Hemodynamics and myocardial oxygen metabolism of pulsus alternans in patients with dilative cardiomyopathy.

Abstract:

:The hemodynamic and myocardial energetic changes due to pulsus alternans were investigated by left and right heart catheterization and by oxygen consumption measurements in three patients with dilative cardiomyopathy. In all three patients, pulsus alternans developed after intravenous administration of the phosphodiesterase inhibitor enoximone. Following enoximone (Patients 1/2/3), left ventricular peak systolic pressure was reduced, in the respective patients, from 100/103/115 mmHg (normal beat) to 91/96/94 mmHg (strong beat) and further to 59/80/85 mmHg (weak beat); left ventricular end-diastolic pressure was reduced from 24/23/22 mmHg (normal beat) to 5/10/6 mmHg (strong beat) and further to 3/7/4 mmHg (weak beat). Cardiac output increased by an average of 16%. Heart rate increased by an average of 12%. Stroke work (during pulsus alternans mean between strong and weak beats) did not change (less than 5%) in any of the three patients. Arterial-coronary-sinus oxygen content difference decreased by 5%/13%/22, respectively. Myocardial oxygen consumption per beat decreased in Patient 1 by 8%, in Patient 2 by 8% and remained unchanged in Patient 3. It is concluded that pulsus alternans occurred in consequence of alternating systolic performance. The alternation in systolic performance most probably resulted from a disturbance in excitation-contraction coupling induced by enoximone. The pronounced reduction of left ventricular preload following administration of enoximone may have augmented further the differences between the strong and the weak beat. A disturbance in myocardial oxygen metabolism was ruled out as the cause of pulsus alternans in these patients.

journal_name

Clin Cardiol

journal_title

Clinical cardiology

authors

Hasenfuss G,Holubarsch C,Heiss HW,Bonzel T,Funfack M,Revenaugh M,Meinertz T,Just H

doi

10.1002/clc.4960100506

subject

Has Abstract

pub_date

1987-05-01 00:00:00

pages

323-7

issue

5

eissn

0160-9289

issn

1932-8737

journal_volume

10

pub_type

杂志文章
  • Effects of theophylline on exercise indices in a patient with chronotropic incompetence.

    abstract::Several investigators have documented the successful use of oral sustained-release theophylline in treating symptomatic bradycardia and sick sinus syndrome. This paper reports a case of chronotropic incompetence in which specific exercise indices, including the chronotropic response index, were used to measure the the...

    journal_title:Clinical cardiology

    pub_type: 临床试验,杂志文章,评审

    doi:10.1002/clc.4960231019

    authors: Dixon WC 4th,Bauch TD

    更新日期:2000-10-01 00:00:00

  • Endothelial function, fibrinolysis, and angiotensin-converting enzyme inhibition.

    abstract::Experimental and clinical studies with angiotensin-converting enzyme (ACE) inhibitors have suggested that these agents may reduce the risk of atherothrombotic events. Recent studies have identified the role of angiotensin II and ACE in the regulation of fibrinolysis. There is now substantial evidence that the renin-an...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:

    authors: Vaughan DE

    更新日期:1997-11-01 00:00:00

  • Therapeutic hypothermia-induced electrocardiographic changes and relations to in-hospital mortality.

    abstract:BACKGROUND:Therapeutic hypothermia improves survival for selected patients who remain comatose after cardiac arrest. Hypothermia triggers changes in electrocardiographic (ECG) parameters; however, the association of these changes to in-hospital mortality remains unclear. HYPOTHESIS:QT interval changes induced by thera...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.22224

    authors: Lam DH,Dhingra R,Conley SM,Kono AT

    更新日期:2014-02-01 00:00:00

  • Predictors of ventricular fibrillation or cardiac arrest in patients hospitalized for acute myocardial infarction.

    abstract::A community-wide study of patients hospitalized with acute myocardial infarction in metropolitan Baltimore was conducted to examine socio-demographic and clinical characteristics in association with ventricular fibrillation and cardiac arrest (VF/CA). Multivariate analyses revealed that variables significantly associa...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960040404

    authors: Tonascia J,Szklo M,Goldberg R,Kennedy H

    更新日期:1981-07-01 00:00:00

  • Exercise worsening of electromechanical disturbances: A predictor of arrhythmia in long QT syndrome.

    abstract:BACKGROUND:Electromechanical (EM) coupling heterogeneity is significant in long QT syndrome (LQTS), particularly in symptomatic patients; EM window (EMW) has been proposed as an indicator of interaction and a better predictor of arrhythmia than QTc. HYPOTHESIS:To investigate the dynamic response of EMW to exercise in ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.23132

    authors: Charisopoulou D,Koulaouzidis G,Rydberg A,Michael HY

    更新日期:2019-02-01 00:00:00

  • Carotid artery stenting in clinical practice: does sex matter? Results from the carotid artery stenting registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK).

