Abstract:
:In 10 men with stable exertional angina, the changes in exercise capacity, hemodynamics, and left ventricular (LV) function were measured after 20 mg sublingual nifedipine (N) and again after adding 100 mg oral metoprolol (M). Nifedipine alone did not significantly improve exercise workloads (+18%) and duration (+21%), but the addition of metoprolol increased both parameters by a further 37 and 32%, respectively (both p less than 0.005 vs. N). After nifedipine the onset of angina was slightly delayed (5.14 +/- 2.41 min placebo (P), 6.00 +/- 2.31 min N, p less than 0.1) and occurred at higher workloads (36 +/- 17 W P, 43 +/- 8 W N, p less than 0.1). After the addition of metoprolol, the onset of angina was delayed substantially more (9.57 +/- 2.22 min, p less than 0.001 vs. P and N) and occurred at much higher workloads (62 +/- 20 W, p less than 0.001 vs. P and N). At rest (R) and during exercise (E), nifedipine decreased systemic vascular resistance (-36% R, -27% E, both p less than 0.001) and mean arterial pressure (-18% R, -21% E, both p less than 0.001), and increased heart rate (+15% R, +11% E, both p less than 0.001), Pulmonary artery wedge pressure on exercise increased less (22 +/- 7 mmHg P, 13 +/- 5 mmHg N, p less than 0.001). After adding metoprolol, the major change was a reduced heart rate (-25% vs. N at R and E, both p less than 0.001), and arterial pressure was unaltered. Pulmonary artery wedge pressure on exercise increased to 18 +/- 5 mmHg (p less than 0.05 vs. N). Exercise LV ejection fraction and volume did not change significantly after adding metoprolol despite marked improvement in angina. In this acute exercise study in patients with stable exertional angina, metoprolol added to nifedipine markedly improved exercise capacity by preventing the increase in heart rate seen with nifedipine. In our patients with relatively normal LV function at rest, the combination was safe and produced no deleterious effects on LV function.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Choong CY,Roubin GS,Shen WF,Tokuyasu Y,Harris PJ,Kelly DTdoi
10.1002/clc.4960080405subject
Has Abstractpub_date
1985-04-01 00:00:00pages
213-24issue
4eissn
0160-9289issn
1932-8737journal_volume
8pub_type
杂志文章abstract:BACKGROUND:Due to chronic inflammatory status, rheumatoid arthritis (RA) patients are exposed to changes in left ventricular (LV) geometry and function. We assessed prevalence, factors associated with, and prognostic role of concentric LV geometry and systolic dysfunction (LVSD) detected by echocardiography in a large ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22926
更新日期:2018-06-01 00:00:00
abstract::In a series of 20 coronary excimer laser angioplasties, two patients presented with a peculiar type of malignant restenosis 6 and 8 weeks after a successful laser angioplasty procedure. One patient had a successful recanalization of an occluded left anterior descending (LAD) coronary artery and the second patient had ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960130606
更新日期:1990-06-01 00:00:00
abstract::To assess the immediate and long-term effects of exercise on factors regulating blood flow, we measured plasma viscosity (eta p) and plasma renin activity (PRA) in 17 trained runners and 16 sedentary healthy subjects before and 10 min after graded treadmill exercise. Resting eta p was lower in runners primarily becaus...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960040405
更新日期:1981-07-01 00:00:00
abstract:BACKGROUND:ST-segment depression during exercise testing is frequently observed in the absence of restenosis after percutaneous transluminal coronary angioplasty (PTCA). HYPOTHESIS:With the goal of improving the prediction of restenosis after PTCA, we evaluated the usefulness of ST-segment depression plus QT dispersio...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960220608
更新日期:1999-06-01 00:00:00
abstract::Embolism of a fragment of a central venous catheter is a serious clinical complication, especially when the fragment cannot be made visible by radiological methods. We report a case where such a fragment could only be localized by transesophageal echocardiography (TEE). With combined use of x-rays and TEE, the cathete...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960110614
更新日期:1988-06-01 00:00:00
abstract::Based on the foregoing data it is not unreasonable to hypothesize that restoration of flow in the infarct-related artery at a later date might decrease mortality. If that is the case, then a strong argument can be made for coronary angiography in patients surviving acute myocardial infarction. Of course, the ideal way...
