Abstract:
BACKGROUND:The physiological assessment of angiographically intermediate-severity stenoses remains problematic. Functional measurements of poststenotic intracoronary Doppler coronary flow reserve can be performed in humans but have not been correlated with hyperemic myocardial perfusion imaging or angiographic data in this patient population. METHODS AND RESULTS:Thirty-three patients undergoing diagnostic quantitative coronary angiography (QCA) for assessment of intermediate-severity coronary artery disease (mean QCA percent diameter stenosis, 56 +/- 14%) were studied. Proximal and distal poststenotic Doppler coronary flow velocities were measured (left anterior descending coronary artery, 16; right coronary artery, 10; left circumflex artery, 7 patients) before and during peak maximal hyperemia with intracoronary adenosine (8 to 12 micrograms). Intravenous pharmacological stress (adenosine, 20 patients; dipyridamole, 13 patients) 99mTc-sestamibi tomographic perfusion imaging was performed within 1 week of coronary flow-velocity studies. kappa statistics were calculated to measure the strength of correlation among coronary flow velocities, perfusion imaging data, and QCA results. QCA stenosis severity (abnormal, > or = 50% diameter stenosis) and poststenotic Doppler coronary flow reserve (ratio of abnormal distal hyperemic to basal flow, < or = 2.0) were correctly correlated in 20 of 27 patients (74%; kappa = .48). QCA stenosis severity and 99mTc-sestamibi imaging (abnormal if one or more reversible myocardial segments were present in the poststenotic zone) were correlated in 28 of 33 patients (85%; kappa = .63). 99mTc-sestamibi imaging results agreed with the basal (nonhyperemic) proximal-to-distal velocity ratio (normal, < 1.7) in 15 of 31 patients (48%; kappa = .17). The strongest correlation occurred between hyperemic distal flow-velocity ratio measurements and 99mTc-sestamibi perfusion imaging results in 24 of 27 patients (89%; kappa = .78). All 14 patients with abnormal distal hyperemic flow-velocity values had corresponding reversible 99mTc-sestamibi tomographic defects. More reversibly hypoperfused segments were present in patients with abnormal poststenotic hyperemic flow-velocity ratios (abnormal, 2.4 +/- 0.7 segments; normal, 0.6 +/- 1.0 segments; P < .05). The number of poststenotic myocardial 99mTc-sestamibi perfusion defects was correlated with the QCA percent cross-sectional area reduction (P < .02) and with minimal luminal diameter (P < .05) of intermediate-severity coronary artery stenoses. CONCLUSIONS:Two technologically diverse functional measures of stenosis severity--Doppler-derived poststenotic hyperemic intracoronary flow reserve and vasodilator stress 99mTc-sestamibi myocardial perfusion imaging--are highly (89%) correlated. The physiological assessment of coronary stenoses of angiographically intermediate severity may be improved by the use of these techniques.
journal_name
Circulationjournal_title
Circulationauthors
Miller DD,Donohue TJ,Younis LT,Bach RG,Aguirre FV,Wittry MD,Goodgold HM,Chaitman BR,Kern MJdoi
10.1161/01.cir.89.5.2150subject
Has Abstractpub_date
1994-05-01 00:00:00pages
2150-60issue
5eissn
0009-7322issn
1524-4539journal_volume
89pub_type
杂志文章相关文献
CIRCULATION文献大全abstract:BACKGROUND:Bone marrow implantation (BMI) was shown to enhance angiogenesis in a rat ischemic heart model. This preclinical study using a swine model was designed to test the safety and therapeutic effectiveness of BMI. METHODS AND RESULTS:BM-derived mononuclear cells (BM-MNCs) were injected into a zone made ischemic ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc3501.093817
更新日期:2001-08-28 00:00:00
abstract:BACKGROUND:Sudden cardiac death (SCD) is a major cause of mortality in adults with congenital heart disease (CHD). The aim of this study was to determine the adult CHD population at risk of SCD and the clinical parameters associated with SCD. METHODS AND RESULTS:We performed a multicenter case-control study. Patients ...
