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 again becomes laminar downstream. Of these, only the flow disturbance area has markedly turbulent flow, although some turbulence can be at times detected in the area beside the jet. The purpose of this investigation was to test a technique of patient examination that might allow a range-gated pulsed Doppler to detect each of these known areas in the aorta (Ao) of valvular AS patients. A method for mapping flow in the lumen of the Ao root and ascending Ao is detailed. The transverse Ao arch was studied in the standard manner. With this mapping method, 14 patients with AS were studied. We were able to identify the jet in 13 of 14 as a high velocity, narrow-width signal in the Ao root. The parajet area was characterized by no detectable or low flow in 12 of 14, but two patients had late systolic flow disturbance in the parajet area. All patients had a strong flow disturbance detected; 3 of 14 were first detected in the Ao root and the remainder were first detected higher in the ascending Ao. The area of relaminarization was not addressed in this study. This investigation demonstrates that a proper interpretation of range-gated pulsed Doppler recordings from areas distal to AS requires knowledge of flow dynamics beyond an obstruction and a methodical range-gated pulsed Doppler examination technique.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Goldberg SJ,Kececioglu-Draelos Z,Sahn DJ,Valdes-Cruz LM,Allen HDdoi
10.1016/0002-8703(82)90400-8subject
Has Abstractpub_date
1982-05-01 00:00:00pages
858-63issue
5eissn
0002-8703issn
1097-6744pii
0002-8703(82)90400-8journal_volume
103pub_type
杂志文章abstract:BACKGROUND:Coronary heart disease (CHD) in women is strongly associated with estrogen deprivation. For example, risk for CHD increases dramatically after menopause. However, the role of hormone replacement therapy (HRT) in CHD prevention currently is unresolved. To better understand CHD in women, the precise mechanisms...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.121262
更新日期:2002-04-01 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
abstract:BACKGROUND:Dobutamine and exercise echocardiography are accepted as tests of comparable efficacy for the diagnosis of coronary artery disease. Although dobutamine has been classified as "exercise simulating," the mechanisms of ischemia with dobutamine and exercise have not been well studied. This study sought to compar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70183-8
更新日期:1998-07-01 00:00:00
abstract::Myocardial ischemia, electrolyte changes, and fluctuations in autonomic tone may play an important role in the presentation of malignant ventricular arrhythmias. beta-Adrenoceptor blocking agents have been shown to decrease the incidence of ventricular fibrillation and sudden cardiac death in patients with coronary ar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90015-9
更新日期:1994-07-01 00:00:00
abstract::Mechanisms responsible for the well-documented "protection" against myocardial ischemia and infarction in young women and subsequent loss of protection after menopause remain speculative. One possibility is that gender-related variables (such as endogenous hormone levels or regular loss of stored iron) alter the susce...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90390-9
更新日期:1995-06-01 00:00:00
abstract:BACKGROUND:Many young investigators are interested in cardiovascular (CV) outcomes research; however, the current training experience of early investigators across the United States is uncertain. METHODS:From April to November 2014, we surveyed mentees and mentors of early-stage CV outcomes investigators across the Un...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2017.07.022
更新日期:2018-02-01 00:00:00
abstract::Current evidence suggests that the pathogenesis of atrial fibrillation (AF) is multifactorial. The observation that AF, once present, alters the electrophysiologic properties of the atrial myocardium causing self-perpetuation of the arrhythmia raised the importance of electrical remodeling in its pathogenesis. Althoug...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2008.10.009
更新日期:2009-02-01 00:00:00
abstract::The efficacy of mexiletine used alone, and in combination with a class Ia antiarrhythmic drug, was assessed in 159 previously drug-refractory patients with ventricular tachycardia (VT) during serial electrophysiologic studies and during long-term (5-year) clinical follow-up. Electrically-inducible ventricular tachycar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90482-6
更新日期:1988-02-01 00:00:00
abstract::Under electrophysiologic studies, 44 asymptomatic chagasic individuals were studied. The mean age was 39.9 years, with 26 being male. The surface ECG showed normal tracings in 12 patients, left anterior fascicular block in three, incomplete right bundle branch block in two, and right bundle branch block in 27 (isolate...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90206-5
更新日期:1983-08-01 00:00:00
abstract::To test alterations in plasma potassium and magnesium levels with maximal exercise, 15 sedentary, healthy men (mean age 29 years) participated in a double-blind crossover study for 11 weeks with propranolol, atenolol, and placebo. Maximal exercise tests were done at baseline and after placebo and beta-blockade phases....
