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4521. Randomized, double-blind, placebo-controlled study evaluating the efficacy and safety of AS-013, a prostaglandin E1 prodrug, in patients with intermittent claudication.
作者: J J Belch.;P R Bell.;D Creissen.;J A Dormandy.;R C Kester.;R D McCollum.;Y Mizushima.;C V Ruckley.;J H Scurr.;J H Wolfe.
来源: Circulation. 1997年95卷9期2298-302页
Intermittent claudication due to peripheral arterial occlusive disease (PAOD) is a common cause of pain and disability in the middle-aged. Clinical trials of the potent vasodilator prostaglandin E1 have been disappointing. This is the first report of a controlled clinical trial of AS-0:3, a novel prodrug of prostaglandin E1 incorporated into lipid microspheres that has been developed to improve delivery of the active compound to blood vessel walls.
4522. Effects of inhibition of the L-arginine/nitric oxide pathway on vasodilation caused by beta-adrenergic agonists in human forearm.
We examined whether vasodilator responses to beta-agonists in human forearm vasculature are mediated in part through the nitric oxide pathway.
4523. Differential effects of captopril and nitrates on muscle sympathetic nerve activity in volunteers.
The sympathetic nervous system (SNS) is an important regulator of cardiovascular function. Activation of SNS plays an important role in the pathophysiology and the prognosis of cardiovascular diseases such as heart failure, acute coronary syndromes, arrhythmia, and possibly hypertension. Vasodilators such as adenosine and sodium nitroprusside are known to activate SNS via baroreflex mechanisms. Because vasodilators are widely used in the treatment of patients with cardiovascular diseases, the aim of the present study was to assess the influence of clinically used dosages of isosorbide dinitrate and captopril on sympathetic nerve activity at rest and during stimulatory maneuvers.
4524. Cold stress provokes sympathoinhibitory presyncope in healthy subjects and hemodialysis patients with low cardiac output.
作者: G Ligtenberg.;P J Blankestijn.;P L Oey.;G H Wieneke.;A C van Huffelen.;H A Koomans.
来源: Circulation. 1997年95卷9期2271-6页
Sudden hypotension in progressive hypovolemia or during hemodialysis is attributed to sudden inhibition of sympathetic activity. Critical ventricular underfilling seems responsible for this paradox, but it is unknown why the transition from sympathoactivation accompanying hypovolemia to sympathoinhibition is so abrupt. We studied whether brief fluctuation of sympathetic activity induced by cold pressor test (CPT) evokes sympathoinhibition if applied during low cardiac output.
4525. Prediction of restenosis after coronary balloon angioplasty. Results of PICTURE (Post-IntraCoronary Treatment Ultrasound Result Evaluation), a prospective multicenter intracoronary ultrasound imaging study.
作者: R J Peters.;W E Kok.;C Di Mario.;P W Serruys.;F W Bär.;G Pasterkamp.;C Borst.;O Kamp.;J G Bronzwaer.;C A Visser.;J J Piek.;R N Panday.;W Jaarsma.;L Savalle.;N Bom.
来源: Circulation. 1997年95卷9期2254-61页
Intracoronary ultrasound (ICUS) imaging is potentially suitable to identify lesions at high risk of restenosis after percutaneous transluminal coronary angioplasty (PTCA), but it has not been studied systematically.
4526. Influence of inhaled nitric oxide on systemic flow and ventricular filling pressure in patients receiving mechanical circulatory assistance.
作者: J M Hare.;S K Shernan.;S C Body.;E Graydon.;W S Colucci.;G S Couper.
来源: Circulation. 1997年95卷9期2250-3页
In patients with left ventricular (LV) dysfunction, inhaled nitric oxide (NO) decreases pulmonary vascular resistance (PVR) but causes a potentially clinically significant increase in left atrial pressure (LAP). This has led to the suggestion that inhaled NO may reach the coronary circulation and have a negative inotropic effect. This study tested an alternative hypothesis that LAP increases because of volume shifts to the pulmonary venous compartment caused by NO-induced selective pulmonary vasodilation.
4527. Effect of exercise training on myocardial remodeling in patients with reduced left ventricular function after myocardial infarction: application of magnetic resonance imaging.
作者: P Dubach.;J Myers.;G Dziekan.;U Goebbels.;W Reinhart.;P Vogt.;R Ratti.;P Muller.;R Miettunen.;P Buser.
