American heart journal
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American heart journal · Dec 2006
Patterns of use and potential impact of early beta-blocker therapy in non-ST-elevation myocardial infarction with and without heart failure: the Global Registry of Acute Coronary Events.
Early beta-blocker (BB) therapy improves outcomes in ST-segment elevation myocardial infarction; however, limited data are available on its early use and its impact in non-ST-segment elevation myocardial infarction (NSTEMI). ⋯ Many eligible patients do not receive early BB therapy. Treatment with early BBs may have a beneficial impact on hospital and 6-month mortality in all patients, including those presenting with heart failure.
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American heart journal · Dec 2006
Echocardiographic insights into atrial and ventricular mechanisms of functional tricuspid regurgitation.
The etiology of functional tricuspid regurgitation (TR) is thought to be annular dilatation and tethering of tricuspid valve (TV) leaflets. However, mechanisms of leaflet tethering are incompletely understood. The purpose of this study was therefore to investigate the relationships between TV annular dilatation and leaflet tethering with the severity of functional TR and to investigate factors that influence these TV deformations. ⋯ Tethering of TV leaflets, a determinant of functional TR, is associated with changes in right-sided cavity size as well as RV sphericity and LV function, emphasizing the impact of changes in ventricular geometry and function on the severity of functional TR.
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American heart journal · Nov 2006
Randomized Controlled Trial Multicenter StudyThe effects of perioperative beta-blockade: results of the Metoprolol after Vascular Surgery (MaVS) study, a randomized controlled trial.
Patients undergoing vascular surgery comprise the highest risk group for perioperative cardiac mortality and morbidity after noncardiac procedures. Many current guidelines recommend the use of beta-blockers in all patients undergoing vascular surgery. We report a trial of the perioperative administration of metoprolol and its effects on the incidence of cardiac complications at 30 days and 6 months after vascular surgery. ⋯ Our results showed metoprolol was not effective in reducing the 30-day and 6-month postoperative cardiac event rates. Prophylactic use of perioperative beta-blockers in all vascular patients is not indicated.
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American heart journal · Nov 2006
Influence of history of heart failure on diagnostic performance and utility of B-type natriuretic peptide testing for acute dyspnea in the emergency department.
The aim of this study was to assess the impact of a history of heart failure (HF) on emergency department (ED) B-type natriuretic peptide (BNP) testing and impact of feedback of BNP level to ED physicians. ⋯ B-type natriuretic peptide test performance for diagnosis of dyspnea cause is significantly reduced in patients with a history of HF and must be taken into consideration in the evaluation of such patients in the ED.
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American heart journal · Nov 2006
Rationale and design of a randomized, double-blind, placebo-controlled trial of ivabradine in patients with stable coronary artery disease and left ventricular systolic dysfunction: the morBidity-mortality EvAlUaTion of the I(f) inhibitor ivabradine in patients with coronary disease and left ventricULar dysfunction (BEAUTIFUL) study.
Raised resting heart rate (HR) is associated with increased cardiovascular and total mortality. Ivabradine is a new specific HR-reducing agent, which has been shown to have antianginal and anti-ischemic properties in patients with stable angina. Because patients with coronary artery disease and left ventricular dysfunction are at high risk of cardiac events and death, we hypothesized that they could derive particular benefit from a specific HR-lowering agent such as ivabradine. ⋯ BEAUTIFUL will be the first major outcome trial of a specific HR-reducing agent. The study results are expected in 2008.