficacy of magnesium to terminate these arrhythmias. Eleven normomagnesemic patients, seven with orthodromic reentrant supr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80021-3
更新日期:1990-02-01 00:00:00
abstract::The results of percutaneous transseptal balloon mitral valvuloplasty (PTBMV) in 30 Chinese patients with rheumatic mitral stenosis are reported. PTBMV with the Inoue balloon catheter was successfully performed in 27 patients without any significant complications. The mean left atrial pressure decreased from 20.15 +/- ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90061-0
更新日期:1988-05-01 00:00:00
abstract::Functional, ambulatory, community-dwelling subjects (n = 423, aged 75 to 85 years) underwent baseline 24-hour ambulatory electrocardiography (ECG) examinations as part of the Bronx Aging Study, a 10-year prospective cohort study designed to identify risk factors and disease markers for cardiovascular, cerebrovascular,...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90425-1
更新日期:1996-08-01 00:00:00