(Circulation. 1997;96:3294-3299.)
© 1997 American Heart Association, Inc.
Articles |
From the Brigham and Women's Hospital, Harvard Medical School, Boston, Mass, and University of Pennsylvania Medical Center (Philadelphia).
Correspondence to M. St. John Sutton, FRCP, Division of Cardiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104.
| Abstract |
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Methods and Results Two-dimensional echocardiograms were obtained in 512 patients at 11±3 days and 1 and 2 years postinfarction to assess LV size, percentage of the LV that was akinetic/dyskinetic (%AD), and LV shape index. LV function was assessed by radionuclide ejection fraction. Two hundred sixty-three patients (51.4%) sustained cardiovascular death and/or LV diastolic dilatation; 279 (54.5%) had cardiovascular death and/or systolic dilatation. In 373 patients with serial echocardiograms, LV end-diastolic and end-systolic sizes increased progressively from baseline to 2 years (both P<.01). More patients with LV dilatation had a decrease in ejection fraction: 24.8% versus 6.8% (P<.001) (diastole) and 25.7% versus 5.3% (P<.001) (systole). Captopril attenuated diastolic LV dilatation at 2 years (P=.048), but this effect was carried over from the first year of therapy because changes in LV size with captopril beyond 1 year were similar to those with placebo. Predictors of cardiovascular death and/or dilatation were age (P=.023), prior infarction (P<.001), lower ejection fraction (P<.001), angina (P=.007), heart failure (P=.002), LV size (P<.001), and infarct size (%AD) (P<.001).
Conclusions Cardiovascular death and/or LV dilatation occurred in >50% of patients by 2 years. LV dilatation is progressive, associated with chamber distortion and deteriorating function that is unaffected by captopril beyond 1 year.
Key Words: remodeling myocardial infarction trials
| Introduction |
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The aims of this study were to quantify the incidence of cardiovascular death and/or LV dilatation in a large population of survivors of acute MI from SAVE18 and to determine the impact of LV dilatation on LV chamber shape and function over a minimum of 2-year follow-up. We assessed whether LV dilatation continued beyond 1 year after MI and, if so, whether this late LV dilatation was attenuated by the continued administration of ACE inhibitor therapy. In addition, we wanted to determine whether any patient demographics or echocardiographic descriptors at baseline predicted increased risk for cardiovascular death and/or progressive LV dilatation.
| Methods |
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Transthoracic two-dimensional echocardiograms of the short axis of the LV were recorded from the left parasternal region at three levels: the mitral valve and the high and mid papillary muscle levels. The long axis of the LV was imaged from the apex in the four-chamber view and in either the apical long axis or apical two-chamber views.
All two-dimensional echocardiograms were submitted to the core laboratory at the Brigham and Women's Hospital for assessment of technical quality and suitability for quantitative analysis. The definition of a technically acceptable two-dimensional echocardiogram was one that included images of both the long and short axes of the LV in a minimum of three of the five views. Two-dimensional echocardiographic images were transferred to the hard disk of a Freeland Medical off-line computer analysis system and digitized to obtain LV cavity areas at end diastole and end systole. LV short-axis cavity areas were summed, and the average short-axis areas at end diastole and end systole were calculated. Similarly, LV long-axis cavity areas were summed, and average long-axis areas were calculated at end diastole and at end systole. Thus, LV size was quantified from multiple orthogonal echocardiographic views and defined as the sum of the average short-axis and average long-axis cavity areas at end diastole and end systole as described previously19 at baseline (mean, 11 days after MI) and 1 and 2 years after MI.
MI size was estimated by two-dimensional echocardiography as the percentage of the total LV cavity perimeter that was either akinetic or dyskinetic in each of the multiple echocardiographic images, and the average value for all images (%AD) was calculated, similar to that described angiographically.29
LV shape index, calculated as the ratio of the average LV short-axis cavity area to average long-axis cavity area at end diastole and end systole, was used as a measure of LV distortion (a ratio of unity would represent a sphere).
LV myocardial areas at end diastole and end systole were calculated from the three parasternal LV short-axis echocardiographic images by subtracting the cavity area from the total epicardial area. The ratio of myocardial to cavity area was used as a surrogate for the ratio of LV mass to volume and is an indirect indicator of wall tension.
