Abstract:
OBJECTIVES:We sought to assess the ability of the "biphasic" response (i.e., initial improvement in wall thickening followed by reduced wall thickening) during serial dobutamine stress echocardiography to detect ischemia in patients with a wall motion abnormality. Furthermore, we compared the power of the biphasic echocardiographic response with that of myocardial perfusion imaging for the detection of myocardial ischemia. BACKGROUND:Stress echocardiography has been shown to be less sensitive than radionuclide perfusion imaging for detecting ischemia in patients with a wall motion abnormality. Peak stress wall thickening in such areas may not give a full account of the intermediate changes, whereas initial improvement (the biphasic response) may enhance diagnosis. METHODS:Patients with a wall motion abnormality and documented coronary artery disease underwent simultaneous graded dobutamine (5 to 40 micrograms/kg body weight per min) stress echocardiography and radionuclide perfusion imaging with single-photon emission computed tomography using either technetium-99m sestamibi or technetium-99m tetrofosmin. Semiquantitative analyses of image groups were performed in blinded manner by two separate groups of observers. RESULTS:Myocardial ischemia was detected by perfusion imaging in 45 of the 54 patients. High dose dobutamine echocardiography detected ischemia in only 25 (56%) of these patients. However, when the biphasic response was taken into account, ischemia was detected in 44 (98%) of the 45 patients (p < 0.001). Agreement between radionuclide imaging and echocardiographic findings for the detection of ischemia was significantly enhanced (p = 0.03) when the biphasic response was used (89%, kappa = 0.51) instead of high dose stress dobutamine echocardiography (56%, kappa = 0.10). CONCLUSIONS:The detection of myocardial ischemia may be significantly enhanced by utilizing the biphasic response during serial stress dobutamine echocardiography in patients with a wall motion abnormality.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Senior R,Lahiri Adoi
10.1016/0735-1097(95)00139-qsubject
Has Abstractpub_date
1995-07-01 00:00:00pages
26-32issue
1eissn
0735-1097issn
1558-3597pii
073510979500139Qjournal_volume
26pub_type
临床试验,杂志文章abstract:OBJECTIVES:The purpose of this study was to characterize long-term outcomes of percutaneous coronary intervention (PCI) in elderly diabetic patients in routine practice. BACKGROUND:Although drug-eluting stent (DES) implantation in diabetic patients is common practice, pivotal randomized trials enrolled <2,500 diabetic...
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.2012.08.993
更新日期:2012-12-04 00:00:00
abstract:OBJECTIVES:the purpose of this study was to evaluate the association of the percentage of platelet inhibitory response to clopidogrel as assessed by modified thromboelastography with bleeding and transfusion requirement after off-pump coronary artery bypass graft (OPCABG) surgery. BACKGROUND:Interindividual variabilit...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章
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更新日期:2010-12-07 00:00:00
abstract:OBJECTIVES:We investigated the safety and efficacy of cryoablation in the treatment of pediatric patients with accessory pathways (APs) located near the atrioventricular junction and with atrioventricular nodal re-entrant tachycardia (AVNRT). BACKGROUND:Few studies concern cryoablation in a significant number of pedia...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2004.12.048
更新日期:2005-04-05 00:00:00
abstract:OBJECTIVES:This study sought to examine, in vivo, the shape and position of atheroma in the proximal left anterior descending coronary artery. BACKGROUND:The prevalence, shape and location of atheromas involving the proximal left anterior descending artery have implications regarding the role of disturbed shear forces...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(95)00551-x
更新日期:1996-03-15 00:00:00
abstract::Seventy-four patients with chronic stable mild angina, mild coronary artery disease (83% had one- or two-vessel disease) and normal left ventricular function were studied to measure the response of treadmill exercise performance and painful and silent ischemia in the ambulatory setting to randomly assigned treatment w...
