Abstract:
:Antiarrhythmic therapy for prevention of sustained ventricular tachycardia is commonly guided by programmed electrical stimulation, and the persistent ability to initiate ventricular tachycardia during drug therapy often leads to the use of nonpharmacologic therapies such as surgery. Prior studies suggest that programmed stimulation has a high sensitivity but a lower specificity for predicting recurrences of ventricular tachycardia during drug therapy. We constructed a model to evaluate the impact of various programmed stimulation specificities and sensitivities on total mortality when patients with inducible ventricular tachycardia during drug therapy proceed to arrhythmia surgery. Assumptions for this model included an 11.5% surgical mortality, a 13% risk of arrhythmia recurrence for surgery survivors, and that 33% of ventricular tachycardia recurrences are fatal. In this model the relative impact of test sensitivity and specificity on total population mortality depended on the pretest probability that drug therapy would be effective. When this probability was high, variations in test sensitivity had relatively little impact on mortality, but a low specificity increased mortality by increasing the number of false positive patients treated surgically who then suffered the surgical mortality. When the probability of effective drug therapy was low, varying test specificity had relatively little impact on mortality, but a low sensitivity increased mortality by increasing the number of patients with a false negative test who suffered fatal arrhythmia recurrences. If the specificity of programmed stimulation is low and the probability that drug therapy will be effective is high, the total population mortality can exceed the mortality expected from drug therapy alone.(ABSTRACT TRUNCATED AT 250 WORDS)
journal_name
Am Heart Jjournal_title
American heart journalauthors
Stevenson WG,Weiss J,Oye RKdoi
10.1016/s0002-8703(05)80325-4subject
Has Abstractpub_date
1990-04-01 00:00:00pages
871-7issue
4eissn
0002-8703issn
1097-6744pii
S0002-8703(05)80325-4journal_volume
119pub_type
杂志文章abstract:BACKGROUND:The study rationale was to compare the biomarker profile of metalloproteinases (MMPs) and inflammation markers (IMs) in patients requiring revascularization with that of patients with long-term, clinically quiescent coronary artery disease (CAD). METHODS:Seventy-eight patients with symptomatic CAD (S-CAD) (...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.08.021
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The diagnosis of angina is challenging because it relies on symptom descriptions. Natural language processing (NLP) of the electronic medical record (EMR) can provide access to such information contained in free text that may not be fully captured by conventional diagnostic coding. OBJECTIVE:To test the hyp...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.12.022
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Bleeding and blood transfusion are associated with increased morbidity and mortality among patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS); however, the economic consequences of these complications are not well defined. We sought to determine the relationship between bleeding, bloo...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.10.014
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:The long-term prognostic significance of elevated cardiac markers in an undifferentiated patient population with chest pain is unknown. METHODS:Serum troponin I (cTnI), creatine kinase-MB (CK-MB), and myoglobin were measured at presentation in 951 consecutive patients evaluated in the emergency department f...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.06.020
更新日期:2008-11-01 00:00:00
abstract::Programmed ventricular stimulation with a standard protocol that used up to three extrastimuli was compared prospectively with a short-to-long protocol and a two-site protocol in 77 consecutive patients undergoing electrophysiologic study in an attempt to increase the yield of ventricular tachycardia (VT) induction. T...
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(91)90957-j
更新日期:1991-01-01 00:00:00
abstract::To investigate the significance of atrial natriuretic polypeptide (ANP) in essential hypertension, we measured plasma ANP concentrations in 43 subjects with essential hypertension uncomplicated by cardiac or renal failure, in 16 subjects with borderline hypertension, and in 17 normotensive control subjects. Plasma ANP...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90929-x
更新日期:1987-05-01 00:00:00
abstract::The hearts from 10 necropsy patients with Ebstein's anomaly of the tricuspid valve were examined for abnormalities of the mitral valve. Five patients were under 1 year of age and none had an abnormal mitral valve. The other five patients were ages 18 to 72 years (mean 36 years); all had focal fibrous thickening of the...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90663-3
更新日期:1981-02-01 00:00:00
abstract:BACKGROUND:High-sensitivity C-reactive protein (hsCRP) is promoted as an independent predictor of atherosclerotic risk. In addition, cardiorespiratory fitness is inversely related to hsCRP in single-sex cross-sectional analyses. Our objective was to determine if modulating fitness with exercise training imposes changes...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2006.04.019
更新日期:2006-10-01 00:00:00
abstract::The pharmacokinetic properties and hemodynamic effect of molsidomine and its pharmacologically active metabolite SIN-1 were investigated in 13 healthy volunteers following single oral doses. Hemodynamic changes were measured by finger plethysmography (peripheral arterial resistance), impedance plethysmography (venous ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90671-4
更新日期:1985-03-01 00:00:00
abstract:BACKGROUND:To examine sex differences in pain and associated symptoms in patients with exercise-related ischemia, as well as the independence of these findings from other clinical factors. METHODS:Prospective study of 482 women and 425 men (mean age 58 years) undergoing exercise stress testing with myocardial perfusio...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.06.028
更新日期:2006-04-01 00:00:00
abstract::To evaluate the therapeutic efficacy of oral angiotensin-converting inhibition (ACE) with captopril in chronic normotensive congestive heart failure (CHF), acute and cardiocirculatory actions were determined by cardiac catheterization and forearm plethysmography, and ambulatory effects were assessed by echocardiograph...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90379-3
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Patients with diabetes mellitus (DM) experience higher rates of in-stent restenosis and greater benefit from drug-eluting stents implant at the time of percutaneous coronary intervention (PCI), necessitating prolonged dual anti-platelet therapy (DAPT). While DAPT reduces risk of ischemic events post-PCI, it ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.09.010
