Abstract:
OBJECTIVES:The purpose of this study was to compare clinical outcomes and tilt test variables between a single-stage tilt test with an infusion of 5 micrograms/min of isoproterenol and a conventional multistage test with infusions of 0, 2 and 5 micrograms/min of isoproterenol in three successive stages. BACKGROUND:The diagnosis of neuromediated syncope is often established with isoproterenol--head-up tilt table testing. Previous work has suggested that a single infusion of 5 micrograms/min of isoproterenol during 80 degrees head-up tilt for < or = 10 min should be sufficient to establish the diagnosis. METHODS:Forty patients with recurrent syncope underwent both tests in a randomized crossover fashion. RESULTS:Of 24 patients with positive findings on a multistage test, 19 (79%) had positive findings on a single-stage test, whereas 13 (81%) of 16 patients with negative results on a multistage test had negative results on a single-stage test (p < 0.001, chi-square analysis). Presyncope developed monoexponentially with time at similar rates in both tests, with half-times to presyncope of 1.3 and 2 min for the single-stage and multistage test, respectively. Intertest intrapatient times to presyncope correlated well (r = 0.74, p = 0.001). Finally, peak and trough heart rates each were similar and correlated well between tests. The mean peak heart rate was 136 +/- 25 and 133 +/- 18 beats/min for the single-stage and multistage test, respectively (p = NS, t test; r = 0.50, p = 0.002, linear regression). The mean trough heart rate was 76 +/- 31 and 78 +/- 36 beats/min for the single-stage and multistage test, respectively (p = NS, t test; r = 0.86, p < 0.001, linear regression analysis). CONCLUSIONS:The single-stage and multistage tilt tests are equivalent with regard to clinical outcome and tilt test variables, although the single-stage test is considerably less time-consuming.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Sheldon Rdoi
10.1016/0735-1097(93)90824-ksubject
Has Abstractpub_date
1993-07-01 00:00:00pages
114-8issue
1eissn
0735-1097issn
1558-3597pii
0735-1097(93)90824-Kjournal_volume
22pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVES:This study was designed to assess the safety and efficacy of intravenously administered sonicated human serum albumin for enhancing echocardiographic delineation of the left ventricular endocardium and improving assessment of wall motion in patients with incomplete depiction of noncontrast echocardiography. ...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/0735-1097(93)90562-f
更新日期:1993-11-01 00:00:00
abstract:OBJECTIVES:We hypothesized that erythropoietin (EPO)-immersed gelatin hydrogel microspheres (GHM) injected into ischemic legs might continuously release a small amount of EPO to locally stimulate angiogenesis without unfavorable systemic effects. BACKGROUND:EPO is a potent angiogenic factor, but its use for relieving ...
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doi:10.1016/j.jacc.2009.02.056
更新日期:2009-06-23 00:00:00
abstract:OBJECTIVES:This study investigated the effects of androgens on gene expression in male- and female-donor macrophages. BACKGROUND:Men have more severe coronary disease than women. Androgen exposure increases foam cell formation in male but not female macrophages, and male macrophages express >4-fold more androgen recep...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2003.07.002
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to compare metabolic risk factors in men with anginal chest pain and a normal or abnormal coronary angiogram with those in healthy men. BACKGROUND:Risk factors for coronary heart disease, including lipoprotein abnormalities, hypertension and adiposity, may be metabolically interlin...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)90423-5
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to use cardiac magnetic resonance (CMR) imaging and invasive left ventricular (LV) pressure-volume (PV) measurements to explore the relationship between diffuse myocardial fibrosis and indexes of diastolic performance in a cohort of cardiac transplant recipients. BACKGROUND:The...
