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排序方式: 共有2508条查询结果,搜索用时 31 毫秒
61.
Rodriguez LM Timmermans C Nabar A Beatty G Wellens HJ 《Journal of cardiovascular electrophysiology》2003,14(2):135-141
INTRODUCTION: Little is known about the septal activation pattern in patients with heart failure and left bundle branch block (LBBB-HF). METHODS AND RESULTS: The right ventricular (RV) and left ventricular (LV) activation patterns of 12 patients (mean age 67 +/- 11 years) with LBBB-HF and 5 patients (mean age 45 +/- 14) with normal hearts were studied during sinus rhythm using a three-dimensional mapping system. The etiology of HF was myocardial infarction (n = 4) or idiopathic dilated cardiomyopathy (n = 8). In patients with LBBB-HF, endocardial activation usually started before the onset of the surface QRS complex on the RV free wall. Latest RV activation occurred in the basal region, and total RV activation time was longer than in patients with normal hearts. In patients with LBBB-HF, the left septum was activated via slowly conducting LBB or via right-to-left transseptal conduction. In both patients with LBBB-HF and those with normal hearts, latest LV activation occurred either in the posterior or posterolateral-basal region. Conduction velocity was slower in the peri-scar region, in patients with previous myocardial infarct and globally slow, in patients with idiopathic dilated cardiomyopathy. CONCLUSION: The two types of left septal activation observed in patients with LBBB-HF may have consequences for biventricular hemodynamic performance. Conduction slowing along the LV, regionally or globally, suggests a contribution outside the specific conduction system in the ECG pattern of LBBB. 相似文献
62.
针对黄土高原枣园普遍盛行传统清耕制,将生草及覆盖技术引入枣园生产中,于2011—2013年采用人工土槽模拟研究方法,探讨不同生草和覆盖措施对枣树地土壤持水性能的影响。结果表明:生草与枣树枝覆盖能有效改善土壤物理结构、提高土壤孔隙度、降低土壤容重;各处理土壤水分蓄持能力及比水容量均按枣树枝半覆盖+白三叶生草、枣树枝全覆盖、白三叶生草覆盖和清耕处理依次递减,处理间的差异在高吸力阶段更为明显;与清耕处理相比,生草与覆盖处理土壤饱和含水量、田间持水量、凋萎系数均有提高,枣树枝半覆盖+白三叶生草处理增加最为明显,分别增加9%、20%、33%。 相似文献
63.
Tae-Min Rhee Kyung Woo Park Chi-Hoon Kim Jeehoon Kang Jung-Kyu Han Han-Mo Yang Hyun-Jae Kang Bon-Kwon Koo Hyo-Soo Kim 《JACC: Cardiovascular Interventions》2018,11(24):2453-2463
Objectives
The aim of this study was to investigate clinical outcomes after left main coronary artery (LM) bifurcation percutaneous coronary intervention (PCI) and the impact of the duration of dual antiplatelet therapy (DAPT) according to treatment strategy.Background
There are limited data regarding the optimal PCI strategy for LM bifurcation lesions with new-generation drug-eluting stents.Methods
A patient-level pooled analysis of 5 nationwide multicenter registries was performed. Rates of target lesion failure, thrombotic adverse cardiovascular events, and their individual components at 3-year were analyzed. Subgroup analysis according to DAPT duration was performed.Results
From 13,172 patients undergoing PCI with new-generation drug-eluting stents, a total of 700 patients were treated for LM bifurcation lesions, 567 with a 1-stent strategy and 133 with a 2-stent strategy. Rates of target lesion failure and target lesion revascularization were higher in the 2-stent group, driven mainly by complex lesion profiles. Risks for thrombotic adverse cardiovascular events and its components were comparable between the 2 strategies. Subgroup analysis showed that risks for target lesion failure and thrombotic adverse cardiovascular events in the 2-stent group were significantly higher than in the 1-stent group in those with DAPT interruption <1 year, while they were similar in those receiving DAPT maintenance ≥1 year.Conclusions
Up to 20% of patients who underwent LM bifurcation PCI eventually required a 2-stent strategy, which was as safe as a 1-stent strategy with the use of new-generation drug-eluting stents. Careful pre-emptive case selection as well as prolonged DAPT may be necessary when considering a 2-stent strategy in LM PCI given its higher rate of repeat revascularization and lesion failure than the 1-stent approach. 相似文献64.
