Abstract:
:The integrated response to severe exercise involves fourfold to fivefold increases in cardiac output, which are due primarily to increases in cardiac rate and to a lesser extent to augmentation of stroke volume. The increase in stroke volume is partly due to an increase in end-diastolic cardiac size (Frank-Starling mechanism) and secondarily due to a reduction in end-systolic cardiac size. The full role of the Frank-Starling mechanism is masked by the concomitant tachycardia. The reduction in end-systolic dimensions can be related to increased contractility, mediated by beta adrenergic stimulation. Beta adrenergic blockade prevents the inotropic response, the decrease in end-systolic dimensions, and approximately 50% of the tachycardia of exercise. The enhanced cardiac output is distributed preferentially to the exercising muscles including the heart. Blood flow to the heart increases fourfold to fivefold as well, mainly reflecting the augmented metabolic requirements of the myocardium due to near maximal increases in cardiac rate and contractility. Blood flow to the inactive viscera (e.g., kidney and gastrointestinal tract) is maintained during severe exercise in the normal dog. It is suggested that local autoregulatory mechanisms are responsible for maintained visceral flow in the face of neural and hormonal autonomic drive, which acts to constrict renal and mesenteric vessels and to reduce blood flow. However, in the presence of circulatory impairment, where oxygen delivery to the exercising muscles is impaired as occurs to complete heart block where normal heart rate increases during exercise are prevented, or in congestive right heart failure, where normal stroke volume increases during exercise are impaired, or in the presence of severe anemia, where oxygen-carrying capacity of the blood is limited, visceral blood flows are reduced drastically and blood is diverted to the exercising musculature. Thus,, visceral flow is normally maintained during severe exercise as long as all other compensatory mechanisms remain intact. However, when any other compensatory mechanism is disrupted (even the elimination of splenic reserve in the dog), reduction and diversion of visceral flow occur.
journal_name
Prog Cardiovasc Disjournal_title
Progress in cardiovascular diseasesauthors
Vatner SF,Pagani Mdoi
10.1016/0033-0620(76)90018-9subject
Has Abstractpub_date
1976-09-01 00:00:00pages
91-108issue
2eissn
0033-0620issn
1873-1740pii
0033-0620(76)90018-9journal_volume
19pub_type
杂志文章,评审abstract::Functional tricuspid regurgitation (FTR) has been neglected for a long time, however its prevalence and clinical relevance is not negligible. In presence of FTR, a certain quote of annular dilatation is present thus contributing to the mechanism of regurgitation. Historically, surgical annuloplasty has been the main t...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2019.10.002
更新日期:2019-01-01 00:00:00
abstract::Beta blockers have long been used in patients who have experienced a myocardial infarction. However, many new therapies are available for this patient group, and as a result, the current role of beta blockers may have become uncertain. In this article we address a series of questions related to the important and conti...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1053/pcad.2002.31586
更新日期:2002-01-01 00:00:00
abstract::The direct medical cost of cardiovascular and circulatory diseases was $151 billion in 1995, approximately 17% of all direct medical care costs in the United States. Incidence and prevalence based estimates indicate that smoking is a major contributing factor for cardiovascular disease and associated costs. Statewide ...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/s0033-0620(03)00077-x
更新日期:2003-07-01 00:00:00
abstract::There are a number of difficulties inherent in the analysis of such a large and diverse quantity of data. In a substantial number of clinical trials, there is no significant effort made to evaluate prosthetic performance as a function of preoperative cardiac anatomy. Hemodynamics have not been systematically studied i...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/0033-0620(83)90008-7
更新日期:1983-11-01 00:00:00
abstract::Current methodology permits one to define the functional basis of the preexcitation syndromes with reasonable certainty and to develop a rationale for instituting trials of medical therapy. Future studies will hopefully result in a more exact definition of the anatomic substrates of preexcitation and their relationshi...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/0033-0620(78)90015-4
更新日期:1978-01-01 00:00:00
abstract::Tricuspid regurgitation (TR) remains a complex valve pathology affecting nearly two million people in the United States. Although it can present as a primary valve pathology, TR often presents as a late finding in patients with severe pulmonary disease or end-stage chronic heart failure. Surgical repair of isolated TR...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2019.11.016
