Abstract:
:It has been shown that streptokinase administration at the time of acute myocardial infarction reduces mortality significantly, and that this reduction in mortality should be related to salvage of jeopardized myocardium and preservation of left ventricular function. To better define the relation between thrombolytic therapy and left ventricular modeling and function after acute myocardial infarction, 331 consecutive patients enrolled in the Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto Miocardico trial were studied by two-dimensional echocardiography just before discharge from the hospital. A 6 month follow-up examination was also available in 232 of these patients. Ventricular volumes were computed from an apical four chamber view, according to a previously published algorithm. An infarct size index was also semiquantitatively assessed, according to the number of akinetic and dyskinetic segments in an 11 segment left ventricular model. At predischarge examination, the 161 patients assigned to streptokinase treatment showed smaller ventricular volumes (end-diastolic volume 119.3 +/- 49.7 versus 134.5 +/- 57.8 ml [p = 0.011]; end-systolic volume 65.4 +/- 36.4 versus 74.9 +/- 45.7 ml [p = 0.036]) and smaller regional wall motion index (2.2 +/- 1.9 versus 2.7 +/- 1.9 segments; p = 0.019) compared with values in the 170 patients assigned to standard care; there was no difference in ejection fraction (46.6 +/- 14.1 versus 45.9 +/- 14.9%; p = 0.64). For both groups of patients, there was a significant relation between end-systolic volume and regional wall motion index (p less than 0.001); for large and similar extents of infarct size, ventricular volume was smaller in patients assigned to thrombolytic treatment than in patients assigned to standard care. At 6 months' follow-up, the differences in volume and regional dysfunction detected at the early examination persisted: 110.8 +/- 47.6 versus 127.9 +/- 53.8 ml for end-diastolic volume (p = 0.001), 56.3 +/- 33.6 versus 69.4 +/- 42.1 ml for end-systolic volume (p = 0.001) and 1.8 +/- 1.8 versus 2.3 +/- 1.8 segments for regional wall motion index (p = 0.001). Again, for comparable extents of infarct size, end-systolic volume was smaller in patients who received streptokinase (n = 110) than in those assigned to conventional treatment (n = 122). It is concluded that streptokinase improves left ventricular modeling and function in patients with myocardial infarction, reducing the extent of regional wall motion abnormalities and lessening postinfarction ventricular dilation. The beneficial effects persist up to 6 months.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Marino P,Zanolla L,Zardini Pdoi
10.1016/0735-1097(89)90409-9subject
Has Abstractpub_date
1989-11-01 00:00:00pages
1149-58issue
5eissn
0735-1097issn
1558-3597pii
0735-1097(89)90409-9journal_volume
14pub_type
临床试验,杂志文章,随机对照试验abstract::Beta-adrenergic blocking agents differ considerably in their effects on myocardial excitable properties. The possibility that intrinsic sympathomimetic activity might contribute to such differences has not been adequately explored. This study examined the influence of intrinsic sympathomimetic activity on the electrop...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(83)80047-3
更新日期:1983-06-01 00:00:00
abstract:BACKGROUND:Long-term benefits of off-pump versus on-pump coronary artery bypass grafting (CABG) are controversial. OBJECTIVES:The authors sought to compare long-term survival and morbidity after on-pump versus off-pump CABG. METHODS:Mandatory clinical and administrative registries from New Jersey Department of Health...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2018.07.029
更新日期:2018-09-25 00:00:00
abstract:BACKGROUND:Women with atrial fibrillation are at a higher risk of stroke, despite treatment with warfarin. It is unclear if women treated with direct oral anticoagulants (DOACs) have better clinical outcomes, especially when considering the quality of anticoagulation control of warfarin. OBJECTIVES:This study compared...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2018.04.066
更新日期:2018-07-17 00:00:00
abstract::The majority of studies generating normal echocardiographic reference values for left ventricular dimensions have been based on blindly performed M-mode measurements, and there are no previous reports based on two-dimensional echocardiography that provide a comprehensive analysis of the two-dimensional measurements fr...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(88)80006-8
更新日期:1988-12-01 00:00:00
abstract::Atrial fibrillation is the most common sustained cardiac arrhythmia encountered in clinical practice. Atrial fibrillation increases with age and is relatively common (> 5%) in patients > 69 years old. Despite this, our understanding of the underlying electrophysiologic mechanisms and the optimal management remains inc...
