Abstract:
BACKGROUND:Balloon inflation during coronary angioplasty results in shear stress-induced vessel wall injury with development of restenosis. This randomized trial compared the impact of two different balloon inflation strategies (slow versus fast) on restenosis after coronary angioplasty. METHODS:Two hundred seven patients were randomized to undergo either fast or gradually increased slow inflation after successful placement of the balloon catheter inside the target lesion. One hundred six underwent fast, and 101 underwent gradually increased slow balloon inflation. Coronary angiograms were quantitatively analyzed before angioplasty, after angioplasty, and at follow-up 5.9+/-1.6 months after the initial procedure. RESULTS:Both groups had an identical primary success rate (98.1% vs 98%; p = 0.96) and a similar minimal luminal diameter before (0.49+/-0.26 mm vs 0.48+/-0.22 mm; p = 0.8) and after (2.22+/-0.97 mm vs 2.26+/-0.66 mm; p = 0.7) angioplasty. Slow balloon inflation did not reduce late luminal loss (0.58+/-0.77 mm vs 0.74+/-0.87 mm; p = 0.2), net gain (1.33+/-0.84 mm vs 1.19+/-0.81 mm; p = 0.3), or minimal luminal diameter at follow-up (1.80+/-0.97 mm vs 1.72+/-1.0 mm; p = 0.6) significantly. Restenosis, defined as >50% diameter stenosis at follow-up, occurred in 24% in the slow inflation group versus 36% in the fast inflation group (p = 0.09). Clinical events during 6-month follow-up were similar in both groups (repeat angioplasty, fast 5.6%, slow 4.8%, p = 0.8; nonfatal myocardial infarction, fast 2.2%, slow 1.2%, p = 0.6; death, fast 1.1%, slow 0%, p = 0.3). CONCLUSION:The present randomized trial of two different balloon inflation strategies shows no statistically significant difference in net gain, minimal luminal diameter, or restenosis after coronary angioplasty. The difference in net gain, minimal luminal diameter, and restenosis rate were not statistically significant, but may represent a trend toward a reduction of smooth muscle cell proliferation and intimal hyperplasia induced by careful dilation of the stenotic lesion with gradually increased slow balloon inflation and reduction of shear stress-related vessel wall injury.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Miketic S,Carlsson J,Tebbe Udoi
10.1016/s0002-8703(98)70290-xsubject
Has Abstractpub_date
1998-04-01 00:00:00pages
709-13issue
4eissn
0002-8703issn
1097-6744pii
S0002870398002944journal_volume
135pub_type
临床试验,杂志文章,随机对照试验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:BACKGROUND:The 2020 American Heart Association Impact Goal aims to improve cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular disease and stroke by 20%. A large step toward this goal would be to better understand and take advantage of the significant intersection between behavior an...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2017.02.020
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVES:We analyzed the antiplatelet effects of different P2Y(12) receptor blockers with VerifyNow P2Y12 assay (VN-P2Y12) and light transmittance aggregometry (LTA). BACKGROUND:The point-of-care VN-P2Y12 has been used to assess the antiplatelet effects in clopidogrel-treated patients but has not been evaluated in d...
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.2012.03.022
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:ST-elevation myocardial infarctions (STEMI) caused by proximal left-anterior descending (LAD) lesions have more myocardium at risk and worse outcomes than those located in other segments. The aim is to compare outcomes of patients with STEMI and proximal-LAD lesions treated with bare-metal stents (BMS) versu...
