Abstract:
:The cause and associated pathophysiology of precordial ST-segment depression (ST decreases) during acute inferior myocardial infarction (IMI) are controversial. To investigate this problem, electrocardiographic findings in 48 consecutive patients with acute IMI were prospectively compared with results of coronary angiography, submaximal exercise thallium-201 (201TI) scintigraphy and multigated blood pool imaging, all obtained 2 weeks after IMI, and with clinical follow-up at 3 months. Patients were classified according to the admission ECG obtained 3.3 +/- 3.1 hours after the onset of chest pain. Twenty-one patients (group A) had no or less than 1.0 mm ST decreases, and 27 (group B) had greater than or equal to 1.0 mm ST decreases in two or more precordial (V1-6) leads. Patients in group B had more prolonged chest pain after admission to the coronary care unit than those in group A (2.8 +/- 3.0 vs 1.2 +/- 1.1 hours, p less than 0.03), greater summed ST-segment elevation in leads II, III, aVF (6.7 +/- 4.7 vs 3.3 +/- 4.5 mm, p less than 0.02), higher plasma peak creatine kinase levels (1133 +/- 781 vs 653 +/- 482 IU/l, p less than 0.01), a higher prevalence of "true posterior" infarction by ECG criteria (26% vs 5%, p less than 0.05), a lower radionuclide ejection fraction (46 +/- 9% vs 54 +/- 6%, p less than 0.001), more extensive infarct-related asynergy (p less than 0.001) and 201TI perfusion abnormalities (p less than 0.01), more complications during hospitalization (p less than 0.03), and more cardiac events at 3 months (p less than 0.02). There were no significant differences between group A and group B in the extent of underlying coronary disease, prevalence of left anterior descending coronary artery disease, exercise-induced ST decreases or angina, and 201TI defects or wall motion abnormalities in anterior or septal segments. Thus, patients with acute IMI who have associated precordial ST decreases have greater global and regional left ventricular dysfunction due to more extensive inferior or inferoposterior wall infarction, rather than concomitant anteroseptal ischemic injury.
journal_name
Circulationjournal_title
Circulationauthors
Gibson RS,Crampton RS,Watson DD,Taylor GJ,Carabello BA,Holt ND,Beller GAdoi
10.1161/01.cir.66.4.732subject
Has Abstractpub_date
1982-10-01 00:00:00pages
732-41issue
4eissn
0009-7322issn
1524-4539journal_volume
66pub_type
杂志文章相关文献
CIRCULATION文献大全abstract:BACKGROUND:Although clockwise rotation and counterclockwise rotation are distinct findings of the ECG, their prognostic significance is rarely studied. METHODS AND RESULTS:We studied prognostic values of clockwise and counterclockwise rotation on total, cardiovascular disease (CVD), and subtype mortality using the Nat...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.111.070045
更新日期:2012-03-13 00:00:00
abstract:BACKGROUND:Right ventricular function may be an important determinant of exercise capacity, peak oxygen consumption (VO2), and the ventilatory response to carbon dioxide production (VE/VCO2 relation) in patients with chronic heart failure (CHF). METHODS AND RESULTS:We studied the role of right ventricular function in ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.89.5.2062
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:The evolution of cell phenotypes and matrix architecture in cardiac valves during fetal maturation and postnatal adaptation through senescence remains unexplored. METHODS AND RESULTS:We hypothesized that valvular interstitial (VIC) and endothelial cell (VEC) phenotypes, critical for maintaining valve functi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.591768
更新日期:2006-03-14 00:00:00
abstract:BACKGROUND:Previous studies have demonstrated that synchronized coronary venous retroperfusion (SRP) can restore blood flow to the ischemic myocardium, resulting in infarct size reduction and improvement of the left ventricular function. Despite the nutritive blood flow achieved by SRP being relatively limited, SRP has...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.88.5.2370
更新日期:1993-11-01 00:00:00
abstract::Serial sections of the conduction system (CS) were performed in two patients with recurrent tachyarrhythmias. Case 1, a 34-year-old female who had dual atrioventricular (AV) nodal pathways with recurrent paroxysmal supraventricular tachycardia, committed suicide. Autopsy revealed an abnormally formed atrial septum wit...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.59.3.593
更新日期:1979-03-01 00:00:00
abstract:BACKGROUND:Whether and to what extent complement is activated in acute myocardial infarction (AMI) and how it contributes to inflammation of the ischemic area are not yet clear. Fibrinolytic agents used for thrombolysis are known to activate complement in vitro and may contribute to its activation in vivo. The aim of t...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.89.1.76
