Abstract:
BACKGROUND:Recently, a new exercise test criterion diagnosing coronary artery disease was proposed, based on a composite of changes in Q-, R- and S-waves: the QRS score. We compared this new criterion with conventional ST-segment depression and other compositions of Q-, R- and S-wave changes in patients and normals and related the QRS score to reversible thallium-201 scintigraphic defects and ST-segment depression as markers for ischaemia. The influence of beta-blockade on the QRS score was also studied. METHODS:The study population consisted of 155 persons with 53 normals (group I) and 102 patients with documented coronary artery disease (group II). Another 20 patients (group III) with proven coronary artery disease and a positive exercise test by ST-segment criteria were studied for the influence of beta-blockade on the QRS score. A symptom-limited exercise protocol according to the modified Bruce protocol was used. For the QRS score, Q-, R- and S-wave amplitudes which could be recovered immediately were subtracted from pretest values: delta Q, delta R, delta S respectively. The score was calculated by the formula: (delta R - delta Q - delta S)AVF + (delta R - delta Q - delta S)V5. RESULTS:Using a cut-off point of > 5 as normal, the QRS score resulted in a sensitivity of 88.2%, a specificity of 84.8% and a predictive accuracy of 87.1%. For ST-segment depression these values were 54.9%, 83% and 64.5% respectively (P < 0.001 compared to the QRS score). Predictive accuracies of changes in Q-, R- and S-waves in leads AVF and V5 separately, combinations of changes and combining the two leads, resulted-with the exception of solitary S-wave changes-in predictive accuracies higher than those of ST-segment depression, but all were lower than the QRS score. We found a significant correlation between the QRS score, the summed ST-segment depression (P < 0.004) and the extent of reversible thallium-201 defects (P < 0.001). Applying Bayes' theorem, the combination of an abnormal QRS score and ST-segment depression resulted in the highest post-test risk for coronary artery disease and a normal QRS score without ST-segment depression in the lowest post-test risk. The QRS score and the maximal ST-segment depression changed significantly under the influence of beta-blockade (P < 0.02 and P < 0.001 respectively). CONCLUSION:Our data suggest that an abnormal QRS score reflects myocardial ischaemia. Furthermore, for the interpretation of the exercise test, the combined analysis of ST-segments and the QRS score is of value for the prediction of the presence or absence of coronary artery disease and its follow-up.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
van Campen CM,Visser FC,Visser CAdoi
10.1093/oxfordjournals.eurheartj.a014936subject
Has Abstractpub_date
1996-05-01 00:00:00pages
699-708issue
5eissn
0195-668Xissn
1522-9645journal_volume
17pub_type
杂志文章abstract:AIM:The purpose of our study was to evaluate the relative impact of bivalirudin on bleeding outcomes associated with trans-radial interventions (TRI) in real world practice. METHODS AND RESULTS:Data for patients undergoing percutaneous coronary intervention (PCI) between January 2010 and March 2014 at the 47 hospitals...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehv434
更新日期:2016-06-21 00:00:00
abstract:AIMS:Delayed lipoprotein clearance is associated with atherosclerosis. This study examined whether chronic intermittent hypoxia (CIH), a hallmark of obstructive sleep apnoea (OSA), can lead to hyperlipidaemia by inhibiting clearance of triglyceride rich lipoproteins (TRLP). METHODS AND RESULTS:Male C57BL/6J mice on hi...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehr097
更新日期:2012-03-01 00:00:00
abstract::In a prospective study, an elderly group of patients (n = 63, 47 male, 16 female, age 40-65 years) was examined before and after open-heart surgery under cardiopulmonary bypass: postoperatively, 19 patients (30%) showed no clinical neuropsychiatric symptoms, whereas in 35 patients (56%) mild or transient neurological ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.7.885
更新日期:1993-07-01 00:00:00
abstract::Cardiac hypertrophy was induced in rats either by isoprenaline treatment or by experimental abdominal aortic stenosis. In both models, the UTP content increased in the hypertrophying heart, while the ATP level remained depressed. The rate of net synthesis of uracil nucleotides, estimated by phosphate incorporation int...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/5.suppl_f.155
更新日期:1984-12-01 00:00:00
abstract:AIMS:The aim of this study was to evaluate the effect of valve surgery (VS) in infective endocarditis (IE) on 5-year mortality and to evaluate whether conflicting results reported by previous studies could be due to differences in their methodological approaches. METHODS AND RESULTS:Four hundred and forty-nine patient...
