Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Mar 1999
Perioperative morbidity and mortality after transmyocardial laser revascularization: incidence and risk factors for adverse events.
The purpose of this study was to describe the incidence and spectrum of perioperative cardiac and noncardiac morbidity and mortality after transmyocardial laser revascularization (TMR) and to identify predictors of these adverse clinical events. ⋯ Perioperative mortality in patients undergoing isolated TMR is low. Transmyocardial laser revascularization patients are at higher risk for adverse perioperative cardiac and noncardiac events, likely reflecting the lack of immediate benefit from the procedure in the setting of severe CAD. These patients merit vigilant surveillance for adverse events and aggressive medical management in the perioperative period.
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J. Am. Coll. Cardiol. · Mar 1999
Randomized Controlled Trial Comparative Study Clinical TrialUtility of a single-stage isoproterenol tilt table test in adults: a randomized comparison with passive head-up tilt.
This study was conducted to develop a time-efficient tilt table test. ⋯ The single-stage isoproterenol tilt table test was more effective in inducing a positive vasovagal response in an adult population than the standard passive tilt table test, and it significantly reduced the procedural time. The increase in positive yield was associated with a moderate decrease in apparent specificity. These observations support the conclusion that single-stage tilt table testing could be a reasonable diagnostic option in patients undergoing syncope evaluation.
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J. Am. Coll. Cardiol. · Mar 1999
Tolerability and efficacy of carvedilol in patients with New York Heart Association class IV heart failure.
The purpose of this study was to assess the tolerability and efficacy of carvedilol in patients with New York Heart Association (NYHA) functional class IV symptoms. ⋯ Patients with chronic NYHA class IV heart failure are more likely to develop adverse events during initiation and dose titration when compared with less symptomatic patients but are more likely to show symptomatic improvement in the long term. We conclude that carvedilol is a useful adjunctive therapy for patients with NYHA class IV heart failure; however, they require close observation during initiation and titration of the drug.
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J. Am. Coll. Cardiol. · Mar 1999
Comparative StudyImproved accuracy and precision of thermodilution cardiac output measurement using a dual thermistor catheter system.
To assess whether thermodilution cardiac output determination based on measurement of injectate temperature in vivo leads to more accurate and precise estimates and to study the influence of chilled injectate on test performance. ⋯ This new dual thermistor approach results in a significant improvement in both precision and accuracy of thermodilution cardiac output measurement.