来源: Circulation. 1997年95卷8期2060-7页
There are conflicting reports on the effects of training on the remodeling process in post-myocardial infarction patients with ventricular damage.
4528. Improved procedural results of coronary angioplasty with intravascular ultrasound-guided balloon sizing: the CLOUT Pilot Trial. Clinical Outcomes With Ultrasound Trial (CLOUT) Investigators.
作者: G W Stone.;J M Hodgson.;F G St Goar.;A Frey.;H Mudra.;H Sheehan.;T J Linnemeier.
来源: Circulation. 1997年95卷8期2044-52页
Indiscriminate use of balloons larger than the angiographic reference segment lumen results in high rates of ischemic complications after percutaneous transluminal coronary angioplasty (PTCA). We hypothesized that angiographically unsuspected atheromatous remodeling with vessel expansion (the Glagov phenomenon) at and adjacent to PTCA target lesions would safely accommodate oversized balloons in selected patients undergoing PTCA with intravascular ultrasound (IVUS) guidance.
4529. Asymptomatic Cardiac Ischemia Pilot (ACIP) study two-year follow-up: outcomes of patients randomized to initial strategies of medical therapy versus revascularization.
作者: R F Davies.;A D Goldberg.;S Forman.;C J Pepine.;G L Knatterud.;N Geller.;G Sopko.;C Pratt.;J Deanfield.;C R Conti.
来源: Circulation. 1997年95卷8期2037-43页
Patients with ischemia during stress testing and ambulatory ECG monitoring have an increased risk of cardiac events, but it is not known whether their prognosis is improved by more aggressive treatment with anti-ischemic drugs or revascularization.
4530. Intermediate-density lipoproteins and progression of carotid arterial wall intima-media thickness.
作者: H N Hodis.;W J Mack.;M Dunn.;C Liu.;C Liu.;R H Selzer.;R M Krauss.
来源: Circulation. 1997年95卷8期2022-6页
Although LDL cholesterol (LDL-C) is generally accepted to be a major risk factor for progression of atherosclerosis, the traditional measurement of LDL-C includes measurement of IDL. Little is known about the relationship between IDL and progression of atherosclerosis. Therefore, we investigated the association of plasma lipoprotein subclasses with progression of preintrusive carotid artery atherosclerosis in the Monitored Atherosclerosis Regression Study (MARS).
4531. Major benefit from antiplatelet therapy for patients at high risk for adverse cardiac events after coronary Palmaz-Schatz stent placement: analysis of a prospective risk stratification protocol in the Intracoronary Stenting and Antithrombotic Regimen (ISAR) trial.
The Intracoronary Stenting and Antithrombotic Regimen (ISAR) Trial is a randomized study in which antiplatelet therapy is compared with anticoagulant therapy after coronary stent placement, showing a significantly lower rate of noncardiac and cardiac events with antiplatelet therapy. The present study is a report of the analysis of a prospective risk stratification protocol in the ISAR Trial and the association with the incidence of adverse cardiac events and stent vessel occlusion.
4532. Effect of single-drug therapy on reduction of left ventricular mass in mild to moderate hypertension: comparison of six antihypertensive agents. The Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents.
作者: J S Gottdiener.;D J Reda.;B M Massie.;B J Materson.;D W Williams.;R J Anderson.
来源: Circulation. 1997年95卷8期2007-14页
Antihypertensive drugs may differ in their ability to reduce LV mass. Covariates other than drug selection, such as pretreatment LV mass, body weight, the magnitude of blood pressure reduction, race, and age may modify the response of LV mass to therapy.
4533. Improvement of alveolar-capillary membrane diffusing capacity with enalapril in chronic heart failure and counteracting effect of aspirin.
KII ACE, the enzyme that converts angiotensin I and inactivates bradykinin, is highly concentrated in the lungs; its blockade reduces exposure to angiotensin II and enhances exposure to prostaglandins generated by local kinin hyperconcentration. Our hypothesis is that ACE inhibitors improve pulmonary function in chronic heart failure (CHF) by readjusting lung vessel tone and permeability or alveolar-capillary membrane diffusion.
4534. Bridge experience with long-term implantable left ventricular assist devices. Are they an alternative to transplantation?
作者: M C Oz.;M Argenziano.;K A Catanese.;M T Gardocki.;D J Goldstein.;R C Ashton.;A C Gelijns.;E A Rose.;H R Levin.
