Abstract:
UNLABELLED:Peripheral vessels provide a useful in vivo haemodynamic model allowing evaluation of local intravascular fluid dynamics. Velocity measurements using a 0.018 inch Doppler-tipped angioplasty guidewire, quantitative angiography and laboratory data were gathered from 45 patients with a total of 48 percutaneous transluminal laser assisted angioplasties (PTLA) in the superficial femoral, in the iliac, in the popliteal artery and in the peroneal artery. From these data, blood flow, whole blood viscosity, Reynold's numbers, Womersley numbers and shear stress were calculated, evaluated as to their changes post PTLA and correlated with clinical improvement at early follow-up. The clinical result was quantified as categorial improvement according to the American Heart Association guidelines. The primary angiographic results of angioplasty were satisfactory in all patients. Clinically 17/45 patients showed a marked, 6/45 a moderate, 18/45 a minimal, and 4/45 no improvement. The mean values of maximal peak velocity at stenosis decreased from 235 +/- 28 cms-1 to 84 +/- 8 cms-1 after PTLA (P < 0.01). The minimal intrastenotic cross section increased from 7.7 +/- 0.9 to 21.9 +/- 1.6 mm2 (P < 0.01). Mean trans-stenotic flow increased after intervention by about 50% (P < 0.01) and improved further by 135% after administration of adenosine triphosphosphate i.a. (P < 0.01). Reynold's numbers were elevated intrastenotically (1285 +/- 198) pre-intervention as compared to values proximal (564 +/- 81) and distal (449 +/- 66) to the stenosis and were reduced significantly (P < 0.05) at stenosis by PTLA, whereas values proximally and distally increased significantly (P < 0.01) post PTLA (proximal 829 +/- 84, intra 773 +/- 107, distal 676 +/- 98). Shear stress, reflecting mechanical interaction between flow and vessel wall, was elevated at stenosis pre-intervention to 44 +/- 8.9 Pa and reduced at post-stenoric vessel sites to 2.4 +/- 0.5 Pa. PTLA caused a decrease in stenosis to 6.3 +/- 1 Pa (P < 0.01) and an increase distally to 4.6 +/- 1 Pa (P < 0.01). Whereas in single stenoses removal of the obstruction was associated with a significant (P < 0.05) increase in trans-stenotic flow and shear stress distally, there was only auenuated increase in trans-stenotic flow in multiple lesions despite an angiographically good PTLA result. Shear stress distally remained low in those patients. Velocities and Reynold's numbers were lower in these vessels even pre PTLA. Residual flow, Reynold's number and minimal cross-section pre-intervention correlated significantly with clinical outcome. Pooling cases with no or minimal, as opposed to those with marked or moderate improvement, 81% of patients were correctly classified using the Reynold's numbers pre- and post-PTLA. CONCLUSION:Peak velocity monitoring is feasible and safe during angioplasty. Velocity provides clinically relevant physiological information in addition to angiography. Combining quantitative angiography, velocity measurements and laboratory data allow the calculation of blood flow, Reynold's numbers and shear stress, thereby providing complex fluid dynamic information. Thus the evaluation of haemo-dynamics in single and multiple obstructions before and after intervention is improved. Fluid dynamic parameters pre-and post-PTLA are significantly correlated with clinical short-term result.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Wellnhofer E,Biamino G,Sauer HU,Trebeljahr A,Stalke J,Ragg C,Oswald H,Gotze S,Fleck E,Felix Rdoi
10.1093/eurheartj/16.suppl_j.60subject
Has Abstractpub_date
1995-10-01 00:00:00pages
60-70eissn
0195-668Xissn
1522-9645journal_volume
16 Suppl Jpub_type
杂志文章abstract:AIMS:We sought to define the mechanisms and correlates of leptin's vascular actions in humans with coronary artery disease. METHODS AND RESULTS:In 131 patients (age 65.7+/-0.7 years mean+/-SEM), ex vivo vascular reactivity to leptin (10(-13)-10(-7) M) was assessed in saphenous vein (SV) rings. Leptin led to SV relaxat...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi831
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:The EURObservational Research Programme-Atrial Fibrillation General Registry Pilot Phase (EORP-AF Pilot) provides systematic collection of contemporary data regarding the management and treatment of 3119 subjects with AF from 9 member European Society of Cardiology (ESC) countries. In this analysis, we repor...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehu374
更新日期:2014-12-14 00:00:00
abstract:BACKGROUND:The syndrome with an electrocardiographic pattern of right bundle branch block, ST segment elevation in leads V(1)to V(3)and sudden death is genetically determined and caused by mutations in the cardiac sodium channel. The inheritance of the disease is autosomal dominant. Sudden death may, however, occur fro...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1999.1751
更新日期:2000-02-01 00:00:00
abstract::Lyme borreliosis (LB) is a multisystem disorder that may cause self-limiting or chronic diseases of the skin, the nervous system, the joints, heart and other organs. The aetiological agent is the recently discovered Borrelia burgdorferi. In 1980, cardiac manifestations of LB were first described, including acute condu...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/12.suppl_d.73
更新日期:1991-08-01 00:00:00
abstract::The class III antiarrhythmic drug dofetilide is known to prolong action potential duration by specific blockade of the delayed rectifier potassium channel Ik. As dofetilide is likely to be used in the treatment of atrial arrhythmias it is important to determine the relative sensitivity of the atrium and ventricle in m...
