Abstract:
:Reductions in mobility and cognitive function linked to accrual of brain microvascular disease related white matter hyperintensities (WMHs) on magnetic resonance imaging can occur in older hypertensive patients in as little as 2 years. We have designed a trial evaluating 2 levels of ambulatory blood pressure (ABP) control in individuals with normal or mildly impaired mobility and cognition who have detectable cerebrovascular disease (>0.5% WMH fraction of intracranial volume) on functional outcomes. The study is a prospective randomized, open-label trial with blinded end points, in patients ages ≥75 years with elevated 24-hour systolic blood pressure (BP) (145 mm Hg in the untreated state) who do not have unstable cardiovascular disease, heart failure, or stroke. The primary and key secondary outcomes in the trial are change from baseline in mobility and cognitive function and damage to brain white matter as demonstrated by accrual of WMH volume and changes in diffusion tensor imaging. Approximately 300 patients will be enrolled, and 200 randomized to 1 of 2 levels of ABP control (intensive to achieve a goal 24-hour systolic BP of ≤130 mm Hg or standard to achieve a goal 24-hour systolic BP of ≤145 mm Hg) for a total of 36 months using similar antihypertensive regimens. The analytical approach provides 85% power to show a clinically meaningful effect in differences in mobility accompanied by quantitative differences in WMH between treatment groups. The INFINITY trial is the first to guide antihypertensive therapy using ABP monitoring rather than clinic BP to reduce cerebrovascular disease.
journal_name
Am Heart Jjournal_title
American heart journalauthors
White WB,Marfatia R,Schmidt J,Wakefield DB,Kaplan RF,Bohannon RW,Hall CB,Guttmann CR,Moscufo N,Fellows D,Wolfson Ldoi
10.1016/j.ahj.2012.11.008subject
Has Abstractpub_date
2013-03-01 00:00:00pages
258-265.e1issue
3eissn
0002-8703issn
1097-6744pii
S0002-8703(12)00836-8journal_volume
165pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Compared with men, women have more evidence of myocardial ischemia with no obstructive coronary artery disease. Although low endogenous estrogen levels are associated with endothelial dysfunction, the role of low-dose hormone therapy has not been fully evaluated. We postulate that a 12-week duration of low-d...
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.2010.03.024
更新日期:2010-06-01 00:00:00
abstract::To assess the effects of pacing-induced tachycardia on phasic coronary blood flow pattern and flow reserve of left anterior descending artery, we examined 16 patients with chest pain and angiographically normal coronary arteries by using an intravascular Doppler catheter with spectral analysis of the velocity signal. ...
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
abstract::A longitudinal study was performed in nine nonhydropic and nine hydropic fetuses with supraventricular tachycardia (SVT). First, because of a lack of reference methods in utero, the validity of spatial (length and area) and temporal parameters for semiquantitative grading of atrioventricular (AV) valve regurgitation b...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90997-n
更新日期:1993-05-01 00:00:00
abstract::Digoxin pharmacokinetics were studied in 16 obese (mean +/- SD weight, 100.2 +/- 36.8 kg) and 13 control (64.6 +/- 10.5 kg) subjects. All subjects had normal renal function and no other coexisting disease. After administration of 0.75 mg digoxin by intravenous infusion, multiple plasma samples obtained over the 96 hou...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90100-9
更新日期:1981-10-01 00:00:00
abstract:BACKGROUND:Noninvasive methods are needed for the identification of women at highest risk for coronary artery disease (CAD) who might benefit most from aggressive preventive therapy. Identification of brachial artery atherosclerosis, which correlates with coronary artery atherosclerosis, may be useful to estimate or st...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1067/mhj.2002.121735
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:A large proportion of patients with heart failure (HF) have a large and poorly contracting left ventricle. The noninvasive recognition of the ischemic etiology of such patients is difficult, and for this purpose, usually patients undergo coronary angiography. It has been shown that cardiovascular magnetic re...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.03.068
