Abstract:
BACKGROUND:Less invasive methods are replacing traditional invasive means of measuring coronary flow reserve (CFR). Transesophageal echocardiography (TEE) is becoming a useful tool for evaluation of coronary artery disease and has recently been used to measure CFR. This has always been done using dipyridamole, but adenosine has a greater vasodilator potency and more favorable kinetics than dipyridamole. This study was done to evaluate the hypothesis that adenosine is safe, rapid, and accurate in measuring coronary blood flow reserve by TEE Doppler. METHODS AND RESULTS:Forty-nine patients who had recently undergone angiography had a transesophageal echocardiogram with visualization of the coronary arteries and measurement of blood flow velocity in the left anterior descending coronary artery (LAD) during adenosine infusion of 0.14 mg/kg per minute. Angiograms were analyzed by quantitative coronary angiography, and significant stenosis was defined as > 70% lumenal diameter narrowing. Thirty-nine of the 49 patients did not have a significant LAD stenosis (group 1); the remainder had significant disease (group 2). Good spectral Doppler recordings of blood flow velocity in the LAD were obtained in 41 of 46 patients (89%). There were no significant differences in baseline coronary blood flow velocities between the two groups. Hyperemic to baseline flow ratios were significantly higher in patients without significant LAD stenosis for peak (2.83 +/- 1.04 versus 1.78 +/- 0.36) and mean (2.68 +/- 0.96 versus 1.75 +/- 0.39) diastolic velocity. A CFR ratio > 2.1 had a sensitivity of 86%, a specificity of 79%, a positive predictive value of 46%, and a negative predictive value of 96% for the absence of critical LAD stenosis. The infusion was well tolerated. It had to be prematurely terminated in only 3 patients (6.5%), and they were asymptomatic. No patient experienced chest pain, palpitations, or flushing. Intraobserver and interobserver variabilities were low, and reproducibility of data was good (< 4%). CONCLUSIONS:Adenosine Doppler TEE is an effective, rapid, safe, and superior means of measuring CFR ratio. This method is convenient for serial measurements of CFR as well as in clinical settings such as evaluation of syndrome X, cardiomyopathy, and aortic regurgitation.
journal_name
Circulationjournal_title
Circulationauthors
Redberg RF,Sobol Y,Chou TM,Malloy M,Kumar S,Botvinick E,Kane Jdoi
10.1161/01.cir.92.2.190subject
Has Abstractpub_date
1995-07-15 00:00:00pages
190-6issue
2eissn
0009-7322issn
1524-4539journal_volume
92pub_type
临床试验,杂志文章相关文献
CIRCULATION文献大全abstract:BACKGROUND:Whether reperfusion can cause necrosis of previously viable myocytes (lethal reperfusion injury) remains controversial. Numerous studies examined the ability of various agents to prevent or limit reperfusion injury, but the results were contradictory. In a single-canine-heart model of ischemia-reperfusion, w...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.91.12.2989
更新日期:1995-06-15 00:00:00
abstract::Since the discovery that neuregulin-1 (NRG-1)/ErbB signaling is indispensable in cardiac development, evidence has shown that this system also plays a crucial role in the adult heart. In patients, an inhibitory ErbB2 antibody, trastuzumab, used in the treatment of mammary carcinomas, increases the risk for the develop...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/CIRCULATIONAHA.107.690487
更新日期:2007-08-21 00:00:00
abstract:BACKGROUND:Few data exist regarding the effects of angiotensin converting enzyme inhibitors in patients with regurgitant valvular lesions. We postulated an immediate improvement in cardiac performance with captopril in mitral regurgitation, which, in a hemodynamically compensated group of patients, might be mediated th...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.84.5.2049
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:The patency of AV expanded polytetrafluoroethylene (ePTFE) grafts for hemodialysis is impaired by intimal hyperplasia (IH) at the venous outflow tract. The absence of a functional endothelial monolayer on the prosthetic grafts is an important stimulus for IH. In the present study, we evaluated the feasibilit...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.104.504407
更新日期:2005-07-05 00:00:00
abstract:BACKGROUND:Peroxisome proliferator-activated receptors (PPARs) are transcription factors of the nuclear receptor superfamily. It has been reported that the thiazolidinediones, which are antidiabetic agents and high-affinity ligands for PPARgamma, regulate growth of vascular cells. In the present study, we examined the ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc1002.105225
更新日期:2002-03-12 00:00:00
abstract::Finn Waagstein was born in Copenhagen in 1938. He graduated from Aarhus University Medical School in 1964. He received his cardiology training in the Sahlgrenska University Hospital at the University of Gothenburg, Sweden. He was appointed Associate Professor in 1980, and he assisted in establishing and directing the ...
