Abstract:
:The objectives of this study were to assess current practice patterns in pharmacotherapy for congestive heart failure at an academic medical center and to analyze temporal trends in management of congestive heart failure from 1990 to 1995. Records of all patients discharged from the hospital in 1990 or 1995 with a primary diagnosis of congestive heart failure who also underwent echocardiography were found by a search of the hospital's medical records database. All charts were reviewed, and relevant clinical data, including all discharge medications, were recorded. On the basis of echocardiograms, patients were classified as having preserved or impaired left ventricular systolic function (estimated ejection fraction > or =45% versus <45%). The use of digoxin, diuretics, angiotensin-converting enzyme (ACE) inhibitors, calcium and beta-blockers, nitrates, and hydralazine in 1990 and 1995 were compared in subgroups according to left ventricular function. A total of 297 patients were identified who fulfilled study criteria and for whom all pertinent data were available (1990, n = 109; 1995, n = 188). The median age was 74 years; 37.3% of the patients were men, and 45.1% were white. Among patients with impaired systolic function, the proportion receiving either an ACE inhibitor or the combination of nitrates and hydralazine increased from 80.9% in 1990 to 95.4% in 1995 (p = 0.009). In addition, among patients treated with an ACE inhibitor, the proportion receiving an optimal dose increased from 24.3% in 1990 to 61.5% in 1995 (p < 0.001). The use of beta-blockers also increased significantly during this time period (2.1% versus 15.7%; p = 0.031 ). Among patients with preserved ventricular function, the use of ACE inhibitors and beta-blockers increased from 1990 to 1995 (both p < 0.05). The use of other medications did not change for either subgroup. Current use of appropriate vasodilator therapy at an academic medical center is very high and is in accordance with published guidelines for the management of congestive heart failure. The use of vasodilators and beta-blockers has increased significantly since 1990 among patients with congestive heart failure with either impaired or preserved left ventricular contractility.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Rich MW,Brooks K,Luther Pdoi
10.1016/s0002-8703(98)70309-6subject
Has Abstractpub_date
1998-03-01 00:00:00pages
367-72issue
3eissn
0002-8703issn
1097-6744pii
S0002870398003093journal_volume
135pub_type
杂志文章abstract::A-II exerts its activity on various target tissues by binding to its receptors. The discovery of local RASs and A-II receptors within various tissues has generated interest in the clinical usefulness of RAS inhibition by directly blocking the action of A-II at the receptor level. Different A-II receptor subtypes have ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(94)90061-2
更新日期:1994-05-01 00:00:00
abstract::High levels of endogenous plasma catecholamines in patients with severe congestive heart failure induce a down-regulation of the myocardial beta-adrenoreceptors and thus cause adrenoreceptor agonists, such as dobutamine, to be less effective in the treatment of these patients. Phosphodiesterase III inhibitors work ind...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(91)90834-5
更新日期:1991-06-01 00:00:00
abstract::The calcium antagonist, manidipine, was developed on the basis of the hypothesis that antihypertensive drugs that act to improve renal hemodynamic alterations will be therapeutically beneficial in hypertensive patients. Manidipine shows long-lasting calcium channel-blocking action in vascular smooth muscle cells and a...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(93)90203-l
更新日期:1993-02-01 00:00:00
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:Previous studies have demonstrated that the adenosine monophosphate deaminase 1 (AMPD1) C34T polymorphism may be associated with survival in cardiac populations with a protective effect of the T allele. However, these studies included limited number of patients with few cardiovascular events. METHODS:We pro...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.04.003
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Guidelines recommend consideration of cardiac biomarker measurement after elective percutaneous coronary intervention (PCI), especially with complex cases or complicated procedures. However, the long-term prognostic implications of biomarker measurement after elective PCI have not been well characterized in ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.09.007
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVES:SUPPORT-HF 2 tests the hypothesis that home monitoring with information technology-supported specialist management is more effective in optimizing medical therapy than is home monitoring alone for patients with heart failure. METHODS AND RESULTS:The study was designed as a 2-armed partially blinded parallel...
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.2018.09.007
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Current acetylsalicylic acid (ASA) dosing algorithms for the prevention of secondary thrombotic events in acute coronary syndrome (ACS) patients are inconsistent and lack sufficient data support. METHODS:We performed a systematic review of the literature for studies that assessed clinical outcomes in patien...
