Abstract:
:To test the hypothesis that elevated plasma levels of natriuretic peptides may serve to identify patients with left ventricular (LV) dysfunction, we assessed the predictive diagnostic value of natriuretic peptide levels, in addition to clinical and electro-cardiographic risk factors, as noninvasive indicators of cardiac dysfunction. Plasma levels of atrial natriuretic peptide (cANP) (99-126), N-terminal fragment of proANP (nANP) (26-55), nANP(80-96), brain natriuretic peptide (BNP-32), proBNP(22-46), and C-type natriuretic peptide (CNP-22) were measured in 211 subjects before cardiac catheterization. The strongest correlations with parameters of LV function were found for nANP(80-96) (up to r = -0.55, p < 0.0001), whereas there was no significant correlation with proBNP(22-46) or CNP-22. In patients with LV ejection fractions (LVEF) < or = 45% (n = 38) nANP(26-55), nANP(80-96), cANP(99-126), and BNP-32 were significantly increased (p < 0.001). Partition values for elevated versus normal natriuretic peptide levels were obtained from normal controls and used to separate subjects with and without LV dysfunction. Receiver operating characteristic analysis for LVEF < or = 45% indicated a significantly better diagnostic accuracy for high levels of nANP(80-96), nANP(22-56), cANP(99-126), and BNP-32 than for proBNP and CNP-22. Multivariate analysis by logistic regression identified Q waves and bundle branch block in the electrocardiogram as well as elevated plasma levels of cANP, nANP(80-96), and nANP(26-55) as the strongest independent predictors of low ejection fractions. The relative risk of LV dysfunction was raised up to tenfold in subjects with high natriuretic peptide levels (p < 0.001). The addition of nANP(80-96) and nANP(26-55) to the combination of clinical and electrocardiographic risk factors did not further improve the diagnostic sensitivity for the detection of LVEF < or = 45%, but it markedly increased the overall accuracy (59% to 81%, p < 0.001) and specificity (55% to 81%, p < 0.001). Among natriuretic peptides, elevated nANP(80-96) and nANP(26-55) levels have the strongest impact on the detection of LV dysfunction. They add to the diagnostic information contained in clinical and electrocardiographic factors. Plasma levels alone or in combination with clinical factors seem to be of value for a refined identification of abnormal LV function in the individual patient.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Muders F,Kromer EP,Griese DP,Pfeifer M,Hense HW,Riegger GA,Elsner Ddoi
10.1016/s0002-8703(97)70079-6subject
Has Abstractpub_date
1997-09-01 00:00:00pages
442-9issue
3eissn
0002-8703issn
1097-6744pii
S0002-8703(97)70079-6journal_volume
134pub_type
杂志文章abstract::Oxygen free radical scavengers have been found to decrease infarct size in dogs subjected to myocardial ischemia-reperfusion injury. A baboon open-chest model was used to determine if superoxide dismutase (SOD), an oxygen free radical scavenger, together with catalase would be equally effective in subhuman primates (b...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90697-8
更新日期:1993-10-01 00:00:00
abstract:BACKGROUND:Anemia is now recognized as being a common finding in CHF and is associated with increased mortality and morbidity. However, it is uncertain whether the anemia is actually causing the worse prognosis or is merely a marker of more severe cardiac disease. Previous intervention studies with subcutaneous (s.c.) ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2006.08.005
更新日期:2006-12-01 00:00:00
abstract::To explore the contribution of reperfusion injury to final infarct size after a short duration of ischemia, closed-chest dogs underwent 40 minutes of proximal left anterior descending artery occlusion followed by 3 days of reperfusion. Animals randomly received intracoronary adenosine (n = 8) at 3.75 mg/min during the...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90272-j
更新日期:1991-12-01 00:00:00
abstract::The acute electrophysiologic effects of a bolus injection of 100 mg. of lidocaine were investigated in 39 patients with impulse formation and conduction defects by means of His-bundle recording and were correlated with plasma lidocaine levels. The effects of therapeutic plasma levels on conduction intervals and refrac...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90183-0
更新日期:1975-06-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to assess whether pharmacologic preconditioning by exogenous or endogenous adenosine prevents the deterioration of hemodynamic function and left ventricular performance during percutaneous transluminal coronary angioplasty (PTCA). Ischemic preconditioning renders the heart more ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mhj.2000.110287
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:Chocolate consumption has been inconsistently associated with risk of atrial fibrillation (AF). We investigated the association between chocolate consumption and risk of AF in Swedish adults from two cohort studies and conducted a meta-analysis to summarize available evidence from cohort studies on this topi...
