Abstract:
:Recently developed unstable angina clinical practice guidelines have recommended risk stratification with dipyridamole thallium-201 myocardial imaging in patients at "intermediate" pretest clinical risk who cannot exercise maximally. The prognostic value of predischarge dipyridamole technetium 99m sestamibi (MIBI) tomography has not been assessed in this clinical setting. To this end, 128 medically treated patients with unstable angina at intermediate pretest clinical risk underwent follow-up for 16 +/- 11 (mean +/- SD) months after predischarge intravenous dipyridamole MIBI tomography. An abnormal MIBI scan result was present in 99 patients (77%), of whom 47 had one or more reversible and 76 had one or more fixed perfusion defects. Cardiac events occurred in 68 (53%) patients after dipyridamole testing: recurrent unstable angina (n = 36), nonfatal acute myocardial infarction (n = 6), or death (n = 26). A cardiac event occurred in 10% of patients with normal MIBI tomography results compared with 69% of those with abnormal results (p < 0.01). Event rates associated with specific perfusion defects were similar (reversible = 68%; fixed = 71%) and were greater than rates in patients without defects (both p < 0.05). Clinical variables associated with increased risk of cardiac events by univariate analysis included a history of congestive heart failure, prior myocardial infarction, and diabetes mellitus (all p < 0.05). Independent multivariable predictors (Cox proportional hazards model) of any cardiac event were an abnormal result of MIBI scan (relative risk [RR] = 4.3, 95% confidence interval [CI] 1.5 to 12.0) and a reversible (RR = 1.8, 95% CI 1.1 to 2.9) or a fixed perfusion defect (RR = 2.9, 95% CI 1.6 to 5.4).(ABSTRACT TRUNCATED AT 250 WORDS)
journal_name
Am Heart Jjournal_title
American heart journalauthors
Stratmann HG,Tamesis BR,Younis LT,Wittry MD,Amato M,Miller DDdoi
10.1016/0002-8703(95)90071-3subject
Has Abstractpub_date
1995-10-01 00:00:00pages
734-40issue
4eissn
0002-8703issn
1097-6744pii
0002-8703(95)90071-3journal_volume
130pub_type
杂志文章abstract:BACKGROUND:Chronic kidney disease (CKD) is associated with an adverse prognosis in patients with coronary heart disease. Cardiac rehabilitation (CR) improves morbidity and mortality among patients with coronary heart disease, but its impact on patients with concomitant CKD has not been described. METHODS:We compared b...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.01.048
更新日期:2005-12-01 00:00:00
abstract::Cardiovascular anomalies are a frequently reported feature of the fetal alcohol syndrome, but only rarely have such children been catheterized. This article fully described the cardiac anomaly in two infants with this syndrome. The malformations found in both cases include a ventricular septal defect, and the rather u...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90290-4
更新日期:1979-11-01 00:00:00
abstract::Major cardiovascular risk factors, such as hypertension, hyperlipidemia, and diabetes, often cluster in the same individuals. It has been claimed that obesity, hyperinsulinemia, insulin resistance, and a deranged intracellular handling of ions have pathogenetic importance in the development of this metabolic syndrome....
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(93)90446-g
更新日期:1993-05-01 00:00:00
abstract::Bacterial shock due to Gram-negative bacilli is best managed by prompt control of the infection with appropriate antibiotics and surgical drainage or excision. Corticosteroids for purposes of controlling systemic reactions to bacteria and their toxins constitute adjunctive therapy. Volume repletion and respiratory sup...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80352-9
更新日期:1977-07-01 00:00:00
abstract::Nitrates are widely used for the management of congestive heart failure (CHF), as well as angina pectoris. In both situations, nitrates significantly increase exercise capacity. The mechanism of this beneficial effect is unclear, especially in CHF. Isosorbide dinitrate reduces pulmonary capillary wedge pressure (PCWP)...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(85)90494-6
更新日期:1985-07-01 00:00:00
abstract:BACKGROUND:A subset of patients hospitalized with acute heart failure experiences in-hospital worsening heart failure, defined as persistent or worsening signs or symptoms requiring an escalation of therapy. METHODS:We analyzed data from the Acute Decompensated Heart Failure National Registry (ADHERE) linked to Medica...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.04.021
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:We evaluated an Internet- and telephone-based telemedicine system for reducing blood pressure (BP) in underserved subjects with hypertension. METHODS:A total of 241 patients with systolic BP ≥140 mm Hg were randomized to usual care (C; n = 121) or telemedicine (T; n = 120). The T group reported BP, heart ra...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2013.01.004
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:We aim to review the studies comparing coronary calcification across different ethnic groups. BACKGROUND:There is still uncertainty regarding ethnic differences in the prevalence, progression, and risk of coronary artery disease. Clues to possible racial differences in rates of coronary heart disease (CHD) ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2006.08.008
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Coronary artery disease in women appears 10 to 15 years later than in men. To test the hypothesis that the effects of estrogen may manifest themselves as histologic differences in coronary plaques, we examined the hearts of premenopausal and postmenopausal women who died suddenly from coronary artery disease...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.109946
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:Although prior studies have demonstrated disparities in the management and outcomes of women with acute coronary syndrome (ACS), there are limited large-scale contemporary data on gender differences in post-intervention outcomes in this population. METHODS:We analyzed patients according to 2 ACS categories,...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.08.012
更新日期:2009-01-01 00:00:00
abstract::A 47-year-old man presented with exertional angina. Selective coronary arteriography showed complete systolic segmental occlusion of the left anterior descending coronary artery producing milking effect. Permanent relief of symptoms was achieved by surgical excision of myocardial bridges. Postoperative angiography per...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90118-0
更新日期:1980-08-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:The extent to which individual knowledge, preferences, and priorities explain lower use of invasive cardiac care among older vs. younger adults presenting with acute coronary syndrome (ACS) is unknown. We directly surveyed a group of patients to ascertain their preferences and priorities for invas...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2019.09.008
更新日期:2020-01-01 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:INTRODUCTION:Heart Failure (HF) is a common cause of hospitalization in older adults. The transition from hospital to home is high-risk, and gaps in transitional care can increase the risk of re-hospitalization and death. Combining health care services supported by meta-analyses, we designed the PACT-HF transitional ca...
