Abstract:
AIMS:Adenosine stress computed tomography myocardial perfusion imaging (CTP) is an emerging non-invasive method for detecting myocardial ischaemia. Its value when compared with fractional flow reserve (FFR), a highly accurate index of ischaemia, is unknown. Our aim was to determine the diagnostic accuracy of CTP and its incremental value when used with computed tomography coronary angiography (CTA) for detecting ischaemia compared with FFR. METHODS AND RESULTS:Forty-two patients (126 vessel territories), who had at least one ≥50% angiographic stenosis on invasive angiography considered for non-urgent revascularization, were included and underwent FFR and CT assessment, including CTP, delayed contrast enhancement scan and CTA all acquired using 320-detector row CT, and prospective ECG gating. Fractional flow reserve was determined in 86 territories subtended by vessels with ≥50% stenosis upon visual assessment. Fractional flow reserve ≤0.8 was considered to indicate significant ischaemia. Computed tomography myocardial perfusion imaging correctly identified 31/41 (76%) ischaemic territories and 38/45 (84%) non-ischaemic territories. Per-vessel territory sensitivity, specificity, positive, and negative predictive values of CTP were 76, 84, 82, and 79%, respectively. The combination of a ≥50% stenosis on CTA and perfusion defect on CTP was 98% specific for ischaemia, while the presence of <50% stenosis on CTA and normal perfusion on CTP was 100% specific for exclusion of ischaemia. Mean radiation for CTP and combined CT was 5.3 and 11.3 mSv, respectively. CONCLUSION:Computed tomography myocardial perfusion imaging is moderately accurate in identifying perfusion defects associated with ischaemia as assessed by FFR in patients considered for revascularization. In territories, where CTA and CTP are concordant, CTA/CTP is highly accurate in the detection and exclusion of ischaemia. This is achievable with acceptable radiation exposure using 320-detector row CT and prospective ECG gating.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Ko BS,Cameron JD,Meredith IT,Leung M,Antonis PR,Nasis A,Crossett M,Hope SA,Lehman SJ,Troupis J,DeFrance T,Seneviratne SKdoi
10.1093/eurheartj/ehr268subject
Has Abstractpub_date
2012-01-01 00:00:00pages
67-77issue
1eissn
0195-668Xissn
1522-9645pii
ehr268journal_volume
33pub_type
杂志文章abstract::A previously described nitroglycerin-induced heparin resistance could not be verified by in-vitro experiments or in a randomized, double-blind, crossover trial in healthy volunteers. A clinically relevant attenuation of the anticoagulant effect of a heparin bolus (40 U.kg-1) by a concomitant infusion of nitroglycerin ...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/oxfordjournals.eurheartj.a060182
更新日期:1992-03-01 00:00:00
abstract:UNLABELLED:Peripheral vessels provide a useful in vivo haemodynamic model allowing evaluation of local intravascular fluid dynamics. Velocity measurements using a 0.018 inch Doppler-tipped angioplasty guidewire, quantitative angiography and laboratory data were gathered from 45 patients with a total of 48 percutaneous ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/16.suppl_j.60
更新日期:1995-10-01 00:00:00
abstract::Acute myocardial infarction remains the principal cause of death in people aged over 40 years, despite the reductions in coronary heart disease (CHD) mortality that have been observed over the past 25 years in many European countries. Consequently, there is considerable potential to decrease further the risk of cardio...
journal_title:European heart journal
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract::This study analyses the immediate outcome and the risk of recurrent restenosis in patients who, at the time of repeat coronary angioplasty for a first restenosis, had unstable (n = 50), 19%) or stable (n = 218, 81%) angina. Successful angioplasty was accomplished in 250 (93%) patients, 222 (89%) of whom had follow-up ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.2.235
更新日期:1993-02-01 00:00:00
abstract::Liaison with two important scientific societies in the field of hypertension improves contact with readers. ...
journal_title:European heart journal
pub_type: 新闻
doi:
更新日期:2012-05-01 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:AIMS:The aim of this study involves the early identification, among apparently healthy individuals, of those at high risk for sudden cardiac death. We tested the hypothesis that individuals who respond to mild mental stress in preparation for exercise test with the largest heart rate increases might be at highest risk....