更新日期:2019-01-01 00:00:00
abstract::The response to injury in the vasculature and the heart is inflammation. Atherosclerosis is often the result of injury followed by inflammation and atherosclerosis. Vascular and myocardial infections from various pathogens, including viruses, bacteria, chlamydia, and other infections result in vascular inflammation an...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1053/pcad.2002.123782
更新日期:2002-05-01 00:00:00
abstract::It is being increasingly appreciated that a substantial number of patients with congestive heart failure (CHF) have relatively preserved systolic function. Although these individuals appear to have a somewhat better prognosis than those with low ejection fractions, they experience significant symptoms and frequently r...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/s0033-0620(98)80053-4
更新日期:1998-01-01 00:00:00
abstract::We will review the epidemiology, risk factors, and consequences of obstructive sleep apnea (OSA) and short/long sleep duration. Obstructive sleep apnea is a disease characterized by recurrent upper airway obstruction during sleep. Obstructive sleep apnea is common, with moderate to severe disease present in approximat...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2008.08.001
更新日期:2009-01-01 00:00:00
abstract::Pulmonary and/or tricuspid valve dysfunction is common among individuals with congenital heart disease, and surgical intervention often carries prohibitive risks. Transcatheter valve replacement (TVR) of the right-sided cardiac valves has become a viable treatment option over the past two decades, while continued tech...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2018.09.003
更新日期:2018-01-01 00:00:00
abstract::Patients at a low probability of acute cardiac pathology constitute a considerable proportion in many coronary care units (CCUs), such that physicians should consider more effective alternatives than CCU admission "to rule out myocardial infarction." In this article, strategies to increase the efficiency of managing p...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/s0033-0620(05)80021-0
更新日期:1995-05-01 00:00:00
abstract::Several randomized trials and meta-analyses have shown that primary angioplasty is superior to thrombolysis in the treatment of ST-segment elevation myocardial infarction (MI) in terms of death, reinfarction, and stroke. However, primary angioplasty should be regarded as the preferred strategy as long as it can not be...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2007.11.004
更新日期:2008-03-01 00:00:00
abstract::Due to advances in prevention, early detection and treatment, early breast cancer mortality has decreased by nearly 40% during the last four decades. Yet, the risk of cardiovascular disease (CVD) mortality is significantly elevated following a breast cancer diagnosis, and it is a leading cause of death in this populat...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2019.02.002
更新日期:2019-01-01 00:00:00
abstract::Coronary computed tomography angiography (CTA) offers a non-invasive method to detect coronary plaque and stenosis. However, to date, CTA has been most useful as a method of ruling out coronary artery disease (CAD) among patients with low to intermediate pretest probability of significant CAD. The reduced specificity ...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2015.03.003
更新日期:2015-05-01 00:00:00
abstract::Pulmonary hypertension (PH) in the setting of left side heart disease is associated with adverse outcomes. The exact prevalence of PH in the different pathologies that affect the left ventricle, however, is difficult to access with the current literature. The lack of a standard definition of PH in older studies, the d...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2016.07.001
更新日期:2016-07-01 00:00:00
abstract::Spurred by large-scale public and private efforts as well as technological developments, the last few years have seen a major leap forward in our understanding of the genetic basis of cardiovascular disease. This revolution is in its infancy and will continue to alter the medical landscape for years to come. There is ...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2012.04.006
更新日期:2012-07-01 00:00:00
abstract::Transcatheter therapy with the MitraClip system (Abbott Structural, Menlo Park, CA) is the most commonly used transcatheter therapy for patients with tricuspid regurgitation, with over 1000 cases performed worldwide. The procedure is an off-label approach that requires meticulous attention to anatomical features obtai...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2019.10.001
更新日期:2019-01-01 00:00:00
abstract::The definition of syncope has clinical and pathophysiological parts. The clinical part is that syncope is a form of transient loss of consciousness (TLOC), while the pathophysiological element is that syncope differs from other forms of TLOC by virtue of the basis of true syncope - specifically cerebral hypoperfusion....
