Abstract:
OBJECTIVES:This study sought to determine whether early disease is identifiable in asymptomatic relatives of patients with dilated cardiomyopathy (DCM) by means of noninvasive cardiologic assessment. BACKGROUND:DCM is diagnosed on the basis of advanced heart failure, where cardiac dilation and impaired contractility are recognized in the absence of a recognized etiology (World Health Organization criteria). However, initial clinical presentation may be with severe complications: thromboembolism, arrhythmia or sudden death. DCM has recently been recognized to be familial, with autosomal dominant inheritance in many cases. Familial disease is present in 9% to 20% of patients with DCM, and the ability to identify early disease in such people may improve patient management and aid in the understanding of pathogenesis. METHOD:We prospectively assessed 408 asymptomatic relatives (mean [+/-SD] age 35 +/- 15 years, 193 men) of 110 consecutive patients with DCM by means of history and physical examination, two-dimensional echocardiography, 12-lead and signal-averaged electrocardiography and metabolic exercise testing. We hypothesized that signs of lesser cardiac dysfunction in such relatives might indicate early disease. RESULTS:Twenty-nine percent of relatives had abnormal results on the echocardiogram. Twenty percent (n = 45) had left ventricular enlargement (LVE), defined as LV end-diastolic diameter (LVEDD) > or = 112% predicted; 6% (n = 13) had depressed fractional shortening (dFS), defined as FS < or = 25%; and 3% (n = 7) had frank DCM, defined as LV dilation, impaired contractile performance and LVEDD > or = 112% plus FS < or = 25%. Other abnormalities of cardiac function were identified in relatives with LVE or dFS: A greater number with LVE had an abnormal metabolic exercise test result than normal relatives (9% vs. 1%, p < 0.05). Relatives with LVE and abnormal maximal oxygen consumption (VO2max) (defined as VO2max < 80% predicted) had a lower absolute VO2max than normal relatives (30 +/- 8 vs. 43 +/- 9 ml/min per kg, p = 0.01). The QRS duration (at the 25-Hz filter) on the signal-averaged electrocardiogram was prolonged in relatives with LVE (103 +/- 13 ms) and dFS (102 +/- 12 ms) compared with that of normal relatives (97 +/- 12 ms, p < 0.05). Over a mean 39-month follow-up period, 12 relatives with LVE (27%) and none with dFS developed symptomatic DCM (p < 0.0001). One relative with LVE died suddenly, and another underwent heart transplantation. CONCLUSIONS:Nearly one-third of asymptomatic relatives (29%) have echocardiographic abnormalities, and 27% of such relatives progress to development of overt DCM. Early identification of such people would permit appropriate intervention that might influence the serious complications and mortality of this disease.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Baig MK,Goldman JH,Caforio AL,Coonar AS,Keeling PJ,McKenna WJdoi
10.1016/s0735-1097(97)00433-6subject
Has Abstractpub_date
1998-01-01 00:00:00pages
195-201issue
1eissn
0735-1097issn
1558-3597pii
S0735-1097(97)00433-6journal_volume
31pub_type
杂志文章abstract:BACKGROUND:Transcatheter mitral valve replacement (TMVR) is a rapidly evolving therapy. Follow-up of TMVR patients remains limited in duration and number treated. OBJECTIVES:The purpose of this study was to examine outcomes with expanded follow-up for the first 100 patients who underwent TMVR with the prosthesis. MET...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2018.12.066
更新日期:2019-03-26 00:00:00
abstract:OBJECTIVES:We sought to determine the impact of valve prosthesis-patient mismatch (PPM) on pulmonary arterial (PA) pressure after mitral valve replacement (MVR). BACKGROUND:Pulmonary arterial hypertension is a serious complication of mitral valve disease, and it is a major risk factor for poor outcome after MVR. We hy...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2004.10.073
更新日期:2005-04-05 00:00:00
abstract:OBJECTIVES:The aim of the current study was to evaluate the effect of recipient age on the regenerative response to implantation with young skeletal myoblasts (SKMCs) after a coronary artery ligation. BACKGROUND:In contrast with previous findings in animals, the initial clinical trials of cell transplantation after a ...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2007.06.009
更新日期:2007-09-11 00:00:00
abstract:OBJECTIVES:To examine the effect of a polymeric-based periadventitial delivery of a nitric oxide (NO)-releasing diazeniumdiolate, spermine/NO (SPER/NO), on balloon injury-induced neointimal hyperplasia in rat ileofemoral arteries. BACKGROUND:Reduced local bioavailability and adverse side effects limit systemic adminis...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(99)00543-4
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVES:Our purpose was to evaluate the efficacy and safety of drug-eluting stents in the setting of primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI). BACKGROUND:There is inconsistent and limited evidence about the efficacy and safety of drug-eluting stents in STEMI ...
