Abstract:
:It has been suggested that the myocardium is able to recruit endogenous protective mechanisms in response to repeated ischemia and reperfusion. We set out to study whether this is manifested in patients with coronary artery disease in the form of fewer signs of myocardial ischemia during the second of two successive exercise tests and whether any relations exist between ischemia adaptation and findings at cardiac catheterization. Twenty-one patients with typical angina pectoris symptoms underwent two repeated bicycle exercise tests with identical protocols, followed by cardiac catheterization and coronary angiography the next day. The first exercise test was discontinued whenever a 2 mm ST depression in the electrocardiogram (ECG) was achieved or further exercise was limited by symptoms. The second exercise test was performed after disappearance of the symptoms or ST depression or both. Kaplan-Meier survival analysis for the appearance of a 1 mm ST depression demonstrated improved ischemia tolerance during the second test, when the required time for its appearance was significantly longer (6.5 +/- 0.8 min vs 4.5 +/- 0.5 min; p = 0.005). The maximal intensity of anginal pain was lower during the second exercise (2.2 +/- 1.0 min vs 0.7 +/- 0.3 min in Borg's scale; p < 0.001), and the time required for disappearance of the ST depression was shorter after this exercise (3.0 +/- 0.8 min vs 6.2 +/- 0.9 min; p = 0.003), with a similar tendency in the disappearance of angina. The rate-pressure product on the appearance of a 1 mm ST depression was significantly higher during the second test (17,990 +/- 1210 mm Hg x min-1 vs 15,960 +/- 869 mm Hg x min-1; p = 0.009). Eighteen of the patients had three-vessel disease, as evidenced by coronary angiography, and the change in the time required for the appearance of a 1 mm ST depression in the repeated exercise tests was inversely correlated with the severity of the left anterior descending (LAD) coronary artery obstruction (r = -0.61; p = 0.006) and left ventricular end-diastolic pressure (r = -0.50; p = 0.03). No significant correlation with the degree of collateral vessels was found. We conclude that most patients with extensive coronary artery disease are able to increase their tolerance of ischemia during repeated dynamic exercise and that increased vasodilation and oxygen delivery are the major mechanisms for this warm-up phenomenon. On the other hand, collaterals visible in routine resting anglography do not predict the degree of adaptation to ischemia during repeated dynamic exercise.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Ylitalo K,Jama L,Raatikainen P,Peuhkurinen Kdoi
10.1016/s0002-8703(96)90272-0subject
Has Abstractpub_date
1996-04-01 00:00:00pages
689-97issue
4eissn
0002-8703issn
1097-6744pii
S0002-8703(96)90272-0journal_volume
131pub_type
杂志文章abstract::Out of 160 prospectively followed patients with aortic regurgitation, the clinical courses of 53 patients with pure, severe, and chronic aortic regurgitation and without coronary artery disease who were selected for surgery on the basis of predefined criteria is discussed. Surgical criteria were either unequivocal sym...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(90)90023-q
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:Aldosterone antagonist therapy is recommended for selected patients with heart failure and reduced ejection fraction. Adherence to therapy in the transition from hospital to home is not well understood. METHODS:We identified patients with heart failure and reduced ejection fraction who were ≥65 years old, e...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2013.03.007
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:The outpatient prognostic assessment of coronary artery disease (CAD) by exercise electrocardiography has limitations, including the feasibility of the test and its low positive predictive value in several clinical conditions. In the current study we investigated the safety, feasibility, and prognostic value...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.113997
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Several non-vitamin K antagonist oral anticoagulant (NOAC) alternatives to warfarin are available for stroke prevention in atrial fibrillation (AF). We aimed to describe the factors associated with selection of NOACs versus warfarin in patients with new onset AF. METHODS:The ORBIT-AF II study is a national,...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ahj.2017.03.024
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Optimal antithrombotic treatment after transcatheter aortic valve replacement (TAVR) is unknown and determined empirically. The direct factor Xa inhibitor rivaroxaban may potentially reduce TAVR-related thrombotic complications and premature valve failure. DESIGN:GALILEO is an international, randomized, ope...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2016.10.017