journal_title:American heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ahj.2012.04.001
更新日期:2012-08-01 00:00:00
abstract::The effects and possible mechanisms of actions of indomethacin on systemic and coronary hemodynamics were studied in 17 patients with coronary artery disease. Group I patients (12) were given either indomethacin or placebo in the absence of prior cyclooxygenase inhibition and group II (five) were given indomethacin af...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(85)90149-8
更新日期:1985-08-01 00:00:00
abstract::The proximal flow convergence method of multiplying color Doppler aliasing velocity by flow convergence surface area has yielded a new means of quantifying flow rate by noninvasively derived measurements. Unlike previous methods of visualizing the turbulent jet of mitral regurgitation on color flow Doppler mapping, fl...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90025-5
更新日期:1993-02-01 00:00:00
abstract::Intramuscular lidocaine administration is known to produce blood concentration levels considered to be therapeutic for prevention of premature ventricular contractions. This double blind study was designed to study the effect of intramuscular lidocaine in the prevention of PVC's in acute myocardial infarction. Forty-s...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-8703(76)80323-7
更新日期:1976-04-01 00:00:00
abstract::Despite gratifying immediate results, significant recoarctation at follow-up has been observed after balloon angioplasty of native aortic coarctation. Risk factors for such recurrences have been identified in one of our previous studies. In this study we examined the value of these risk factors in the prediction of re...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90245-7
更新日期:1995-07-01 00:00:00
abstract::Critical limb ischemia is associated with excessively high risk for cardiovascular events, including myocardial infarction and death. Additionally, in this patient population non-invasive evaluation of coronary artery disease is limited due to (1) inability of exercise testing, (2) frequent occurrence of balanced isch...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2019.05.005
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Cohort studies have suggested little effect of coffee consumption on risk of acute myocardial infarction. The effect of coffee consumption on prognosis after myocardial infarction is uncertain. METHODS:In a population-based inception cohort study, we followed 1,369 patients hospitalized with a confirmed fir...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.11.009
更新日期:2009-03-01 00:00:00
abstract::Complex coronary morphologic abnormalities with thrombus and ulceration have been recognized in acute ischemic syndromes by angiography, angioscopy, and autopsy. However, in vivo histopathologic correlates of unstable ischemic syndromes have not been described. The purpose of this study was to characterize intracorona...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90612-2
更新日期:1994-09-01 00:00:00
abstract::Antiplatelet therapy has been shown to significantly reduce the risk of serious vascular events in high-risk patients, including those with a prior acute ischemic event. The long-term use of antiplatelet agents is a key component of secondary prevention measures following acute coronary syndromes, including ST-segment...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2010.10.014
更新日期:2010-12-01 00:00:00
abstract::The QRS complex and ST segment in the ECGs of 80 patients who died of an acute myocardial infarction (MI) were studied in relation to the extent of the MI (subendocardial vs. transmural). Changes in the QRS complex developed in nine out of the 15 cases with an acute subendocardial MI. Five of these cases fulfilled the...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90219-9
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus and impaired glucose metabolism are associated with increased risk for cardiovascular disease (CVD). However, it is still not clear whether glucose levels can predict CVD risk among patients without diabetes. The primary aim of this study is to assess whether normoglycemic fasting plasma gl...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2012.03.023
更新日期:2012-07-01 00:00:00
abstract::Sodium-glucose cotransporter 2 inhibitor (SGLT2i) use is associated with improved cardiovascular and kidney outcomes. However, the magnitude and potential heterogeneity of effect across patients with varying types of cardiometabolic and kidney disease is unclear. To examine the effect of SGLT2i on cardiovascular and k...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2020.10.064
更新日期:2021-02-01 00:00:00
abstract::Contrast bidimensional echocardiographic (2DE) studies were performed in eight patients with d-transposition of the great vessels in the postoperative period of the Senning technique. Contrast was injected into a peripheral vein of all patients, and into the arterial atrium in five in the postoperative period. The 2DE...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90552-0
更新日期:1984-07-01 00:00:00
abstract::The effect of participation in cardiac rehabilitation on medical costs was determined by measuring hospitalization charges for cardiac admissions over a 3-year period in 580 post-coronary event patients (58% after coronary bypass surgery, 42% after myocardial infarction), of whom 230 entered a cardiac rehabilitation p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90696-s
更新日期:1992-04-01 00:00:00
abstract:BACKGROUND:The activated coagulation time (ACT) is a rapid measurement of a patient's level of heparin anticoagulation during cardiac catheterization. Patients receiving warfarin therapy occasionally are seen at the catheterization laboratory for emergent procedures. The effects of warfarin on ACT activity have not bee...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70223-6
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Little is known on the "very" long-term incidence of major adverse cardiac events (MACE), target-lesion revascularization (TLR), target-vessel revascularization and stent thrombosis after sirolimus-eluting stent (SES) implantation. We present the first study to provide a 10-year clinical follow-up in an unse...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.12.013
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:The objective was to report recent trends in the incidence, adoption of evidence-based treatment, and clinical outcomes for first-time hospitalization for acute myocardial infarction. METHODS:This is a large retrospective population-based cohort study using medical administrative data (International Classif...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.08.026
更新日期:2013-11-01 00:00:00
abstract::Radionuclide angiographic evaluation of LV performance at rest and during exercise in patients with AR have shown that an abnormal EF response to exercise may be observed in asymptomatic patients with normal resting LV function. The EF response to exercise has been correlated with a number of clinical and exercise mea...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90019-0
更新日期:1986-06-01 00:00:00
abstract::A new agent for use in contrast echocardiography that is capable of passing through the pulmonary circulation and opacifying the left ventricular cavity after intravenous injection was evaluated in a canine model. Air-filled albumin microbubbles were produced by sonication. A Coulter counter was used to size and count...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90754-x
更新日期:1987-09-01 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
doi:10.1016/s0002-8703(97)70164-9
更新日期:1997-06-01 00:00:00
abstract::This study was designed to investigate the hypothesis that mitral valve prolapse (MVP) can be induced after diuresis in women without the abnormality who have characteristic body habitus. Fifteen tall, slim, healthy female volunteers with a normal cardiac findings, echocardiogram, and history were investigated after m...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(92)90068-7
更新日期:1992-12-01 00:00:00
abstract:AIMS:In adults with coarctation of the aorta (CoA), hypertension (HTN) is a common long-term complication. We investigated the prevalence of HTN and analyzed factors associated with HTN. METHODS AND RESULTS:In the national register for congenital heart disease, 653 adults with repaired CoA were identified (mean age 36...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.07.012
更新日期:2016-11-01 00:00:00
abstract::Two double-blind multicenter studies compared acebutolol with placebo (acebutolol, N = 121; placebo, N = 116) and with propranolol (acebutolol, N = 186; propranolol, N = 190) in essential hypertension. Acebutolol significantly reduced mean sitting diastolic blood pressure from 99.2 +/- 0.3 mm Hg at baseline to 89.1 +/...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(85)90702-1
更新日期:1985-05-01 00:00:00