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2012.10.016
更新日期:2013-01-01 00:00:00
abstract::Hypertension (HTN) is the most common chronic disease in the U.S., and the standard model of office-based care delivery has yielded suboptimal outcomes, with approximately 50% of affected patients not achieving blood pressure (BP) control. Poor population-level BP control has been primarily attributed to therapeutic i...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2016.09.005
更新日期:2016-01-01 00:00:00
abstract::The recent advent of an entirely subcutaneous implantable defibrillator (ICD) has provided a relevant contribution to the debate concerning the use of ICD therapy in patients at high risk for death. Although conventional transvenous ICDs have proven very effective during the past 23 years, they still appear to be limi...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2012.03.006
更新日期:2012-05-01 00:00:00
abstract::The application of ultrasound to clinical evaluation of the symptomatic patient requires less precision and accuracy than when it is used as an instrument to study atherogenesis. The clinician's goal is to locate hemodynamically significant lesions; studies of atherogenesis require auxometry (measurement of the growth...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章
doi:10.1016/0033-0620(84)90007-0
更新日期:1984-01-01 00:00:00
abstract::Infective endocarditis continues to be associated with significant morbidity and mortality despite recent advances in its management and remains a serious and challenging condition requiring a multidisciplinary approach. Surgery is essential in at least 50% of cases. Surgical outcomes have improved with the introducti...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2008.08.007
更新日期:2009-05-01 00:00:00
abstract::Obesity is a systemic disease of the white adipose tissue, which has evolved into a global epidemic. It is associated with a plethora of adipocyte hormonal (adipokine) imbalances, dysregulation of the energy-balance system, imbalances in metabolic homeostasis, a pro-inflammatory state and multiple target organ damages...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2018.07.005
更新日期:2018-01-01 00:00:00
abstract::Valvular heart disease (VHD) carries documented risks for active individuals. At the same time, many individuals with intermediate degrees of valve disease can safely exercise and even participate in competitive athletics. Unfortunately for clinicians caring for these patients, data are scarce. Understanding the patho...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2011.02.010
更新日期:2011-05-01 00:00:00
abstract::Our review of the current literature and experience in caring for pacemaker patients suggests that a consideration of hemodynamics is a logical way to approach pacemaker selection and programming. Multiple clinical factors enter into the selection of a pacemaker or pacemaker programming settings in each case. It appea...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/0033-0620(92)90039-3
更新日期:1992-03-01 00:00:00
abstract::Cardiac imaging plays an important role in coronary artery disease (CAD), congestive heart failure (HF) and valvular heart disease (VHD) in the elderly. Imaging defines the structure and function of the cardiac system, refining the understanding of patients' anatomy and physiology and informing a host of clinical care...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2014.07.003
更新日期:2014-09-01 00:00:00
abstract::Key questions concerning strategies for diagnosis, prevention, and treatment of heart disease in women remain unanswered. Thrombolytic therapy has been shown to reduce mortality similarly in men and women. In addition, percutaneous coronary intervention for acute coronary syndromes is as effective in women as in men. ...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2010.07.004
更新日期:2010-11-01 00:00:00
abstract::This study systematically analyzed the incidence and variety of adverse reactions to quinidine sulfate in 652 consecutively monitored hospitalized patients. Fourteen percent of the patients sustained adverse reactions of sufficient severity to warrant discontinuation of the drug. These reactions include GI intolerance...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/0033-0620(77)90004-4
更新日期:1977-09-01 00:00:00
abstract::The revolution in cardiac care over the past two decades, characterized by emergent revascularization, drug eluting stents, anti-platelet medications, and advanced imaging has had little impact on overall ACS recurrence, or ACS prevention. The "Perfect Storm" refers to a confluence of events and processes, including a...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2013.03.003
更新日期:2013-05-01 00:00:00
abstract::Obesity is an independent contributor to cardiovascular disease (CVD) and a major driving force behind racial/ethnic and gender disparities in risk. Due to a multitude of interrelating factors (i.e., personal, social, cultural, economic and environmental), African-American (AA) women are disproportionately obese and t...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2016.02.003
更新日期:2016-05-01 00:00:00