Abstract：
OBJECTIVES:We sought to determine the frequency of spontaneous cerebrovascular events in adult patients with cyanotic congenital heart disease and to evaluate any contributing factors. BACKGROUND:Cerebrovascular events are a serious complication of cyanotic congenital heart disease in infants and children but are said to be uncommon in adults. METHODS:Between 1988 and 1995, 162 patients with cyanotic congenital heart disease (mean age 37 years, range 19 to 70) were retrospectively evaluated for any well documented cerebrovascular events that occurred at > or = 18 years of age. Events related to procedures, endocarditis or brain abscess were excluded. RESULTS:Twenty-two patients (13.6%) had 29 cerebrovascular events (1/100 patient-years). There was no significant difference between those with and without a cerebrovascular event in terms of age, smoking history, degree of erythrocytosis, ejection fraction or use of aspirin or warfarin (Coumadin). Patients who had a cerebrovascular event had a significantly increased tendency to develop hypertension, atrial fibrillation, microcytosis (mean corpuscular volume < 82) and history of phlebotomy (p < 0.05). Even when patients with hypertension or atrial fibrillation were excluded, there was an increased risk of cerebrovascular events associated with microcytosis (p < 0.01). CONCLUSIONS:Adults with cyanotic congenital heart disease are at risk of having cerebrovascular events. This risk is increased in the presence of hypertension, atrial fibrillation, history of phlebotomy and microcytosis, the latter condition having the strongest significance (p < 0.005). This finding leads us to endorse a more conservative approach toward phlebotomy and a more aggressive approach toward treating microcytosis in adults with cyanotic congenital heart disease.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Ammash N,Warnes CAdoi
10.1016/0735-1097(96)00196-9subject
Has Abstractpub_date
1996-09-01 00:00:00pages
768-72issue
3eissn
0735-1097issn
1558-3597pii
0735-1097(96)00196-9journal_volume
28pub_type
杂志文章abstract：:The feasibility of in vivo coronary angioscopy was tested utilizing a 1.8 mm angioscope in vessels where blood had been replaced by optically clear liquids, including a new perfluorocarbon emulsion. After trials in postmortem canine and human coronary arteries, in vivo intraluminal visualization was accomplished in th...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(83)80145-4
更新日期：1983-05-01 00:00:00
abstract：OBJECTIVES:The goal of this study was to examine the association between paraoxonase-1 (PON1) activity and concentration and the severity and extent of coronary artery disease (CAD). BACKGROUND:Paraoxonase-1, a high-density lipoprotein-associated enzyme, is proposed to have an antiatherogenic effect by protecting low-...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/j.jacc.2006.01.074
更新日期：2006-06-20 00:00:00
abstract：OBJECTIVES:Our goal was to compare histologically the mechanisms producing congenital complete heart block in normally structured hearts and in hearts with isomerism of the atrial appendages. BACKGROUND:It is known that several different histologic patterns can underscore the existence of congenital complete heart blo...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/0735-1097(92)90191-o
更新日期：1992-10-01 00:00:00
abstract：OBJECTIVES:This analysis sought to estimate the risk ratio for cancer incidence and cancer-related mortality associated with the use of calcium channel blocking agents (CCBs) in a large group of patients with chronic coronary heart disease (CHD). BACKGROUND:Recent publications contend that the use of short-acting CCBs...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(98)00008-4
更新日期：1998-03-15 00:00:00
abstract：OBJECTIVES:This study was designed to investigate the association between hypertension and aortic valve stenosis (AVS) in a rabbit model. BACKGROUND:Degenerative AVS is a prevalent disease in elderly persons. Its molecular mechanisms remain unclear, in part because of the absence of experimental models. Epidemiologic ...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/j.jacc.2005.12.070
更新日期：2006-06-06 00:00:00
abstract：OBJECTIVES:We investigated the acute effect of orally administered high-dose folic acid on coronary dilator function in humans. BACKGROUND:Folic acid and its active metabolite, 5-methyltetrahydrofolate, increase endothelium-dependent vasodilation in human peripheral circulation. However, the acute effect on coronary c...