journal_title:Circulation
pub_type: 面试
doi:10.1161/CIRCULATIONAHA.117.029934
更新日期:2017-09-05 00:00:00
abstract:BACKGROUND:It remains unclear how mineralocorticoids induce cardiac hypertrophy and fibrosis. Recently, activation of the calcium-dependent phosphatase, calcineurin, has been shown to induce cardiac hypertrophy. In the present study, we examine the role of calcineurin in mineralocorticoid-induced cardiac hypertrophy an...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc0602.104675
更新日期:2002-02-12 00:00:00
abstract:BACKGROUND:Platelet-rich thrombus formation is a critical event in the onset of cardiovascular disease. Because ADP plays a significant role in platelet aggregation, its metabolism is important in the regulation of platelet activation and recruitment. Ectonucleoside triphosphate diphosphohydrolase (E-NTPDase) is a key ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000155239.46511.79
更新日期:2005-02-15 00:00:00
abstract:BACKGROUND:According to the American Heart Association, passive smoking is an important risk factor for coronary heart disease (CHD), but the mechanisms underlying this association are not fully understood. We studied the acute effect of passive smoking on the factors that influence the development of CHD: the antioxid...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.97.20.2012
更新日期:1998-05-26 00:00:00
abstract:BACKGROUND:We postulated that the variability of the phase shift between blood pressure and heart rate fluctuation near the frequency of 0.10 Hz might be useful in assessing autonomic circulatory control. METHODS AND RESULTS:We tested this hypothesis in 4 groups of subjects: 28 young, healthy individuals; 13 elderly h...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.CIR.0000079222.91910.EE
更新日期:2003-07-22 00:00:00
abstract:BACKGROUND:In patients with neurogenic orthostatic hypotension (NOH), the availability of the sympathetic neurotransmitter norepinephrine (NE) in the synaptic cleft is insufficient to maintain blood pressure while in the standing posture. METHODS AND RESULTS:We determined the effect of oral administration of the synth...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.CIR.0000083721.49847.D7
更新日期:2003-08-12 00:00:00
abstract:BACKGROUND:Reduced renal function is associated with a poorer prognosis and increased bleeding risk in patients with acute coronary syndromes and may therefore alter the risk-benefit ratio with antiplatelet therapies. In the Platelet Inhibition and Patient Outcomes (PLATO) trial, ticagrelor compared with clopidogrel re...
journal_title:Circulation
pub_type: 杂志文章,随机对照试验
doi:10.1161/CIRCULATIONAHA.109.933796
更新日期:2010-09-14 00:00:00
abstract:BACKGROUND:Dilated cardiomyopathy is an important cause of morbidity and mortality among patients with congestive heart failure. Hemodynamic and prognostic characterization are critical in guiding selection of medical and surgical therapies. METHODS AND RESULTS:A cohort of 102 patients with the clinical diagnosis of d...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.90.6.2772
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:Atherosclerosis is associated with immune responses to oxidized lipoproteins and certain microorganisms, but the role of specific immunity has remained unclear. METHODS AND RESULTS:To study the role of immunity in atherosclerosis, we crossed atherosclerosis-prone apoE(-/-) mice with immunodeficient scid/sci...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.24.2919
更新日期:2000-12-12 00:00:00
abstract::A low level of high-density lipoprotein cholesterol (HDL-C) is an important risk factor for cardiovascular disease. Epidemiological and clinical studies provide evidence that HDL-C levels are linked to rates of coronary events. The cardioprotective effects of HDL-C have been attributed to its role in reverse cholester...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/01.CIR.0000131512.50667.46
更新日期:2004-06-15 00:00:00
abstract:BACKGROUND:Experimental studies revealed proinflammatory properties of angiotensin II. We evaluated antiinflammatory effects of the angiotensin II subtype 1 receptor antagonist olmesartan medoxomil alone and in cotherapy with the HMG-CoA reductase inhibitor pravastatin in patients with essential hypertension and microi...
