Abstract:
:Chronic total coronary occlusions (CTOs) are a frequent finding in patients with coronary disease and remain one of the most challenging target lesion subsets for intervention. CTOs have been reported in approximately one-third of patients undergoing diagnostic coronary angiography. By nature of their complexity, CTO percutaneous interventions (PCIs) are associated with lower rates of procedural success, higher complication rates, greater radiation exposure, and longer procedure times compared with interventions in non-CTO stenoses. Despite these obstacles, reported benefits of successful CTO PCI include a reduction in symptoms and improvement in both ventricular function and survival. This article examines the technical challenges, procedural complications, and possible outcomes associated with CTO PCI.
journal_name
Cardiol Clinjournal_title
Cardiology clinicsauthors
Galla JM,Whitlow PLdoi
10.1016/j.ccl.2009.10.003subject
Has Abstractpub_date
2010-02-01 00:00:00pages
71-9issue
1eissn
0733-8651issn
1558-2264pii
S0733-8651(09)00114-3journal_volume
28pub_type
杂志文章,评审abstract::Syncope is a common but complex medical disorder with a multitude of etiologies, some of which are still not well understood. In a general population, the greatest diagnostic yield is from the history and physical examination. Numerous other diagnostic modalities include Holter monitoring, signal-averaged ECG, cardiac...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1991-11-01 00:00:00
abstract::In this article, the author sought to review the two primary components of diastolic function that are most directly and accurately determined using invasive methodologies. For chamber relaxation this is optimally achieved using a micromanometer catheter, whereas for chamber compliance (or its inverse stiffness) this ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70162-4
更新日期:2000-08-01 00:00:00
abstract::Acute coronary syndrome (ACS) represents an umbrella of ischemic myocardial disease and diagnoses encompassing unstable angina (UA), non-ST-elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI). UA and NSTEMI for all intents and purposes, share similar pathophysiology, but at increas...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2017.08.003
更新日期:2018-02-01 00:00:00
abstract::Syncope due to idiopathic AV block is characterized by: 1) ECG documentation (usually by means of prolonged ECG monitoring) of paroxysmal complete AV block with one or multiple consecutive pauses, without P-P cycle lengthening or PR interval prolongation, not triggered by atrial or ventricular premature beats nor by r...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2015.04.012
更新日期:2015-08-01 00:00:00
abstract::Given the rapid evolution of cardiovascular medicine, clinicians must sift through an enormous array of information about new therapies in order to determine how best to treat patients with ischemic heart disease. They should first consider the evidence from randomized clinical trials, because these trials eliminate b...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:
更新日期:1995-08-01 00:00:00
abstract::During the past decade, ambulatory monitoring of the blood pressure has become an important tool for evaluating the pharmacodynamics and clinical efficacy of antihypertensive drugs during development. Furthermore, this methodology aids physicians in practice in the assessment of blood pressure control in many subsets ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1995-11-01 00:00:00
abstract::To whatever extent the improvement in symptoms and survival rendered by treatment with ACE inhibitors is attributable to their effects on the circulation and the kidneys, this benefit can be rescinded by concomitant administration of aspirin. Although some useful prostaglandin-independent actions may persist, shutting...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70246-0
更新日期:2001-11-01 00:00:00
abstract::Quantification of regional myocardial blood flow and of its responses to targeted physiologic and pharmacologic interventions, which is now available with positron emitting tracers of blood flow and positron emission tomography (PET), extends the diagnostic potential of standard myocardial perfusion imaging. These non...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2008.12.009
更新日期:2009-05-01 00:00:00
abstract::In the past, much attention in imaging research was focused on the macroscopic morphology and patency of arteries. Only recently, research and clinical interest have shifted to the microcirculation and its impact on the long-term prognosis in patients with vascular diseases. This focus and newly developed therapeutic ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(03)00110-3
更新日期:2003-11-01 00:00:00
abstract::Coronary computed tomographic angiography (CTA) is a promising noninvasive tool that allows the visualization of plaque morphology. Plaques characterized by positive remodeling, low attenuation, and napkin ring circular enhancement on contrast-enhanced coronary CTA have been regarded as rupture-prone vulnerable plaque...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:10.1016/j.ccl.2011.10.002
更新日期:2012-02-01 00:00:00
abstract::Following the development of the first automated methods in the 1980s, quantitative coronary angiography (QCA) has undergone substantial evolution from simplistic computer-assisted methods of visual interpretation of coronary angiograms to recently introduced three-dimensional reconstruction and quantitative analysis ...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:10.1016/j.ccl.2009.03.008
更新日期:2009-08-01 00:00:00
abstract::Atrial fibrillation (AF), an escalating dysrhythmia, is accountable for extensive population morbidity and mortality. In the United States, approximately 2.3 million people are presently diagnosed with AF and it is estimated that this prevalence may increase to 5.6 million by 2050. Foremost predisposing risk factors f...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2008.09.015
更新日期:2009-02-01 00:00:00
abstract::Because 1.1 million myocardial infarctions occur in the United States alone each year, and 450,000 of them are recurrent infarctions, which carry an inherently greater risk of death and disability than first events, the importance of secondary prevention strategies that can be implemented widely is unparalleled in hea...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2007.12.017
更新日期:2008-05-01 00:00:00
abstract::This article discusses the epidemiology of cardiovascular (CV) events in end-stage and early renal disease, summarizes the profile of classic and nonclassic CV risk factors in renal patients, highlights recent evidence documenting accelerated atherogenesis in renal disease, and provides information on the central arte...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2005.03.002
