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4862. Aspirin versus heparin in the acute phase of unstable angina.4863. Randomized study of aprotinin and DDAVP to reduce postoperative bleeding after cardiopulmonary bypass surgery.
作者: E Rocha.;F Hidalgo.;R Llorens.;J M Melero.;J L Arroyo.;J A Páramo.
来源: Circulation. 1994年90卷2期921-7页
Patients on cardiopulmonary bypass (CPB) have an increased susceptibility to postoperative bleeding. Previous reports using desmopressin acetate (DDAVP) for the prevention of postoperative bleeding have given contradictory results, whereas the protease inhibitor aprotinin has been shown to reduce blood loss after this type of surgery. This randomized study was performed to assess the efficacy of DDAVP versus aprotinin in the prevention of bleeding after CPB.
4864. Reduction in QT interval dispersion by successful thrombolytic therapy in acute myocardial infarction. TEAM-2 Study Investigators.
QT dispersion (QTd, equals maximal minus minimal QT interval) on a standard ECG has been shown to reflect regional variations in ventricular repolarization and is significantly greater in patients with than in those without arrhythmic events.
4865. Impact of age on clinical outcome and postlytic management strategies in patients treated with intravenous thrombolytic therapy. Results from the TIMI II Study. TIMI II Investigators.
作者: F V Aguirre.;R P McMahon.;H Mueller.;N S Kleiman.;M J Kern.;P Desvigne-Nickens.;W P Hamilton.;B R Chaitman.
来源: Circulation. 1994年90卷1期78-86页
Few thrombolytic studies have assessed whether patient age is an indication for routine postlytic cardiac catheterization and revascularization or evaluated the impact of age on 1-year outcome differences after acute myocardial infarction.
4866. Adjunctive thrombolytic therapy during angioplasty for ischemic rest angina. Results of the TAUSA Trial. TAUSA Investigators. Thrombolysis and Angioplasty in Unstable Angina trial.
作者: J A Ambrose.;O D Almeida.;S K Sharma.;S R Torre.;J D Marmur.;D H Israel.;D E Ratner.;M B Weiss.;C E Hjemdahl-Monsen.;R K Myler.
来源: Circulation. 1994年90卷1期69-77页
Acute closure is increased after angioplasty in unstable angina, and adjunctive intracoronary thrombolytic therapy has been used successfully to increase angiographic success. The role of prophylactic thrombolytic therapy during angioplasty in unstable angina is unknown.
4867. Triglyceride- and cholesterol-rich lipoproteins have a differential effect on mild/moderate and severe lesion progression as assessed by quantitative coronary angiography in a controlled trial of lovastatin.
作者: H N Hodis.;W J Mack.;S P Azen.;P Alaupovic.;J M Pogoda.;L LaBree.;L C Hemphill.;D M Kramsch.;D H Blankenhorn.
来源: Circulation. 1994年90卷1期42-9页
The Monitored Atherosclerosis Regression Study, a randomized, double-blind, placebo-controlled, 2-year trial of lovastatin monotherapy, found that coronary lesions < 50% diameter stenosis (%S) and coronary lesions > or = 50% S at baseline had different responses to therapy. We now report on clinical, lipid, and nonlipid risk factors of treatment response in these lesion subsets.
4869. Effect of intense angiotensin II suppression on the diuretic response to furosemide during chronic ACE inhibition.
作者: J M Good.;A J Brady.;F H Noormohamed.;C M Oakley.;J G Cleland.
来源: Circulation. 1994年90卷1期220-4页
Contrary to expectation, most studies have demonstrated that initiation of an angiotensin-converting enzyme (ACE) inhibitor in conventional doses in patients with heart failure reduces the diuretic efficacy of furosemide. Recently, it has been suggested that single low doses (1 mg) but not high doses (25 mg) of captopril enhance furosemide-induced diuresis. It is not known whether the interaction between diuretics and ACE inhibitors are altered during long-term dosing.
4870. Six-month clinical and angiographic follow-up after direct angioplasty for acute myocardial infarction. Final results from the Primary Angioplasty Registry.
