Abstract:
:Standard evaluation of children with sinus node (SN) dysfunction cannot distinguish abnormal autonomic tone from intrinsic SN disease. This distinction has potentially important therapeutic and prognostic implications. Intrinsic heart rate (IHR)--the peak heart rate (HR) measured during pharmacologic combined autonomic blockade--reflects intrinsic SN function. The purpose of this study was to evaluate the use of IHR--and its relationship with resting heart rate (RHR)--in distinguishing autonomic influence from intrinsic SN disease among children with SN dysfunction. IHR was determined in the electrophysiology laboratory using intravenous propranolol, 0.2 mg/kg, followed by intravenous atropine, 0.04 mg/kg; the peak HR recorded was the IHR. IHR was measured in two groups. Seven control subjects, defined as patients with normal noninvasive SN testing, had IHR mean of 128 +/- 24 beats/min; this was greater than RHR mean of 89 +/- 16 beats/min (p less than 0.01). Eight patients with abnormal noninvasive SN testing had IHR mean of 103 +/- 6 beats/min; this was greater than RHR mean of 71 +/- 9 beats/min (p less than 0.01). We therefore reached the following conclusions. (1) Among this particular group of patients with abnormal noninvasive SN testing, IHR was consistently in the normal range for age and greater than RHR, suggesting that excess vagal tone can play a significant role in the expression of SN dysfunction. (2) Among normal individuals, IHR is age-related, decreasing with advancing age. IHR greater than RHR suggests that vagal tone predominates in the normal resting state as the net increase in HR during combined autonomic blockade is due to blockade of vagally mediated chronotropic inhibition.(ABSTRACT TRUNCATED AT 250 WORDS)
journal_name
Am Heart Jjournal_title
American heart journalauthors
Marcus B,Gillette PC,Garson A Jrdoi
10.1016/s0002-8703(05)80331-xsubject
Has Abstractpub_date
1990-04-01 00:00:00pages
911-6issue
4eissn
0002-8703issn
1097-6744pii
S0002-8703(05)80331-Xjournal_volume
119pub_type
杂志文章abstract:BACKGROUND:Studies have shown that cigarette smokers constitute a substantial proportion of patients with acute coronary syndromes (ACS) and have platelet-rich coronary thrombi. We characterized the influence of smoking status on outcome of patients with ACS without persistent ST-segment elevation and tested the hypoth...
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(00)90089-9
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Hypertrophic cardiomyopathy (HCM) is histopathologically characterized by myocyte hypertrophy, disarray, interstitial fibrosis, and small intramural coronary arteriole dysplasia, which contribute to disease progression. Longitudinal systolic and early diastolic strain rate (SR) measurements by speckle tracki...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.06.011
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:With one-quarter of initial myocardial infarctions (MI) being unrecognized MI (UMI), recognition is critical to minimize further cardiovascular risk. Diabetes mellitus is an established risk factor for UMI. If impaired fasting glucose (IFG) also increased the risk for UMI, it would represent a significant pu...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2015.08.003
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:The latest cholesterol guidelines have shifted focus from achieving low-density lipoprotein cholesterol (LDL-C) targets toward statin use and intensity guided by atherosclerotic cardiovascular disease (ASCVD) risk. METHODS:Statin use and intensity were evaluated in 5,905 statin-eligible primary or secondary...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2017.08.005
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Vesnarinone has yielded controversial results on morbidity in patients with congestive heart failure. We tested the hypothesis that vesnarinone may have a beneficial effect on cardiac remodeling and function. METHODS:Thirty-four patients with left ventricular ejection fraction (LVEF) <30% (17 treated with v...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-8703(98)70120-6
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:Systolic wall motion abnormality (WMA) after acute myocardial infarction (AMI) is a major determinant of outcome; the presence and importance of diastolic WMA after AMI are unknown. We therefore sought to detect diastolic WMA using color kinesis and to assess its relation to neurohormonal activation and its ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.11.024
更新日期:2005-10-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2008.09.004
更新日期:2008-12-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90462-7
更新日期:1996-12-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90508-2
更新日期:1978-06-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.108520
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:The benefits of intra-aortic balloon pumping (IABP) usage reportedly occur through systolic unloading of the left ventricle and the augmentation of diastolic coronary flow. The aim of this study was to assess the change in intracoronary pressure distal to the coronary stenosis after the IABP by using an intr...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.05.019
更新日期:2007-10-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.06.013
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:The incidence of end-stage renal disease (ESRD) has been consistently shown to be higher among blacks and Hispanics compared to whites with unmeasured risk factors and access to care as suggested explanations. In a high-risk cohort with frequent protocol-directed follow-up, we evaluated the influence of race...
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.2015.05.008
更新日期:2015-08-01 00:00:00
abstract::Sequential bedside electrophysiologic testing was performed over 22 hours at intervals of 1 to 2 hours in 13 patients with left-sided Kent bundles to assess possible daily variations in the capacity to electrically induce reciprocating tachycardia. In all patients the tachycardia involved the accessory pathway in retr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90499-6
更新日期:1987-08-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2006.10.017
更新日期:2007-01-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1067/mhj.2000.105300
更新日期:2000-06-01 00:00:00
abstract::Three patients with subpulmonic ventricular septal defect and pulmonary valve fluttering by echocardiography are presented. The echographic changes appear identical to that reported with infundibular pulmonic stenosis and the mechanism causing this fluttering is probably similar. ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80336-0
更新日期:1977-07-01 00:00:00
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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.2016.12.004
更新日期:2017-03-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90277-6
更新日期:1983-01-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.05.049
更新日期:2004-12-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.07.018
更新日期:2008-12-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2015.04.023
更新日期:2015-07-01 00:00:00
abstract::Congestive heart failure with dilated left ventricle developed in two patients with symptomatic hypertrophic obstructive cardiomyopathy. Both patients previously underwent cardiac surgery for relief of their outflow obstruction. Alterations in structure and function of the left ventricle during their episode of cardia...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90012-7
更新日期:1979-06-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2016.06.008
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:There are limited data regarding the clinical correlates and prognostic significance of echocardiographically defined mitral regurgitation (MR) early after acute myocardial infarction (MI). The current study addressed these issues. METHODS:Seven hundred thirty-seven patients with acute MI who underwent tran...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.01.020
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:A simple approach is the predominant strategy for the percutaneous coronary intervention of bifurcation lesions. Performing side branch (SB) predilation in this context is currently a matter of controversy. In this study, we assess the efficacy of SB predilatation before a provisional T-stent strategy for bi...
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.2014.05.014
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:The risk for reinfarctions and delays in reperfusion after streptokinase therapy may be caused by the antifibrinolytic effect of platelet-derived type 1 plasminogen activator inhibitor (PAI-1). This study aims to show the relation of pretreatment PAI-1 levels of patients with acute myocardial infarction trea...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70213-3
更新日期:1998-09-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90049-2
更新日期:1983-12-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.06.015
更新日期:2007-10-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90661-0
更新日期:1994-03-01 00:00:00