Abstract:
:Over the last 20 years, operative mortality has decreased and late survival has improved for patients with chronic stable angina who have coronary artery bypass surgery. However, this favorable trend may not continue because the operation is now extended to elderly and high-risk patients. The most powerful predictors of operative mortality include indexes of left ventricular function, age, and the number of associated medical conditions. Female gender, severity of angina, and extent of coronary artery disease appear to be predictors of operative mortality in some series but not in all. Indexes of left ventricular dysfunction remain the most powerful predictors of late death, but the extent of coronary disease, older age, and presence of associated diseases (including noncardiac vascular disease) remain important determinants. Analyses of the randomized trials and registry studies reveal a consistent trend: in patients at high risk on the basis of clinical, functional, and anatomic characteristics, coronary artery bypass surgery prolongs survival in comparison with medical therapy alone. In patients determined to be at low risk, medical therapy is initially recommended with the realization that revascularization may be necessary subsequently if symptoms worsen or the severity of ischemia increases.
journal_name
Circulationjournal_title
Circulationauthors
Gersh BJ,Califf RM,Loop FD,Akins CW,Pryor DB,Takaro TCsubject
Has Abstractpub_date
1989-06-01 00:00:00pages
I46-59issue
6 Pt 2eissn
0009-7322issn
1524-4539journal_volume
79pub_type
临床试验,杂志文章,评审相关文献
CIRCULATION文献大全abstract:BACKGROUND:It has been suggested that intracellular Ca2+ overload in cardiac myocytes leads to the development of diabetic cardiomyopathy. Troglitazone, an insulin-sensitizing agent, is a promising therapeutic agent for diabetes and has been shown to prevent diabetes-induced myocardial changes. To elucidate the underly...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.99.22.2942
更新日期:1999-06-08 00:00:00
abstract:BACKGROUND:During ischemia, the intracellular calcium and inorganic phosphate (P(i)) concentrations rise and pH falls. We investigated the effects of these changes on force development in donor and failing human hearts to determine if altered contractile protein composition during heart failure changes the myocardial r...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc3501.095485
更新日期:2001-09-04 00:00:00
abstract:BACKGROUND:Coronary revascularization with bypass has been shown to improve survival in patients with coronary artery disease and left ventricular dysfunction. In these patients, use of nonsurgical revascularization with percutaneous transluminal coronary angioplasty (PTCA) is increasing, although their long-term outco...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.87.1.21
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Epidemiological findings suggest an association between low-for-age birth weight and the risk to develop coronary heart diseases in adulthood. During pregnancy, an imbalance between fetal demands and supply may result in permanent alterations of neuroendocrine development in the fetus. We evaluated whether c...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.23.2892
更新日期:2000-12-05 00:00:00
abstract:BACKGROUND:Classically, intrinsic coagulation proteins are thought to have a minor role in hemostasis. Recently, these proteins, especially FXII, were implicated as possible key players in the pathogenesis of arterial thrombosis. This study aims to determine the risks of arterial thrombosis conferred by increased activ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.110.943738
更新日期:2010-11-02 00:00:00
abstract:BACKGROUND:Peroxisome proliferator-activated receptors (PPARs) are transcription factors of the nuclear receptor superfamily. It has been reported that the thiazolidinediones, which are antidiabetic agents and high-affinity ligands for PPARgamma, regulate growth of vascular cells. In the present study, we examined the ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc1002.105225
更新日期:2002-03-12 00:00:00
abstract:BACKGROUND:Mutations in the gene G4.5 result in a wide spectrum of severe infantile cardiomyopathic phenotypes, including isolated left ventricular noncompaction (LVNC), as well as Barth syndrome (BTHS) with dilated cardiomyopathy (DCM). The purpose of this study was to investigate patients with LVNC or BTHS for mutati...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.103.9.1256
更新日期:2001-03-06 00:00:00
abstract:BACKGROUND:We recently demonstrated that phospholipase C (PLC)-delta1 activity in cultured skin fibroblasts obtained from patients with coronary spastic angina (CSA) is enhanced. We tested the hypothesis that structural abnormality in PLC-delta1 isoform is a cause of the enhanced activity. METHODS AND RESULTS:Sequence...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000014613.36469.3f
更新日期:2002-04-30 00:00:00
