Abstract:
:Research protocols often utilize serial exercise testing to examine the efficacy of anti-ischemic therapies. These tests, however, are prone to multiple sources of bias. This investigation sought to determine the influence of varying precordial electrocardiographic (ECG) electrode placement on the detection of exercise-induced ST-segment shifts. Fifteen coronary artery disease patients with abnormal exercise tests were studied. Based on the previous exercise test, the precordial electrode position exhibiting the greatest ST-segment shift was selected as the reference electrode. Four additional electrodes were placed around this reference electrode and exercise testing was performed. ECG strips were recorded every minute. The time-to-onset and -offset of ischemic-type ST-segment depression was recorded. ST-segment depression was recorded during exercise from the reference electrode in 12 of 15 patients. Ischemic-type ST-depression was also recorded in each of these 12 patients with the surrounding electrodes; however, the time-to-onset detected by all four surrounding electrodes concurred in only 5 of 12 (42%) patients. The time-to-offset of the ST-segment depression concurred in 9 of 12 (75%) patients. Serial ECGs recorded from similar but not exactly the same precordial ECG electrode position should yield similar results for the detection of ischemia, but time-to-onset or -offset of ischemia may differ by 60 s or more. Small changes in the time-to-onset and -offset of ischemia should not be considered reliable indicators of anti-ischemia efficacy.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Bertolet BD,Boyette AF,Mardis M,Hill JAdoi
10.1002/clc.4960180409subject
Has Abstractpub_date
1995-04-01 00:00:00pages
223-4issue
4eissn
0160-9289issn
1932-8737journal_volume
18pub_type
杂志文章abstract::The renin-angiotensin system regulates blood pressure and sodium homeostasis through a series of coordinated substrate-enzyme interactions. These interactions result in the production of angiotensin II (AII), which exerts a number of diverse biologic effects mediated through AII cell-surface receptors. Dysregulation o...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960200103
更新日期:1997-01-01 00:00:00
abstract::Based on the foregoing data it is not unreasonable to hypothesize that restoration of flow in the infarct-related artery at a later date might decrease mortality. If that is the case, then a strong argument can be made for coronary angiography in patients surviving acute myocardial infarction. Of course, the ideal way...
journal_title:Clinical cardiology
pub_type: 社论
doi:10.1002/clc.4960170405
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:Ventricular arrhythmias are the most common consequences of structural and functional heart diseases, but cases with no evident pathology are also observed. A parameter indicating asymptomatic circulatory failure could support decisions related to possible treatment of ventricular arrhythmias. HYPOTHESIS:Th...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20611
更新日期:2009-12-01 00:00:00
abstract::Severe aortic regurgitation may be associated with premature aortic valve opening. Several possible etiologies for this diastolic opening have been suggested. We present a patient with hemodynamic data, M-mode and 2-D echocardiography in the setting of severe aortic regurgitation and diastolic aortic valve opening. Ou...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960090513
更新日期:1986-05-01 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::Non-vitamin K dependent oral anticoagulants (NOAC) are now widely used in patients with nonvalvular atrial fibrillation (NVAF) for stroke prevention and in patients with venous thromboembolism (VTE) for the treatment and secondary prevention of the disease. Among NOAC, edoxaban demonstrated noninferiority to warfarin ...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1002/clc.23037
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:QT dispersion (QTd = QTmax-QTmin) measured as interlead variability of QT interval reflects the spatial inhomogeneity of ventricular repolarization times, and increased QTd may provide a substrate for malignant ventricular arrhythmias. Ischemia is associated with regional abnormalities of conduction and repo...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960220109
更新日期:1999-01-01 00:00:00
abstract::Sertraline is a selective serotonin reuptake inhibitor with established safety for the treatment of depression. Among the common adverse effects associated with sertraline are nausea, insomnia, diarrhea, somnolence, and dizziness. Cardiac arrest had not been reported in the literature, although tachycardia was frequen...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20647
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Transient pacing failure caused by transient increased pacing threshold has been reported in patients with transient left ventricular apical dysfunction (Takotsubo cardiomyopathy [TC]). Normal pacing thresholds usually recover after normalization of systolic dysfunction. HYPOTHESIS:Pacing failure correlates...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23082
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:ECG U-wave inversion can be classified as initial and terminal U inversion according to the phasic relationship to positive U-wave deflection. Initial U inversion is occasionally observed in hypertensive patients while terminal U inversion frequently appears during severe myocardial ischemia. HYPOTHESIS:The...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20487
更新日期:2009-10-01 00:00:00
abstract::We report a patient who presented with new onset atrial fibrillation in the setting of inferior ST-segment elevation myocardial infarction (STEMI). Cardiac catheterization revealed proximal occlusion of the left circumflex artery. Balloon angioplasty and stenting restored flow to a large left atrial branch, with promp...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20573
更新日期:2010-12-01 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::Full recovery occurred after 15 months of severe congestive heart failure in a patient with peripartum cardiomyopathy. Clinical improvement was noted when propranolol was added to conventional therapy. ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960030211
更新日期:1980-08-01 00:00:00
abstract:BACKGROUND:An experimental study showed that nebivolol is an effective agent in contrast-induced nephropathy (CIN) prophylaxis. HYPOTHESIS:We hypothesized that prophylactic nebivolol use had protective effects on renal function in human beings subjected to iodinated contrast agent since it has vasodilatory effect and ...
