Abstract:
BACKGROUND:The magnitude of benefit of cardiac resynchronization therapy (CRT) varies significantly among its recipients; approximately 30% of CRT patients do not report clinical improvement. Optimization of CRT pacing parameters can further improve cardiac function, both acutely and chronically. Echocardiographic optimization is used in clinical practice, but it is time and resource consuming. In addition, optimal settings at rest may change later with activity or cardiac remodeling. The adaptive CRT (aCRT) algorithm was designed to provide automatic ambulatory adjustment of CRT pacing configuration (left ventricular or biventricular pacing) and device delays based on periodic measurement of electrical conduction intervals. METHODS:The aCRT algorithm is currently undergoing evaluation in a prospective, randomized, double-blinded, worldwide clinical trial. The trial enrolled 522 patients, who satisfied standard clinical indications for a CRT device. Within 2 weeks after the implant, the patients were randomized to aCRT versus echo-optimized biventricular pacing (Echo) settings in 2:1 ratio and followed up at 1-, 3-, 6-, and 12-month postrandomization. The noninferiority primary trial objectives at 6-month postrandomization are to demonstrate that (a) the percentage of aCRT patients who improved in their clinical composite score is at least as high as the percentage of Echo patients; (b) cardiac performance as assessed by echocardiography is similar when using aCRT settings versus echo-optimized settings; and (c) aCRT does not result in inappropriate device settings. First and last patient enrollments occurred in November 2009 and December 2010, respectively. CONCLUSIONS:The safety and efficacy of the aCRT algorithm will be evaluated in this ongoing clinical trial.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Krum H,Lemke B,Birnie D,Lee KL,Aonuma K,Starling RC,Gasparini M,Gorcsan J,Rogers T,Sambelashvili A,Kalmes A,Martin Ddoi
10.1016/j.ahj.2012.02.007subject
Has Abstractpub_date
2012-05-01 00:00:00pages
747-752.e1issue
5eissn
0002-8703issn
1097-6744pii
S0002-8703(12)00091-9journal_volume
163pub_type
杂志文章,多中心研究,随机对照试验abstract::The prevalence of heart failure (HF) is high and still on the rise. In 2004, an estimated 5.2 million adults in the United States carried the diagnosis of HF with a mortality rate of >19%. The incidence of HF is higher in individuals 65 years or older. As the US population grows older, the personal and economic costs ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2009.04.007
更新日期:2009-06-01 00:00:00
abstract::In 30 years of follow-up in the Framingham study, routine biennial ECG examinations revealed 315 subjects with ECG-LVH and 164 with unrecognized ECG-MI without previous cardiac explanation. Among subjects initially free of clinically evident coronary heart disease and both ECG abnormalities, the incidence of ECG-LVH w...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90156-0
更新日期:1986-02-01 00:00:00
abstract::Resting measurements of left ventricular systolic function do not reliably predict exercise capacity in patients with cardiac disease. Therefore left ventricular filling shortly after a myocardial infarction was prospectively studied to determine whether it could predict subsequent exercise time. Consecutive patients ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80086-9
更新日期:1990-01-01 00:00:00
abstract::To determine the clinical usefulness of echocardiography in patients with anteroseptal myocardial infarction, echocardiograms were performed within 24 hours of admission on 40 patients with acute transmural anteroseptal myocardial infarction. Twenty-one patients had normal septal motion and septal systolic thickening,...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90007-3
更新日期:1979-06-01 00:00:00
abstract:BACKGROUND:Rheumatic disease and heart disease share common underpinnings involving inflammation. The high levels of inflammation that characterize rheumatic diseases provide a "natural experiment" to help elucidate the mechanisms by which inflammation accelerates heart disease. Rheumatoid arthritis (RA) is the most co...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2013.07.010
更新日期:2013-10-01 00:00:00
abstract::Head-up tilt provokes vasodepressor syncope in patients with this disorder but may also cause fainting in unaffected subjects. The aims of this study were to examine autonomic function and sequential changes in heart rate variability and plasma catecholamines during graded head-up tilt in patients with vasodepressor s...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70213-8
更新日期:1997-02-01 00:00:00
abstract::To assess the influence of viscosity and iodine concentration, three matched and standardized left coronary arteriograms were obtained in 20 patients using iopamidol (Isovue-370), ioversol (Optiray-320), and iohexol (Omnipaque-350). The order of contrast media was randomized and the administration of contrast was doub...
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)90760-s
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Current recommendations for antithrombotic therapy after drug-eluting stent (DES) implantation include prolonged dual antiplatelet therapy (DAPT) with aspirin and clopidogrel ≥12 months. However, the impact of such a regimen for all patients receiving any DES system remains unclear based on scientific eviden...
