Abstract：
:It has long been unclear how exercise training improves myocardial perfusion in patients with stable CAD. Regression of coronary atherosclerosis and collateral formation have been favorite theories; however, angiographic techniques have so far failed to document any significant increase in coronary collaterals at rest. Although net regression of stenotic lesions may be achieved in high-intensity exercise training, it is unlikely that it causes the significant improvement in myocardial perfusion that is seen much earlier than plaque regression. The novel tools to examine coronary endothelial function in vivo and in vitro have now made it clear that exercise training enhances myocardial perfusion by increasing both eNOS and ecSOD expression, which attenuates the premature breakdown of NO by ROS. These increases in local NO production and half-life improve endothelium-dependent vasodilation in response to flow or acetylcholine. These functional changes will occur rather rapidly after the initiation of an exercise training program, although no studies are available on their precise time course. Anatomic changes, such as augmentation of the capillary bed and slowing of the progression of coronary atherosclerosis, may require more extended periods of training (Fig. 4). Recently, first reports about a possible association between endothelial dysfunction and the frequency of clinical events has been documented. Further prospective studies are needed to establish whether endothelial dysfunction is just an indicator of plaque instability or an independent prognostic marker. If it turns out to be the latter, exercise training may be promoted from a symptomatic intervention to a preventive strategy with long-term prognostic benefits.
journal_name
Cardiol Clinjournal_title
Cardiology clinicsauthors
Gielen S,Hambrecht Rdoi
10.1016/s0733-8651(05)70222-8subject
Has Abstractpub_date
2001-08-01 00:00:00pages
357-68issue
3eissn
0733-8651issn
1558-2264pii
S0733-8651(05)70222-8journal_volume
19pub_type
杂志文章,评审abstract：:One of the major drivers of change in the practice of cardiology is population change. This article discusses the current debate about epidemiologic transition paired with other ongoing transitions with direct relevance to cardiovascular conditions. Challenges specific to patterns of risk factors over time; readiness ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2016.08.004
更新日期：2017-02-01 00:00:00
abstract：:The number of supporters of complete arch replacement in the surgery of acute type A aortic dissection has been steadily increasing as a result of cerebral perfusion techniques that enable the extension of safe circulatory arrest time. However, there is no agreement in the surgical community on an optimal surgical app...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2010.01.007
更新日期：2010-05-01 00:00:00
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...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(03)00054-7
更新日期：2003-08-01 00:00:00
abstract：:Intracoronary ultrasound provides unique information during percutaneous transluminal coronary angioplasty (PTCA), including more accurate measurement of vessel size and plaque burden as well as plaque characteristics such as composition and distribution. As a research tool, it has been useful in determining the mecha...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(05)70316-7
更新日期：1997-02-01 00:00:00
abstract：:There are 240 million 9-1-1 calls in the United States every year. The burden of managing these emergencies until first responders can arrive is on the dispatchers working in the 5806 public safety answering points, more commonly known as dispatch centers. They are the first link in the chain of survival between the p...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2018.03.001
更新日期：2018-08-01 00:00:00
abstract：:The work of the pioneers in PFO closure finally may evolve into a front-line therapy for secondary prevention of stroke in selected patients who have PFO and embolic events. Current implants, although new to most of interventional cardiology and neurology, are the result of years of steady, progressive work. It seems ...
journal_title：Cardiology clinics
pub_type： 历史文章,杂志文章,评审
doi：10.1016/j.ccl.2004.10.012
更新日期：2005-02-01 00:00:00
abstract：:The pericardium consists of a visceral mesothelial monolayer (epicardium) that reflects over the great vessels and joins an outer, relatively inelastic fibrous parietal layer of organized collagen and elastin fibers, between which is a potential space that normally contains up to 50 mL of plasma filtrate. Although not...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2017.07.002
更新日期：2017-11-01 00:00:00
abstract：:The development and use of antiretroviral medications to treat patients infected with human immunodeficiency virus (HIV) has dramatically changed the course of this disease from one that was fatal to a chronic and more manageable condition. Recommendations and guidelines for the general population are presented in thi...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2015.01.003
更新日期：2015-05-01 00:00:00
abstract：:Congenital abnormalities of the pericardium are a rare group of disorders that include congenital absence of the pericardium, pericardial cysts, and diverticula. These congenital defects result from alterations in the embryologic formation and structure of the pericardium. Although many cases are incidentally found, t...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2017.07.012
更新日期：2017-11-01 00:00:00
abstract：:In recent years many guidelines on the treatment of specific medical conditions have been published with the goal of advising physicians, promoting good clinical care, and achieving a degree of equity and equality in the delivery of care. Differences exist between European and American guidelines for the management of...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2007.12.015
更新日期：2008-02-01 00:00:00
abstract：:Parenterally administered narcotic analgesics are a critically important part of therapy for the patient with acute myocardial ischemic syndromes. These agents are very effective and, when used with appropriate caution and monitoring, are also generally safe. They not only relieve the sensation of severe pain but also...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1988-02-01 00:00:00
abstract：:Exercise therapy is a valid therapeutic modality in patients with hyperlipoproteinemia (HLP). In combination with appropriate dietary modification, it can be a powerful therapeutic tool and may allow a reduction in hyperlipidemic medication doses. Improved triglyceride values and lipoprotein profiles can be obtained. ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1987-05-01 00:00:00
abstract：:The role of heart catheterization continues to evolve as the sophistication of cardiac MRI and CT improves and the breadth of interventional catheter techniques widens. This analysis is approached from four perspectives: (1) planning of the procedure, including information required, potential pitfalls, and equipment; ...