来源: Circulation. 1997年95卷7期1844-52页
If long-term use of left ventricular assist devices (LVADs) as bridges to transplantation is successful, the issue of permanent device implantation in lieu of transplantation could be addressed through the creation of appropriately designed trials. Our medium-term experience with both pneumatically and electrically powered ThermoCardiosystems LVADs is presented to outline the benefits and limitations of device support in lieu of transplantation.
4535. Defibrillation efficacy of commercially available biphasic impulses in humans. Importance of negative-phase peak voltage.
作者: G Tomassoni.;K Newby.;S Deshpande.;K Axtell.;J Sra.;M Akhtar.;A Natale.
来源: Circulation. 1997年95卷7期1822-6页
Recent studies have shown that specifically shaped biphasic waveforms can lower energy requirements for ventricular defibrillation. We prospectively compared the defibrillation efficacy of three different biphasic wave shapes incorporated in three commercially available implantable defibrillators. The results led to the development of a second protocol in which the importance of negative-phase peak voltage and duration was investigated.
4536. Nitroglycerin-augmented 201T1 reinjection enhances detection of reversible myocardial hypoperfusion. A randomized, double-blind, parallel, placebo-controlled trial.
Recent observations suggest that administration of nitrates before 201Tl reinjection enhances the detection of reversible myocardial hypoperfusion.
4537. Nonselective beta-adrenergic blockade with carvedilol does not hinder the benefits of exercise training in patients with congestive heart failure.
作者: L Demopoulos.;M Yeh.;M Gentilucci.;M Testa.;R Bijou.;S D Katz.;D Mancini.;M Jones.;T H LeJemtel.
来源: Circulation. 1997年95卷7期1764-7页
Long-term beta-adrenergic blockade does not appear to be associated with drug-induced training in patients with congestive heart failure (CHF); whether exercise training can increase peak aerobic capacity in patients with CHF who are treated with beta-adrenergic blockers is currently unknown.
4538. Restoration of coronary flow in myocardial infarction by intravenous chimeric 7E3 antibody without exogenous plasminogen activators. Observations in animals and humans.
作者: H K Gold.;H D Garabedian.;R E Dinsmore.;L J Guerrero.;J E Cigarroa.;I F Palacios.;R C Leinbach.
来源: Circulation. 1997年95卷7期1755-9页
Coronary thrombus is composed of platelets and fibrin, and during thrombolytic treatment, reflow may be slowed by platelet deposition. It may be possible to initiate coronary reflow without exogenous plasminogen activators by blocking platelet aggregation while fibrin generation is impeded with heparin.
4539. Effects of long-term infusion of prostacyclin (epoprostenol) on echocardiographic measures of right ventricular structure and function in primary pulmonary hypertension. Primary Pulmonary Hypertension Study Group.
作者: A L Hinderliter.;P W Willis.;R J Barst.;S Rich.;L J Rubin.;D B Badesch.;B M Groves.;M D McGoon.;V F Tapson.;R C Bourge.;B H Brundage.;S K Koerner.;D Langleben.;C A Keller.;S Murali.;B F Uretsky.;G Koch.;S Li.;L M Clayton.;M M Jöbsis.;S D Blackburn.;J W Crow.;W A Long.
来源: Circulation. 1997年95卷6期1479-86页
Right heart failure is an important cause of morbidity and mortality in primary pulmonary hypertension. In a recent prospective, randomized study of severely symptomatic patients, treatment with prostacyclin (epoprostenol) produced improvements in hemodynamics, quality of life, and survival. This article describes the echocardiographic characteristics of participants in this trial; the relationship of echocardiographic variables to hemodynamic parameters, exercise capacity, and quality of life; and the echocardiographic changes associated with prostacyclin therapy.
4540. Ambulatory blood pressure is superior to clinic blood pressure in predicting treatment-induced regression of left ventricular hypertrophy. SAMPLE Study Group. Study on Ambulatory Monitoring of Blood Pressure and Lisinopril Evaluation.
作者: G Mancia.;A Zanchetti.;E Agabiti-Rosei.;G Benemio.;R De Cesaris.;R Fogari.;A Pessina.;C Porcellati.;A Rappelli.;A Salvetti.;B Trimarco.
来源: Circulation. 1997年95卷6期1464-70页
In cross-sectional studies, ambulatory blood pressure (ABP) correlates more closely than clinic BP with the organ damage of hypertension. Whether ABP predicts development or regression of organ damage over time better than clinic BP, however, is unknown.
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