Predictors of primary atrial fibrillation and concomitant clinical and hemodynamic changes in patients with chronic heart failure: a prospective study in 344 patients with baseline sinus rhythm.


OBJECTIVES:This study investigated the incidence, predisposing factors and significance of the onset of atrial fibrillation (AF) in patients with chronic congestive heart failure (CHF). BACKGROUND:The association between CHF and AF is well documented, but the factors that predispose to the onset of the arrhythmia and its impact remain controversial. Methods. We prospectively followed up 344 patients with CHF and sinus rhythm (SR). Over a period of 19 +/- 12 months (mean +/- SD), 28 patients developed atrial fibrillation (AF), which became chronic in 18. RESULTS:At baseline, no differences were found in any clinical and hemodynamic variables between patients who developed chronic AF and those who did not. Reversible AF occurring during follow-up and lower mitral flow velocity at atrial contraction as detected at the last evaluation in SR were independent predictors of the subsequent development of chronic AF. When AF occurred, New York Heart Association functional class worsened (from 2.4 +/- 0.5 to 2.9 +/- 0.6, p = 0.0001), peak exercise oxygen consumption declined (from 16 +/- 5 to 11 +/- 5 ml/kg per min, p = 0.002), cardiac index decreased (from 2.2 +/- 0.4 to 1.8 +/- 0.4, p = 0.0008), and mitral and tricuspid regurgitation increased (from grade 1.8 +/- 1.1 to grade 2.4 +/- 1.4, p = 0.0001 and from grade 1.0 +/- 1.2 to grade 1.8 +/- 1.2, p = 0.001, respectively). Systemic thromboembolism occurred in 3 of the 18 patients with AF. Nine of 18 patients died after AF, and the occurrence of AF was a predictor of major cardiac events. CONCLUSIONS:In patients with CHF, reversible AF and reduction of left atrial contribution to left ventricular filling predict the subsequent development of chronic AF. The onset of AF is associated with clinical and hemodynamic deterioration and may predispose to systemic thromboembolism and poorer prognosis.


J Am Coll Cardiol


Pozzoli M,Cioffi G,Traversi E,Pinna GD,Cobelli F,Tavazzi L




Has Abstract


1998-07-01 00:00:00














  • Expression profiling of cardiac genes in human hypertrophic cardiomyopathy: insight into the pathogenesis of phenotypes.

    abstract:OBJECTIVES:The goal of this study was to identify genes upregulated in the heart in human patients with hypertrophic cardiomyopathy (HCM). BACKGROUND:Hypertrophic cardiomyopathy is a genetic disease caused by mutations in contractile sarcomeric proteins. The molecular basis of diverse clinical and pathologic phenotype...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Lim DS,Roberts R,Marian AJ

    更新日期:2001-10-01 00:00:00

  • Building Sustainable Capacity for Cardiovascular Care at a Public Hospital in Western Kenya.

    abstract::Cardiovascular disease deaths are increasing in low- and middle-income countries and are exacerbated by health care systems that are ill-equipped to manage chronic diseases. Global health partnerships, which have stemmed the tide of infectious diseases in low- and middle-income countries, can be similarly applied to a...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,评审


    authors: Binanay CA,Akwanalo CO,Aruasa W,Barasa FA,Corey GR,Crowe S,Esamai F,Einterz R,Foster MC,Gardner A,Kibosia J,Kimaiyo S,Koech M,Korir B,Lawrence JE,Lukas S,Manji I,Maritim P,Ogaro F,Park P,Pastakia SD,Sugut W,Ve

    更新日期:2015-12-08 00:00:00

  • Do cardiologists do it better?

    abstract::Pressure to lower the cost of health care delivery has fostered widespread efforts to limit patients' access to specialists such as cardiologists. However, there is concern that diminished specialist involvement may lead to poorer patient outcomes for specific clinical conditions. As part of a state-sponsored effort t...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Nash IS,Nash DB,Fuster V

    更新日期:1997-03-01 00:00:00

  • A prospective, randomized, 6-month comparison of the coronary vasomotor response associated with a zotarolimus- versus a sirolimus-eluting stent: differential recovery of coronary endothelial dysfunction.