LV dilatation was defined using the previously reported two-dimensional echocardiographic reproducibility analysis19 as an increase in LV end-diastolic or end-systolic area above baseline values of >1.96 times the SDs of the difference between the three independent assessments of LV size.19 The overall incidence of post-MI LV dilatation and/or death was an objective ascertainment independent of treatment assignment.
The incidences of LV dilatation in patients randomized to treatment with placebo or captopril were compared at 1 and 2 years after MI, and the interval change from 1 to 2 years was calculated in the two-treatment groups to determine whether LV dilatation occurring beyond 1 year was attenuated by the continued long-term therapy with the ACE inhibitor captopril.
In surviving patients, the effect of LV dilatation on LV function was evaluated with radionuclide angiography. Decreased LV function was defined as a reduction in ejection fraction of >9 units from baseline to the repeat study at the end of the trial. The 9-unit decrease in LV ejection fraction was prespecified18 as an important change in radionuclide ejection fraction that was unlikely to be produced by a technical difference but rather result from a biological change.18
To identify potential predictors of death and/or progressive LV dilatation, we assessed the relationships among the clinical demographics, echocardiographic measurements at baseline, and progressive LV dilatation. The clinical demographics examined included age; sex; heart rate; blood pressure; history of hypertension, diabetes, or prior MI; radionuclide ejection fraction; use of thrombolytic agents, aspirin, diuretics, or ß-adrenergic receptor blockers; percutaneous angioplasty, coronary artery bypass graft surgery, heart failure, and angina. Baseline echocardiographic measurements were entered into this analysis individually. These measurements included LV cavity areas at end diastole and end systole, an estimate of %AD, LV cavity shape, and the ratio of LV short-axis myocardial-to-cavity areas.
Statistical Analysis
Changes in echocardiographic measurements
over time were assessed using two-way repeated measures ANOVA, with
time being the "within-subjects" variable. Assessment of the
effect of therapy over time was made by evaluating the interaction term
in the model. Patients were considered to have developed LV dilatation
if they met the criteria previously reported in the SAVE
echocardiographic substudy, which was based on the
reproducibility analysis.19
Cardiovascular cause of death was established in every
case by the mortality committee as described in the parent
trial.18 The analyses for predictors of
dilatation required the creation of a "time to first dilatation"
variable. The event of dilatation and the time of dilatation were
noted for each patient in the cohort. If patients did not develop LV
dilatation, they were censored (ie, removed from the analysis
as a nonevent) at the time of their 2-year echocardiogram. This allowed
a Cox proportional hazard analysis, in which we examined the
relationships with the occurrence of dilatation, with the time of
occurrence being the dependent variable. We were able to examine
the relationship between independent variables and the time to
first dilatation. The P value, relative risk, and confidence
intervals provided for changes in the independent variables are
based on the Cox analysis.
| Results |
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Of the 373 survivors who had serial echocardiograms at baseline and 1
and 2 years; LV end-diastolic cavity area increased
progressively from a mean value of 69.6±11.7 cm2
at baseline to 72.1±13.3 cm2 at 1 year
(P<.01), and 73.0±14.8 cm2
(P=.02) at 2 years (Fig 1
). LV
end-systolic cavity area increased progressively from a mean of
49.7±11.1 cm2 at baseline to 52.3±14.0
cm2 at 1 year (P<.01) and 53.7±16.2
cm2 (P<.001) at 2 years (Fig 1
). The
number of 2-year survivors who developed LV dilatation, defined by the
strict criteria based on the reproducibility analysis, was 113
of 373 (30.3%) at end diastole (P<.01) and 125
of 373 (33.5%) at end systole (P<.01) at 1 year; this
increased further to 132 of 373 (35.4%) at end diastole
(P<.01) and 144 of 373 (38.6%) at end systole
(P<.01) at 2 years, regardless of treatment assignment (Fig 2
). The effect of captopril on LV
enlargement in patients at 1 year has been demonstrated in SAVE
patients.19 In this study, we evaluated the
treatment effect of captopril on the number of patients who developed
LV dilatation and on LV dilatation per se beyond 1 year compared with
placebo (Fig 3
). At 2 years, captopril
was still efficacious in attenuating LV dilatation in
diastole (P=.048) (Fig 4
); however, the attenuation of LV
dilatation beyond 1 year was a "carried over" effect from the first
year of therapy, after which LV sizes at end diastole and
end systole in the captopril increased in parallel with the placebo
treatment group (Fig 4
). This was best demonstrated by comparing the
interval changes in LV size at end diastole and at end
systole between 1 and 2 years, which were similar in the captopril
versus the placebo treatment arms in the 373 patients who survived and
had serial echocardiograms (Table 1
).