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehp160
更新日期:2009-07-01 00:00:00
abstract:AIMS:The aim of this study is to compare the efficacy of sirolimus-eluting stents (SES) on neointimal growth and vessel remodelling for in-stent restenosis versus de novo coronary artery lesions using serial intravascular ultrasound (IVUS). METHODS AND RESULTS:The study population consisted of 86 patients with in-sten...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/j.ehj.2003.10.012
更新日期:2004-01-01 00:00:00
abstract:AIMS:To evaluate the effect of thrombolysis on mortality and its causes in older patients with acute myocardial infarction (AMI). METHODS AND RESULTS:An analysis of 706 consecutive patients > or =75 years old with a first AMI enrolled in the PPRIMM75 registry showed that although there were important differences in ba...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi284
更新日期:2005-09-01 00:00:00
abstract::We assessed the incremental effect of cardiac catheterization upon the management of 93 adult patients with aortic and/or mitral valve disease, referred for surgical consideration. There were 52 patients with aortic valve disease, 29 with mitral valve disease and 12 with aortic and mitral valve disease. Prior to cardi...
journal_title:European heart journal
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract::In a pilot study, a prophylactic regimen including ciprofloxacin and amphotericin B was applied in 102 consecutive patients on artificial respiration for greater than or equal to 5 days to prevent respiratory tract infection with aerobic Gram-negative bacilli. Ciprofloxacin was given twice a day, as 500 mg through a g...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/10.suppl_h.22
更新日期:1989-12-01 00:00:00
abstract::Coronary vasodilator responses to pharmacological (acetylcholine) and physiological (cold pressor test and flow dependent dilation) stimuli are impaired in hypertensive patients. The ability of angiotensin-converting enzyme inhibitors to restore normal coronary responses in hypertension and the potential mechanisms in...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:
更新日期:1998-09-01 00:00:00
abstract:Aim:Hypertrophic cardiomyopathy (HCM) exhibits genetic heterogeneity that is dominated by variation in eight sarcomeric genes. Genetic variation in a large number of non-sarcomeric genes has also been implicated in HCM but not formally assessed. Here we used very large case and control cohorts to determine the extent t...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehw603
更新日期:2017-12-07 00:00:00
abstract::In atrial flutter, chemical conversion with class I drugs is often unsuccessful, whereas class III drugs seem more promising. The different electrophysiological effects of these drugs may explain this discrepancy. To date, only experimental data show the differential effects of these drugs on conversion rate and atria...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1093/oxfordjournals.eurheartj.a060402
更新日期:1994-10-01 00:00:00
abstract::To compare the blood pressure (BP) changes during a long-distance run with those during bicycle ergometry, nine normotensive and 18 hypertensive joggers were studied by means of ambulatory intra-arterial monitoring. In all subjects the ergometric test caused a progressive increase in systolic and little change in dias...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059709
更新日期:1990-04-01 00:00:00
abstract::The utility of high-frequency current applied through the distal electrode of a conventional electrode-catheter for altering atrio-ventricular conduction was studied in 18 anaesthetized dogs. Following adequate unipolar His bundle recording, current was applied over periods of 20-30 s, with an output power of 30 W. Co...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059450
更新日期:1989-02-01 00:00:00
abstract:AIMS:The cardiac extracellular matrix is highly involved in regulating inflammation, remodelling, and function of the heart. Whether matrix alterations relate to the degree of inflammation, fibrosis, and overall rejection in the human transplanted heart remained, until now, unknown. METHODS AND RESULTS:Expression of m...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehs375
更新日期:2013-07-01 00:00:00
abstract:AIMS:Atrial fibrillation (AF) is associated with abnormal sarcoplasmic reticulum (SR) calcium release, which is promoted by adenosine A(2A) receptor (A(2A)R) activation. Here, we tested the hypothesis that abnormal calcium release in AF is linked to A(2A)R remodelling. METHODS AND RESULTS:Western blotting and quantita...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehq464
更新日期:2011-03-01 00:00:00
