Abstract:
BACKGROUND:Little is known of the prognostic significance of mitral regurgitation (MR) on transcatheter aortic valve replacement (TAVR), the impact of TAVR on MR severity, and the variables associated with possible post-TAVR improvement in MR. We evaluated these issues in a multicenter registry of patients undergoing CoreValve Revalving System-TAVR. METHODS AND RESULTS:Among 1007 consecutive patients, 670 (66.5%), 243 (24.1%), and 94 (9.3%) presented with no/mild, moderate, and severe MR, respectively. At 1 month after TAVR, patients with severe or moderate MR showed comparable mortality rates (odds ratio, 1.1; 95% confidence interval [95% CI], 0.7-1.55; P=0.2), but both were significantly higher compared with patients with mild/no MR (odds ratio, 2.2; 95% CI, 1.78-3.28; P<0.001; and odds ratio, 1.9; 95% CI, 1.1-3.3; P=0.02, respectively). One-year mortality was also similar between patients with severe and those with moderate MR (hazard ratio, 1.4; 95% CI, 0.94-2.4; P=0.06) and still significantly higher compared with patients with mild/no MR (hazard ratio, 1.7; 95% CI, 1.2-3.41; P<0.001; and hazard ratio, 1.4; 95% CI, 1.2-2.2; P=0.03, respectively). Severe pulmonary hypertension, atrial fibrillation, and MR more than mild, but not an improvement of ≥1 grade in MR severity, were independent predictors of mortality at 1 year. At 1 year, an improved MR was observed in 47% and 35% of patients with severe and moderate MR, respectively. The rate of low implantation was consistent across groups with improved, unchanged, or worsened MR. A functional type of MR and the absence of severe pulmonary hypertension and atrial fibrillation independently predicted the improvement in MR severity. CONCLUSIONS:Baseline MR greater than mild is associated with higher mortality after CoreValve Revalving System-TAVR. A significant improvement in MR was more likely in patients with functional MR and without severe pulmonary hypertension or atrial fibrillation. The improvement in MR did not independently predict mortality.
journal_name
Circulationjournal_title
Circulationauthors
Bedogni F,Latib A,De Marco F,Agnifili M,Oreglia J,Pizzocri S,Latini RA,Lanotte S,Petronio AS,De Carlo M,Ettori F,Fiorina C,Poli A,Cirri S,De Servi S,Ramondo A,Tarantini G,Marzocchi A,Fiorilli R,Klugmann S,Ussia GPdoi
10.1161/CIRCULATIONAHA.113.001822subject
Has Abstractpub_date
2013-11-05 00:00:00pages
2145-53issue
19eissn
0009-7322issn
1524-4539pii
CIRCULATIONAHA.113.001822journal_volume
128pub_type
杂志文章,多中心研究相关文献
CIRCULATION文献大全abstract:BACKGROUND:Catheter-based ultrasound is a new imaging modality to examine endovascular detail in the coronary circulation. This technique requires direct placement of the catheter in the arterial segment of interest. METHODS AND RESULTS:We examined the feasibility of a less invasive approach by imaging the coronary ar...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.84.5.1957
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:Hypertension and other vascular diseases are more prevalent in diabetic patients than in the general population. In humans and in several animal models of diabetes, a disturbance of endothelium-dependent responses has been shown. Oxyhemoglobin is one of the most known modulators of these endothelium-dependen...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.88.5.2111
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:Electric stimulation of mediastinal sympathetic cardiac nerves increases cardiac contractility but is not selective for the left ventricle because it elicits sinus tachycardia and enhanced atrioventricular conduction. The aim of this study was to identify sympathetic neural structures inside the heart that s...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.109.874263
更新日期:2010-03-23 00:00:00
abstract:BACKGROUND:Ruling out acute myocardial infarction (AMI) on the basis of rapid assays for cardiac markers will allow early triage of patients and cost-effective use of available coronary care facilities. METHODS AND RESULTS:We studied the value of myoglobin, creatine kinase (CK)-MBmass, and troponin T in ruling out an ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.12.3401
更新日期:1995-12-15 00:00:00
abstract:BACKGROUND:ST-segment depression during exercise testing is frequently observed in the absence of restenosis after coronary angioplasty. METHODS AND RESULTS:We studied the determinants of this phenomenon in 70 consecutive patients with unstable angina related to a single left anterior descending coronary artery lesion...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.90.1.148
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Numerous scales exist for the classification of major bleeding events. Limited data compare the most commonly used bleeding scales within a single at-risk cohort of patients with atrial fibrillation. Here, we analyze bleeding outcomes according to the ISTH (International Society on Thrombosis and Hemostasis)...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.119.041346