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/j.jacc.2005.02.038
更新日期：2005-05-17 00:00:00
abstract：OBJECTIVES:This study sought to investigate the efficacy and safety of catheter ablation for atrial fibrillation (AF) in patients with heart failure with preserved ejection fraction (HFPEF). BACKGROUND:AF is a precipitating factor for clinical deterioration of HFPEF. METHODS:Catheter ablation for AF was performed in ...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/j.jacc.2013.07.020
更新日期：2013-11-12 00:00:00
abstract：OBJECTIVES:The aim of the present study was to investigate whether there is diurnal fluctuation in the endothelial function of patients with variant angina (VA). BACKGROUND:Coronary spasm is induced by acetylcholine and is promptly relieved by nitroglycerin. Thus, it is possible that endothelial dysfunction is involve...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(02)01956-3
更新日期：2002-07-17 00:00:00
abstract：:To assess the potential of in vivo nuclear magnetic resonance imaging for the detection of reperfused myocardium, in vivo T2-weighted spin echo images were obtained of dogs at 0.15 tesla. Imaging was done during 3 hours of coronary occlusion (group I), and during 3 hours of coronary occlusion followed by 1 hour of rep...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(87)80091-8
更新日期：1987-01-01 00:00:00
abstract：OBJECTIVES:This study was designed to examine whether the myocardium can be maintained in a protected state by extending the delayed phase of cardioprotection with chronic, intermittent adenosine A1 receptor activation. BACKGROUND:Several recent studies have explored the temporal characteristics of the protective effe...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(98)00054-0
更新日期：1998-04-01 00:00:00
abstract：OBJECTIVES:This study characterizes the histology of myocardium predicted to be hibernating using three different imaging techniques to explain the discordance among them. BACKGROUND:Both radionuclide and functional imaging techniques were used to assess myocardial hibernation. The former have high sensitivity and the...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(01)01766-1
更新日期：2002-02-06 00:00:00
abstract：OBJECTIVES:This study sought to investigate the prevalence and mechanisms underlying right ventricular (RV) dyssynchrony in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) using tissue Doppler echocardiography (TDE). BACKGROUND:An ARVD/C is characterized by fibrofatty replacement of RV myocardium an...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/j.jacc.2009.04.038
更新日期：2009-07-28 00:00:00
abstract：OBJECTIVES:We investigated whether the serum markers of collagen turnover differed in various forms of atrial fibrillation (AF) and in sinus rhythm (SR) in humans. BACKGROUND:Structural alterations and fibrosis have been implicated in the generation and perpetuation of AF. METHODS:Serum C-terminal propeptide of colla...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/j.jacc.2008.03.045
更新日期：2008-07-15 00:00:00
abstract：OBJECTIVES:The primary objective of the Monotherapy Assessment of Ranolazine In Stable Angina (MARISA) trial was to determine the dose-response relationship of ranolazine, a potentially new anti-anginal compound, on symptom-limited exercise duration. BACKGROUND:Fatty acids rise precipitously in response to stress, inc...
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
doi：10.1016/j.jacc.2003.11.045
更新日期：2004-04-21 00:00:00
abstract：:The records of 90 patients with Wolff-Parkinson-White syndrome who presented with supraventricular tachycardia in the first 4 months of life were reviewed. Among these, 63% were male. Structural heart disease was present in 20%, most commonly Ebstein's anomaly. All patients presented with a regular narrow QRS tachycar...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(85)80095-4
更新日期：1985-01-01 00:00:00
abstract：OBJECTIVES:Our goal was to assess the effect of hypercoagulability on the risk of stroke in patients with aortic plaques. BACKGROUND:Atherosclerotic plaques in the aortic arch are a risk factor for ischemic stroke. Their relationship with blood hypercoagulability, which might enhance their embolic potential and affect...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/j.jacc.2008.04.062
更新日期：2008-09-02 00:00:00
abstract：BACKGROUND:Many patients report adverse reactions to, and may not tolerate, statin therapy. These patients may be at increased risk for coronary heart disease (CHD) events and mortality. OBJECTIVES:This study evaluated the risk for recurrent myocardial infarction (MI), CHD events, and all-cause mortality in Medicare b...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/j.jacc.2016.12.036
更新日期：2017-03-21 00:00:00
abstract：:Long-term variation in the frequency of myocardial ischemia during daily activity in patients with coronary artery disease who do not experience symptomatic changes has not been documented. Because at one point in time, the magnitude of such ischemia is strongly related to the ischemic threshold measured during exerci...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(10)80261-x
更新日期：1992-03-01 00:00:00
