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排序方式: 共有98条查询结果,搜索用时 31 毫秒
91.
PATRICIO PÉREZ‐BERBEL M.D. JOSÉ VALENCIA M.D. Ph.D. JUAN MIGUEL RUIZ‐NODAR M.D. Ph.D. JAVIER PINEDA M.D. Ph.D. PASCUAL BORDES M.D. Ph.D. VICENTE MAINAR M.D. Ph.D. FRANCISCO SOGORB M.D. Ph.D. 《Journal of interventional cardiology》2011,24(1):42-48
Purpose and Methods: Rescue angioplasty (RA) has demonstrated its efficacy for the treatment of failed thrombolysis after acute myocardial infarction (AMI). We analyzed clinical, angiographic, and procedural characteristics, and prognosis at 30 days of prospective cohort of unselected patients admitted for RA. Results: From August 2004 to August 2009, 361 patients were included in a single center. The median time pain to the thrombolysis was 140 minutes (interquartile range [IQR] 90–210), delay transfer 100 minutes (IQR 65–120); pain to PCI was 330 minutes (IQR 270–400). Initial flow TIMI 3 (Thrombolysis in Myocardial Infarction) was presented in 102 (28.3%) of cases and blush grade 3 in 88 (24.4%). After the procedure, TIMI 3 flow was achieved in 286 (79.2%) and blush grade 3 in 256 (71%) (P < 0.001 and P < 0,001, respectively). A glycoprotein IIb/IIIa receptor inhibitor (Abciximab) was used in 115 patients (32%). Stents were implanted in 339 (94%) of patients, 137 (38%) of which were drug‐eluting stent. Complete ST segment resolution was observed in 202 (64.5%) patients in 12‐lead electrocardiogram (ECG) and procedural success was 77.6%. Adverse cardiac events and death after 30 days follow‐up were 13.6% and 10.7%, respectively. Target vessel revascularization at 30 days was 1.9%. Conclusions: Routine application of RA in patients with persistent ST elevation 90 minutes after thrombolysis is a useful technique for achieving revascularization of the affected artery. In‐hospital mortality remains high especially in patients with cardiac shock, despite new interventional techniques available, and adjunctive antithrombotic therapy. (J Interven Cardiol 2011;24:42–48) 相似文献
92.
93.
EL-SAID M. EL-SAID M.B. B.CH. M.S. HANS RIJSTERBORGH Ph.D. JOS R.T.C. ROELANDT M.D. WIM B. VLETTER M.Sc PAOLO M. FIORETTI M.D. DAVID T. LINKER M.D. 《Echocardiography (Mount Kisco, N.Y.)》1994,11(5):445-453
The aim of this study was to investigate the reproducibility of transmitral Doppler parameters of left ventricular filling in subjects undergoing dobutamine stress and to estimate threshold values, which can be used as a reference to detect significant changes in Doppler measurements from baseline to peak dobutamine in an individual patient. The study groups included 11 male volunteers and 26 patients with coronary artery disease. Intra-and interobserver tests were performed on 14 randomly selected tracings. The random variation of measurements (beat-to-beat variations plus random observer error) was estimated at baseline and peak dobutamine both in normals and patients. The parameters studied were: peak early (E) and atrial (A) filling velocities and their ratio (ElA), early filling acceleration (E-AC) and deceleration (E-DC) rates, and diastolic time-velocity integral (TVI). Intra-and interobserver mean differences were generally small (lt; 5%) with the largest found in the interobserver differences in E-AC (12%) and TVI (7%). The random variation of measurements at baseline were similar in normals and patients with the smallest (lt; 5%) variation in E and the largest in E-AC (12%) and El A (8%). There was a significant (P lt; 0.01) increase in the coefficient of variation from baseline to peak dobutamine for E (4.5% vs 7.6%), E-AC (11% vs 14.8%), and E-DC (6.5% vs 9.3%) in the patient group. The threshold values were calculated based on the random variation in a single patient and with the assumption that 3, 5, or 8 beats were analyzed at both instances. Conclusions: When Doppler evaluation of left ventricular filling is used during dobutamine stress, the following points should be considered: (1) peak E has the smallest variability among Doppler indices that assess early filling phase; (2) the variability of Doppler measurements of early filling increases with stress intervention in patients with CAD; (3) increasing the number of beats averaged from 3–8 reduces the threshold needed to decide significant differences in Doppler measurements between baseline and peak dobutamine by more than the half. 相似文献
94.
JESÚS ALMENDRAL M.D. Ph.D. RAÚL CAULIER‐CISTERNA Ph.D. JOSÉ LUIS ROJO‐ÁLVAREZ Ph.D. 《Pacing and clinical electrophysiology : PACE》2013,36(4):508-532
In this paper, we review the information accumulated over the years regarding the phenomena of resetting and entrainment of reentrant arrhythmias. Over three decades of research and clinical applications, these phenomena have demonstrated that they stay as a main tool for an intellectual understanding of reentry and to base strategies for localization of critical areas for ablative therapies. This review will be divided into two parts. This first part deals with the bases for the concept development, the means for the detection of these phenomena, and their mechanistic implications. Resetting is described as a particular response of a given rhythm to an external perturbation, indicating interaction between them. Entrainment indicates continuous reset of the rhythm when the perturbation is repetitive. The mechanisms that explain these responses in reentrant rhythms are presented. Fusion, both at the surface electrocardiogram and at the level of intracardiac recordings, is discussed in detail, with its value and limitations as a key concept to recognize entrainment and reentry. Computer simulations are used as an aid to a better understanding. Differences between resetting and entrainment are considered, and a pacing protocol to study these phenomena described. 相似文献
95.