journal_title:American heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ahj.2017.12.013
更新日期:2018-05-01 00:00:00
abstract::We compared the pauses that followed the spontaneous termination of supraventricular tachyarrhythmias with the pauses that followed the cessation of atrial overdrive pacing in 21 patients. In 10 patients with abnormal sinus node function and in 11 patients with normal sinus node function we recorded the spontaneous te...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90515-x
更新日期:1983-02-01 00:00:00
abstract:BACKGROUND:Left atrial appendage flow velocity (LAAFV) is a predictor of thromboembolism in atrial fibrillation (AF) patients, as well as CHA2DS2-VASc score. However, little is known about LAAFV in sinus rhythm (SR) after catheter ablation. The aim of this study was to determine clinical predictors of low LAAFV in pati...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2014.11.009
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:The pulmonary venous flow signal measured by transesophageal echocardiography is generally recorded from the left upper pulmonary vein in the left lateral decubitus position, whereas that by transthoracic echocardiography is from the right upper pulmonary vein in the left semi-lateral decubitus position. The...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70486-2
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Infants born to cocaine-using mothers have a 3- to 8-fold increase in sudden infant death syndrome. Its underlying cause, in part, may be attributed to abnormal autonomic function. We proposed to study heart rate variability, reflecting autonomic control of the heart, in cocaine-exposed infants. METHODS:Fro...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.118112
更新日期:2001-11-01 00:00:00
abstract::To evaluate the therapeutic efficacy of oral angiotensin-converting inhibition (ACE) with captopril in chronic normotensive congestive heart failure (CHF), acute and cardiocirculatory actions were determined by cardiac catheterization and forearm plethysmography, and ambulatory effects were assessed by echocardiograph...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90379-3
更新日期:1981-01-01 00:00:00
abstract::While the total ischemic burden on the left ventricle represents the combined effects of both symptomatic and asymptomatic myocardial ischemia, the total vascular burden has many components including an increased systemic peripheral vascular resistance, an increased pulmonary vascular resistance, and an increased coro...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(88)90551-0
更新日期:1988-01-01 00:00:00
abstract::Ventricular late potentials at the end of the surface QRS, detected on the signal-averaged electrocardiogram (SAECG) have been shown to be markers for spontaneous and/or inducible ventricular tachycardia (VT) in patients with coronary artery disease (CAD). We examined the correlations between electrophysiologic study ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90884-8
更新日期:1988-04-01 00:00:00
abstract:BACKGROUND:Although inflammation is a core element of atherogenesis and plasma levels of fibrinogen (FGB), homocysteine, and intercellular adhesion molecule-1 (ICAM-1) differ by race/ethnicity, little is known about the role of genetic polymorphisms in the FGB, methylenetetrahydrofolate reductase (MTHFR), and ICAM-1 ge...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.12.012
更新日期:2009-04-01 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:INTRODUCTION:Despite known associations between obesity and cardiovascular disease, the relationship between obesity as reflected by body mass index (BMI) and angiographic coronary artery disease (CAD) is not fully understood. Moreover, this relationship has not been adequately defined in black patients, a group demons...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.12.009
更新日期:2014-04-01 00:00:00
abstract::Oxygen free radical scavengers have been found to decrease infarct size in dogs subjected to myocardial ischemia-reperfusion injury. A baboon open-chest model was used to determine if superoxide dismutase (SOD), an oxygen free radical scavenger, together with catalase would be equally effective in subhuman primates (b...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90697-8
更新日期:1993-10-01 00:00:00
abstract::A new translation of Roger's description of the clinical and anatomical findings in uncomplicated small VSD is presented. Reappraisal of Roger's observations in the light of our present understanding confirms that only our attitudes change; diseases remain the same. ...
journal_title:American heart journal
pub_type: 传,历史文章,杂志文章
doi:10.1016/0002-8703(79)90041-3
更新日期:1979-09-01 00:00:00
abstract::In 30 years of follow-up in the Framingham study, routine biennial ECG examinations revealed 315 subjects with ECG-LVH and 164 with unrecognized ECG-MI without previous cardiac explanation. Among subjects initially free of clinically evident coronary heart disease and both ECG abnormalities, the incidence of ECG-LVH w...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90156-0
更新日期:1986-02-01 00:00:00
abstract::Exercise stress testing is a well-established method for the diagnostic, prognostic, and functional assessment of patients with known or suspected CAD. A variety of alternative tests have been described in patients unable to perform leg exercise. Atrial pacing and dipyridamole imaging have been evaluated most extensiv...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(89)90417-1
更新日期:1989-06-01 00:00:00
abstract::Forty-four patients with atrial septal defects, aged 7 months to 18 years (median 8.9), underwent biplane transesophageal (TEE) and transthoracic (TTE) echocardiography. The size of the defect and the shunt flow volume were measured by TEE and compared with the actual size at surgery (N = 14) or the shunt volume measu...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)91008-3
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Protease inhibitors (PIs) may be associated with accelerated atherosclerosis in individuals infected with human immunodeficiency virus (HIV). We assessed the effects of HIV PIs on subclinical atherosclerosis. METHODS:The lipid profiles, C-reactive protein (CRP) levels, coronary artery calcification (CAC) sc...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.125009
更新日期:2002-10-01 00:00:00