Abstract:
OBJECTIVES:We investigated whether the reverse remodeling after cardiac resynchronization therapy (CRT) might reduce the occurrence of ventricular arrhythmias (VAs). BACKGROUND:It is currently debated whether CRT has an effect on the burden of VAs. METHODS:The study included 398 patients treated with a CRT defibrillator and with a follow-up of at least 12 months. Spontaneous VAs detected by the device were reviewed and validated. RESULTS:A significant reduction in VA episodes and shock therapies was evident during the follow-up with greater decrease after 1 month. After 6 months of CRT, 227 patients (57%) showed a reduction in end-systolic volume of >or=10% and were defined as "responders." The baseline characteristics were similar between the responders and the nonresponders. Nonetheless, the proportion of patients with recurrence of VA after 1 month of CRT was significantly lower in responders (32% vs. 43%, p = 0.024). Among baseline variables no parameters emerged as predictors of tachyarrhythmia recurrence. However, receiver-operating curve analysis recognized a reduction of left ventricular end-systolic volume at 6 months of 13% as the best cutoff to identify the reduction of VAs (with a sensitivity of 58% and a specificity of 54%). CONCLUSIONS:In patients treated with CRT defibrillators, a reduction in ventricular arrhythmic events occurs during the initial 12 months after implant and is correlated with the degree of ventricular remodeling induced by the therapy. Patients demonstrating reverse remodeling at midterm follow-up show a reduction in arrhythmias soon after the implant, pronounced improvements at long-term, and a better survival.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Di Biase L,Gasparini M,Lunati M,Santini M,Landolina M,Boriani G,Curnis A,Bocchiardo M,Vincenti A,Denaro A,Valsecchi S,Natale A,Padeletti L,InSync\/InSync ICD Italian Registry Investigators.doi
10.1016/j.jacc.2008.07.043subject
Has Abstractpub_date
2008-10-28 00:00:00pages
1442-9issue
18eissn
0735-1097issn
1558-3597pii
S0735-1097(08)02721-6journal_volume
52pub_type
杂志文章abstract:OBJECTIVES:To elucidate signal transduction pathways regulating expression of myocardial gap junction channel proteins (connexins) and to determine whether mediators of cardiac hypertrophy might promote remodeling of gap junctions, we characterized the effects of angiotensin II on expression of the major cardiac gap ju...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(98)00317-9
更新日期:1998-09-01 00:00:00
abstract::Drug-induced long QT syndrome (diLQTS) and congenital LQTS (cLQTS) share many features, and both syndromes can result in life-threatening torsades de pointes (TdP). Our understanding of their mechanistic and genetic similarities has led to their improved clinical management. However, our inability to prevent diLQTS ha...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2015.12.063
更新日期:2016-04-05 00:00:00
abstract:OBJECTIVES:This study was designed to evaluate and compare the patterns of arrhythmogenic right ventricular cardiomyopathy in young people and adults. BACKGROUND:Few data are available on this cardiomyopathy in young people because clinical and morphologic findings considered pathognomonic are normally based on observ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)00433-Q
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVES:The present study was designed to establish possible predictors of unfavorable outcome in infants with pulmonary valve stenosis. BACKGROUND:Balloon pulmonary valvuloplasty is the treatment of choice for typical pulmonary valve stenosis. Patients with dysplastic valves may be less suitable candidates for thi...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(92)90100-2
更新日期:1992-08-01 00:00:00
abstract::Twelve cardiac electrophysiology centers conducted an open label prospective trial of bethanidine sulfate, an oral bretylium analog, for the prevention of ventricular tachyarrhythmias during programmed electrical stimulation. The study group included 56 patients (44 men, 12 women; mean age 60 years; 55 with structural...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章
doi:10.1016/s0735-1097(85)80106-6
更新日期:1985-09-01 00:00:00
abstract:OBJECTIVES:We sought to determine whether the amount of myocardial ischemic burden differs in patients with painful or silent myocardial hypoperfusion during exercise testing. BACKGROUND:Whether a lack of symptoms during ischemia reflects an alteration in pain perception or less myocardium in jeopardy remains a contro...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(97)00006-5
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:Persistent severe left ventricular (LV) systolic dysfunction after myocardial infarction (MI) is associated with increased mortality and is a class I indication for implantation of a cardioverter-defibrillator. OBJECTIVES:This study developed models and assessed independent predictors of LV recovery to >35%...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jacc.2015.12.042
