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4061. Inspiratory impedance during active compression-decompression cardiopulmonary resuscitation: a randomized evaluation in patients in cardiac arrest.
Blood pressure is severely reduced in patients in cardiac arrest receiving standard cardiopulmonary resuscitation (CPR). Although active compression-decompression (ACD) CPR improves acute hemodynamic parameters, arterial pressures remain suboptimal with this technique. We performed ACD CPR in patients with a new inspiratory threshold valve (ITV) to determine whether lowering intrathoracic pressures during the "relaxation" phase of ACD CPR would enhance venous blood return and overall CPR efficiency.
4062. Randomized trial comparing intravenous nitroglycerin and heparin for treatment of unstable angina secondary to restenosis after coronary artery angioplasty.
作者: S Doucet.;M Malekianpour.;P Théroux.;L Bilodeau.;G Côté.;P de Guise.;J Dupuis.;M Joyal.;G Gosselin.;J F Tanguay.;M Juneau.;F Harel.;S Nattel.;J C Tardif.;J Lespérance.
来源: Circulation. 2000年101卷9期955-61页
The treatment of unstable angina targets the specific pathophysiological thrombotic process at the site of the active culprit lesion. In unstable angina due to a restenotic lesion, smooth muscle cell proliferation and increased vasoreactivity may play a more important role than thrombus formation. Therefore, the relative benefits of nitroglycerin and heparin might differ in unstable angina associated with restenosis compared with classic unstable angina.
4063. Transcatheter closure of atrial septal defects without fluoroscopy: feasibility of a new method.
作者: P Ewert.;F Berger.;I Daehnert.;J van Wees.;M Gittermann.;H Abdul-Khaliq.;P E Lange.
来源: Circulation. 2000年101卷8期847-9页
In an effort to reduce x-ray exposure, we developed a technique for transcatheter closure of atrial septal defects under echocardiographic guidance without fluoroscopy. To assess the efficiency of this procedure for routine use, we compared our initial results with those for the conventional procedure.
4064. Exaggerated renal vasoconstriction during exercise in heart failure patients.
作者: H R Middlekauff.;E U Nitzsche.;C K Hoh.;M A Hamilton.;G C Fonarow.;A Hage.;J D Moriguchi.
来源: Circulation. 2000年101卷7期784-9页
During static exercise in normal healthy humans, reflex renal cortical vasoconstriction occurs. Muscle metaboreceptors contribute importantly to this reflex renal vasoconstriction. In patients with heart failure, in whom renal vascular tone is already increased at rest, it is unknown whether there is further reflex renal vasoconstriction during exercise.
4065. Prospective randomized comparison of irrigated-tip versus conventional-tip catheters for ablation of common flutter.
作者: P Jaïs.;D C Shah.;M Haïssaguerre.;M Hocini.;S Garrigue.;P Le Metayer.;J Clémenty.
来源: Circulation. 2000年101卷7期772-6页
Radiofrequency (RF) ablation of common flutter requires the creation of a complete ablation line to produce bidirectional conduction block in the cavotricuspid isthmus. An irrigated-tip ablation catheter has been shown to be effective in patients in whom conventional ablation has failed. This randomized study compares the efficacy and safety of this catheter with those of a conventional catheter for de novo flutter ablation.
4066. Effect of mibefradil, a T-type calcium channel blocker, on morbidity and mortality in moderate to severe congestive heart failure: the MACH-1 study. Mortality Assessment in Congestive Heart Failure Trial.
作者: T B Levine.;P J Bernink.;A Caspi.;U Elkayam.;E M Geltman.;B Greenberg.;W J McKenna.;J K Ghali.;T D Giles.;A Marmor.;L H Reisin.;S Ammon.;E Lindberg.
来源: Circulation. 2000年101卷7期758-64页
Calcium antagonists have proved disappointing in long-term congestive heart failure (CHF) studies. Mibefradil, a new calcium antagonist that selectively blocks T-type calcium channels, has been shown to be an effective antihypertensive, antianginal, and anti-ischemic agent, and because of its different mechanism of action, it may be beneficial as adjunct therapy in CHF patients.
4067. Early percutaneous coronary intervention, platelet inhibition with eptifibatide, and clinical outcomes in patients with acute coronary syndromes. PURSUIT Investigators.
