Abstract:
BACKGROUND:Cardiac effects of hypertension include increased left ventricular (LV) mass and LV hypertrophy, as well as increased left atrial size, a predictor of stroke and atrial fibrillation. Although literature on reduction of LV mass with antihypertensive therapy is extensive, little information is available on effects of treatment on left atrial size. METHODS AND RESULTS:Patients with mild to moderate hypertension (diastolic blood pressure 95 to 109 mm Hg) were randomly allocated to treatment with atenolol, captopril, clonidine, diltiazem, hydrochlorothiazide, or prazosin in a double-masked trial. Two-dimensional targeted M-mode echocardiography was used to assess left atrial size and LV mass at baseline, 8 weeks, and 1 and 2 years. Longitudinal analysis examined changes in left atrial size from the baseline study, statistically adjusting for age, race, pretreatment left atrial size and LV mass, and serial measurements of systolic blood pressure, body weight, urinary sodium excretion, and physical activity score. Without adjustment for covariates, only hydrochlorothiazide was associated with decreases in left atrial size from baseline at 8 weeks (-1.0 +/- 5.2 mm; P=0.052), 1 year (-2.0 +/- 5.1 mm; P=0.02), and 2 years (4.6+/-7.2 mm; P=0.002). After adjustment for effects of covariates, patients with normal left atrial size had greater reduction (-3.3 mm) in left atrial size at 2 years with hydrochlorothiazide than with any other drug. For patients with left atrial enlargement, left atrial size decreased significantly with hydrochlorothiazide, atenolol, clonidine, and diltiazem at 1 year and with all treatments at 2 years. However, reduction at 2 years was greater with hydrochlorothiazide than with captopril or prazosin. CONCLUSIONS:Antihypertensive drugs differ in their effects on left atrial size. Hydrochlorothiazide was associated with greater overall reduction of left atrial size than other drugs effective for the treatment of hypertension. Reduction of left atrial size with therapy is in part independent of factors known to influence left atrial size, including LV mass and reduction of LV mass with treatment. The clinical benefit of reducing left atrial size with antihypertensive treatment remains to be determined.
journal_name
Circulationjournal_title
Circulationauthors
Gottdiener JS,Reda DJ,Williams DW,Materson BJ,Cushman W,Anderson RJdoi
10.1161/01.cir.98.2.140subject
Has Abstractpub_date
1998-07-14 00:00:00pages
140-8issue
2eissn
0009-7322issn
1524-4539journal_volume
98pub_type
临床试验,杂志文章,随机对照试验相关文献
CIRCULATION文献大全abstract:BACKGROUND:Considerable controversy exists on the association between coffee consumption and cardiovascular disease (CVD) risk. A meta-analysis was performed to assess the dose-response relationship of long-term coffee consumption with CVD risk. METHODS AND RESULTS:PubMed and EMBASE were searched for prospective cohor...
journal_title:Circulation
pub_type: 杂志文章,meta分析,评审
doi:10.1161/CIRCULATIONAHA.113.005925
更新日期:2014-02-11 00:00:00
abstract:BACKGROUND:Cystathionine γ-lyase (CSE) produces H2S via enzymatic conversion of L-cysteine and plays a critical role in cardiovascular homeostasis. We investigated the effects of genetic modulation of CSE and exogenous H2S therapy in the setting of pressure overload-induced heart failure. METHODS AND RESULTS:Transvers...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.112.000855
更新日期:2013-03-12 00:00:00
abstract:BACKGROUND:Inhaled nitric oxide (NO) is a potent and selective pulmonary vasodilator, which induces cGMP synthesis by activating soluble guanylate cyclase (sGC) in ventilated lung regions. Carbon monoxide (CO) has also been proposed to influence smooth muscle tone via activation of sGC. We examined whether direct stimu...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000144469.01521.8A
更新日期:2004-10-12 00:00:00
abstract::Coronal, horizontal, and sagittal sections through the mid-line are excellent ways of depicting the anatomical position of the aortic root and for studying its topographical relationship to the surrounding vascular structures. Minimal radiographic abnormalities or no abnormalities at all may be present with an enlarge...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.51.2.389
更新日期:1975-02-01 00:00:00
abstract:BACKGROUND:Receptor-mediated activation of myocardial Gq signaling is postulated as a biochemical mechanism transducing pressure-overload hypertrophy. The specific effects of Gq activation on the functional and morphological adaptations to pressure overload are not known. METHODS AND RESULTS:To determine the effects o...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.97.15.1488
更新日期:1998-04-21 00:00:00
abstract:BACKGROUND:There has been increasing interest in the development of agents that utilize endogenous adenosine to exert their actions. We tested the hypothesis that substances that either potentiate the activity (allosteric enhancers) or increase the interstitial concentration (inhibitors of metabolism) of endogenous ade...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.10.2551
