Abstract:
AIM:In this study we sought to determine the safety, feasibility and prognostic value of pharmacological stress echocardiography performed in a primary care cardiology centre, populated by unselected patients evaluated with the aid of limited financial and technological resources. METHODS AND RESULTS:The study population was 1082 patients undergoing pharmacological stress echocardiography with either dipyridamole (n=714) or dobutamine (n=368) for the evaluation of known or suspected coronary artery disease. The echocardiogram was positive in 284 (26%) patients. Two sustained ventricular tachycardias, reversible by antidote, occurred during stress testing. Limiting ischaemia-independent side effects occurred in 1.5% dipyridamole and in 2.4% dobutamine stress echocardiograms. During follow-up (33+/-18 months), 17 cardiac deaths and 27 non-fatal myocardial infarctions occurred. One hundred and twenty-seven patients underwent coronary revascularization, of whom 105 (37%) had a positive and 22 (3%) a negative stress testing result (P<0.0001). At Cox analysis, allowing for 14 clinical and stress-echo variables. the independent predictors of cardiac death were, in decreasing order, a positive stress testing result (Odds ratio [OR]=6.0), resting wall motion score index (OR=5.7), age greater than 65 years (OR=4.9), previous Q-wave myocardial infarction (OR=3.5), and hypercolesterolaemia (OR=2.7). The 4-year survival rate was 99.2% for patients with a negative and 89.8% for patients with a positive stress testing result (P=0.0000). When cardiac hard events (cardiac death and non-fatal myocardial infarction) were considered as end-points, the following variables were independently associated with prognosis: positive result of stress testing (OR=3.1), hypercolesterolaemia (OR=2.4), and resting wall motion score index (OR=2.7). The 4-year infarction-free survival rate was 97.0% for patients with a negative and 81.4% for patients with a positive stress testing result (P=0.0000). CONCLUSIONS:Pharmacological stress echocardiography with either dipyridamole or dobutamine was safe and feasible, providing an excellent tool for prognostic assessment of coronary artery disease in a primary care cardiology centre.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Cortigiani L,Lombardi M,Landi P,Paolini EA,Nannini Edoi
10.1053/euhj.1998.1096subject
Has Abstractpub_date
1998-11-01 00:00:00pages
1673-80issue
11eissn
0195-668Xissn
1522-9645pii
S0195668X9891096Xjournal_volume
19pub_type
杂志文章abstract::ACE inhibitors may influence the actual concentrations of the peptides angiotensin I, angiotensin II and bradykinin. Since all three peptides are able to modulate catecholamine release, a change in noradrenaline and adrenaline release should be expected when angiotensin I converting enzyme (kininase II) is inhibited. ...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:
更新日期:1993-11-01 00:00:00
abstract:AIM:Cross-sectional studies reported associations between short leucocyte telomere length (LTL) and measures of vascular and cardiac damage. However, the contribution of LTL dynamics to the age-related process of cardiovascular (CV) remodelling remains unknown. In this study, we explored whether the rate of LTL shorten...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehu226
更新日期:2014-12-07 00:00:00
abstract::In the initial phase of heart failure, cardiac output and pressure are maintained by increasing sympathetic drive and by cell hypertrophy. Elevated end-diastolic volume, a reduced ejection fraction and a higher filling pressure also occur. Only in more severe heart failure, when cardiac output cannot be maintained, do...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/16.suppl_f.2
更新日期:1995-07-01 00:00:00
abstract::The class III antiarrhythmic drug dofetilide is known to prolong action potential duration by specific blockade of the delayed rectifier potassium channel Ik. As dofetilide is likely to be used in the treatment of atrial arrhythmias it is important to determine the relative sensitivity of the atrium and ventricle in m...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/oxfordjournals.eurheartj.a060790
更新日期:1995-11-01 00:00:00
abstract::Large-scale trials have demonstrated a consistent mortality reduction from angiotensin converting enzyme (ACE) inhibitor therapy for chronic heart failure. Nonetheless, the pharmacologic and physiologic mechanisms of this favourable affect and the appropriate target population remain controversial. ACE inhibitors exer...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/16.suppl_o.133
更新日期:1995-12-01 00:00:00
