Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Oct 2003
Randomized Controlled Trial Multicenter Study Clinical TrialPercutaneous coronary intervention for cardiogenic shock in the SHOCK trial.
We examined the clinical, angiographic, and procedural characteristics determining survival after percutaneous coronary intervention (PCI) for cardiogenic shock. ⋯ Restoration of coronary blood flow is a major predictor of survival in cardiogenic shock. Benefit appears to extend beyond the generally accepted 12-h post-infarction window. Surgery should be considered in shock patients with severe mitral insufficiency or multivessel disease not amenable to relatively complete percutaneous revascularization.
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J. Am. Coll. Cardiol. · Oct 2003
Time interval between onset of mitral inflow and onset of early diastolic velocity by tissue Doppler: a novel index of left ventricular relaxation: experimental studies and clinical application.
The goal of this study was to examine the diagnostic utility of the time to onset of early (Ea) diastolic velocity of the mitral annulus by tissue Doppler (TD) in comparison with the time to onset of mitral inflow (T(Ea-E)) for the assessment of left ventricular (LV) relaxation. ⋯ T(Ea-E) is a useful novel index of LV relaxation. It can be used to identify patients with diastolic dysfunction and predict PCWP.
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J. Am. Coll. Cardiol. · Oct 2003
Role of left atrial appendage obliteration in stroke reduction in patients with mitral valve prosthesis: a transesophageal echocardiographic study.
The aim of our study was to assess whether left atrial appendage (LAA) ligation in patients undergoing mitral valve replacement is associated with the risk of future embolisms. ⋯ Our study shows that LAA ligation during surgery of mitral valve replacement, performed in a high-risk population, is consistent with a reduction of the risk of late embolism and supports this technique if a mitral valve replacement is indicated.
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J. Am. Coll. Cardiol. · Sep 2003
Is aortic dilatation an atherosclerosis-related process? Clinical, laboratory, and transesophageal echocardiographic correlates of thoracic aortic dimensions in the population with implications for thoracic aortic aneurysm formation.
The study determined, in a population-based setting, whether dilatation of the thoracic aorta is an atherosclerosis-related process. ⋯ Age, gender, and BSA are major determinants of thoracic aortic dimensions. Atherosclerosis risk factors and aortic atherosclerotic plaques are weakly associated with distal aortic dilatation, suggesting that atherosclerosis plays a minor role in aortic dilatation in the population.
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J. Am. Coll. Cardiol. · Sep 2003
Symptom-onset-to-balloon time and mortality in patients with acute myocardial infarction treated by primary angioplasty.
The aim of the study was to evaluate the relationship between symptom-onset-to-balloon time and one-year mortality in patients with ST-segment elevation myocardial infarction (STEMI) treated by primary angioplasty. ⋯ This study shows that, in patients with STEMI treated by primary angioplasty, symptom-onset-to-balloon time, but not door-to-balloon time, is related to mortality, particularly in non-low-risk patients and in the absence of preprocedural anterograde flow. Furthermore, a symptom-onset-to-balloon time >4 h was identified as independent predictor of one-year mortality.