作者: B R Brodie.;C L Grines.;R Ivanhoe.;W Knopf.;G Taylor.;J O'Keefe.;R A Weintraub.;L G Berdan.;J E Tcheng.;L H Woodlief.
来源: Circulation. 1994年90卷1期156-62页
After direct angioplasty in the setting of acute myocardial infarction, patients were followed clinically and angiographically for 6 months at six experienced centers to evaluate outcomes.
4871. Intravenous Fluosol in the treatment of acute myocardial infarction. Results of the Thrombolysis and Angioplasty in Myocardial Infarction 9 Trial. TAMI 9 Research Group.
作者: T C Wall.;R M Califf.;J Blankenship.;J D Talley.;M Tannenbaum.;M Schwaiger.;G Gacioch.;M D Cohen.;M Sanz.;J D Leimberger.
来源: Circulation. 1994年90卷1期114-20页
This study was performed to determine the safety and potential efficacy of an intravenous perfluorochemical emulsion (Fluosol) as an adjunct reperfusion therapy aimed at preventing reperfusion injury for patients with acute myocardial infarction.
4872. Effects of converting enzyme inhibition on heart period variability in patients with acute myocardial infarction.
作者: D Bonaduce.;F Marciano.;M Petretta.;M L Migaux.;G Morgano.;V Bianchi.;L Salemme.;G Valva.;M Condorelli.
来源: Circulation. 1994年90卷1期108-13页
Heart period variability provides useful prognostic information on autonomic cardiac control, and a strong association has been demonstrated after myocardial infarction (MI) between cardiac mortality, sudden death, and reduced total power, ultralow-frequency (ULF) power, and very-low-frequency (VLF) power. Converting enzyme inhibitors are widely used in MI patients, but their influence on heart period variability remains to be defined.
4873. Ventricular arrhythmias in the acute and chronic phases after acute myocardial infarction. Effect of intervention with captopril.
Ventricular arrhythmias (VAs) are independent predictors of mortality in survivors of myocardial infarction (MI), and they are more likely to be induced in dilated hearts with increased wall stress. Angiotensin-converting enzyme (ACE) inhibitors have been shown to prevent progressive dilation of the left ventricle after MI.
4874. Efficacy of a single-lead unipolar transvenous defibrillator compared with a system employing an additional coronary sinus electrode. A prospective, randomized study.
作者: P J Kudenchuk.;G H Bardy.;G L Dolack.;J E Poole.;R Mehra.;G Johnson.
来源: Circulation. 1994年89卷6期2641-4页
Recent development of a prototype single-lead unipolar transvenous defibrillator offers the possibility of device implantation with the ease of a permanent pacemaker. Lowering defibrillation energy requirements would allow for a further reduction in defibrillator generator size and enhance the feasibility of pacemaker-like placement. However, if achieving a lower defibrillation energy requires placing additional intracardiac leads, the potential advantage of a smaller generator may be offset by the disadvantages of a more complex lead system. The purpose of this study was to compare defibrillation energy requirements of a single-lead unipolar defibrillator with a three-electrode system employing an additional lead in the coronary sinus.
4875. Potentiation of isosorbide dinitrate effects with N-acetylcysteine in patients with chronic heart failure.
作者: A Mehra.;A Shotan.;E Ostrzega.;W Hsueh.;J Vasquez-Johnson.;U Elkayam.
来源: Circulation. 1994年89卷6期2595-600页
Supply of sulfhydryl groups with the administration of N-acetylcysteine (NAC) has been reported to reverse tolerance to nitroglycerin but not to isosorbide dinitrate (ISDN). Lack of interaction between NAC and ISDN was suggested as an explanation for these findings. The present study was therefore designed to further evaluate this hypothesis. For this purpose, we compared the hemodynamic and hormonal effects of ISDN when given alone and in combination with NAC.
4876. Exclusion of atrial thrombus by transesophageal echocardiography does not preclude embolism after cardioversion of atrial fibrillation. A multicenter study.
