Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Apr 1996
Influence of right ventricular pacing site on left ventricular outflow tract obstruction in patients with hypertrophic obstructive cardiomyopathy.
This study was designed to show the influence of right ventricular pacing site on left ventricular outflow tract obstruction during pacing treatment of patients with hypertrophic obstructive cardiomyopathy. ⋯ The right ventricular pacing site is of crucial importance for reducing left ventricular outflow tract obstruction when patients with hypertrophic obstructive cardiomyopathy are treated with pacing. Cardiac output is not reduced by apical pacing.
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J. Am. Coll. Cardiol. · Mar 1996
Left ventricular echocardiographic and histologic changes: impact of chronic unloading by an implantable ventricular assist device.
We studied the effects of chronic left ventricular unloading by a ventricular assist device and assessed left ventricular morphologic and histologic changes. ⋯ Left ventricular unloading with the implantable assist device induces an immediate increase in wall thickness, consistent with the reduction in chamber size, thereby decreasing wall stress. Chronic unloading allows myocardial healing and fibrosis without evidence for ongoing myocyte damage or atrophy. Left ventricular assist device insertion may have a role in "resting" the ventricle for selected patients with heart failure.
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J. Am. Coll. Cardiol. · Mar 1996
Development and validation of a Bayesian model for perioperative cardiac risk assessment in a cohort of 1,081 vascular surgical candidates.
This study sought to develop and validate a Bayesian risk prediction model for vascular surgery candidates. ⋯ Simple clinical markers, weighted according to prognostic impact, will reliably stratify risk in vascular surgery candidates referred for dipyridamole-thallium testing, thus obviating the need for the more expensive testing. Our prediction model retains its prognostic accuracy when applied to the validation sets and can reliably estimate risk in this group.
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J. Am. Coll. Cardiol. · Mar 1996
Practice Guideline GuidelineGuidelines for perioperative cardiovascular evaluation for noncardiac surgery. Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Perioperative Cardiovascular Evaluation for Noncardiac Surgery).
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J. Am. Coll. Cardiol. · Mar 1996
Randomized Controlled Trial Comparative Study Clinical TrialMild systolic dysfunction in heart failure (left ventricular ejection fraction >35%): baseline characteristics, prognosis and response to therapy in the Vasodilator in Heart Failure Trials (V-HeFT)
This analysis sought to evaluate the clinical characteristics and outcome in heart failure with mild systolic dysfunction. ⋯ In V-HeFT, heart failure with mild systolic dysfunction was associated with different characteristics and a more favorable prognosis than heart failure with more severe systolic dysfunction. Enalapril decreased overall mortality and sudden death compared with hydralazine/isosorbide dinitrate. Prospective trials are needed to address therapy for heart failure with mild systolic dysfunction.