journal_title:Clinical cardiology
pub_type: 社论
doi:10.1002/clc.4960170405
更新日期:1994-04-01 00:00:00
abstract::We describe two patients in whom spontaneous angina following acute myocardial infarction (postinfarction angina caused by coronary artery spasm) and worsening angina were successfully eliminated after clinical dosage of oral diltiazem, while marked sinus node suppression developed and temporary pacing was performed. ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960071110
更新日期:1984-11-01 00:00:00
abstract:BACKGROUND:Compared with medical therapy, percutaneous coronary intervention (PCI) does not reduce mortality or myocardial infarction in patients with stable angina. Therefore, PCI should be guided by refractory anginal symptoms and not just lesion characteristics. HYPOTHESIS:We hypothesized that angiographic lesion c...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22510
更新日期:2016-04-01 00:00:00
abstract::The prognosis for patients with non-Q-wave myocardial infarction (MI) remains controversial, although a number of studies have shown a less favorable outlook after hospital discharge for patients with non-Q-wave than for those with Q-wave infarction. Numerous management strategies are available to the clinician, many ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:
更新日期:1989-07-01 00:00:00
abstract::The success of percutaneous transluminal coronary angioplasty is limited by acute occlusion and late restenosis. In 25 patients (20 men, 5 women, age range 36-81 years) coronary angioplasty was performed using a new cutting balloon into which 3-4 longitudinally orientated blades are incorporated so as to reduce the ra...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960160907
更新日期:1993-09-01 00:00:00
abstract::Lipoprotein (a) [Lp(a)] concentrations were determined in 365 patients undergoing coronary angiography for stable angina (n = 159), unstable angina (n = 99), recent myocardial infarction (n = 45), and nonischemic heart disease (cardiomyopathy or valvular disease, n = 62, non-IHD). Mean +/- SD and median Lp(a) concentr...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960180909
更新日期:1995-09-01 00:00:00
abstract::Far less attention has been paid to the prognostic effect of right-side heart disease on outcomes after transcatheter aortic valve replacement (TAVR) when compared with the left side. Therefore, we performed a systematic review and meta-analysis on the impact of tricuspid regurgitation (TR) and right ventricular (RV) ...
journal_title:Clinical cardiology
pub_type: 杂志文章,meta分析
doi:10.1002/clc.23126
更新日期:2019-01-01 00:00:00
abstract::Six patients undergoing aortic valve replacement had rare or unusual causes of isolated, pure aortic regurgitation. Two patients had congenitally bicuspid aortic valves with a false commissure (raphe) displaced to the aortic wall ("tethered bicuspid aortic valve"), two had floppy aortic valves, one had a congenital qu...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960130812
更新日期:1990-08-01 00:00:00
abstract:BACKGROUND:The effect of body fat distribution on left ventricular (LV) mass and geometry has been recently recognized. However, data regarding circulating inflammatory markers in relation to regional visceral fat deposits, which are metabolically active tissues that can impact cardiac structural remodeling, remain spa...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22242
更新日期:2014-03-01 00:00:00
abstract::Hyperkalemia was associated with complete heart block in one patient that resolved by first showing right anterior hemiblock). Then the right bundle branch block resolved, leaving the marked left axis deviation that was present before the hyperkalemic episode. Another patient with hyperkalemia had right bundle branch ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960040110
更新日期:1981-01-01 00:00:00
abstract::Cardiac anatomy and rhythm were evaluated in the fetuses of 18 pregnant women (between 20 and 42 weeks of gestation) referred because of abnormal fetal heart rate or rhythm. Utilizing a 3 MHz two-dimensional scan head with M-mode capability, M-mode recordings were obtained at paper speeds of 50 and 100 mm/s from 16 fe...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960080102
更新日期:1985-01-01 00:00:00
abstract::The pharmacologic management of the patient post myocardial infarction (MI) aims to achieve several goals. Chief among these is to prevent subsequent events, which include death, reinfarction, and rehospitalization. Secondary goals include preventing arrhythmias, minimizing left ventricular (LV) remodeling, and preven...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960281306
更新日期:2005-11-01 00:00:00
abstract::A 49-year-old female with significant (75%) left main coronary artery stenosis was initially considered to have developed early obstruction of a saphenous vein graft to the left anterior descending coronary artery, because of recurrent postoperative angina. In a second catheterization study, left ventriculography show...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960100413
