Correlation of the width of the QRS complex with the pathologic anatomy of the cardiac conduction system in patients with chronic complete atrioventricular block.

Abstract:

:A study correlating the electrocardiographic findings and the histology of the atrioventricular (AV) conduction system was carried out in 14 cases with chronic complete AV block and in 13 cases without chronic complete AV block. Patients with chronic complete AV block were divided into two groups, based on the width of the QRS complex. The QRS complexes were narrow (less than 0.12 second) in four cases (group 1) and wide (greater than or equal to 0.12 second) in 10 cases (group 2). In group 1, the main lesion was located in the penetrating portion of His bundle (Hisp) in one heart, in the branching portion of the His bundle (Hisb) in another and in the combined regions of Hisb and the left bundle branch in two. Three of the four cases in group 1 had idiopathic fibrosis of the conduction system and one had calcific nodules in the central fibrous body. In group 2, the main lesion was located in Hisb in two cases, in the combined regions of Hisb and the right bundle branch in one, in the Hisb and in the bilateral bundle branches in two, and in the bilateral bundle branches in five. All cases in group 2 were of the idiopathic type, except case 5, which had calcific aortic stenosis. In 13 cases without chronic complete AV block the AV conduction system was histologically normal, except for slight-to-moderate aging changes in the His bundle or the bundle branches. Lesions of the Hisb, which is believed to be the "distal His" electrophysiologically, may induce complete AV block with narrow or wide QRS complexes, depending upon the severity of the lesions in Hisb or adjacent bundle branches.

journal_name

Circulation

journal_title

Circulation

authors

Ohkawa S,Hackel DB,Ideker RE

doi

10.1161/01.cir.63.4.938

subject

Has Abstract

pub_date

1981-04-01 00:00:00

pages

938-47

issue

4

eissn

0009-7322

issn

1524-4539

journal_volume

63

pub_type

杂志文章
  • Female gender is an independent predictor of operative mortality after coronary artery bypass graft surgery: contemporary analysis of 31 Midwestern hospitals.

    abstract:BACKGROUND:Women have a higher operative mortality (OM) after coronary artery bypass graft (CABG) surgery than men. Suggested contributing factors have included women's increased age, advanced disease, comorbidities, and smaller body surface area (BSA). It is unclear whether women's increased risk factors fully account...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究

    doi:10.1161/CIRCULATIONAHA.104.525139

    authors: Blankstein R,Ward RP,Arnsdorf M,Jones B,Lou YB,Pine M

    更新日期:2005-08-30 00:00:00

  • Altered age-related blood pressure pattern in type 1 diabetes.

    abstract:BACKGROUND:Pulse pressure (PP) increases with age as a result of arterial stiffening and is a powerful predictor of cardiovascular disease. Type 1 diabetes is associated with excessive cardiovascular mortality and increased arterial stiffness. We examined whether the age-related blood pressure changes in type 1 diabeti...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000139903.29522.8D

    authors: Rönnback M,Fagerudd J,Forsblom C,Pettersson-Fernholm K,Reunanen A,Groop PH,Finnish Diabetic Nephropathy (FinnDiane) Study Group.

    更新日期:2004-08-31 00:00:00

  • Apoptosis induced by inhibition of cyclic AMP response element-binding protein in vascular smooth muscle cells.

    abstract:BACKGROUND:The balance between apoptosis and proliferation of vascular smooth muscle cells (VSMCs) is believed to contribute to the vascular remodeling process. Cyclic AMP response element-binding protein (CREB) is a critical transcription factor for the survival of neuronal cells and T lymphocytes. However, the role o...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000085164.13439.89

    authors: Tokunou T,Shibata R,Kai H,Ichiki T,Morisaki T,Fukuyama K,Ono H,Iino N,Masuda S,Shimokawa H,Egashira K,Imaizumi T,Takeshita A

    更新日期:2003-09-09 00:00:00

  • Bleeding increases the risk of ischemic events in patients with peripheral arterial disease.