    abstract:BACKGROUND:Carotid artery stenting (CAS) is increasingly used for treatment of severe carotid artery stenosis, but only few procedural risk factors for complications of CAS are clearly defined yet. A possible impact of the patient's gender on the outcome of patients undergoing CAS has not been investigated properly and...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,多中心研究

    doi:10.1002/clc.21015

    authors: Werner N,Zeymer U,Mark B,Hochadel M,Hauptmann KE,Jung J,Hoffmann E,Elsässer A,Fürste T,Leschke M,Mudra H,Zahn R,Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK).

    更新日期:2012-02-01 00:00:00

  • Echocardiographic and hemodynamic features of severe aortic regurgitation with diastolic opening of the aortic valve.

    abstract::Severe aortic regurgitation may be associated with premature aortic valve opening. Several possible etiologies for this diastolic opening have been suggested. We present a patient with hemodynamic data, M-mode and 2-D echocardiography in the setting of severe aortic regurgitation and diastolic aortic valve opening. Ou...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960090513

    authors: Martinez EE,Herman MV,Kay RH,Pontes SC Jr,Brandao AC,Pfefferman A,Arroyo JB,Portugal OP

    更新日期:1986-05-01 00:00:00

  • Outcomes associated with preoperative use of extracorporeal membrane oxygenation in children undergoing heart operation for congenital heart disease: a multi-institutional analysis.

    abstract:BACKGROUND:There are very sparse data on patient outcomes related to the use of extracorporeal membrane oxygenation (ECMO) prior to heart operation in children with congenital heart disease. This study was designed to evaluate this association using the Pediatric Health Information System (PHIS) database. HYPOTHESIS:W...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,多中心研究

    doi:10.1002/clc.22358

    authors: Gupta P,Robertson MJ,Beam BW,Rettiganti M

    更新日期:2015-02-01 00:00:00

  • Signal-averaged electrocardiographic late potentials in children with complete heart block.

    abstract::The purpose of this study was to examine signal-averaged electrocardiographic (SA-ECG) late potentials to predict ventricular arrhythmias during intrinsic cardiac rhythm and during ventricular pacing in children with complete heart block (CHB). Recordings of SA-ECG were obtained from eight patients (aged 3-18 years) w...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960170610

    authors: Hayabuchi Y,Matsuoka S,Kubo M,Akita H,Kuroda Y

    更新日期:1994-06-01 00:00:00

  • Thrombolytic agents: balancing cost, efficacy, and side effects.

    abstract::Balancing the benefits, risks, and cost of thrombolytic treatment is a complex issue which depends considerably upon the variable threat of the thrombus to organ physiology and patient survival. For example, after deep vein thrombosis (DVT), the major risk is long-term disability due to the postphlebitic syndrome, whi...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:

    authors: Marder VJ

    更新日期:1990-04-01 00:00:00

  • Genetics of coronary artery disease in the 21st century.

    abstract::Coronary artery disease (CAD) is still the number-one killer in the world, and clinical trials indicate that it is preventable. Mortality and morbidity can be reduced by at least 30% to 40% by treating known risk factors. Genetic susceptibility is claimed to account for 50% of predisposition. The challenge of preventi...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.22002

    authors: Roberts R,Stewart AF

    更新日期:2012-09-01 00:00:00

  • Catheter balloon valvuloplasty of stenotic aortic valves--Part II: Balloon valvuloplasty during life subsequent tissue examination.

    abstract::This review describes 23 patients with aortic valve stenosis who underwent balloon valvuloplasty during life and had subsequent valve tissue examined at the time of aortic valve replacement or at necropsy. Of 23 stenotic aortic valves, 17 were examined within 30 days (early) after balloon dilation. Of these 94% had no...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960141113

    authors: Waller BF,Dorros G,Lewin RF,King JF,McKay C,van Tassel JW

    更新日期:1991-11-01 00:00:00

  • Predictors of very late recurrence of atrial fibrillation after circumferential pulmonary vein ablation.

    abstract:BACKGROUND:Early recurrence of atrial fibrillation (ERAF) after catheter ablation is common and has been thoroughly studied. However, very late recurrence of atrial fibrillation (VLRAF) is rarely researched, and its characteristics have not been determined. HYPOTHESIS:The aim of this study was to investigate the clini...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.20340

    authors: Tao H,Liu X,Dong J,Long D,Tang R,Zheng B,Kang J,Yu R,Tian Y,Ma C

    更新日期:2008-10-01 00:00:00

  • A restrictive inflow pattern does not predict implantable cardioverter-defibrillator therapy in primary prevention.

