Abstract:
BACKGROUND:During the initial phase of an ischemic insult, left ventricular (LV) performance depends on the complex interaction between oxygen deprivation, vascular turgor, and accumulation of metabolites. In experimental preparations, low-flow ischemia decreases systolic shortening and increases diastolic LV distensibility, whereas pacing-induced ischemia or hypoxic perfusion produces smaller decreases in systolic shortening but decreases LV diastolic distensibility. The purpose of this study was to investigate the different effects of low-flow ischemia, pacing-induced ischemia, and hypoxemic perfusion on LV performance in humans. METHODS AND RESULTS:In 20 patients with a significant stenosis in the left anterior descending coronary artery, micromanometer-tip LV pressure recordings (n = 20), LV angiography (n = 18), and coronary sinus blood sampling (n = 11) were obtained at rest and during the following conditions: pacing-induced ischemia (PI) (n = 11), low-flow ischemia of balloon coronary occlusion (CO) (n = 20), and hypoxemia induced by balloon coronary occlusion with hypoxemic perfusion distal to the occlusion (CO+P) (n = 11). LV stroke work index fell from 75 +/- 17 g.m at rest to 43 +/- 14 g.m at the end of CO (n = 18; P < .001). In addition, LV stroke work index was lower at the end of CO than during PI (50 +/- 11 vs 77 +/- 15 g.m; n = 11; P < .002) and was lower at the end of CO than at the end of CO+P (35 +/- 7 vs 46 +/- 9 g.m; n = 9; P < .02). LV end-diastolic pressure rose from 16 +/- 5 mm Hg at rest to 23 +/- 6 mm Hg at the end of CO (n = 20; P < .001). However, LV end-diastolic pressure was lower at the end of CO than during PI (20 +/- 5 vs 30 +/- 5 mm Hg; n = 11; P < .002) and was lower at the end of CO than at the end of CO+P (26 +/- 5 vs 34 +/- 7 mm Hg; n = 11; P < .01). LV end-diastolic volume index increased from 75 +/- 14 mL/m2 at rest to 79 +/- 15 mL/m2 at the end of CO (n = 18; P < .05). Left ventricular end-diastolic volume index increased to values similar to those for CO during PI (79 +/- 13 mL/m2; n = 11; P = NS) and at the end of CO+P (78 +/- 14 mL/m2; n = 9; P = NS). Higher values of LV end-diastolic pressure and unchanged values of LV end-diastolic volume index for PI and CO+P, compared with CO, suggested a lower end-diastolic LV distensibility during PI and during hypoxemia, as compared with low-flow ischemia. Upward shifts of individual diastolic LV pressure-volume curves during PI (9 of 11 patients) and at the end of CO+P (7 of 9 patients), compared with CO, were also consistent with lower LV diastolic distensibility during pacing-induced ischemia and during hypoxemia, compared with low-flow ischemia. Coronary sinus lactate, H+, and K+ levels increased after balloon deflation (CO and CO+P) and during pacing (PI). CONCLUSIONS:Thus, during low-flow ischemia, LV systolic performance was lower and LV diastolic distensibility larger than during pacing-induced ischemia or hypoxemia. The variable response of the human myocardium to different types of ischemia was probably related to the degree of vascular turgor and accumulation of tissue metabolites.
journal_name
Circulationjournal_title
Circulationauthors
De Bruyne B,Bronzwaer JG,Heyndrickx GR,Paulus WJdoi
10.1161/01.cir.88.2.461subject
Has Abstractpub_date
1993-08-01 00:00:00pages
461-71issue
2eissn
0009-7322issn
1524-4539journal_volume
88pub_type
杂志文章相关文献
CIRCULATION文献大全abstract:BACKGROUND:We developed a computer model to predict lysis rates of thrombi for intravenous thrombolytic regimens based on the convective/diffusive penetration of reacting and adsorbing fibrinolytic species from the circulation into the proximal face of a dissolving clot. METHODS AND RESULTS:Solution of a one-compartme...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.4.763
更新日期:1996-08-15 00:00:00
abstract:BACKGROUND:Circumferential pulmonary vein ablation (CPVA) is effective in curing atrial fibrillation (AF), but new-onset left atrial tachycardia (AT) is a potential complication. We evaluated whether a modified CPVA approach including additional ablation lines on posterior wall and the mitral isthmus would reduce the i...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.CIR.0000147186.83715.95
更新日期:2004-11-09 00:00:00
abstract:BACKGROUND:The coexistence of atrial fibrillation (AF) and atrial flutter (AFL) is well recognized. AF precedes the onset of AFL in almost all instances. We evaluated the effect of 2 ablation strategies in patients with paroxysmal AF (PAF) and AFL. METHODS AND RESULTS:Ninety-eight patients with PAF/AFL were prospectiv...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/CIRCULATIONAHA.107.711622
更新日期:2007-12-11 00:00:00
abstract:BACKGROUND:It is unclear whether increased left ventricular (LV) mass in overweight individuals is related to their adiposity or to greater fat-free mass (FFM). METHODS AND RESULTS:We compared echocardiographic LV mass to FFM and adipose body mass by bioelectric impedance and to anthropometric measurements in 3107 Ame...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.98.23.2538