作者: I W Black.;D Fatkin.;K B Sagar.;B K Khandheria.;D Y Leung.;J M Galloway.;M P Feneley.;W F Walsh.;R A Grimm.;C Stollberger.
来源: Circulation. 1994年89卷6期2509-13页
Transesophageal echocardiography (TEE) has been used recently to detect atrial thrombi before cardioversion of atrial arrhythmias. It has been assumed that embolic events after cardioversion result from embolism of preexisting atrial thrombi that are accurately detected by TEE. This study examined the clinical and echocardiographic findings in patients with embolism after cardioversion of atrial fibrillation despite exclusion of atrial thrombi by TEE.
4877. Relation between coronary artery stenosis assessed by visual, caliper, and computer methods and exercise capacity in patients with single-vessel coronary artery disease. The Veterans Affairs ACME Investigators.
作者: E D Folland.;R A Vogel.;P Hartigan.;E R Bates.;G J Beauman.;T Fortin.;C Boucher.;A F Parisi.
来源: Circulation. 1994年89卷5期2005-14页
Practitioners often assume a close relation between angiographic coronary artery stenosis and patient functional capacity. To test this unproven hypothesis, we analyzed the relation between coronary artery stenosis measured by different methods and maximal treadmill exercise tolerance in patients with single-vessel disease before and after intervention by percutaneous transluminal coronary angioplasty (PTCA).
4878. Recombinant human superoxide dismutase (h-SOD) fails to improve recovery of ventricular function in patients undergoing coronary angioplasty for acute myocardial infarction.
作者: J T Flaherty.;B Pitt.;J W Gruber.;R R Heuser.;D A Rothbaum.;L R Burwell.;B S George.;D J Kereiakes.;D Deitchman.;N Gustafson.
来源: Circulation. 1994年89卷5期1982-91页
Animal studies have demonstrated a burst of oxygen free radical generation after reperfusion of ischemic myocardium that could be blocked by administration of the free radical scavenger recombinant human superoxide dismutase (h-SOD). A multicenter, randomized, placebo-controlled clinical trial was designed to test the hypothesis that free radical-mediated reperfusion injury could be reduced by intravenous administration of h-SOD begun before percutaneous transluminal coronary angioplasty (PTCA) in patients with acute transmural myocardial infarction.
4879. N-terminal proatrial natriuretic factor. An independent predictor of long-term prognosis after myocardial infarction.
作者: C Hall.;J L Rouleau.;L Moyè.;J de Champlain.;D Bichet.;M Klein.;B Sussex.;M Packer.;J Rouleau.;M O Arnold.
来源: Circulation. 1994年89卷5期1934-42页
Atrial natriuretic factor (ANF) is a peptide hormone secreted from cardiac atria in response to increased atrial pressure. Because of a longer half-life and greater stability, the N-terminal of ANF prohormone (N-terminal proANF) may be a better integrator of atrial peptide secretion than ANF itself. After myocardial infarction, elevation of ANF and other neurohormones has been associated with a poor prognosis. However, when left ventricular ejection fraction (LVEF) and other important clinical variables are included in multivariate analysis, the independent predictive value of these neurohormones has been reduced markedly.
4880. An enantiomer-enantiomer interaction of (S)- and (R)-propafenone modifies the effect of racemic drug therapy.
作者: H K Kroemer.;M F Fromm.;K Bühl.;H Terefe.;G Blaschke.;M Eichelbaum.
来源: Circulation. 1994年89卷5期2396-400页
Therapy with racemic compounds produces effects that can be attributed to both (S)- and (R)-enantiomers. Here we have tested the hypothesis that an enantiomer-enantiomer interaction would modulate the effects of treatment with a racemate, the antiarrhythmic propafenone. Previous studies have shown that while the enantiomers of propafenone exert similar sodium channel-blocking (QRS widening) effects, it is the (S)-enantiomer that produces beta-blockade; moreover, we have demonstrated recently that (R)-propafenone inhibits the metabolism of (S)-propafenone in vitro.
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