Abstract:
:The acute effects of diltiazem on coronary reactive hyperemia were studied in 12 patients with flow-limiting coronary stenosis. Reactive hyperemia was elicited by injection of 8 ml contrast medium into the left coronary artery, while coronary sinus blood flow and left ventricular and aortic pressures were continuously recorded. Relative magnitude of hyperemia was estimated by the ratio of coronary flow at peak hyperemia to baseline flow (hyperemic ratio). Coronary resistance was calculated as the ratio between mean aortic pressure minus left ventricular mean diastolic pressure and coronary sinus blood flow. The 12 patients studied had flow-limiting coronary stenosis since their hyperemic ratio was significantly restrained when compared to that of seven control subjects (1.45 +/- 0.17 vs 2.02 +/- 0.24, respectively; p less than 0.001). The intravenous infusion of diltiazem (0.30 mg X kg-1) reduced heart rate, mean aortic pressure, and myocardial oxygen consumption (all p less than 0.001). After diltiazem the hyperemic ratio was blunted when compared to the basal state (1.36 +/- 0.15 vs 1.45 +/- 0.17, respectively; p less than 0.05), and hyperemia volume was reduced (-33%; p less than 0.001). The decrease in coronary resistance at peak hyperemia was also reduced from -30 +/- 8% to -25 +/- 8% (p less than 0.05). We conclude that diltiazem blunts coronary reactive hyperemia in patients with demonstrated flow-limiting coronary stenosis. This reduction of coronary flow response to a hyperemic stimulus could favorably influence blood flow distribution in patients with significant coronary stenosis.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Foult JM,Nitenberg A,Blanchet F,Zouiouèche Sdoi
10.1016/0002-8703(86)90353-4subject
Has Abstractpub_date
1986-12-01 00:00:00pages
1232-7issue
6eissn
0002-8703issn
1097-6744pii
0002-8703(86)90353-4journal_volume
112pub_type
杂志文章abstract::Traditionally, assessment of therapy has been judged by the ability of treatment to alleviate symptoms with tolerable side effects or toxicity. In recent years, it has become obvious that more subtle and patient-oriented approaches are urgently needed to evaluate progression of cardiovascular disease and to monitor th...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90963-x
更新日期:1987-07-01 00:00:00
abstract::Myocardial reperfusion is associated with increased influx of activated neutrophils and intracellular accumulation of sodium in the ischemic zone. Lidocaine is a sodium channel blocker that also inhibits several neutrophil functions. We investigated the effect of lidocaine on infarct size in rabbits undergoing 30 minu...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70226-6
更新日期:1997-03-01 00:00:00
abstract::We performed a chronologic investigation of left (LV) and right (RV) ventricular myosin ATPase activity and hemodynamics in newborn lambs. We found an elevation in myosin ATPase activity for the LV, which was achieved by 6 to 8 weeks of age and which correlated directly with increasing ventricular stroke work. Myosin ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90396-9
更新日期:1982-05-01 00:00:00
abstract::Although successful dilatation of a target lesion by means of percutaneous transluminal coronary angioplasty (PTCA) can be attained as frequently in elderly as in younger patients, elderly patients have a higher risk of complications. Furthermore, cohorts of patients older than 75 years and undergoing PTCA include mor...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90267-4
更新日期:1994-10-01 00:00:00
abstract::Forty-one patients with acute myocardial infarction and ST segment elevation were studied to determine the relationship between early changes in ST segment elevation, time to peak serum creatine kinase (CK), peak serum CK, left ventricular function, and patency of the infarct-related artery. ST segment elevation decre...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90262-0
更新日期:1986-08-01 00:00:00
abstract::High levels of endogenous plasma catecholamines in patients with severe congestive heart failure induce a down-regulation of the myocardial beta-adrenoreceptors and thus cause adrenoreceptor agonists, such as dobutamine, to be less effective in the treatment of these patients. Phosphodiesterase III inhibitors work ind...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(91)90834-5
更新日期:1991-06-01 00:00:00
abstract::Intracoronary stents may potentially alleviate some of the problems associated with coronary angioplasty. Since the anatomy and physiology of swine coronary arteries closely resemble those of humans, the response to implantation of the Glanturco-Roubin, balloon-expandable, flexible stent was studied in this model. Add...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90506-d
更新日期:1991-09-01 00:00:00
abstract::In this study, we reviewed M-mode and two-dimensional (2DE) echocardiographic observations in 13 patients with pulmonary atresia with ventricular septal defect and in six patients with truncus arteriosus in order to attempt to identify echocardiographic features distinguishing these two abnormalities in which no anato...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90528-8
更新日期:1983-02-01 00:00:00
abstract::To determine which method of surgical therapy might be optimal for patients with anomalous left coronary artery from the pulmonary artery (ALCAPA), a follow-up study was performed. Twenty-nine teenagers and adults who had ALCAPA diagnosed during life at age 13 years or older were identified mainly by literature search...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90248-5
更新日期:1979-10-01 00:00:00
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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:BACKGROUND:The Amplatzer septal occluder (ASO) allows the percutaneous closure of small to very large atrial septal defects (ASDs). The CardioSEAL/STARflex (CS/SF) can be used only for closure of small to moderate ASDs (stretch size up to 18 mm). These 2 devices are widely used in clinical practice. Therefore, a compar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.03.013
更新日期:2004-09-01 00:00:00