更新日期:1998-12-08 00:00:00
abstract:BACKGROUND:Differences in vascular reactivity to phenylephrine (PE) responsiveness have been largely evidenced in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Because nitric oxide (NO) strongly affects modulation of the vascular tone in response to vasopressor agents, we hypothesized that the ...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.99.24.3096
更新日期:1999-06-22 00:00:00
abstract::This study analyzes the response to overdrive suppression of junctional pacemakers (JP) and correlates it with symptoms in 21 patients. Junctional rhythm (JR) was seen in 5 patients with intact A-V conduction, and in 16 with complete heart block, the JPs were located proximal to or within the His bundle (BH). Junction...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.57.5.880
更新日期:1978-05-01 00:00:00
abstract:BACKGROUND:Type 2 diabetes (DM-2) and impaired glucose metabolism (IGM) are associated with an increased cardiovascular disease risk. In nondiabetic individuals, increased arterial stiffness is an important cause of cardiovascular disease. Associations between DM-2 and IGM and arterial stiffness have not been systemati...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000065222.34933.FC
更新日期:2003-04-29 00:00:00
abstract:BACKGROUND:Oxidative stress has been implicated in vascular injury and atherogenesis, and antioxidant treatment has shown favorable results in preclinical studies. Despite this, antioxidant therapy has failed to show benefit in clinical trials. Failure of antioxidants in clinical trials may be partly because such thera...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000128034.70732.C2
更新日期:2004-05-25 00:00:00
abstract:BACKGROUND:The potential biological significance of hydrogen sulfide (H(2)S) has attracted growing interest in recent years. The aim of this study was to characterize a novel, water-soluble, slow-releasing H(2)S compound [morpholin-4-ium 4 methoxyphenyl(morpholino) phosphinodithioate (GYY4137)] and evaluate its use as ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.753467
更新日期:2008-05-06 00:00:00
abstract::Instantaneous aortic arch blood velocity was recorded transcutaneously from the suprasternal notch, using a 2.2 MHz Doppler ultrasound unit, in 18 normals and 16 patients undergoing cardiac catheterization who had murmurs of mitral regurgitation. In normals aortic blood velocity rose rapidly in early systole to a mids...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.54.4.656
更新日期:1976-10-01 00:00:00
abstract:BACKGROUND:Perivascular adipose tissue (PVAT) surrounds most vessels and shares common features with brown adipose tissue (BAT). Although adaptive thermogenesis in BAT increases energy expenditure and is beneficial for metabolic diseases, little is known about the role of PVAT in vascular diseases such as atheroscleros...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.112.104489
更新日期:2012-08-28 00:00:00
abstract:BACKGROUND:Chronic heart failure remains a major cause of mortality and morbidity. The role of antithrombotic therapy in patients with chronic heart failure has long been debated. The objective of this study was to determine the optimal antithrombotic agent for heart failure patients with reduced ejection fractions who...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/CIRCULATIONAHA.108.801753
更新日期:2009-03-31 00:00:00
abstract:BACKGROUND:Smoking is a major risk factor for cardiovascular events. One of the potential mechanisms may be related to both coronary endothelial dysfunction and increased inflammatory response. The present study was designed to test the hypothesis that smoking is associated with epicardial coronary endothelial dysfunct...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.641654
更新日期:2007-05-22 00:00:00
abstract:BACKGROUND:A family history of premature coronary artery disease (CAD) in a first-degree relative is an independent risk factor for coronary disease. Both genetic and environmental influences are likely to be responsible and may interact, but their relative importance is unclear. METHODS AND RESULTS:We studied endothe...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.10.3378
更新日期:1997-11-18 00:00:00
abstract::Premature escape beats induced in conscious dogs with chronic complete atrioventricular block have been defined as escape beats occurring on cessation of overdrive pacing and having a coupling interval to the last paced beat shorter than the coupling interval between the premature escape beat and the second postpacing...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.82.1.234
更新日期:1990-07-01 00:00:00
abstract:BACKGROUND:Thoracic endovascular aortic repair offers a less invasive approach for the treatment of ruptured descending thoracic aortic aneurysms (rDTAA). Due to the low incidence of this life-threatening condition, little is known about the outcomes of endovascular repair of rDTAA and the factors that affect these out...