journal_title:American heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ahj.2017.09.013
更新日期:2018-01-01 00:00:00
abstract::Postoperative atrial fibrillation/flutter (PoAF) commonly complicates cardiac surgery, occurring in 25% to 60% of patients. Postoperative atrial fibrillation/flutter is associated with significant morbidity, higher long-term mortality, and increased health care costs. Novel preventive therapies are clearly needed. In ...
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.2011.03.035
更新日期:2011-07-01 00:00:00
abstract::CHD remains the leading cause of death in most developed countries; therefore, elucidation of risk factors and associated mechanisms for atherosclerosis and development of CHD has been a high priority. Data from the Framingham Heart Study and other large-scale epidemiologic studies have identified major risk factors a...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(96)90096-4
更新日期:1996-06-01 00:00:00
abstract::In the Cardiovascular Measurement System (CMS) the edge-detection algorithm, which was primarily designed for the Philips digital cardiac imaging system (DCI), is applied to cinefilms. Comparative validation of CMS and DCI was performed in vitro and in vivo with intracoronary insertion of stenosis phantoms in anesthet...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)91045-g
更新日期:1993-08-01 00:00:00
abstract::Current antitachycardia systems are incapable of adequately distinguishing stable from unstable tachycardias. Previously, integration of a pressure sensor or an impedance sensor, together with electrogram analysis, has been investigated as an improved method of identifying unstable arrhythmias. A mixed venous oxygen s...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90519-n
更新日期:1991-09-01 00:00:00
abstract::This study evaluated the efficacy of a comprehensive transthoracic Doppler echocardiographic examination for correct detection of SVA and its associated lesions of VSD and aortic insufficiency. A consecutive series of 36 patients was obtained; all had surgical confirmation of the anatomic defects. The location of the ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90153-1
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:Patients with left ventricular dysfunction who undergo coronary artery bypass graft (CABG) surgery frequently have late sudden cardiac death. The CABG Patch Trial is a prospective, randomized, multicenter clinical trial that randomized patients at high risk at the completion of CABG surgery to implantation o...
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(97)80001-4
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:l-arginine is a commonly consumed dietary conditional essential amino acid found in food items and supplements, which is closely related to asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA). l-arginine is thought to increase nitric oxide and be cardioprotective, whereas ADMA and SDMA m...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.07.021
更新日期:2016-12-01 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:OBJECTIVES:We investigated the presence of left ventricular hypertrophy (LVH) and features of diastolic dysfunction in genotype-confirmed children from families with hypertrophic cardiomyopathy (HCM) and healthy control children. BACKGROUND:In subjects with HCM-causing mutations, LVH usually does not evolve until adol...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.12.005
更新日期:2006-03-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.01.018
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Peak oxygen consumption is a cornerstone for prognostic determination in patients with congestive heart failure. The purpose of this study was to assess whether plasma B-type natriuretic peptide (BNP) provided any additional prognostic information. METHODS:Plasma concentrations of atrial natriuretic peptide...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/S0002-8703(03)00365-X
更新日期:2003-10-01 00:00:00
abstract::Three kinds of torso surface isopotential maps (measured, simulated, and difference maps) were delineated at every 1.5 (or 3) msec. during the QRS duration from the 85 unipolar lead ECG's led from the surface of a cylindrical torso model filled with perfusate and containing a canine heart undergoing Langendorff's perf...