abstract:AIMS:We investigated the potential influence of a moderate-to-high cardiovascular (CV) risk (CVR) (defined as a Systematic COronary Risk Evaluation model, or SCORE ≥ 4%), in the absence of an established CV disease, on the duration and cost of CV and non-CV sick leave (SL) resulting from common and occupational acciden...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/eht156
更新日期:2014-02-01 00:00:00
abstract:AIMS:The management and outcomes of patients with functional moderate/severe mitral regurgitation and severe left ventricular (LV) systolic dysfunction are not well defined. We sought to determine the characteristics, management strategies, and outcomes of patients with moderate or severe mitral regurgitation (MR) and ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehv343
更新日期:2015-10-21 00:00:00
abstract:AIMS:The totally subcutaneous implantable-defibrillator (S-ICD) is a new alternative to the conventional transvenous ICD system to minimize intravascular lead complications. There are limited data describing the long-term performance of the S-ICD. This paper presents the first large international patient population col...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehu112
更新日期:2014-07-01 00:00:00
abstract:AIMS:To assess safety, feasibility and short term outcome of pulmonary vein (PV) isolation in paroxysmal atrial fibrillation (AF) with a cryoballoon. METHODS:We consecutively treated 57 patients with a double lumen 23 or 28 mm cryoballoon. The acute results, complications and follow-up over the first three months were...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm227
更新日期:2007-09-01 00:00:00
abstract:Aims:Epidemiological studies strongly suggest a link between stress, depression, and cardiovascular diseases (CVDs); the mechanistic correlation, however, is poorly understood. A single-nucleotide polymorphism in the BDNF gene (BDNFVal66Met), associated with depression and anxiety, has been proposed as a genetic risk f...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehv655
更新日期:2017-05-07 00:00:00
abstract::Experience accumulated from several large trials strongly suggests that beta-blockers should be used for the management of chronic heart failure[87]. It is appropriate to add beta-blockade to conventional therapy such as diuretics, ACE inhibitors and digoxin, as this was the approach used in the major trials. It is ap...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/oxfordjournals.eurheartj.a014745
更新日期:1996-11-01 00:00:00
abstract::Increased levels of low density lipoprotein (LDL) cholesterol and triglyceride, and low levels of high density lipoprotein (HDL) cholesterol, are associated with increased risk of coronary heart disease (CHD). Only a minor part of the variation in lipids can be explained by defects in single genes of large effect; the...
journal_title:European heart journal
pub_type: 杂志文章
doi:
更新日期:1998-04-01 00:00:00
abstract:AIMS:Patients undergoing catheter ablation for atrial fibrillation (AF) often experience recurrent arrhythmias within the first few months post-ablation. We aimed to investigate whether short-term use of amiodarone to prevent early arrhythmias following radiofrequency ablation for AF could reduce later recurrence. MET...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehu354
更新日期:2014-12-14 00:00:00
abstract:AIMS:The relative benefits of computed tomography coronary angiography (CTCA)-guided management in women and men with suspected angina due to coronary heart disease (CHD) are uncertain. METHODS AND RESULTS:In this post hoc analysis of an open-label parallel-group multicentre trial, we recruited 4146 patients referred ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehz903
更新日期:2020-04-01 00:00:00
abstract:AIMS:In mechanical heart valve recipients, low-dose international normalized ratio (INR) self-management of oral anticoagulants can reduce the risk of developing thrombo-embolic events and improve long-term survival compared with INR control by a general practitioner. Here, we present data on the safety of low-dose INR...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehm391
更新日期:2007-10-01 00:00:00
abstract:AIMS:Drug-eluting stents (DES) represent a major advance in interventional cardiology. Along with the success shown, current DES also present limitations related to the presence of polymer-coating, fixed drug, and dose used. With the ISAR (Individualized Drug-Eluting Stent System to Abrogate Restenosis) project, a DES ...
journal_title:European heart journal
pub_type: 临床试验,杂志文章
doi:10.1093/eurheartj/ehi405
更新日期:2005-08-01 00:00:00
abstract:AIMS:The purpose of this study was to identify novel genetic variants influencing circulating asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) levels and to evaluate whether they have a prognostic value on cardiovascular mortality. METHODS AND RESULTS:We conducted a genome-wide association stud...
