Abstract:
OBJECTIVES:The main goal of this study was to determine whether induction of an angerlike state can result in significant levels of T-wave alternans, a marker of electrical instability, in the normal and ischemic heart. BACKGROUND:Outbursts of anger have been implicated in the occurrence of myocardial infarction and sudden cardiac death, but the pathophysiologic mechanisms remain unknown. METHODS:A standardized behavioral challenge of eliciting an angerlike state was conducted before and during a 3-min period of coronary artery occlusion in six canines. RESULTS:Precordial T-wave alternans increased from 0.04 +/- 0.02 at baseline to 1.40 +/- 0.32 mV X ms (p < 0.05) during the angerlike response. When the angerlike state and myocardial ischemia were superimposed, the augmentation in T-wave alternans magnitude (to 3.27 +/- 0.61 mV X ms, p < 0.05) exceeded their additive effects, increasing by 130% over the angerlike state alone (p < 0.05) and by 390% over occlusion alone (p < 0.05). Adrenergic influences were reduced by the beta1-adrenergic receptor blocking agent metoprolol (1.5 mg/kg, intravenous), which diminished T-wave alternans magnitude (p < 0.0004 for all) during the angerlike response (from 1.40 +/- 0.32 to 0.80 +/- 0.17 mV x ms) and during the combined intervention (from 3.27 +/- 0.61 to 1.23 +/- 0.13 mV X ms). In five additional normal anesthetized canines, atrial pacing at 180 beats/min did not increase T-wave alternans magnitude monitored from lead II electrocardiogram. CONCLUSIONS:Provocation of an angerlike state results in T-wave alternans in the normal heart and potentiates the magnitude of ischemia-induced T-wave alternans. Elevation in heart rate during arousal does not appear to be the main factor in the development of alternans in the normal heart but may be an important component during myocardial ischemia. Enhanced adrenergic activity appears to mediate the effects in both the normal and ischemic hearts. T-wave alternans may constitute a useful electrophysiologic measure for clinical use in conjunction with behavioral stress testing or ambulatory monitoring.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Kovach JA,Nearing BD,Verrier RLdoi
10.1016/s0735-1097(01)01196-2subject
Has Abstractpub_date
2001-05-01 00:00:00pages
1719-25issue
6eissn
0735-1097issn
1558-3597pii
S0735-1097(01)01196-2journal_volume
37pub_type
杂志文章abstract:OBJECTIVES:We investigated the effect of adrenergic stimulation on left ventricular relaxation in patients with hypertrophic cardiomyopathy. BACKGROUND:Exercise-induced decreases in acceleration of left ventricular relaxation have been observed in patients with hypertrophic cardiomyopathy. However, data on sequential ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/S0735-1097(96)00378-6
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVES:Our objective in this research was the evaluation of the long-term results after directional atherectomy using the Silverhawk device (FoxHollow Technologies, Redwood City, California) of femoro-popliteal lesions. BACKGROUND:Considering reports on stent fractures in femoro-popliteal arteries, atherectomy may...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2006.07.031
更新日期:2006-10-17 00:00:00
abstract:BACKGROUND:Although guideline-recommended therapies reduce major adverse cardiovascular events (MACE) in patients after myocardial infarction (MI) or those with atherosclerotic disease (ATH), adherence is poor. OBJECTIVES:The goal of this study was to determine the association between medication adherence levels and l...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jacc.2016.06.005
更新日期:2016-08-23 00:00:00
abstract:OBJECTIVES:This study sought to determine the relationship between coronary calcification and plaque progression in response to established medical therapies. BACKGROUND:Coronary calcification correlates with the extent of atherosclerosis and predicts clinical outcome. METHODS:Atheroma volume was determined in serial...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2006.10.038
更新日期:2007-01-16 00:00:00
abstract:BACKGROUND:Elevated triglyceride-rich lipoprotein (TRL) and small-dense low-density lipoprotein (sdLDL) particles are hallmarks of atherogenic dyslipidemia, and their cholesterol content is hypothesized to drive atherosclerotic risk. Prospective epidemiological data pertaining to cholesterol content of TRLs and sdLDL i...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jacc.2020.02.059
更新日期:2020-05-05 00:00:00
abstract:OBJECTIVES:This study assessed coronary artery endothelial function in patients with hypercholesterolemia before and after lipid lowering, using quantitative angiography to examine the acetylcholine (Ach) response along the entire analyzable vessel. BACKGROUND:Lipid lowering reverses endothelial dysfunction, but wheth...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(00)01180-3