    abstract:BACKGROUND:Patients with peripheral arterial disease are at high risk of ischemic events and therefore are treated with antithrombotics. In patients with coronary artery disease or cerebrovascular disease, bleeding is related to the subsequent occurrence of ischemic events. Our objective was to assess whether this is a...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1161/CIRCULATIONAHA.109.858365

    authors: van Hattum ES,Algra A,Lawson JA,Eikelboom BC,Moll FL,Tangelder MJ

    更新日期:2009-10-20 00:00:00

  • Tissue Doppler imaging consistently detects myocardial contraction and relaxation abnormalities, irrespective of cardiac hypertrophy, in a transgenic rabbit model of human hypertrophic cardiomyopathy.

    abstract:BACKGROUND:Hypertrophic cardiomyopathy (HCM) is diagnosed clinically by the presence of left ventricular hypertrophy (LVH). However, LVH is absent in a significant number of genotype-positive patients. Because myocyte dysfunction and disarray are the primary abnormalities in HCM, we reasoned that tissue Doppler imaging...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.102.12.1346

    authors: Nagueh SF,Kopelen HA,Lim DS,Zoghbi WA,Quiñones MA,Roberts R,Marian AJ

    更新日期:2000-09-19 00:00:00

  • Effects of continuous positive airway pressure on sleep apnea and ventricular irritability in patients with heart failure.

    abstract:BACKGROUND:Patients with heart failure and systolic dysfunction may develop disordered breathing during sleep. Repeated episodes of apnea and hypopnea may result in desaturation and arousals, which could adversely affect left ventricular function. The purpose of this study was to determine the short-term effects of con...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.101.4.392

    authors: Javaheri S

    更新日期:2000-02-01 00:00:00

  • Reliability of multicenter pediatric echocardiographic measurements of left ventricular structure and function: the prospective P(2)C(2) HIV study.

    abstract:BACKGROUND:To assess the reliability of pediatric echocardiographic measurements, we compared local measurements with those made at a central facility. METHODS AND RESULTS:The comparison was based on the first echocardiographic recording obtained on 735 children of HIV-infected mothers at 10 clinical sites focusing on...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1161/01.cir.104.3.310

    authors: Lipshultz SE,Easley KA,Orav EJ,Kaplan S,Starc TJ,Bricker JT,Lai WW,Moodie DS,Sopko G,Schluchter MD,Colan SD

    更新日期:2001-07-17 00:00:00

  • Pooling in chronic orthostatic intolerance: arterial vasoconstrictive but not venous compliance defects.

    abstract:BACKGROUND:Orthostatic intolerance is characterized by postural tachycardia syndrome (POTS) with exaggerated tachycardia, orthostatic symptoms, and "pooling" (which comprises acrocyanosis and dependent edema when upright). My colleagues and I tested the hypothesis that pooling results from increased venous compliance i...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.cir.0000016348.55378.c4

    authors: Stewart JM

    更新日期:2002-05-14 00:00:00

  • Humanized mouse model of thrombosis is predictive of the clinical efficacy of antiplatelet agents.

    abstract:BACKGROUND:In vivo testing of novel antiplatelet agents requires informative biomarkers. By genetically modifying mouse von Willebrand factor (VWF(R1326H)), we have developed a small animal model that supports human but not mouse platelet-mediated thrombosis. Here, we evaluate the use of this biological platform as a p...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.110.951970

    authors: Magallon J,Chen J,Rabbani L,Dangas G,Yang J,Bussel J,Diacovo T

    更新日期:2011-01-25 00:00:00

  • Immediate effects of hydralazine-isosorbide dinitrate combination on exercise capacity and exercise hemodynamics in patients with left ventricular failure.

    abstract::Resting hemodynamics improve during vasodilator administration in patients, with congestive heart failure (CHF), but the effects of these agents on exercise is unknown. Twenty-two patients with class II or III CHF performed bicycle exercise to symptomatic maximum before and 90 minutes after random double-blind adminis...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.cir.59.6.1085

    authors: Franciosa JA,Cohn JN

    更新日期:1979-06-01 00:00:00

  • Potentiation of isosorbide dinitrate effects with N-acetylcysteine in patients with chronic heart failure.