更新日期:1987-04-01 00:00:00
abstract:BACKGROUND:The maximal negative dP/dt [max (-)dP/dt] and time constant (T) are useful indices for evaluating left ventricular (LV) relaxation, but they require invasive procedures. HYPOTHESIS:The purpose of this study was to obtain max (-)dP/dt and T using the continuous-wave Doppler aortic regurgitation velocity curv...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960190907
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:Advanced practice providers (APPs) can fill care gaps created by physician shortages and improve adherence/compliance with preventive ASCVD interventions. HYPOTHESIS:APPs utilizing guideline-based algorithms will more frequently escalate ASCVD risk factor therapies. METHODS:We retrospectively reviewed data...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22963
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Little is known about the relationship of body fluid status with the levels and fluctuations of B-type natriuretic peptide (BNP) over the long-term. HYPOTHESIS:If BNP is to become useful for monitoring of patients with chronic heart failure (HF), the levels should reliably reflect both decompensation and im...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960291008
更新日期:2006-10-01 00:00:00
abstract::Various types of pulmonary venous return abnormalities have been described in the literature. This report presents a case in which a 4-h-old neonate presented with cyanotic heart disease and respiratory distress. This neonate was subsequently shown to have complete absence of the pulmonary veins (CAPV), a previously u...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960110415
更新日期:1988-04-01 00:00:00
abstract:BACKGROUND AND HYPOTHESIS:The prognostic value of exercise technetium 99m sestamibi single-photon emission computed tomography (SPECT) imaging in patients with previous bypass surgery is unknown. The aim of our study was to assess the prognostic information obtained with exercise scintigraphy performed for routine foll...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960200913
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:The Reduction in ENdpoints with the Angiotensin Antagonist Losartan (RENAAL) study reported that losartan delayed the progression of renal disease in patients with type 2 diabetes and nephropathy. Diabetic or renally impaired patients are at high cardiovascular risk, a risk potentially increased in patients ...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章
doi:10.1002/clc.4960280307
更新日期:2005-03-01 00:00:00
abstract::Paradoxical interventricular septal motion with right ventricular dilatation has been considered the hallmark of right ventricular volume overload. We report a 43-year-old woman with severe pulmonary hypertension due to pulmonary veno-occlusive disease who exhibited these echocardiographic abnormalities. Right ventric...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960081111
更新日期:1985-11-01 00:00:00
abstract:BACKGROUND:The prognostic ability of cardiac troponin I (TnI) has been demonstrated in general populations and among cardiovascular disease patients, but it has not been evaluated in cancer patients. HYPOTHESIS:This study assumes to have the prognostic ability of cardiac troponin in cancer patients visiting the emerge...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23486
更新日期:2020-12-01 00:00:00
abstract::In the past, many have avoided nuts because of their high fat content. The Dietary Approaches to Stop Hypertension (DASH) diet, however, recommends regular consumption of this food along with seeds and dried beans (4-5 servings per week) as part of a diet to control hypertension. Nuts are nutrient-dense and most of th...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960221504
更新日期:1999-07-01 00:00:00
abstract::Three cases are presented where acute myocardial infarction occurred in young individuals after an episode of heavy alcohol intake. Subsequent coronary arteriograms demonstrated normal coronary arteries. Several mechanisms by which acute ethanol intoxication might precipitate myocardial infarction are discussed. To ou...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960050707
更新日期:1982-07-01 00:00:00
abstract:BACKGROUND:Until now there were no clinical studies or systematic reviews to investigate the impact of timing on efficacy and safety of intracoronary bone marrow stem cell (BMSC) transfer in patients with acute myocardial infarction (AMI). HYPOTHESIS:Timing of BMSC administration might play an important role in the th...
journal_title:Clinical cardiology
pub_type: 杂志文章,meta分析,评审
doi:10.1002/clc.20575
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Overt hypothyroidism has been found to be associated with cardiovascular disease. Moreover, subclinical hypothyroidism is a strong indicator of risk for aortic atherosclerosis and myocardial infarction. HYPOTHESIS:We hypothesized that variation of thyroid function within the normal range may influence the p...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960261205
更新日期:2003-12-01 00:00:00