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the feasibility of re-expansion of balloon expandable intravascular stents and to examine the gross and histologic effects of re-expansion on vascular integrity. BACKGROUND:Intravascular stents have been used successfully as an adjunct to balloon dilation of congeni...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(93)90791-x
更新日期:1993-12-01 00:00:00
abstract::Fifty patients with anteroapical left ventricular aneurysm secondary to prior myocardial infarction underwent aneurysmectomy, at which time endocardial sinus rhythm mapping was performed. Forty patients had a history of recurrent sustained monomorphic ventricular tachycardia, and 10 had an aneurysm but no history of s...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(88)90409-3
更新日期:1988-08-01 00:00:00
abstract::Electrocardiographic monitoring and provocative ventricular pacing were used to evaluate control and nadolol treatment groups 6 to 24 hours after left anterior descending coronary artery ligation in the dog. During the 6 to 24 hour period, the control group (n = 20) developed ventricular triplets at rates exceeding 27...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(86)80309-6
更新日期:1986-12-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to compare the effectiveness of the implantable cardioverter defibrillator (ICD) and medical strategies for prevention of arrhythmic events and death. BACKGROUND:The ICD is a potential strategy to reduce mortality in patients at risk of sudden death. METHODS:The MEDLINE, EMBASE, a...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,meta分析
doi:10.1016/s0735-1097(03)00253-5
更新日期:2003-05-07 00:00:00
abstract::Frequency analysis with fast Fourier transform and time domain analysis after signal averaging of the electrocardiogram (ECG) have given contradictory results in patients with sustained ventricular tachycardia after myocardial infarction. Therefore, the same orthogonal ECGs were analyzed in the frequency domain (Black...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(88)90368-3
更新日期:1988-07-01 00:00:00
abstract:OBJECTIVES:The study sought to determine the effects of lipid-lowering with pravastatin on the systemic fibrinolytic profile and on thrombus formation under dynamic flow conditions. BACKGROUND:Lowering cholesterol (C) decreases clinical events in coronary artery disease (CAD) patients, but an analysis of the effects o...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0735-1097(99)00018-2
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVES:The purpose of the present study was to test the potential of colchicine, an agent with potent anti-inflammatory action, to reduce atrial fibrillation (AF) recurrence after pulmonary vein isolation in patients with paroxysmal AF. BACKGROUND:Proinflammatory processes induced by AF ablation therapy have been ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jacc.2012.07.031
更新日期:2012-10-30 00:00:00
abstract:OBJECTIVES:The aim of this study was to compare metabolic risk factors in men with anginal chest pain and a normal or abnormal coronary angiogram with those in healthy men. BACKGROUND:Risk factors for coronary heart disease, including lipoprotein abnormalities, hypertension and adiposity, may be metabolically interlin...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)90423-5
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine if combined intense lifestyle and pharmacologic lipid treatment reduce myocardial perfusion abnormalities and coronary events in comparison to usual-care cholesterol-lowering drugs and whether perfusion changes predict outcomes. BACKGROUND:Lifestyle and lipid drugs...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,评论,杂志文章
doi:10.1016/s0735-1097(02)02693-1
更新日期:2003-01-15 00:00:00
abstract:OBJECTIVES:We investigated whether the reverse remodeling after cardiac resynchronization therapy (CRT) might reduce the occurrence of ventricular arrhythmias (VAs). BACKGROUND:It is currently debated whether CRT has an effect on the burden of VAs. METHODS:The study included 398 patients treated with a CRT defibrilla...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2008.07.043
更新日期:2008-10-28 00:00:00
abstract::Percutaneous transvenous balloon mitral valvotomy was performed successfully in a 57 year old man with refractory congestive heart failure due to calcific mitral stenosis. Cardiac surgery was not an option because of other major medical problems. Balloon mitral valvotomy was performed using the transseptal technique. ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(86)80165-6
更新日期:1986-06-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to identify families affected by early repolarization syndrome (ERS) and to determine the mode of transmission of the disease. BACKGROUND:Early repolarization (ER) has recently been linked to idiopathic ventricular fibrillation. Familial inheritance of the disease has been suggeste...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2012.09.040
更新日期:2013-01-15 00:00:00