    abstract:BACKGROUND:Supply of sulfhydryl groups with the administration of N-acetylcysteine (NAC) has been reported to reverse tolerance to nitroglycerin but not to isosorbide dinitrate (ISDN). Lack of interaction between NAC and ISDN was suggested as an explanation for these findings. The present study was therefore designed t...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.cir.89.6.2595

    authors: Mehra A,Shotan A,Ostrzega E,Hsueh W,Vasquez-Johnson J,Elkayam U

    更新日期:1994-06-01 00:00:00

  • Oxidative stress activates endothelial innate immunity via sterol regulatory element binding protein 2 (SREBP2) transactivation of microRNA-92a.

    abstract:BACKGROUND:Oxidative stress activates endothelial innate immunity and disrupts endothelial functions, including endothelial nitric oxide synthase-derived nitric oxide bioavailability. Here, we postulated that oxidative stress induces sterol regulatory element-binding protein 2 (SREBP2) and microRNA-92a (miR-92a), which...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.114.013675

    authors: Chen Z,Wen L,Martin M,Hsu CY,Fang L,Lin FM,Lin TY,Geary MJ,Geary GG,Zhao Y,Johnson DA,Chen JW,Lin SJ,Chien S,Huang HD,Miller YI,Huang PH,Shyy JY

    更新日期:2015-03-03 00:00:00

  • Characterization of nontransmural myocardial infarction by positron-emission tomography.

    abstract::The present study was performed to determine whether positron emission tomography (PET) performed after i.v. 11C-palmitate permits detection and characterization of nontransmural myocardial infarction. PET was performed after the i.v. injection of 11C-palmitate in 10 normal subjects, 24 patients with initial nontransm...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.65.4.747

    authors: Geltman EM,Biello D,Welch MJ,Ter-Pogossian MM,Roberts R,Sobel BE

    更新日期:1982-04-01 00:00:00

  • A hemodynamically responsive antitachycardia system. Development and basis for design in humans.

    abstract::Current automatic implantable cardioverter-defibrillators detect tachyarrhythmias primarily by rate-only algorithms and cannot adequately distinguish hemodynamically stable from unstable tachyarrhythmias. The responses of right atrial (mean) and right ventricular pressures (mean, systolic, diastolic, and pulse) to 64 ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.82.2.394

    authors: Cohen TJ,Liem LB

    更新日期:1990-08-01 00:00:00

  • Results of maze surgery for lone paroxysmal atrial fibrillation.

    abstract:BACKGROUND:If drug refractoriness to paroxysmal atrial fibrillation (PAF) occurs, arrhythmia surgery that involves channelling and the exclusion of specific atrial areas can abolish atrial fibrillation. The purpose of this study was to establish the effectiveness and safety of maze III surgery to abolish PAF. METHODS ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.101.13.1559

    authors: Jessurun ER,van Hemel NM,Defauw JA,Stofmeel MA,Kelder JC,de la Rivière AB,Ernst JM

    更新日期:2000-04-04 00:00:00

  • Costs and benefits of targeted screening for causes of sudden cardiac death in children and adolescents.

    abstract:BACKGROUND:Sudden cardiac death in children is a rare but devastating event. Experts have debated the merits of community-based screening programs using an ECG and targeting 2 potential high-risk groups: school-aged children initiating stimulant medications to treat attention-deficit/hyperactivity disorder and adolesce...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.111.087940

    authors: Leslie LK,Cohen JT,Newburger JW,Alexander ME,Wong JB,Sherwin ED,Rodday AM,Parsons SK,Triedman JK

    更新日期:2012-05-29 00:00:00

  • Circulatory assistance with a permanent implantable IABP: initial human experience.

    abstract:PURPOSE:The Kantrowitz CardioVAD (KCV) is an electrically powered, pneumatically driven circulatory assist device which provides diastolic augmentation and systolic unloading to the failing heart. It consists of a 60cc-pumping chamber, a percutaneous access device (PAD), and an external controller. The pumping chamber,...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:

    authors: Jeevanandam V,Jayakar D,Anderson AS,Martin S,Piccione W Jr,Heroux AL,Wynne J,Stephenson LW,Hsu J,Freed PS,Kantrowitz A