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.0000140265.21608.8E
更新日期:2004-08-31 00:00:00
abstract:BACKGROUND:Intimal smooth muscle cells (SMCs) contribute to the foam cell population in arterial plaque, and express lower levels of the cholesterol exporter ATP-binding cassette transporter A1 (ABCA1) in comparison with medial arterial SMCs. The relative contribution of SMCs to the total foam cell population and their...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.113.005015
更新日期:2014-04-15 00:00:00
abstract:BACKGROUND:Abnormal vascular reactivity represents a fundamental disturbance in vascular biology with the development of atherosclerosis. Because endothelial vasodilator function plays a pivotal role in controlling vasomotor tone, we hypothesized that atherosclerotic wall thickening might directly interfere with defici...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.89.6.2525
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:We investigated whether L-arginine induces regression of preexisting atheromatous lesions and reversal of endothelial dysfunction in hypercholesterolemic rabbits, whether similar effects can be obtained by cholesterol-lowering therapy with lovastatin, and which mechanism leads to these effects. METHODS AND ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.4.1282
更新日期:1997-08-19 00:00:00
abstract::Venous thromboembolism (VTE) is a major preventable disease that affects hospitalized inpatients. Risk stratification and prophylactic measures have good evidence supporting their use, but multiple reasons exist that prevent full adoption, compliance, and efficacy that may underlie the persistence of VTE over the past...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIR.0000000000000769
更新日期:2020-06-16 00:00:00
abstract:BACKGROUND:Production of NO by inducible NO synthase (iNOS) has been implicated in the pathology of spontaneous and antigen-induced autoimmune diseases, and iNOS is expressed in the myocardium of patients with heart failure. It is not clear whether inflammatory murine autoimmune heart disease, an experimental model for...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1997-07-15 00:00:00
abstract::Total body surface maps from 15 subjects with left bundle branch block and normal axis (LBBB-NA) and 10 subjects with left bundle branch block and left axis (LBBB-LA) were analyzed and compared with maps from normal subjects. In 19 of the 25 subjects with LBBB, the timing of early upper sternal positivity was similar ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.67.3.660
更新日期:1983-03-01 00:00:00
abstract:BACKGROUND:Cardiopulmonary bypass and cardiac surgery are associated with a significant systemic inflammatory response that may increase postoperative complications. This meta-analysis assessed whether the benefits and risks of corticosteroid use were dose dependent in adult cardiac surgery. METHODS AND RESULTS:Random...
journal_title:Circulation
pub_type: 杂志文章,meta分析
doi:10.1161/CIRCULATIONAHA.108.848218
更新日期:2009-04-14 00:00:00
abstract:BACKGROUND:We tested the hypothesis that intracoronary delivery of an adenovirus encoding adenylyl cyclase type VI (Ad.AC(VI)) would be associated with increased left ventricular (LV) function in pigs with congestive heart failure. METHODS AND RESULTS:Pigs (52+/-6 kg; n=16) underwent placement of pacemakers, LV pressu...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000136033.21777.4D
更新日期:2004-07-20 00:00:00
abstract:BACKGROUND:Left ventricular outflow tract obstruction (LVOTO) occurs in 4% to 5% of patients after prosthetic ring mitral valve repair. Major anatomic factors incriminated in the genesis of LVOTO include degenerative mitral valve insufficiency with excess leaflet tissue, nondilated left ventricular cavity, and narrow m...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:The pathophysiology of hypertension in the immediate postpartum period is unclear. METHODS AND RESULTS:We studied 988 consecutive women admitted to a tertiary medical center for cesarean section of a singleton pregnancy. The angiogenic factors soluble fms-like tyrosine kinase 1 and placental growth factor, ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.115.015721
更新日期:2015-11-03 00:00:00
abstract:BACKGROUND:We have previously demonstrated vasculoprotective effects after repeated intravenous administration of recombinant apolipoprotein A-IMilano (apoA-Im)/phospholipid complex. In this study, we sought to determine the effects of local recombinant apoA-Im/1-palmitoyl,2-oleoyl phosphatidylcholine complex (ETC-216)...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000074042.19447.B1
更新日期:2003-05-27 00:00:00
abstract:BACKGROUND:C-reactive protein (CRP) and interleukin (IL)-6 are important risk factors for atherosclerosis and coronary heart disease. In the present study, we examined serum levels of CRP and IL-6, IL-6 production by monocytes, and the effect of nasal continuous positive airway pressure (nCPAP) in patients with obstruc...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.0000052627.99976.18
更新日期:2003-03-04 00:00:00
abstract:BACKGROUND:Xenografts ultimately fail as a result of acute vascular rejection (AVR), a process characterized by intravascular thrombosis, fibrin deposition, and endothelial cell activation. METHODS AND RESULTS:We studied whether targeted deletion of Fgl-2, an inducible endothelial cell procoagulant, (Fgl-2-/-) in the ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.534271
更新日期:2005-07-12 00:00:00
abstract:BACKGROUND:Arterial grafts for CABG have been used increasingly, and the radial artery (RA) has become a preferable graft, secondary to the internal mammary artery (IMA). In the present study, we investigated and compared NO release and endothelium-derived hyperpolarizing factor (EDHF)-mediated hyperpolarization for IM...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc37t1.094930
更新日期:2001-09-18 00:00:00