更新日期:2016-12-01 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:BACKGROUND:Several studies have shown that patency of the epicardial vessel does not guarantee optimal myocardial perfusion in patients undergoing primary angioplasty for ST-segment elevation myocardial infarction (STEMI). The aim of the current study was to identify clinical and angiographic correlates of unsuccessful...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.10.044
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Symptoms of anxiety are associated with increased risk of coronary artery disease and potentially poor prognosis among patients with existing coronary artery disease, but whether symptoms of anxiety influence atherosclerotic progression among such patients is uncertain. Accordingly, we evaluated the hypothes...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2009.08.019
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Knowledge of pressure gradients across valves, arteries, and ventricular septal defects (VSD) is important in patient management. It was determined how well such gradients can be estimated by auscultation of a murmur's frequencies. METHODS:In 151 patients with pulmonary stenosis (PS) (n = 77), aortic stenos...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.113222
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:The Gly16 beta(2)-adrenergic receptor (beta(2)AR) polymorphism is a common variant of the beta(2)AR that displays depressed function caused by enhanced receptor downregulation in vitro compared with the Arg16 receptor. METHODS AND RESULTS:We studied 20 healthy, normotensive, nonsmoking white individuals who...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-8703(00)90099-1
更新日期:2000-03-01 00:00:00
abstract::For 29 patients with congestive heart failure (CHF), 24-hour noninvasive ambulatory blood pressure (ABP) and heart rate (HR) measurement profiles were described, using the periodogram method, and were compared with the same findings in 22 matched controls. Right-sided heart catheterization was performed in all patient...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90710-d
更新日期:1992-04-01 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:BACKGROUND:Current practice related to the management of atrial fibrillation (AF) complicating coronary artery bypass grafting (CABG) is uncertain. METHODS:We examined management of post-CABG AF in the PREVENT-IV trial, and we explored patterns of use of postoperative rhythm versus rate control and anticoagulation for...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.09.003
更新日期:2009-11-01 00:00:00
abstract::Vessel dilator consisting of amino acids (a.a.) 31-67 and atrial natriuretic factor (ANF) composed of a.a. 99-126 of the 126 a.a. ANF prohormone circulate in humans and have potent vasodilatory properties. To determine whether these atrial natriuretic peptides are directly related to blood pressure in healthy normoten...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90111-6
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:Analysis of high-frequency QRS amplitudes (HF-QRS) may provide an additional diagnostic tool in patients with heart disease, but the basic properties of these waveforms have not been sufficiently investigated. This study describes the spatial, individual, and temporal variation at rest of HF-QRS recorded wit...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.101782
更新日期:2000-02-01 00:00:00
abstract::Congenitally corrected transposition of the great arteries (ccTGA) is associated with various types of arrhythmia, including supraventricular tachycardia (SVT) and complete atrioventricular block (cAVB). Our study aims to characterize the arrhythmia burden, associated risk factors, arrhythmia mechanisms, and the long-...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2020.10.057
更新日期:2021-01-01 00:00:00
abstract::To test alterations in plasma potassium and magnesium levels with maximal exercise, 15 sedentary, healthy men (mean age 29 years) participated in a double-blind crossover study for 11 weeks with propranolol, atenolol, and placebo. Maximal exercise tests were done at baseline and after placebo and beta-blockade phases....
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(91)90962-h
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Sirolimus-eluting stents (SES) prevent restenosis and repeat percutaneous coronary intervention (PCI), but safety data in unselected patients are limited, especially for intermediate-term follow-up. METHODS:All patients undergoing SES implantation at 4 Italian centers were enrolled into a dedicated database...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2008.06.030
更新日期:2008-11-01 00:00:00
abstract::High degree AV block occurred in 144 of 843 patients consecutively admitted because of acute inferior myocardial infarction and was associated with more extensive myocardial damage and a higher mortality rate, as compared to those without AV block. Patients with power failure at the time of appearance of high degree A...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90308-7
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:Endothelin 1 is a potent endogenous vasoconstrictor neurohormone, and endothelin 1 plasma concentrations predict adverse outcomes in patients with acute heart failure (AHF). Tezosentan, an intravenous endothelin receptor antagonist, improved hemodynamics in patients with AHF; however, its effects on morbidit...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.04.035
更新日期:2005-07-01 00:00:00
abstract::Interatrial septal aneurysm (IASA) has been detected with increasing frequency since the advent of two-dimensional echocardiography (2DE). In this study, we investigated the prevalence, characteristics, and predisposing factors in IASA formation in 724 infants, children, and adolescents undergoing 2DE. Among this grou...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90927-6
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:High-intensity interval training has been shown to be superior to moderate continuous exercise training in improving exercise capacity and endothelial function in patients with coronary artery disease. The objective of this study was to evaluate this training model on in-stent restenosis following percutaneo...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.08.021
更新日期:2009-11-01 00:00:00
abstract::There is evidence that the endothelium plays an important role in the control of human vascular tone by releasing endothelium-derived nitric oxide and, therefore, a defective endothelial function could be involved in the increased peripheral vasoconstriction of patients with chronic congestive heart failure. To invest...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(93)90926-z
更新日期:1993-09-01 00:00:00