    abstract:OBJECTIVES:We prospectively compared coronary endothelial dysfunction in patients with zotarolimus-eluting stent (ZES) versus sirolimus-eluting stent (SES) implantation at 6-month follow-up. BACKGROUND:A ZES has been associated with uniform and rapid healing of the endothelium. METHODS:Fifty patients were randomly tr...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,随机对照试验


    authors: Kim JW,Seo HS,Park JH,Na JO,Choi CU,Lim HE,Kim EJ,Rha SW,Park CG,Oh DJ

    更新日期:2009-05-05 00:00:00

  • Treatment of underlying atrial fibrillation: paced rhythm obscures recognition.

    abstract:OBJECTIVES:The purpose of this study was to evaluate the rate of recognition of atrial fibrillation (AF), use of warfarin and prevalence of cerebrovascular accident (CVA) in paced versus unpaced patients during admission to a tertiary care teaching hospital. BACKGROUND:The presence of AF underlying a continuously pace...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Patel AM,Westveer DC,Man KC,Stewart JR,Frumin HI

    更新日期:2000-09-01 00:00:00

  • Summary of Updated Recommendations for Primary Prevention of Cardiovascular Disease in Women: JACC State-of-the-Art Review.

    abstract::Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality for women in the United States and worldwide. There has been no American College of Cardiology (ACC)/American Heart Association guideline update specifically for the prevention of CVD in women since 2011. Since then, the body of sex-spec...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,评审


    authors: Cho L,Davis M,Elgendy I,Epps K,Lindley KJ,Mehta PK,Michos ED,Minissian M,Pepine C,Vaccarino V,Volgman AS,ACC CVD Womens Committee Members.

    更新日期:2020-05-26 00:00:00

  • Plasma N-terminal B-Type natriuretic peptide as an indicator of long-term survival after acute myocardial infarction: comparison with plasma midregional pro-atrial natriuretic peptide: the LAMP (Leicester Acute Myocardial Infarction Peptide) study.

    abstract:OBJECTIVES:Our aim was to assess the prognostic value of midregional pro-atrial natriuretic peptide (MR-proANP) in patients after acute myocardial infarction (AMI). BACKGROUND:Multimarker strategies may assist risk stratification after AMI. Midregional pro-atrial natriuretic peptide is a newly described stable fragmen...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Khan SQ,Dhillon O,Kelly D,Squire IB,Struck J,Quinn P,Morgenthaler NG,Bergmann A,Davies JE,Ng LL

    更新日期:2008-05-13 00:00:00

  • Vascular function and carotid intimal-medial thickness in children with insulin-dependent diabetes mellitus.

    abstract:OBJECTIVES:The objective of this study was to evaluate endothelium-dependent vasodilation and carotid intimal-medial thickness (IMT) in children with insulin-dependent diabetes mellitus. BACKGROUND:Diabetes mellitus is an established risk factor for atherosclerosis. Vascular complications of diabetes are not clinicall...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Singh TP,Groehn H,Kazmers A

    更新日期:2003-02-19 00:00:00

  • Effects of a meal on hemodynamic function at rest and during exercise in patients with hypertrophic cardiomyopathy.

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    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Gilligan DM,Chan WL,Ang EL,Oakley CM

    更新日期:1991-08-01 00:00:00

  • Age as a risk factor for stroke in atrial fibrillation patients: implications for thromboprophylaxis.

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    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,评审


    authors: Marinigh R,Lip GY,Fiotti N,Giansante C,Lane DA

    更新日期:2010-09-07 00:00:00

  • A randomized trial to evaluate the relative protection against post-percutaneous coronary intervention microvascular dysfunction, ischemia, and inflammation among antiplatelet and antithrombotic agents: the PROTECT-TIMI-30 trial.

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    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,随机对照试验


    authors: Gibson CM,Morrow DA,Murphy SA,Palabrica TM,Jennings LK,Stone PH,Lui HH,Bulle T,Lakkis N,Kovach R,Cohen DJ,Fish P,McCabe CH,Braunwald E,TIMI Study Group.

    更新日期:2006-06-20 00:00:00

  • The relation between patients' outcomes and the volume of cardioverter-defibrillator implantation procedures performed by physicians treating Medicare beneficiaries.

    abstract:OBJECTIVES:The purpose of this study is to determine if implantable cardioverter-defibrillator (ICD) implantation should be limited to physicians with high procedural volume. BACKGROUND:Expanding indications for ICDs will result in an increasing number of physicians implanting these devices. METHODS:Using the 20% Par...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Al-Khatib SM,Lucas FL,Jollis JG,Malenka DJ,Wennberg DE

    更新日期:2005-10-18 00:00:00

  • Intracoronary stents: will they fulfill their promise as an adjunct to angioplasty?