作者: N S Kleiman.;A M Lincoff.;G C Flaker.;K S Pieper.;R G Wilcox.;L G Berdan.;T J Lorenz.;D V Cokkinos.;M L Simoons.;E Boersma.;E J Topol.;R M Califf.;R A Harrington.
来源: Circulation. 2000年101卷7期751-7页
Platelet glycoprotein (GP) IIb/IIIa antagonists prevent the composite end point of death or myocardial infarction (MI) in patients with acute coronary syndromes. There is uncertainty about whether this effect is confined to patients who have percutaneous coronary interventions (PCIs) and whether PCIs further prevent death or MI in patients already treated with GP IIb/IIIa antagonists.
4068. Antiarrhythmic efficacy of dipyridamole in treatment of reperfusion arrhythmias : evidence for cAMP-mediated triggered activity as a mechanism responsible for reperfusion arrhythmias.
作者: Y Yoshida.;M Hirai.;T Yamada.;Y Tsuji.;T Kondo.;Y Inden.;M Akahoshi.;Y Murakami.;M Tsuda.;N Tsuboi.;H Hirayama.;M Okamoto.;T Ito.;H Saito.;J Toyama.
来源: Circulation. 2000年101卷6期624-30页
Intracellular calcium overload is believed to play an important role in development of reperfusion arrhythmias. Dipyridamole, an inhibitor of cellular uptake of adenosine, may prevent or terminate reperfusion arrhythmias by reducing intracellular calcium overload.
4069. Effectiveness and limitations of beta-blocker therapy in congenital long-QT syndrome.
作者: A J Moss.;W Zareba.;W J Hall.;P J Schwartz.;R S Crampton.;J Benhorin.;G M Vincent.;E H Locati.;S G Priori.;C Napolitano.;A Medina.;L Zhang.;J L Robinson.;K Timothy.;J A Towbin.;M L Andrews.
来源: Circulation. 2000年101卷6期616-23页
beta-blockers are routinely prescribed in congenital long-QT syndrome (LQTS), but the effectiveness and limitations of beta-blockers in this disorder have not been evaluated.
4070. Spironolactone increases nitric oxide bioactivity, improves endothelial vasodilator dysfunction, and suppresses vascular angiotensin I/angiotensin II conversion in patients with chronic heart failure.
The RALES study showed that spironolactone, added to conventional therapy for chronic heart failure, dramatically reduced mortality. We tested the hypothesis that this benefit was partially due to improvement in endothelial function and/or to amplified suppression of the vascular renin-angiotensin axis.
4071. A randomized comparison of clopidogrel and aspirin versus ticlopidine and aspirin after the placement of coronary-artery stents.
The introduction of an effective antiplatelet therapy with aspirin and ticlopidine after the placement of coronary-artery stents has decreased the risk of thrombotic stent occlusions (TSO) and hemorrhagic complications. However, the use of ticlopidine is limited by hematological and gastrointestinal adverse effects. The safety and efficacy of clopidogrel after stenting remains to be established.
4072. Evaluation of sympathetic nerve terminals with [(11)C]epinephrine and [(11)C]hydroxyephedrine and positron emission tomography.
作者: G Münch.;N T Nguyen.;S Nekolla.;S Ziegler.;O Muzik.;P Chakraborty.;D M Wieland.;M Schwaiger.
来源: Circulation. 2000年101卷5期516-23页
The goal of the present study was to directly compare the new radiopharmaceutical agent [(11)C]epinephrine (EPI) with [(11)C]hydroxyephedrine (HED) through the use of PET.
4073. The pressor response to water drinking in humans : a sympathetic reflex?
作者: J Jordan.;J R Shannon.;B K Black.;Y Ali.;M Farley.;F Costa.;A Diedrich.;R M Robertson.;I Biaggioni.;D Robertson.
来源: Circulation. 2000年101卷5期504-9页
Water drinking increases blood pressure profoundly in patients with autonomic failure and substantially in older control subjects. The mechanism that mediates this response is not known.
4074. Hemodynamic, renal, and hormonal effects of adrenomedullin infusion in patients with congestive heart failure.
作者: N Nagaya.;T Satoh.;T Nishikimi.;M Uematsu.;S Furuichi.;F Sakamaki.;H Oya.;S Kyotani.;N Nakanishi.;Y Goto.;Y Masuda.;K Miyatake.;K Kangawa.
