Abstract:
BACKGROUND:Assessment of patients with aortic stenosis (AS) and impaired left ventricular function remains challenging. Aortic valve calcium (AVC) scoring with computed tomography (CT) and fluoroscopy has been proposed as means of diagnosing and predicting outcomes in patients with severe AS. HYPOTHESIS:Severity of aortic valve calcification correlates with the diagnosis of true severe AS and outcomes in patients with low-gradient low-flow AS. METHODS:Echocardiography and CT database records from January 1, 2000 to September 26, 2009 were reviewed. Patients with aortic valve area (AVA)<1.0 cm2 who had ejection fraction (EF)≤25% and mean valvular gradient≤25 mmHg with concurrent noncontrast CT scans were included. AVC was evaluated using CT and fluoroscopy. Mortality and aortic valve replacement (AVR) were established using the Social Security Death Index and medical records. The role of surgery in outcomes was evaluated. RESULTS:Fifty-one patients who met the above criteria were included. Mean age was 75.1±9.6 years, and 15 patients were female. Mean EF was 21%±4.6% with AVA of 0.7±0.1 cm2. The peak and mean gradients were 35.5±10.6 and 19.0±5.1 mmHg, respectively. Median aortic valve calcium score was 2027 Agatston units. Mean follow-up was 908 days. Patients with calcium scores above the median value were found to have increased mortality (P=0.02). The benefit of surgery on survival was more pronounced in patients with higher valvular scores (P=0.001). Fluoroscopy scoring led to similar findings, where increased AVC predicted worse outcomes (P=0.04). CONCLUSIONS:In patients with low-gradient low-flow AS, higher valvular calcium score predicts worse long-term mortality. AVR is associated with improved survival in patients with higher valve scores.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Aksoy O,Cam A,Agarwal S,Ige M,Yousefzai R,Singh D,Griffin BP,Schoenhagen P,Kapadia SR,Tuzcu MEdoi
10.1002/clc.22212subject
Has Abstractpub_date
2014-01-01 00:00:00pages
26-31issue
1eissn
0160-9289issn
1932-8737journal_volume
37pub_type
杂志文章abstract::The noninvasive assessment of the severity of aortic stenosis is difficult. A recent description of systolic flutter of aortic valve leaflets as a screening test for severe aortic stenosis was applied to a group of patients who had undergone catheterization. As opposed to the previous report, we found this an inaccura...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960070407
更新日期:1984-04-01 00:00:00
abstract::Coronary artery stents have been developed to overcome arterial abrupt closure and restenosis following balloon angioplasty. Complications of stent insertion include loss of the device from its delivery system into the peripheral circulation. Certain types of stents are almost radiolucent, making localization of the l...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960180313
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:Due to sensorial autonomic neuropathy, the type and severity of angina pectoris in patients with diabetes mellitus (DM) may be rather different from the type and severity of angina pectoris in patients without DM. HYPOTHESIS:The aim of the study was to understand if angina pectoris is related to extensive c...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22151
更新日期:2013-08-01 00:00:00
abstract::An unusual case of metastatic disease of the right ventricle is described in a 74-year-old woman who had presented with a malignant fibrous histiocytoma of the right thigh previously treated with surgery and radiotherapy. Two years later she presented with signs and symptoms of tricuspid regurgitation and right ventri...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960140216
更新日期:1991-02-01 00:00:00
abstract::A patient with severe pulmonary hypertension secondary to the CREST syndrome variant of scleroderma is described. Acute reductions in both pulmonary artery pressure and total pulmonary resistance were seen with nifedipine and oxygen administration. Reductions in resistance were maintained for over one month with this ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960070111
更新日期:1984-01-01 00:00:00
abstract::A fulminant psychiatric disturbance, as the sole noncardiac manifestation of digitalis toxicity, emerged in a 85-year-old woman during treatment for congestive heart failure. Described more than a century ago as "digitalis delirium," the disorder is characterized by severe agitation, delusional thinking, assaultive be...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960180611
更新日期:1995-06-01 00:00:00
abstract::Intracoronary (i.c.) thrombus is a frequent finding in patients with unstable angina (UA). Accordingly, thrombolytic treatment could be beneficial, as resolution of thrombus might result in increased delivery of blood flow to the ischemic regions. To test this hypothesis, we studied 13 patients with active UA and ST-s...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960150206