journal_title:Journal of the American College of Cardiology
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更新日期:2008-02-12 00:00:00
abstract:OBJECTIVES:This study was conducted to evaluate the sensitivity and specificity of traditional electrocardiographic (ECG) criteria for right atrial enlargement and identify improve criteria, using quantitative two-dimensional echocardiography. BACKGROUND:Traditional ECG criteria for right atrial enlargement, such as P...
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
doi:10.1016/0735-1097(94)90763-3
更新日期:1994-03-01 00:00:00
abstract::Cholesteryl ester transfer protein (CETP) facilitates exchange of triglycerides and cholesteryl ester between high-density lipoprotein (HDL) and apolipoprotein B100-containing lipoproteins. Evidence from genetic studies that variants in the CETP gene were associated with higher blood HDL cholesterol, lower low-density...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2018.10.072
更新日期:2019-02-05 00:00:00
abstract:OBJECTIVES:The aim of this randomized placebo-controlled trial was to determine if withdrawing clopidogrel therapy leads to increased platelet activity compared with pre-treatment values in patients with stable coronary artery or peripheral arterial disease. BACKGROUND:Reports of increased cardiovascular events after ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2014-01-28 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2003-10-15 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(90)90545-z
更新日期:1990-11-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(94)90006-x
更新日期:1994-09-01 00:00:00
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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
doi:10.1016/s0735-1097(97)00188-5
更新日期:1997-08-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2003-03-05 00:00:00
abstract::Drug-induced long QT syndrome (diLQTS) and congenital LQTS (cLQTS) share many features, and both syndromes can result in life-threatening torsades de pointes (TdP). Our understanding of their mechanistic and genetic similarities has led to their improved clinical management. However, our inability to prevent diLQTS ha...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
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更新日期:2016-04-05 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(86)80154-1
更新日期:1986-06-01 00:00:00
abstract::In a retrospective analysis 139 patients with hypertrophic cardiomyopathy were followed up for 8.9 years (range 1 to 28 years). Patients were divided into two groups: Group 1 consisted of 60 patients with medical therapy and Group 2 of 79 patients with surgical therapy (septal myectomy). Groups 1 and 2 were subdivided...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/s0735-1097(10)80176-7
更新日期:1991-03-01 00:00:00
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
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journal_title:Journal of the American College of Cardiology
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更新日期:2004-02-18 00:00:00
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更新日期:2010-05-04 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:1990-12-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:1990-02-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(92)90279-v
更新日期:1992-04-01 00:00:00
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更新日期:2000-01-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(86)80279-0
更新日期:1986-01-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:2020-03-03 00:00:00
abstract:OBJECTIVES:This study sought to investigate the prevalence of potentially abnormal electrocardiographic (ECG) patterns in young individuals to assess the implications for a nationwide screening program for conditions causing sudden cardiac death (SCD). BACKGROUND:The Italian experience suggests that pre-participation ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2014.01.046
更新日期:2014-05-20 00:00:00
abstract:OBJECTIVES:The purpose of this study was to examine the relation of the mitral flow velocity curves to left ventricular filling pressures in patients with two different types of myocardial problems: hypertrophic cardiomyopathy and severe left ventricular systolic dysfunction. BACKGROUND:Previous studies have suggested...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/S0735-1097(96)00315-4
更新日期:1996-11-01 00:00:00
abstract::Cardiovascular disease is the leading cause of mortality in the world, and the increasing burden is largely a consequence of modifiable behavioral risk factors that interact with genomics and the environment. Continuous cardiovascular health promotion and disease prevention throughout the lifespan is critical, and the...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2016.01.036
更新日期:2016-04-12 00:00:00