Abstract:
AIM:The purpose of this study was to assess the relationship between pulse pressure (PP) and cardiovascular outcomes in a large, elderly, coronary artery disease (CAD) population with hypertension, and compare the predictive power of PP with other blood pressure measures. METHODS AND RESULTS:In INternational VErapamil-trandolapril STudy, 22,576 CAD patients with hypertension (mean age 66 years) were randomized to verapamil-SR or atenolol-based strategies and followed for 2.7 years (mean). Primary outcome (PO) was time to first occurrence of death (all-cause), non-fatal myocardial infarction (MI), or non-fatal stroke. Mean follow-up PP was summarized by 5 mmHg subgroups for association with incidence of PO. Stepwise Cox proportional hazards models were used to estimate adjusted relative hazard ratios (HR) for the risk of PO with follow-up PP as a continuous variable, with linear and quadratic terms. Similar models were constructed for follow-up systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressures (MAP). A -2 log-likelihood statistic was used to assess the predictive power of PP compared with SBP, DBP, and MAP. For follow-up PP, the incidence and adjusted HR for the PO formed a J- or U-shaped curve. After adjusting for baseline covariates, both linear and quadratic terms for PP were significant (P < 0.0001 for both), with a nadir of 54 mmHg (bootstrapping 95% CI 42-60 mmHg). Similar quadratic relationships were found between PP and all-cause mortality or MI; the relationship between PP and stroke was linear. Pulse pressure was a predictor of PO even after including SBP (P = 0.007 linear term) or DBP (P < 0.0001 for both linear and quadratic terms) or MAP (P < 0.01 for both liner and quadratic terms) in the model. Using -2 log-likelihood differences, SBP (-2 log-likelihood difference 77.1 vs. 7.3 for PP), DBP (-2 log-likelihood difference 138.5 vs. 44.6 for PP), and MAP (-2 log-likelihood difference 125.0 vs. 13.4 for PP) were stronger predictors of PO than PP. CONCLUSION:In CAD patients with hypertension, PP (on anti-hypertensive treatment) is a weaker predictor of cardiovascular outcomes than SBP, DBP, or MAP.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Bangalore S,Messerli FH,Franklin SS,Mancia G,Champion A,Pepine CJdoi
10.1093/eurheartj/ehp109subject
Has Abstractpub_date
2009-06-01 00:00:00pages
1395-401issue
11eissn
0195-668Xissn
1522-9645pii
ehp109journal_volume
30pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Oral dipyridamole induces accumulation of endogenous adenosine, which in a hypoxic milieu exerts experimentally an angiogenic effect on coronary collateral circulation. A meta-analysis of 13 randomized placebo-controlled trials published between 1960 and 1992 showed evidence of benefit for dipyridamole in th...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1053/euhj.2001.2623
更新日期:2001-10-01 00:00:00
abstract::Large-scale randomized clinical trials have established the efficacy of cholesterol-lowering, blood pressure-lowering, and anti-platelet therapy to prevent cardiovascular diseases. A challenge for clinicians is to apply group-level evidence from these trials to individual patients. Trials typically report a single tre...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehu004
更新日期:2014-04-01 00:00:00
abstract::Contraceptive counselling should begin early in females with heart disease, preferably directly after the start of menstruation. In coming to a decision about the method of contraception, the following issues should be considered: (i) the risk of pregnancy for the mother and the consequences of an unplanned pregnancy;...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehv141
更新日期:2015-07-14 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::Hypertension (HTN) is quantitatively the major cardiovascular risk factor and responsible for ∼50% of cardiovascular morbidity and mortality. Blood pressure (BP) is also a classical complex genetic trait with heritability estimates of 30-50%. Although much is known about BP regulation, the intrinsic origin of essentia...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehs455
更新日期:2013-04-01 00:00:00
abstract:AIMS:Pericardial effusion (PE) is a common finding in cardiac patients with chronic heart failure. The prognostic relevance of a small, haemodynamically non-compromising PE in such patients, however, remains to be determined. METHODS AND RESULTS:All patients referred to our heart failure clinic and having a baseline e...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/eht006