abstract:OBJECTIVES:The goal of this study was to report a variety of atrial tachycardia that might be caused by an unusual electrophysiologic substrate. BACKGROUND:The mechanism of atrial tachycardias is attributed to re-entry, abnormal automaticity or triggered activity, based on their electropharmacological responses. A rat...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章
doi:10.1016/s0735-1097(00)00906-2
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVES:This study sought to evaluate the relationship between brain natriuretic peptide (BNP), renal function, and the severity of congestive heart failure (CHF). BACKGROUND:Both BNP and renal function are prognostic predictors in CHF patients. METHODS:We measured the plasma BNP level in the aortic root and coron...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2005.10.038
更新日期:2006-02-07 00:00:00
abstract::The role and even the existence of new myocyte formation in the adult heart remain controversial. Documentation of cell cycle regulators, deoxyribonucleic acid synthesis, and mitotic images has only in part modified the view that myocardial growth can be accomplished exclusively from hypertrophy of an irreplaceable po...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2006.02.003
更新日期:2006-05-02 00:00:00
abstract:OBJECTIVES:We sought to evaluate whether fasting hyperhomocystinemia reduces endothelial function by oxidative stress in normotensive subjects and hypertensive patients. BACKGROUND:Subjects with hyperhomocystinemia have endothelial dysfunction. METHODS:In 23 normotensive subjects and 28 hypertensive patients, classif...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(01)01492-9
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVES:We prospectively evaluated the mechanism of syncope in patients with positive adenosine triphosphate (ATP) tests (defined as the induction of atrioventricular [AV] block with a ventricular pause >/=6 s after an intravenous bolus of 20 mg ATP). BACKGROUND:Patients with unexplained syncope tend to have more p...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(02)02621-9
更新日期:2003-01-01 00:00:00
abstract::Left ventricular noncompaction (LVNC) describes a ventricular wall anatomy characterized by prominent left ventricular (LV) trabeculae, a thin compacted layer, and deep intertrabecular recesses. Individual variability is extreme, and trabeculae represent a sort of individual "cardioprinting." By itself, the diagnosis ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2016.05.096
更新日期:2016-08-30 00:00:00
abstract:OBJECTIVES:We investigated whether abnormal pteridine metabolism is related to coronary endothelial dysfunction in insulin-resistant subjects. BACKGROUND:Depletion of tetrahydrobiopterin (BH(4)) and elevation of the 7,8-dihydrobiopterin (BH(2)) (activating and inactivating cofactors of nitric oxide synthase [NOS], res...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(01)01659-x
更新日期:2001-12-01 00:00:00
abstract::N-acetylprocainamide (NAPA) is said to have class III antiarrhythmic drug properties. The effects of NAPA (25 mg/kg intravenously) on sustained, stable, reentrant atrial flutter induced in 12 conscious dogs using a sterile pericarditis model were studied and compared with the effects of quinidine (5 mg/kg intravenousl...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(87)80474-6
更新日期:1987-06-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to identify the remodeling parameters cardiomyocyte (CM) damage or death, hypertrophy, and fibrosis that may be linked to outcomes in patients with advanced heart failure (HF) in an effort to understand the pathogenic mechanisms of HF that may support newer therapeutic modalities. ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2010.09.080
更新日期:2011-04-05 00:00:00
abstract::The criteria proposed for the clinical diagnosis of Takayasu's disease (chronic inflammatory arteriopathy of unknown origin) were based on clinical and angiographic data from 108 Japanese patients: 96 with Takayasu's disease and 12 with another disease of the aorta. The criteria consist of one obligatory criterion (ag...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(88)90462-7
更新日期:1988-10-01 00:00:00
abstract:OBJECTIVES:We sought to determine an anticoagulation protocol for use during cardiac catheterization in children. BACKGROUND:There are few data to indicate which dose of heparin represents adequate anticoagulation or how best to monitor its efficacy. In this study, adequate anticoagulation was defined as the amount of...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)00438-V
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:Ibrutinib has revolutionized treatment for several B-cell malignancies. However, a recent clinical trial where ibrutinib was used in a front-line setting showed increased mortality during treatment compared with conventional chemotherapy. Cardiovascular toxicities were suspected as the culprit but not direct...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2019.07.056
更新日期:2019-10-01 00:00:00