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.a060790
更新日期:1995-11-01 00:00:00
abstract::The duration of the reduction of mortality after coronary artery bypass grafting (CABG) is an important issue and this study was undertaken to evaluate time in relation to excess mortality among CABG patients compared with the general population. Survival was analysed in 4661 patients who had undergone their first iso...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060654
更新日期:1994-09-01 00:00:00
abstract::We report a subaortic aneurysm of the left ventricle causing compression of a coronary artery in a 52-year-old white man presenting with angina on effort. Endocarditis seemed to be implicated as the cause of this rare condition. To what extent coronary obstruction influenced the development of myocardial ischaemia was...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062318
更新日期:1987-05-01 00:00:00
abstract:AIMS:To assess the prognostic significance of infarct core tissue characteristics using cardiac magnetic resonance (CMR) imaging in survivors of acute ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS:We performed an observational prospective single centre cohort study in 300 reperfused STEMI patients (m...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehv372
更新日期:2016-04-01 00:00:00
abstract:AIMS:White matter hyperintensities (WMH) progress with age and hypertension, but the key period of exposure to elevated blood pressure (BP), and the relative role of systolic BP (SBP) vs. diastolic BP (DBP), remains unclear. This study aims to determine the relationship between WMH and concurrent vs. past BP. METHODS ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehaa756
更新日期:2020-11-26 00:00:00
abstract:AIMS:Mitral regurgitation (MR) following an acute myocardial infarction (AMI) confers an adverse prognosis during long-term follow-up. There are no studies evaluating the influence of pre-AMI MR in the short- and long-term prognosis of such patients. Our aim was to assess the prognostic value of pre-AMI MR in the short...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi065
更新日期:2005-02-01 00:00:00
abstract:AIMS:The utilization and timing of revascularization in unstable coronary artery disease varies, which could have important consequences for patients and for treatment costs. The FRISC II invasive trial compared an early invasive strategy vs a non-invasive strategy with respect to the composite end-point of death and m...
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.2001.2695
更新日期:2002-01-01 00:00:00
abstract:AIMS:To determine the diagnostic utility of circulating angiopoietin-1 (Ang-1) and its antagonist angiopoietin-2 (Ang-2) as potential biomarkers of disease severity or response to treatment in idiopathic pulmonary arterial hypertension (IPAH). Imbalances in angiogenic factors including vascular endothelial cell growth ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehq226
更新日期:2010-09-01 00:00:00
abstract::Exercise-induced U-wave inversion on chest wall mapping was compared with coronary arteriographic findings in 160 consecutive patients who presented with chest pain suggestive of ischaemic heart disease. ECG recordings were made from 16 points on the chest wall before, during and after exercise. None of the 27 patient...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061883
更新日期:1985-05-01 00:00:00
abstract::A total of 546 patients with severe aortic stenosis (AS) were retrospectively reviewed to assess the efficacy of percutaneous transluminal valvuloplasty (PTV) and valve replacement (VR). Of these, 490 underwent VR between 1968 and 1986 (mean age 62 +/- 12 years, 71.7% were in NYHA class III or IV), 68.8% received mech...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/9.suppl_e.163
更新日期:1988-04-01 00:00:00
abstract::The purpose of this study was to compare rubidium-82 PET with thallium-201 SPECT imaging in 150 patients. Both techniques followed a single dipyridamole-handgrip stress, and images were displayed using the same 3-dimensional format and quantitative colour scale. Coronary arteriography was employed to assign the correc...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059838
更新日期:1991-10-01 00:00:00
abstract:AIMS:Although inflammation contributes to cardiovascular disease, the associations of appendectomy and tonsillectomy, which remove mucosa-associated lymphoid tissue, with risk of acute myocardial infarction (AMI) are unknown. Our aim was to assess the association between these operations performed in childhood and AMI ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehr137
更新日期:2011-09-01 00:00:00
abstract::Between 1968 and 1984, 78 patients (mean age 43, range 14 to 65 years) underwent combined aortic, mitral and tricuspid surgery (22 triple valve replacements, 56 aortic valve replacements with tricuspid conservative surgery and mitral valve replacement (N = 48), or commissuroplasty (N = 8). Pre-operative consequences o...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062305
更新日期:1987-05-01 00:00:00
abstract::The effect of sublingually administered nitroglycerin (0.5 mg) on distribution of blood volume in 16 patients with congestive heart failure (NYHA class II and III), randomly assigned to placebo (N = 8) or nitroglycerin (N = 8) was studied 20 minutes after in vivo labelling of red blood cells with 99m-Tc pertechnetate....
