Abstract:
:Analysis of the rate-related change in exercise-induced ST segment depression using the exercise ST segment/heart rate slope and ST segment/heart rate index can improve the accuracy of the exercise electrocardiogram (ECG) for the identification of patients with coronary artery disease, recognition of patients with anatomically or functionally severe coronary obstruction and detection of patients at increased risk for future coronary events. These methods provide a more physiologic approach to analysis of the ST segment response to exercise by adjusting the apparent severity of ischemia for the corresponding increase in myocardial oxygen demand, which in turn can be linearly related to increasing heart rate. Solid-angle theory provides a model for the linear relation of ST segment depression to heart rate during exercise and a framework for understanding the relation of the ST segment/heart rate slope to the presence and extent of coronary artery disease. False positive and false negative test results of the heart rate-adjusted methods are well known in selected populations and require further clarification. Application of these methods is also highly dependent on the type of exercise protocol, number of ECG leads examined, timing of ST segment measurement relative to the J point and accuracy and precision of ST segment measurement. These methodologic details have been an important limitation to test application when traditional protocols and measurement procedures are required. When applied with attention to required details, the heart rate-adjusted methods can improve the usefulness of the exercise ECG in a range of clinically relevant populations.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Okin PM,Kligfield Pdoi
10.1016/0735-1097(95)00085-isubject
Has Abstractpub_date
1995-06-01 00:00:00pages
1726-35issue
7eissn
0735-1097issn
1558-3597pii
0735-1097(95)00085-Ijournal_volume
25pub_type
杂志文章,评审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 assess the value of implantable cardioverter-defibrillator (ICD) electrograms (EGMs) in identifying clinically documented ventricular tachycardias (VTs). BACKGROUND:Twelve-lead electrocardiograms (ECG) of spontaneous VT often are not available in patients referred for cathet...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2010.04.043
更新日期:2010-09-14 00:00:00
abstract::Relief of left ventricular (LV) outflow obstruction in patients with hypertrophic cardiomyopathy (HCM) and disabling symptoms refractory to maximum medical management has historically been a surgical problem. Surgical septal myectomy permanently abolishes systolic anterior motion of the mitral valve and mitral regurgi...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2004.04.063
更新日期:2004-11-16 00:00:00
abstract:OBJECTIVES:The purpose of this study is investigate the effects of variants in the apolipoprotein(a) gene (LPA) on vascular diseases with different atherosclerotic and thrombotic components. BACKGROUND:It is unclear whether the LPA variants rs10455872 and rs3798220, which correlate with lipoprotein(a) levels and coron...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,meta分析
doi:10.1016/j.jacc.2012.01.078
更新日期:2012-08-21 00:00:00
abstract::To delineate the role of plasmin inhibitors, especially the two molecular forms of alpha 2-antiplasmin (that is, the plasminogen-binding and the nonplasminogen-binding forms), in the control of systemic effects during thrombolytic therapy, the consumption of plasmin inhibitors and the degree of fibrinogen breakdown we...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80003-8
更新日期:1990-05-01 00:00:00
abstract:OBJECTIVES:We sought to study the anatomy of human ligament of Marshall (LOM). BACKGROUND:Although the LOM has been implicated in the genesis of focal atrial tachyarrhythmias, its gross anatomic and microscopic features in humans hearts have not been completely defined. METHODS:We studied seven postmortem human heart...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(00)00819-6
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVES:We evaluated the efficacy and safety of the percutaneous ventricular assist device (pVAD) in patients in severe refractory cardiogenic shock (SRCS) despite intra-aortic balloon pump (IABP) and/or high-dose vasopressor support. BACKGROUND:SRCS is associated with substantial mortality despite IABP counterpuls...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2010.08.613
更新日期:2011-02-08 00:00:00
abstract::It has been 40 years since the first human-to-human heart transplant performed in South Africa by Christiaan Barnard in December 1967. This achievement did not come as a surprise to the medical community but was the result of many years of early pioneering experimental work by Alexis Carrel, Frank Mann, Norman Shumway...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2008.05.020
更新日期:2008-08-19 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine the outcome of patients with nonischemic dilated cardiomyopathy, unexplained syncope and a negative electrophysiology test who are treated with an implantable defibrillator. BACKGROUND:Patients with nonischemic cardiomyopathy and unexplained syncope may be at high ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(99)00148-5
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVES:This study assessed the feasibility of implanting a device in the left atrial appendage (LAA) in patients with atrial fibrillation (AF) to prevent thromboembolic stroke. BACKGROUND:Meta-analyses confirmed that in cases of left atrial thrombus in nonrheumatic AF patients approximately 90% of them are in the ...
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/j.jacc.2007.02.035
更新日期:2007-04-03 00:00:00
abstract:OBJECTIVES:This study sought to evaluate whether pulse wave velocity (PWV), a noninvasive index of arterial stiffness, is a predictor of the longitudinal changes in systolic blood pressure (SBP) and of incident hypertension. BACKGROUND:Although arterial stiffness is believed to underlie, in part, the age-associated ch...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2007.10.065
更新日期:2008-04-08 00:00:00
abstract:OBJECTIVES:This study sought to determine the long-term outcome of adult patients undergoing percutaneous balloon aortic valvuloplasty. BACKGROUND:Percutaneous balloon aortic valvuloplasty has been offered as an alternative to aortic valve replacement for selected patients with valvular aortic stenosis. Although ballo...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(95)00363-0
更新日期:1995-11-15 00:00:00
abstract:OBJECTIVES:This study sought to determine the diagnostic accuracy of 64-slice computed tomographic coronary angiography (CTCA) to detect or rule out significant coronary artery disease (CAD). BACKGROUND:CTCA is emerging as a noninvasive technique to detect coronary atherosclerosis. METHODS:We conducted a prospective,...