abstract:AIMS:The aim of this study was to investigate the 12-month incidence, predictive factors, and prognosis of sustained ventricular tachycardia (VT) in chronic heart failure patients implanted with biventricular pacemakers without a back-up defibrillator (CRT-P), assessed by continuous intracardiac ventricular electrogram...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehp071
更新日期:2009-05-01 00:00:00
abstract:AIMS:The obesity paradox refers to the epidemiological evidence that obesity compared with normal weight is associated with counter-intuitive improved health in a variety of disease conditions. The aim of this study was to investigate the relationship between body mass index (BMI) and mortality in patients with acute c...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehs217
更新日期:2013-02-01 00:00:00
abstract::We found that the incidence and distribution of conduction system disease simultaneously affecting several levels of the system had been incompletely described. We therefore analysed all patients in whom conduction disease had been diagnosed and a complete electrophysiological study of the conduction system had been m...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061429
更新日期:1983-02-01 00:00:00
abstract::This study describes the clinical profile and prognosis of elderly patients not eligible for predischarge exercise testing. The database consisted of 133 patients 55-64 years of age, and 111 patients older than 64 years of age who survived an acute myocardial infarction. Follow-up was one year. In the younger age grou...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/5.suppl_e.97
更新日期:1984-11-01 00:00:00
abstract:BACKGROUND:In the acute phase of myocardial infarction (acute MI) marked endothelial damage occurs within the first 24h following thrombolysis with streptokinase. We investigated whether this is associated with a change in levels of vascular endothelial growth factor (VEGF, possibly marking angiogenesis) in the first 2...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2002.3312
更新日期:2002-10-01 00:00:00
abstract::A 54 year old woman with isolated stenosis of the left coronary ostium died following cardiac catheterisation and emergency coronary artery bypass surgery. Histological examination showed the ostial narrowing to be a local and discrete plaque of atherosclerosis. Like most reported cases this patient was a young woman ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062359
更新日期:1987-08-01 00:00:00
abstract::Two patients with myocardial bridging of the left anterior descending coronary artery associated with myocardial infarction are described. One of them died from acute cerebral emboli related to cardiac thrombosis in a left ventricular aneurysm. The other died suddenly while sleeping. Both patients were found to have a...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059530
更新日期:1989-06-01 00:00:00
abstract::The purpose of this study was to evaluate the accuracy of adenosine Tc-99m sestamibi single photon emission computed tomography (SPECT) in the detection of jeopardized myocardium early after acute myocardial infarction. Coronary arteriography and myocardial scintigraphy were performed in 50 consecutive patients with a...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061074
更新日期:1995-09-01 00:00:00
abstract:AIMS:Supernatants of serum-free cultured mononuclear cells (MNC) contain a mix of immunomodulating factors (secretome), which have been shown to attenuate detrimental inflammatory responses following myocardial ischaemia. Inflammatory dilated cardiomyopathy (iDCM) is a common cause of heart failure in young patients. E...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehs459
更新日期:2015-03-14 00:00:00
abstract::In the blood-vessel wall, the endothelium plays a key functional role by generating several substances that modulate vascular smooth muscle tone, as well as growth, and platelet function. This review focuses on the role of the endothelial L-arginine/nitric oxide signal transduction pathway in the maintenance of vascul...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/16.suppl_k.4
更新日期:1995-11-01 00:00:00
abstract:AIM:Previous studies have reported lifestyle and risk factor deterioration following completion of a cardiac rehabilitation program (CRP). We report the results of a one-year Extensive Lifestyle Management Intervention (ELMI) aimed at preventing these adverse changes. METHODS AND RESULTS:A total of 302 men and women w...
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:10.1016/j.ehj.2003.08.015
更新日期:2003-11-01 00:00:00
abstract:AIMS:This study investigated the functional outcome of wall-thinned, akinetic myocardium after revascularization and evaluated the accuracy of dobutamine echocardiography in predicting post-revascularization functional recovery with the assessment of end-diastolic wall thickness in chronic ischaemic patients. METHODS ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a015345
更新日期:1997-05-01 00:00:00