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.2013.04.012
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Recent studies suggest that smokers' coronary endothelial function is impaired because of increased oxidative stress, and their coronary flow velocity reserve (CFVR) is reduced. It is uncertain whether oral antioxidant vitamin C restores impaired CFVR in smokers. Recent technological advances in transthoraci...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.03.006
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND:Anemia in heart failure is both common and associated with worse symptoms and increased mortality. Several small randomized controlled trials (RCTs) have assessed erythropoiesis-stimulating agents (ESAs), but definitive evaluation and clinical guidance are required. We sought to systematically review the eff...
journal_title:American heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ahj.2011.02.013
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Myocardial contractile reserve has been shown to provide important prognostic information in patients with heart failure. We hypothesized that myocardial contractile reserve would predict left ventricular (LV) reverse remodeling after cardiac resynchronization therapy (CRT). METHODS:Thirty-one consecutive p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.07.035
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Many young investigators are interested in cardiovascular (CV) outcomes research; however, the current training experience of early investigators across the United States is uncertain. METHODS:From April to November 2014, we surveyed mentees and mentors of early-stage CV outcomes investigators across the Un...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2017.07.022
更新日期:2018-02-01 00:00:00
abstract::Traditionally, assessment of therapy has been judged by the ability of treatment to alleviate symptoms with tolerable side effects or toxicity. In recent years, it has become obvious that more subtle and patient-oriented approaches are urgently needed to evaluate progression of cardiovascular disease and to monitor th...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90963-x
更新日期:1987-07-01 00:00:00
abstract::Nearly 800,000 of the 1 million patients hospitalized with acute heart failure (AHF) every year are initially treated by emergency physicians. Signs and symptoms are typically most severe at initial presentation, but with timely diagnostic and therapeutic management, rapid improvement can be achieved. As a direct resu...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2013.03.009
更新日期:2013-06-01 00:00:00
abstract:AIMS:Furosemide is commonly prescribed for symptom relief in heart failure (HF) patients. Although few data support the continuous use of loop diuretics in apparently euvolemic HF patients with mild symptoms, there is concern about safety of diuretic withdrawal in these patients. The ReBIC-1 trial was designed to evalu...
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.2017.08.012
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Over 3 million patients annually present with symptoms suggestive of obstructive coronary artery disease (oCAD) in the United States (US), but a cardiac etiology is found in as few as 10% of cases. Usual care may include advanced cardiac testing with myocardial perfusion imaging (MPI), with attendant radiati...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2014.02.005
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:The 6-minute walk test is a submaximal exercise test that is widely used as an outcomes measure in clinical trials and cardiopulmonary rehabilitation. An initial learning effect with repeated administration is well documented, but it is unknown whether this learning effect persists with time. METHODS:This s...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/S0002-8703(03)00119-4
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Single center studies using serial cerebral diffusion-weighted magnetic resonance imaging in patients having cardiac catheterization have suggested that cerebral microembolism might be responsible for silent cerebral infarct (SCI) as high as 15% to 22%. We evaluated in a multicenter trial the incidence of SC...
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.2012.04.005
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Several studies have shown that patency of the epicardial vessel does not guarantee optimal myocardial perfusion in patients undergoing primary angioplasty for ST-segment elevation myocardial infarction (STEMI). The aim of the current study was to identify clinical and angiographic correlates of unsuccessful...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.10.044
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Analysis of high-frequency QRS amplitudes (HF-QRS) may provide an additional diagnostic tool in patients with heart disease, but the basic properties of these waveforms have not been sufficiently investigated. This study describes the spatial, individual, and temporal variation at rest of HF-QRS recorded wit...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.101782
更新日期:2000-02-01 00:00:00
abstract:INTRODUCTION:Heart Failure (HF) is a common cause of hospitalization in older adults. The transition from hospital to home is high-risk, and gaps in transitional care can increase the risk of re-hospitalization and death. Combining health care services supported by meta-analyses, we designed the PACT-HF transitional ca...