更新日期:2013-05-01 00:00:00
abstract:UNLABELLED:To study the ablation effects induced by excimer laser coronary angioplasty (ELCA), we examined 41 segments of nine isolated coronary arteries. An electronic intracoronary ultrasound device (ICUS: 20 MHz, 3.5F, Endosonics) was positioned coaxially within the vessel. Angioplasty was performed using a 1.7 mm E...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060884
更新日期:1995-02-01 00:00:00
abstract:AIMS:To assess the outcome and costs of patients with acute myocardial infarction (AMI) after initial admission to hospitals with or without catheterization facilities in Belgium. METHODS AND RESULTS:From a nationwide hospital register, we retrieved the data of 34 961 patients discharged during 1999-2001 with a princi...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehl161
更新日期:2006-11-01 00:00:00
abstract::We describe a patient with a large intramyocardial hydatid cyst lying in the postero-lateral segment of the left ventricle near the atrioventricular groove level which ruptured into the pericardial sac, resulting in cardiac tamponade. Cross-sectional echocardiographic examination from a modified four-chamber apical vi...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/9.7.819
更新日期:1988-07-01 00:00:00
abstract:AIMS:Psoriasis is a chronic inflammatory disease and inflammation contributes to the pathogenesis of atrial fibrillation (AF) and ischaemic stroke. We therefore investigated the risk of these endpoints in patients with psoriasis. METHODS AND RESULTS:Cohort study of the entire Danish population followed from 1997 to 20...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehr285
更新日期:2012-08-01 00:00:00
abstract:AIMS:We examined the left lateral ridge (LLR) between the orifices of the left pulmonary veins and the left atrial appendage for a better understanding of its structural composition relevant to ablations for atrial fibrillation (AF). METHODS AND RESULTS:The LLR and its surrounding areas were studied in 40 heart specim...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm606
更新日期:2008-02-01 00:00:00
abstract:AIMS:Diastolic dysfunction in acute myocardial infarction (MI) is associated with adverse outcome. Recently, the ratio of early mitral inflow velocity (E) to global diastolic strain rate (e'sr) has been proposed as a marker of elevated LV filling pressure. However, the prognostic value of this measure has not been demo...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/eht179
更新日期:2014-03-01 00:00:00
abstract::A 45-year-old patient with the Wolff-Parkinson-White syndrome suffering from recurrent intractable reciprocating atrioventricular tachycardia (RAVT) is reported. He used amiodarone, sotalol, quinidine, propafenone and flecainide unsuccessfully. An electrophysiological study (EPS) performed with four catheters localize...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/12.12.1321
更新日期:1991-12-01 00:00:00
abstract::Aims Epidemiological studies reported two contrasting trends: on one hand, a significant improvement in the use of evidence-based treatments of patients discharged with a myocardial infarction (MI). On the other hand, the increasing number of elderly and co-morbid patients who are usually less treated. The aim of this...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehr410
更新日期:2012-02-01 00:00:00
abstract::The clinical expert consensus statement on takotsubo syndrome (TTS) part II focuses on the diagnostic workup, outcome, and management. The recommendations are based on interpretation of the limited clinical trial data currently available and experience of international TTS experts. It summarizes the diagnostic approac...
journal_title:European heart journal
pub_type: 共识发展会议,杂志文章
doi:10.1093/eurheartj/ehy077
更新日期:2018-06-07 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::The effects of the calcium antagonist, diltiazem (D), on left ventricular (LV) response to postextrasystolic potentiation (PESP) were investigated in 15 coronary artery disease patients. Several haemodynamic and LV function parameters, as well as regional wall kinetics, were analysed. During LV angiography, which was ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059772
更新日期:1990-07-01 00:00:00
abstract::All citizens (N = 22066) aged 16 to 65 of a medium-sized Belgian town were personally invited to CPR training sessions held in their neighbourhood. 1152 responded by attending a training session. Those who did not so respond were surveyed (random sample N = 600) for reasons of their not coming. The sample fitted well ...
