American heart journal
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American heart journal · Feb 2003
Randomized Controlled Trial Clinical TrialComparison of dobutamine versus milrinone therapy in hospitalized patients awaiting cardiac transplantation: a prospective, randomized trial.
The use of dobutamine or milrinone for inotropic support in patients with heart failure awaiting cardiac transplantation is largely arbitrary and based on institutional preference. The costs and effectiveness of these drugs have yet to be compared in a prospective, randomized study. ⋯ Both dobutamine and milrinone can be used successfully as pharmacologic therapy for a bridge to heart transplantation. Despite similar clinical outcomes, treatment with milrinone incurs greater cost.
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American heart journal · Jan 2003
Frequency, patient characteristics, and outcomes of mild-to-moderate heart failure complicating ST-segment elevation acute myocardial infarction: lessons from 4 international fibrinolytic therapy trials.
There is a paucity of data on the incidence of mild-to-moderate heart failure (HF) complicating ST-segment elevation acute myocardial infarction (MI) and its impact on short-term outcomes. Our objective was to determine the incidence, timing, and consequences of mild-to-moderate HF complicating acute MI. ⋯ Mild-to-moderate HF is a frequent and ominous complication of MI, especially when it does not resolve or develops after admission.
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American heart journal · Jan 2003
Randomized Controlled Trial Clinical TrialLeft Atrial Appendage Occlusion Study (LAAOS): a randomized clinical trial of left atrial appendage occlusion during routine coronary artery bypass graft surgery for long-term stroke prevention.
Many patients undergoing coronary artery bypass graft (CABG) surgery have risk factors for both atrial fibrillation (AF) and stroke. The left atrial appendage (LAA) is a main source of thrombus coming from the left atrium. LAA occlusion should be tested as a means to reduce future cerebral ischemic events in these patients. ⋯ The clinical trial designed to evaluate LAA occlusion at the time of routine CABG surgery is currently in the pilot phase.
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American heart journal · Jan 2003
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialDouble-blind comparison between zofenopril and lisinopril in patients with acute myocardial infarction: results of the Survival of Myocardial Infarction Long-term Evaluation-2 (SMILE-2) study.
Angiotensin-converting enzyme (ACE) inhibitors have been reported to be effective in placebo-controlled trials in various subsets of patients with acute myocardial infarction (MI). However, no direct comparisons have been performed between different ACE inhibitors in the same patient population. ⋯ The SMILE-2 study demonstrates that both zofenopril and lisinopril are safe and associated with a rather low rate of severe hypotension when given in accordance with a dose-titrated scheme to thrombolyzed patients with acute MI. These findings could have a positive clinical impact and increase the proportion of patients with acute MI who can be safely treated with ACE inhibitors.
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American heart journal · Jan 2003
Clinical TrialFlow volume asymmetry in the right aortic arch in children with magnetic resonance phase encoded velocity mapping.
The right aortic arch is not uncommon in pediatrics. Flow dynamics in this type of aortic arch, which is important for cardiac energetics, organ perfusion, and Doppler flow calculations, have not been defined. Although there are complex secondary flow patterns, bulk axial flow makes up most of the energy use. ⋯ Flow volume asymmetry exists in the ascending and descending portions of the right aortic arch, which has implications for cardiac energetics, organ perfusion, and Doppler scanning flow calculations. This information may be useful in designing improved aortic surgical reconstructions in cases of congenital heart disease.