Abstract:
:The distinction between idiopathic dilated cardiomyopathy and myocarditis is controversial, both clinically and pathologically. To increase diagnostic accuracy and provide prognostic information, we prospectively tested the routine application of immunofluorescence and electron microscopy in endomyocardial biopsy evaluation. Biopsy samples from a consecutive series of 79 patients with cardiomyopathy and possible myocarditis were thus evaluated by light (LM), immunofluorescence (IF), and electron microscopy (EM). Patient course was followed prospectively to determine prognostic factors. Immunoglobulin (IgG) and complement (C) in biopsy tissue were graded 0 to 3+ and an IF score was derived as 2 (IgG) grade + C grade. A highly significant association was found between IF score greater than or equal to 2 and the presence of mononuclear cells (lymphocytes plus macrophages) greater than 5/high-power field, confirmed by EM; 12 of 15 (80%) with IF score greater than or equal to 2 had inflammatory cells, vs only 2 of 64 (3%) with IF score less than 2 (p less than 0.000001). EM was used to confirm the identity of infiltrating cells and to grade myofilament loss (0 to 3+) and 11 other ultrastructural features. EM did not provide important predictive information in myocarditis, but confirmed the presence of inflammatory cells. However, the EM finding of myofilament loss provided prognostic information both in patients with and without myocarditis (p less than 0.03). Mortality at 18 months was 37% for patients with 2 to 3+ myofilament loss, vs 10% in those with 0 to 1+ loss. Moreover, myofilament loss was prognostically independent of clinical class and ejection fraction. EM determination of myofilament loss is valuable as a prognostic indicator, whether or not myocarditis is present. Routine IF and EM increase the diagnostic accuracy and prognostic information in endomyocardial biopsies from patients with suspected myocarditis or cardiomyopathy.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Hammond EH,Menlove RL,Anderson JLdoi
10.1016/0002-8703(87)90180-3subject
Has Abstractpub_date
1987-11-01 00:00:00pages
1055-65issue
5eissn
0002-8703issn
1097-6744pii
0002-8703(87)90180-3journal_volume
114pub_type
杂志文章abstract::The effects of lorcainide, a new antiarrhythmic drug, on serum electrolytes and osmolality are described in a series of 33 patients with organic heart disease and complex ventricular arrhythmias treated with lorcainide. In eight patients, a mean decrease in serum Na+ of 8.25 +/- 3.2 mEq/L was observed after a single 2...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90690-2
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:Dyspnea is a complex system with multiple etiologies, including myocardial ischemia ("anginal equivalent"). Few studies have examined the utility of stress testing to detect coronary artery disease in this setting. The purpose of this study was to examine the prevalence, severity, and prognostic value of per...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.03.002
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Heart failure (HF) remains a major public health issue. Data on long-term trends in the incidence of HF and survival after its onset are limited. METHODS:A prospective cohort study conducted between 1985 and 2004 in 21,906 participants of the Physicians' Health Study I who were alive and free of HF on Janua...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.07.004
更新日期:2007-11-01 00:00:00
abstract::Cardiovascular anomalies are a frequently reported feature of the fetal alcohol syndrome, but only rarely have such children been catheterized. This article fully described the cardiac anomaly in two infants with this syndrome. The malformations found in both cases include a ventricular septal defect, and the rather u...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90290-4
更新日期:1979-11-01 00:00:00
abstract::We retrospectively contrasted the medical outcome of patients removed from the heart transplant consideration list because of clinical improvement with that of transplant recipients. Of 60 patients awaiting transplantation, 18 were removed from the list (group A), and 42 required transplant or died (group B). Group A ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90462-7
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Previous works have suggested an association between Chlamydia pneumoniae infection and coronary heart disease. We evaluated the prevalence of C. pneumoniae infection in patients with acute myocardial infarction (AMI) and coronary heart disease (CHD). METHODS AND RESULTS:Ninety-eight patients with AMI, 80 p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70371-6
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:The optimal antiplatelet regimen in elective patients undergoing complex percutaneous coronary interventions (PCIs) is uncertain. We aimed to assess the impact of glycoprotein IIb/IIIa (GpIIb/IIIa) inhibition with eptifibatide in clinically stable subjects with diffuse coronary lesions. METHODS:Patients wit...
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.2012.02.009
更新日期:2012-05-01 00:00:00
abstract::Two hundred twenty-four patients underwent ventricular programmed stimulation (VPS) without prior documentation of the clinical occurrence of sustained ventricular tachycardia (VT) or ventricular fibrillation-flutter (VF). Indications for VPS were: palpitations or nonsustained VT during ambulatory monitoring (85 patie...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90235-2
更新日期:1985-05-01 00:00:00
abstract::The hemodynamic, electrocardiographic, and metabolic responses of dogs with acute myocardial ischemia to intravenous administration of fructose-1,6-diphosphate (FDP) were assessed. Analysis of the results (compared to dextrose control) revealed evidence of major improvement of LVEDP and cardiac output, significant dec...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90228-8
更新日期:1980-11-01 00:00:00
abstract:BACKGROUND:The aim of this study was to test the hypothesis that patients with atherosclerotic cardiovascular (CV) disease optimally treated on a statin but with residual atherogenic dyslipidemia (low high-density lipoprotein cholesterol [HDL-C] and high triglycerides) will benefit from addition of niacin with fewer CV...
