Abstract:
:Patients experiencing out-of-hospital cardiac arrest (OHCA) without ST-segment elevation are a heterogenic group with a variety of underlying causes. Up to one-third of patients display a significant coronary lesion compatible with myocardial infarction as OHCA trigger. There are no randomized data on patient selection and timing of invasive coronary angiography after admission. METHODS AND RESULTS: The TOMAHAWK trial randomly assigns 558 patients with return of spontaneous circulation after OHCA with no obvious extracardiac origin of cardiac arrest and no ST-segment elevation/left bundle-branch block on postresuscitation electrocardiogram to either immediate coronary angiography or initial intensive care assessment with delayed/selective angiography in a 1:1 ratio. The primary end point is 30-day all-cause mortality. Secondary analyses will be performed with respect to initial rhythm, electrocardiographic patterns, myocardial infarction as underlying cause, neurological outcome, as well as clinical and laboratory markers. Clinical follow-up will be performed at 6 and 12 months. Safety end points include bleeding and stroke. CONCLUSION: The TOMAHAWK trial will address the unresolved issue of timing and general indication of angiography after OHCA without ST-segment elevation.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Desch S,Freund A,Graf T,Fichtlscherer S,Haake H,Preusch M,Hammer F,Akin I,Christ M,Liebetrau C,Skurk C,Steiner S,Voigt I,Schmitz R,Mudra H,Ledwoch J,Menck N,Horstkotte J,Pels K,Lahmann AL,Otto S,Lenk K,Ohlow Mdoi
10.1016/j.ahj.2018.12.005subject
Has Abstractpub_date
2019-03-01 00:00:00pages
20-28eissn
0002-8703issn
1097-6744pii
S0002-8703(18)30341-7journal_volume
209pub_type
杂志文章,多中心研究,随机对照试验abstract::Twenty-six patients with Ebstein's anomaly were classified into three types according to their clinical features, heart catheterization data, angiocardiographic and anatomical findings which were obtained on surgery or autopsy. The hemodynamics in each type were discussed. 1. Tricuspid Stenosis Dominant Type. Eight pa...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90458-1
更新日期:1978-02-01 00:00:00
abstract::The acute and chronic cellular electrophysiologic actions of ketanserin, a selective blocker of 5-hydroxytriptamine (5-HT2) receptor, were examined in the isolated rabbit ventricular muscle. This work was prompted by the recent observations that small numbers of patients treated with hypertension develop QTc prolongat...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90012-9
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:Current practice related to the management of atrial fibrillation (AF) complicating coronary artery bypass grafting (CABG) is uncertain. METHODS:We examined management of post-CABG AF in the PREVENT-IV trial, and we explored patterns of use of postoperative rhythm versus rate control and anticoagulation for...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.09.003
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Exercise training is recommended for chronic heart failure (HF) patients to improve functional status and reduce risk of adverse outcomes. Elevated plasma levels of amino-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), and cardiac troponin T (cTnT) are associ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2013.10.018
更新日期:2014-02-01 00:00:00
abstract::Motion of the posterior aortic root on echocardiography is related to left atrial volume changes. Early diastolic posterior motion of the aortic root reflects both LA emptying and filling and has been measured as the atrial emptying index. To study late diastolic motion of the aortic root, we measured the slope of pos...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90654-7
更新日期:1980-10-01 00:00:00
abstract::The plasma concentration of atrial natriuretic polypeptide (ANP) was measured in nine patients with essential hypertension during two grades of exercise tests performed in the supine position on a bicycle ergometer. The plasma ANP concentration significantly increased from 97.0 +/- 19.2 pg/ml to 107.6 +/- 23.7 pg/ml (...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90159-7
更新日期:1988-10-01 00:00:00
abstract::To assess the prevalence and prognostic implications of complicated ventricular ectopic depolarizations (VEDs) after hospital discharge in patients with acute myocardial infarction (AMI), we obtained serial 24-hour Holter recordings in 85 patients during the first 6 weeks after AMI. Recordings were obtained during two...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90745-2
更新日期:1984-11-01 00:00:00
abstract::To assess the effects of standard therapeutic interventions on the total ischemic burden, 86 patients with stable angina underwent 48 hours of ambulatory ST segment monitoring and treadmill exercise testing before and at a mean of 10 weeks after coronary artery bypass surgery (CABG) (group 1, N = 46) or percutaneous t...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90495-h
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Low heart rate recovery (HRR) at exercise test and the metabolic syndrome (MetS) are both predictors of cardiovascular morbidity and mortality. We studied in 75-year-old women and men, representative of the general population, the relationship between (1) HRR and the MetS, (2) HRR and the individual componen...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.06.025
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Transcatheter aortic valve replacement (TAVR) is an effective therapeutic option for patients with severe aortic stenosis at high risk for surgery. Identification of causes of death after TAVR may help improve patient selection and outcome. METHODS:We enrolled 874 consecutive patients who underwent TAVR at ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2014.07.023
更新日期:2014-11-01 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
abstract::In order to validate the measurement of pressure-volume loops and stroke work in humans, simultaneous digital subtraction ventriculography (DSA) and first-pass radionuclide angiocardiography (RNA) coupled with high-fidelity micromanometer left ventricular pressure measurements were undertaken in 34 patients, mean age ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90234-2
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:Some studies have reported that patients with mitral valve prolapse syndrome (MVPS) also have a disorder in the autonomic or neuroendocrine function, which can cause a host of related symptoms. A potential role of the renin-angiotensin system in the pathogenesis of MVPS has been addressed. However, the role ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2003.26
更新日期:2003-01-01 00:00:00