更新日期:1992-02-01 00:00:00
abstract::Catheter ablation has become an accepted technique for creating complete heart block in patients with drug refractory supraventricular tachycardias. However, it remains experimental for other indications, such as ablation of accessory pathway or ventricular tachycardia. The use of high energy defibrillator discharges ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960140712
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:For patients with ST elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI), rapid restoration of coronary blood flow is the primary therapeutic goal. Because of the acute nature of this clinical presentation, bleeding risks may not be adequately evaluated, limiting the us...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20295
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:The Senning operation for transposition of the great arteries (TGA) was first introduced by Senning in 1959 and was revived by Quaegebeur et al. in the late 1970s, thus becoming the intervention of choice for the correction of TGA in many centers. HYPOTHESIS:The purpose of this study was to evaluate the lon...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960271107
更新日期:2004-11-01 00:00:00
abstract::A 33-year-old man was investigated for dyspnea on exertion and the presence of a pansystolic murmur. Physical examination revealed dextrocardia confirmed by chest radiograph, which also showed oligemic right lung field. Subsequent cardiac catheterization revealed secundum atrial septal defect, persistent left sided su...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960180713
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Inflammatory process plays an important role in the pathogenesis of acute coronary syndromes. HYPOTHESIS:The study was undertaken to evaluate whether admission levels of C-reactive protein (CRP), fibrinogen, interleukin-6 (IL-6). and macrophage colony stimulating factor (MCSF) can predict short-term prognos...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960251106
更新日期:2002-11-01 00:00:00
abstract::Flecainide is reported to be effective in patients with paroxysmal tachycardias, but its effect on rapid ventricular response over accessory atrioventricular pathway during atrial fibrillation is not known. The influence of flecainide on various electrophysiological properties of the accessory pathway with special emp...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960080603
更新日期:1985-06-01 00:00:00
abstract::Left ventricular systolic dysfunction (LVSD) and clinical heart failure are common complications of acute myocardial infarction (AMI) and result in substantially increased mortality and morbidity. Evidence-based cardiovascular protective therapies, including angiotensin-converting enzyme inhibitors, beta blockers, ant...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960290103
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Although the outcome of patients with angiographically insignificantly narrowed coronary arteries (INCA) is not clearly defined, such lesions can progress or rupture, thus causing cardiovascular morbidity. Preventive therapy with aspirin and lipid-lowering drugs therefore seems warranted in these patients. ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960270605
更新日期:2004-06-01 00:00:00
abstract::Cardiac rehabilitation (CR) is an important component in the continuum of care for patients with cardiovascular diseases, including the older population. Benefits of CR which include mortality benefit, decreased hospitalizations, increased functional capacity all extend to an older population. In Medicare beneficiarie...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.23296
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Prior studies suggest that the incidence of ventricular arrhythmias is high in patients with Fabry cardiomyopathy. This study evaluated the incidence of significant arrhythmias in a series of patients with Fabry cardiomyopathy. HYPOTHESIS:Arrhythmias are important causes of morbidity and mortality in Fabry ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22047
更新日期:2012-12-01 00:00:00
abstract::A 56-year-old male with atrial fibrillation developed rapid ventricular response up to 200 beats/min or more in the postoperative stage of emergency aortocoronary bypass surgery. Resuscitation for cardiac arrest triggered this rapid ventricular rate. The idea that retrograde conduction into atrioventricular node may p...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960100412
更新日期:1987-04-01 00:00:00
abstract:BACKGROUND:Increased salt intake may induce hypertension, lead to cardiac hypertrophy, and exacerbate heart failure. When elderly patients develop heart failure, diastolic dysfunction is often observed, although the ejection fraction has decreased. Diabetes mellitus (DM) is an established risk factor for heart failure....