journal_title:Circulation
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.112.104786
更新日期:2012-10-16 00:00:00
abstract:BACKGROUND:Fe2+ released from tissue iron stores may accelerate lipid peroxidation by virtue of its pro-oxidant properties and thus promote early atherogenesis. METHODS AND RESULTS:The present prospective survey addresses the potential association between serum ferritin concentrations and the 5-year progression of car...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.10.3300
更新日期:1997-11-18 00:00:00
abstract::In a group of 39 patients who received fibrinolytic therapy for acute myocardial infarction, serum crosslinked fibrin degradation products (XLDP) were quantitated by an enzyme-linked immunosorbent assay (ELISA) using an antibody reactive with a site near the gamma gamma crosslink of fibrin, and characterized by a gel ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.74.5.1027
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:Out-of-hospital cardiac arrest (OHCA) is a major public health problem. We sought to describe changes in 1-month survival after OHCA in patients given cardiopulmonary resuscitation (CPR) during the last 14 years in Sweden. METHODS AND RESULTS:All patients experiencing OHCA in whom CPR was attempted between ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.734137
更新日期:2008-07-22 00:00:00
abstract:BACKGROUND:For patients with acute dilated cardiomyopathy, definition of prognosis and of clinical features predictive of outcome is particularly important due to the availability of cardiac transplantation and other innovative treatment strategies. METHODS AND RESULTS:We reviewed our experience with 24 children under...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.90.3.1310
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:Comprehensive data based on single-beat analysis of the ventricular activation sequence during sinus rhythm in infarcted hearts are currently not available. It was the aim of our study (1) to measure and analyze these activation sequences on the epicardial surface of the right and left ventricles and on the ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.91.5.1480
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:Pain triggers a homeostatic alarm reaction to injury. It remains unknown, however, whether nociceptive signaling activated by ischemia is relevant for progenitor cells (PC) release from bone marrow. To this end, we investigated the role of the neuropeptide substance P (SP) and cognate neurokinin 1 (NK1) noci...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.111.089763
更新日期:2012-04-10 00:00:00
abstract:BACKGROUND:Long-term survival after acute kidney injury (AKI) is poorly studied. We report the relationship between long-term mortality and AKI with small changes in serum creatinine during hospitalization after various cardiothoracic surgery procedures. METHODS AND RESULTS:This was a retrospective study of 2973 patie...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.800011
更新日期:2009-05-12 00:00:00
abstract:BACKGROUND:High-density lipoproteins have antidiabetic properties in vitro. Furthermore, elevated high-density lipoprotein levels accompanying a genetic deficiency of cholesteryl ester transfer protein are associated with decreased levels of plasma glucose. We now investigate effects on glucose homeostasis of inhibitin...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.111.018259
更新日期:2011-08-02 00:00:00
abstract:BACKGROUND:The coagulation system is closely linked with vascular inflammation, although the underlying mechanisms are still obscure. Recent studies show that protease-activated receptor (PAR)-2, a major receptor of activated factor X, is expressed in both vascular cells and leukocytes, suggesting that PAR-2 may contri...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.118.033544
更新日期:2018-10-16 00:00:00
abstract:BACKGROUND:The cross-talk between vascular endothelial growth factor (VEGF)-A, angiopoietin (Ang), and VE-cadherin coregulates endothelial cell (EC) survival. Cardiac expression of VEGF-A but not its receptor KDR is blunted in dilated cardiomyopathy (DCM). Whether VE-cadherin/Ang function is affected in DCM is unknown....
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000091085.12422.19
更新日期:2003-09-30 00:00:00
abstract::The coronavirus disease 2019 (COVID-19) pandemic has affected health and economy worldwide on an unprecedented scale. Patients have diverse clinical outcomes, but those with preexisting cardiovascular disease, hypertension, and related conditions incur disproportionately worse outcome. The high infectivity of severe a...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.120.047549
更新日期:2020-07-07 00:00:00
abstract::Disorders associated with the overproduction or delayed clearance of beta-very low density lipoprotein and low density lipoprotein (LDL) are strikingly related to premature coronary artery disease. There are five recognized classes of LDL-lowering drugs, each acting through different basic mechanisms. The increased pr...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:
更新日期:1993-04-01 00:00:00
abstract::To estimate the effect of distance between the electrode and the signal source on the amplitude of the His bundle electrogram (HBE) recorded during open heart surgery, a specially designed probe, containing six pairs of closely spaced (1 mm) electrodes was placed on the endocardial surface of the right atrium such tha...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.53.2.224
更新日期:1976-02-01 00:00:00
abstract:BACKGROUND:In people with atrial fibrillation (AF), periods of sinus rhythm present an opportunity to detect prothrombotic atrial remodeling through measurement of P-wave indices (PWIs)-prolonged P-wave duration, abnormal P-wave axis, advanced interatrial block, and abnormal P-wave terminal force in lead V1. We hypothe...