    abstract:BACKGROUND:Current guidelines for the use of implantable cardioverter-defibrillators (ICDs) are broad and significantly increase the cost of caring for patients with heart failure. In an effort to identify the specific subset of patients who benefit from this therapy, the predictive value of numerous echocardiographic ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.20474

    authors: Dorosz JL,Aaronson KD,Good ED,Kolias TJ

    更新日期:2009-12-01 00:00:00

  • Effects of acute exercise on hemorheological, endothelial, and platelet markers in patients with chronic heart failure in sinus rhythm.

    abstract:BACKGROUND:Chronic heart failure (CHF) is associated with an increased risk of thrombosis and thromboembolic events, including stroke and venous thromboembolism. which may be related to a prothrombotic or hypercoagulable state. Acute vigorous exercise has been associated with activation of hemostasis, and this risk may...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960241107

    authors: Gibbs CR,Blann AD,Edmunds E,Watson RD,Lip GY

    更新日期:2001-11-01 00:00:00

  • Ventricular arrhythmias in congestive heart failure.

    abstract::Despite advances in the treatment of congestive heart failure (CHF), the mortality rate continues to be high. A large number of the deaths are sudden, presumably due to ventricular arrhythmias. Complex ventricular arrhythmias are recorded in as many as 80% of patients with CHF, with nonsustained ventricular tachycardi...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960120910

    authors: Chakko S,de Marchena E,Kessler KM,Myerburg RJ

    更新日期:1989-09-01 00:00:00

  • Obstructive sleep apnea is associated with increased readmission in heart failure patients.

    abstract:BACKGROUND:Heart failure (HF) readmission rates have become an increasingly important quality metric since the advent of the Hospital Readmissions Reduction Program. Despite many well-intentioned efforts to reduce readmissions, clinicians continue to struggle with the problem of high HF readmission rates. HYPOTHESIS:H...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.22738

    authors: Sommerfeld A,Althouse AD,Prince J,Atwood CW,Mulukutla SR,Hickey GW

    更新日期:2017-10-01 00:00:00

  • Monocyte-endothelial cell interaction in atherogenesis and thrombosis.

    abstract::Cellular interactions between leukocytes and the endothelium are critical events in vascular biology, such as atherosclerosis and acute coronary syndrome. When monocytes and endothelial cells are activated via direct cell-cell interaction, both types of cells express several biologically active molecules such as adhes...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960210103

    authors: Ikeda U,Takahashi M,Shimada K

    更新日期:1998-01-01 00:00:00

  • ACC/AHA guidelines for preoperative cardiovascular evaluation for noncardiac surgery: a critical point of view.

    abstract::This review examines the issue of preoperative cardiac evaluation from a critical point of view, based on recent medical literature. We reviewed the history of that field and focused on the American College of Cardiology and American Heart Association guidelines, which are a cornerstone in the field of cardiac patient...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960290505

    authors: Barak M,Ben-Abraham R,Katz Y

    更新日期:2006-05-01 00:00:00

  • Relationships between heart rate variability, functional capacity, and left ventricular function following myocardial infarction: an evaluation after one week and six months.

    abstract:BACKGROUND:Relationships between heart rate (HR) variability and different prognostic markers such as ejection fraction, functional capacity, and patency of the infarct-related artery, as well as the comparison of their time courses are not fully elucidated. HYPOTHESIS:The aim of study was to assess prospectively the ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960240411

    authors: Monmeneu JV,Chorro FJ,Bodí V,Sanchis J,Llácer A,García-Civera R,Ruiz R,Sanjuán R,Burguera M,López-Merino V

    更新日期:2001-04-01 00:00:00

  • Association of Physical Fitness With the Risk of Atrial Fibrillation: A Systematic Review and Meta-Analysis.

    abstract::Several studies have investigated the role of physical fitness in atrial fibrillation (AF), but the results remain controversial. We aimed to estimate the association between physical fitness and risk of AF. We comprehensively retrieved data from the Cochrane Library, PubMed, and Embase databases until February 29, 20...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/clc.22552

    authors: Zhu W,Shen Y,Zhou Q,Xu Z,Huang L,Chen Q,Hong K

    更新日期:2016-07-01 00:00:00

  • Prolonged low-dose thrombolytic therapy: a novel adjunctive strategy in the management of an infected right atrial thrombus.