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Chlamydia pneumoniae (Cp) has been demonstrated in arteries and abdominal aortic aneurysms (AAAs). However, the validity of the methods used is questioned, and antibiotic treatment trials have thus far shown disappointing results. Nevertheless, antibodies against the Cp outer membrane proteins (OMPs) have be...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000127772.58427.7E
更新日期:2004-05-04 00:00:00
abstract:BACKGROUND:Percutaneous transluminal coronary angioplasty of the infarct-related artery in stable survivors of acute myocardial infarction is often performed, even in patients without any symptoms or residual ischemia. Despite the lack of randomized studies, it is widely believed that this intervention will improve the...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1161/01.CIR.0000087605.09362.0E
更新日期:2003-09-16 00:00:00
abstract::One hundred eighteen consecutive patients undergoing valve replacement for aortic stenosis were analyzed to determine the incidence of and predisposing factors to postoperative atrial tachyarrhythmias. Univariate and multivariate analyses were performed on 70 clinical, hemodynamic, radiographic, electrocardiographic, ...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract:BACKGROUND:Chagas heart disease is a frequent cause of morbidity and mortality in Latin America. Echocardiography provides useful diagnostic and prognostic information and is an important tool in the management of patients with Chagas disease. METHODS AND RESULTS:A search for relevant publications was obtained from ME...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/CIRCULATIONAHA.106.627323
更新日期:2007-03-06 00:00:00
abstract:BACKGROUND:A role for myeloperoxidase (MPO) as a mediator of coronary artery disease and acute coronary syndromes has recently received considerable attention. Although active MPO and hypochlorite-modified proteins and peptides have been detected in human atherosclerotic lesions, detection of novel chlorinated oxidized...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000104564.01539.6A
更新日期:2003-12-23 00:00:00
abstract:BACKGROUND:The clinical profiles and outcomes of patients treated surgically for acute type B aortic dissection (ABAD) are often reported for those in small series or for those cared for at a single institution over a long time period, during which a continuous evolution in techniques has occurred. Accordingly, we soug...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.000620
更新日期:2006-07-04 00:00:00
abstract::Survival rates were determined for a group of 598 patients in whom severe coronary disease was demonstrated by arteriography; initially they were treated medically and were followed-up for 15 years. Deaths due to noncoronary causes were uncommon (5% of total) in the first 5 year period but were frequent (36%) in the t...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.68.5.986
更新日期:1983-11-01 00:00:00
abstract:BACKGROUND:We studied in coronary conductance and resistance arteries the coronary vasodilator effects of the angiotensin-converting enzyme inhibitor ramiprilat and the contribution of nitric oxide, bradykinin, and prostaglandins to this vasodilation. METHODS AND RESEARCH:In seven anesthetized dogs, a Doppler guidewir...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.93.9.1734
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Data from single-center studies suggest that echocardiographic parameters of mechanical dyssynchrony may improve patient selection for cardiac resynchronization therapy (CRT). In a prospective, multicenter setting, the Predictors of Response to CRT (PROSPECT) study tested the performance of these parameters ...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.107.743120
更新日期:2008-05-20 00:00:00
abstract:BACKGROUND:As part of the Worcester Heart Attack Study, a community-wide study examining changes over time in the incidence and long-term case-fatality rates of greater Worcester, Mass, residents hospitalized with confirmed acute myocardial infarction (AMI), we investigated the hypothesis that census tract-level socioe...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.104.496174
更新日期:2005-06-14 00:00:00
abstract::The effect of diabetes on survival after coronary bypass surgery is uncertain. Also, although the overall clinical benefits of internal mammary artery (IMA) grafting are well established, the survival benefit attributable to IMA grafting in diabetics is not well characterized. To determine the influence of diabetes an...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
abstract::In 15 of 126 (12%) patients with truncus arteriosus who were catheterized at the Mayo Clinic from 1967 through 1975, natural agenesis of one pulmonary artery was present. Ten truncus patients with either natural or acquired absence of one pulmonary artery have undergone definitive operation. The criteria for operabili...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.55.4.641
更新日期:1977-04-01 00:00:00