abstract:BACKGROUND:Natural history of aortic dissection (AD) with intimal tear in the descending or abdominal aorta and retrograde extension into the ascending aorta (retrograde AD) remains unknown. The purpose of this study was to elucidate medium-term prognosis of patients with retrograde AD. METHODS AND RESULTS:Study popul...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000087424.32901.98
更新日期:2003-09-09 00:00:00
abstract:BACKGROUND:Vasomotor reactivity may contribute to the pathophysiology of ischemic injury. The atherosclerotic vessel may be particularly susceptible to vasoconstriction because of the damaged endothelial layer with resultant loss of vasodilatory factors. While dietary omega 3 fatty acids have been proposed to protect a...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.84.3.1393
更新日期:1991-09-01 00:00:00
abstract::To assess myocardial infarction quantitatively in 15 mm thick transverse sections of the canine heart in vivo we utilized a new technique, positron emission transaxial tomography (PETT) and cyclotron-produced 11C-palmitate (11C-P) injected intravenously. Results were compared to regional myocardial creatine phosphokin...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.55.1.66
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:Cardiopulmonary bypass and cardiac surgery are associated with a significant systemic inflammatory response that may increase postoperative complications. This meta-analysis assessed whether the benefits and risks of corticosteroid use were dose dependent in adult cardiac surgery. METHODS AND RESULTS:Random...
journal_title:Circulation
pub_type: 杂志文章,meta分析
doi:10.1161/CIRCULATIONAHA.108.848218
更新日期:2009-04-14 00:00:00
abstract:BACKGROUND:Although hepatocyte growth factor (HGF), a novel angiogenic growth factor, plays an important role in angiogenesis, regulation of local HGF production under hypoxia has not yet been clarified in vascular smooth muscle cells (VSMC) and endothelial cells (EC). Thus, we have studied the role of HGF in hypoxia-i...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.100.suppl_2.ii-301
更新日期:1999-11-09 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::For monotherapy, beta-blockers and calcium-entry blockers are effective and safe antianginal medications. For prophylaxis of myocardial ischemia, a different mechanism of action for each class of drugs is reflected by the different heart rate and rate-pressure product during exercise. In patients who continue to have ...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:
更新日期:1987-06-01 00:00:00
abstract::Echocardiography and Doppler ultrasound are useful in evaluating a variety of pathological conditions affecting the pericardium. Cardiac tamponade results in right atrial collapse and right ventricular diastolic collapse detectable by echocardiography. These echocardiographic signs have a high degree of sensitivity an...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1991-09-01 00:00:00
abstract::The indication for prophylactic temporary and permanent pacing during acute myocardial infarction (MI) complicated by bundle branch block is high risk of progression via a Type II pattern to second or third degree (high degree) AV block during hospitalization or follow-up. In this study, determinants of high degree AV...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.58.4.689
更新日期:1978-10-01 00:00:00
abstract:BACKGROUND:Modeling of the time-[1-(11)C]acetate activity curve assumes a constant concentration of labeled tricarboxylic acid cycle intermediates and associated metabolites, such as glutamate and aspartate, which may, however, decrease in short-term hibernating myocardium. METHODS AND RESULTS:In 12 anesthetized pigs,...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.97.10.1009
更新日期:1998-03-17 00:00:00
abstract:BACKGROUND:The enzyme 11beta-hydroxysteroid dehydrogenase (11beta-HSD) prevents inappropriate activation of the nonselective mineralocorticoid receptors by glucocorticoids. Renal activity of 11beta-HSD is decreased in patients with apparent mineralocorticoid excess (SAME), licorice-induced hypertension, and essential h...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.103.25.3129
更新日期:2001-06-26 00:00:00
abstract::Amiodarone is the most effective antiarrhythmic drug for maintaining sinus rhythm for patients with atrial fibrillation. Extra-cardiac side effects have been a limiting factor, especially during chronic use, and may offset its benefits. Dronedarone is a noniodinated benzofuran derivative of amiodarone that has been de...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/CIRCULATIONAHA.109.858027
更新日期:2009-08-18 00:00:00
abstract::Recent reports of selected observational studies and a meta-analysis have stirred controversy and have become the impetus for calls to abandon recommendations for reduced sodium intake by the US general population. A detailed review of these studies documents substantial methodological concerns that limit the usefulne...