    abstract::Coronary angioplasty as it is now performed has several limitations, including abrupt early arterial closure and delayed restenosis. To obviate these problems and to enhance the safety of the technique, several intracoronary stenting devices have been developed and are under investigation. This report reviews the scie...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,评审


    authors: Ellis SG,Topol EJ

    更新日期:1989-05-01 00:00:00

  • Electromagnetic interference from welding and motors on implantable cardioverter-defibrillators as tested in the electrically hostile work site.

    abstract:OBJECTIVES:This study was designed to determine the susceptibility of an implanted cardioverter-defibrillator to electromagnetic interference in an electrically hostile work site environment, with the ultimate goal of allowing the patient to return to work. BACKGROUND:Normal operation of an implanted cardioverter-defi...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Fetter JG,Benditt DG,Stanton MS

    更新日期:1996-08-01 00:00:00

  • Intermittent claudication: an objective office-based assessment.

    abstract:OBJECTIVES:We sought to compare standard lower extremity vascular laboratory treadmill exercise with the office-based active pedal plantarflexion technique. BACKGROUND:Intermittent claudication is relatively common in elderly patients and is an important predictor of cardiovascular morbidity and mortality. Noninvasive...

    journal_title:Journal of the American College of Cardiology

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: McPhail IR,Spittell PC,Weston SA,Bailey KR

    更新日期:2001-04-01 00:00:00

  • High technology near the end of life: setting limits.

    abstract::High technology interventions near the end of life exact a high cost both in human and economic terms. Breathtaking advances in cardiology have helped to prolong life and improve its quality for many. For some, it has transformed the process of dying into a medical nightmare. The "do everything possible" attitude that...

    journal_title:Journal of the American College of Cardiology

    pub_type: 社论


    authors: Basta L,Tauth J

    更新日期:1996-11-15 00:00:00

  • Syncope in hypertrophic cardiomyopathy: multivariate analysis of prognostic determinants.

    abstract::Twenty-nine consecutive patients with symptomatic hypertrophic cardiomyopathy and a mean age of 44.8 +/- 12.2 years (range 21 to 63) underwent complex invasive and noninvasive testing to identify a risk profile for syncope. Clinical, morphologic, electrophysiologic and hemodynamic variables at rest and at a symptom-li...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Nienaber CA,Hiller S,Spielmann RP,Geiger M,Kuck KH

    更新日期:1990-04-01 00:00:00

  • Mechanisms of early death despite thrombolytic therapy: experience from the Thrombolysis in Myocardial Infarction Phase II (TIMI II) study.

    abstract::Mechanisms of death among patients who died within 18 h of enrollment in the Thrombolysis in Myocardial Infarction Phase II (TIMI II) study were analyzed. Of 3,339 patients enrolled, 32 died within the 1st 4 h and 31 died within the subsequent 14 h. Thirteen of the 63 patients had shock at enrollment; 22 had advanced ...

    journal_title:Journal of the American College of Cardiology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Kleiman NS,Terrin M,Mueller H,Chaitman B,Roberts R,Knatterud GL,Solomon R,McMahon RP,Braunwald E

    更新日期:1992-05-01 00:00:00

  • Coronary Calcium Score and Cardiovascular Risk.

    abstract::Coronary artery calcium (CAC) is a highly specific feature of coronary atherosclerosis. On the basis of single-center and multicenter clinical and population-based studies with short-term and long-term outcomes data (up to 15-year follow-up), CAC scoring has emerged as a widely available, consistent, and reproducible ...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,评审


    authors: Greenland P,Blaha MJ,Budoff MJ,Erbel R,Watson KE

    更新日期:2018-07-24 00:00:00

  • Human ventricular unloading induces cardiomyocyte proliferation.

    abstract:BACKGROUND:The adult mammalian heart is incapable of meaningful regeneration after substantial cardiomyocyte loss, primarily due to the inability of adult cardiomyocytes to divide. Our group recently showed that mitochondria-mediated oxidative DNA damage is an important regulator of postnatal cardiomyocyte cell cycle a...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Canseco DC,Kimura W,Garg S,Mukherjee S,Bhattacharya S,Abdisalaam S,Das S,Asaithamby A,Mammen PP,Sadek HA

    更新日期:2015-03-10 00:00:00

  • Plasma natriuretic peptide levels increase with symptoms and severity of mitral regurgitation.

