Abstract:
BACKGROUND:Coronary artery disease (CAD) is the most common cause of left ventricular systolic dysfunction (LVSD). Patients with ischemia as the cause of LVSD may warrant revascularization. Angiography is the most accurate method of CAD diagnosis but is invasive, expensive, and associated with some risk. Noninvasive imaging for CAD often involves expensive equipment, radiation exposure, medication, and/or contrast administration. Carotid ultrasound with measurement of intima-media thickness (IMT) is safe and inexpensive. Carotid IMT is well correlated with the presence of CAD. We assessed the accuracy of carotid ultrasound for identification of CAD as a potential etiology of LVSD. METHODS:Patients with LVSD (ejection fraction < or =40%) of uncertain etiology referred for angiography underwent carotid ultrasound. Patients with history of myocardial infarction were excluded. Two experienced cardiologists blinded to CAD status determined common carotid artery (CCA) IMT and plaque. Significant CAD was defined as > or =50% stenosis of any major artery. Ischemic LVSD was defined as (1) left main and/or proximal left anterior descending coronary artery > or =75% or (2) > or =2 major arteries with > or =75% stenosis. RESULTS:Mean ejection fraction was 27% +/- 10% in 150 patients. Significant CAD was found in 64 (42.7%) and ischemic LVSD in 40 (26.7%). Carotid plaque was seen in 95 (63.3%). Mean CCA IMT was > or =0.9 mm in 69 (46.0%). The combination of mean CCA IMT <0.9 mm and no plaque had negative predictive value for ischemic LVSD of 98%. CONCLUSIONS:Carotid ultrasound with IMT measurement is a valuable screening tool for excluding an ischemic etiology of LVSD when CAD is suspected.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Reynolds HR,Steckman DA,Tunick PA,Kronzon I,Lobach I,Rosenzweig BPdoi
10.1016/j.ahj.2010.03.026subject
Has Abstractpub_date
2010-06-01 00:00:00pages
1059-66issue
6eissn
0002-8703issn
1097-6744pii
S0002-8703(10)00252-8journal_volume
159pub_type
临床试验,杂志文章abstract::Currently available antiplatelet agents are limited in the scope and magnitude of platelet inhibition. Orally active platelet glycoprotein IIb/IIIa antagonists are currently in clinical testing. These agents may extend platelet inhibition and clinical benefit from parenteral glycoprotein IIb/IIIa antagonists. The most...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1053/hj.1999.v138.99080
更新日期:1999-07-01 00:00:00
abstract::Adenosine infusion is accompanied by increases in coronary blood flow and myocardial blood volume. Myocardial blood volume may produce changes in diastolic left ventricular (LV) performance by increasing myocardial turgor. Diastolic dysfunction may also be the result of myocardial ischemia. The relation between change...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90318-6
更新日期:1995-04-01 00:00:00
abstract:BACKGROUND:Exercise training is recommended for chronic heart failure (HF) patients to improve functional status and reduce risk of adverse outcomes. Elevated plasma levels of amino-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), and cardiac troponin T (cTnT) are associ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2013.10.018
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Previous works have suggested an association between Chlamydia pneumoniae infection and coronary heart disease. We evaluated the prevalence of C. pneumoniae infection in patients with acute myocardial infarction (AMI) and coronary heart disease (CHD). METHODS AND RESULTS:Ninety-eight patients with AMI, 80 p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70371-6
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:Although angiotensin-converting enzyme inhibitor attenuates ventricular enlargement, whether beta-blocker therapy induces regression of left ventricular remodeling is not known. The purpose of this study was to compare the effects of bisoprolol therapy with those of imidapril therapy on left ventricular remo...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1067/mhj.2000.110934
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Decreased heart rate variability (HRV) is often assumed to be associated with mortality in all patients after myocardial infarction (MI), independent of clinical factors or time after MI. METHOD:HRV was determined from Holter tapes in the Cardiac Arrhythmia Suppression Trial (CAST). Patients were 71 +/- 120...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(03)00520-9
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Experimental evidence shows that activation of the autonomic nervous system influences ventricular repolarization and, therefore, the QT interval on the ECG. To test the hypothesis that the QT interval is abnormal in autonomic dysfunction, we examined ECGs in patients with severe primary autonomic failure an...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70014-6
更新日期:1998-10-01 00:00:00
abstract::The relation of alcohol consumption to coronary heart disease (CHD) was examined in a cohort of 1910 employed men aged 38 to 55 years enrolled in the Albany Study, a prospective investigation of factors related to cardiovascular disease. Two follow-up periods were examined, one between 1953-54 and 1971-72, the other a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90152-8
更新日期:1985-08-01 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::Serum digoxin and/quinidine concentration were measured before and following the institution of quinidine therapy in 11 patients who were receiving maintenance oral digoxin therapy and who required quinidine therapy for suppression of extrasystoles. Steady-state serum digoxin concentrations after quinidine administra...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90643-3
更新日期:1982-07-01 00:00:00
abstract::This article reviews the evidence that congestive heart failure is accompanied by an increased plasma norepinephrine concentration and that this is due not only to a reduced tissue clearance of the substance but also to a marked increase in sympathetic nerve activity. It also reports data that indicate that the sympat...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(90)90054-2
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:Physician adherence to guidelines is often poor, but the reasons have not been completely studied. We investigated whether physician adherence to guidelines for percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) varied by source, development methods, or the exten...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2003.35