abstract：:The purpose of this study was to determine whether measurement of aortic blood flow velocity and acceleration by pulsed Doppler ultrasound can be used to assess the global performance of the systemic right ventricle noninvasively in young patients who have undergone intraatrial repair of aortopulmonary transposition. ...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/0735-1097(89)90352-5
更新日期：1989-06-01 00:00:00
abstract：BACKGROUND:Life-threatening heparin-induced thrombocytopenia (HIT) is treated with the alternative nonheparin anticoagulants argatroban, lepirudin, or danaparoid. Frequently, the pentasaccharide fondaparinux is used off-label. OBJECTIVES:The authors sought to investigate the safety and efficacy of the different antico...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jacc.2017.09.1099
更新日期：2017-11-28 00:00:00
abstract：OBJECTIVES:This study sought to examine whether plasma brain natriuretic peptide levels can predict prognosis after myocardial infarction. BACKGROUND:It has been suggested that concentrations of plasma brain natriuretic peptide reflect left ventricular function. Although the prognosis after myocardial infarction depen...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/0735-1097(96)00067-8
更新日期：1996-06-01 00:00:00
abstract：OBJECTIVES:The aim of this study was to assess the pattern of the adoption of internal mammary artery (IMA) grafting in the United States, test its association with clinical outcomes, and assess whether its effectiveness differs in key clinical subgroups. BACKGROUND:The effect of IMA grafting on major clinical outcome...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jacc.2013.08.1632
更新日期：2014-01-07 00:00:00
abstract：OBJECTIVES:We sought to compare anterograde and retrograde balloon dilation of severe aortic valve stenosis in neonates. BACKGROUND:There is a high incidence of iliofemoral artery complications after retrograde balloon dilation of the aortic valve in the neonate. Therefore, a nonarterial technique of catheter access t...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(97)00266-0
更新日期：1997-10-01 00:00:00
abstract：OBJECTIVES:The aim of this research was to assess the efficacy of paclitaxel-eluting stents in chronic total coronary occlusions (CTO). BACKGROUND:Percutaneous coronary interventions for CTOs are characterized by a high target vessel failure rate. METHODS:In 48 consecutive patients, paclitaxel-eluting stents (Taxus, ...
journal_title：Journal of the American College of Cardiology
pub_type： 临床试验,杂志文章
doi：10.1016/j.jacc.2004.09.040
更新日期：2004-12-21 00:00:00
abstract：OBJECTIVES:Our aim was to clarify the anatomic substrate in hearts diagnosed as having tricuspid atresia by studying autopsy specimens and comparing the findings with those in two-dimensional echocardiograms. BACKGROUND:Traditionally, tricuspid atresia was thought, and is still believed by some, to be due to an imperf...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/0735-1097(95)00250-8
更新日期：1995-09-01 00:00:00
abstract：:A 72 year old woman was thought to have a paradoxically split second heart sound. Echocardiography with simultaneous phonocardiography revealed a late systolic click resulting from isolated tricuspid valve prolapse. Respiratory variation of the click in relation to the second heart sound resulted in an auscultatory ph...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(85)80414-9
更新日期：1985-03-01 00:00:00
abstract：:A large number of prosthetic heart valves (PHV) are being implanted in patients with both congenital and acquired valvular disease. Many of the recipients of such valves are women of childbearing age who desire to have children. The main issues involved with pregnancy in a patient with PHV include the selection of PHV...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章,评审
doi：10.1016/j.jacc.2005.02.087
更新日期：2005-08-02 00:00:00
abstract：OBJECTIVES:To examine the relationship between the persistence of ST segment depression in leads V5-V6 after Q-wave anterior wall myocardial infarction (MI) and the filling pattern of the left ventricle (LV). BACKGROUND:Precordial ST segment depression predominantly in leads V5-V6 is associated with increased in-hospi...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(99)00577-x
更新日期：2000-02-01 00:00:00
abstract：:The short-term effects of oral diltiazem on hemodynamics and distribution of cardiac output at rest and during semiupright bicycle exercise were evaluated in eight patients with stable effort angina on long-term beta 1-adrenergic blockade. Cardiac output and iliofemoral blood flow were measured using thermodilution. T...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/0735-1097(90)90198-x
更新日期：1990-01-01 00:00:00
abstract：:Electrophysiologic studies were performed at 12.7 +/- 4 months postoperatively in 20 patients who had the arterial switch repair at 1 to 120 days (mean 13 +/- 26 [SD]) for d-transposition of the great arteries. Preoperative electrocardiograms (ECGs) at rest revealed an ectopic atrial rhythm in one patient. Postoperati...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/0735-1097(88)90379-8
更新日期：1988-07-01 00:00:00
