Abstract：
:On a variety of fronts, chronic infection has been found to be significantly associated with the development of atherosclerosis and the clinical complications of unstable angina, myocardial infarction, and stroke. For the most part, these relationships are still just associations. Failure to confirm initial reports of serologic associations also has been common. Specific causative relationships on par with that determined between H pylori and peptic ulcer disease have not yet been established. Potential mechanisms whereby chronic infections may play a role in atherogenesis are myriad. In the case of C pneumoniae, the effect may result from direct vessel wall colonization that may damage the vessel either directly or indirectly by initiating immunologic responses. In other cases the effect may simply be that of enhancing the pre-existing chronic inflammatory response of the body to standard risk factors such as hyperlipidemia. Even though the infectious agent may not directly infect the vessel wall, it may perform its critical role from afar. Chronic infection might also influence pre-existing plaque by enhancing T-cell activation or other inflammatory responses that may participate in the destabilization of the intimal cap. Hence chronic infection may play a role either in the initiation, progression, or the destabilization of atherosclerotic plaques. The infectious agents with the most evidence to support an etiologic role in atherosclerosis include C pneumoniae and cytomegalovirus. Evidence is mounting for a variety of other potential agents including other herpes viruses, influenza, other specific bacteria (such as M pneumoniae), and chronic infections with common bacterial agents (periodontal disease, chronic bronchitis, and chronic urinary tract infection, among others) [191]. Future studies are expected to elucidate further the pathophysiologic relationship between chronic infection and atherosclerosis and to evaluate further the potential of a variety of treatment approaches, including antibiotics.
journal_name
Cardiol Clinjournal_title
Cardiology clinicsauthors
Muhlestein JB,Anderson JLdoi
10.1016/s0733-8651(03)00054-7subject
Has Abstractpub_date
2003-08-01 00:00:00pages
333-62issue
3eissn
0733-8651issn
1558-2264pii
S0733-8651(03)00054-7journal_volume
21pub_type
杂志文章,评审abstract：:Myocardial systolic contractile dysfunction can occur despite preservation of myocardial viability, conditions referred to as myocardial 'stunning' or 'hibernation.' Because simple assessment of wall motion does not adequately distinguish nonviable from viable but noncontracting myocardial regions, clinicians require ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1994-05-01 00:00:00
abstract：:The epidemiology of IE has evolved over the past 50 years. Mitral valve prolapse and degenerative valvular disease have replaced rheumatic heart disease as the most common predisposing conditions. The average age of patients with IE has increased, and nosocomially acquired cases are becoming more common. Although viri...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(05)70289-7
更新日期：1996-08-01 00:00:00
abstract：:A syncope evaluation should start by identifying potentially life-threatening causes, including valvular heart disease, cardiomyopathies, and arrhythmias. Most patients who present with syncope, however, have the more benign vasovagal (reflex) syncope. A busy syncope practice often also sees patients with neurogenic o...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2012.09.003
更新日期：2013-02-01 00:00:00
abstract：:Thoracoabdominal aortic aneurysms are increasing in incidence. Rupture is associated with a high rate of morbidity and mortality. The historic gold standard of open repair can be performed with low rates of complications at centers of excellence. However, these results are not universally achievable, with significantl...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2017.03.008
更新日期：2017-08-01 00:00:00
abstract：:Coronary computed tomographic angiography (CTA) is a promising noninvasive tool that allows the visualization of plaque morphology. Plaques characterized by positive remodeling, low attenuation, and napkin ring circular enhancement on contrast-enhanced coronary CTA have been regarded as rupture-prone vulnerable plaque...
journal_title：Cardiology clinics
pub_type： 杂志文章
doi：10.1016/j.ccl.2011.10.002
更新日期：2012-02-01 00:00:00
abstract：:Cardiac arrest in pregnancy is not only uncommon but also catastrophic. Early aggressive resuscitation by well-trained health care providers improves the chances of successful outcomes for both the patient and her fetus. Significant physiologic changes that occur normally in pregnancy require several modifications to ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2012.04.006
更新日期：2012-08-01 00:00:00
abstract：:The indications for clinical electrophysiologic study have continued to evolve since the introduction of this technique in the mid 1960s. They now include evaluation of sinus node dysfunction, AV conduction disturbances, syncope of unknown etiology, supraventricular arrhythmias with and without Wolff-Parkinson-White s...
