Abstract:
:In this study, the acute haemodynamic effects of angiotensin converting enzyme (ACE) inhibition with intravenous enalaprilat alone or in combination with preload restoration were determined in patients with severe heart failure complicating acute myocardial infarction. Ten patients with raised pulmonary arterial wedge pressure (PAWP > or = 18 mmHg) were first studied during constant conventional vasodilation with diuretic and inotropic medication, by monitoring central haemodynamics and arterial blood gases. The same variables were measured before enalaprilat infusion, after preload reduction with enalaprilat (1 mg.h-1, rate doubled every 30 min until PAWP decreased > or = 25% or up to total cumulative dose of 10 mg) and after preload restoration with fluid loading (4% albumin given 15 ml.min-1 to restore PAWP to baseline) during continuous low dose enalaprilat infusion. Enalaprilat alone (median dose 0.9 mg) reduced significantly the PAWP (from 25 to 17 mmHg; P = 0.004), the mean arterial pressure (from 87 to 83 mmHg; P = 0.008), the mean pulmonary arterial pressure and the right atrial pressure. The cardiac index, stroke volume index and systemic vascular resistance index remained unchanged. Preload restoration during continuous enalaprilat infusion (median dose of 4% albumin 230 ml, and enalaprilat 0.2 mg) did not further enhance left ventricular function; rather, there was a nearly significant decrease in myocardial perfusion pressure. Arterial oxygenation remained unchanged throughout the study. In conclusion, adding intravenous enalaprilat to conventional therapy makes it possible to relieve pulmonary congestion while maintaining the cardiac function and arterial oxygenation. Preload restoration during continuous ACE inhibition offers no further advantages, and may have adverse effects, since the myocardial perfusion pressure may fall.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Tohmo H,Karanko M,Korpilahti Kdoi
10.1093/oxfordjournals.eurheartj.a060537subject
Has Abstractpub_date
1994-04-01 00:00:00pages
523-7issue
4eissn
0195-668Xissn
1522-9645journal_volume
15pub_type
杂志文章abstract:BACKGROUND:Emerging evidence suggests that a mildly elevated body mass index (BMI), is related to improved survival and fewer cardiovascular events in patients with coronary artery disease (CAD). We hypothesize that these results are related to the poor diagnostic performance of BMI to detect adiposity, especially in t...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm243
更新日期:2007-09-01 00:00:00
abstract:AIMS:The role of aspirin in the primary prevention setting is continuously evolving. Recent randomized trials have challenged the role of aspirin in the primary prevention setting. METHODS AND RESULTS:Electronic databases were searched for randomized trials that compared aspirin vs. placebo (or control) in subjects wi...
journal_title:European heart journal
pub_type: 杂志文章,meta分析
doi:10.1093/eurheartj/ehy813
更新日期:2019-02-14 00:00:00
abstract::The author reviews statistical methods commonly applied in economic evaluations that rely on individual patient-level data. The paper includes a review of foundational concepts, unique characteristics of health economic data, and methods developed to address them. The paper then highlights issues that should be consid...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehu174
更新日期:2014-07-01 00:00:00
abstract:AIMS:The aim of this study was to compare on-thienopyridine platelet reactivity of elderly patients (≥75 years) vs. younger patients (<75 years). Elderly patients represent a growing and challenging segment of the coronary population for whom the effect of dual antiplatelet therapy on platelet inhibition has not been s...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehr407
更新日期:2012-05-01 00:00:00
abstract::The prevalence and type of arrhythmias has been studied in a representative sample of 2000 Athenians, aged 18-81 years, who underwent exercise testing on a treadmill according to the Bruce protocol. It was found that 121 persons (mean age 55.7 +/- 14.9 years, 31% greater than 65 years), exhibited arrhythmias on the EC...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/8.suppl_d.17
更新日期:1987-08-01 00:00:00
abstract::Heart disease frequently occurs in advanced acromegaly. In order to investigate cardiac mass and function in acromegaly in the absence of obvious cardiac disease, we performed Doppler echocardiography in 15 asymptomatic acromegalic patients (six of them had systemic hypertension). The data were compared with those of ...