更新日期:2006-01-01 00:00:00
abstract::Although the Doppler mitral flow velocity pattern changes in accordance with the degree of left ventricular diastolic dysfunction, it is "normalized" in the presence of heart failure. In this study the pulmonary venous flow velocity pattern was characterized in 43 hypertensive patients with and without heart failure t...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90982-2
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:Clinical trials have helped clarify the efficacy of clopidogrel for the treatment and prevention of vascular disease. Costs for its use exceeded $5.9 billion in 2005, making it the second greatest source of drug expenditure in the world. However, little is known about the appropriateness of that use. Overuse...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.11.039
更新日期:2008-05-01 00:00:00
abstract::After dipyridamole, canine studies have demonstrated a slower rate of myocardial thallium-201 clearance from zones distal to a coronary artery stenosis compared to normal zones. To determine if criteria based on canine myocardial thallium-201 clearance rates could be applied clinically, 40 patients with and 26 patient...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90088-7
更新日期:1984-03-01 00:00:00
abstract:BACKGROUND:Several non-vitamin K antagonist oral anticoagulant (NOAC) alternatives to warfarin are available for stroke prevention in atrial fibrillation (AF). We aimed to describe the factors associated with selection of NOACs versus warfarin in patients with new onset AF. METHODS:The ORBIT-AF II study is a national,...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ahj.2017.03.024
更新日期:2017-07-01 00:00:00
abstract::Selective inhibition of sinus node function offers the possibility to decrease heart rate and reduce myocardial oxygen consumption in patients with impaired cardiac function, if myocardial contractility is not further attenuated. To study the influence of a specific sinus node inhibitor on myocardial function, alinidi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80185-1
更新日期:1990-06-01 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::This study prospectively assessed the electrophysiologic effects of parenteral magnesium sulfate administration on paroxysmal atrioventricular (AV) reentrant supraventricular tachycardia and the efficacy of magnesium to terminate these arrhythmias. Eleven normomagnesemic patients, seven with orthodromic reentrant supr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80021-3
更新日期:1990-02-01 00:00:00
abstract:BACKGROUND:Optimal antithrombotic treatment after transcatheter aortic valve replacement (TAVR) is unknown and determined empirically. The direct factor Xa inhibitor rivaroxaban may potentially reduce TAVR-related thrombotic complications and premature valve failure. DESIGN:GALILEO is an international, randomized, ope...
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.2016.10.017
更新日期:2017-02-01 00:00:00
abstract::Adenosine thallium stress testing has a demonstrated utility in the detection of coronary artery disease. The optimal dose for diagnostic efficacy with minimal side effects has not been critically evaluated. A randomized 3- and 6-minute infusion of adenosine (140 micrograms/kg/min) was performed in 11 subjects. Subjec...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(07)80015-9
更新日期:1993-07-01 00:00:00
abstract::The associations between socioeconomic status, ethnic origin, and risk factors for CHD were studied in 2,591 white and black children from two socioeconomically dissimilar populations in the New York City area. The study subjects were selected from all fourth graders in 44 elementary schools. Blood pressure, plasma li...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90724-1
更新日期:1987-03-01 00:00:00
abstract::We aimed to investigate long-term (≥5 years) outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) using a meta-analysis from updated published randomized trials. Our data showed that the risk of all-cause death as well as cardi...
