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4301. Percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: results with respect to intraprocedural myocardial contrast echocardiography.
Percutaneous transluminal septal myocardial ablation (PTSMA) has been introduced as an alternative procedure for reducing the left ventricular outflow tract gradient (LVOTG) in hypertrophic obstructive cardiomyopathy. We report on the acute and mid-term results in 91 symptomatic patients with respect to intraprocedural myocardial contrast echocardiography (MCE).
4302. Mechanisms underlying spontaneous and induced ventricular arrhythmias in patients with idiopathic dilated cardiomyopathy.
To define the electrophysiological mechanism(s) of inducible and spontaneously occurring ventricular arrhythmias associated with nonischemic cardiomyopathy, 3-dimensional intraoperative mapping from 156 intramural sites was performed in 6 patients with idiopathic dilated cardiomyopathy undergoing cardiac transplantation.
4303. Effect of dietary patterns on measures of lipid peroxidation: results from a randomized clinical trial.
Free radical-mediated oxidative damage to lipids is thought to be an important process in the pathogenesis of atherosclerosis. Although previous studies have demonstrated a beneficial impact of antioxidant vitamin supplements on lipid peroxidation, the effect of dietary patterns on lipid peroxidation is unknown.
4304. Long-term beneficial effect of late reperfusion for acute anterior myocardial infarction with percutaneous transluminal coronary angioplasty.
作者: H Horie.;M Takahashi.;K Minai.;M Izumi.;A Takaoka.;M Nozawa.;H Yokohama.;T Fujita.;T Sakamoto.;O Kito.;H Okamura.;M Kinoshita.
来源: Circulation. 1998年98卷22期2377-82页
Although the short-term and long-term beneficial effects of early coronary revascularization by primary PTCA or thrombolytic therapy have been established for acute myocardial infarction, thrombolytic therapy >24 hours after the onset of acute myocardial infarction has not been shown to improve clinical outcome. The purpose of this study was to assess the effect of late revascularization by primary PTCA over a 5-year period.
4305. Enhanced inflammatory response to coronary angioplasty in patients with severe unstable angina.
作者: G Liuzzo.;A Buffon.;L M Biasucci.;J R Gallimore.;G Caligiuri.;A Vitelli.;S Altamura.;G Ciliberto.;A G Rebuzzi.;F Crea.;M B Pepys.;A Maseri.
来源: Circulation. 1998年98卷22期2370-6页
Systemic markers of inflammation have been found in unstable angina. Disruption of culprit coronary stenoses may cause a greater inflammatory response in patients with unstable than those with stable angina. We assessed the time course of C-reactive protein (CRP), serum amyloid A protein (SAA), and interleukin-6 (IL-6) after single-vessel PTCA in 30 patients with stable and 56 patients with unstable angina (protocol A). We also studied 12 patients with stable and 15 with unstable angina after diagnostic coronary angiography (protocol B).
4306. Short-term oral endothelin-receptor antagonist therapy in conventionally treated patients with symptomatic severe chronic heart failure.
作者: G Sütsch.;W Kiowski.;X W Yan.;P Hunziker.;S Christen.;W Strobel.;J H Kim.;P Rickenbacher.;O Bertel.
来源: Circulation. 1998年98卷21期2262-8页
The vasoconstrictor peptide endothelin-1 (ET-1) is important for increased vascular tone in patients with chronic heart failure, but the effects of endothelin-receptor blockade in addition to conventional triple therapy are unknown.
4307. Hemodynamic and coronary effects of the endothelin antagonist bosentan in patients with coronary artery disease.
作者: R R Wenzel.;M Fleisch.;S Shaw.;G Noll.;U Kaufmann.;R Schmitt.;C R Jones.;M Clozel.;B Meier.;T F Lüscher.
来源: Circulation. 1998年98卷21期2235-40页
Endothelin is a potent endothelium-derived vasoconstrictor peptide with proliferative properties. Elevated levels of the peptide occur in coronary artery disease; however, its pathophysiological role as a regulator of coronary tone and structure is uncertain. Endothelin-receptor antagonists are specific tools to clarify this issue and might be useful in the treatment of coronary artery disease.
4308. ACE (I/D) genotype as a predictor of the magnitude and duration of the response to an ACE inhibitor drug (enalaprilat) in humans.