journal_title：Cardiology clinics
pub_type： 杂志文章
doi：
更新日期：1985-02-01 00:00:00
abstract：:Apoptosis consists of a complex set of biochemical events initiated by an array of different stimuli and enzymatic pathways. There is a set of common morphologic and biochemical features of apoptosis that could be exploited as hot or cold targets to image cardiovascular apoptosis. First, the authors review the potenti...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(05)70202-2
更新日期：2001-02-01 00:00:00
abstract：:Stress-first approaches to myocardial perfusion imaging provide diagnostically and prognostically accurate perfusion data equivalent to a full rest-stress study, save time in the imaging laboratory, and reduce the radiation exposure to patients and laboratory staff. Converting a nuclear cardiology laboratory from a co...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2015.06.006
更新日期：2016-02-01 00:00:00
abstract：:Quantification of regional myocardial blood flow and of its responses to targeted physiologic and pharmacologic interventions, which is now available with positron emitting tracers of blood flow and positron emission tomography (PET), extends the diagnostic potential of standard myocardial perfusion imaging. These non...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2008.12.009
更新日期：2009-05-01 00:00:00
abstract：:Bacterial infections of the heart in compromised patients are uncommon but may be increasing in relative frequency. They are associated with near-equal frequencies in patients who have pre-existing or simultaneous infections at other sites, patients with neoplasms (usually solid tumors), those who have undergone cardi...
journal_title：Cardiology clinics
pub_type： 杂志文章
doi：
更新日期：1984-11-01 00:00:00
abstract：:Cardiac transplantation is now an accepted therapeutic procedure in the management of patients suffering from end-stage congestive heart failure. The advances in myocardial preservation, long-distance procurement, immunosuppression, improvement in the treatment of infectious diseases, and utilization of endomyocardial...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1989-02-01 00:00:00
abstract：:With recent technical and clinical advances, adenosine stress perfusion MRI has evolved from a promising research tool to an everyday clinical test. This article reviews the current state of stress perfusion MRI. Specifically, it addresses the following topics: validation of stress perfusion MRI in preclinical studies...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2007.02.002
更新日期：2007-02-01 00:00:00
abstract：:Incident heart failure and the burden of hospitalization may be demonstrating a decline. However, as the population ages, the prevalence of heart failure continues to increase. Mortality among heart failure patients is increasingly due to non-cardiovascular causes. Current evidence-based therapy for heart failure has ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2016.12.008
更新日期：2017-05-01 00:00:00
abstract：:The chronotropic response is the most important means by which cardiac output is increased and oxygen delivery is maintained in response to increased oxygen consumption during exercise or stress. When the chronotropic response is suboptimal or absent, exercise intolerance results. This condition, called chronotropic i...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(05)70132-6
更新日期：2000-02-01 00:00:00
abstract：:Targeted ultrasound imaging uses acoustically active contrast agents bearing a ligand on the surface that binds to a function-specific molecule. These ultrasound contrast agents are typically gas-filled microbubbles, nongaseous liposomes, or lipid-encapsulated perfluorocarbon emulsions. Binding of the contrast agent t...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2004.02.008
更新日期：2004-05-01 00:00:00
abstract：:There has been heightened interest in the design and role of preparticipation screening for high school and college athletes. An American Heart Association consensus panel, composed of cardiovascular specialists and other physician experts having extensive clinical experience with athletes of all ages as well as a leg...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(05)70353-2
更新日期：1997-08-01 00:00:00
abstract：:The major adaptations of the maternal cardiovascular system that progress throughout gestation may unmask previously unrecognized heart disease and result in significant morbidity and mortality. Most of these changes are almost fully reversed in the weeks and months after delivery. Hemodynamic changes during pregnancy...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2012.05.004
更新日期：2012-08-01 00:00:00
