Abstract:
:Since many patients with chest pain cannot exercise adequately, an alternative stress would be useful to evaluate coronary reserve. We studied the physiologic responses to epinephrine to assess its potential. We report on 39 patients with chest pain. Doses from 0.03 to 0.30 micrograms/kg/min were administered intravenously. Heart rate increased from 72 +/- 10 to 86 +/- 12 bpm (mean +/- SD), systolic blood pressure (BP) from 122 +/- 20 to 158 +/- 18 mm Hg (increased afterload), and rate-pressure product/100 from 88 +/- 21 to 133 +/- 18. Rate-corrected pre-ejection period decreased from 141 +/- 23 to 92 +/- 14 msec and LVET/PEP ratio from 0.41 +/- 0.1 to 0.24 +/- 0.05 (increased contractility). Increased afterload and contractility increased myocardial oxygen demand. Simultaneously diastolic time and BP decreased, reducing myocardial blood supply. The endocardial viability ratio fell from 1.27 +/- 0.3 to 0.80 +/- 0.2. These data suggest that epinephrine infusion would be a useful stress test for coronary disease and are supported by a sensitivity of 87% and specificity of 100% in 23 patients with known coronary anatomy.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Schechter E,Wilson MF,Kong YSdoi
10.1016/0002-8703(83)90477-5subject
Has Abstractpub_date
1983-04-01 00:00:00pages
554-60issue
4eissn
0002-8703issn
1097-6744pii
0002-8703(83)90477-5journal_volume
105pub_type
杂志文章abstract::Fifteen patients who arrived between 6 and 24 hours after the onset of acute myocardial infarction and who were found to have totally occluded coronary arteries, received aspirin, heparin, and tissue plasminogen activator given over 3 hours. Eight patients were randomly assigned to receive intravenous prostaglandin E1...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(94)90539-8
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVE:To analyze the effect of delay times on racial differences in thrombolysis for acute myocardial infarction. BACKGROUND:Lower rates of thrombolytic therapy in blacks with acute myocardial infarction have recently been reported, but the reasons for this disparity are unknown. We hypothesized that lower rates o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.109644
更新日期:2000-10-01 00:00:00
abstract::Recent developments have provided a unique opportunity for the organization of regional ST-elevation myocardial infarction (STEMI) receiving center (SRC) networks. Because cumulative evidence has demonstrated that rapid primary percutaneous coronary intervention (PCI) is the most effective reperfusion strategy for acu...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2006.06.001
更新日期:2006-10-01 00:00:00
abstract::The efficacy and safety of sotalol therapy for ventricular arrhythmias was evaluated in 133 patients with drug-refractory ventricular arrhythmias. All patients had baseline electrophysiologic studies before and after oral sotalol therapy. Sixty-six patients were discharged home, treated with sotalol (52 patients witho...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90008-3
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:The aim of this study was to assess one-year outcomes of invasive and non-invasive strategies in ST-elevation myocardial infarction (STEMI) among multimorbid older people with complex health needs. METHODS:We included patients, registered between 2006 and 2013 in the SWEDEHEART registry, who were 70 years o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2019.01.008
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Although the management of thoracic aortic aneurysms (TAAs) has improved significantly, patients presenting with aortic dissections, rupture, or other acute complications of TAAs continue to have high rates of morbidity and mortality. Accumulating data have indicated that many TAAs are due to underlying gene...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.10.005
更新日期:2009-02-01 00:00:00
abstract::A case with total intra-His bundle block and intermittent pre-excitation syndrome is presented. During A-V conduction there was a P-delta interval of 130 msec. with a P-A interval of 20 msec., an A-H interval of 60 msec. and an H-V interval of 50 msec. During rapid atrial pacing the P-delta interval increased primaril...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80350-5
更新日期:1977-07-01 00:00:00
abstract::A substantial proportion of patients with dilated cardiomyopathy have circulating autoantibodies directed against the cardiac beta-adrenoceptor. These antireceptor antibodies inhibit both ligand binding to membrane beta-receptors and isoproterenol-sensitive adenylate cyclase. The functional consequences of antibody-re...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90766-b
更新日期:1991-07-01 00:00:00
abstract::Although many patients with coronary artery disease (CAD) have a positive exercise test without pain, the frequency and significance of this "silent" ischemia is unclear. Therefore, we studied 122 consecutive clinically stable patients with angiographically defined CAD (greater than 75 per cent luminal stenosis) and a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90234-x
更新日期:1978-04-01 00:00:00
abstract:BACKGROUND:Single center studies using serial cerebral diffusion-weighted magnetic resonance imaging in patients having cardiac catheterization have suggested that cerebral microembolism might be responsible for silent cerebral infarct (SCI) as high as 15% to 22%. We evaluated in a multicenter trial the incidence of SC...