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.2010.11.017
更新日期:2011-03-01 00:00:00
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...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2017.11.016
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Few telemedicine programs have undergone cost analyses, impeding their implementation into practice. We report on the economic analysis of a nurse-administered intervention designed to improve blood pressure control among hypertensive veterans. METHODS:We randomized hypertensive patients at the Durham Veter...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2010.05.024
更新日期:2010-08-01 00:00:00
abstract::Flow beyond a stenotic aortic valve (AS) is dynamically complex. Numerous hydraulic studies have demonstrated that at least four well-known major flow areas occur distal to a stenotic valve. These include a jet, an area alongside the jet (the parajet), an area of flow disturbance, and an area in which disturbed flow a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90400-8
更新日期:1982-05-01 00:00:00
abstract:BACKGROUND:Weekly fish consumption has been related to a lower risk of fatal coronary heart disease (CHD) and incident stroke in populations with a low fish intake. This relation has mainly been attributed to n-3 fatty acids in fish, that is, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). It is at present ...
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.2009.12.033
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:The oxygen uptake efficiency slope (OUES) is a new submaximal parameter which objectively predicts the maximal exercise capacity in children and healthy subjects. However, the usefulness of OUES in adult patients with and without advanced heart failure remains undetermined. The present study investigates the...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.07.004
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Whether low-molecular-weight heparin (LMWH) is superior to unfractionated heparin (UFH) in acute ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) remains unclear. METHODS:A total of 3,372 STEMI patients wh...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ahj.2009.12.041
更新日期:2010-04-01 00:00:00
abstract::Sodium-glucose cotransporter 2 inhibitor (SGLT2i) use is associated with improved cardiovascular and kidney outcomes. However, the magnitude and potential heterogeneity of effect across patients with varying types of cardiometabolic and kidney disease is unclear. To examine the effect of SGLT2i on cardiovascular and k...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2020.10.064
更新日期:2021-02-01 00:00:00
abstract::Echocardiography was performed on 26 patients with prosthetic Björk-Shiley aortic valves (BSAV). Technically satisfactory records were obtained in 22 patients. The systolic displacement of the valve disc varied from 1 to 1.8 cm. (mean, 1.4 cm.). Six patients developed valve dysfunction. Two patients had complete absen...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80215-3
更新日期:1976-03-01 00:00:00
abstract:BACKGROUND:The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) study showed that cholesterol-lowering therapy prevented further events in patients with coronary heart disease and average cholesterol levels. The aim of this subgroup analysis was to assess the effects of pravastatin in women. METHOD...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,meta分析
doi:10.1067/mhj.2003.1
更新日期:2003-04-01 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::The prevention of major bleeding during percutaneous coronary intervention is one of the most widely discussed and often controversial topics within interventional cardiology. The choice of arterial access should be considered a mechanism for bleeding avoidance, and various strategies have been proposed to prevent or ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2015.04.023
更新日期:2015-07-01 00:00:00
abstract::Transient U wave inversion can be caused either by regional myocardial ischemia or by an elevation of systemic blood pressure. The characteristics of U wave inversion during chest pain attacks in 21 patients with variant angina were compared with those observed in 38 patients with hypertension without apparent ischemi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90104-h
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Patients with diabetes have an increased incidence and severity of ischemic heart disease, which leads to an increased requirement for coronary revascularization. Comparative information regarding mode of revascularization--coronary artery bypass graft surgery surgery (CABG) or percutaneous coronary interven...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.07.001
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Patients with kidney failure have a heavy burden of coronary artery disease. The results of preventive, diagnostic, and therapeutic measures developed in nonuremic populations cannot automatically be extrapolated to this unique group of patients. METHODS AND RESULTS:Articles were reviewed if they contained ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1067/mhj.2000.105300
更新日期:2000-06-01 00:00:00
abstract::Atrial fibrillation is a common disease of the elderly, conferring considerable morbidity and mortality related to cardiovascular effects and thromboembolic risks. Anticoagulation, antiarrhythmic medications, and rate control are the cornerstone of contemporary management, whereas ablation and evolving surgical techni...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2014.12.015
更新日期:2015-04-01 00:00:00
abstract::ECGs taken from four patients with concealed atrial bigeminy were analyzed to find the mechanisms of disappearance and reappearance of extrasystoles. Observations in three patients showing the classic form of concealed bigeminy suggest that when the extrasystole disappeared, the first sinus impulse after the last mani...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90828-7
更新日期:1984-05-01 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::An angioplasty catheter was developed to allow measurement of absolute coronary blood flow during interventional procedures. This method uses electrical impedance changes induced by a 0.5 ml bolus of 5% dextrose solution and indicator-dilution principles. The indicator is injected through a port located just proximal ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90184-j
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Concerns raised regarding adverse cardiovascular (CV) outcomes with new therapies for type 2 diabetes mellitus (T2DM) have led to several large-scale CV outcome trials. The EXAMINE trial confirmed noninferiority of the dipeptidyl dipeptidase 4 inhibitor alogliptin to placebo on major adverse cardiac event ra...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2016.01.011
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:There is interest in measuring and comparing outcomes of percutaneous transluminal coronary angioplasty (PTCA) other than death, but there are no accepted methods for adjusting these outcomes for preprocedure differences in populations. We sought to identify independent predictors of functional outcome after...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70142-0
更新日期:1999-09-01 00:00:00