journal_title:Circulation
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.118.035411
更新日期:2019-01-08 00:00:00
abstract:BACKGROUND:Adenosine receptor activation has been proposed to explain the cardioprotective effect of ischemic preconditioning in rabbit hearts. We tested this hypothesis in a rat model by assessing whether administration of an adenosine antagonist could block the protective effect of preconditioning and whether adenosi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.87.5.1642
更新日期:1993-05-01 00:00:00
abstract::A Y-shaped lesion in the right atrium allows induction of atrial flutter in dogs. We recorded the activation sequence during this tachycardia from 96 endocardial bipolar electrodes using intracavitary electrode arrays during 12 separate episodes in three isolated perfused hearts. In each case a reentrant impulse circu...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.76.5.1155
更新日期:1987-11-01 00:00:00
abstract:BACKGROUND:Cardiac tissue engineering offers the prospect of a novel treatment for acquired or congenital heart defects. We have created vascularized pieces of beating cardiac muscle in the rat that are as thick as the adult rat right ventricle wall. METHOD AND RESULTS:Neonatal rat cardiomyocytes in Matrigel were impl...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.657379
更新日期:2007-01-23 00:00:00
abstract::The 21-amino acid peptide endothelin-1 (ET-1) is the predominant isoform of the endothelin peptide family, which includes ET-2, ET-3, and ET-4. It exerts various biological effects, including vasoconstriction and the stimulation of cell proliferation in tissues both within and outside of the cardiovascular system. ET-...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.19.2434
更新日期:2000-11-07 00:00:00
abstract:BACKGROUND:Red blood cell transfusion can both benefit and harm. To inform decisions about transfusion, we aimed to quantify associations of transfusion with clinical outcomes and cost in patients having cardiac surgery. METHODS AND RESULTS:Clinical, hematology, and blood transfusion databases were linked with the UK ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.698977
更新日期:2007-11-27 00:00:00
abstract::Plasma and lipoprotein cholesterol and triglyceride concentrations were measured in Pima Indians, a genetically homogeneous population with a high prevalence of obesity and diabetes and a low frequency of coronary heart disease. The data for nondiabetic Pima Indians were compared with those of U.S. Caucasians measured...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.68.4.714
更新日期:1983-10-01 00:00:00
abstract:BACKGROUND:Endurance athletes have higher high density lipoprotein (HDL) concentrations than sedentary controls. To examine the mechanism for this effect, we compared HDL apoprotein metabolism in 10 endurance athletes aged 34 +/- 6 years (mean +/- SD) and 10 sedentary men aged 36 +/- 8 years. METHODS AND RESULTS:Subje...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.84.1.140
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:Secretoneurin is a neuropeptide located in nerve fibers along blood vessels, is upregulated by hypoxia, and induces angiogenesis. We tested the hypothesis that secretoneurin gene therapy exerts beneficial effects in a rat model of myocardial infarction and evaluated the mechanism of action on coronary endoth...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.111.076950
更新日期:2012-11-20 00:00:00
abstract:BACKGROUND:The importance of clinical presentation and pretransplantation course on outcome in children with dilated cardiomyopathy listed for heart transplantation is not well defined. METHODS AND RESULTS:The impact of age, duration of illness, sex, race, ventricular geometry, and diagnosis of myocarditis on outcome ...
journal_title:Circulation
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.110.011999
更新日期:2012-08-28 00:00:00
abstract:BACKGROUND:Cardiovascular disease is the major cause of death in older women. Information on the relation of menopause and hormone replacement therapy with carotid atherosclerosis is limited. METHODS AND RESULTS:We examined cross-sectionally the association of menopausal status, years since last menstruation, and horm...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.8.1857
更新日期:1996-10-15 00:00:00
abstract:BACKGROUND:Epidemiological studies and animal experiments have provided evidence supporting the role of lipid peroxidation in atherogenesis and cardiovascular diseases. Direct evidence linking lipid oxidation to atherosclerotic progression in humans, however, has been lacking. We investigated the association of lipid o...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.95.4.840
更新日期:1997-02-18 00:00:00
abstract:BACKGROUND:Despite a recent American Heart Association (AHA) consensus statement emphasizing the importance of resistant hypertension, the incidence and prognosis of this condition are largely unknown. METHODS AND RESULTS:This retrospective cohort study in 2 integrated health plans included patients with incident hype...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.111.068064
更新日期:2012-04-03 00:00:00
abstract:BACKGROUND:The associations between pregnancy hypertensive disorders and common cardiovascular disorders have not been investigated at scale in a contemporaneous population. We aimed to investigate the association between preeclampsia, hypertensive disorders of pregnancy, and subsequent diagnosis of 12 different cardio...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.118.038080
更新日期:2019-09-24 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