journal_title:European heart journal
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract::Ten patients with chronic intermittent claudication were included in a double-blind, randomized cross-over study of placebo, propranolol 80 mg b.i.d. and metoprolol 100 mg b.i.d., each given for two months. At the end of each treatment period, the patients were tested on a treadmill and the time to first claudication ...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/oxfordjournals.eurheartj.a061440
更新日期:1983-03-01 00:00:00
abstract::The aim of the study was to assess the relationship between paroxysmal atrial fibrillation during acute myocardial infarction and the long-term prognosis of patients after acute myocardial infarction. The incidence of paroxysmal atrial fibrillation among 5803 consecutive hospitalized patients was 9.9% (557/5803). Inci...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060046
更新日期:1992-01-01 00:00:00
abstract::One case of unruptured sinus of Valsalva aneurysm causing left coronary artery compression and lethal myocardial infarction in a 39-year old woman is described. In reviewing the literature, 15 previously published cases of sinus of Valsalva aneurysms disturbing coronary flow were found. It is concluded that the mechan...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061811
更新日期:1985-12-01 00:00:00
abstract:Aims:Fractional flow reserve (FFR) has proven to its prognostic and therapeutic value. However, the additive prognostic value of coronary flow reserve (CFR) remains unclear. This study sought to investigate the clinical utility of combined FFR and CFR measurements to predict outcomes. Methods and results:Using the pro...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehx139
更新日期:2017-07-01 00:00:00
abstract:Aims:The aim of this study is to develop models to aid the decision to prolong dual antiplatelet therapy (DAPT) that requires balancing an individual patient's potential benefits and harms. Methods and results:Using population-based electronic health records (EHRs) (CALIBER, England, 2000-10), of patients evaluated 1 ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehw683
更新日期:2017-04-07 00:00:00
abstract:AIMS:The aim of this study was to assess whether perioperative N-acetylcysteine (NAC), an antioxidant, prevents acute renal injury (ARI) after cardiac surgery. METHODS AND RESULTS:We performed a systematic review of randomized controlled trials (RCTs) of NAC in adult cardiac surgery patients. The RCTs were identified ...
journal_title:European heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1093/eurheartj/ehp053
更新日期:2009-08-01 00:00:00
abstract:AIMS:The objectives of this study were to determine the association of waist circumference (WC) and waist-to-hip ratio (WHR) with the risk of incident cardiovascular disease (CVD) events and to determine whether the strength of association of WC and WHR with CVD risk is different. METHODS AND RESULTS:This meta-regress...
journal_title:European heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1093/eurheartj/ehm026
更新日期:2007-04-01 00:00:00
abstract::Falipamil hydrochloride (AQA 39) is a new antiarrhythmic agent structurally related to verapamil. We evaluated the electrophysiologic properties of intravenous falipamil (1.5 mg kg-1 within 20 minutes) in 12 patients. The spontaneous cycle length was significantly (P less than 0.001) prolonged (+79 +/- 59 ms). Atriove...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062198
更新日期:1987-11-01 00:00:00
abstract::Clonidine administration by i.v. infusion in 12 patients with hypertension emergencies (diastolic blood pressure over 130 mmHg) resulted in the normalization of blood pressure (BP) in all patients. Lowering of BP was associated with a reduction in total and lower limb vascular resistance. Heart rate showed a slight an...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061605
更新日期:1984-12-01 00:00:00
abstract:AIMS:In acute coronary syndromes (ACS), the optimal revascularization strategy for unprotected left main coronary disease (ULMCD) has been little studied. The objectives of the present study were to describe the practice of ULMCD revascularization in ACS patients and its evolution over an 8-year period, analyse the pro...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehp353
更新日期:2009-10-01 00:00:00
abstract:AIMS:The guidelines of the European Society of Cardiology (ESC) define the current standard for the management of syncope, but are still incompletely applied in the clinical setting. METHODS AND RESULTS:Prospective systematic evaluation, on strict adherence to the guidelines, of consecutive patients referred for synco...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehi647
更新日期:2006-01-01 00:00:00
abstract::Exercise-induced U-wave inversion on chest wall mapping was compared with coronary arteriographic findings in 160 consecutive patients who presented with chest pain suggestive of ischaemic heart disease. ECG recordings were made from 16 points on the chest wall before, during and after exercise. None of the 27 patient...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061883