更新日期:2019-11-26 00:00:00
abstract:BACKGROUND:Administration of protease inhibitors (PIs) to HIV-infected individuals has been associated with hyperlipidemia. In this study, we characterized the lipoprotein profile in subjects receiving ritonavir, indinavir, or nelfinavir, alone or in combination with saquinavir. METHODS AND RESULTS:Plasma lipoprotein ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.100.7.700
更新日期:1999-08-17 00:00:00
abstract:BACKGROUND:Matricellular proteins are extracellular matrix proteins that do not contribute directly to tissue integrity but are capable of modulating cell function. We hypothesized that the matricellular protein thrombospondin (TSP)-1, a potent inhibitor of angiogenesis and activator of transforming growth factor (TGF-...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.104.510354
更新日期:2005-06-07 00:00:00
abstract:BACKGROUND:Calcineurin is a calcium-regulated phosphatase that plays a major role in cardiac hypertrophy. We previously described that alternative splicing of the calcineurin Aβ (CnAβ) gene generates the CnAβ1 isoform, with a unique C-terminal region that is different from the autoinhibitory domain present in all other...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.110.012211
更新日期:2011-06-21 00:00:00
abstract:BACKGROUND:Arterial relaxation is largely regulated by endothelial nitric oxide (NO). Its diminished activity has been associated with incipient atherosclerosis. We investigated the endothelium-dependent relaxation of aorta in apolipoprotein E-knockout (apoE-KO) mice exposed to single or repeated Chlamydia pneumoniae i...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.9.1039
更新日期:2000-08-29 00:00:00
abstract:BACKGROUND:Bolus thrombolytic therapy is a simplified means of administering thrombolysis that facilitates rapid time to treatment. TNK-tissue plasminogen activator (TNK-tPA) is a highly fibrin-specific single-bolus thrombolytic agent. METHODS AND RESULTS:In TIMI 10B, 886 patients with acute ST-elevation myocardial in...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1161/01.cir.98.25.2805
更新日期:1998-12-22 00:00:00
abstract::The acute coronary hemodynamic and metabolic effects of intravenous dipyridamole were studied in 13 patients. Total left ventricular (LV), anterior (supplied by the left anterior descending coronary artery) and inferior (supplied by circumflex and right coronary arteries) regional flows and metabolic responses were as...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.64.2.333
更新日期:1981-08-01 00:00:00
abstract:BACKGROUND:The influence of changes in heart rate on myocardial contractility (the force-frequency effect) differs under various experimental conditions, including the anesthetized versus the conscious state. METHODS AND RESULTS:To assess the influence of beta-adrenergic stimulation on force-frequency effects on myoca...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.86.2.572
更新日期:1992-08-01 00:00:00
abstract::The role of right ventricular (RV) fibrosis in pulmonary hypertension (PH) remains a subject of ongoing discussion. Alterations of the collagen network of the extracellular matrix may help prevent ventricular dilatation in the pressure-overloaded RV. At the same time, fibrosis impairs cardiac function, and a growing b...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.118.035326
更新日期:2019-01-08 00:00:00
abstract:BACKGROUND:Peripheral arterial disease (PAD) is associated with an impairment in exercise performance and muscle function that is not fully explained by the reduced leg blood flow during exercise. This study characterized the effects of PAD on muscle function, histology, and metabolism. METHODS AND RESULTS:Twenty-six ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.87.2.413
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND:Heart rate (HR) variability is a marker of tonic cardiac autonomic activity and contributes in assessing risk for sudden death after myocardial infarction. Recent clinical observations have indicated that attenuation of HR variability, which occurs after myocardial infarction, may be transient. This study ad...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.90.2.976
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:We sought to define the factors associated with the occurrence of stroke and systemic embolism in a large, international atrial fibrillation (AF) trial. METHODS AND RESULTS:In ROCKET AF (Rivaroxaban Once-daily, oral, direct factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.112.107128
更新日期:2013-01-15 00:00:00
abstract::Four revolutions are transforming the cardiology of our day. The first is a social revolution. It has resulted in plummeting esteem for the medical profession reflecting disenchantment coupled with the rapid emergence of the recognition that health care is a right rather than a privilege. The second revolution, interv...