更新日期:1996-11-15 00:00:00
abstract:BACKGROUND:Cyclooxygenase (COX)-2 expression in the heart increases after myocardial infarction (MI). In murine models of MI, COX-2 inhibition preserves left ventricular dimensions and function. We studied the effect of selective COX-2 inhibition on left ventricular remodeling and function after MI in a pig model. MET...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.647230
更新日期:2007-01-23 00:00:00
abstract:BACKGROUND:Recently, it has been shown that stem/progenitor cells may repair damaged/lost endothelial cells in vein grafts and wire-injured arteries. In the present study, we investigated endothelial cell turnover and regeneration in apolipoprotein E (apoE)(-/-)/transgenic mice carrying LacZ genes driven by an endothel...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.746008
更新日期:2008-04-08 00:00:00
abstract:BACKGROUND:Hypertrophic cardiomyopathy (HCM) is characterized by myocardial hypertrophy of unknown etiology. Missense mutations of the cardiac beta-myosin-heavy-chain (beta-MHC) gene that may be responsible for cardiac hypertrophy have been detected in patients with HCM. On the other hand, gross structural abnormalitie...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.91.12.2911
更新日期:1995-06-15 00:00:00
abstract:BACKGROUND:Myocardial infarction (MI) is an ischemic wound that recruits millions of leukocytes. MI-associated blood leukocytosis correlates inversely with patient survival, yet the signals driving heightened leukocyte production after MI remain incompletely understood. METHODS AND RESULTS:With the use of parabiosis s...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.115.016160
更新日期:2015-11-17 00:00:00
abstract:BACKGROUND:The site of cannulation for repair of ascending aortic dissection remains controversial. We present our experience with ascending aortic cannulation for acute aortic dissection type A. METHODS AND RESULTS:From January 1988 to September 2007, we operated on 242 patients for acute aortic dissection type A. Me...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.844480
更新日期:2009-09-15 00:00:00
abstract:BACKGROUND:Paraplegia continues to complicate thoracoabdominal aortic interventions. The elusive mechanism of spinal cord ischemia-reperfusion injury has delayed the development of pharmacological adjuncts. Microglia, the resident macrophages of the central nervous system, can have pathological responses after a variet...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.112.000024
更新日期:2013-09-10 00:00:00
abstract:BACKGROUND:A recent study has shown that the implantable atrial defibrillator can restore sinus rhythm in patients with recurrent atrial fibrillation when therapy was delivered under physician observation. The objective of this study was to evaluate the safety and efficacy of ambulatory use of the implantable atrial de...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.12.1407
更新日期:2000-09-19 00:00:00
abstract::To define the prevalence, frequency and characteristics of premature ventricular complexes (PVCs) in adults free of recognizable heart disease, we performed 24-hour ambulatory electrocardiography on 101 subjects (51 men and 50 women, mean age 48.8 years) in whom physical examination, chest x-ray, ECG, echocardiogram, ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.63.6.1351
更新日期:1981-06-01 00:00:00
abstract:BACKGROUND:The mechanisms responsible for the association between advanced age and atherosclerotic diseases are not clear. Because atherosclerosis develops in response to local endothelial injuries, we investigated the effect of aging on vascular healing and reendothelialization. METHODS AND RESULTS:Endothelium denuda...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000050652.47145.4c
更新日期:2003-01-21 00:00:00
abstract:BACKGROUND:Heparin administration is usually limited to intravenous or subcutaneous injection. Oral delivery of heparin is an alternative to this and has been in great demand for treating patients who are at a high risk of deep vein thrombosis or pulmonary embolism. In this study, new heparin derivatives were synthesiz...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc5001.100627
更新日期:2001-12-18 00:00:00
abstract:BACKGROUND:Because complement-mediated vascular injury participates in atherosclerosis and C-reactive protein (CRP) can activate the complement cascade, we sought to determine whether CRP affects the expression of the protective complement-inhibitory factors on the cell surface of endothelial cells (ECs). METHODS AND ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000117087.27524.0E
更新日期:2004-02-24 00:00:00
abstract:BACKGROUND:The purpose of this study was to compare differential effects of a segment of slow conduction during ventricular tachycardia (VT) due to depression of the action potential and electrical uncoupling. METHODS AND RESULTS:In 33 Langendorff-perfused rabbit hearts, a ring of anisotropic left ventricular subepica...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.99.7.949