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.a062177
更新日期:1987-10-01 00:00:00
abstract:AIMS:Cardiac angiotensin-I converting enzyme (ACE) activity is influenced by the ACE I/D polymorphism. Evidence suggests that the DD-genotype may be a risk factor for cardiac hypertrophy and heart failure, especially in hypertensive subjects. We assessed the relation between the ACE I/D polymorphism and the risk of inc...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/j.ehj.2004.08.026
更新日期:2004-12-01 00:00:00
abstract:AIMS:Cardiac dyssynchrony is common in patients with heart failure, whether or not they have ischaemic heart disease (IHD). The effect of the underlying cause of cardiac dysfunction on the response to cardiac resynchronization therapy (CRT) is unknown. This issue was addressed using data from the CARE-HF trial. METHOD...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehn577
更新日期:2009-04-01 00:00:00
abstract::Left ventricular performance at rest and during supine symptom-limited exercise was determined by radionuclide ventriculography (RNV) in 65 subjects of the age of 65 years or older. Eleven subjects had no evidence of coronary artery disease (CAD) by history or submaximal stress ECG. In this control group left ventricu...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/5.suppl_e.55
更新日期:1984-11-01 00:00:00
abstract:AIMS:Our objective was to create a simple prognostic risk score for patients with systolic heart failure and mild symptoms. We then assessed the efficacy of eplerenone across different categories of risk. METHODS AND RESULTS:The Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure trial (EMP...
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/eht247
更新日期:2013-09-01 00:00:00
abstract:AIMS:We used the hospital discharge records of Piedmont region (northern Italy) to evaluate whether a national law banning smoking in public resulted in a short-term reduction in hospital admissions for acute myocardial infarction (AMI). METHODS AND RESULTS:Rates of admission for AMI before the ban (October-December 2...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehl201
更新日期:2006-10-01 00:00:00
abstract::The effect of 24 weeks of treatment with simvastatin, a new HMG coenzyme A reductase inhibitor (dosages of 20 and 40 mg day-1) on serum lipid, lipoprotein and apolipoprotein A-I and B concentrations as well as safety parameters and subjective side effects were studied in 11 patients with familial (FH) and 10 patients ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062541
更新日期:1988-05-01 00:00:00
abstract:AIMS:Vascular endothelial growth factor-A (VEGF-A) is an angiogenic and vasoprotective molecule whose expression is modulated by hypoxia and inflammatory mediators. Here we have tested the hypothesis that plasma levels of VEGF-A are influenced by pre-existing coronary artery disease and by changes in circulating interl...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2001.3034
更新日期:2002-06-01 00:00:00
abstract:AIM:Short-term psychological stress is associated with an immediate physiological response and may be associated with a transiently higher risk of cardiovascular events. The aim of this study was to determine whether brief episodes of anger trigger the onset of acute myocardial infarction (MI), acute coronary syndromes...
journal_title:European heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1093/eurheartj/ehu033
更新日期:2014-06-01 00:00:00
abstract::A necessary part of the strategy of modification of hypercholesterolaemia to prevent coronary heart disease (CHD) is the detection and treatment, by diet or by drugs, of high risk individuals. There are several drawbacks to this approach: (1) the cost of screening to find individuals at risk and of monitoring by physi...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/8.suppl_e.71
更新日期:1987-08-01 00:00:00
abstract:AIMS:To compare the precursor of atrial and brain natriuretic peptide (N-ANP, N-BNP), brain natriuretic peptide (BNP), big endothelin-1, the 6-min walk test and the Minnesota Living with Heart Failure Questionnaire (LHFQ) with regard to short-term outcome in an ambulatory heart failure population. METHODS AND RESULTS:...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2001.3115
更新日期:2002-06-01 00:00:00
abstract::To investigate the haemodynamic changes after physical training in patients with left ventricular aneurysm, 60 uncomplicated patients, mean age 51 +/- 10 years, underwent a maximal ergometric test in the supine position with haemodynamic monitoring (Swan-Ganz catheter) 37 +/- 10 days from acute myocardial infarction a...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/9.suppl_f.11
更新日期:1988-04-01 00:00:00
abstract:AIMS:To analyse the relationship between initial exercise parameters and peak oxygen consumption and prognosis in 96 patients with congestive heart failure. METHODS AND RESULTS:Comparison of responses during the initial 6 min of cardiopulmonary exercise testing (Naughton modified protocol) in patients stratified to th...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a015201
更新日期:1997-12-01 00:00:00