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doi:10.1016/j.jacc.2013.10.084
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abstract::Cardiac resynchronization therapy (CRT) is used to treat a subset of heart failure patients with discoordinate wall motion. Defining appropriate patients is important, and, although electrical delay (wide QRS) is commonly used, recent data show that measures of mechanical dyssynchrony improve the sensitivity and speci...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2007.09.027
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Exercise has been proposed as a trigger for arrhythmogenic right ventricular cardiomyopathy (ARVC) phenotype manifestation; however, research is hampered by the limited availability of animal models in which disease-associated mutations can be tested. OBJECTIVES:This study evaluated the impact of exercise o...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2015.01.045
更新日期:2015-04-14 00:00:00
abstract:BACKGROUND:The risk-benefit ratio of left atrial appendage closure (LAAC) versus systemic therapy (warfarin) for prevention of stroke, systemic embolism, and cardiovascular death in nonvalvular atrial fibrillation (NVAF) requires continued evaluation. OBJECTIVES:This study sought to assess composite data regarding lef...
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pub_type: 杂志文章,meta分析
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更新日期:2015-06-23 00:00:00
abstract:OBJECTIVES:This study compared the efficacy and safety of two antitachycardia pacing algorithms in the treatment of ventricular tachycardia. BACKGROUND:There is agreement that antitachycardia pacing should be adapted to tachycardia rate and be delivered in a burst, but the ideal pacing pattern is not well understood. ...
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(93)90318-u
更新日期:1993-05-01 00:00:00
abstract::The appropriateness and timing of mitral valve surgery in patients with advanced heart failure and severe mitral regurgitation remains controversial. Recent surgical results provide evidence for beneficial effects on left ventricular remodeling and functional capacity. Given the absence of randomized trials comparing ...
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pub_type: 杂志文章,评审
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更新日期:2010-01-26 00:00:00
abstract::To elucidate the effects of ventricular asynchrony with or without myocardial ischemia on the time constant of left ventricular pressure decay and asymptote, that is, the level to which pressure would decrease if isovolumic pressure decrease continued infinitely, left ventriculography and pressure measurements were in...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(85)80118-2
更新日期:1985-09-01 00:00:00
abstract::Among 126 consecutive patients undergoing percutaneous mitral valvuloplasty, 34 were judged to be at high risk for surgery on the basis of age greater than 70 years (n = 13), New York Heart Association functional class IV (n = 11), ejection fraction less than or equal to 35% (n = 3), severe pulmonary hypertension (n =...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80098-1
更新日期:1991-02-01 00:00:00
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...
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doi:10.1016/s0735-1097(01)01509-1
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to examine the interaction between cigarette smoking and the clinical efficacy of clopidogrel in ST-segment elevation myocardial infarction (STEMI). BACKGROUND:Cigarette smoking induces cytochrome P450 (CYP)1A2, which converts clopidogrel into its active metabolite, and prior studi...
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doi:10.1016/j.jacc.2008.12.044
更新日期:2009-04-14 00:00:00
abstract::Decision analysis, an analytic approach to making decisions when uncertainty is present, has its foundation in probability and utility theory. It provides insights into the trade-offs that are involved when a selection must be made among patient management strategies. In general, several broad steps are involved. The ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(89)90159-9
更新日期:1989-09-01 00:00:00
abstract:OBJECTIVES:We sought to analyze age-gender differences in the rate-corrected QT (QTc) interval in the presence of a QT-prolonging gene. BACKGROUND:Compared with men, women exhibit a longer QTc interval and an increased propensity toward torsade de pointes. In normal subjects, the QTc gender difference reflects QTc int...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(96)00454-8
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to address the timing of sudden death in advanced heart failure patients. BACKGROUND:Sudden death is a catastrophic event in cardiovascular disease. It has a circadian pattern prominent in the early AM, which has been thought to be due to a surge of sympathetic stimulation. We p...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章
doi:10.1016/s0735-1097(00)00728-2
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to investigate the clinical expression of adenosine monophosphate-activated protein kinase (AMPK) gene mutations (PRKAG2) in adenosine monophosphate (AMP) kinase disease based on 12 years follow-up of known mutation carriers and to define the prevalence of PRKAG2 mutations in hypert...
