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 with aging. In addition, mechanical approaches with lower operative risks should be explored and the search should continue for a valve substitute that is durable, hemodynamically efficient, easy to implant, and does not require anticoagulation. Hopefully, future intervention trials will include quality of life assessments such as symptoms, functional capacity and perceptions of well being. At present, the degenerative valvular processes must be followed closely by the clinician, and individual management decisions for the elderly based on the type and severity of valve disease, comorbid medical conditions, and the risks and benefits of intervention, along with patient preferences, rather than on the chronologic age of the patient. It is becoming clear that both survival and quality of life outcomes can improve by consideration of surgery at the onset of indications, before further deterioration eliminates the opportunity to provide benefit for the elderly patient with valvular disease.
journal_name
Cardiol Clinjournal_title
Cardiology clinicsauthors
Hinchman DA,Otto CMdoi
10.1016/s0733-8651(05)70061-8subject
Has Abstractpub_date
1999-02-01 00:00:00pages
137-58issue
1eissn
0733-8651issn
1558-2264pii
S0733-8651(05)70061-8journal_volume
17pub_type
杂志文章,评审abstract：:Carcinoid heart disease is the collective term for all cardiac manifestations that develop in patients with carcinoid. The cardiac manifestations of carcinoid tumors are attributed to the paraneoplastic effects of vasoactive substances released by the malignant cells. The clinical manifestations of carcinoid heart dis...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2019.07.014
更新日期：2019-11-01 00:00:00
abstract：:Medical management of PAD is a considerable challenge. Although patients typically present with IC, there is a substantial pool of subclinical PAD patients. PAD, whether symptomatic or not, confers a marked cardiovascular risk; with affected patients dying of heart attack or stroke, identification of index patients an...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(02)00089-9
更新日期：2002-11-01 00:00:00
abstract：:Quality of life is discussed with focus on the importance of individual patient perspectives. Eight studies including at least one aspect of quality of life in patients with atrial fibrillation are reviewed with three approaches evident in assessing quality of life: patient interview, self-reported symptoms, and multi...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(05)70307-6
更新日期：1996-11-01 00:00:00
abstract：:Atrial septal defects (ASDs) can be complicated by cardioembolic strokes, but the exact incidence is unknown. Patients with large and small shunts may present with a cardioembolic stroke. Patients with cryptogenic strokes should have cardiac ultrasound to see if an ASD is present. Cardioembolic strokes associated with...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2015.12.004
更新日期：2016-05-01 00:00:00
abstract：:Coronary computed tomographic angiography (CTA) is a promising noninvasive tool that allows the visualization of plaque morphology. Plaques characterized by positive remodeling, low attenuation, and napkin ring circular enhancement on contrast-enhanced coronary CTA have been regarded as rupture-prone vulnerable plaque...
journal_title：Cardiology clinics
pub_type： 杂志文章
doi：10.1016/j.ccl.2011.10.002
更新日期：2012-02-01 00:00:00
abstract：:Cardiac transplantation is now an accepted therapeutic procedure in the management of patients suffering from end-stage congestive heart failure. The advances in myocardial preservation, long-distance procurement, immunosuppression, improvement in the treatment of infectious diseases, and utilization of endomyocardial...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1989-02-01 00:00:00
abstract：:This article discusses exercise testing in valvular heart disease, hypertension, and the evaluation of patients for surgery. It also provides information on the effects of drugs on the exercise test and the clinical significance of block patterns and arrhythmias encountered during exercise. ...