journal_title:American heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ahj.2017.12.013
更新日期:2018-05-01 00:00:00
abstract::After injecting 125I- or 131I-labeled lipoproteins, plasma was subjected to discontinuous density gradient centrifugation, which separates low-density lipoproteins (LDL) into three subfractions. Analysis of changes in apolipoprotein B-specific activity with time showed that light LDL is normally the product of interme...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90623-5
更新日期:1987-02-01 00:00:00
abstract:BACKGROUND:This study examines how the dissemination of stenting and procedural shifts to high-volume facilities have affected short-term outcomes after percutaneous coronary intervention (PCI). METHODS:Discharge information from the 1994 and 1997 US Nationwide Inpatient Sample was used. Data from 1994 involved 84,036...
journal_title:American heart journal
pub_type: 杂志文章
doi:
更新日期:2002-08-01 00:00:00
abstract::The antiarrhythmic effect of nadolol, a long-acting, nonselective beta antagonist without intrinsic sympathomimetic or membrane-stabilizing properties, was evaluated in 36 patients with ventricular dysrhythmias as determined by three baseline 24-hour Holter recordings at a time when subjects were receiving placebo. Na...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(84)90590-8
更新日期:1984-10-01 00:00:00
abstract::The distinction between idiopathic dilated cardiomyopathy and myocarditis is controversial, both clinically and pathologically. To increase diagnostic accuracy and provide prognostic information, we prospectively tested the routine application of immunofluorescence and electron microscopy in endomyocardial biopsy eval...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90180-3
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVES:The study aimed to analyze the use of intensive lipid-lowering therapy (I-LLT) at discharge in a broad population of patients hospitalized with acute coronary syndrome (ACS). BACKGROUND:Early and intensive statin therapy in ACS has been shown to reduce cardiovascular morbidity and mortality. Utilization and...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2010.12.014
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Glycoprotein (GP) IIb/IIIa inhibitors can improve outcomes in patients with non-ST-segment elevation acute coronary syndromes but raise the risk of bleeding, particularly if dosed in excess. The impact of GP IIb/IIIa dosing feedback on safety and major bleeding is unknown. METHODS:Glycoprotein IIb/IIIa dosi...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2010.08.008
更新日期:2010-12-01 00:00:00
abstract::The relationship between coronary artery size and left ventricular (LV) muscle mass was studied in 10 control subjects and in 10 patients with chronic mitral regurgitation before and 28 +/- 15 months after mitral valve surgery. Left and right coronary artery size was determined by quantitative coronary arteriography. ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90659-w
更新日期:1993-11-01 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::Atherosclerotic coronary artery disease is a serious clinical problem. Clinicians dealing with patients can make a diagnosis of coronary disease in several ways. Unfortunately all too often the diagnosis is made via sudden death or acute myocardial infarction. At other times the diagnosis is made by evaluation of pati...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(92)91039-4
更新日期:1992-05-01 00:00:00
abstract::Myocarditis Disease Unit (MDU) is a functional multidisciplinary network designed to offer multidisciplinary assistance to patients with myocarditis. More than 300 patients coming from the whole Country are currently followed up at a specialized multidisciplinary outpatient clinic. Following the pandemic outbreak of t...
journal_title:American heart journal
pub_type: 信件
doi:10.1016/j.ahj.2020.07.015
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:The follow-up of patients with mitral and tricuspid regurgitation is important for their clinical treatment. We aimed to evaluate the reproducibility of the flow convergence method in mitral and tricuspid regurgitation. METHODS:The proximal flow convergence region was imaged with color Doppler ultrasound sc...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2003.11.006
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Dual antiplatelet therapy with aspirin and clopidogrel is currently recommended in off-pump coronary artery bypass (OPCAB). However, no data exist concerning platelet reactivity on clopidogrel after OPCAB. The aim of this study was to assess the relationship between platelet reactivity and late major adverse...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2014.01.016
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Enhanced external counterpulsation (EECP) reduces angina and extends time to exercise-induced ischemia in patients with symptomatic coronary disease. One- and two-center studies and a retrospective case series reported that EECP improves myocardial perfusion in stable angina pectoris. We sought to critically...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2005.01.054
更新日期:2005-11-01 00:00:00