Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Dec 2002
Reversible myocardial dysfunction in survivors of out-of-hospital cardiac arrest.
The aim of the study was to assess the hemodynamic status of survivors of out-of-hospital cardiac arrest (OHCA). ⋯ In survivors of OHCA, hemodynamic instability requiring administration of vasoactive drugs is frequent and appears several hours after hospital admission. It is characterized by a low CI that is reversible in most cases within 24 h, suggesting post-resuscitation myocardial dysfunction. Early death by multiorgan failure is associated with a persistent low CI at 24 h.
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J. Am. Coll. Cardiol. · Dec 2002
Comparative StudyRight ventricular function in adults with repaired tetralogy of Fallot assessed with cardiovascular magnetic resonance imaging: detrimental role of right ventricular outflow aneurysms or akinesia and adverse right-to-left ventricular interaction.
We examined the relationship among biventricular hemodynamics, pulmonary regurgitant fraction (PRF), right ventricular outflow tract (RVOT) aneurysm or akinesia, and baseline and surgical characteristics in adults with repaired tetralogy of Fallot (rTOF). ⋯ Pulmonary regurgitation and RVOT aneurysm/akinesia were independently associated with RV dilation and the latter with RV hypertrophy late after rTOF. The RVOT aneurysm/akinesia was common but related only in part to RVOT or transannular patching. Both RV hypertrophy and RVOT aneurysm/akinesia were associated with lower RVEF. Left ventricular systolic dysfunction correlated with RV dysfunction, suggesting an unfavorable ventricular-ventricular interaction. Measures to maintain or restore pulmonary valve function and avoid RVOT aneurysm/akinesia are mandatory for preserving biventricular function late after rTOF.
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J. Am. Coll. Cardiol. · Dec 2002
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialInduction of mild systemic hypothermia with endovascular cooling during primary percutaneous coronary intervention for acute myocardial infarction.
The purpose of this study was to evaluate the safety and feasibility of endovascular cooling during primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). ⋯ Endovascular cooling can be performed safely as an adjunct to primary PCI for AMI. Further clinical trials are required to determine whether induction of mild systemic hypothermia with endovascular cooling will limit infarct size in patients undergoing reperfusion therapy.
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J. Am. Coll. Cardiol. · Nov 2002
Comparative StudyComparative value of Doppler echocardiography and B-type natriuretic peptide assay in the etiologic diagnosis of acute dyspnea.
We compared the accuracy of B-type natriuretic peptide (BNP) assay with Doppler echocardiography for the diagnosis of decompensated congestive left-heart failure (CHF) in patients with acute dyspnea. ⋯ Bedside BNP measurement and Doppler echocardiography are both useful for establishing the cause of acute dyspnea. However, Doppler analysis of the mitral inflow pattern was more accurate, particularly in patients with intermediate BNP levels or "flash" pulmonary edema.
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J. Am. Coll. Cardiol. · Nov 2002
Cardiac catheterization of patients supported by extracorporeal membrane oxygenation.
The goal of this study was to describe the clinical outcomes of patients undergoing cardiac catheterization while supported with extracorporeal membrane oxygenation (ECMO). ⋯ Cardiac catheterization can be performed safely on patients supported with ECMO. Catheterization during ECMO enables the diagnosis of residual lesions and can facilitate important therapeutic interventions.