journal_title：Cardiology clinics
pub_type： 杂志文章
doi：
更新日期：1993-05-01 00:00:00
abstract：:Pulmonary hypertension is a complex disorder with multiple etiologies; the World Health Organization classification system divides pulmonary hypertension patients into 5 groups based on the underlying cause and mechanism. Group 5 pulmonary hypertension is a heterogeneous group of diseases that encompasses pulmonary hy...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2016.04.004
更新日期：2016-08-01 00:00:00
abstract：:Percutaneous transluminal coronary angioplasty was first performed in a human coronary artery in 1977. In this article, we review the possible mechanisms of angioplasty, current indications for angioplasty, and complications of angioplasty including acute closure and restenosis. ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1988-08-01 00:00:00
abstract：:Abnormal systolic ventricular function and persistent ischemia are sensitive indicators of poor prognosis following myocardial infarction. The use of exercise improves the utility of both radionuclide ventriculography and myocardial perfusion scintigraphy in the identification of postinfarction patients at high risk o...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1984-08-01 00:00:00
abstract：:Addressing the psychosocial concerns of the growing population of adults with congenital heart disease presents a unique challenge to health care providers. These patients frequently need information about their disease with emphasis on how it may affect their sexuality, childbearing, and risk of having children with ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1993-11-01 00:00:00
abstract：:Subaortic stenosis can be a complex disease of multiple anatomic etiologies. At the core is either an elongated and narrow outflow tract as compared to normal or a fully muscle-rimmed VSD used as an intraventricular routing pathway. An array of treatment modalities is needed for an effective management strategy. ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(02)00013-9
更新日期：2002-08-01 00:00:00
abstract：:Clinical trial results support the aggressive use of anticoagulant therapy to prevent systemic embolism in patients with acute myocardial infarction who are at high risk for embolism (e.g., anterior transmural infarction). Other patients at risk for systemic embolism include those with chronic left ventricular aneurys...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1994-08-01 00:00:00
abstract：:There have been significant advances in the diagnosis and treatment of the patient with mitral stenosis over the past two decades. Two-dimensional and Doppler echocardiography have supplanted the cardiac catheterization laboratory in the diagnosis and determination of the hemodynamic severity of the stenotic mitral va...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(05)70021-7
更新日期：1998-08-01 00:00:00
abstract：:Targeted ultrasound imaging uses acoustically active contrast agents bearing a ligand on the surface that binds to a function-specific molecule. These ultrasound contrast agents are typically gas-filled microbubbles, nongaseous liposomes, or lipid-encapsulated perfluorocarbon emulsions. Binding of the contrast agent t...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2004.02.008
更新日期：2004-05-01 00:00:00
abstract：:Proarrhythmia is a potentially lethal adverse effect of antiarrhythmic drugs. Underlying mechanisms and the approaches to identification are discussed. The applicability of electrophysiologic testing is considered, with particular reference to the validity of the different responses to programmed stimulation considere...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1986-08-01 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：:In this era of interventional electrophysiology, the accuracy of the electrocardiogram in diagnosis of supraventricular tachycardia could be improved by detailed endocardial mapping and confirmed by results of radiofrequency catheter ablation. This article describes the electrocardiographic characteristics for differe...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(05)70361-1
更新日期：1997-11-01 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 treatment of cardiorenal syndrome is as complex as the various mechanisms underlying its pathophysiology. Randomized controlled data typically focus on the treatment of heart failure with cardiac specific endpoints and a lack of worsening renal function used as a surrogate for efficacy. When heart failure is consi...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2019.04.002
更新日期：2019-08-01 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：:Cardiac implantable electronic devices (CIEDs) store clinically valuable, time-sensitive information regarding system integrity, arrhythmias, and heart failure parameters. Remote monitoring has impacted clinical practice by reducing scheduled office visits, providing protocols for device recalls and advisories, and fa...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2014.01.001
更新日期：2014-05-01 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：: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：:Although it is convenient to think of hypertension in its renal, epidemiologic, and vascular eras, a new perspective is rapidly coming to the forefront. As we become more critical in evaluating the performance of our health care systems, it is obvious that the major problems in hypertension do not lie entirely with un...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1995-11-01 00:00:00
abstract：:Except for the unique eccentricities of individual devices, most dual-chamber paced rhythms, both normal and abnormal, are readily understood and lend themselves to analysis if the programmed parameters are known. Although they may appear intimidating, this need not be the case if the physician is initially willing to...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1985-11-01 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：: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：:Exercise training can have a profound effect on cardiac structure. Recent evidence suggests that the greatest determinants of exercise-induced cardiac remodeling are the intensity, duration, and frequency of training. This also has overlap with athlete fitness. There are many additional factors that are important in d...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2016.06.001
更新日期：2016-11-01 00:00:00