更新日期:2016-03-15 00:00:00
abstract:OBJECTIVES:This study was designed to evaluate dobutamine stress echocardiography in identifying reversible dysfunction and assessing the extent of irreversibly damaged myocardium early in acute myocardial infarction. BACKGROUND:Several experimental and clinical studies have suggested that dobutamine enhances contract...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)90006-x
更新日期:1994-09-01 00:00:00
abstract:OBJECTIVES:The goal of this study was to identify differences in shear-induced platelet aggregation (SIPA) between patients who did or did not experience subacute stent thrombosis (SAT). BACKGROUND:Despite dual antiplatelet therapy, SAT after coronary stenting occurs in approximately 1% of patients. There is no accept...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2004.10.079
更新日期:2005-06-07 00:00:00
abstract:OBJECTIVES:This prospective study evaluated the association of obesity and hypertension with left atrial (LA) volume over 10 years. BACKGROUND:Although left atrial enlargement (LAE) is an independent risk factor for atrial fibrillation, stroke, and death, little information is available about determinants of LA size i...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2009.07.034
更新日期:2009-11-17 00:00:00
abstract::The mechanism of electrocardiographic ST segment changes during acute coronary occlusion was evaluated in 28 consecutive patients with single vessel coronary artery disease undergoing coronary angioplasty. Patients were continuously monitored with a six lead electrocardiogram. Twenty-three patients showed ST changes i...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(85)80250-3
更新日期:1985-07-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to investigate the impact of the chordae tendineae force distribution on systolic mitral leaflet geometry and mitral valve competence in vitro. BACKGROUND:Functional mitral regurgitation is caused by changes in several elements of the valve apparatus. Interaction among these ha...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(98)00627-5
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVES:This study examined the relation between left atrial spontaneous echo contrast, hematologic variables and thrombo-embolism in patients with nonvalvular atrial fibrillation. BACKGROUND:Left atrial spontaneous echo contrast is associated with left atrial stasis and thromboembolism in patients with nonvalvular...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(93)90688-w
更新日期:1993-02-01 00:00:00
abstract::Hypertension accounts for 1 in 5 deaths among American women, posing a greater burden for women than men, and is among their most important risk factors for death and development of cardiovascular and other diseases. Hypertension affects women in all phases of life, with specific characteristics relating to risk facto...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2018.02.033
更新日期:2018-04-24 00:00:00
abstract:OBJECTIVES:The purpose of this study was to assess the value of cardiovascular magnetic resonance (CMR)-determined graft flow and flow reserve in differentiating significant from non-significant vein graft disease. BACKGROUND:In patients after coronary artery bypass grafting (CABG), non-invasive testing may be helpful...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0735-1097(02)02491-9
更新日期:2002-11-20 00:00:00
abstract:OBJECTIVES:This study was done to test the hypothesis that a forced diuresis with maintenance of intravascular volume after contrast exposure would reduce the rate of contrast-induced renal injury. BACKGROUND:We have previously shown a graded relationship with the degree of postprocedure renal failure and the probabil...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0735-1097(98)00574-9
更新日期:1999-02-01 00:00:00
abstract::The highest-risk patients with heart failure with reduced ejection fraction are those with ischemic cardiomyopathy and severe left ventricular systolic dysfunction (ejection fraction≤35%). The cornerstone of treatment is guideline-driven medical therapy for all patients and implantable device therapy for appropriately...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2014.10.070
更新日期:2015-02-17 00:00:00
abstract:OBJECTIVES:This study sought to describe the clinical correlates and heritability of the early repolarization pattern (ERP) in 2 large, population-based cohorts. BACKGROUND:There is growing recognition that ERP is associated with adverse outcomes. METHODS:Participants of the Framingham Heart Study (FHS) (N = 3,995) a...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2011.04.003
更新日期:2011-05-31 00:00:00