来源: Circulation. 2000年101卷5期498-503页
Experimental studies have shown that adrenomedullin (AM) causes vasodilatation, diuresis, and a positive inotropic effect. In humans, however, whether infusion of AM has beneficial effects in congestive heart failure (CHF) remains unknown.
4075. Relation between baseline and on-treatment lipid parameters and first acute major coronary events in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS).
作者: A M Gotto.;E Whitney.;E A Stein.;D R Shapiro.;M Clearfield.;S Weis.;J Y Jou.;A Langendörfer.;P A Beere.;D J Watson.;J R Downs.;J S de Cani.
来源: Circulation. 2000年101卷5期477-84页
The Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS) is the first primary-prevention study in a cohort with average total cholesterol (TC) and LDL cholesterol (LDL-C) and below-average HDL cholesterol (HDL-C). Treatment with lovastatin (20 to 40 mg/d) resulted in a 25% reduction in LDL-C and a 6% increase in HDL-C, as well as a 37% reduction in risk for first acute major coronary event (AMCE), defined as fatal or nonfatal myocardial infarction, unstable angina, or sudden cardiac death. This article describes the relation between baseline and on-treatment lipid and apolipoprotein (apo) parameters and subsequent risk for AMCEs.
4076. Alcohol potentiates orthostatic hypotension : implications for alcohol-related syncope.
Alcohol consumption may be linked to syncopal events. The mechanisms by which alcohol may induce syncope are unknown. Impairment of the response to orthostatic stress may be involved. Using a double-blind, randomized, placebo-controlled study, we tested the hypothesis that short-term alcohol intake causes orthostatic hypotension because of an impairment in the vasoconstrictor response to orthostatic stress.
4077. Immunoglobulin adsorption in patients with idiopathic dilated cardiomyopathy.
作者: J Müller.;G Wallukat.;M Dandel.;H Bieda.;K Brandes.;S Spiegelsberger.;E Nissen.;R Kunze.;R Hetzer.
来源: Circulation. 2000年101卷4期385-91页
Idiopathic dilated cardiomyopathy (IDC) frequently is a progressive disease without causative therapy options. Following the hypothesis that in certain patients autoantibodies against cardiac structures may induce, maintain, or promote the progression of the disease, we investigated whether the elimination of these autoantibodies through immunoadsorption would improve cardiac function.
4078. Effects of metoprolol CR in patients with ischemic and dilated cardiomyopathy : the randomized evaluation of strategies for left ventricular dysfunction pilot study.
来源: Circulation. 2000年101卷4期378-84页
Metoprolol provides clinical benefits in patients with congestive heart failure (CHF). In this study, we investigated the effects of controlled-release metoprolol (metoprolol CR) on clinical status, on left ventricular (LV) volumes and function, and on neurohumoral activation in a large number of patients with CHF of mixed causes.
4079. Cost-effectiveness of platelet glycoprotein IIb/IIIa inhibition with eptifibatide in patients with non-ST-elevation acute coronary syndromes.
作者: D B Mark.;R A Harrington.;A M Lincoff.;R M Califf.;C L Nelson.;A A Tsiatis.;H Buell.;K W Mahaffey.;L Davidson-Ray.;E J Topol.
来源: Circulation. 2000年101卷4期366-71页
In the PURSUIT trial, eptifibatide significantly reduced the 30-day incidence of death and myocardial infarction relative to placebo in 9461 patients with an acute coronary syndrome (unstable angina or non-Q-wave myocardial infarction).
4080. Three-year clinical and angiographic follow-up after intracoronary radiation : results of a randomized clinical trial.
作者: P S Teirstein.;V Massullo.;S Jani.;J J Popma.;R J Russo.;R A Schatz.;E M Guarneri.;S Steuterman.;K Sirkin.;D A Cloutier.;M B Leon.;P Tripuraneni.
来源: Circulation. 2000年101卷4期360-5页
Although several early trials indicate treatment of restenosis with radiation therapy is safe and effective, the long-term impact of this new technology has been questioned. The objective of this report is to document angiographic and clinical outcome 3 years after treatment of restenotic stented coronary arteries with catheter-based (192)Ir.
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