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Carvedilol therapy during congestive heart failure demonstrated a good efficacy in mortality rate reduction and in improvement of left ventricular (LV) systolic performance. However, currently there is not any finding about the drug's effect on diastolic filling. The aim of this study was to evaluate the eff...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(03)00525-8
更新日期:2004-01-01 00:00:00
abstract::Little is known about the impact of accountable care organizations (ACO) on hospitalized heart failure (HF) patients, a high-cost and high-risk population. OBJECTIVE:We linked Medicare fee-for-service claims from 2013 to 2015 with data from American Heart Association Get With The Guidelines-HF registry to compare HF ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2020.04.028
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:National registries are advocated as instrumental to the solution of rarity-related problems for patients with hypertrophic cardiomyopathy (HCM), including limited access to advanced treatment options. Thus, an Italian Registry for HCM was created to assess the clinical profile and the level of care nationwi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.01.005
更新日期:2005-11-01 00:00:00
abstract::This study investigated the correlation between cardiac abnormalities and cytosine-thymine-guanine (CTG) trinucleotide repeat expansion in patients with myotonic dystrophy (MD). We studied 18 patients with the adult form of classical MD and 18 age-matched control subjects. In patients with MD, left ventricular systoli...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70137-6
更新日期:1997-08-01 00:00:00
abstract::Besides reperfusion treatment, which is the most powerful approach to the underlying pathophysiological cause of myocardial infarction, adjunctive therapies should be considered to reduce clinical symptoms, and improve left ventricular function and mortality rates. Randomized clinical trials and overviews of adjunctiv...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(99)70341-8
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Lipid lowering through statin therapy significantly reduces the risk of cardiovascular events. The ENHANCE study is an international 2-year, randomized, double-blind, controlled trial designed to test the hypothesis that treatment of hypercholesterolemia by use of 2 complementary agents, ezetimibe (a specifi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.06.024
更新日期:2005-02-01 00:00:00
abstract::Atrial pacing-induced changes in the sum of R-wave amplitude were measured in leads V5, X, Y, and Z at rates of 100 bpm (phase I), 150 bpm (phase II), and immediately after pacing (phase III) in 33 patients undergoing cardiac catheterization for evaluation of chest pain. Seventeen (51%) patients showed evidence of isc...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90133-9
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:The objective of this study was to determine if depression is associated with worse disease-specific functional status in patients with coronary artery disease. The study was designed as a cross-sectional survey and 3-month longitudinal cohort. METHODS AND RESULTS:The study took place in outpatient clinics ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.106600
更新日期:2000-07-01 00:00:00
abstract::A 17-year-old man with staphylococcal endocarditis of the mitral valve developed an infective aneurysm of the posterior left ventricular wall. Echocardiography revealed an echo-free space posterior to the posterior left ventricular wall. This echo-free space undoubtedly represented the aneurysmal sac, because it could...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90051-0
更新日期:1978-09-01 00:00:00
abstract::Percutaneous transluminal coronary angioplasty (PTCA) has, in general, been restricted to therapy for patients with angina pectoris. Thrombolytic therapy and guide wire recanalization have been used to recanalize coronary arteries in patients with evolving myocardial infarction. Recently we and others have examined th...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90352-1
更新日期:1984-04-01 00:00:00
abstract::Inhibition of the enzyme that synthesizes thromboxanes may protect against the development of ventricular fibrillation (VF) during acute myocardial ischemia. This study was carried out to test this hypothesis with a new thromboxane synthetase inhibitor, and to extend the studies to alternative animal models of myocard...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90622-4
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND:According to a recent meta-analysis, parathyroid hormone (PTH) excess is associated with increased cardiovascular disease (CVD) risk, but existing studies are limited. We examined in a prospective study the association of PTH with the incidence of CVD, taking into account vitamin D and other confounding vari...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2014.04.017
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Atrioventricular septal defect (AVSD) and double outlet right ventricle (DORV) with normally related great arteries and normal ventricular sizes are associated with a good long-term prognosis after biventricular (BV) repair. The outcome of cases with a borderline small left ventricle (bLV) is unclear. The pu...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.04.018