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.2012.04.005
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Limited information is available on the health behavior profile of patients with premature acute coronary syndrome (ACS). The purpose of this study is to desribe the health bahvior of young patients with ACS at the baseline and 1 year post-ACS and examine sex differences. METHODS:GENESIS-PRAXY is a prospect...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2015.04.016
更新日期:2015-08-01 00:00:00
abstract::The effects and possible mechanisms of actions of indomethacin on systemic and coronary hemodynamics were studied in 17 patients with coronary artery disease. Group I patients (12) were given either indomethacin or placebo in the absence of prior cyclooxygenase inhibition and group II (five) were given indomethacin af...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(85)90149-8
更新日期:1985-08-01 00:00:00
abstract::The rate and form of creatine kinase-MB (CK-MB) enzyme release following reflow to ischemic myocardium has not been specifically examined in man. In this investigation, we examined the combined CK-MB time-activity curves during acute transmural myocardial infarction (AMI) in a group of patients receiving conventional ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90084-4
更新日期:1983-10-01 00:00:00
abstract::The present study refers to six patients in whom an A-V reciprocal rhythm could be documented; in four cases it took the form of sustained tachycardia. None of the patients showed any ECG feature of ventricular pre-excitation (PR interval of more than 0.12 sec. and normal QRS configuration). The extrastimulus method s...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80427-9
更新日期:1976-01-01 00:00:00
abstract::Atherosclerosis and its vascular sequela are responsible for considerable morbidity and mortality rates. Several risk factors have been implicated in the pathogenesis of atherosclerosis, and the search for other risk factors continues on the medical horizon. Renin-angiotensin system (RAS), a multienzyme, multilocale a...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(97)70089-9
更新日期:1997-09-01 00:00:00
abstract::Head-up tilt provokes vasodepressor syncope in patients with this disorder but may also cause fainting in unaffected subjects. The aims of this study were to examine autonomic function and sequential changes in heart rate variability and plasma catecholamines during graded head-up tilt in patients with vasodepressor s...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70213-8
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:Assessing risk and weighing the potential benefits from evidence-based therapies are essential in the clinical decision making process of optimizing care and outcomes for patients presenting with acute coronary syndromes (ACS). Such practices are advocated in international clinical guidelines of ACS care. Wh...