journal_title：Cardiology clinics
pub_type： 杂志文章
doi：10.1016/j.ccl.2006.08.008
更新日期：2006-11-01 00:00:00
abstract：:Patients who have chest pain following the use of cocaine have become more common in emergency departments throughout the United States,with approximately 6% of these patients sustaining an acute MI. The authors have described the rationale for recommending aspirin, benzodiaze-pines, and nitroglycerin as first-line tr...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2005.09.003
更新日期：2006-02-01 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：:Athletes with syncope warrant a full evaluation, as it is possible that athletics may unmask heart disease, either structural or electrical, and these athletes may be at risk for sudden cardiac death. The work-up and treatment of syncope in the athlete offers some unique challenges: to diagnose potentially life-threat...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2007.07.005
更新日期：2007-08-01 00:00:00
abstract：:Hypertensive crises, which include hypertensive emergencies and urgencies, are frequently encountered in the emergency department, and require immediate attention as they can lead to irreversible end-organ damage. Normal blood pressure (BP) regulation is altered during acute rises in BP, leading to end-organ damage. M...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2012.07.011
更新日期：2012-11-01 00:00:00
abstract：:Ebstein anomaly is a congenital malformation involving primarily the tricuspid valve, with failure of delamination from the underlying myocardium and right ventricular myopathy. Echocardiography is diagnostic in most patients and demonstrates apical displacement of the septal leaflet and variable tethering of leaflet ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2020.04.004
更新日期：2020-08-01 00:00:00
abstract：:Significant advances have been made in understanding the pathogenesis and clinical physiology of primary hypertension. This article presents an overview of the physiology of normal blood pressure control and the pathophysiologic mechanisms that predispose individuals and populations to primary hypertension. The role o...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2010.07.001
更新日期：2010-11-01 00:00:00
abstract：:As the incidence of valvular disease in the elderly is increasing, understanding of its pathogenesis and natural progression as well as surgical approaches and device technologies are improving. Future studies are needed to develop medical interventions that slow or halt the degenerative valvular processes associated ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(05)70061-8
更新日期：1999-02-01 00:00:00
abstract：:Initial pharmacologic therapy for hypertension is low-dose thiazide diuretics, beta-blockers, and ACE inhibitors. Increasing data have confirmed that ACE inhibitors have specific benefit in patients with diabetes, atherosclerosis, left ventricular dysfunction, and renal insufficiency. CCBs are alternative agents for I...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(05)70213-7
更新日期：2001-05-01 00:00:00
abstract：:The most important factor in the interpretation of any heart lesion is the radiographic appearance of the pulmonary vessels (vascularity) and lung parenchyma. The author discusses several abnormalities; he focuses particularly on pulmonary venous hypertension. ...
journal_title：Cardiology clinics
pub_type： 杂志文章
doi：
更新日期：1983-11-01 00:00:00
abstract：:The electrocardiographic diagnosis of myocardial infarction (MI) in the presence of left bundle branch block (LBBB) has long been considered problematic or even almost impossible. Many proposed ECG markers in the old literature have now been discarded. However, the advent of reperfusion therapy has generated greater i...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2006.05.002
更新日期：2006-08-01 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：:Mechanical circulatory assistance is making the transition from an investigational technique to standard clinical practice, especially for post-cardiotomy shock. History, techniques, medications, complications, and results of mechanical assistance are reviewed. Promising trends for the future are presented. ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1988-08-01 00:00:00
abstract：:Cardiovascular drugs are often used in pregnancy for the treatment of maternal and fetal conditions. The complex physiologic changes occurring during pregnancy may significantly affect the pharmacokinetics of many drugs and, consequently, the toxicity and therapeutic response. Of special concern are the effects of mat...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1987-11-01 00:00:00
abstract：:In cases of suspected acute coronary syndrome (ACS), rapid and accurate diagnosis is essential to establish effective evidence-based medical treatment. Patients' history, clinical examination, 12-lead electrocardiogram, and cardiac biomarkers are cornerstones in initial management. Since high-sensitivity cardiac tropo...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2020.06.001
更新日期：2020-11-01 00:00:00
abstract：:Although the growing use of continuous-flow left ventricular assist devices (LVADs) has improved the survival and quality of life of patients with stage D heart failure, ischemic and hemorrhagic cerebrovascular accidents remain one of the most-feared complications of this therapy and a significant source of disability...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2018.06.007
更新日期：2018-11-01 00:00:00
abstract：:High-density lipoproteins (HDLs) have presented an attractive target for development of new therapies for cardiovascular prevention on the basis of epidemiology and preclinical studies demonstrating their protective properties. Development of HDL mimetics provides an opportunity to administer functional HDL. However, ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2017.12.012
更新日期：2018-05-01 00:00:00
abstract：:Catheter ablation for atrial fibrillation in patients with heart failure with reduced ejection fraction is associated with improvement in patient-centered outcomes, such as mortality, heart failure readmission, and atrial fibrillation recurrence, compared with standard medical therapy with or without device therapy. T...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2019.01.004
更新日期：2019-05-01 00:00:00