    abstract:OBJECTIVES:This paper will describe associations between plasma natriuretic peptide levels and the severity and symptoms of mitral regurgitation (MR). BACKGROUND:A biochemical test that assisted grading of the severity of MR and the interpretation of symptoms would be of clinical value. METHODS:Forty-nine patients wi...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Sutton TM,Stewart RA,Gerber IL,West TM,Richards AM,Yandle TG,Kerr AJ

    更新日期:2003-06-18 00:00:00

  • Predictors of super-response to cardiac resynchronization therapy and associated improvement in clinical outcome: the MADIT-CRT (multicenter automatic defibrillator implantation trial with cardiac resynchronization therapy) study.

    abstract:OBJECTIVES:The authors investigated predictors of left ventricular ejection fraction (LVEF) super-response to cardiac resynchronization therapy with defibrillator (CRT-D) and whether super-response translated into improved event-free survival in patients with mildly symptomatic heart failure (HF). BACKGROUND:Few data ...

    journal_title:Journal of the American College of Cardiology

    pub_type: 临床试验,杂志文章


    authors: Hsu JC,Solomon SD,Bourgoun M,McNitt S,Goldenberg I,Klein H,Moss AJ,Foster E,MADIT-CRT Executive Committee.

    更新日期:2012-06-19 00:00:00

  • A Contemporary Picture of Enterococcal Endocarditis.

    abstract:BACKGROUND:Enterococcal endocarditis (EE) is a growing entity in Western countries. However, quality data from large studies is lacking. OBJECTIVES:The purpose of this study was to describe the characteristics and analyze the prognostic factors of EE in the GAMES cohort. METHODS:This was a post hoc analysis of a pros...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,多中心研究


    authors: Pericàs JM,Llopis J,Muñoz P,Gálvez-Acebal J,Kestler M,Valerio M,Hernández-Meneses M,Goenaga MÁ,Cobo-Belaustegui M,Montejo M,Ojeda-Burgos G,Sousa-Regueiro MD,de Alarcón A,Ramos-Martínez A,Miró JM,GAMES Investigators.

    更新日期:2020-02-11 00:00:00

  • Intracellular calcium transients in human working myocardium as detected with aequorin.

    abstract::The calcium transients associated with contraction in human working myocardium were recorded by use of the bioluminescent protein, aequorin, a substance that emits light when it combines with calcium ion (Ca++). Small amounts of aequorin were microinjected into superficial cells of human atrial and ventricular muscle ...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Morgan JP,Chesebro JH,Pluth JR,Puga FJ,Schaff HV

    更新日期:1984-02-01 00:00:00

  • Payment source, quality of care, and outcomes in patients hospitalized with heart failure.

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    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,多中心研究


    authors: Kapoor JR,Kapoor R,Hellkamp AS,Hernandez AF,Heidenreich PA,Fonarow GC

    更新日期:2011-09-27 00:00:00

  • Timing of Oral P2Y12 Inhibitor Administration in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome.

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    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Tarantini G,Mojoli M,Varbella F,Caporale R,Rigattieri S,Andò G,Cirillo P,Pierini S,Santarelli A,Sganzerla P,Cacciavillani L,Babuin L,De Cesare N,Limbruno U,Massoni A,Rognoni A,Pavan D,Belloni F,Cernetti C,Favero L,

    更新日期:2020-11-24 00:00:00

  • Myocardial creatine kinase expression after left ventricular assist device support.

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    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Park SJ,Zhang J,Ye Y,Ormaza S,Liang P,Bank AJ,Miller LW,Bache RJ

    更新日期:2002-06-05 00:00:00

  • Incidence, Characteristics, Predictors, and Outcomes of Surgical Explantation After Transcatheter Aortic Valve Replacement.

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    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Hirji SA,Percy ED,McGurk S,Malarczyk A,Harloff MT,Yazdchi F,Sabe AA,Bapat VN,Tang GHL,Bhatt DL,Thourani VH,Leon MB,O'Gara P,Shah PB,Kaneko T

    更新日期:2020-10-20 00:00:00

  • When children with Kawasaki disease grow up: Myocardial and vascular complications in adulthood.

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    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,评审


    authors: Gordon JB,Kahn AM,Burns JC

    更新日期:2009-11-17 00:00:00

  • Atrial emptying with orthotopic heart transplantation using bicaval and pulmonary venous anastomoses: a magnetic resonance imaging study.

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    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章


    authors: Freimark D,Silverman JM,Aleksic I,Crues JV,Blanche C,Trento A,Admon D,Queral CA,Harasty DA,Czer LS

    更新日期:1995-03-15 00:00:00