Abstract:
:Recent clinical investigations have provided new insights into physiologic alterations taking place as heart failure progresses. As a result, new end points may be more relevant to monitor in patients, rather than the classical assessment of severity based on subjective evaluation of functional capacity. Structural changes of the myocardium, referred to as remodeling, have profound effects on the performance of the left ventricle and on long-term prognosis. Left ventricular ejection fraction may serve as a clinical marker for remodeling changes. Remodeling changes involve hypertrophy of the muscle mass, dilation of the left ventricle, and a change in the shape of the ventricle. Histologically, these changes are produced by myocyte lengthening, interstitial growth, and myocyte slippage. The consequences of remodeling include an abnormal bio-energetic state because of the augmented wall stress and accentuated myocardial oxygen consumption. The elevated wall stress promotes further hypertrophy. Superimposed on the remodeling changes is neurohormonal activation. Both remodeling and neurohormonal activation are directly related to mortality. An experimental canine model has been used successfully to investigate the potential impact of pharmacologic intervention on remodeling. Angiotensin-converting enzyme inhibitors and the combination of hydralazine and isosorbide dinitrate have been shown in clinical trials to reduce long-term mortality and increase ejection fraction. The effects of these drugs appear to be mediated in part by alterations in remodeling and neurohormonal activation. Thus, left ventricular ejection fraction can be used as a clinical marker for remodeling processes, and plasma norepinephrine levels can be used as a marker for neurohormonal activation.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Cohn JNdoi
10.1002/clc.4960181603subject
Has Abstractpub_date
1995-09-01 00:00:00pages
IV4-12issue
9 Suppl 4eissn
0160-9289issn
1932-8737journal_volume
18pub_type
杂志文章,评审abstract:BACKGROUND:Late potentials (LP) on signal-averaged electrocardiography (SAECG), recorded 6 to 30 days after an acute myocardial infarction (AMI), identify patients at risk for late arrhythmic events. Angiotensin-converting enzyme (ACE) inhibitors have been shown to reduce ventricular remodeling and cardiovascular morta...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章
doi:10.1002/clc.4960230206
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Following successful cavotricuspid isthmus (CTI) ablation during typical atrial flutter (AFL), anticoagulation therapy is usually withdrawn. However, potential subsequent atrial fibrillation (AF) in these patients may increase embolic risk in the long term. Embolic rates in this setting have not been clearly...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22538
更新日期:2016-06-01 00:00:00
abstract::While the prevalence of cardiovascular risk factors has decreased in the United States in recent years, cardiovascular disparities by sex and race persist. Among the factors contributing to these disparities is the physical environment in which individuals live. Neighborhood characteristics, ranging from air pollution...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.23107
更新日期:2019-01-01 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::Marijuana is the most abused recreational drug in the United States. Cannabinoids, the active ingredients of marijuana, affect multiple organ systems in the human body. The pharmacologic effects of marijuana, based on stimulation of cannabinoid receptors CB1 and CB2, which are widely distributed in the cardiovascular ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.21962
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Preventive cardiology is currently not an American Board of Medical Specialties-recognized subspecialty. However, several programs offer non-accredited fellowships throughout the country. No source currently exists listing all available programs, and finding programs requires time-intensive search strategies...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.21959
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:The objective of this study was to estimate the prevalence of prehypertension and hypertension in the rural adults of Liaoning province of China. METHODS:The study was conducted in 2004-2006, using a multistage cluster sampling method to select a representative sample. A total of 45925 adults, 35 years or o...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20073
更新日期:2007-04-01 00:00:00
abstract::Type II heparin-induced thrombocytopenia (HIT) is a potentially severe adverse effect of heparin treatment triggered by an immune response. Although most cases occur in patients receiving unfractioned heparin, HIT can also arise after low-molecular-weight heparin (LMWH). We report a case of HIT in a postoperative orth...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20546
更新日期:2010-02-01 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::In an open, multicenter extension of a short-term study, 159 patients with mild to moderate hypertension were treated with either ramipril monotherapy or a combination of ramipril and hydrochlorothiazide for up to 1 year. Patients started with either 5 mg ramipril once daily (responders in the short-term study) or a c...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1002/clc.4960160111
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Triage decisions for chest pain patients receiving usual care are based on a dynamic and comprehensive strategy performed in the physician's mind. It remains controversial whether simple, structured risk tools can surpass real, complex judgments. HYPOTHESIS:The potentially used History, Electrocardiogram, A...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23325
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:There are no studies in the literature related to the effect of beta blockers (BB) on changes in C-reactive protein (CRP) levels after percutaneous coronary intervention (PCI). HYPOTHESIS:We designed a prospective randomized study to investigate the impact of BB therapy on CRP in patients who underwent elec...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/clc.4960280509