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:All patients who present to an emergency department (ED) are triaged. The ED triage score may determine when patients are seen by a physician. Half of patients with acute myocardial infarction (AMI) were given a low priority score in Ontario in 2000/2001. We assessed the appropriateness of ED triage and its ...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2011.05.015
更新日期:2011-09-01 00:00:00
abstract::In 10 treated and 2 control dogs, the short-term effects of intravenous propafenone (2 mg/kg/10 minutes, followed by 1 mg/min [n = 2] or 25 micrograms/kg/min [n = 8]) on the internal ventricular defibrillation energy requirements (DER) were investigated. Multiple stored energy levels were randomly tested and the perce...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90577-5
更新日期:1991-11-01 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::Continuous-mode Doppler ultrasound and cardiac catheterization were performed within 1.4 +/- 2.0 days in 70 patients, aged 26 to 84 (mean 67 +/- 11) years, with suspected aortic stenosis. Optimal Doppler spectral display signal was recorded from the apical window in 43% of the patients, the second or third right paras...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90694-0
更新日期:1986-07-01 00:00:00
abstract:BACKGROUND:High mortality rates were reported in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary interventions (PPCI) "off-hours." The objective of this study was to evaluate this issue in a more recent population of patients with STEMI treated with PPCI in a high-volume ter...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.04.025
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVES:In patients with severe heart failure additional therapeutic support with intravenous inotropic or vasodilator drugs is frequently used in the attempt to obtain hemodynamic control. The nature and extent to which diastolic filling, atrial function, and mitral regurgitation are modified by these drugs have no...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70030-9
更新日期:1997-12-01 00:00:00
abstract::Digoxin pharmacokinetics were studied in 16 obese (mean +/- SD weight, 100.2 +/- 36.8 kg) and 13 control (64.6 +/- 10.5 kg) subjects. All subjects had normal renal function and no other coexisting disease. After administration of 0.75 mg digoxin by intravenous infusion, multiple plasma samples obtained over the 96 hou...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90100-9
更新日期:1981-10-01 00:00:00
abstract:BACKGROUND:Drug-eluting stents (DES) are increasingly used for the treatment of coronary artery disease. An optimized DES performance is desirable to successfully treat various challenging coronary lesions in a broad population of patients. In response to this demand, third-generation DES with an improved deliverabilit...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2012.02.001
更新日期:2012-04-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2014.11.010
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Preoperative use of angiotensin-blocking drug therapy (ABDT) with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and its link to occurrence of postoperative atrial fibrillation (POAF), a common marker of poor outcomes after cardiac surgery, remain controversial. METHODS:From 19...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2010.05.033
更新日期:2010-08-01 00:00:00
abstract::The distinction between idiopathic dilated cardiomyopathy and myocarditis is controversial, both clinically and pathologically. To increase diagnostic accuracy and provide prognostic information, we prospectively tested the routine application of immunofluorescence and electron microscopy in endomyocardial biopsy eval...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90180-3
更新日期:1987-11-01 00:00:00
abstract::Electrophysiologic studies were prospectively performed in 91 consecutive patients referred for evaluation of sustained ventricular tachycardia or sudden cardiac death. Fifty-two patients had a history of sustained ventricular tachycardia and 39 patients had a history of sudden cardiac death. The identical stimulation...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90088-2
更新日期:1985-09-01 00:00:00
abstract::Doxazosin, a selective alpha 1-inhibitor, was assessed for antihypertensive efficacy, effect on lipid parameters, and safety profile in 21 hypertensive patients with noninsulin-dependent diabetes mellitus. The study involved a 2- to 4-week baseline period, a 10-week period in which patients received doxazosin, 1 to 8 ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90229-3
更新日期:1988-12-01 00:00:00
abstract:BACKGROUND:Glycoprotein (GP) IIb/IIIa antagonists have become a mainstay for the treatment of acute coronary syndromes. Yet, they have rarely been evaluated under relevant pathophysiologic conditions, for example, high shear rates in the presence of physiologic calcium concentrations. We compared the efficacy of eptifi...
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.2003.11.003
更新日期:2004-04-01 00:00:00
abstract::Histological study of the sinoatrial node (SAN) was performed in 111 patients in order to estabilsh correlations between the ECG findings and the anatomical lesions. This series includes both patients with sinus rhythm and patients with atrial arrhythmias. The results are as fololows: (a) the amount of nodal cells in ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80070-7
更新日期:1977-06-01 00:00:00
abstract:BACKGROUND:Anginal chest pain without creatine kinase (CK) elevation is frequently observed in the first hours after coronary stenting. Possible causes of ischemic episodes are microembolism, side branch occlusion, coronary vasospasm, and disturbances of microvascular circulation. In a prospective, double-blind, random...
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(00)90306-5
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVES:We analyzed the antiplatelet effects of different P2Y(12) receptor blockers with VerifyNow P2Y12 assay (VN-P2Y12) and light transmittance aggregometry (LTA). BACKGROUND:The point-of-care VN-P2Y12 has been used to assess the antiplatelet effects in clopidogrel-treated patients but has not been evaluated in d...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2012.03.022
更新日期:2012-07-01 00:00:00
abstract::Atherosclerosis and its vascular sequela are responsible for considerable morbidity and mortality rates. Several risk factors have been implicated in the pathogenesis of atherosclerosis, and the search for other risk factors continues on the medical horizon. Renin-angiotensin system (RAS), a multienzyme, multilocale a...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(97)70089-9
更新日期:1997-09-01 00:00:00