Abstract:
:Guidelines published in 2001 recommended 1 regional adult congenital heart disease (ACHD) center per 3 to 10 million population. Our objective was to determine if published guidelines on the numbers of regional ACHD centers are sufficient to meet the needs of adults with congenital heart disease in the general population. Population data were examined to evaluate the recommendations for the number of regional centers. We extrapolated a population prevalence of 4.09 per 1,000 adults corresponding to 847,896 and 87,375 patients with ACHD in the United States and Canada, respectively. We reviewed the information currently available on the numbers of ACHD facilities of any kind indexed to continental populations. We examined the distribution of disease and health services in pediatric and adult populations and examined the evidence for pressure points during the transition process. Published data on 6 of the largest regional ACHD centers were used to model regional center care. We reviewed determinants and recommendations for follow-up in regional centers. We explore 3 scenarios of referral patterns to regional centers, examining their impact of the number of centers required per country population. In conclusion, we demonstrate that 1 regional ACHD center for a population of 2.0 million adults appears to be closer to what is required for improving access to specialized care for patients with ACHD in the United States and Canada.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Marelli AJ,Therrien J,Mackie AS,Ionescu-Ittu R,Pilote Ldoi
10.1016/j.ahj.2008.08.029subject
Has Abstractpub_date
2009-01-01 00:00:00pages
1-8issue
1eissn
0002-8703issn
1097-6744pii
S0002-8703(08)00792-8journal_volume
157pub_type
杂志文章,评审abstract::We investigated the relation between the angiographic collateral grade (Rentrop's classification) and the collateral flow velocity pattern in 43 patients with angina pectoris. Collateral flow velocity was measured with a Doppler guide wire during balloon occlusion in coronary angioplasty. Collateral flow was detected ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90232-5
更新日期:1995-07-01 00:00:00
abstract::In 14 patients with severe congestive heart failure, the effects of captopril on the forearm circulation were evaluated with strain gauge plethysmography. Changes in plasma renin activity, angiotensin II, norepinephrine, epinephrine, bradykinin, prostaglandin E2, and 6-keto-prostaglandin F1 alpha concentrations were a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90662-5
更新日期:1989-01-01 00:00:00
abstract::The resonant frequencies of five commonly used fluid-filled catheters connected to a solidstate microdisplacement pressure gauge were 18 to 33 per cent higher than those obtained with a conventional manometer. Four catheters had a flat amplitude response to 26 Hz. or more at the 20 per cent amplitude distortion level...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90508-6
更新日期:1975-05-01 00:00:00
abstract::The presence and severity of functional mitral regurgitation were quantified by Doppler echocardiography in 17 patients with dilated cardiomyopathy and no evidence of primary valvular disease. Mitral regurgitant fraction was greater than 20% in 11 of the 17 patients, and exceeded 40% in four patients. Total stroke vol...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90334-1
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:We aim to validate the diagnostic performance of the first fully automatic, electronic heart failure (HF) identification algorithm and evaluate the implementation of an HF Dashboard system with 2 components: real-time identification of decompensated HF admissions and accurate characterization of disease char...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.10.001
更新日期:2017-01-01 00:00:00
abstract::The role of prostaglandins in mediating the hemodynamic response to nitroglycerin in vivo is controversial. To determine the effect of inhibiting prostaglandin production on the response to nitroglycerin, either placebo or aspirin (650 mg) was administered 1 hour prior to the administration of nitroglycerin (432 micro...
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(88)90252-9
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Erythropoietin mitigates myocardial damage and improves ventricular performance after experimental ischemic injury. This study assessed safety and efficacy markers relevant to the biological activity of recombinant human erythropoietin (rHuEpo) in patients with acute myocardial infarction (MI). METHODS:We c...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.06.032
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:There are limited data regarding the clinical correlates and prognostic significance of echocardiographically defined mitral regurgitation (MR) early after acute myocardial infarction (MI). The current study addressed these issues. METHODS:Seven hundred thirty-seven patients with acute MI who underwent tran...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.01.020
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Statins (3-hydroxy-3-methyl-glutaryl coenzyme A reductase inhibitors) are known to reduce mortality and cardiac events in patients with coronary artery disease who have not progressed to left ventricular systolic dysfunction (LVSD) and/or heart failure (HF). This study investigated the effect of changes in s...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.01.029
更新日期:2007-04-01 00:00:00
abstract::Three patients with subpulmonic ventricular septal defect and pulmonary valve fluttering by echocardiography are presented. The echographic changes appear identical to that reported with infundibular pulmonic stenosis and the mechanism causing this fluttering is probably similar. ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80336-0
更新日期:1977-07-01 00:00:00
abstract::To investigate the influence of intrinsic limb vasodilator capacity on exercise performance, limb reactive hyperemic flows and their relations to exercise capacity during upright bicycle exercise were examined in 52 patients with recent myocardial infarction. Reactive hyperemic flow was measured in the forearm and the...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90243-4
更新日期:1996-09-01 00:00:00
abstract::New postoperative electrocardiographic Q waves have been described in eight of 40 per cent of patients undergoing bypass grafting for coronary artery disease. Various theories have been proposed to explain these new Q waves. Correlations of new Q waves to vein bypass occlusion, prolonged pump time or aortic cross-clam...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90233-8
更新日期:1978-04-01 00:00:00
abstract::The method for evaluating right ventricular and pulmonary artery systolic pressures by subtracting the systolic pressure gradient across the ventricular septal defect from the cuff systolic blood pressure is documented. To confirm the reliability and accuracy of this method, simultaneous continuous wave Doppler echoca...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90116-q