journal_title:American heart journal
pub_type: 信件,meta分析
doi:10.1016/j.ahj.2020.06.001
更新日期:2020-09-01 00:00:00
abstract::There are many similarities between the clinical features of viral heart disease and of rheumatic carditis, as defined in the revised Jones criteria for the diagnosis of rheumatic fever. Because of this, it is likely that viral heart disease has been, and still is, diagnosed as rheumatic. This situation can be avoided...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80137-8
更新日期:1976-05-01 00:00:00
abstract:BACKGROUND:Although cross-sectional studies have identified lifestyle factors associated with high-density lipoprotein cholesterol (HDL-C), no studies have examined the association between changes in lifestyle factors and long-term changes in HDL-C. METHODS:We examined the association between changes in lifestyle fact...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2010.12.015
更新日期:2011-04-01 00:00:00
abstract::We evaluated the usefulness of peripherally injected sonicated albumin microbubbles in transesophageal echo-Doppler cardiographic assessment of the left atrial appendage in 19 patients (age 61 +/- 19 [range 21 to 86] years; 12 [63%] women). Multiplane transesophageal echocardiography was performed before and after int...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70180-7
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:Acute myocardial infarction (AMI) is a leading cause of mortality in Asia. However, quantitative risk scores to predict mortality after AMI were developed without the participation of Asian countries. METHODS:We evaluated the performance of the Global Registry of Acute Coronary Events (GRACE) in-hospital mo...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2011.05.016
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Surgical ventricular restoration (SVR) is an operation that demonstrates promise to improve outcomes for patients with left ventricular dysfunction. Current use and operative outcomes of SVR have come from centers of expertise, and operative risks of SVR in community practice are unknown. We sought to charac...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.01.016
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:In patients with coronary heart disease (CHD), atrial fibrillation (AF) is associated with increased morbidity and mortality. We investigated the associations between clinical risk factors and biomarkers with incident AF in patients with CHD. METHODS AND RESULTS:Around 13,153 patients with optimally treated...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2020.12.016
更新日期:2021-01-02 00:00:00
abstract::The response of S1 amplitude to exercise stress was investigated in patients with coronary heart disease. Phonocardiograms were recorded at rest and during a multistage bicycle ergometer exercise test in a group of 22 patients with angina pectoris and documented coronary disease, and in a normal control group comprise...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90461-5
更新日期:1975-12-01 00:00:00
abstract::Meta-analyses of major outcome trials have demonstrated that the benefits of antihypertensive treatment for reduction of the incidence of stroke are entirely consistent with the benefits predicted from epidemiologic data; however, there remains a shortfall in the expected reduction of the incidence of coronary heart d...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:
更新日期:1996-07-01 00:00:00
abstract::We studied the effect of propranolol administration on risk assessment based on submaximal exercise testing performed early after myocardial infarction. A total of 70 patients with recent infarction underwent modified Bruce treadmill testing with simultaneous measurement of expired gases in the absence of antianginal ...
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)90009-7
更新日期:1991-06-01 00:00:00
abstract::Metoprolol or placebo was gradually withdrawn during 1 week in 115 patients participating in a 3-year, double-blind, postinfarction study. During the first month after withdrawal mental symptoms and increased cardiac symptoms occurred significantly more frequently in the metoprolol group. Disabling symptoms requiring ...
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(84)90408-3
更新日期:1984-09-01 00:00:00
abstract::Complex coronary morphologic abnormalities with thrombus and ulceration have been recognized in acute ischemic syndromes by angiography, angioscopy, and autopsy. However, in vivo histopathologic correlates of unstable ischemic syndromes have not been described. The purpose of this study was to characterize intracorona...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90612-2
更新日期:1994-09-01 00:00:00
abstract::Of 178 transseptal left heart catheterizations performed, 173 successful cases are reported, with the use of a Swan-Ganz, flow-directed, balloon-tipped catheter. By means of a modified Brockenbrough technique, which is described in detail, a 10F Teflon tube (3.3 mm outside diameter) was inserted into the left atrium. ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90603-9
更新日期:1985-02-01 00:00:00
abstract::Electrolyte balance has been regarded as a factor important to cardiovascular stability, particularly in congestive heart failure. Among the common electrolytes, the significance of magnesium has been debated because of difficulty in accurate measurement and other associated factors, including other electrolyte abnorm...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(96)90253-7
更新日期:1996-09-01 00:00:00