作者: S Ueda.;P A Meredith.;J J Morton.;J M Connell.;H L Elliott.
来源: Circulation. 1998年98卷20期2148-53页
We have investigated the possible effects of contrasting ACE (I/D) genotypes on the responses to the ACE inhibitor enalaprilat in normotensive men.
4309. Randomized evaluation of anticoagulation versus antiplatelet therapy after coronary stent implantation in high-risk patients: the multicenter aspirin and ticlopidine trial after intracoronary stenting (MATTIS).
作者: P Urban.;C Macaya.;H J Rupprecht.;F Kiemeneij.;H Emanuelsson.;A Fontanelli.;M Pieper.;T Wesseling.;L Sagnard.
来源: Circulation. 1998年98卷20期2126-32页
Although the association of ticlopidine and aspirin has been shown to be superior to anti-vitamin K agents and aspirin after coronary stent implantation in low-risk patients, the latter combination has remained an unproven reference regimen for high-risk patients until recently.
4310. Evaluation of a weight-adjusted single-bolus plasminogen activator in patients with myocardial infarction: a double-blind, randomized angiographic trial of lanoteplase versus alteplase.
作者: P den Heijer.;F Vermeer.;E Ambrosioni.;Z Sadowski.;J L López-Sendón.;R von Essen.;P Beaufils.;U Thadani.;J Adgey.;L Pierard.;J Brinker.;R F Davies.;R W Smalling.;L Wallentin.;A Caspi.;A Pangerl.;L Trickett.;C Hauck.;D Henry.;P Chew.
来源: Circulation. 1998年98卷20期2117-25页
Lanoteplase (nPA) is a rationally designed variant of tissue plasminogen activator with greater fibrinolytic potency and slower plasma clearance than alteplase.
4311. Influence of the angiotensin II antagonist valsartan on left ventricular hypertrophy in patients with essential hypertension.
Left ventricular hypertrophy (LVH) represents an independent risk factor in patients with essential hypertension. Because reversal of LVH may be associated with an improvement of prognosis, the influence of new antihypertensive compounds, such as angiotensin II AT1 receptor antagonists, on LVH should be determined.
4312. Intensive medical therapy versus coronary angioplasty for suppression of myocardial ischemia in survivors of acute myocardial infarction: a prospective, randomized pilot study.
作者: H A Dakik.;N S Kleiman.;J A Farmer.;Z X He.;J A Wendt.;C M Pratt.;M S Verani.;J J Mahmarian.
来源: Circulation. 1998年98卷19期2017-23页
Patients who have inducible ischemia after acute myocardial infarction (AMI) generally undergo coronary angiography with the intent to revascularize. Whether this approach is superior to intensive treatment with anti-ischemic medications is unknown.
4313. Very early risk stratification using combined ECG and biochemical assessment in patients with unstable coronary artery disease (A thrombin inhibition in myocardial ischemia [TRIM] substudy). The TRIM Study Group.
作者: L Holmvang.;M S Lüscher.;P Clemmensen.;K Thygesen.;P Grande.
来源: Circulation. 1998年98卷19期2004-9页
The diagnostic capability of troponin T (TnT), troponin I (TnI), myoglobin, and creatine kinase (CK)-MB mass for detection of myocardial injury seems evident. Newer studies have found these sensitive markers to carry independent prognostic information in patients with unstable coronary artery disease as well. ST-segment depression in the admission ECG is known to be an important indicator of poor outcome in these patients. The present study investigates the prognostic capacities of the ECG in combination with biochemical admission measurements in 516 patients admitted to hospital with unstable coronary artery disease.
4314. Associations between lipoproteins and the progression of coronary and vein-graft atherosclerosis in a controlled trial with gemfibrozil in men with low baseline levels of HDL cholesterol.
作者: M Syvänne.;M S Nieminen.;M H Frick.;H Kauma.;S Majahalme.;V Virtanen.;Y A Kesäniemi.;A Pasternack.;C Ehnholm.;M R Taskinen.
来源: Circulation. 1998年98卷19期1993-9页
Lipid-lowering secondary-prevention trials of coronary artery disease (CAD) have implicated triglyceride-rich lipoproteins as the main determinants of angiographic progression after elevated LDL cholesterol levels have been lowered with therapy. The present study focuses on the lipoprotein determinants of angiographic CAD progression in men with low HDL cholesterol concentration as their main baseline lipid abnormality who underwent 32 months of randomized therapy with gemfibrozil or placebo.