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/j.jacc.2008.08.058
更新日期:2008-12-16 00:00:00
abstract:OBJECTIVES:This study sought to evaluate the prognostic value of wavelet correlation functions of the signal-averaged electrocardiogram (ECG) for arrhythmic events in patients after myocardial infarction. BACKGROUND:Wavelet transform of the signal-averaged ECG has been shown to be a nonstationary analysis technique de...
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(96)80739-X
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to understand the initial mechanism of arterial thrombus formation induced by vulnerable human atherosclerotic plaques to re-assess and improve current antithrombotic strategies. BACKGROUND:Rupture of atherosclerotic plaques causes arterial thrombus formation that might lead to myo...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2009.11.051
更新日期:2010-03-16 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...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(01)01509-1
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVES:The current study was designed to determine the effect of secular trend and referral bias on the natural history of idiopathic dilated cardiomyopathy. BACKGROUND:In a previous study of 104 patients with idiopathic dilated cardiomyopathy conducted in a referral population at the Mayo Clinic between 1960 and ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(93)90780-5
更新日期:1993-12-01 00:00:00
abstract::Left ventricular performance was evaluated noninvasively in 111 patients participating at one study center in the Norwegian Multicenter Study on Timolol After Myocardial Infarction. Systolic time intervals were measured in 55 patients treated with timolol and in 56 patients receiving placebo. Measurements were made be...
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/s0735-1097(87)80094-3
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVES:We sought to investigate the usefulness of integrated positron emission tomography (PET) and computed tomography (CT) for in vivo characterization of an angiogenesis-directed molecular intervention. BACKGROUND:Controversies about the effectiveness of molecular therapies for cardiovascular disease have promp...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2006.08.029
更新日期:2006-11-21 00:00:00
abstract::Inadvertent puncture of the intrapericardial aorta is a serious complication of transseptal catheterization. Two-dimensional echocardiography allows delineation and spatial resolution of the aorta and interatrial septum. Thirteen patients underwent transseptal catheterization with simultaneous monitoring of needle and...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(84)80234-x
更新日期:1984-08-01 00:00:00
abstract:OBJECTIVES:We sought to determine the frequency of spontaneous cerebrovascular events in adult patients with cyanotic congenital heart disease and to evaluate any contributing factors. BACKGROUND:Cerebrovascular events are a serious complication of cyanotic congenital heart disease in infants and children but are said...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(96)00196-9
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to determine whether the release of nitric oxide (NO) from the ischemic heart increases during exercise in patients with effort angina. BACKGROUND:Myocardial ischemia increases NO production in the canine heart, but no such increase has been demonstrated in the ischemic human heart...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(98)00196-x
更新日期:1998-07-01 00:00:00
abstract::Although clinical trials using laser and thermal angioplasty devices have been underway, the effects of pulsed laser and thermal ablation of atherosclerotic plaque on surface thrombogenicity are poorly understood. This study examined the changes in platelet adherence and thrombus formation on freshly harvested atheros...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(92)90301-3
更新日期:1992-04-01 00:00:00
abstract::To investigate the use of high energy ultrasound as an alternative energy for angioplasty, an experimental ultrasonic angioplasty device was developed. The device was studied in two bioassay systems: an in vitro system for the disruption of atherosclerotic plaques and thrombi and an in vivo system for the recanalizati...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(90)90651-5
更新日期:1990-03-01 00:00:00
abstract::To evaluate acute and follow-up changes in left ventricular diastolic performance, simultaneous digital left ventriculography and micromanometry were performed in 49 patients undergoing aortic balloon valvuloplasty. All patients improved symptomatically after valvuloplasty, and 26 returned 6.3 +/- 1.5 months later for...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80324-9
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVES:This study assessed the predictive value of preprocedural C-reactive protein (CRP) levels on six-month clinical and angiographic outcome in patients undergoing coronary stent implantation. BACKGROUND:Recent data indicate that low-grade inflammation as detected by elevated CRP serum levels predicts the risk ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(00)01193-1
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVES:In this study, our goal was to determine if human resistin plays a role in regulating the uptake of atherogenic low-density lipoproteins in human hepatocytes. BACKGROUND:Serum levels of resistin, an adipose tissue-derived adipokine, are increased in human obesity and are positively correlated with atheroscl...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2011.11.064
更新日期:2012-05-08 00:00:00
abstract::Frequency analysis with fast Fourier transform and time domain analysis after signal averaging of the electrocardiogram (ECG) have given contradictory results in patients with sustained ventricular tachycardia after myocardial infarction. Therefore, the same orthogonal ECGs were analyzed in the frequency domain (Black...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(88)90368-3
更新日期:1988-07-01 00:00:00
abstract:OBJECTIVES:This study sought to investigate the prevalence and mechanisms underlying right ventricular (RV) dyssynchrony in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) using tissue Doppler echocardiography (TDE). BACKGROUND:An ARVD/C is characterized by fibrofatty replacement of RV myocardium an...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2009.04.038
更新日期:2009-07-28 00:00:00
abstract:OBJECTIVES:We sought to examine the effects of endurance training on the ultrastructural characteristics of skeletal muscle in heart transplant recipients (HTRs) and age-matched control subjects (C). BACKGROUND:Deconditioning is one of the factors involved in the peripheral limitation of exercise capacity of HTRs, and...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(98)00227-7
更新日期:1998-08-01 00:00:00