American heart journal
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American heart journal · Mar 2004
Implications of elevated cardiac troponin T in ambulatory patients with heart failure: a prospective analysis.
Elevated concentrations of cardiac troponin T (TnT) have been reported in patients hospitalized for decompensated heart failure (HF). We assessed whether elevated TnT levels are associated with the severity, etiology, and prognosis of HF in stable, ambulatory patients. ⋯ Nearly one fourth of ambulatory patients with chronic HF have ongoing myocardial necrosis as shown by abnormal TnT values, which are associated with increased mortality and morbidity.
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American heart journal · Mar 2004
Feasibility of point-of-care echocardiography by internal medicine house staff.
To determine whether internal medicine house staff with limited training in echocardiography can use point-of-care echocardiography to make simple, clinically important diagnoses. ⋯ Medical house staff with limited training in echocardiography can use point-of-care echocardiography to assess left ventricular function and pericardial effusion with moderate accuracy that is lower than that of standard echocardiography. Assessment of valvular disease and other diagnoses likely requires more training and/or experience in echocardiography.
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American heart journal · Mar 2004
Cardiovascular risk factors for stable angina pectoris versus unheralded myocardial infarction.
Ischemic heart disease can vary substantially in its clinical presentation. Some patients have acute myocardial infarction (MI) without any previous signs of myocardial ischemia, whereas other patients may have stable angina pectoris for years without periods of acute unstability. This study compared baseline risk factors between subjects in whom stable angina pectoris developed and subjects in whom unheralded fatal or nonfatal MI developed during the follow-up period. ⋯ Serum lipid levels were important risk factors for the development of both stable and acute coronary heart disease. In addition, proinsulin levels and blood pressure were independent predictors of unheralded MI only, which suggests that these factors are involved in thrombosis, plaque rupture, or both.
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American heart journal · Mar 2004
Comparative StudyEvaluation of the ulnopalmar arterial arches with pulse oximetry and plethysmography: comparison with the Allen's test in 1010 patients.
To avoid ischemic hand complications, the percutaneous transradial approach is only performed in patients with patent hand collateral arteries, which is usually evaluated with the modified Allen's test (MAT). This qualitative test measures the time needed for maximal palmar blush after release of the ulnar artery compression with occlusive pressure of the radial artery. The objectives were to evaluate the patency of the hand collateral arteries and to compare MAT with combined plethysmography (PL) and pulse oximetry (OX) tests before the percutaneous transradial approach. ⋯ In the evaluation of hand collaterals, PL and OX were found to be more sensitive than MAT. When applied to transradial approach screening, only 1.5% of patients were not suitable candidates for the transradial approach.