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LV dilatation from baseline through 2-year follow-up was
associated with progressive LV distortion with increase in the LV shape
index toward a more spherical configuration (Table 2
, Fig 5
).
In patients who met the criteria for LV dilatation, the degree of
distortion to a more spherical ventricle was even greater (Table 2
, Fig 5
).
|
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Progressive LV dilatation was also accompanied by deterioration in LV
performance, shown by the greater number of patients who
experienced a 9-unit fall in radionuclide ejection fraction from
baseline to the end of study. Of the 373 2-year survivors, 362 (97%)
had both initial and end-of-study radionuclide ejection fractions
determined, whereas 11 had no end-of-study ejection fraction
determination. Forty-seven of the 362 patients (13%) had a fall in
ejection fraction of >9 units. A significantly greater proportion of
patients who met the criteria for LV dilatation had a 9-unit fall in
ejection fraction: 24.8% with diastolic dilatation versus
6.8% without dilatation (P<.001) and 25.7% with
systolic LV dilatation versus 5.3% without dilatation
(P<.001) by 2 years after MI (Table 3
).
|
Of the multiple baseline clinical and echocardiographic
demographics assessed in a Cox proportional hazard model, patient age
(P=.023), a history of prior MI (P<.001), lower
radionuclide LV ejection fraction (P<.001), development of
angina (P=.007), baseline heart failure (P=.002),
use of diuretics (P=.018), presence of an S3 gallop
(P=.03), increased heart rate (P=.009), baseline
echocardiographic measures of LV areas at end
diastole (P<.001) and at end systole
(P<.001), and MI size (%AD) (P<.001) all
predicted cardiovascular death and/or LV dilatation
(Table 4
). In addition, two-dimensional
echocardiographic estimates of cavity shape index and
muscle-to-cavity area ratio were strongly predictive of
cardiovascular death (P=.003;
P<.001) and development of severe heart failure
(P=.006; P=.002) but did not predict repeat MI
(Table 5
).
|
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| Discussion |
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This prospective study of a large cohort of after MI patients with
impaired LV function (ejection fractions <40%) demonstrates that
>50% sustain cardiovascular death and/or develop LV
dilatation during the initial 3.5-year follow-up period. Of the
survivors of acute MI who had serial echocardiograms at baseline and 1
and 2 years; more than one third had developed LV dilatation by 2
years. This latter figure underestimates the true incidence of LV
dilatation after MI because this subanalysis required that all
patients survive 2 years and censored the highest-risk group of
patients who died from a cardiovascular cause within
the 2 years of follow-up (89 patients). Importantly, there was
progressive LV dilatation beyond 1 year with significant increases in
the mean values for diastolic and systolic cavity
areas from baseline to 1 year and from 1 to 2 years, indicating that in
a proportion of patients, LV remodeling continues insidiously. In this
SAVE echocardiographic study population, LV dilatation
after MI correlated with the echocardiographic estimate
of MI size at baseline (%AD) (Table 4
). In addition, increasing LV
size at end diastole and end systole was associated with
increasing distortion of cavity shape and progressive deterioration in
LV performance compared with those who did not develop
ventricular dilatation35 (Tables 2
and 3
; Fig 5
).