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20664
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:The finding of aortic regurgitation at a classical examination is a diastolic murmur. HYPOTHESIS:Aortic regurgitation is more likely to be associated with a systolic than with a diastolic murmur during routine screening by a noncardiologist physician. METHODS:In all, 243 asymptomatic patients (mean age 42 ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960270905
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Current guidelines for the use of implantable cardioverter-defibrillators (ICDs) are broad and significantly increase the cost of caring for patients with heart failure. In an effort to identify the specific subset of patients who benefit from this therapy, the predictive value of numerous echocardiographic ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20474
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:C-reactive protein (CRP) and myeloperoxidase (MPO) are involved in the pathogenesis of atherosclerosis, mainly during periods of instabilization. This study aims to test the hypothesis that patients with acute coronary syndrome (ACS) maintain a persistent inflammatory state, and that this is associated with ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20462
更新日期:2009-11-01 00:00:00
abstract::The combination of cilostazol, aspirin, and clopidogrel (triple therapy) after percutaneous coronary intervention has been considered as an alternative therapy. We performed a meta-analysis based on 8 randomized controlled trials with a total of 3332 patients to compare the effectiveness and safety of this triple ther...
journal_title:Clinical cardiology
pub_type: 杂志文章,meta分析,评审
doi:10.1002/clc.22001
更新日期:2012-10-01 00:00:00
abstract::A case of aortic ball valve prosthesis malfunction is described in which the poppet became alternately stuck in the open and closed position. The patient experienced chest pain followed by pulmonary edema and cardiac arrest. Malfunction of prosthetic valve was diagnosed on echocardiogram and cardiopulmonary resuscitat...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960051105
更新日期:1982-11-01 00:00:00
abstract:BACKGROUND:Epicardial placement of the left ventricular (LV) lead via a video-assisted thoracoscopic (VAT) approach is an alternative to the standard transvenous technique. HYPOTHESIS:Long-term safety and efficacy of VAT and transvenous LV lead implantation are comparable. To test it, we reviewed our experience and we...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23300
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Late potentials (LP) on signal-averaged electrocardiography (SAECG), recorded 6 to 30 days after an acute myocardial infarction (AMI), identify patients at risk for late arrhythmic events. Angiotensin-converting enzyme (ACE) inhibitors have been shown to reduce ventricular remodeling and cardiovascular morta...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章
doi:10.1002/clc.4960230206
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Ablation procedures in patients with paroxysmal atrial fibrillation (PAF) includes isolation of all pulmonary veins (PVs). We hypothesized that an approach using an algorithm to detect arrhythmogenic PVs (aPVs) might lead to shorter procedure duration (PD) and fewer proarrhythmic effects (PE). HYPOTHESIS:Is...
journal_title:Clinical cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1002/clc.22132
更新日期:2013-07-01 00:00:00
abstract::The realization that cardiovascular morbidity and mortality increases in patients with mild elevation of either systolic or diastolic blood pressure has led to a consideration to treat millions of patients with mild diastolic or isolated systolic hypertension. The cost of administering a successful antihypertensive tr...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章
doi:10.1002/clc.4960060101
更新日期:1983-01-01 00:00:00
abstract:BACKGROUND:In animal models, pretreatment with angiotensin-converting enzyme inhibitor (ACEI) can reduce no-reflow. In the present study, we investigated whether pretreatment with ACEI may prevent no-reflow in patients who underwent primary coronary intervention for AMI. METHOD AND RESULTS:A total of 259 consecutive p...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20060
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:In this study, we evaluated the feasibility and clinical usefulness of TS(E-E(') ), the time interval between the onsets of early diastolic mitral inflow velocity (E) and mitral annular velocity (E'), obtained by simultaneously tracing E and E', in terms of evaluating diastolic function. METHODS:By the dias...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20241
更新日期:2008-08-01 00:00:00