4315. Acute coronary syndromes in the GUSTO-IIb trial: prognostic insights and impact of recurrent ischemia. The GUSTO-IIb Investigators.
作者: P W Armstrong.;Y Fu.;W C Chang.;E J Topol.;C B Granger.;A Betriu.;F Van de Werf.;K L Lee.;R M Califf.
来源: Circulation. 1998年98卷18期1860-8页
Recurrent ischemia after an acute coronary syndrome portends an unfavorable outcome and has major resource-use implications. This issue has not been studied systematically among the spectrum of patients with acute coronary presentations, encompassing those with and without ST-segment elevation.
4316. Hyperhomocysteinemia after an oral methionine load acutely impairs endothelial function in healthy adults.
作者: M F Bellamy.;I F McDowell.;M W Ramsey.;M Brownlee.;C Bones.;R G Newcombe.;M J Lewis.
来源: Circulation. 1998年98卷18期1848-52页
Elevated plasma homocysteine is a risk factor for arteriosclerosis, but a cause-and-effect relationship remains to be fully established. Endothelial dysfunction, an early event in the atherogenic process, has been shown to be associated with hyperhomocysteinemia in experimental and human studies. To further establish a direct relationship between changes in plasma homocysteine and endothelial dysfunction, we investigated whether moderate hyperhomocysteinemia induced by an oral methionine load would acutely impair flow-mediated endothelium-dependent vasodilatation in healthy adults.
4317. Asymmetric dimethylarginine (ADMA): a novel risk factor for endothelial dysfunction: its role in hypercholesterolemia.
作者: R H Böger.;S M Bode-Böger.;A Szuba.;P S Tsao.;J R Chan.;O Tangphao.;T F Blaschke.;J P Cooke.
来源: Circulation. 1998年98卷18期1842-7页
Asymmetric dimethylarginine (ADMA) is an endogenous competitive inhibitor of nitric oxide (NO) synthase. Because endothelial NO elaboration is impaired in hypercholesterolemia, we investigated whether plasma concentrations of ADMA are elevated in young, clinically asymptomatic hypercholesterolemic adults. We further studied whether such elevation of ADMA levels was correlated with impaired endothelium-dependent, NO-mediated vasodilation and urinary nitrate excretion. In a randomized, double-blind, placebo-controlled study, we investigated whether these changes could be reversed with exogenous L-arginine.
4318. Cardiac autonomic patterns preceding occasional vasovagal reactions in healthy humans.
作者: R Furlan.;S Piazza.;S Dell'Orto.;F Barbic.;A Bianchi.;L Mainardi.;S Cerutti.;M Pagani.;A Malliani.
来源: Circulation. 1998年98卷17期1756-61页
The wide range of clinical presentation of orthostatic vasovagal syncope suggests different underlying changes in the cardiac autonomic modulation.
4319. Echocardiography-guided ethanol septal reduction for hypertrophic obstructive cardiomyopathy.
作者: N M Lakkis.;S F Nagueh.;N S Kleiman.;D Killip.;Z X He.;M S Verani.;R Roberts.;W H Spencer.
来源: Circulation. 1998年98卷17期1750-5页
Left ventricular outflow tract (LVOT) obstruction is frequently responsible for symptoms in hypertrophic obstructive cardiomyopathy (HOCM). Medical therapy is often not sufficient to control these symptoms, and surgical myotomy-myomectomy is required.
4320. Improved exercise tolerance after losartan and enalapril in heart failure: correlation with changes in skeletal muscle myosin heavy chain composition.
作者: G Vescovo.;L Dalla Libera.;F Serafini.;C Leprotti.;L Facchin.;M Volterrani.;C Ceconi.;G B Ambrosio.
来源: Circulation. 1998年98卷17期1742-9页
In congestive heart failure, fatigue-resistant, oxidative, slow type I fibers are decreased in leg skeletal muscle, contributing to exercise capacity (EC) limitation. The mechanisms by which ACE inhibitors and AII antagonists improve EC is still unclear. We tested the hypothesis that improvement in EC is related to changes in skeletal muscle composition toward type I fibers.
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