更新日期:1993-04-01 00:00:00
abstract::While sudden death after acute myocardial infarction or ischemia most commonly occurs in the first few minutes, usually from tachyarrhythmias, little is known of associated hemodynamics. We monitored hemodynamics for 15 minutes following coronary embolization with mercury in 31 awake dogs. In 17 nonsurvivors, mean art...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90131-9
更新日期:1981-04-01 00:00:00
abstract::To investigate the incidence and clinical significance of postoperative pericardial effusion (PE), the presence of PE was evaluated by echocardiography, 1 and 2 weeks postoperatively, in 50 patients after insertion of a valve prosthesis and in 100 patients after coronary bypass surgery (50 patients receiving a combina...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90255-4
更新日期:1988-07-01 00:00:00
abstract::Head-up tilt provokes vasodepressor syncope in patients with this disorder but may also cause fainting in unaffected subjects. The aims of this study were to examine autonomic function and sequential changes in heart rate variability and plasma catecholamines during graded head-up tilt in patients with vasodepressor s...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70213-8
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:The impact of race and sex on clinical outcomes after percutaneous coronary interventions remains incompletely understood. Specific data on patient demographics, lesion characteristics, and outcomes of black versus white patients are poorly described. To further evaluate these issues, we analyzed the New App...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.106645
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Patients undergoing percutaneous coronary intervention (PCI) for unstable coronary syndromes have substantial emotional and spiritual distress that may promote procedural complications. Noetic (nonpharmacologic) therapies may reduce anxiety, pain and distress, enhance the efficacy of pharmacologic agents, or...
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.2001.119138
更新日期:2001-11-01 00:00:00
abstract::Our experience with the use of five new antiarrhythmic drugs for treating life-threatening arrhythmias in children will be briefly reviewed. Prevention of recurrent episodes of atrial flutter with digoxin and local anesthetic antiarrhythmic drugs often is only moderately successful, benefiting 65% of patients. Amiodar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90027-5
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Tamoxifen has mixed estrogen agonist and antagonist properties in estrogen-regulated tissues. Its effect on the cardiovascular system is not well defined. We carried out a study to investigate the effect of tamoxifen on peripheral vascular endothelial function. METHODS:Three groups of postmenopausal women (...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.117323
更新日期:2001-10-01 00:00:00
abstract::Pulmonary function was measured serially in two separate randomized trials of pindolol in the treatment of essential hypertension. Patients with overt obstructive airways disease were excluded. In study 1, 131 hypertensive patients were randomized to placebo (31) and 15 mg (33), 30 mg (33), and 60 mg (34) of pindolol....
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(82)90135-1
更新日期:1982-08-01 00:00:00
abstract::We studied the prevalence and clinical significance of transient U wave inversion in 43 patients with variant angina. Twenty-four patients (group A) had ST segment elevation in the anterolateral and 19 patients (group B) had this finding in the inferoposterior leads of the ECG during spontaneous angina. In none of the...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90452-6
更新日期:1984-10-01 00:00:00
abstract::We examined intraindividual variability in serum TC in 2912 men and women having TC measured at each of biennial examinations 2 through 7 of the FHS. RMSE described variability around the linear slope of an individual's TC during the baseline decade. Average biennial difference +/- SD was +3.7 +/- 6.7 mg/dl in men, +6...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90393-x
更新日期:1994-06-01 00:00:00
abstract::Fifteen cases of the sick-sinus syndrome in young Negroes are presented. The etiology was unknown in all cases; organic heart disease was absent. The very high default rate suggests that the prognosis may be grave. This disorder is by no means uncommon in young persons in tropical countries and the dangers of a mistak...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90078-2
更新日期:1975-03-01 00:00:00
abstract::Patients with intractable heart failure (New York Heart Association [NYHA] class III and IV) who were receiving maximal conventional treatment were enrolled in an outpatient program that included inotropic infusions, intensive patient education, and close follow-up. The effects of this approach to therapy were evaluat...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90315-4
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine in pediatric Duchenne (DMD) and Becker muscular dystrophy (BMD) or other dilated cardiomyopathies (ODCM) whether outcomes differ by diagnosis. BACKGROUND:Children with dilated cardiomyopathy are treated as a single undifferentiated group. METHODS:This cohort study of 1...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.01.018
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Performing preoperative coronary angiography (CA) before surgical repair of a type A acute aortic dissection (TA-AAD) remains controversial. Although the information provided by CA may be useful in planning the surgical approach, the potential delay to surgery and complications of CA may confer added risk of...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.01.010
更新日期:2011-04-01 00:00:00
abstract::To determine the factors relating to prognosis, the records of 15 neonates with persistent prolongation of the QT interval on the electrocardiogram after the fourth day of life were reviewed. Patients were admitted for symptoms (syncope, cardiac failure, or seizures), abnormal auscultation with an irregular heart rate...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90940-w
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:Familial dilated cardiomyopathy (FDCM) is attributed to defects in cytoskeletal proteins, and different patterns of inheritance and phenotypic expressions according to assorted-protein modifications have been identified to date. We describe a clinical family study with 24 individuals in 3 generations affecte...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2003.141
更新日期:2003-02-01 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