journal_title:European heart journal
pub_type: 杂志文章
doi:
更新日期:1987-03-01 00:00:00
abstract:AIMS:To document tracking patterns, if any, over time, of classical cardiovascular risk factors in men and women participants in the Vorarlberg Health Monitoring and Promotion Programme (VHM&PP) METHODS AND RESULTS: 67,413 men and 82,237 women underwent a total of 45,4448 standardised examinations in the 15 year period...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/s0195-668x(03)00170-2
更新日期:2003-06-01 00:00:00
abstract::Five, ten and fifteen min after sublingual administration of 10mg isosorbide dinitrate (ISDN) in chewing capsules, in 10 patients with coronary artery disease, ISDN plasma levels were correlated with the dilation of epicardial coronary arteries as well as with changes in aortic blood pressure and heart rate. Due to th...
journal_title:European heart journal
pub_type: 杂志文章
doi:
更新日期:1989-11-01 00:00:00
abstract::619 patients with suspected acute myocardial infarction (MI) were randomized to receive either a high-dose short-term intravenous infusion of streptokinase (1.5 MU over one hour) or placebo. Using a '2 X 2 X 2 factorial' design, patients were also randomized to receive either oral aspirin (325 mg on alternate days for...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1987-06-01 00:00:00
abstract::We now have conclusive data that ACE inhibitors reduce mortality, morbidity, and symptoms in patients with low ejection fraction and/or heart failure. Therefore, ACE inhibitors should be routinely used in all such patients, as long as there are no clear contraindications. Routine use of ACE inhibitors will lead to pro...
journal_title:European heart journal
pub_type: 杂志文章,meta分析
doi:10.1093/eurheartj/15.suppl_b.9
更新日期:1994-05-01 00:00:00
abstract::The Doppler ultrasonic estimation of cardiac output in man is reviewed. Minimal requirements for accurate measurements are discussed, and the published results of reproducibility studies and validation studies are summarized and analysed. Analysis of Doppler records has a coefficient of repeat determination of 5-8% fo...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/11.suppl_i.49
更新日期:1990-12-01 00:00:00
abstract:AIM:To describe the relative impact on survival of the delay from estimated time of collapse to call for an ambulance among patients who suffer from a bystander witnessed out of hospital cardiac arrest of a cardiac aetiology. METHODS:A majority of all ambulance organizations in Sweden (covering 85% of Sweden inhabitan...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/s0195-668x(03)00475-5
更新日期:2003-10-01 00:00:00
abstract::From January 1978 to August 1983, 41 prosthetic valve thromboses in 34 patients were operated upon in our service. They comprised 15 aortic, 25 mitral and one tricuspid valve thromboses. Seven patients had massive thrombus with dysfunction of the prosthesis; others had small and disseminated thrombi on their prosthesi...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/5.suppl_d.39
更新日期:1984-10-01 00:00:00
abstract::The study was designed to examine the safety and efficacy of acute interventional use of captopril on left ventricular volumes, ventricular arrhythmias and neurohormones during thrombolysis in patients with a first anterior myocardial infarction, within 6 h of onset of symptoms. Left ventricular dysfunction and progno...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1093/oxfordjournals.eurheartj.a060608
更新日期:1994-07-01 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::Advanced coronary artery disease (CAD), impaired left ventricular function and prolongation of the QT-interval are considered risk factors for sudden cardiac death in CAD-patients. So far, however, there are no studies investigating in detail whether there is a correlation between the QT-interval and changes in corona...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061951
更新日期:1986-01-01 00:00:00
abstract:AIMS:Very few data exist on the occurrence of acute kidney injury (AKI) associated with transcatheter aortic valve implantation (TAVI). The objectives of the present study were (i) to determine the incidence, predictive factors, and prognostic value of AKI following TAVI, and (ii) to compare the occurrence of AKI in TA...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehp552
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to describe the frequencies of various diagnoses in patients admitted with acute chest pain, but without acute myocardial infarction, and to evaluate a non-invasive screening programme for these patients. PATIENTS:A total of 204 consecutive non-acute myocardial infarction patien...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a014998
更新日期:1996-07-01 00:00:00