journal_title:European heart journal
pub_type: 杂志文章,meta分析
doi:10.1093/eurheartj/eht447
更新日期:2014-02-01 00:00:00
abstract::A 54-year-old man suffering from effort angina pectoris had an anomalous origin of the left anterior descending coronary artery (LAD) from the right sinus of Valsalva (RSV). The anomalous LAD with a small ostium and without other significant narrowing initially ran into the interventricular septum and subsequently the...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.1.129
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Recent identification of mutations in the beta-myosin heavy chain gene (MYH7), a major responsible gene for HCM, has provided the opportunity to characterize genotype-phenotype correlation in HCM families. In this study we analysed the phenotypic expression of two beta-myosin heavy chain (beta MHC) mutations...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060920
更新日期:1995-03-01 00:00:00
abstract::The effect of 24 weeks of treatment with simvastatin, a new HMG coenzyme A reductase inhibitor (dosages of 20 and 40 mg day-1) on serum lipid, lipoprotein and apolipoprotein A-I and B concentrations as well as safety parameters and subjective side effects were studied in 11 patients with familial (FH) and 10 patients ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062541
更新日期:1988-05-01 00:00:00
abstract:AIMS:Psoriasis is a chronic inflammatory disease and inflammation contributes to the pathogenesis of atrial fibrillation (AF) and ischaemic stroke. We therefore investigated the risk of these endpoints in patients with psoriasis. METHODS AND RESULTS:Cohort study of the entire Danish population followed from 1997 to 20...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehr285
更新日期:2012-08-01 00:00:00
abstract::Alterations in the right ventricular function may or may not contribute to progressive cardiac dysfunction after left ventricular infarction. Ligation of the left coronary artery (LCAL) was lethal within 24 h for 25% of 100 rats, whereas none of 21 sham-operated rats died. No rats died during the following 4 weeks, af...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.11.1554
更新日期:1993-11-01 00:00:00
abstract:AIMS:N-terminal pro-brain natriuretic peptide (NT-proBNP) levels predict outcomes in ST-elevation myocardial infarction patients treated with fibrinolysis or primary percutaneous coronary intervention (PCI). However, its role in facilitated PCI has not yet been assessed; it may be a tool to evaluate the lower event rat...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehp246
更新日期:2009-09-01 00:00:00
abstract::Torsade de pointes may occur as a complication of amiodarone therapy. We report a patient receiving amiodarone who was resuscitated from cardiovascular collapse and documented ventricular fibrillation. At subsequent electrophysiology study, while the patient was taking amiodarone therapy, monophasic action potentials ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059849
更新日期:1991-10-01 00:00:00
abstract:AIMS:To assess the effect of experimentally induced atrial fibrillation on coronary flow in humans. METHODS AND RESULTS:In 16 patients (10 men, mean age 43+/-13 years) with normal coronary vessels, baseline and hyperaemic blood pressure and Doppler phasic coronary flow velocity were measured, using a 0.014 inch intrac...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2001.2894
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:In the acute phase of myocardial infarction (acute MI) marked endothelial damage occurs within the first 24h following thrombolysis with streptokinase. We investigated whether this is associated with a change in levels of vascular endothelial growth factor (VEGF, possibly marking angiogenesis) in the first 2...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2002.3312
更新日期:2002-10-01 00:00:00
abstract:AIMS:Ivabradine, a new I(f) inhibitor which acts specifically on the pacemaker activity of the sinoatrial node, is a pure heart rate lowering agent. Ivabradine has shown anti-ischaemic and anti-anginal activity in a placebo-controlled trial. The objective of this study was to compare the anti-anginal and anti-ischaemic...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehi586
更新日期:2005-12-01 00:00:00
abstract::Myocardial protection and the control of ischemic injury has been highly successful clinically in the field of cardiac surgery where hearts are made globally ischemic. By contrast, protection of the regionally ischemic myocardium, as found during evolving myocardial infarction, has been less successful and, despite nu...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/4.suppl_c.43
更新日期:1983-05-01 00:00:00
abstract:AIM:It has recently been suggested that exercise testing may be more valuable prognostically than it is diagnostically in apparently healthy subjects. We wanted to compare the accuracy of CHD risk assessment based on classical risk factors with an assessment also based on multiple exercise test parameters. METHODS AND...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/j.ehj.2004.04.009
更新日期:2004-06-01 00:00:00
abstract::The implementation of molecular biological approaches has led to the discovery of single genetic variations that contribute to the development of cardiac failure. In the present review, the characteristics that are invariably associated with the development of failure in experimental animals and clinical studies are d...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0195-668x(02)00829-1
更新日期:2003-05-01 00:00:00