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.2012.09.009
更新日期:2012-12-01 00:00:00
abstract::The results of surgical therapy performed in 51 consecutive patients with ventricular tachycardia were reviewed to determine short- and long-term predictors of success of such therapy in preventing recurrences of life-threatening ventricular arrhythmias. Of 41 patients (80%) who survived surgery, 40 had postoperative ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90404-j
更新日期:1992-11-01 00:00:00
abstract::Oxygen free radical scavengers have been found to decrease infarct size in dogs subjected to myocardial ischemia-reperfusion injury. A baboon open-chest model was used to determine if superoxide dismutase (SOD), an oxygen free radical scavenger, together with catalase would be equally effective in subhuman primates (b...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90697-8
更新日期:1993-10-01 00:00:00
abstract:BACKGROUND:Intramyocardial injection of autologous bone marrow (ABM) may induce angiogenesis. We tested the safety and feasibility of catheter-based direct percutaneous intramyocardial delivery of ABM in patients with refractory angina pectoris. METHODS:Ten patients (9 men, 67 +/- 8 years) with refractory angina (Cana...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.04.033
更新日期:2006-03-01 00:00:00
abstract::The detection of premature ectopic beats coinciding with the T-wave of the antecedent beat is important for patient monitoring. In the method described here, the difficulties of direct measurement of QT time are avoided by evaluating the changes of QT time according to heart rate by use of a diode function generator. ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90191-x
更新日期:1975-06-01 00:00:00
abstract::Doxorubicin (Adriamycin) is an effective anticancer agent but its therapeutic value is limited by its myocardial cardiotoxicity. To improve early detection of doxorubicin cardiotoxicity, studies were performed in patients with long-term doxorubicin treatment using pulsed Doppler echocardiography to assess the changes ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90077-x
更新日期:1989-07-01 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:OBJECTIVES:The objective of this study was to examine prospectively the incidence, predisposing cardiovascular conditions, and risk factors for sudden death in women compared with men. METHODS AND RESULT:The study design was a prospective general population examination of a cohort of 2873 women for development of sudd...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1053/hj.1998.v136.90226
更新日期:1998-08-01 00:00:00
abstract::Atherosclerotic coronary artery disease is a serious clinical problem. Clinicians dealing with patients can make a diagnosis of coronary disease in several ways. Unfortunately all too often the diagnosis is made via sudden death or acute myocardial infarction. At other times the diagnosis is made by evaluation of pati...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(92)91039-4
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:Appropriate thromboprophylaxis for patients with atrial fibrillation or atrial flutter (AF) remains a national challenge. METHODS:We hypothesized that a shared decision-making interaction facilitated by an Atrial Fibrillation Shared Decision Making Tool (AFSDM) would improve patient knowledge about atrial f...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2018.01.003
更新日期:2018-05-01 00:00:00
abstract::During the last few decades, acute ST-elevation on an electrocardiogram (ECG) in the proper clinical context has been a reliable surrogate marker of acute coronary occlusion requiring primary percutaneous coronary intervention (PPCI). In 2004, the American College of Cardiology/American Heart Association ST-elevation ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2010.08.011
更新日期:2010-12-01 00:00:00
abstract::The development of ECG Minnesota Q-QS codes and their subsequent evolution were studied in the first 692 subjects to enter the POSCH program who had had one MI. The mean interval from MI to entry into the study was 2.2 years. Sixty-three percent of the subjects developed the most significant code with the infarction. ...
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(85)90169-3
更新日期:1985-08-01 00:00:00
abstract::In over 30 years of surveillance of 2873 women, 574 developed initial clinical manifestations of CHD. A number of antecedent metabolic risk factors proved atherogenic, including blood lipids, glucose tolerance, uric acid, and menopause. Serum total cholesterol predicts as strongly in women as in men. The predictive po...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90511-4
更新日期:1987-08-01 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::Three cases of large multiple coronary aneurysms, situated on both right and left coronary arteries, were seen in three middle-aged adult patients. These patients were hospitalized for myocardial infarction in two cases and for angina pectoris in the third case. On the coronary angiogram, the coronary lesions were qui...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90617-1
更新日期:1980-06-01 00:00:00
abstract:BACKGROUND:Cardiovascular disease is the leading cause of death among blacks and whites in the United States. Despite this, there are insufficient data on the long-term prognosis of black patients with coronary artery disease (CAD) as well as the major clinical related determinants of outcome. METHODS:We studied 22,61...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2010.06.014
更新日期:2010-10-01 00:00:00
abstract::We assessed the safety of early (2 to 4 days) intravenous dipyridamole infusion in conjunction with technetium 99m sestamibi tomographic myocardial perfusion imaging in patients with first myocardial infarction (MI). Early risk stratification with myocardial perfusion imaging of patients after acute MI may be useful t...
journal_title:American 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/s0002-8703(97)70113-3
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine in pediatric Duchenne (DMD) and Becker muscular dystrophy (BMD) or other dilated cardiomyopathies (ODCM) whether outcomes differ by diagnosis. BACKGROUND:Children with dilated cardiomyopathy are treated as a single undifferentiated group. METHODS:This cohort study of 1...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.01.018
更新日期:2008-06-01 00:00:00
abstract::To better characterize the cardiac structural and functional changes that are associated with aging, Doppler-echocardiography was performed on 23 young (mean age, 25 years) and 30 old (mean age, 70 years) healthy normotensive subjects. Left ventricular cavity dimensions and wall thickness were determined and left vent...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90201-r
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Heart failure (HF) is one of the leading causes of morbidity and mortality among Americans. Despite increased interest in end-of-life care, the implications of do-not-resuscitate (DNR) orders in acutely ill patients with HF remain unclear. The goals of this observational study were to describe the use of DNR...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.01.030
更新日期:2008-07-01 00:00:00
abstract::Women with coronary artery disease are less likely to undergo percutaneous transluminal coronary angioplasty (PTCA) because of the potential referral bias in favor of men with coronary artery disease in the use of invasive diagnostic procedures and interventions. This difference may represent a sex bias in the deliver...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(97)70056-5
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:In chronic heart failure the cause of exercise limitation is still unclear: ergoreceptors, muscle afferents sensitive to exercise metabolites, are proposed as a neural link between muscular abnormalities and the limited exercise responses in this syndrome. METHODS:In 92 stable patients with heart failure (3...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70361-3
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:Previous studies reported an impairment of nervous autonomic activity in patients with Duchenne muscular dystrophy (DMD). However, the relationship of the autonomic dysfunction to the impairment of cardiac mechanical function and of respiratory failure is not completely understood. METHODS:We evaluated card...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.114804
更新日期:2001-05-01 00:00:00