Deterioration in LV function with progressive LV dilatation was
demonstrated by the significantly larger number of patients who
experienced a 9-unit reduction in radionuclide ejection fraction (from
baseline to the end of study), in whom there was a threefold to
fourfold increased risk of death compared with patients who did not
develop LV dilatation. In a previous study, we demonstrated that LV
dilatation is strongly associated with adverse
cardiovascular events at long-term
follow-up.19 Echocardiographic
estimates of baseline LV ratio of short-axis muscle to cavity area and
of shape index used in this study also emerged as powerful predictors
of survival and adverse cardiovascular events (Tables 4
and 5
).
Progressive LV dilatation is not a universal finding after MI even in SAVE patients with LV dysfunction and ejection fractions of <40%. Although the precise mechanisms by which LV dilatation is obviated after MI have not been elucidated, it may relate to the combination of a number of factors, including patency of the infarct-related coronary artery,30,31 recovery of stunning, blunting of neurohormonal activation,8 interaction between neurohormones and the fibrinolytic system, initial MI size,4 and adequate LV hypertrophy to normalize wall stress, reduce wall tension, and minimize LV dilatation and distortion.
Post-MI LV remodeling has generally been regarded as a process that is completed over a period of months, as the myocardium remote from the infarct zone dilates and hypertrophies to offset the change in loading conditions induced by the early loss of contractile elements when the repair of the infarct zone is completed histologically. Our study indicates that LV dilatation can continue beyond 1 year, long after the infarct repair is completed; with further increases in end-diastolic and end-systolic chamber sizes occurring in more than one third of survivors by 2 years.
Early LV dilatation after MI can be attenuated by the administration of ACE inhibitors,13-20 and the linkage between attenuation of LV dilatation and reduction in adverse cardiovascular events has been demonstrated.19 Although the effect of ACE inhibitor therapy on attenuating LV dilatation was still present at 2 years compared with placebo; this effect was a "carry over" from the initial year of therapy. Evidence for this was that there were parallel increases in LV end-diastolic and end-systolic sizes beyond 1 year in the captopril and placebo treatment groups such that the interval changes between 1 and 2 years were similar in the two groups. This novel observation suggests that patients appeared to "escape" from ACE inhibitor therapy beyond 1 year in terms of its impact on attenuation of LV dilatation.
Early identification of patients prone to
cardiovascular death and LV dilatation is of paramount
importance to stratify those at high risk in whom prolonged treatment
(up to 1 year) might reduce the likelihood of severe adverse
cardiovascular events. LV end-systolic size and
ejection fraction have been previously shown to be powerful predictors
of survival9,10,19; in the present study, we
demonstrated that echocardiographic estimates of
infarct size, myocardial-to-cavity area ratio, and cavity distortion
(shape index) also correlated strongly with
cardiovascular death and severe congestive heart
failure, although not with repeat MI (Tables 2
, 4
, and 5
). Because
little information is available regarding baseline demographics that
predict cardiovascular death and/or progressive LV
dilatation, we examined a large number of baseline clinical
demographics, LV geometry by transthoracic
echocardiography, and therapeutic interventions
that are all well known to have a direct impact on survival. The
baseline descriptors that predicted cardiovascular
death and/or progressive LV dilatation were patient age, resting
radionuclide ejection fraction, history of prior MI, development of
angina, baseline heart failure (increased resting heart rate, an S3
gallop, use of diuretics), and
echocardiographic measurements of LV cavity areas and
%AD (Table 4
).
We conclude from this large cohort of SAVE patients that cardiovascular death and/or LV dilatation occurs in >50% of survivors of acute MI with LV dysfunction in the initial 3.5 years of follow-up. Progressive LV dilatation is associated with distortion of ventricular shape, deterioration in systolic function, and increased risk of adverse cardiovascular events. Late LV dilatation beyond 1 year appears to be refractory to continued treatment with captopril in this study, indicating that patients may escape from the attenuating effect of ACE inhibitor therapy on LV dilatation. Patients with a history of prior MI, low ejection fraction, early heart failure, or older age and those demonstrating continued changes in echocardiographic indices of LV geometry and function identify a particularly high-risk group for progressive dilatation and adverse cardiovascular events.
| Selected Abbreviations and Acronyms |
|---|
|
Received June 19, 1997; accepted August 2, 1997.
