Abstract:
BACKGROUND:It has been reported that mineralocorticoid receptor antagonist improves the prognosis of chronic heart failure (CHF). Recently, hemoglobin A₁(c) (HbA₁(c)) levels have been reported to be an independent risk factor for mortality in CHF, suggesting the important role of insulin resistance in CHF. We compared the metabolic effect of a selective mineralocorticoid receptor blocker eplerenone with spironolactone in CHF patients. METHODS:One hundred seven stable outpatients with mild CHF, who were already receiving standard therapy for CHF, were randomized (1:2) to spironolactone (25 mg/d) or eplerenone (50 mg/d). Plasma levels of B-type natriuretic peptide, adiponectin, HbA₁(c) and cortisol were measured before and after 4 months treatment with spironolactone or eplerenone. RESULTS:There were no differences in baseline characteristics including hemodynamic parameters and plasma levels of biomarkers between 2 groups. In both groups, plasma B-type natriuretic peptide levels were significantly decreased and plasma aldosterone levels were significantly increased after 4 months. In patients receiving spironolactone (n = 34), plasma adiponectin levels were significantly decreased (12.6 ± 1.4-11.2 ± 1.3 μg/mL, P < .0001) and HbA₁(c) and cortisol levels were significantly increased (5.61 ± 0.1-5.8 ± 0.1%, P < .0001, 11.3 ± 0.8-14.7 ± 1.3 μg/dL, P = .003, respectively). In patients receiving spironolactone, there was a significant positive correlation between the change in cortisol and the change in HbA₁(c) (r = 0.489, P = .003). In contrast, in patients receiving eplerenone (n = 73), plasma levels of adiponectin, HbA₁(c) and cortisol did not change. CONCLUSION:These findings indicated that the metabolic effect of eplerenone differed from that of spironolactone and that eplerenone had a superior metabolic effect especially on HbA₁(c) in CHF patients.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Yamaji M,Tsutamoto T,Kawahara C,Nishiyama K,Yamamoto T,Fujii M,Horie Mdoi
10.1016/j.ahj.2010.04.024subject
Has Abstractpub_date
2010-11-01 00:00:00pages
915-21issue
5eissn
0002-8703issn
1097-6744pii
S0002-8703(10)00659-9journal_volume
160pub_type
杂志文章,随机对照试验abstract::The 2,000 heart donors available annually continue to be inadequate for the 50,000 patients with end-stage congestive heart failure who require heart transplantation to survive. This discrepancy has led to the successful use of long-term implantable LVADs as a bridge to transplantation and has raised the issue of perm...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90056-x
更新日期:1995-01-01 00:00:00
abstract::The effects of handgrip and supine bicycle exercise on hemodynamics and left ventricular (LV) performance were compared in 25 patients with moderate to severe aortic regurgitation (AR) and normal LV ejection fraction at rest (greater than or equal to 50%) and in 10 control subjects. In both groups, heart rate, systoli...
journal_title:American heart journal
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doi:10.1016/0002-8703(85)90355-2
更新日期:1985-06-01 00:00:00
abstract:BACKGROUND:Protease inhibitors (PIs) may be associated with accelerated atherosclerosis in individuals infected with human immunodeficiency virus (HIV). We assessed the effects of HIV PIs on subclinical atherosclerosis. METHODS:The lipid profiles, C-reactive protein (CRP) levels, coronary artery calcification (CAC) sc...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.125009
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Physical activity and symptom questionnaires have been used as surrogates for exercise testing to estimate a patient's functional capacity and to individualize an exercise testing protocol in accordance with exercise testing guidelines. To validate these approaches, they must be compared with measured oxygen...
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doi:10.1067/mhj.2001.118740
更新日期:2001-12-01 00:00:00
abstract::Fenoldopam mesylate (SK&F 82526-J) is a novel benzazepine derivative. It has selective agonist activity at post-junctional (DA1) vascular dopaminergic receptors, which normally subserve renal artery vasodilation. Previous studies in normal subjects and in patients with hypertension indicate that fenoldopam increases r...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90620-5
更新日期:1988-08-01 00:00:00
abstract::The incidence of cardiac events in Japanese men (mean age 54 +/- 10 years) with atypical or nonanginal chest pain was assessed prospectively. Three groups of patients, those with typical angina (TA; n = 134), those with atypical angina (AA; n = 192), and those with nonanginal chest pain (NA; n = 311) were studied with...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90802-3
更新日期:1992-06-01 00:00:00
abstract::To compare the effects of two thrombolytic agents, streptokinase and recombinant tissue-type plasminogen activator (rTPA) with early heparinization, on left ventricular function, coronary patency and reinfarction rates, bleeding complications, and short- and long-term mortality, we studied 122 patients with acute myoc...
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)90685-o
更新日期:1992-04-01 00:00:00
abstract::Mitral valve prolapse (MVP) is a common cardiac valve abnormality that affects women more frequently than men. We have previously shown that mild dehydration induces echocardiographic signs of MVP in approximately 50% of healthy asthenic women with previously normal cardiac findings. The present study was designed to ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90047-0
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Exercise training is now an accepted component of the therapeutic regimen in patients with heart failure and underlying ischemia, but few data are available on the effects of training in patients with nonischemic dilated cardiomyopathy. METHODS:Twenty-four patients (mean age 55 +/- 9 years, mean ejection fr...