更新日期:1985-05-01 00:00:00
abstract:AIMS:We recently found that resting muscle sympathetic nerve activity is inversely related to peak oxygen uptake (VO(2) peak) in patients with heart failure, suggesting a peripheral neurogenic limit to exercise in heart failure. No such relationship was observed in healthy controls. To determine whether this observatio...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2001.2942
更新日期:2002-05-01 00:00:00
abstract:AIMS:To assess the long-term benefit-risk ratio of drug-eluting (DES) vs. bare-metal stents (BMS) relative to stent size. METHODS AND RESULTS:All 826 consecutive BASKET (BAsel Stent Kosten-Effektivitäts Trial) patients randomized 2:1 to DES vs. BMS were followed after 3 years. Data were analysed separately for patient...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehn516
更新日期:2009-01-01 00:00:00
abstract:AIMS:We analysed the contemporary incidence, outcomes, and predictors of heart failure (HF) and/or left ventricular systolic dysfunction (LVSD) before discharge in patients with acute myocardial infarction (MI). The baseline presence of HF or LVSD, or its development during hospitalisation, increases short- and long-te...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ehj.2004.08.006
更新日期:2004-11-01 00:00:00
abstract::Recent innovations have the potential to improve rhythm control therapy in patients with atrial fibrillation (AF). Controlled trials provide new evidence on the effectiveness and safety of rhythm control therapy, particularly in patients with AF and heart failure. This review summarizes evidence supporting the use of ...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehz782
更新日期:2019-12-07 00:00:00
abstract:BACKGROUND:While prior work has suggested that a high-grade atrioventricular block (HAVB) in the setting of an acute coronary syndrome (ACS) is associated with in-hospital death, limited information is available on the incidence of, and death associated with, HAVB in ACS patients receiving contemporary management. MET...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehu357
更新日期:2015-04-21 00:00:00
abstract::Impaired coronary reserve and increased minimal coronary resistance have been documented in several animal models of left ventricular hypertrophy. There is controversy whether the increased minimal coronary resistance is due to vascular or extravascular causes. To test the hypothesis that pressure-overloaded left vent...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/oxfordjournals.eurheartj.a060237
更新日期:1992-05-01 00:00:00
abstract:AIMS:Currently available non-invasive imaging methods frequently fail to detect alterations in left ventricular (LV) function despite histological evidence of injury. Tissue Doppler imaging (TDI) can detect subtle LV dysfunction. The aim of this study was to investigate whether TDI indices can predict LV systolic dysfu...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehl013
更新日期:2006-08-01 00:00:00
abstract:AIMS :Individuals with low socioeconomic status (SES) face widespread prejudice in society. Whether SES disparities exist in treatment and survival following in-hospital cardiac arrest (IHCA) is unclear. The aim of the current retrospective registry study was to examine SES disparities in IHCA treatment and survival, a...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehaa954
更新日期:2020-12-21 00:00:00
abstract::Forty-nine patients admitted for assessment of chest pain underwent coronary angiography, planar Thallium 201 myocardial scintigraphy after submaximal exercise (TE) and transoesophageal atrial pacing (TAP). Early hypofixation with redistribution after 4 h indicated ischaemia. The criterion for a myocardial infarction ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060259
更新日期:1992-06-01 00:00:00
abstract:AIMS:Aortic aneurysm/dissection (AAD) is a life-threatening disorder lacking effective pharmacotherapeutic remedies. Aldehyde dehydrogenase 2 (ALDH2) polymorphism is tied with various risk factors for AAD including hypertension, atherosclerosis, and hypercholesterolaemia although direct correlation between the two rema...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehaa352
更新日期:2020-07-07 00:00:00
abstract::Thrombolytic therapy is a practical, effective approach to the management of acute myocardial infarction that is widely used in Europe today. Early European trials demonstrated a clear reduction in mortality in patients who received thrombolytic therapy compared with those given conventional treatment. The findings of...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/17.suppl_e.21
更新日期:1996-09-01 00:00:00
abstract::An investigation was undertaken to assess the value of adding streptokinase therapy to standard penicillin treatment of artificially induced infective endocarditis due to Streptococcus sanguis. In pigs a low-grade infection could be induced which closely simulated streptococcal endocarditis in man, but for technical r...
journal_title:European heart journal
pub_type: 临床试验,杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062100
更新日期:1986-06-01 00:00:00