| References |
|---|
|
|
|---|
2. Erlebacher JA, Weiss JL, Easton LW, Kallman C, Weisfeldt ML, Bulkley BH. Late effects of acute infarct dilatation on heart size: a two-dimensional echocardiographic study. Am J Cardiol. 1982;49:1120-1126.[Medline] [Order article via Infotrieve]
3. Erlebacher JA, Weiss JL, Bulkley BJ, Weisfeldt ML. Early dilation of the infarcted segment in acute transmural myocardial infarction: role of infarct expansion in acute left ventricular enlargement. J Am Coll Cardiol. 1984;4:201-08.[Abstract]
4.
Pfeffer MA, Braunwald E. Ventricular
remodeling after myocardial infarction: experimental observations and
clinical implications. Circulation. 1990;81:1161-1172.
5.
Pfeffer JM, Pfeffer MA, Fletcher PJ, Braunwald E.
Progressive ventricular remodeling in rat with myocardial
infarction. Am J Physiol. 1991;260:H1406-H1414.
6.
Gaudron P, Eilles C, Kugler I, Ertl G. Progressive
left ventricular dysfunction and remodeling after
myocardial infarction. Circulation. 1993;87:755-763.
7.
McAlpine HM, Morton JJ, Leckie B, Rumley A, Gillen G,
Dargie HJ. Neuroendocrine activation after acute myocardial
infarction. Br Heart J. 1988;60:117-124.
8. Rouleau JL, de Champlain J, Klein M, Bichet D, Moye L, Packer M, Dagenais GR, Sussex B, Arnold JM, Sestier F, Parker JO, McEwan P, Bernstein V, Cuddy E, Lamas GA, Gottlieb SS, McCans J, Nadeau C, Delage F, Hamm P, Pfeffer MA. Activation of neurohumoral systems in post infarction left ventricular dysfunction. J Am Coll Cardiol. 1993;22:390-8.[Abstract]
9. Norris RM, Barnaby PF, Brandt PWT, Geary GG, Whitlock RML, Wild CJ, Barratt-Boyes BG. Prognosis after recovery from first acute myocardial infarction: determinants of reinfarction and sudden death. Am J Cardiol. 1984;53:408-413.[Medline] [Order article via Infotrieve]
10.
White HD, Norris RM, Brown MA, Brandt PWT, Whitlock
RML, Wild CJ. Left ventricular end-systolic volume
as the major determinant of survival after recovery from myocardial
infarction. Circulation. 1987;76:44-51.
11. Warren SE, Royal H, Markis JE, Grossman W, McKay R. Time course of left ventricular dilation after myocardial infarction: influence of infarct-related artery and success of coronary thrombolysis. J Am Coll Cardiol. 1988;11:12-19.[Abstract]
12. Jeremy RW, Allman KC, Bautovitch G, Harris PJ. Patterns of left ventricular dilation during the six months after myocardial infarction. J Am Coll Cardiol. 1989;13:304-310.[Abstract]
13.
Ertl G, Kloner RA, Alexander RA, Braunwald E.
Limitation of experimental infarct size by an
angiotensin-converting enzyme inhibitor.
Circulation. 1982;65:40-48.
14.
Pfeffer JM, Pfeffer MA, Braunwald E. Influence of
chronic captopril therapy on the infarcted left ventricle of the rat.
Circ Res. 1985;57:84-95.
15.
Pfeffer MA, Pfeffer JM, Steinberg C, Finn P. Survival
after an experimental myocardial infarction: beneficial effects of
long-term therapy with captopril. Circulation. 1985;72:406-412.
16. Pfeffer MA, Lamas GA, Vaughan DE, Parisi AF, Braunwald E. Effect of captopril on progressive ventricular dilatation after anterior myocardial infarction. N Engl J Med. 1988;319:80-86.[Abstract]
17. Sharpe N, Smith H, Murphy J, Greaves S, Hart H, Gamble G. Early prevention of left ventricular dysfunction after myocardial infarction with angiotensin converting enzyme inhibition. Lancet. 1991;337:872-876.[Medline] [Order article via Infotrieve]
18. Pfeffer MA, Braunwald E, Moye LA, Basta L, Brown EJ, Cuddy TE, Davis BR, Geltman EM, Godman S, Flaker GC, Klein M, Lamas GA, Packer M, Rouleau J, Rouleau JL, Rutherford JR, Wertheimer JH, Hawkins CM, on behalf of the SAVE Investigators. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction: results of the Survival and Ventricular Enlargement Trial. N Engl J Med. 1992;327:669-677.[Abstract]
19.