更新日期:2005-08-01 00:00:00
abstract::Anger is the affective state most commonly associated with myocardial ischemia and life-threatening arrhythmias. The scope of the problem is sizeable-at least 36,000 (2.4% of 1.5 million) heart attacks are precipitated annually in the United States by anger. The lethal cardiovascular consequences in ischemic heart dis...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70281-2
更新日期:1996-05-01 00:00:00
abstract::Cardiac CT is an accurate and reasonable alternative modality for valvular imaging. It is used primarily for the evaluation of coronary artery disease; however, important information regarding valvular anatomy and function can be derived from CT. Calcification is a common CT finding in various valvular abnormalities a...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2009.06.010
更新日期:2009-11-01 00:00:00
abstract::Once considered dangerous and potentially life threatening, cardiac catheterization of the patient with pulmonary hypertension can be performed safely and provides essential information in the diagnosis and management of pulmonary hypertension. This article summarizes the modern techniques used for right-heart cathete...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2004.04.011
更新日期:2004-08-01 00:00:00
abstract::With recent technical and clinical advances, adenosine stress perfusion MRI has evolved from a promising research tool to an everyday clinical test. This article reviews the current state of stress perfusion MRI. Specifically, it addresses the following topics: validation of stress perfusion MRI in preclinical studies...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2007.02.002
更新日期:2007-02-01 00:00:00
abstract::Thoracoabdominal aortic aneurysms are increasing in incidence. Rupture is associated with a high rate of morbidity and mortality. The historic gold standard of open repair can be performed with low rates of complications at centers of excellence. However, these results are not universally achievable, with significantl...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2017.03.008
更新日期:2017-08-01 00:00:00
abstract::The Fontan operation is a unique approach to create a circulation in series without 2 distinct pumping chambers. Although the approach has enabled many patients to live well into adulthood, the unique physiology results in many complications, cardiac and extracardiac. This review focuses on the pathophysiology of the ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2015.07.010
更新日期:2015-11-01 00:00:00
abstract::Proarrhythmia is a potentially lethal adverse effect of antiarrhythmic drugs. Underlying mechanisms and the approaches to identification are discussed. The applicability of electrophysiologic testing is considered, with particular reference to the validity of the different responses to programmed stimulation considere...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1986-08-01 00:00:00
abstract::In this era of interventional electrophysiology, the accuracy of the electrocardiogram in diagnosis of supraventricular tachycardia could be improved by detailed endocardial mapping and confirmed by results of radiofrequency catheter ablation. This article describes the electrocardiographic characteristics for differe...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70361-1
更新日期:1997-11-01 00:00:00
abstract::Under normal baseline conditions the unique anatomy, myocardial ultrastructure, and coronary physiology of the right ventricle (RV) reflect a high-volume low-pressure pump. Early work described the RV as a passive conduit with minimal pumping capability. It is now appreciated that through a mechanism of ventricular in...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2012.03.009
更新日期:2012-05-01 00:00:00
abstract::This is an extensive review of thrombolysis in myocardial infarction with discussions of the pathophysiology of occlusion, clinical occlusion and rationale for thrombolysis, thrombolytic agents, results of thrombolysis (incidence of reperfusion, left ventricular function, and mortality), complications of thrombolytic ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-02-01 00:00:00
abstract::The role of heart catheterization continues to evolve as the sophistication of cardiac MRI and CT improves and the breadth of interventional catheter techniques widens. This analysis is approached from four perspectives: (1) planning of the procedure, including information required, potential pitfalls, and equipment; ...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:10.1016/j.ccl.2006.08.008
更新日期:2006-11-01 00:00:00
abstract::The merits of Holter monitor recording, intermittent event recording, and transtelephonic recording are stated, the equipment used for each method is described, and the type of data obtained is analyzed. ...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:
更新日期:1983-05-01 00:00:00
abstract::High-density lipoproteins (HDLs) have presented an attractive target for development of new therapies for cardiovascular prevention on the basis of epidemiology and preclinical studies demonstrating their protective properties. Development of HDL mimetics provides an opportunity to administer functional HDL. However, ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2017.12.012
更新日期:2018-05-01 00:00:00
abstract::Congenital abnormalities of the pericardium are a rare group of disorders that include congenital absence of the pericardium, pericardial cysts, and diverticula. These congenital defects result from alterations in the embryologic formation and structure of the pericardium. Although many cases are incidentally found, t...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2017.07.012
更新日期:2017-11-01 00:00:00
abstract::Parenterally administered narcotic analgesics are a critically important part of therapy for the patient with acute myocardial ischemic syndromes. These agents are very effective and, when used with appropriate caution and monitoring, are also generally safe. They not only relieve the sensation of severe pain but also...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-02-01 00:00:00
abstract::Systemic hypertension is a major public health problem and is perhaps the most common chronic disorder in most societies. Most patients with vascular disease report hypertension in their medical history. Irrespective of the specialty that one practices, every physician will likely encounter patients with systemic hype...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(01)00008-x
更新日期:2002-05-01 00:00:00