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pub_type: 杂志文章
doi:10.1016/j.jacc.2004.11.053
更新日期:2005-03-15 00:00:00
abstract:BACKGROUND:It is unclear what level of moderate to vigorous intensity physical activity (MVPA) offsets the health risks of sitting. OBJECTIVES:The purpose of this study was to examine the joint and stratified associations of sitting and MVPA with all-cause and cardiovascular disease (CVD) mortality, and to estimate th...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2019.02.031
更新日期:2019-04-30 00:00:00
abstract:BACKGROUND:It is unclear whether the non-vitamin K antagonist oral anticoagulant agents rivaroxaban and dabigatran are superior to warfarin for efficacy and safety outcomes in Asians with nonvalvular atrial fibrillation (NVAF). OBJECTIVES:The aim of this study was to compare the risk for thromboembolic events, bleedin...
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pub_type: 杂志文章
doi:10.1016/j.jacc.2016.06.062
更新日期:2016-09-27 00:00:00
abstract:OBJECTIVES:This study sought to determine whether hyperoxemic reperfusion with aqueous oxygen (AO) improves recovery of ventricular function after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). BACKGROUND:Hyperbaric oxygen reduces myocardial injury and improves ventricular function whe...
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pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jacc.2007.01.099
更新日期:2007-07-31 00:00:00
abstract:OBJECTIVE:We studied the effect of the angiotensin II type 1 (AT1)-receptor antagonist candesartan on infarct size resulting from regional myocardial ischemia in pigs. BACKGROUND:The effects of AT1-receptor blockade on infarct size in different species remain controversial and its potential cardioprotective mechanisms...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(98)00441-0
更新日期:1998-11-15 00:00:00
abstract:OBJECTIVES:The purpose of this analysis was to define the factors that predict 3-year graft patency. BACKGROUND:The success of coronary artery bypass graft surgery (CABG) is dependent on vein graft patency after the operation. It has been well established by a series of Department of Veterans Affairs Cooperative Trial...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(97)82539-9
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to assess the role of transcatheter aortic valve implantation (TAVI) compared with medical treatment (MT) and surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis (AS) at increased surgical risk. BACKGROUND:Elderly patients with comorbidities are at cons...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jacc.2011.05.063
更新日期:2011-11-15 00:00:00
abstract:OBJECTIVES:Our objective was to evaluate the efficacy of triphasic waveforms for transthoracic defibrillation in a swine model. BACKGROUND:Triphasic shocks have been found to cause less post-shock dysfunction than biphasic shocks in chick embryo studies. METHODS:After 30 s of electrically induced ventricular fibrilla...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(03)00656-9
更新日期:2003-08-06 00:00:00
abstract::A case of paroxysmal bradycardia- and tachycardia-dependent atrioventricular (AV) block is described in a patient with right bundle branch block. The His bundle recordings demonstrated the site of the AV block to be distal to the His bundle recording site (probably in the left bundle branch). Whereas AV block distal t...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(87)80402-3
更新日期:1987-02-01 00:00:00
abstract:OBJECTIVES:We sought to determine the importance of nitric oxide (NO) production in maintaining coronary blood flow during exercise in hearts with collateral-dependent myocardium. BACKGROUND:Coronary collateral vessels demonstrate endothelium-mediated NO-dependent vasodilation in response to agonists such as acetylcho...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(97)00437-3
更新日期:1998-01-01 00:00:00
abstract::The myocardial uptake of a new technetium-99m-labeled myocardial perfusion agent, methoxyisobutyl isonitrile (Tc-99m MIBI), and thallium-201 was correlated with microsphere flow in an open chest canine model of low coronary flow and postischemic dysfunction. Eighteen dogs were given an injection of thallium-201 (0.5 m...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(89)90034-x
更新日期:1989-12-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to explore in pulmonary arterial hypertension (PAH) whether the cause of interventricular asynchrony lies in onset of shortening or duration of shortening. BACKGROUND:In PAH, leftward ventricular septal bowing (LVSB) is probably caused by a left-to-right (L-R) delay in myocardi...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2007.10.041
更新日期:2008-02-19 00:00:00
abstract:OBJECTIVES:the aim of this study was to determine whether telmisartan decreases all-cause and cardiovascular mortality and morbidity in hemodialysis patients with chronic heart failure (CHF) and impaired left ventricular ejection fraction (LVEF) when added to standard therapies with angiotensin-converting enzyme inhibi...
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
doi:10.1016/j.jacc.2010.03.105
更新日期:2010-11-16 00:00:00