abstract:OBJECTIVES:We describe a new stepwise anatomically and electrogram-guided strategy for radiofrequency catheter ablation of the fast pathway. BACKGROUND:Anatomically and electrogram-guided approaches have been developed for slow pathway ablation in patients with atrioventricular (AV) node reentrant tachycardia; however...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)00509-o
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVES:The effect of dipyridamole on smooth muscle cell proliferation and prevention of intimal thickening after arterial injury was investigated. BACKGROUND:In addition to antiplatelet activity, dipyridamole also inhibits cell proliferation. We examined whether the antiproliferative action of dipyridamole on smoo...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)90752-8
更新日期:1994-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the potential of paclitaxel to prevent restenosis in vivo. BACKGROUND:Paclitaxel (Taxol) is a microtubule-stabilizing compound with potent antitumor activity. It influences the cytoskeleton equilibrium by increasing the assembly of altered microtubules, thereby inducing ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(00)00614-8
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:The combination of autologous mesenchymal stem cells (MSCs) and cardiac stem cells (CSCs) synergistically reduces scar size and improves cardiac function in ischemic cardiomyopathy. Whereas allogeneic (allo-)MSCs are immunoevasive, the capacity of CSCs to similarly elude the immune system remains controversi...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2017.09.036
更新日期:2017-11-14 00:00:00
abstract::The patient with heart disease and the physician providing cardiovascular health care have experienced dramatic change since the American College of Cardiology first published its journal 25 years ago. During the decade before 1958, cardiology and cardiovascular surgery emerged as specialties. Surgery by closed techni...
journal_title:Journal of the American College of Cardiology
pub_type: 历史文章,杂志文章
doi:10.1016/s0735-1097(83)80005-9
更新日期:1983-01-01 00:00:00
abstract:OBJECTIVES:Using both in vitro and in vivo techniques, we investigated the extent to which cardiac motion alters Doppler-measured blood flow velocity and thus potentially can alter the calculation of valve areas or pressure gradients. BACKGROUND:Blood flow velocity measured by Doppler ultrasound represents the net mot...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(93)90843-p
更新日期:1993-07-01 00:00:00
abstract:OBJECTIVES:This research was undertaken to assess the status of the coronary wall morphology late after the arterial switch operation (ASO) for transposition of the great arteries employing intravascular ultrasound (IVUS). BACKGROUND:Long-term patency of the reimplanted coronary arteries is a key issue after ASO. Foll...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2005.02.076
更新日期:2005-06-21 00:00:00
abstract:OBJECTIVES:This study sought to evaluate the time course of improvement of left ventricular (LV) dysfunction in stable patients and its implications on the accuracy of dobutamine echocardiography for predicting improvement after surgical revascularization. BACKGROUND:Little is known about the optimal timing for evalua...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(98)00067-9
更新日期:1998-04-01 00:00:00
abstract::The efficacy and safety of intravenous propafenone was studied in 10 patients with Wolff-Parkinson-White syndrome and in 2 patients with a concealed accessory pathway. During electrophysiologic study, the effect of propafenone on the effective refractory period of the accessory pathway was determined, as well as its e...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章
doi:10.1016/s0735-1097(87)80478-3
更新日期:1987-06-01 00:00:00
abstract:BACKGROUND:The risk-benefit ratio of left atrial appendage closure (LAAC) versus systemic therapy (warfarin) for prevention of stroke, systemic embolism, and cardiovascular death in nonvalvular atrial fibrillation (NVAF) requires continued evaluation. OBJECTIVES:This study sought to assess composite data regarding lef...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,meta分析
doi:10.1016/j.jacc.2015.04.025
更新日期:2015-06-23 00:00:00
abstract:OBJECTIVES:The goal of this study was to evaluate the effect of preconditioning on out-of-hospital ventricular fibrillation (VF) in patients with acute myocardial infarction (AMI). BACKGROUND:More than half of the deaths associated with AMI occur out of the hospital and within 1 h of symptom onset. In humans, preinfar...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(01)01561-3
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVES:We sought to evaluate approaches used to control rate, the effectiveness of rate control, and switches from one drug class to another in the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study. BACKGROUND:The AFFIRM study showed that atrial fibrillation (AF) can be treated effect...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.jacc.2003.11.032
更新日期:2004-04-07 00:00:00