journal_title:Circulation
pub_type: 传,历史文章,杂志文章
doi:10.1161/01.cir.87.6.2047
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine whether antianginal medications affect the prognostic value of pharmacological stress echocardiography. METHODS AND RESULTS:From the EPIC-EDIC Data Bank, 7333 patients (5452 men; age; 59+/-10 years) underwent pharmacological stress echocardiography with either high-dos...
journal_title:Circulation
pub_type: 杂志文章,多中心研究
doi:10.1161/01.CIR.0000127427.03361.5E
更新日期:2004-05-25 00:00:00
abstract:BACKGROUND:The safety of drug-eluting stents in ST-segment elevation myocardial infarction (STEMI) continues to be debated. Pathological studies have demonstrated an association between uncovered struts and subsequent stent thrombosis. Optical coherence tomography can detect stent strut coverage in vivo on a micron-sca...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.110.963181
更新日期:2011-01-25 00:00:00
abstract:BACKGROUND:The relationship between autonomic activation and the mechanisms of paroxysmal atrial fibrillation remains unclear. METHODS AND RESULTS:We implanted a pacemaker and a radio transmitter in 7 dogs (group 1). After baseline recording, we paced the left atrium at 20 Hz for 1 week and then monitored left stellat...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.776203
更新日期:2008-08-26 00:00:00
abstract:BACKGROUND:The results of angiographic studies have suggested that calcium channel-blocking agents may prevent new coronary lesion formation, the progression of minimal lesions, or both. METHODS AND RESULTS:The Prospective Randomized Evaluation of the Vascular Effects of Norvasc Trial (PREVENT) was a multicenter, rand...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1161/01.cir.102.13.1503
更新日期:2000-09-26 00:00:00
abstract::Reperfusion of the globally ischemic myocardium with mannitol has been shown to preserve myocardial function. However, it remains unclear whether the mechanism of mannitol protection relates to its hyperosmolar or free radical scavenging properties. Three groups of isolated, perfused rabbit hearts underwent 45 min of ...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract::To define the mechanisms of unexpected cardiac arrest in advanced heart failure, we reviewed the causes of cardiac arrest as established from electrocardiographic monitoring and from clinical and autopsy data in patients hospitalized for cardiac transplantation evaluation and management of advanced heart failure (mean...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.80.6.1675
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:The suggestion that increased QT dispersion (QTD) is due to increased differences in local action potential durations within the myocardium is wanting. An alternative explanation was sought by relating QTD to vectorcardiographic T-loop morphology. METHODS AND RESULTS:The T loop is characterized by its ampli...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.99.11.1458
更新日期:1999-03-23 00:00:00
abstract:BACKGROUND:Chimeric molecules comprising the A-chain of tissue-type plasminogen activator (t-PA) and the catalytic domain of urokinase-type plasminogen activator (u-PA) have intact enzymatic characteristics of u-PA, partial fibrin-binding properties of t-PA, and thrombolytic properties in animal models comparable with ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.84.3.1216
更新日期:1991-09-01 00:00:00
abstract::Vigorous hyperventilation was induced for five minutes immediately after a five-minute infusion of 100 ml of Tris-buffer (pH 10) in nine patients with Prinzmetal's variant angina. In eight of the patients, chest pain with ischemic changes in the electrocardiogram occurred during this procedure or within five minutes a...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.58.1.56
更新日期:1978-07-01 00:00:00
abstract:BACKGROUND:Insulin sensitivity varies up to threefold in apparently healthy individuals, but the mechanism for this is unknown. We have examined the hypothesis that vascular endothelial nitric oxide production and insulin sensitivity are directly related in humans. METHODS AND RESULTS:Nineteen healthy male subjects we...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.93.7.1331
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:Vascular Ehlers-Danlos syndrome (vEDS), also known as EDS type IV, an inherited disorder of connective tissue, results from mutations in the gene encoding type III procollagen (COL3A1). Affected patients are at risk for arterial dissection or rupture, the main cause of death. To understand the pathogenesis o...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000121741.50315.C2
更新日期:2004-03-30 00:00:00
abstract:BACKGROUND:Since 1990, sternotomy has been the preferred approach for construction of a modified Blalock-Taussig shunt (MBTS) at Children's Hospital, Boston, Mass. In retrospect, we sought to test the hypothesis that this approach yields less mortality and morbidity than the traditional thoracotomy approach. METHODS A...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.9.256
更新日期:1995-11-01 00:00:00