An interesting case of wide QRS tachycardia with right bundle branch block morphology: What is the mechanism?
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65.
66.
Ivan Stankovic Aleksandra Janicijevic Aleksandra Dimic Milica Stefanovic Radosav Vidakovic Biljana Putnikovic 《Annals of medicine》2018,50(2):128-138
Objectives: Bundle branch blocks (BBB)-related mechanical dyssynchrony and dispersion may improve patient selection for device therapy, but their effect on the natural history of this patient population is unknown.Methods: A total of 155 patients with LVEF?≤?35% and BBB, not treated with device therapy, were included. Mechanical dyssynchrony was defined as the presence of either septal flash or apical rocking. Contraction duration was assessed as time interval from the electrocardiographic R-(Q-)wave to peak longitudinal strain in each of 17 left ventricular segments. Mechanical dispersion was defined as either the standard deviation of all time intervals (dispersionSD) or as the difference between the longest and shortest time intervals (dispersiondelta). Patients were followed for cardiac mortality during a median period of 33 months.Results: Mechanical dyssynchrony was not associated with survival. More pronounced mechanical dispersiondelta was found in patients with dyssynchrony than in those without. In the multivariate regression analysis, patients’ functional class, diabetes mellitus and dispersiondelta were independently associated with mortality.Conclusions: Mechanical dispersion, but not dyssynchrony, was independently associated with mortality and it may be useful for risk stratification of patients with heart failure (HF) and BBB.
- Key Messages
Mechanical dispersion, measured by strain echocardiography, is associated with poor outcome in heart failure with a severely depressed left ventricular function and bundle branch blocks.
Mechanical dispersion may be useful for risk stratification of patients with heart failure and bundle branch blocks.
67.
Enes Elvin Gul MD Rajiv A. Kabadi MD Santosh K. Padala MD Paula Sanchez Somonte MD Jordana Kron MD Richard K. Shepard MD Jayanthi N. Koneru MD Gautham Kalahasty MD Maria Terricabras MD Bernice Tsang MD Yaariv Khaykin MD Zaev Wulffhart MD Alfredo Pantano MD Kenneth A. Ellenbogen MD Atul Verma MD 《Journal of cardiovascular electrophysiology》2021,32(9):2515-2521
68.
69.
70.
G La Canna R Giubbini M Metra G Arosio A Curnis R Cicogna O Visioli 《European heart journal》1992,13(7):942-946
Myocardial perfusion scintigraphy with thallium-201 was performed in 33 subjects (mean age 45 years, range 28-61) with exercise-induced, rate-dependent left bundle branch block (LBBB) in order to assess both the value of Thallium-201 myocardial imaging for the diagnosis of coronary artery disease (CAD) and the pathogenesis (ischaemic or not) of the conduction defect. Of the 33 patients evaluated, 16 had chest pain suggestive of CAD and 17 were asymptomatic. None had a history of prior myocardial infarction or clinical and echocardiographic signs of heart disease. LBBB appeared at a heart rate ranging from 70 to 160 b.min-1. Eighteen patients showed repolarization abnormalities (ST segment depression with deep inverted T waves) compatible with ischaemia, after QRS normalization. Thallium-201 myocardial uptake was normal in 12 subjects; in the remaining 21, reversible Thallium-201 defects were demonstrated in the septum (18 patients), septum and apex (2), and septum and infero-apical wall (1). No patient had irreversible defects and all had normal coronary angiography, with negative ergonovine tests for coronary artery spasm. The patients were followed up for a mean of 43 months (range 16-80). One patient died from sudden death, but no cardiac event occurred in the other patients. In conclusion, exercise Thallium-201 myocardial scintigraphy showed a high prevalence (64%) of reversible perfusion defects in a group of patients with exercise-induced LBBB without any evidence of CAD at angiography or coronary spasm at ergonovine test. Moreover, follow-up showed a relatively low rate of major cardiac events. 相似文献