abstract::Since many patients with chest pain cannot exercise adequately, an alternative stress would be useful to evaluate coronary reserve. We studied the physiologic responses to epinephrine to assess its potential. We report on 39 patients with chest pain. Doses from 0.03 to 0.30 micrograms/kg/min were administered intraven...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90477-5
更新日期:1983-04-01 00:00:00
abstract::To observe the stereoscopic structure and the motion of the prolapsing mitral valve and its regurgitant jet in comparison with the normal mitral valve, four-dimensional (or dynamic three-dimensional) echocardiography of mitral valve apparatus was obtained in 20 patients with mitral valve prolapse and 10 unaffected sub...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70257-6
更新日期:1997-01-01 00:00:00
abstract::The resonant frequencies of five commonly used fluid-filled catheters connected to a solidstate microdisplacement pressure gauge were 18 to 33 per cent higher than those obtained with a conventional manometer. Four catheters had a flat amplitude response to 26 Hz. or more at the 20 per cent amplitude distortion level...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90508-6
更新日期:1975-05-01 00:00:00
abstract::The pharmacokinetic properties and hemodynamic effect of molsidomine and its pharmacologically active metabolite SIN-1 were investigated in 13 healthy volunteers following single oral doses. Hemodynamic changes were measured by finger plethysmography (peripheral arterial resistance), impedance plethysmography (venous ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90671-4
更新日期:1985-03-01 00:00:00
abstract::Progress in our understanding diabetic angiopathy has been slow, but we are now learning a number of lessons of interest to the cardiologist. Diabetic angiopathy is a collective term for conditions specific to the diabetic state and related to its duration more than to patient age. The angiopathy produces calcificatio...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(78)90053-4
更新日期:1978-09-01 00:00:00
abstract:BACKGROUND:Platelet inhibition is critical in reducing both short- and long-term atherothrombotic risks after acute myocardial infarction (MI), especially among patients managed with percutaneous coronary intervention (PCI). Currently available antiplatelet medications, including adenosine diphosphate (ADP) receptor in...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.08.021
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Peak exercise oxygen consumption (peak VO2) is an important discriminator of survival in patients with systolic heart failure and is used to select ambulatory patients for transplantation. The major trials assessing the relationship between peak VO2 and survival have used a variety of low-level exercise prot...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mhj.2001.117508
更新日期:2001-09-01 00:00:00
abstract::Compared with pathologic studies coronary angiography is a relatively insensitive technique to detect early atherosclerosis. Coronary angioscopy is a new technique providing direct information on luminal vessel surface. To determine whether coronary angioscopy may detect the presence of atherosclerotic disease on angi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90198-1
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:The diagnostic value of 12-lead electrocardiography during dobutamine stress echocardiography (DSE) is not well documented. METHODS AND RESULTS:We reviewed the records of 116 patients referred for DSE and coronary angiography, 52 of whom were excluded because of abnormal ST segment or inadequate DSE. Of the...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70163-2
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:Moderate alcohol drinking and marine omega-3 fatty acids (omega3) have both been associated with low mortality from coronary heart disease (CHD). However, there is little data evaluating the interactions of wine ethanol drinking with omega3 in CHD patients. METHODS:The relationships between wine drinking an...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.08.009
更新日期:2008-01-01 00:00:00
abstract::A substantial proportion of patients with dilated cardiomyopathy have circulating autoantibodies directed against the cardiac beta-adrenoceptor. These antireceptor antibodies inhibit both ligand binding to membrane beta-receptors and isoproterenol-sensitive adenylate cyclase. The functional consequences of antibody-re...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90766-b
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:The optimal antibiotic treatment length for infective endocarditis (IE) is uncertain. International guidelines recommend treatment duration of up to 6 weeks for patients with left-sided IE but are primarily based on historical data and expert opinion. Efficacies of modern therapies, fast recovery seen in man...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2020.05.012
更新日期:2020-09-01 00:00:00
abstract::Incidence of myonecrosis in patients undergoing rotational atherectomy was evaluated by preprocedural statin use. The incidence of any myonecrosis (24.1% vs 52.3%, P < .001) or significant myonecrosis (7.5% vs 21.8%, P < .001) was significantly lower among patients pretreated with statins. This difference remained sig...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.02.026
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:To assess whether serum uric acid, which is a marker of impaired oxidative metabolism, might correlate with left ventricular systolic and diastolic dysfunction in patients with chronic heart failure (CHF). BACKGROUND:Uric acid levels, which are frequently elevated in patients with CHF, correlate with leg vas...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.122122
更新日期:2002-06-01 00:00:00
abstract::Limited data are available on mitral valve replacement in the elderly patient. Therefore we report our 10-year experience including predictors of perioperative mortality and subsequent long-term cardiac mortality in elderly patients with mitral valve replacement compared to younger patients. Of the 126 consecutive pat...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90934-n
更新日期:1992-07-01 00:00:00
abstract::Economic assessment can be incorporated into clinical trials to evaluate and compare the costs and benefits of different health care programs. In this article the three main types of evaluation are discussed: cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. The measurement of direct and i...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(05)80059-6
更新日期:1990-03-01 00:00:00
abstract::The expected implant lifetime of pacemaker generators has been extended with the introduction of lithium power sources. Consequently, the pacing lead may become the component that determines the total implant lifetime of the pacemaker. This fact emphasizes the necessity for accurate assessment of the integrity of a ch...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90269-2
更新日期:1984-06-01 00:00:00