    更新日期:2002-09-24 00:00:00

  • Cytosolic heat shock protein 60, apoptosis, and myocardial injury.

    abstract:BACKGROUND:Heat shock proteins (HSPs) are well known for their ability to "protect" the structure and function of native macromolecules, particularly as they traffic across membranes. Considering the role of key mitochondrial proteins in apoptosis and the known antiapoptotic effects of HSP27 and HSP72, we postulated th...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.0000019403.35847.23

    authors: Kirchhoff SR,Gupta S,Knowlton AA

    更新日期:2002-06-18 00:00:00

  • Pathogenesis of paradoxical hypertension after coarctation resection.

    abstract::The pathogenesis of paradoxical hypertension after resection of coarctation of the aorta was investigated by comparing the course of seven children undergoing repair of coarctation with five acyanotic children undergoing elective cardiovascular surgery. During the first 24 hours after surgery, all coarctation patients...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.54.3.382

    authors: Rocchini AP,Rosenthal A,Barger AC,Castaneda AR,Nadas AS

    更新日期:1976-09-01 00:00:00

  • Metabolic syndrome from adolescence to early adulthood: effect of infancy-onset dietary counseling of low saturated fat: the Special Turku Coronary Risk Factor Intervention Project (STRIP).

    abstract:BACKGROUND:Adolescent metabolic syndrome (MetS) predicts type 2 diabetes mellitus and subclinical atherosclerosis in adulthood. Our aim was to establish the relationship between an infancy-onset dietary intervention and risk of having MetS between 15 and 20 years of age. METHODS AND RESULTS:The Special Turku Coronary ...

    journal_title:Circulation

    pub_type: 杂志文章,随机对照试验

    doi:10.1161/CIRCULATIONAHA.114.010532

    authors: Nupponen M,Pahkala K,Juonala M,Magnussen CG,Niinikoski H,Rönnemaa T,Viikari JS,Saarinen M,Lagström H,Jula A,Simell O,Raitakari OT

    更新日期:2015-02-17 00:00:00

  • Influence of nitric oxide synthase and adrenergic inhibition on adenosine-induced myocardial hyperemia.

    abstract:BACKGROUND:Myocardial perfusion during adenosine-induced hyperemia is used both in clinical diagnosis of coronary heart disease and for scientific investigations of the myocardial microcirculation. The objective of this study was to clarify whether adenosine-induced hyperemia is dependent on endothelial NO production o...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/hc4401.098293

    authors: Buus NH,Bøttcher M,Hermansen F,Sander M,Nielsen TT,Mulvany MJ

    更新日期:2001-11-06 00:00:00

  • Outcomes of endovascular repair of ruptured descending thoracic aortic aneurysms.

    abstract:BACKGROUND:Thoracic endovascular aortic repair offers a less invasive approach for the treatment of ruptured descending thoracic aortic aneurysms (rDTAA). Due to the low incidence of this life-threatening condition, little is known about the outcomes of endovascular repair of rDTAA and the factors that affect these out...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究

    doi:10.1161/CIRCULATIONAHA.109.908871

    authors: Jonker FH,Verhagen HJ,Lin PH,Heijmen RH,Trimarchi S,Lee WA,Moll FL,Athamneh H,Muhs BE

    更新日期:2010-06-29 00:00:00

  • Genetic--epidemiologic study of early-onset ischemic heart disease.

    abstract::A genetic-epidemiologic study was undertaken of a white Colorado population of 207 patients who had a myocardial infarction before age 55 years. Nineteen independent variables were compared between the 207 cases and 621 controls, matched 3:1. The highest risk ratios were associated with a positive family history for i...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.61.3.503

    authors: Nora JJ,Lortscher RH,Spangler RD,Nora AH,Kimberling WJ

    更新日期:1980-03-01 00:00:00

  • Comparative effects of nicardipine, a new calcium antagonist, on size of myocardial infarction after coronary artery occlusion in dogs.