journal_title:American heart journal
pub_type: 杂志文章
doi:
更新日期:1976-08-01 00:00:00
abstract::We investigated the incidence and mechanism of pulmonary artery hypertension (PAH) in a consecutive series of patients with aortic stenosis who were undergoing diagnostic cardiac catheterization. Forty-five patients with severe aortic stenosis were divided into two groups: group 1 comprised 13 patients (29%) with PAH ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90067-j
更新日期:1993-01-01 00:00:00
abstract::We developed a logistic regression model with data from the GUSTO-I trial to predict mortality rate differences in individual patients who received accelerated tissue plasminogen activator (TPA) versus streptokinase treatment for acute myocardial infarction. A nomogram was developed from a reduced version of this mode...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1997-06-01 00:00:00
abstract:BACKGROUND:In adults, the most common cause of out-of-hospital cardiac arrests (OHCA) is acute coronary artery occlusion. If an immediate coronary angiogram (CAG) is recommended for survivors presenting a ST segment elevation on the electrocardiogram (ECG) performed after resuscitation, there is still a debate regardin...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2020-04-01 00:00:00
abstract::Currently available internal cardiac defibrillators use a uniphasic, truncated exponential waveform morphology of about 6 msec in duration at an energy level of 23 to 33 joules. To determine if improved defibrillation could be achieved with a different waveform morphology, we implanted 4.5 cm2 titanium patches to the ...
journal_title:American heart journal
pub_type: 杂志文章
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更新日期:1989-08-01 00:00:00
abstract:BACKGROUND:Stroke prevention in anticoagulation-naïve patients with atrial fibrillation undergoing cardioversion has not been systematically studied. OBJECTIVE:To determine outcomes in anticoagulation-naïve patients (defined as those receiving an anticoagulant for <48 hours during the index episode of atrial fibrillat...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2016.06.008
更新日期:2016-09-01 00:00:00
abstract::Although the cardiac manifestations of Lyme disease may be diverse, in general they are treatable with currently available therapies. A high index of suspicion is required to make a diagnosis, especially for patients who may lack a suggestive history of tick exposure or residence in an endemic region. Lyme disease-rel...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(91)90589-a
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:The long-term effects of smoking and smoking cessation on markers of cardiovascular disease (CVD) prognosis obtained during treadmill stress testing (TST) are unknown. The purpose of this study was to evaluate the long-term effects of smoking cessation and continued smoking on TST parameters that predict CVD...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2011.06.023
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:This study assessed the feasibility of a 12-week program of exercise, with and without intramuscular testosterone supplementation, in male patients with chronic heart failure (CHF) and low testosterone status and collected preliminary data for key health outcomes. METHODS:Male patients with CHF (n = 41, age...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2012.09.016
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Under the hypothesis that the G-308A polymorphism in the promoter region of the tumor necrosis factor alpha gene might increase tumor necrosis factor alpha expression, several investigations have been performed to examine the influence of the -308A allele on the risk of cardiovascular events. The results of ...
journal_title:American heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ahj.2007.02.031
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Peroxisome proliferator-activated receptors (PPARs) regulate transcription of genes involved in glucose uptake, lipid metabolism, and inflammation. Aleglitazar is a potent dual PPAR agonist with insulin-sensitizing and glucose-lowering actions and favorable effects on lipid profiles and biomarkers of cardiov...
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.2013.05.013
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Although the use of clopidogrel in patients "unlikely" to require coronary artery bypass grafting (CABG) is recommended in current guidelines of acute coronary syndrome (ACS) management, an important minority of patients require CABG. We assessed the ability to predict need for CABG from demographics known a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.12.002
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVES:The DANHEART trial is a multicenter, randomized (1:1), parallel-group, double-blind, placebo-controlled study in chronic heart failure patients with reduced ejection fraction (HFrEF). This investigator driven study will include 1500 HFrEF patients and test in a 2 × 2 factorial design: 1) if hydralazine-isoso...
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.2020.09.020
更新日期:2021-01-01 00:00:00