abstract:BACKGROUND:Drugs with negative inotropic effect are widely used to decrease obstruction in hypertrophic cardiomyopathy (HCM). However, the mechanism of therapeutic benefit has not been studied. METHODS AND RESULTS:We used M-mode, two-dimensional, and pulsed Doppler echocardiography to study 11 patients with obstructiv...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.97.1.41
更新日期:1998-01-06 00:00:00
abstract::Vigorous hyperventilation was induced for five minutes immediately after a five-minute infusion of 100 ml of Tris-buffer (pH 10) in nine patients with Prinzmetal's variant angina. In eight of the patients, chest pain with ischemic changes in the electrocardiogram occurred during this procedure or within five minutes a...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.58.1.56
更新日期:1978-07-01 00:00:00
abstract:BACKGROUND:This study examines the cellular basis for the phenotypic appearance of broad-based T waves, increased transmural dispersion of repolarization (TDR), and torsade de pointes (TdP) induced by beta-adrenergic agonists under conditions mimicking the LQT1 form of the congenital long-QT syndrome. METHODS AND RESU...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.98.21.2314
更新日期:1998-11-24 00:00:00
abstract:BACKGROUND:Ventricular tachyarrhythmias are the major clinical manifestation of arrhythmogenic right ventricular disease. Although antiarrhythmic therapy has been widely advocated, there is only limited information available on the efficacy of antiarrhythmic drugs in these patients. METHODS AND RESULTS:The short- and ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.86.1.29
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:Adenosine has several potentially cardioprotective effects. We hypothesized that the effects of endogenous adenosine vary with degree of ischemia and that elevating endogenous levels is protective. METHODS AND RESULTS:Isolated blood-perfused piglet hearts underwent 120 minutes of low-flow ischemia (10% flow...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.9.3094
更新日期:1997-11-04 00:00:00
abstract:BACKGROUND:Various myocardial cell surface and intracellular antigens have been associated with autoimmune myocarditis. Since sarcoplasmic calcium overload is a recognized pathobiochemical finding in cardiomyopathy, we reasoned that there might be a causal relation between inhibition of sarcoplasmic calcium exclusion a...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.89.3.1217
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:Randomized trials that studied clinical outcomes after percutaneous coronary intervention (PCI) with bare metal stenting versus coronary artery bypass grafting (CABG) are underpowered to properly assess safety end points like death, stroke, and myocardial infarction. Pooling data from randomized controlled t...
journal_title:Circulation
pub_type: 杂志文章,meta分析
doi:10.1161/CIRCULATIONAHA.107.752147
更新日期:2008-09-09 00:00:00
abstract::Endocardial catheter mapping was performed in 15 patients in sinus rhythm who had no evidence of structural heart disease and normal left ventricles. Mapping was performed with the use of 10 mm interelectrode distance from various left ventricular endocardial sites. In 10 patients a quantitative analysis of electrogra...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.70.1.37
更新日期:1984-07-01 00:00:00
abstract:BACKGROUND:Uncoupling protein 2 (UCP2) regulates the production of reactive oxygen species in macrophages. However, its role in atherosclerosis is unknown. METHODS AND RESULTS:Irradiated low-density lipoprotein receptor deficient mice (LDLR-/-) were transplanted with bone marrow from either UCP2 deficient mice (Ucp2-/...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000051722.66074.60
更新日期:2003-01-28 00:00:00
abstract:BACKGROUND:The left ventricular (LV) dilatation of isolated mitral regurgitation (MR) is associated with an increase in chymase and a decrease in interstitial collagen and extracellular matrix. In addition to profibrotic effects, chymase has significant antifibrotic actions because it activates matrix metalloproteinase...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.109.921619
更新日期:2010-10-12 00:00:00
abstract:BACKGROUND:Inflammation and matrix degradation may play a pathogenic role in chronic heart failure (CHF), and therefore, we examined whether thalidomide, a drug with potential immunomodulating and matrix-stabilizing properties, could improve left ventricular (LV) function in patients with CHF secondary to idiopathic di...
journal_title:Circulation
pub_type: 杂志文章,随机对照试验
doi:10.1161/CIRCULATIONAHA.105.564971
更新日期:2005-11-29 00:00:00
abstract:BACKGROUND:Coronary calcification detected by electron beam tomography may improve cardiovascular risk prediction. The technique is particularly promising in the elderly because the predictive power of cardiovascular risk factors weakens with age. We investigated the prognostic value of coronary calcification for cardi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.104.488916
更新日期:2005-07-26 00:00:00