abstract::Pulsed Doppler echocardiographic studies of both right and left ventricular diastolic inflow patterns were performed in 10 full-term newborn infants and serially during the first month of life in 21 premature (28 to 35 weeks' gestation) infants with no clinical cardiorespiratory disease. Results of studies performed d...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90745-4
更新日期:1988-12-01 00:00:00
abstract:BACKGROUND:The American Heart Association recommends women with congenital heart defects (CHD) receive contraceptive counseling early in their reproductive years, but little is known about contraceptive method use among women with CHD. We describe recent female sterilization and reversible prescription contraceptive me...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2020.01.008
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Embolic events to the central nervous system are a major cause of morbidity and mortality in patients with infective endocarditis (IE). The appropriate role of valvular surgery in reducing such embolic events is unclear. The purpose of this study was to determine the relationship between the initiation of an...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.07.023
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Chronotropic incompetence and left ventricular (LV) dilatation have both been shown to be markers of an adverse cardiovascular prognosis. Chronotropic incompetence has been described in patients with symptomatic LV dilatation and dysfunction, but the effect of asymptomatic LV dilatation and hypertrophy on ex...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70415-1
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus is an increasingly prevalent condition among heart failure (HF) patients. The long-term morbidity and mortality among patients with and without diabetes with HF with reduced (HFrEF), borderline (HFbEF), and preserved ejection fraction (HFpEF) are not well described. METHODS:Using the Get W...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2019.01.006
更新日期:2019-05-01 00:00:00
abstract::The effects of alcohol intake on serum lipids and lipoproteins depend on the dose and mode of alcohol intake, individual susceptibility, genetic variables, and dietary factors. Therefore the changes of lipoprotein pattern are different among moderate and heavy drinkers. Moderate intake of alcohol increases the concent...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(87)90614-4
更新日期:1987-02-01 00:00:00
abstract::To investigate the significance of atrial natriuretic polypeptide (ANP) in essential hypertension, we measured plasma ANP concentrations in 43 subjects with essential hypertension uncomplicated by cardiac or renal failure, in 16 subjects with borderline hypertension, and in 17 normotensive control subjects. Plasma ANP...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90929-x
更新日期:1987-05-01 00:00:00
abstract::Right ventricular myocardial infarction has been reported to occur exclusively in association with inferior left ventricular infarction. To determine the frequency of right ventricular myocardial infarction in association with anterior left ventricular myocardial infarction, all hearts with anterior myocardial infarct...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90004-4
更新日期:1987-01-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2003.109
更新日期:2003-02-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.04.004
更新日期:2007-07-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.10.024
更新日期:2008-02-01 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::Major depression is a common comorbidity associated with ischemic heart disease (IHD). There is growing evidence that psychological stress in general and depression in particular predispose to cardiovascular disease. Persons who have mental stress during daily life are at twice the risk of myocardial ischemia, and pat...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1067/mhj.2000.109979
更新日期:2000-10-01 00:00:00
abstract::The prevalence of heart failure (HF) is high and still on the rise. In 2004, an estimated 5.2 million adults in the United States carried the diagnosis of HF with a mortality rate of >19%. The incidence of HF is higher in individuals 65 years or older. As the US population grows older, the personal and economic costs ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2009.04.007
更新日期:2009-06-01 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::Drug trials during electrophysiologic study were performed in 166 patients with sustained ventricular tachycardia (VT) or ventricular fibrillation. In the first 21 patients (group I), a maximum of two extrastimuli was used. In 145 subsequent patients (group II), drug efficacy was assessed using three extrastimuli if o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90432-x
更新日期:1982-11-01 00:00:00
abstract::This study compares the effectiveness of teaching the calculation of frontal plane QRS axis with the use of the classical versus the orderly electrocardiographic limb lead display. Eighty-three students from two environments were randomized into two groups and were taught to determine frontal plane axis with one of th...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(97)70020-6
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:Clinical trials have helped clarify the efficacy of clopidogrel for the treatment and prevention of vascular disease. Costs for its use exceeded $5.9 billion in 2005, making it the second greatest source of drug expenditure in the world. However, little is known about the appropriateness of that use. Overuse...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.11.039
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:The left atrium is afterload sensitive, responding to immediate changes in left ventricular (LV) diastolic pressure, and left atrial volumetric remodeling has been reported in conditions associated with abnormal diastolic function. We examined the relationship between left atrial volumetric remodeling and ob...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.07.017
更新日期:2005-04-01 00:00:00