journal_title:Circulation
pub_type: 共识发展会议,杂志文章
doi:10.1161/CIR.0b013e318279acbf
更新日期:2012-12-11 00:00:00
abstract:BACKGROUND:Whether knowledge of genetic risk for coronary heart disease (CHD) affects health-related outcomes is unknown. We investigated whether incorporating a genetic risk score (GRS) in CHD risk estimates lowers low-density lipoprotein cholesterol (LDL-C) levels. METHODS AND RESULTS:Participants (n=203, 45-65 year...
journal_title:Circulation
pub_type: 杂志文章,随机对照试验
doi:10.1161/CIRCULATIONAHA.115.020109
更新日期:2016-03-22 00:00:00
abstract::Transthyretin amyloid cardiomyopathy (ATTR-CM) results in a restrictive cardiomyopathy caused by extracellular deposition of transthyretin, normally involved in the transportation of the hormone thyroxine and retinol-binding protein, in the myocardium. Enthusiasm about ATTR-CM has grown as a result of 3 simultaneous a...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIR.0000000000000792
更新日期:2020-07-07 00:00:00
abstract:BACKGROUND:Exercise echocardiography (digital cine-loop technique) and 201Tl single-photon emission computed tomography (SPECT) were performed simultaneously in 292 patients being evaluated for coronary artery disease. METHODS AND RESULTS:Pretreadmill and posttreadmill echocardiographic images of diagnostic quality we...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.85.3.1026
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:It is not clear why some plaque ruptures lead to acute coronary syndromes (ACS) but others do not. METHODS AND RESULTS:We analyzed 80 plaque ruptures in 74 patients and compared culprit lesions of ACS patients with nonculprit lesions of ACS patients and lesions of non-ACS patients; both culprit and nonculpr...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.CIR.0000097121.95451.39
更新日期:2003-11-18 00:00:00
abstract:BACKGROUND:Angiotensin-converting enzyme (ACE) inhibition potentiates the tissue-type plasminogen activator (t-PA) response to exogenous bradykinin. This study tested the hypothesis that ACE inhibition increases endothelial t-PA release through endogenous bradykinin. METHODS AND RESULTS:We measured the effect of intra...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.0000046268.59922.a4
更新日期:2003-02-04 00:00:00
abstract::Arterial oxygen transport (cardiac output x arterial oxygen content) may be decreased in heart failure. We studied the determinants of arterial oxygen transport in 15 patients with chronic, severe myocardial failure at rest and during cycle ergometry. During control therapy at rest, arterial oxygen tension was normal ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.66.1.143
更新日期:1982-07-01 00:00:00
abstract:BACKGROUND:The evolution of cell phenotypes and matrix architecture in cardiac valves during fetal maturation and postnatal adaptation through senescence remains unexplored. METHODS AND RESULTS:We hypothesized that valvular interstitial (VIC) and endothelial cell (VEC) phenotypes, critical for maintaining valve functi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.591768
更新日期:2006-03-14 00:00:00
abstract::To determine how survival and clinical status were related to left ventricular (LV) size and systolic function after mitral valve replacement, 104 patients (48 mitral regurgitation [MR], 33 mitral stenosis [MS], and 23 MS/MR) with isolated mitral valve replacement were evaluated before and after surgery. Preoperative ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.81.4.1173
更新日期:1990-04-01 00:00:00
abstract::Genetic analysis can be performed to identify the molecular substrate of inherited arrhythmogenic diseases; however, the role of this information in helping the management of patients is still debated. Here, we support the view that the practical value of genetic analysis is different in the various inherited conditio...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/CIRCULATIONAHA.105.563205
更新日期:2006-02-28 00:00:00