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.2002.124401
更新日期:2002-10-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90062-9
更新日期:1996-01-01 00:00:00
abstract::Phosphodiesterase inhibitors that are selective for cAMP-specific cardiac and vascular PDE III comprise a new group of agents for the treatment of heart failure, which at present are limited to clinical shortterm intravenous use and research uses only. Although both intravenous amrinone and milrinone are FDA approved,...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90078-v
更新日期:1991-06-01 00:00:00
abstract::In January 1997, experts from the United States, Europe, and Japan gathered at Stanford University to review their collective experience with intracoronary and noncoronary stenting and to identify and prioritize issues requiring further clinical investigation. This report summarizes the discussions that took place dur...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(98)70004-3
更新日期:1998-10-01 00:00:00
abstract::Currently available internal cardiac defibrillators use a uniphasic, truncated exponential waveform morphology of about 6 msec in duration at an energy level of 23 to 33 joules. To determine if improved defibrillation could be achieved with a different waveform morphology, we implanted 4.5 cm2 titanium patches to the ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90187-7
更新日期:1989-08-01 00:00:00
abstract::We studied the diagnostic value of exercise electrocardiographic (ECG) testing in 191 patients who were completely asymptomatic 6 months after a successful percutaneous transluminal coronary angioplasty procedure. With > 70%- and > 50%-diameter stenosis at follow-up as restenosis criteria, the sensitivities of exercis...
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(95)90267-8
更新日期:1995-03-01 00:00:00
abstract::Eight cases of top-ranking athletes with "repolarization disorders" are reported. All subjects were asymptomatic and were otherwise suited for excellent cardiovascular performances. Seven athletes did not show any evidence of heart disease. Seven had MVP (mitral valve prolapse). Umprompted variability of ECG tracings ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90117-9
更新日期:1980-08-01 00:00:00
abstract::Cross-sectional echocardiography identified two abnormal patterns of mitral valve closure in 14 patients with mitral regurgitation due to papillary muscle dysfunction: (1) in three patients with an akinetic inferior-posterior wall but normal cavity size, papillary muscle fibrosis was associated with late systolic mitr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90430-7
更新日期:1979-03-01 00:00:00
abstract::Although successful dilatation of a target lesion by means of percutaneous transluminal coronary angioplasty (PTCA) can be attained as frequently in elderly as in younger patients, elderly patients have a higher risk of complications. Furthermore, cohorts of patients older than 75 years and undergoing PTCA include mor...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90267-4
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:Although the use of clopidogrel in patients "unlikely" to require coronary artery bypass grafting (CABG) is recommended in current guidelines of acute coronary syndrome (ACS) management, an important minority of patients require CABG. We assessed the ability to predict need for CABG from demographics known a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.12.002
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:The study aimed to determine the impact on eptifibatide-associated bleeding by implementing a computerized dosing algorithm in the cardiac catheterization suite. BACKGROUND:Excessive dosing of eptifibatide is associated with increased bleeding rates and hospital mortality. Although dosing adjustments based o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2009.10.006
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Furthermore, patients with T2DM and acute coronary syndrome (ACS) have a particularly high risk of CV events. The glucagon-like peptide 1 receptor agonist, lixisenatide, improves glyc...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-05-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.10.005
更新日期:2009-02-01 00:00:00
abstract::A significant diuretic and natriuretic response occurs during paroxysmal supraventricular tachycardia (SVT). Although the diuresis may be secondary to suppression of vasopressin secretion, the etiology of the natriuresis remains unexplained. To determine if atrial natriuretic factor (ANF) could contribute to the polyu...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90301-7
更新日期:1986-11-01 00:00:00
abstract::Transthoracic echocardiography has played a useful role in the screening of cardiac transplant donors. However, transthoracic echocardiograms may be suboptimal in many patients on ventilators. The role of transesophageal echocardiography in cardiac donor screening is unknown. Therefore we compared the potential benefi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90758-2
更新日期:1993-06-01 00:00:00
abstract::Four children with cor triatriatum underwent intraoperative transesophageal echocardiography. Two patients had cor triatriatum alone and two had associated complex congenital heart disease. Transesophageal echocardiography provided optimal imaging of these defects and provided unique information that facilitated surgi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90277-5
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:Coronary heart disease continues to be one of the most common chronic illnesses in the United States and most of the developed world. Clinicians and health authorities have interest in identifying individuals at increased risk of CHD. The Framingham Heart Study has over the years produced mathematical "healt...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.96469
更新日期:2000-02-01 00:00:00
abstract::Fifty adult men with mild to moderate hypertension were recruited to participate in a double-blind crossover study. Each subject received 14 days of drug treatment and 14 days of placebo treatment (random order). Half the subjects were assigned to a metoprolol (150 mg/day) vs placebo treatment regimen and half to an a...
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)90106-8
更新日期:1988-07-01 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::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::The clinical spectrum and outcome of 119 patients with acute non-Q wave myocardial infarction (NQMI) were studied, in comparison with those of 354 patients with acute Q wave myocardial infarction (QMI). The patients with NQMI had a significantly higher incidence of preinfarction angina (73% vs 63%), previous myocardia...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90056-6
更新日期:1986-03-01 00:00:00
abstract:BACKGROUND:Recently revised American College of Cardiology/American Heart Association guidelines for exercise electrocardiography (ExECG) have suggested that ExECG scores be used to assist in management decisions in patients with suspected coronary artery disease (CAD). METHODS:We used 442 women who underwent both ExE...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.125835
更新日期:2002-11-01 00:00:00