journal_title:European heart journal
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doi:10.1093/eurheartj/ehp008
更新日期:2011-08-01 00:00:00
abstract:AIMS:Very few data exist on the occurrence of acute kidney injury (AKI) associated with transcatheter aortic valve implantation (TAVI). The objectives of the present study were (i) to determine the incidence, predictive factors, and prognostic value of AKI following TAVI, and (ii) to compare the occurrence of AKI in TA...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehp552
更新日期:2010-04-01 00:00:00
abstract::Tricuspid regurgitation (TR) is the most common lesion of the tricuspid valve (TV). Mild TR is common and usually is benign. However, moderate or severe TR can lead to irreversible myocardial damage and adverse outcomes. Despite these findings, few patients with significant TR undergo surgery. The treatment of functio...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehv487
更新日期:2017-03-01 00:00:00
abstract:AIMS:Supernatants of serum-free cultured mononuclear cells (MNC) contain a mix of immunomodulating factors (secretome), which have been shown to attenuate detrimental inflammatory responses following myocardial ischaemia. Inflammatory dilated cardiomyopathy (iDCM) is a common cause of heart failure in young patients. E...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehs459
更新日期:2015-03-14 00:00:00
abstract::An 83-year-old man was hospitalized due to general fatigue and dyspnoea. He was diagnosed as having complete atrioventricular (AV) block due to cardiac involvement by a malignant lymphoma. Eleven days after the initiation of chemotherapy, the complete AV block disappeared and only a first degree AV block remained. ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060514
更新日期:1994-03-01 00:00:00
abstract:AIMS:To investigate whether the benefit of thrombolytic therapy was sustained beyond the first decade. We report the 10-14 year outcome of 533 patients who were randomized to treatment with intracoronary streptokinase or to conventional therapy during the years 1980-1985. METHODS AND RESULTS:Details of survival and ca...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/euhj.1998.1443
更新日期:1999-06-01 00:00:00
abstract:AIMS:It is reported that one third of patients with heart failure have normal left ventricular systolic function, and may or may not have left ventricular diastolic dysfunction. We sought to define the prevalence of left ventricular diastolic filling abnormalities in a large unselected group of patients, unlike the dia...
journal_title:European heart journal
pub_type: 临床试验,杂志文章
doi:10.1093/oxfordjournals.eurheartj.a015387
更新日期:1997-06-01 00:00:00
abstract::The purpose of this study was to evaluate the accuracy of adenosine Tc-99m sestamibi single photon emission computed tomography (SPECT) in the detection of jeopardized myocardium early after acute myocardial infarction. Coronary arteriography and myocardial scintigraphy were performed in 50 consecutive patients with a...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061074
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:In patients with postinfarction sustained ventricular tachycardia showing one or more antiarrhythmic drug failures, the question is how long to proceed with new drug trials before deciding to perform map-guided arrhythmia surgery. Although the techniques of this surgery developed rapidly in the early 1980s, ...
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.a014910
更新日期:1996-04-01 00:00:00
abstract:AIMS:The long QT syndrome is mainly defined by QT interval prolongation (QTc > 0.44s). However, data obtained in genotyped patients showed that resting QTc measurement alone may be inaccurate for ascertaining the phenotype. The aim of this study was to evaluate the diagnostic performance of QT interval rate-dependence ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1997.0730
更新日期:1998-01-01 00:00:00
abstract::To compare the blood pressure (BP) changes during a long-distance run with those during bicycle ergometry, nine normotensive and 18 hypertensive joggers were studied by means of ambulatory intra-arterial monitoring. In all subjects the ergometric test caused a progressive increase in systolic and little change in dias...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059709
更新日期:1990-04-01 00:00:00
abstract:AIM:To compare patients treated for heart failure in relation to the management in general practices versus hospital admission. METHODS AND RESULTS:Twelve randomly selected general practices (GP) were screened for patients receiving ACE-inhibitor, digoxin, or loop diuretic treatment. The first 500 volunteers of 959 po...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ehj.2004.06.033
更新日期:2004-10-01 00:00:00
abstract::The pharmacokinetics of glyceryl trinitrate are still not completely understood. The substance disappears rapidly from plasma largely by extrahepatic mechanisms. It is converted in glyceryl dinitrates and glyceryl mononitrates. After transdermal application of a controlled delivery system, plasma concentrations of gly...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/9.suppl_a.33
更新日期:1988-01-01 00:00:00
abstract::The diagnosis of prosthetic valve thrombosis (PVT) may be difficult in cases without valve obstruction. The aim of this study was to evaluate the diagnostic accuracy of 111indium-labelled autologous platelet imaging in the detection of PVT. We studied 41 patients with 45 prostheses, mechanical (37) or biological (8), ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059721
更新日期:1990-05-01 00:00:00
abstract::Clinical management of refractory heart failure remains challenging, with a high rate of rehospitalizations despite advances in medical and device therapy. Care can be provided in person, via telehomecare (by telephone), or telemonitoring, which involves wireless technology for remote follow-up. Telemonitoring wireles...