journal_title:Journal of the American College of Cardiology
pub_type:
doi:
更新日期:1993-12-01 00:00:00
abstract::Compared with recent advances in treatment of serious cardiovascular diseases, such as myocardial infarction and stroke, the treatment and outcome of acute pulmonary embolism (PE) have remained relatively unchanged over the last few decades. This has prompted several experts to call for the formation of multidisciplin...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2015.12.024
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to compare the pulmonary artery (PA) growth after arterial duct (AD) stenting versus modified Blalock-Taussig shunt (MBTS) in neonates with congenital heart disease with duct-dependent pulmonary circulation (CHD-DPC). BACKGROUND:Arterial duct stenting is increasingly deemed a relia...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2009.07.043
更新日期:2009-12-01 00:00:00
abstract::Progressive dyspnea and syncope occurred in a young woman with primary pulmonary hypertension despite therapy with hydralazine. Abnormal pulmonary artery reactivity was documented by an additional increase in pulmonary artery pressure and pulmonary vascular resistance during exercise and after an episode of hydralazin...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(83)80389-1
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVES:This study was conducted to characterize the functional nature of the reentrant tract responsible for ventricular tachycardia due to ischemic heart disease. BACKGROUND:A zone of slow conduction forming the return path is though to form a critical component of the reentrant mechanism in ventricular tachycard...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(95)00086-j
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVES:The study sought to evaluate the effects of endurance exercise training (ET) on endothelial-dependent flow-mediated arterial dilation (FMD) and carotid artery stiffness, and their potential contributions to the training-related increase in peak exercise oxygen consumption (Vo2) in older patients with heart f...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jacc.2013.04.033
更新日期:2013-08-13 00:00:00
abstract:OBJECTIVES:To assess whether 15-(p-[iodine-123] iodophenyl)-3-(R,S) methylpentadecanoic acid (BMIPP) imaging can identify previous ischemic areas, BMIPP SPECT was performed in patients with acute chest pain to compare its findings with those of technetium-99m-tetrofosmin (tetrofosmin) SPECT and coronary angiography. B...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(01)01634-5
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVES:We hypothesized that a standardized outpatient clopidogrel desensitization protocol would be safe and effective. BACKGROUND:Adverse reactions to clopidogrel are not uncommon, and affected patients must switch to ticlopidine after drug-eluting stent placement, despite its more malignant side-effect profile, ...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jacc.2007.08.016
更新日期:2007-11-20 00:00:00
abstract:OBJECTIVES:We sought to assess the efficacy and safety of thrombolytic therapy in patients with an acute pulmonary embolism (PE). BACKGROUND:Thrombolytic therapy is approved for the treatment of acute PE; however, the safety and efficacy of this therapy remain debated. METHODS:A meta-analysis of randomized, controlle...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,meta分析
doi:10.1016/s0735-1097(02)02381-1
更新日期:2002-11-06 00:00:00
abstract::Six patients with coexistent Mahaim and Kent accessory connections are described. Two had left nodoventricular Mahaim connections, the first reported cases demonstrating these findings. In neither were the left-sided Mahaim connections components of a tachycardia and their presence was incidental. In two of four with ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(87)80020-7
更新日期:1987-08-01 00:00:00
abstract:OBJECTIVES:This study investigated whether substance P potentiates the muscular and cardiac pain caused by the intraarterial infusion of adenosine, an autocoid known to induce muscular and cardiac ischemic-like pain in humans. BACKGROUND:Substance P is involved in the generation of neurogenic inflammation and causes c...