journal_title:Circulation
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.109.908871
更新日期:2010-06-29 00:00:00
abstract::Experimental studies have shown that among dogs with a healed myocardial infarction, depressed baroreflex sensitivity (BRS) identifies a subgroup at higher risk for sudden death. We have examined the relation among BRS, several clinical cardiovascular variables, and subsequent mortality in 78 patients below the age of...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.78.4.816
更新日期:1988-10-01 00:00:00
abstract:BACKGROUND:Lipoprotein(a) [Lp(a)] may play a causal role in atherosclerosis. PCSK9 (proprotein convertase subtilisin/kexin 9) inhibitors have been shown to significantly reduce plasma Lp(a) concentration. However, the relationship between Lp(a) levels, PCSK9 inhibition, and cardiovascular risk reduction remains undefin...
journal_title:Circulation
pub_type: 杂志文章,随机对照试验
doi:10.1161/CIRCULATIONAHA.118.037184
更新日期:2019-03-19 00:00:00
abstract::Preservation of regional myocardial function, high-energy phosphate stores and ultrastructure were assessed in 28 canine hearts subjected to 2 hours of global ischemia at either 12 degrees C or 21 degrees C. The preservation achieved with a potassium arrest solution was simultaneously compared in the same heart with e...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1982-08-01 00:00:00
abstract:BACKGROUND:Adenosine has several potentially cardioprotective effects. We hypothesized that the effects of endogenous adenosine vary with degree of ischemia and that elevating endogenous levels is protective. METHODS AND RESULTS:Isolated blood-perfused piglet hearts underwent 120 minutes of low-flow ischemia (10% flow...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.9.3094
更新日期:1997-11-04 00:00:00
abstract:BACKGROUND:The aim of the present study was to evaluate dynamic changes in aortic regurgitant (AR) orifice area with the use of calibrated electromagnetic (EM) flowmeters and to validate a color Doppler flow convergence (FC) method for evaluating effective AR orifice area and regurgitant volume. METHODS AND RESULTS:In...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.93.3.594
更新日期:1996-02-01 00:00:00
abstract::Exit block from a parasystolic focus is recognized when automatic discharges fail to become manifest during the excitable phase of the ventricular cycle. In the present study, an apparently complete exit block and a persistently concealed ventricular parasystole (VP) resulted from an exit refractory period (ExRP) long...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.64.1.199
更新日期:1981-07-01 00:00:00
abstract::The relation between ventricular dysrhythmia during the first 20 hours after hospitalization for acute myocardial infarction and enzymatically estimated infarct size was studied prospectively. The duration of dyshythmia was measured by the total time during which the average premature ventricular depolarization (PVC) ...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1976-03-01 00:00:00
abstract::A prospective electrocardiographic study was designed to establish baseline values for electrocardiographic measurements, with specific reference to the QT interval during infancy, and to test the "QT hypothesis" for the sudden infant death syndrome (SIDS). In this ongoing study, ECGs are recorded on the fourth day of...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.66.3.496
更新日期:1982-09-01 00:00:00
abstract::Analysis of the external brachial pulse recorded during standard blood pressure cuff deflation with use of a transducer with a wide frequency response has revealed a reproducible pattern with three distinct components that we have labeled K1, K2, and K3. K1 is a low-amplitude, low-frequency signal that is present with...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.77.6.1297
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:DC shock catheter ablation for the treatment of ventricular tachycardia (VT) may induce VT episodes that disappear within days. METHODS AND RESULTS:A 30-J cathodal shock was delivered to the endocardial left ventricular wall in 15 closed-chest dogs. All dogs had VT during the first day after ablation. Eleve...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.84.1.267
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:Patients with treated diabetes in the randomized-trial segment of the Bypass Angioplasty Revascularization Investigation (BARI) who were randomized to initial revascularization with PTCA had significantly worse 5-year survival than patients assigned to CABG. This treatment difference was not seen among diabe...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.99.5.633
更新日期:1999-02-09 00:00:00
abstract:BACKGROUND:Visceral adiposity is generally considered to play a key role in the metabolic syndrome, including hypertension. The purpose of this study was to evaluate cross-sectionally whether visceral adiposity is associated with prevalence of hypertension independent of other adipose depots and fasting plasma insulin....
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000087597.59169.8D
更新日期:2003-10-07 00:00:00
abstract:BACKGROUND:Regular exercise in patients with stable coronary artery disease has been shown to improve myocardial perfusion and to retard disease progression. We therefore conducted a randomized study to compare the effects of exercise training versus standard percutaneous coronary intervention (PCI) with stenting on cl...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.CIR.0000121360.31954.1F
更新日期:2004-03-23 00:00:00
abstract:BACKGROUND:This study was performed to determine whether antibodies against the amino-terminus of the beta-chain of fibrin (anti-beta) could noninvasively distinguish actively enlarging thrombi from thrombi stabilized with anticoagulants. METHODS AND RESULTS:Dogs with unilateral femoral vein thrombi were allocated int...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.9.3173
更新日期:1997-11-04 00:00:00