abstract：:Proarrhythmia is a potentially lethal adverse effect of antiarrhythmic drugs. Underlying mechanisms and the approaches to identification are discussed. The applicability of electrophysiologic testing is considered, with particular reference to the validity of the different responses to programmed stimulation considere...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1986-08-01 00:00:00
abstract：:The overall management and prognosis of patients with acute myocardial infarction must take into account not only infarct size but also the site and locus of involvement as determined by electrocardiography. Transmural versus nontransmural infarction is discussed in relation to therapy and prognosis. ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1984-02-01 00:00:00
abstract：:Diabetes and the metabolic syndrome, including insulin resistance, that underlies it are hyper-coagulable states. Increased platelet reactivity,augmented activity of the coagulation system,and impaired fibrinolysis are characteristic and understood to a remarkable extent. In aggregate,these derangements contribute to ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2004.06.009
更新日期：2004-11-01 00:00:00
abstract：:Atrial fibrillation (AF), an escalating dysrhythmia, is accountable for extensive population morbidity and mortality. In the United States, approximately 2.3 million people are presently diagnosed with AF and it is estimated that this prevalence may increase to 5.6 million by 2050. Foremost predisposing risk factors f...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2008.09.015
更新日期：2009-02-01 00:00:00
abstract：:Despite tremendous progress made in the management of CHD, a significant number of fatal and nonfatal CHD events still occur, which leads researchers to target other modifiable risk factors for CHD including low HDL-c (high density lipoprotein cholesterol). Although the torcetrapib experience was a major blow to CETP ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2008.06.005
更新日期：2008-11-01 00:00:00
abstract：:Chronic total coronary occlusions (CTOs) are a frequent finding in patients with coronary disease and remain one of the most challenging target lesion subsets for intervention. CTOs have been reported in approximately one-third of patients undergoing diagnostic coronary angiography. By nature of their complexity, CTO ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2009.10.003
更新日期：2010-02-01 00:00:00
abstract：:Sudden death, a major cause of mortality in the Western world, usually results from electrophysiologic phenomena in chronically damaged hearts with advanced coronary atherosclerosis. The exact pathophysiologic mechanisms are not known, but there is reasonable circumstantial evidence to implicate myocardial ischemia--c...
journal_title：Cardiology clinics
pub_type： 杂志文章
doi：
更新日期：1986-11-01 00:00:00
abstract：:Given the rapid evolution of cardiovascular medicine, clinicians must sift through an enormous array of information about new therapies in order to determine how best to treat patients with ischemic heart disease. They should first consider the evidence from randomized clinical trials, because these trials eliminate b...
journal_title：Cardiology clinics
pub_type： 杂志文章
doi：
更新日期：1995-08-01 00:00:00
abstract：:The AbioCor is a revolutionary device. It is the only device of its kind in the clinical world. The role of the AbioCor is to provide permanent replacement of the failing heart for patients who are not transplant candidates. The clinical trial has been successful in the majority (four of seven) of patients implanted t...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(02)00141-8
更新日期：2003-02-01 00:00:00
abstract：:The myocardium consists of three compartments: cardiac muscle cells; a nutritive microcirculation; and an extracellular matrix composed largely of fibrillar collagen. The hypertrophic remodeling of the myocardium, which involves each of these compartments, can be adaptive or pathologic. This article reviews the remode...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1989-02-01 00:00:00
abstract：:Percutaneous transluminal coronary angioplasty was first performed in a human coronary artery in 1977. In this article, we review the possible mechanisms of angioplasty, current indications for angioplasty, and complications of angioplasty including acute closure and restenosis. ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1988-08-01 00:00:00
abstract：:Acute decompensated heart failure (ADHF) is the most common cause of cardiovascular hospital admission; 1 in 4 patients with heart failure is readmitted within 30 days of being discharged, and ADHF consumes 1% to 2% of the total health care resources. The most effective approach for preventing heart failure hospitaliz...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2012.07.006
更新日期：2012-11-01 00:00:00