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(91)90962-h
更新日期:1991-01-01 00:00:00
abstract::To investigate the incidence and clinical significance of postoperative pericardial effusion (PE), the presence of PE was evaluated by echocardiography, 1 and 2 weeks postoperatively, in 50 patients after insertion of a valve prosthesis and in 100 patients after coronary bypass surgery (50 patients receiving a combina...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90255-4
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:National registries are advocated as instrumental to the solution of rarity-related problems for patients with hypertrophic cardiomyopathy (HCM), including limited access to advanced treatment options. Thus, an Italian Registry for HCM was created to assess the clinical profile and the level of care nationwi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.01.005
更新日期:2005-11-01 00:00:00
abstract::The aim of this prospective study was to compare the short-term reproducibility of the signal-averaged ECG (SAECG) with three analysis techniques, conventional time-domain analysis, spectral-temporal mapping (STM), and spectral-turbulence analysis (STA), in a large series of normal subjects and patients with acute myo...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90202-3
更新日期:1995-11-01 00:00:00
abstract::We evaluated the use of simple balloon overinflation to induce neointimal hyperplasia in a porcine model of coronary artery restenosis. By using standard percutaneous transluminal coronary angioplasty techniques, left anterior descending (LAD) and/or left circumflex (LCX) coronary arteries of either juvenile feeder pi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90505-3
更新日期:1994-01-01 00:00:00
abstract::In this study we have performed human leukocyte antigen (HLA)-A and B typing on nine patients with hypertrophic cardiomyopathy (HCM) and their relatives. Four patients had relatives who also had the disease. HLA typing of the familial form of HCM revealed a very close association of a given HLA-A,B haplotype with the ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90401-5
更新日期:1983-06-01 00:00:00
abstract:BACKGROUND:Although more than one million patients in the United States have permanent pacemakers, little is known about their cause of death. We evaluated the cause of death in 404 patients who died in the Mode Selection Trial (MOST). METHODS:In MOST, patients received a dual-chamber pacemaker randomly programmed to ...
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(03)00429-0
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:Peak creatine kinase (CK)-MB concentration is related to reperfusion success and clinical outcomes after fibrinolytic therapy for acute myocardial infarction. However, prognostic implications of CK-MB measurements after primary percutaneous coronary intervention (PCI), which provides more predictable and con...
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.2014.06.008
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:The diameter pulse waveforms (DPWs) are known to reflect the pressure waveforms at the target vessel. Our purpose was to clarify the usefulness of DPWs recorded noninvasively from the fetal inferior vena cava (IVC) for detecting cardiac function. METHODS:A paired ultrasonic phase-locked echo tracking system...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.06.015
更新日期:2007-10-01 00:00:00
abstract::To determine whether cholinergic mechanisms contribute to blood pressure responses during arterial baroreflex inhibition and stimulation, we assessed the effects of atropine on pressor and depressor responses during and after release of the Valsalva maneuver, upon administration of intravenous phenylephrine and nitrog...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90837-8
更新日期:1984-05-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.08.021
更新日期:2011-11-01 00:00:00
abstract:AIMS:In adults with coarctation of the aorta (CoA), hypertension (HTN) is a common long-term complication. We investigated the prevalence of HTN and analyzed factors associated with HTN. METHODS AND RESULTS:In the national register for congenital heart disease, 653 adults with repaired CoA were identified (mean age 36...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.07.012
更新日期:2016-11-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90533-9
更新日期:1988-01-01 00:00:00
abstract::We studied the effect of propranolol administration on risk assessment based on submaximal exercise testing performed early after myocardial infarction. A total of 70 patients with recent infarction underwent modified Bruce treadmill testing with simultaneous measurement of expired gases in the absence of antianginal ...
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(91)90009-7
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND:Previous studies reported an impairment of nervous autonomic activity in patients with Duchenne muscular dystrophy (DMD). However, the relationship of the autonomic dysfunction to the impairment of cardiac mechanical function and of respiratory failure is not completely understood. METHODS:We evaluated card...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.114804
更新日期:2001-05-01 00:00:00
abstract::The effects of handgrip and supine bicycle exercise on hemodynamics and left ventricular (LV) performance were compared in 25 patients with moderate to severe aortic regurgitation (AR) and normal LV ejection fraction at rest (greater than or equal to 50%) and in 10 control subjects. In both groups, heart rate, systoli...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90355-2
更新日期:1985-06-01 00:00:00
abstract::Coronary angiography of both right and left coronary arteries, using the Sones technique, was performed during the attack of total spastic obstruction in 11 patients with clinically documented history of variant angina. None of the patients had more than 70% stenosis of organic atherosclerosis in any coronary artery a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90635-0
更新日期:1985-04-01 00:00:00
abstract::Quinidine serum levels and pharmacokinetic data were assessed during steady state therapy with oral quinidine sulfate in 19 hospitalized patients who were being treated for ventricular arrhythmias. A new high performance liquid chromatography assay was employed. Four patients were studied both after the first dose of ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90467-8
更新日期:1979-12-01 00:00:00
abstract::The purpose of this study was to assess the recovery of the left ventricular pressure (PLV), and the incidence and type of arrhythmias after effective low-dose defibrillation (Imax = 18-70 A) in healthy hearts and in hearts with acute myocardial infarction (AMI) in the intact dog. In fifteen dogs 84 episodes of fibril...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90195-3
更新日期:1983-08-01 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::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