St John Sutton M, Pfeffer MA, Plappert T, Rouleau J-L,
Moye LA, Dagenais GR, Lamas GA, Klein M, Sussex B, Goldman S, Menapace
FJ, Parker JO, Lewis S, Sestier F, Gorrdon DF, McEwan P, Bernstein V,
Braunwald E. Quantitative two-dimensional
echocardiographic measurements are major predictors of
adverse cardiovascular events after acute myocardial
infarction: the protective effects of captopril.
Circulation. 1994;89:68-75.
20.
Greenberg B, Quinones MA, Koilpillai C, Limacher M,
Shindler D, Benedict C, Shelton B, for the SOLVD Investigators. Effects
of long-term enalapril therapy on cardiac structure and function in
patients with left ventricular dysfunction. results of the
SOLVD Echocardiography Substudy.
Circulation. 1995;91:2573-2581.
21. The SOLVD Investigators. Effect of enalopril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fraction. N Engl J Med. 1992;327:685-691.[Abstract]
22. The Acute Infarction Ramipril Efficacy (AIRE) Study Investigators. Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure. Lancet. 1993;342:821-828.[Medline] [Order article via Infotrieve]
23. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-3). Effects of lisinopril and transdermal glyceryl trinitrate singly and together on 6-week mortality and ventricular function after acute myocardial infarction. Lancet. 1994;343:1115-1122.[Medline] [Order article via Infotrieve]
24.
Ambrosioni E, Borghi C, Magnani B, for the Survival of
Myocardial Infarction Long-term Evaluation (SMILE) Study Investigators.
The effect of the angiotensin-converting-enzyme
inhibitor zofenopril on mortality and morbidity after
anterior myocardial infarction. N Engl J Med. 1995;332:80-85.
25. Foy SG, Crozier IG, Turner JG, Richards AM, Frampton CM, Nicholls MG, Ikram H. Comparison of enalapril vs captopril on left ventricular function and survival three months after acute myocardial infarction (the `PRACTICAL' Study). Am J Cardiol. 1994;73:1180-1186.[Medline] [Order article via Infotrieve]
26. ISIS-4 Collaborative Group. Fourth International Study of Infarct Survival: a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. Lancet. 1995;345:669-685.[Medline] [Order article via Infotrieve]
27. Chinese Cardiac Study Collaborative Group. Oral captopril versus placebo among 13 634 patients with suspected acute myocardial infarction: interim report from the Chinese Cardiac Study (CCS-1). Lancet. 1995;345:686-687.[Medline] [Order article via Infotrieve]
28.
Pfeffer MA. ACE inhibition in acute myocardial
infarction. N Engl J Med. 1995;332:118-120.
29. Lamas GA, Pfeffer MA. Increased left ventricular volume following myocardial infarction in man. Am Heart J. 1986;111:30-35.[Medline] [Order article via Infotrieve]
30. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17 187 cases of suspected acute myocardial infarction. ISIS-2. Lancet. 1988;2:349-360.[Medline] [Order article via Infotrieve]
31. Jeremy RW, Hackworthy RA, Bautovitch G, Hutton BF, Harris PJ. Infarct artery perfusion and changes in left ventricular volume in the month after acute myocardial infarction. J Am Coll Cardiol. 1987;9:989-995.[Abstract]
32.
The GUSTO Angiographic Investigators. The effects of
tissue plasminogen activator, streptokinase, or
both on coronary-artery patency, ventricular
function, and survival after acute myocardial infarction. N
Engl J Med. 1993;329:1615-1622.
33.
