Abstract:
OBJECTIVES:To characterize patient profile and hemodynamic profile of those undergoing intra-aortic balloon pump (IABP) for cardiogenic shock and define predictors of hemodynamic failure of IABP support. BACKGROUND:Clinical characteristics of IABP support in cardiogenic shock not related to acute myocardial infarction (AMI) remain poorly characterized. METHODS:We retrospectively studied a cohort of 74 patients from 2010 to 2015 who underwent IABP insertion for cardiogenic shock complicating acute decompensated heart failure not due to AMI. RESULTS:In the overall cohort, which consisted primarily of patients with chronic systolic heart failure (89%), IABP significantly augmented cardiac index and lowered systemic vascular resistance (P<.05). Despite this improvement, 28% of these patients died (24%) or require urgent escalation in mechanical circulatory support (MCS) (4%). Multivariable regression revealed that baseline left ventricular cardiac power index (LVCPI), a measure of LV power output derived from cardiac index and mean arterial pressure (P=.01), and history of ischemic cardiomyopathy (P=.003) were significantly associated with the composite adverse-event endpoint of death or urgent MCS escalation. An IABP Failure risk score using baseline LVCPI <0.28 W/m2 and ischemic history predicted 28-day adverse events with excellent discrimination. CONCLUSION:Despite hemodynamic improvements with IABP support, patients with non-AMI cardiogenic shock still suffer poor outcomes. Patients with ischemic cardiomyopathy and low LVPCI fared significantly worse. These patients may warrant closer observation or earlier consideration of more advanced hemodynamic support.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Hsu S,Kambhampati S,Sciortino CM,Russell SD,Schulman SPdoi
10.1016/j.ahj.2017.11.016subject
Has Abstractpub_date
2018-05-01 00:00:00pages
181-191eissn
0002-8703issn
1097-6744pii
S0002-8703(17)30395-2journal_volume
199pub_type
杂志文章abstract:BACKGROUND:Single nucleotide polymorphisms of vitamin K epoxide reductase complex subunit 1 (VKORC1) was reported to have association with arterial vascular disease. We investigated whether single nucleotide polymorphism of VKORC1 +2255 is associated with clinical outcomes among patients who underwent drug-eluting sten...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2009.02.001
更新日期:2009-05-01 00:00:00
abstract::Tolerance to prolonged nitroglycerin (NTG) may be due to drug-induced intravascular expansion. To test the hypothesis that concomitant diuretics may reduce volume expansions and thus prevent NTG tolerance, we studied 23 healthy volunteers randomized to hydrochlorthiazide or placebo before and during 74-hour continuous...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(95)90361-5
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:hypertrophic cardiomyopathy (HCM) is a major cause of sudden death in young athletes and one of the most common inherited cardiovascular diseases, affecting 1 in 500 individuals. Often viewed as a disease of the cardiac sarcomere, mutations in genes encoding myofilament proteins are associated with disease p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2010.08.001
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Diastolic dysfunction induced by ischemia may alter transmitral blood flow, but this reflects global ventricular function, and pseudonormalization may occur with increased preload. Tissue Doppler may assess regional diastolic function and is relatively load-independent, but limited data exist regarding its a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.123836
更新日期:2002-09-01 00:00:00
abstract:AIMS:Furosemide is commonly prescribed for symptom relief in heart failure (HF) patients. Although few data support the continuous use of loop diuretics in apparently euvolemic HF patients with mild symptoms, there is concern about safety of diuretic withdrawal in these patients. The ReBIC-1 trial was designed to evalu...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2017.08.012
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Declines in case fatality post-myocardial infarction (MI) have been observed over the past 3 decades. Few studies report socioeconomic disparities in survival post-MI. METHODS:We assessed 1-year case fatality among 9,116 incident MI patients included in the Atherosclerosis Risk in Communities community surv...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2012.10.022
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Previous studies have generated inconsistent results when attempting to define predictors of stroke and death in patients with endocarditis. We sought to examine the relationship between vegetation 2-dimensional size and stroke in those with infective endocarditis (IE) and to identify differences between aor...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.115790