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(94)90306-9
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine if combined intense lifestyle and pharmacologic lipid treatment reduce myocardial perfusion abnormalities and coronary events in comparison to usual-care cholesterol-lowering drugs and whether perfusion changes predict outcomes. BACKGROUND:Lifestyle and lipid drugs...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,评论,杂志文章
doi:10.1016/s0735-1097(02)02693-1
更新日期:2003-01-15 00:00:00
abstract:OBJECTIVES:We sought to determine the physiologic actions and potential therapeutic applications of mutant atrial natriuretic peptide (mANP). BACKGROUND:The cardiac hormone atrial natriuretic peptide (ANP) is a 28-amino acid (AA) peptide that consists of a 17-AA ring structure together with a 6-AA N-terminus and a 5-A...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2009.04.080
更新日期:2009-09-08 00:00:00
abstract:OBJECTIVES:The aim of this study was to compare metabolic risk factors in men with anginal chest pain and a normal or abnormal coronary angiogram with those in healthy men. BACKGROUND:Risk factors for coronary heart disease, including lipoprotein abnormalities, hypertension and adiposity, may be metabolically interlin...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)90423-5
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVES:This study evaluated the acute hemodynamic changes with atrial septal defect closure in the postoperative period in patients undergoing the Fontan procedure. BACKGROUND:The adjustable atrial septal defect is a modification of the Fontan procedure designed to improve cardiac output and reduce systemic venous...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)90673-4
更新日期:1994-06-01 00:00:00
abstract::Venous thromboembolism (VTE) is a common disease associated with high risk for recurrences, death, and late sequelae, accounting for substantial health care costs. Anticoagulant agents are the mainstay of treatment for deep vein thrombosis and pulmonary embolism. The recent availability of oral anticoagulant agents th...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2016.01.072
更新日期:2016-04-26 00:00:00
abstract:OBJECTIVES:This study examined the relations among the triggers of ischemia during the activities of daily life, mental stress-induced ischemia in the laboratory and functional severity of ischemia on exercise testing. BACKGROUND:Myocardial ischemia is readily induced with exercise testing, but most episodes of ischem...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)90169-4
更新日期:1994-12-01 00:00:00
abstract::To determine the rate of induction, specificity and evolution of electrically induced postmyocardial infarction ventricular arrhythmias, 10 dogs that underwent a sham operation and 20 dogs with experimental transmural apical myocardial infarction underwent serial closed chest electrophysiologic studies with programmed...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(85)80010-3
更新日期:1985-05-01 00:00:00
abstract:OBJECTIVES:We sought to evaluate changes in RR interval variability during dipyridamole infusion and dipyridamole-induced myocardial ischemia. BACKGROUND:Myocardial ischemia and the autonomic nervous system can be mutually interdependent. Spectral analysis of RR interval variability is a useful tool in assessing auton...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(96)00270-7
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to assess the utility of tissue Doppler echocardiography in the setting of repaired transposition of the great arteries when the right ventricle (RV) functions as the systemic ventricle. BACKGROUND:Myocardial acceleration during isovolumic contraction, "isovolumic myocardial accele...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2003.06.018
更新日期:2004-01-07 00:00:00
abstract:OBJECTIVES:This study was designed to investigate the mutual effects of chronic atrial dilation and electrical remodeling on the characteristics of atrial fibrillation (AF). BACKGROUND:Both electrical remodeling and atrial dilation promote the inducibility and perpetuation of AF. METHODS:In seven goats AF was induced...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2005.09.041
更新日期:2006-02-07 00:00:00
abstract:OBJECTIVES:The purpose of this study was to examine use and describe outcomes of radial access for percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND:Transradial PCI (TRI) is associated with reduced risk of bleeding and vascular complications, as co...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2012.10.032
更新日期:2013-01-29 00:00:00
abstract:OBJECTIVES:This study sought to evaluate the diagnostic performance of multiparametric cardiovascular magnetic resonance (CMR) for detecting cardiac allograft vasculopathy (CAV) using contemporary invasive epicardial artery and microvascular assessment techniques as reference standards, and to compare the performance o...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jacc.2013.07.119
更新日期:2014-03-04 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:OBJECTIVES:We sought to determine whether exercise-induced U-wave alterations are observed in association with well-developed and well-functioning collateral vessels. BACKGROUND:Although exercise-induced electrocardiographic (ECG) U-wave alterations including negative and prominent U waves have been established as a m...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(99)00394-0
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVES:In a substudy to a recently reported investigation that demonstrated the benefit of immunoglobulin adsorption (immunoadsorption) for patients with idiopathic dilated cardiomyopathy (IDC), we tested whether this benefit is associated with a reduction of oxidative stress. BACKGROUND:The progression of cardiom...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(01)01309-2
更新日期:2001-07-01 00:00:00