journal_title:Clinical cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1002/clc.21013
更新日期:2012-04-01 00:00:00
abstract:INTRODUCTION:Health care demand is increasing due to greater longevity of patients with chronic comorbidities. This increasing demand is occurring in a setting of resource scarcity. To address these changes, high-value care initiatives, such as telemedicine, are valuable resource-preservation strategies. This study int...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22586
更新日期:2016-11-01 00:00:00
abstract::Computer interpretation of electrocardiograms is far from adequate. This paper highlights a particular type of computer error that is merely symbolic of the large number of errors the computer can make. In addition to computer errors in electrocardiography, it is likely that computer interpretation has diminished the ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960190711
更新日期:1996-07-01 00:00:00
abstract::Left ventricular wall rupture after myocardial infarction is a mechanical complication that may result in a pseudoaneurysm. Between January 1994 and October 1996, false or pseudoaneurysms were detected in 6 (0.0026%) of 2,600 consecutive patients (4 women, 2 men; mean age 59.4 years) undergoing cardiac catheterization...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960201021
更新日期:1997-10-01 00:00:00
abstract::Recently, a debate over the merits of statin therapy in primary prevention was published in the Wall Street Journal. The statin opponent claimed that statins should only be used in secondary prevention and never in any primary-prevention patients at risk for cardiovascular events. In this evidence-based rebuttal to th...
journal_title:Clinical cardiology
pub_type: 社论,评审
doi:10.1002/clc.22016
更新日期:2012-01-01 00:00:00
abstract::Tissue-type plasminogen activator (t-PA) derived from a melanoma cell line was first used in patients with acute myocardial infarction in the early 1980s. Recombinant DNA technology then allowed production of large amounts of t-PA. The TIMI-I trial used a two-chain recombinant (rt-PA) product. A predominantly single-c...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1002/clc.4960160404
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Cardiac contractility modulation (CCM) is an electrical-device therapy for patients with heart failure with reduced ejection fraction (HFrEF). Patients with left ventricular ejection fraction (LVEF) ≤35% also have indication for an implantable cardioverter-defibrillator (ICD), and in some cases subcutaneous ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22919
更新日期:2018-04-01 00:00:00
abstract::Rising costs have reached a point at which physicians must assume a major role in dealing with the cost of medicine. Little information is available regarding actual practice at the community hospital level. In order to develop some insight on this issue, a survey of cardiovascular specialists was conducted regarding ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960140104
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Current National Cholesterol Education Program (NCEP) guidelines recognize low-density lipoprotein cholesterol (LDL-C) below 100 mg/dl as an optimal level. Evidence supporting this is scant. Both LDL-C and C reactive protein (CRP) are known correlates of atherosclerosis progression. HYPOTHESIS:We examined t...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/clc.4960270105
更新日期:2004-01-01 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:BACKGROUND AND HYPOTHESIS:Genetic influence on development of athlete's heart is uncertain. This study investigated whether angiotensin-converting enzyme (ACE) gene polymorphism influenced development of athlete's heart. METHODS:Forty-three participants in a 100-km ultramarathon were classified on the basis of ACE gen...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960230814
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Management of acute coronary syndrome (ACS) patients with nonobstructive epicardial coronary artery disease (CAD) remains poorly understood. HYPOTHESIS:Acute coronary syndrome patients with nonobstructive CAD are less likely to receive effective cardiac medications upon discharge from the hospital. METHODS...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20701
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Myocardial infarction in the absence of obstructive coronary artery disease (MINOCA) accounts for approximately 5% - 6% of acute myocardial infarction (AMI) patients. Anxiety symptoms are common in patients with coronary artery disease (CAD), and are associated with a poor prognosis. However, the association...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23386
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:In animal models, pretreatment with angiotensin-converting enzyme inhibitor (ACEI) can reduce no-reflow. In the present study, we investigated whether pretreatment with ACEI may prevent no-reflow in patients who underwent primary coronary intervention for AMI. METHOD AND RESULTS:A total of 259 consecutive p...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20060
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Total serum transforming growth factor-beta 1 (tsTGF-β1) is increased in patients with Marfan syndrome (MFS), but it has not been assessed in thoracic aortic aneurysm and dissection (TAAD), Loeys-Dietz syndrome (LDS), and bicuspid aortic valve disease (BAVD). HYPOTHESIS:tsTGF-β1 is increased in genetic aort...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22320
更新日期:2014-11-01 00:00:00
abstract::The incidence of inadvertent permanent ventricular pacing from the coronary vein is not known. In a retrospective analysis of 69 patients in whom transvenous pacemakers were implanted between 1979 and 1986, 12 patients were discovered to have right bundle-branch block pattern to the paced complexes on electrocardiogra...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960120508
更新日期:1989-05-01 00:00:00
abstract::During myocardial ischemia, fatty acids are the principal source of energy, increasing myocardial oxygen consumption and making a decrease in coronary blood flow less well tolerated. Increasing glucose oxidation during myocardial ischemia may improve cardiac efficiency. The pFOX inhibitors have the potential to accomp...
journal_title:Clinical cardiology
pub_type: 社论
doi:10.1002/clc.4960260402
更新日期:2003-04-01 00:00:00