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(92)90499-d
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to assess and validate 2-dimensional (2D) strain for the detection of ischemia during dobutamine stress echocardiography (DSE). BACKGROUND:Evaluation of abnormalities of left ventricular (LV) function from wall thickening during DSE is unsatisfactory and requires a high level of ex...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2007.07.088
更新日期:2008-01-15 00:00:00
abstract:OBJECTIVES:This study sought to assess the long-term predictive value and net reclassification for risk of cardiovascular disease (CVD) of biomarkers reflecting oxidation-specific epitopes (OSEs). BACKGROUND:OSEs are immunogenic, proinflammatory, and proatherogenic. The long-term predictive value and net reclassificat...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2012.08.979
更新日期:2012-11-20 00:00:00
abstract:OBJECTIVES:We evaluated left atrial appendage obliteration in high-risk patients with atrial fibrillation (AF). BACKGROUND:Left atrial appendage thrombosis and embolization is the principal mechanism of stroke in AF. Anticoagulation is underutilized and often contraindicated. METHODS:Thoracoscopic Left Appendage, Tot...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究
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更新日期:2003-10-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2011.01.056
更新日期:2011-07-19 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2013.07.099
更新日期:2013-12-10 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(97)00276-3
更新日期:1997-11-01 00:00:00
abstract::Hypertension accounts for 1 in 5 deaths among American women, posing a greater burden for women than men, and is among their most important risk factors for death and development of cardiovascular and other diseases. Hypertension affects women in all phases of life, with specific characteristics relating to risk facto...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
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更新日期:2018-04-24 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/0735-1097(94)90443-x
更新日期:1994-02-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2018-02-13 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(86)80040-7
更新日期:1986-08-01 00:00:00
abstract::As new treatments continue to improve clinical outcomes in coronary artery disease (CAD) and heart failure, it is necessary to characterize the appropriate use of β-adrenergic receptor blockers (β-blockers) in the contemporary management of these conditions. This review examines the current evidence supporting β-block...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2019.04.067
更新日期:2019-08-06 00:00:00
abstract:OBJECTIVES:Our objective in this research was the evaluation of the long-term results after directional atherectomy using the Silverhawk device (FoxHollow Technologies, Redwood City, California) of femoro-popliteal lesions. BACKGROUND:Considering reports on stent fractures in femoro-popliteal arteries, atherectomy may...
journal_title:Journal of the American College of Cardiology
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更新日期:2006-10-17 00:00:00
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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
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pub_type: 临床试验,杂志文章
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更新日期:2018-01-30 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:1993-09-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:1983-08-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:1990-09-01 00:00:00
abstract::Twenty-five patients with aortic insufficiency and eight asymptomatic control subjects underwent radionuclide ventriculography at rest and during dynamic and isometric exercise to clarify the mechanisms for preservation of exercise capacity in aortic insufficiency. Regardless of symptomatic state or severity of regurg...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(84)80435-0
更新日期:1984-01-01 00:00:00
abstract::To clarify the role of serotonin in eliciting myocardial ischemia, the effects of serotonin on coronary vasculature and cardiac performance were examined in anesthetized open chest dogs. Without coronary stenosis, intracoronary infusion of serotonin (0.001 to 1.0 micrograms/kg per min) for 40 s caused dose-dependent i...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(89)90201-5
更新日期:1989-08-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80027-0
更新日期:1990-05-01 00:00:00
abstract:OBJECTIVES:This study compared the efficacy and safety of balloon angioplasty with surgical correction of native aortic coarctation in infants < or = 3 months old. BACKGROUND:There is a controversy with regard to the role of balloon angioplasty in the treatment of aortic coarctation, especially in young infants. METH...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)90395-6
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVES:This study was designed to evaluate the efficacy of local versus systemic treatment of thrombosis with various antithrombotic drugs. BACKGROUND:Local use of low dose antithrombotic drugs has been proposed as being effective and safe. METHODS:Heparin (30 U/kg), an antithrombin agent (argatroban, 0.05 mg/kg ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(95)00324-X
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVES:We studied the acute effects of cardiac resynchronization therapy (CRT) on functional mitral regurgitation in heart failure (HF) patients with left bundle branch block (LBBB). BACKGROUND:Both an decrease [corrected] in left ventricular (LV) closing force and mitral valve tethering have been implicated as me...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:2003-03-05 00:00:00