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Few telemedicine programs have undergone cost analyses, impeding their implementation into practice. We report on the economic analysis of a nurse-administered intervention designed to improve blood pressure control among hypertensive veterans. METHODS:We randomized hypertensive patients at the Durham Veter...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2010.05.024
更新日期:2010-08-01 00:00:00
abstract::Incidence of myonecrosis in patients undergoing rotational atherectomy was evaluated by preprocedural statin use. The incidence of any myonecrosis (24.1% vs 52.3%, P < .001) or significant myonecrosis (7.5% vs 21.8%, P < .001) was significantly lower among patients pretreated with statins. This difference remained sig...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.02.026
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:The use of vascular closure devices (VCDs) for the reduction of access site complications following percutaneous coronary intervention (PCI) remains controversial. Patients undergoing primary PCI for acute ST-segment elevation myocardial infarction (STEMI) are at high risk of femoral artery complications. A ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.03.009
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Some pharmacist-managed anticoagulation services (PMAS) provide initial follow-up to patients on oral anticoagulant, who are transferred to their physician once they are stabilized. This may be as effective as and less expensive than long-term PMAS follow-up. METHODS:Once PMAS patients were stabilized and r...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2008.02.009
更新日期:2008-07-01 00:00:00
abstract::Although Q wave and non-Q wave MI are often referred to as "transmural" and "nontransmural," there is no anatomic evidence to justify this distinction. Nevertheless, a distinction is important, because the two entities have a different prognosis. At the present time, between 25% and 35% of MIs are non-Q wave. They are...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(89)90629-7
更新日期:1989-04-01 00:00:00
abstract::The effects of captopril (CPT), an oral angiotensin-converting enzyme (ACE) inhibitor, on systemic failure (CHF). In 15 patients, CPT decreased mean arterial pressure from 75 +/- 3 to 60 +/- 3 mm Hg associated with a 16% increase in cardiac output, a 24% reduction in systemic vascular resistance, and a 36% decrease in...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90052-7
更新日期:1982-11-01 00:00:00
abstract::The aortocaval fistula is a classic model of pure cardiac volume overload in rats. This model is characterized by dilation of the ventricular cavities and eccentric cardiac hypertrophy. There are also changes in peripheral arterial flow: high flow in the proximal part of the aorta, upstream of the shunt, and low flow ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90929-4
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:In patients hospitalized with acutely decompensated heart failure, unresolved signs and symptoms of fluid overload have been consistently associated with poor outcomes. Regardless of dosing and type of administration, intravenous loop diuretics have not reduced heart failure events or mortality in patients w...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2015.05.019
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:The effect of age on diagnostic and prognostic performance of high-sensitivity cardiac troponin T (hs-cTnT) has not been addressed adequately, so far. METHODS:High-sensitivity cardiac troponin T was measured serially in patients with acute symptoms presenting to our emergency department. We tested the diagn...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2012.08.003
更新日期:2012-11-01 00:00:00
abstract::The plasma concentration of atrial natriuretic polypeptide (ANP) was measured in nine patients with essential hypertension during two grades of exercise tests performed in the supine position on a bicycle ergometer. The plasma ANP concentration significantly increased from 97.0 +/- 19.2 pg/ml to 107.6 +/- 23.7 pg/ml (...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90159-7
更新日期:1988-10-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus is a major public health problem in the United States. We assess the prevalence of diabetes in Dallas County, quantify the association between diabetes and subclinical cardiovascular disease, and assess the use of evidence-based cardiovascular disease risk-modifying therapies. METHODS:This...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.10.016
更新日期:2006-05-01 00:00:00
abstract::The aim of this prospective study was to compare the short-term reproducibility of the signal-averaged ECG (SAECG) with three analysis techniques, conventional time-domain analysis, spectral-temporal mapping (STM), and spectral-turbulence analysis (STA), in a large series of normal subjects and patients with acute myo...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90202-3
更新日期:1995-11-01 00:00:00