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.2015.07.032
更新日期:2015-11-01 00:00:00
abstract::A new radiopaque, highly flexible balloon-expandable tantalum stent was tested. Thirty-six of 40 stents were successfully deployed percutaneously in the coronary arteries of 31 dogs. The dogs were given aspirin before, intravenous heparin during, and aspirin alone after the procedure. One dog died at 24 hours because ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90992-5
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:The long-term prognostic significance of elevated cardiac markers in an undifferentiated patient population with chest pain is unknown. METHODS:Serum troponin I (cTnI), creatine kinase-MB (CK-MB), and myoglobin were measured at presentation in 951 consecutive patients evaluated in the emergency department f...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.06.020
更新日期:2008-11-01 00:00:00
abstract::Six hundred fifty seven patients with angina pectoris underwent coronary angiography after measurement of plasma fibrinogen levels. Coronary artery disease (CAD) was angiographically confirmed in 75% of the patients. Other cardiac disease, either alone or in combination with CAD, was diagnosed in 8% and 11% of cases, ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90747-w
更新日期:1993-06-01 00:00:00
abstract::One hundred two patients with evolving myocardial infarction of 6 hours' duration were given aspirin and intravenous heparin and randomly allocated to intravenous front-loaded, weight-adjusted rTPA administration over a 90-minute period (52 patients) or to two 15 mg doses of recombinant staphylokinase, 30 minutes apar...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0002-8703(97)70127-3
更新日期:1997-08-01 00:00:00
abstract::Patients with impaired glucose tolerance (IGT) have increased risk for developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Lifestyle modification and medication can prevent or delay progression to diabetes (PD), but whether such interventions also reduce the risk of CVD has not been rigorously...
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.2008.05.017
更新日期:2008-10-01 00:00:00
abstract::Intracoronary streptokinase (SK) was administered to 11 patients with evolving acute transmural myocardial infarction 5.5 +/- 0.4 hours from the onset of symptoms. Ten patients (91%) had total coronary occlusion, and one had subocclusion of the vessel corresponding to the ECG site of infarction. Intracoronary nitrogly...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90646-3
更新日期:1981-12-01 00:00:00
abstract::We devised a nine-lead Holter monitor system with a lead-switching technique to record electrocardiograms from multiple sites in the anterior and the posterior or lateral chest. Leads CM1 to CM6, high lateral (HL), low lateral (LL), and low posterior chest (LB) were used. The sensitivity, specificity, and predictive a...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(94)90595-9
更新日期:1994-11-01 00:00:00
abstract:BACKGROUND:Although controversial, reducing low-density lipoprotein cholesterol (LDL-C) to target levels remains a common therapeutic goal after acute myocardial infarction (AMI). We sought to illuminate patient and provider characteristics associated with LDL-C goal nonattainment after AMI. METHODS:In an observationa...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2012.10.005
更新日期:2013-01-01 00:00:00
abstract::To investigate the influence of intrinsic limb vasodilator capacity on exercise performance, limb reactive hyperemic flows and their relations to exercise capacity during upright bicycle exercise were examined in 52 patients with recent myocardial infarction. Reactive hyperemic flow was measured in the forearm and the...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90243-4
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:CSL112 (apolipoprotein A-I [human]) is a plasma-derived apolipoprotein A-I developed for early reduction of cardiovascular risk following an acute myocardial infarction (AMI). The safety of CSL112 among AMI subjects with moderate, stage 3 chronic kidney disease (CKD) is unknown. METHODS:CSL112_2001, a multi...
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.2018.11.008
更新日期:2019-02-01 00:00:00
abstract::This study correlates the anatomic pathologic coronary anatomy found by arteriography in each of three groups of symptomatic patients, all with coronary artery disease, divided according to the magnitude of ST-segment depression after an adequate submaximal treadmill exercise test. Group I consists of 45 patients with...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90080-0
更新日期:1975-03-01 00:00:00
abstract::The 2,000 heart donors available annually continue to be inadequate for the 50,000 patients with end-stage congestive heart failure who require heart transplantation to survive. This discrepancy has led to the successful use of long-term implantable LVADs as a bridge to transplantation and has raised the issue of perm...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90056-x
更新日期:1995-01-01 00:00:00
abstract::To determine the factors relating to prognosis, the records of 15 neonates with persistent prolongation of the QT interval on the electrocardiogram after the fourth day of life were reviewed. Patients were admitted for symptoms (syncope, cardiac failure, or seizures), abnormal auscultation with an irregular heart rate...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90940-w
更新日期:1992-07-01 00:00:00