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Recent randomized clinical trials have suggested a benefit of an invasive management strategy in patients with acute coronary syndromes. However, the broader use and impact of the invasive management approach has not been established for patients with acute coronary syndromes beyond the relatively narrow pat...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1067/mhj.2002.122517
更新日期:2002-06-01 00:00:00
abstract::Left ventricular (LV) filling was examined by Doppler and M-mode echocardiography in 24 patients with LV hypertrophy (five with aortic stenosis, six with hypertrophic cardiomyopathy, and 13 with LV hypertrophy secondary to systemic hypertension) and in 18 normal subjects. Patients with LV hypertrophy had significantly...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90657-0
更新日期:1987-06-01 00:00:00
abstract::In prior studies, we have shown that the antikaliuretic drugs, triamterene and amiloride, through a direct cardiac effect reduce the loss of cardiac potassium induced by the administration of digitalis. Since loss of myocardial potassium is thought to underlie digitalis arrhythmias, this study was performed to determi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90257-4
更新日期:1975-07-01 00:00:00
abstract:BACKGROUND:Neonates with critical pulmonary valve stenosis often demonstrate small or hypoplastic right ventricular structures. Relief of the obstruction enhances forward flow across the right ventricle and reduces its pressure load. Growth of the right ventricle and especially of the pulmonary valve annulus was evalua...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1053/hj.1998.v136.89576
更新日期:1998-08-01 00:00:00
abstract::Antiarrhythmic therapy for prevention of sustained ventricular tachycardia is commonly guided by programmed electrical stimulation, and the persistent ability to initiate ventricular tachycardia during drug therapy often leads to the use of nonpharmacologic therapies such as surgery. Prior studies suggest that program...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80325-4
更新日期:1990-04-01 00:00:00
abstract:BACKGROUND:The Total Occlusion Study of Canada (TOSCA) is a multicenter, randomized trial evaluating the effect of stenting with > =1 heparin-coated stent on long-term patency after percutaneous coronary intervention by balloon angioplasty of occluded coronary arteries. The purpose of the current study was to compare t...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mhj.2001.116960
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Previous studies with dexamethasone-eluting stents could not elucidate the role of dexamethasone in the prevention of neointimal hyperplasia because they did not compare their results with a control group. We prospectively evaluated the clinical and angiographic outcomes of dexamethasone-eluting stents, comp...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2006.05.011
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVES:Impedance monitoring has been proposed as a method to assess the adequacy of tissue heating during catheter ablation procedures. The purpose of this study was to evaluate the relation among initial impedance, fall in impedance, and electrode temperature during catheter ablation procedures. METHODS AND RESUL...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70130-9
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVES:The objective of this study is to assess trends in evidence-based therapy use and short- and long-term mortality over time among older patients with non-ST-segment elevation myocardial infarction (NSTEMI). BACKGROUND:With the prevalence of national quality improvement efforts, the use of evidence-based ther...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.10.008
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Inflammation might promote the development of atherosclerosis, and high levels of C-reactive protein (CRP) and fibrinogen are associated with an increased risk of acute coronary events. OBJECTIVE:We assessed the levels of CRP and other risk factors in patients with angiographically documented coronary arter...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1053/hj.1999.v137.92052
更新日期:1999-02-01 00:00:00
abstract::The aim of this study was to investigate whether platelet-activating factor (PAF), PAF receptors, and PAF receptor-mediated effects in the human myocardium play a role in cardiac depression during anaphylaxis or septic shock. The effects of PAF, the biologically inactive derivative lyso-PAF, and the specific PAF antag...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90593-k
更新日期:1992-08-01 00:00:00