    abstract::An 81-year-old man presented with a large, infected right atrial thrombus that was refractory to anticoagulants and several courses of antibiotics. The risk of surgical removal of the thrombus, which was associated with a pacemaker electrode, was considered prohibitive. The patient was treated for 7 days with low-dose...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4950250709

    authors: Chuang S,Mehta RH,Fay WP

    更新日期:2002-07-01 00:00:00

  • Evaluation of flecainide acetate in rapid atrial fibrillation complicating Wolff-Parkinson-White syndrome.

    abstract::Flecainide is reported to be effective in patients with paroxysmal tachycardias, but its effect on rapid ventricular response over accessory atrioventricular pathway during atrial fibrillation is not known. The influence of flecainide on various electrophysiological properties of the accessory pathway with special emp...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960080603

    authors: Kappenberger LJ,Fromer MA,Shenasa M,Gloor HO

    更新日期:1985-06-01 00:00:00

  • Postoperative troponin I values: insult or injury?

    abstract:BACKGROUND:Troponin I (TnI) is increasingly employed as a highly specific marker of acute myocardial ischemia. The value of this marker after cardiac surgery is unclear. HYPOTHESIS:The purpose of this study was to measure serum TnI levels prospectively at 1, 6, and 72 h after elective cardiac operations. In addition, ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960231009

    authors: Horvath KA,Parker MA,Frederiksen JW,Palmer AS,Fullerton DA

    更新日期:2000-10-01 00:00:00

  • The ramifications of recent health policy actions for cardiovascular care of women: Progress, threats, and opportunities.

    abstract::Women's health and well-being are shaped by a combination of healthcare policies that impact the type of health insurance coverage they benefit from, as well as access to preventive, screening, and treatment services. Furthermore, more distal policies, such as those that pertain to housing, education, and employment, ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.22896

    authors: Brindis CD,Freund KM

    更新日期:2018-02-01 00:00:00

  • Transient left ventricular aneurysm in a patient with hypertrophic cardiomyopathy and myocarditis.

    abstract::Left ventricular wall motion abnormalities, aneurysm formation, and progression to global hypokinesis have been described in patients with myocarditis and in patients with hypertrophic cardiomyopathy. We document a case of reversible aneurysm formation, cardiogenic shock, and complete recovery in a patient with myocar...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960160317

    authors: Fisher DZ,DiSalvo TG,Dec GW,DeSanctis RW

    更新日期:1993-03-01 00:00:00

  • Timing of cardiac resynchronization therapy device implantation in heart failure patients and its association with outcomes.

    abstract:BACKGROUND:When used in appropriately selected heart failure (HF) patients, cardiac resynchronization therapy (CRT) reduces mortality and hospitalization. It is not understood whether CRT implantation during hospitalization for HF is associated with similar benefits. HYPOTHESIS:Timing of CRT implantation relative to h...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,多中心研究

    doi:10.1002/clc.23135

    authors: Goldstein SA,Mentz RJ,Hellkamp AS,Randolph TC,Fonarow GC,Hernandez A,Yancy CW,Al-Khatib SM

    更新日期:2019-02-01 00:00:00

  • The pacemaker syndrome: old and new causes.

    abstract::The pacemaker syndrome refers to symptoms and signs in the pacemaker patient caused by inadequate timing of atrial and ventricular contractions. The lack of normal atrioventricular synchrony may result in decreased cardiac output and venous "cannon A waves." A sudden increase in atrial pressure at the onset of asynchr...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960140410

    authors: Schüller H,Brandt J

    更新日期:1991-04-01 00:00:00

  • Calcium channel blocker inhibition of AGE and RAGE axis limits renal injury in nondiabetic patients with stage I or II chronic kidney disease.

    abstract:BACKGROUND:There is a growing body of evidence that advanced glycation end products (AGE) and their receptor (RAGE) system are implicated in chronic kidney disease (CKD). We have previously found that a long-acting calcium channel blocker, azelnidipine, but not amlodipine, improves renal injury in CKD patients. However...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1002/clc.20885

    authors: Nakamura T,Sato E,Fujiwara N,Kawagoe Y,Koide H,Ueda Y,Takeuchi M,Yamagishi S

    更新日期:2011-06-01 00:00:00

  • The role of prolonged thrombolytic infusions and transesophageal echocardiography in thrombosed prosthetic heart valves: case report and review of the literature.

    abstract::Thrombolytic therapy for prosthetic heart valve thrombosis has recently been receiving increased attention and is now frequently used an alternative to high-risk surgery. A case is presented describing a novel thrombolytic therapy regimen with emphasis on the role of transesophageal echocardiography in diagnosis and m...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960181117

    authors: Puleo JA,Fontanet HL,Schocken DD

    更新日期:1995-11-01 00:00:00