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:In addition to the well-investigated proinflammatory cytokine expression, there is an ever increasing interest in the field of anti-inflammatory response to cardiopulmonary bypass (CPB). Evidence suggests that myocardium serves as an important source of cytokines during reperfusion and application of CPB. Th...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960290708
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Monocyte chemoattractant protein-1 (MCP-1) participates in the recruitment of mononuclear cells to the vessel wall. HYPOTHESIS:The aim of the study was to evaluate the potential association between serum concentration of MCP-1 and risk of future cardiovascular events in patients with chronic coronary heart ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960280109
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:For patients with ST elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI), rapid restoration of coronary blood flow is the primary therapeutic goal. Because of the acute nature of this clinical presentation, bleeding risks may not be adequately evaluated, limiting the us...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20295
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Atherosclerosis is widely accepted as a chronic inflammatory disease. Research paid much attention to sensitive specific serum biomarkers for vulnerable plaques. The markers not only serve as diagnostic tools for the identification of patients with acute coronary syndrome (ACS), but also help us to identify ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20254
更新日期:2008-09-01 00:00:00
abstract::Cocaine-related cardiovascular events escalated during the 1980s as cocaine became purer, cheaper, and easier to obtain. Cocaine abuse is a risk factor for myocardial ischemia and/or infarction, cardiac arrhythmias, pulmonary edema, ruptured aortic aneurysm, cerebral infarction, infective endocarditis, vascular thromb...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960140626
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND AND HYPOTHESIS:Noninvasive evaluation of left ventricular (LV) diastolic function was performed on 12 patients with atrial fibrillation (AF) using posterior aortic wall echocardiogram and a parameter for determining the optimal heart rate in patients with chronic atrial fibrillation was considered. METHODS:...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960190316
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND:Increased salt intake may induce hypertension, lead to cardiac hypertrophy, and exacerbate heart failure. When elderly patients develop heart failure, diastolic dysfunction is often observed, although the ejection fraction has decreased. Diabetes mellitus (DM) is an established risk factor for heart failure....
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20664
更新日期:2009-10-01 00:00:00
abstract::Subaortic stenosis has been described with increasing frequency as an ominous feature of atrioventricular septal defect (AVSD), especially following surgical correction of the anomaly in non-Down's syndrome patients. In order to study the surgical anatomy of the left ventricular outflow tract in this malformation, 48 ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960140611
更新日期:1991-06-01 00:00:00
abstract::Antihypertensive drug therapy can lower blood pressure and prolong life, but many hypertensive patients continue to develop further risk factors and to die prematurely of heart disease. Antihypertensive drugs can also interfere with the patient's quality of life, and many are not compatible with the concomitant medica...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960181506
更新日期:1995-06-01 00:00:00
abstract::Transient left ventricular (LV) apical ballooning and normal epicardial coronary arteries are the hallmarks of Takotsubo cardiomyopathy. The syndrome is often triggered by emotional or physiologic stress, and its pathogenesis is poorly understood. Current proposals focus on elevated cathecolamines in association with ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20065
更新日期:2007-07-01 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:Evaluation of chest pain accounts for millions of costly Emergency Department (ED) visits and hospital admissions annually. Of these, approximately 10-20% are myocardial infarctions (MI). HYPOTHESIS:Patients with chest pain whose initial electrocardiogram (ECG) is normal do not require hospital admission fo...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20141
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Exercise-based rehabilitation is an important part of treatment patients following coronary artery bypass graft (CABG) surgery. HYPOTHESIS:To evaluate effect of very short/short-term exercise training on cardiopulmonary exercise testing (CPET) parameters. METHODS:We studied 54 consecutive patients with myo...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22656
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Heart failure (HF) readmission rates have become an increasingly important quality metric since the advent of the Hospital Readmissions Reduction Program. Despite many well-intentioned efforts to reduce readmissions, clinicians continue to struggle with the problem of high HF readmission rates. HYPOTHESIS:H...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22738
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Patients with sinus node dysfunction (SND) have increased risk of atrial tachyarrhythmias, including atrial fibrillation (AF). To date, treatment patterns and outcomes of patients with SND and AF have not been well described. HYPOTHESIS:Patients with SND and AF have higher risk of adverse cardiovascular out...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究
doi:10.1002/clc.22504
更新日期:2016-02-01 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::The effects of monotherapy with atenolol or diltiazem-SR on blood pressure, 24-h blood pressure (BP) load, and exercise capacity were tested in patients with mild to moderate (stages I and II) essential hypertension. After 3-week single-blind placebo therapy, patients with sitting diastolic blood pressure (SDBP) of 94...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/clc.4960171209
更新日期:1994-12-01 00:00:00