abstract::Patients with syndrome X have been found to have an abnormal coronary blood flow reserve. The physical performance during exercise, however, has been incompletely investigated. Cardiopulmonary exercise testing (CPX) is a reliable noninvasive method to provide indexes of lung, heart, circulation, and muscle functions. ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90162-3
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:The study aimed to compare the short-term costs and long-term cost-effectiveness of 2 antithrombotics, fondaparinux and enoxaparin, for non-ST-elevation acute coronary syndrome in the United States. METHODS:It was based on a large randomized trial of 20,078 patients Fifth Organization to Assess Strategies i...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2009.02.017
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Recent work has demonstrated a link between retinopathy, a marker of microvascular disease, and the development of heart failure, a finding particularly relevant in individuals with diabetes. Our objective was to assess the relationship between retinopathy and cardiac structure and function in a cohort of in...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.10.019
更新日期:2009-03-01 00:00:00
abstract::The antihypertensive efficacy, safety, and lipid effects of doxazosin, a selective alpha 1-inhibitor, were assessed in a general practice setting. Three hundred twenty-six patients were entered into the study, which involved three phases: (1) a 2-week baseline period, (2) an 8-week period in which patients received 1 ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(91)90857-e
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Prior studies have reported race and sex differences in cardiac catheterization use after acute myocardial infarction (AMI). It is unclear whether race or sex differences in procedure refusal may contribute to this difference. We sought to determine whether cardiac catheterization refusal rates differ by pat...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.126122
更新日期:2002-12-01 00:00:00
abstract::The normal pattern of the myocardial sympathetic innervation was studied in 15 subjects using single photon emission computed tomography (SPECT) gamma scintigraphy with iodine 123-labeled meta-iodobenzylguanidine (I123MIBG). Seven young subjects (mean age 29.4 +/- 7.5 years SD) with supraventricular tachycardia and ei...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)91056-k
更新日期:1993-08-01 00:00:00
abstract::Because of its unique ability to demonstrate the metabolic consequences of myocardial ischemia, positron emission tomography (PET) is extremely valuable in assessing myocardial viability. PET imaging can identify the myocardial segments that are likely to improve after revascularization and may be more sensitive and s...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(91)90803-p
更新日期:1991-07-01 00:00:00
abstract::This study uses echocardiography to characterize the pattern of left ventricular hypertrophy in a new hypertensive heart failure-prone rat strain designated SHHF/Mcc-cp (SHHF). M-mode echocardiograms of the left ventricle in nine 10- to 12-month old SHHF rats and nine age-matched spontaneously hypertensive rats (SHR) ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90081-0
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:Data on left atrial/left atrial appendage (LA/LAA) thrombus resolution after non-vitamin K antagonist (VKA) oral anticoagulant treatment are scarce. The primary objective of X-TRA was to explore the use of rivaroxaban for the resolution of LA/LAA thrombi in patients with nonvalvular atrial fibrillation (AF) ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.05.007
更新日期:2016-08-01 00:00:00
abstract::Between 1982 and 1988, we observed 312 patients who were affected by syncope or presyncope and whose spontaneous symptoms could be reproduced by means of carotid sinus massage (CSH); no other definite cause of syncope could be identified. The clinical outcome during a 2- to 8-year follow-up period (mean 44 +/- 24 mont...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90507-r
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Platelets play an important role in the natural history of coronary artery disease. Enhanced platelet aggregation and receptor expression unquestionably occur after coronary stent implantation; however, the functional characteristics of platelets before stenting have not been fully elucidated. METHODS:Plate...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.116478
更新日期:2001-10-01 00:00:00
abstract::M-mode echocardiographic records of 26 patients with surgically proven complete atrioventricular canal defect were reviewed. Fragmentation of the interventricular septum and anterior displacement of the mitral annulus into the left ventricular outflow tract were noted in all patients. In 25 of 26 a common atrioventric...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90228-3
更新日期:1981-05-01 00:00:00