    abstract::To examine whether nicardipine, a dihydropyridine derivative, limits size of myocardial infarction, and to compare the protective effects of nicardipine administered before and early and late after coronary artery occlusion, 99mTc-labeled albumin microspheres were injected into the left atrium during 5 min temporary c...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.74.2.420

    authors: Endo T,Nejima J,Fujita S,Kiuchi K,Iida N,Kikuchi K,Hayakawa H,Okumura H

    更新日期:1986-08-01 00:00:00

  • Occurrence and properties of the hyperpolarization-activated current If in ventricular myocytes from normotensive and hypertensive rats during aging.

    abstract:BACKGROUND:Cellular electrophysiological alterations may contribute to arrhythmogenesis in cardiac hypertrophy. An L-like current occurs in left ventricular myocytes (LVMs) isolated from the hypertrophied heart of old spontaneously hypertensive rats (SHR). Factors that influence L occurrence during development of cardi...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.94.7.1674

    authors: Cerbai E,Barbieri M,Mugelli A

    更新日期:1996-10-01 00:00:00

  • Evolving strategies for treatment of acute aortic dissection type A.

    abstract:OBJECTIVE:To assess the outcome of 3 different surgical approaches for treatment of acute aortic dissection type A (AADA). METHODS AND RESULTS:Between October 1990 and October 2003, we operated on 295 patients (pts) for AADA. Follow-up was complete for 257 pts (87%). Supracommissural replacement (SCR) of the ascending...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000138948.14144.d6

    authors: Kallenbach K,Oelze T,Salcher R,Hagl C,Karck M,Leyh RG,Haverich A

    更新日期:2004-09-14 00:00:00

  • Inhibition of matrix metalloproteinase activity by TIMP-1 gene transfer effectively treats ischemic cardiomyopathy.

    abstract:BACKGROUND:Enhanced activity of matrix metalloproteinases (MMPs) has been associated with extracellular matrix degradation and ischemic heart failure in animal models and human patients. This study evaluated the effects of MMP inhibition by gene transfer of TIMP-1 in a rat model of ischemic cardiomyopathy. METHODS AND...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000138946.29375.49

    authors: Jayasankar V,Woo YJ,Bish LT,Pirolli TJ,Berry MF,Burdick J,Bhalla RC,Sharma RV,Gardner TJ,Sweeney HL

    更新日期:2004-09-14 00:00:00

  • Simvastatin, an HMG-coenzyme A reductase inhibitor, improves endothelial function within 1 month.

    abstract:BACKGROUND:Cholesterol-lowering therapy can improve cardiovascular morbidity and mortality in patients with atherosclerosis. Although the mechanisms responsible are unclear, these benefits precede macroscopic changes in the vasculature. Emerging evidence that improvement in endothelial function may occur requires subst...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.cir.95.5.1126

    authors: O'Driscoll G,Green D,Taylor RR

    更新日期:1997-03-04 00:00:00

  • Temporal response and localization of integrins beta1 and beta3 in the heart after myocardial infarction: regulation by cytokines.

    abstract:BACKGROUND:Integrins are involved in structural remodeling and tissue repair. This study aimed to elucidate the role of the beta-integrins in cardiac remodeling after myocardial infarction (MI). METHODS AND RESULTS:The MI model was created by ligation of the left anterior descending coronary artery in rats. We detecte...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.0000051363.86009.3c

    authors: Sun M,Opavsky MA,Stewart DJ,Rabinovitch M,Dawood F,Wen WH,Liu PP

    更新日期:2003-02-25 00:00:00

  • A key role for matrix metalloproteinases and neutral sphingomyelinase-2 in transplant vasculopathy triggered by anti-HLA antibody.

    abstract:BACKGROUND:Outcomes for organ transplantation are constantly improving because of advances in organ preservation, surgical techniques, immune clinical monitoring, and immunosuppressive treatment preventing acute transplant rejection. However, chronic rejection including transplant vasculopathy still limits long-term pa...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.111.021790

    authors: Galvani S,Trayssac M,Augé N,Thiers JC,Calise D,Krell HW,Sallusto F,Kamar N,Rostaing L,Thomsen M,Nègre-Salvayre A,Salvayre R

    更新日期:2011-12-13 00:00:00