Journal of the American College of Cardiology
-
J. Am. Coll. Cardiol. · Nov 1993
Randomized Controlled Trial Comparative Study Clinical TrialActive compression-decompression resuscitation: analysis of transmitral flow and left ventricular volume by transesophageal echocardiography in humans. Cardiopulmonary Resuscitation Working Group.
This study was designed to test the hypothesis that active compression-decompression cardiopulmonary resuscitation increases transmitral flow and end-decompression left ventricular volume over levels achieved with standard manual cardiopulmonary resuscitation. ⋯ Improved transmitral flow, end-decompression left ventricular volume and stroke volume are seen with active compression-decompression resuscitation, suggesting a biphasic cardiothoracic cycle of flow. Active decompression of the chest appears to be a beneficial adjunct to standard cardiopulmonary resuscitation.
-
J. Am. Coll. Cardiol. · Nov 1993
Comparative StudyPrehospital thrombolysis: beneficial effects of very early treatment on infarct size and left ventricular function.
The purpose of this study was to compare the effects of very early (< or = 1.5 h after symptom onset) and later (> 1.5 up to 4 h) thrombolytic therapy on infarct size, left ventricular function and early mortality in patients with acute myocardial infarction. To start thrombolysis at the earliest possible moment, it was performed in the prehospital setting. A cutoff time of 1.5 h was prospectively stipulated. ⋯ The data suggest that in evolving myocardial infarction up to 4 h in duration, the start of thrombolytic therapy at < or = 1.5 h compared with > 1.5 h limits infarct size, preserves left ventricular function and may save lives.
-
J. Am. Coll. Cardiol. · Nov 1993
Comparative StudyMagnetic resonance volume flow and jet velocity mapping in aortic coarctation.
Nuclear magnetic resonance (MRI) velocity mapping was used to characterize flow waveforms and to measure volume flow in the ascending and descending thoracic aorta in patients with aortic coarctation and in healthy volunteers. We present the method and discuss the relation between these measurements and aortic narrowing assessed by MRI. Finally, we compare coarctation jet velocity measured by MRI velocity mapping with that obtained from continuous wave Doppler echocardiography. ⋯ We established normal ranges for volume flow in the descending aorta and demonstrated abnormalities in patients with aortic coarctation. These abnormalities are likely to be related to resistance to flow imposed by the coarctation and could represent an additional index for monitoring patients before and after intervention.
-
J. Am. Coll. Cardiol. · Nov 1993
Comparative StudyCoronary artery bypass grafting in severe left ventricular dysfunction: excellent survival with improved ejection fraction and functional state.
The present study evaluated our experience with coronary artery bypass grafting in patients with severe left ventricular dysfunction. ⋯ In patients with coronary artery disease and advanced ventricular dysfunction: 1) coronary artery bypass grafting can be performed relatively safely, 2) good medium-term survival is attained, 3) improvement in left ventricular function can be documented objectively after bypass grafting, 4) quality of life is improved (as reflected by improvement in anginal and congestive heart failure status), and 5) the internal mammary artery can safely be used as a conduit. The use of coronary artery bypass grafting is encouraged for this group of patients and may provide a viable alternative to transplantation in selected patients.
-
J. Am. Coll. Cardiol. · Nov 1993
Regional cardiac sympathetic denervation in patients with ventricular tachycardia in the absence of coronary artery disease.
The aim of this study was to determine whether patients with ventricular arrhythmias in the absence of coronary artery disease also have abnormalities in sympathetic innervation. ⋯ Patients with ventricular tachycardia in the absence of coronary artery disease have abnormal cardiac sympathetic innervation detectable by cardiac sympathetic scintigraphy. The role of regional cardiac sympathetic denervation in arrhythmogenesis remains to be determined.