更新日期:1999-02-23 00:00:00
abstract:BACKGROUND:Contrast agents can cause a reduction in renal function that may be due to the generation of reactive oxygen species. Conflicting evidence suggests that administration of the antioxidant acetylcysteine prevents this renal impairment. The action of other antioxidant agents has not been investigated. METHODS ...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.CIR.0000146396.19081.73
更新日期:2004-11-02 00:00:00
abstract:BACKGROUND:Flowing erythrocytes and platelets are separated from the luminal endothelial cell (EC) surface by a 0.5-microm-wide space named the endothelial surface layer. We hypothesized that the disruption of the endothelial surface layer by oxidized low-density lipoproteins (Ox-LDL) contributes to atherogenic increas...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.101.13.1500
更新日期:2000-04-04 00:00:00
abstract::The cause and associated pathophysiology of precordial ST-segment depression (ST decreases) during acute inferior myocardial infarction (IMI) are controversial. To investigate this problem, electrocardiographic findings in 48 consecutive patients with acute IMI were prospectively compared with results of coronary angi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.66.4.732
更新日期:1982-10-01 00:00:00
abstract:BACKGROUND:Decreased renal function has been found to be an independent risk factor for cardiovascular outcomes in patients with chronic heart failure (CHF) with markedly reduced left ventricular ejection fraction (LVEF). The aim of this analysis was to evaluate the prognostic importance of renal function in a broader ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.580506
更新日期:2006-02-07 00:00:00
abstract::Depression is commonly present in patients with coronary heart disease (CHD) and is independently associated with increased cardiovascular morbidity and mortality. Screening tests for depressive symptoms should be applied to identify patients who may require further assessment and treatment. This multispecialty consen...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.190769
更新日期:2008-10-21 00:00:00
abstract::Although thrombolytic therapy has been a major advance in the treatment of acute myocardial infarction, in at least 25% of patients the artery remains occluded after administration. In these patients, the strategy of "rescue" or "salvage" angioplasty is frequently used although follow-up data are limited. Sixty-three ...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::Coronary arteriography was performed before and after the intracoronary injection of nitroglycerin to determine the presence or absence of spasm in patients within the first 12 hours of acute myocardial infarction. Coronary arterial spasm was demonstrated in six of fifteen (40%) acute myocardial infarctions associated...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.56.3.366
更新日期:1977-09-01 00:00:00
abstract:BACKGROUND:Ticagrelor, when compared with clopidogrel, reduced the 12-month risk of vascular death/myocardial infarction and stroke in patients with ST-elevation acute coronary syndromes intended to undergo primary percutaneous coronary intervention in the PLATelet inhibition and patient Outcomes (PLATO) trial. This pr...
journal_title:Circulation
pub_type: 杂志文章,随机对照试验
doi:10.1161/CIRCULATIONAHA.111.047530
更新日期:2012-01-24 00:00:00
abstract::The linearity and sensitivity of the end-systolic pressure-volume (P-Ves) relation to the inotropic state of the left ventricle were investigated in 11 patients with coronary heart disease and one patient with congestive cardiomyopathy. To minimize autonomic reflex responses, propranolol, 0.15 mg/kg, and atropine, 1 m...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.63.6.1216
更新日期:1981-06-01 00:00:00
abstract:BACKGROUND:Intimal thickenings of the coronary arteries of newborn children are composed mainly of smooth muscle cell proliferations. To investigate whether thickening of the intima in infants is associated with a family history of coronary artery disease (CAD), we studied the relation of coronary death of grandparents...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.87.6.1960
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:In vivo testing of novel antiplatelet agents requires informative biomarkers. By genetically modifying mouse von Willebrand factor (VWF(R1326H)), we have developed a small animal model that supports human but not mouse platelet-mediated thrombosis. Here, we evaluate the use of this biological platform as a p...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.110.951970
更新日期:2011-01-25 00:00:00
abstract:BACKGROUND:Receptors that couple via the stimulatory G protein, Gs, to adenylate cyclase and to a positive inotropic response have been extensively investigated in falling human heart. In contrast, much less is known about receptors, such as the A1-adenosine receptor, that couple to adenylate cyclase via the inhibitory...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.83.4.1343
更新日期:1991-04-01 00:00:00