journal_title:European heart journal
pub_type: 杂志文章,评审
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更新日期:2011-06-01 00:00:00
abstract:AIMS:This study investigated the effects of irbesartan vs. enalapril, with early vs. late treatment, on markers of inflammation and ischaemic heart disease in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). METHODS AND RESULTS:Patients hospitalized with ischaemic symptoms and evidence of NSTE...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehp301
更新日期:2009-11-01 00:00:00
abstract:AIMS:Periconceptional folate supplementation prevents neural tube defects and possibly congenital heart defects (CHD) as well. The search for candidate genes involved in the folate metabolism includes the methylenetetrahydrofolate reductase (MTHFR) 677C > T polymorphism. We studied the association between MTHFR 677C > ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi815
更新日期:2006-04-01 00:00:00
abstract::With the advent of therapeutic interventions to restore blood flow in patients with acute infarction, early identification of salvageable myocardium has gained clinical importance. It was the purpose of this study to define regional blood flow and glucose metabolism in patients with acute myocardial infarction as asse...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062375
更新日期:1987-09-01 00:00:00
abstract::Hypertension (HTN) is quantitatively the major cardiovascular risk factor and responsible for ∼50% of cardiovascular morbidity and mortality. Blood pressure (BP) is also a classical complex genetic trait with heritability estimates of 30-50%. Although much is known about BP regulation, the intrinsic origin of essentia...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehs455
更新日期:2013-04-01 00:00:00
abstract::The effects of a single oral dose of nisoldipine, 10 mg, were investigated in two groups of patients. Firstly, the effects of nisoldipine on exercise left ventricular function were assessed in 20 patients with chronic stable angina and coronary disease. Secondly, the effects of nisoldipine on the left ventricular resp...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/8.suppl_k.27
更新日期:1987-11-01 00:00:00
abstract::Previous evidence indicates that cells generate molecules that alter transcription in response to stress. Accordingly, we conducted preliminary experiments to characterize these molecules. Extracts were prepared from normal and experimental canine hearts in which a 100 mmHg gradient was created across the ascending ao...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/5.suppl_f.225
更新日期:1984-12-01 00:00:00
abstract:AIMS:To investigate whether Atorvastatin (Ator) treatment improves the cardiac micro-environment that facilitates survival and differentiation of bone-marrow-derived mesenchymal stem cells (MSCs) implanted in the post-infarct myocardium. METHODS AND RESULTS:Myocardial infarction was created by coronary ligation and im...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehn167
更新日期:2008-06-01 00:00:00
abstract:AIMS:To compare effects of heparin and hirudin on biochemical markers of coagulation. METHODS AND RESULTS:Patients (n=395) with unstable angina or myocardial infarction without ST elevation were randomized to a 72-h infusion of one of three regimens: unfractionated heparin (bolus of 5000 IU followed by an infusion of ...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1053/euhj.1999.2005
更新日期:2000-09-01 00:00:00
abstract:AIM:It has recently been suggested that exercise testing may be more valuable prognostically than it is diagnostically in apparently healthy subjects. We wanted to compare the accuracy of CHD risk assessment based on classical risk factors with an assessment also based on multiple exercise test parameters. METHODS AND...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/j.ehj.2004.04.009
更新日期:2004-06-01 00:00:00
abstract::Five, ten and fifteen min after sublingual administration of 10mg isosorbide dinitrate (ISDN) in chewing capsules, in 10 patients with coronary artery disease, ISDN plasma levels were correlated with the dilation of epicardial coronary arteries as well as with changes in aortic blood pressure and heart rate. Due to th...
journal_title:European heart journal
pub_type: 杂志文章
doi:
更新日期:1989-11-01 00:00:00
abstract:AIMS:Patients with atrial fibrillation (AF) present with symptoms of myocardial ischaemia despite exclusion of coronary artery disease. A small vessel disease has been suggested. We quantified myocardial perfusion, perfusion reserve, and coronary vascular resistance (CVR) in AF patients using positron emission tomograp...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm246
更新日期:2007-09-01 00:00:00