JOSÉ M. PORRES M.D. EDURNE LAVIÑETA M.D. CARLOS REVIEJO M.D. JOSEP BRUGADA M.D. Ph.D. 《Pacing and clinical electrophysiology : PACE》2008,31(12):1641-1645
The growing number of implantable cardioverter defibrillator (ICD) implants mean that a high number of patients carrying these devices are attended by physicians. In an attempt to simplify their management, articles have been published on the safety of applying magnets to the ICD in order to avoid the administration of shocks during surgery. However, performance of these procedures without the supervision of expert personnel can be accompanied by serious and potentially fatal complications. We report a case where the use of a clinic magnet over an ICD caused it to switch to “end of life” in the battery indicator and lose some antitachycardia therapies. 相似文献
96.
HENNEKE VERSTEEG M.Sc. ANGÉLIQUE A. SCHIFFER Ph .D.† JOS W. WIDDERSHOVEN M.D. Ph .D.‡ MATHIAS M. MEINE M.D. § PIETER A. DOEVENDANS M.D. Ph .D.§ SUSANNE S. PEDERSEN Ph .D. 《Pacing and clinical electrophysiology : PACE》2009,32(10):1247-1256
Background: Cardiac resynchronization therapy (CRT) is a promising treatment for a subgroup of patients with advanced congestive heart failure and a prolonged QRS interval. Despite the majority of patients benefiting from CRT, 10–40% of patients do not respond to this treatment and are labeled as nonresponders. Given that there is a lack of consensus on how to define response to CRT, the purpose of this viewpoint is to discuss currently used definitions and their shortcomings, and to provide recommendations as to how an expansion of the criteria for CRT response may be useful to clinicians.
Methods and Results: Analysis of the literature and case reports indicates that the majority of established measures of CRT response, including New York Heart Association functional class and echocardiographic, hemodynamic, and neurohormonal parameters, are poor associates of patient-reported symptoms and quality of life. Moreover, the potential moderating role of psychological factors in determining health outcomes after CRT has largely been neglected.
Conclusions: It is recommended to routinely assess health status after CRT with a disease-specific questionnaire in standard clinical practice and to examine its determinants, including psychological factors such as personality traits and depression. This may lead to improved (secondary) treatment and prognosis in CHF patients treated with CRT. 相似文献
Methods and Results: Analysis of the literature and case reports indicates that the majority of established measures of CRT response, including New York Heart Association functional class and echocardiographic, hemodynamic, and neurohormonal parameters, are poor associates of patient-reported symptoms and quality of life. Moreover, the potential moderating role of psychological factors in determining health outcomes after CRT has largely been neglected.
Conclusions: It is recommended to routinely assess health status after CRT with a disease-specific questionnaire in standard clinical practice and to examine its determinants, including psychological factors such as personality traits and depression. This may lead to improved (secondary) treatment and prognosis in CHF patients treated with CRT. 相似文献
97.
JOSÉ M. MARTÍN M.D. ESPERANZA JORDÁ M.D. Ph.D. VICENT ALONSO M.D. 《Pediatric dermatology》2009,26(6):768-768
Letters to the Editor are welcomed for publication (subject to editing). Letters must be signed by all authors, and must not exceed two pages of text including references. Letters should not duplicate material submitted or published in other journals. Prepublication proofs will not be provided. 相似文献
98.
Martínez-Jaramillo G Sánchez-Valle E Gómez-Morales E Montesinos JJ Valencia I Pizzuto-Chavez J Mayani H 《Hematology (Amsterdam, Netherlands)》2000,5(3):247-255
Previous studies have shown that the levels of hematopoietic progenitor cells (colony-forming cells; CFC) are drastically reduced in the vast majority of patients with aplastic anemia (AA). This has been observed both in patients before and after immunosuppressive therapy. In those studies, however, both groups of patients were usually formed by different individuals, thus it was not possible to follow the kinetics of such cells in each particular patient. In the present study, we have determined the content of myeloid and erythroid CFC in individual AA patients before and after therapy. Treated patients were studied at two different times (8-18 months apart) to detect any possible variations due to the ongoing treatment. At diagnosis, the levels of both myeloid and erythroid CFC were drastically reduced, as compared to normal bone marrow, in all the patients studied. This correlated with very low levels of leukocytes and hemoglobin in circulation. After the patients entered an immunosuppressive treatment, all of them showed significant increments in their CFC levels, and this correlated with increments in their hematological parameters in peripheral blood. However, in most patients CFC levels were still below the normal range. When the second sample after treatment was obtained, great variations in CFC numbers were observed. In terms of erythroid CFC levels, a further increase was seen in most patients, and this correlated with a further increase in hemoglobin levels. In contrasts, the levels of myeloid CFC were increased in only some of the patients, whereas in others, significant reductions were evident. Interestingly, in this latter group of patients, CFC never reached the levels observed before treatment. Our results indicate that, in a significant proportion of patients, a common pattern seems to exist. That is to say, low CFC numbers are present before treatment; an increase in the numbers of such cells results as an effect of the immunosuppressive therapy and further variations in CFC numbers (within individual limits that may differ significantly from one patient to another) take place as long as the treatment continues. Finally, we observed a correlation between CFC levels and the clinical status of the patients, i.e., those patients that showed a complete or a partial response to treatment showed higher levels of both myeloid and erythroid CFC than those patients that did not respond to therapy. 相似文献