Kingma JH, van Gilst WH, Peels CH, Dambrink J-HE,
Verheught FWA, Wielenga RP, for the CATS Investigators. Acute
intervention with captopril during thrombolysis in
patients with first anterior myocardial infarction: results from the
Captopril and Thrombolysis Study (CATS). Eur
Heart J. 1994;15:898-907.
34.
Olivetti G, Capasso JM, Sonnenblick EH, Anversa P.
Side-to-side slippage of myocytes participates in
ventricular wall remodelling acutely after myocardial
infarction in rats. Circ Res.. 1990;67:23-34.
35. Mitchell GF, Lamas GA, Vaughan DE, Pfeffer MA. Left ventricular remodeling in the year after first anterior myocardial infarction: a quantitative analysis of contractile segment lengths and ventricular shape. J Am Coll Cardiol. 1992;19:1136-1144.[Abstract]
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H. Sakamoto, L. M. Parish, H. Hamamoto, L. P. Ryan, T. J. Eperjesi, T. J. Plappert, B. M. Jackson, M. G. St John-Sutton, J. H. Gorman III, and R. C. Gorman Effect of Reperfusion on Left Ventricular Regional Remodeling Strains After Myocardial Infarction Ann. Thorac. Surg., November 1, 2007; 84(5): 1528 - 1536. [Abstract] [Full Text] [PDF] |
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C. Adamopoulos, F. Zannad, R. Fay, A. Mebazaa, A. Cohen-Solal, L. Guize, Y. Juilliere, and F. Alla Ejection fraction and blood pressure are important and interactive predictors of 4-week mortality in severe acute heart failure Eur J Heart Fail, September 1, 2007; 9(9): 935 - 941. [Abstract] [Full Text] [PDF] |
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M. Tumkosit, C. G. Martin, E. Bayram, T. M. Morgan, K. S. Lane, P. Rerkpattanapipat, C. A. Hamilton, K. M. Link, and W. G. Hundley Left Ventricular Spherical Remodeling and Apical Myocardial Relaxation: Cardiovascular MR Imaging Measurement of Myocardial Segments Radiology, August 1, 2007; 244(2): 411 - 418. [Abstract] [Full Text] [PDF] |
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R. A. Kloner and D. S. Cannom Uncertainty on the Use of Aldosterone Antagonists for Primary Therapy for Sudden Cardiac Death in the Setting of Implanted Devices Circulation, June 12, 2007; 115(23): 2983 - 2989. [Full Text] [PDF] |
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G. Andreka, M. Vertesaljai, G. Szantho, G. Font, Z. Piroth, G. Fontos, E. D Juhasz, L. Szekely, Z. Szelid, M. S Turner, et al. Remote ischaemic postconditioning protects the heart during acute myocardial infarction in pigs Heart, June 1, 2007; 93(6): 749 - 752. [Abstract] [Full Text] [PDF] |
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K. McDonald, C. Conlon, and M. Ledwidge Disease management programs for heart failure: Not just for the 'sick' heart failure population Eur J Heart Fail, February 1, 2007; 9(2): 113 - 117. [Abstract] [Full Text] [PDF] |
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J. Abdulla, S. Barlera, R. Latini, L. Kjoller-Hansen, P. Sogaard, E. Christensen, L. Kober, and C. Torp-Pedersen A systematic review: Effect of angiotensin converting enzyme inhibition on left ventricular volumes and ejection fraction in patients with a myocardial infarction and in patients with left ventricular dysfunction Eur J Heart Fail, February 1, 2007; 9(2): 129 - 135. [Abstract] [Full Text] [PDF] |
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D. Aronson, N. Goldsher, R. Zukermann, M. Kapeliovich, J. Lessick, D. Mutlak, S. Dabbah, W. Markiewicz, R. Beyar, H. Hammerman, et al. Ischemic Mitral Regurgitation and Risk of Heart Failure After Myocardial Infarction Arch Intern Med, November 27, 2006; 166(21): 2362 - 2368. [Abstract] [Full Text] [PDF] |
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R. Zhou, P. D. Acton, and V. A. Ferrari Imaging Stem Cells Implanted in Infarcted Myocardium J. Am. Coll. Cardiol., November 21, 2006; 48(10): 2094 - 2106. [Abstract] [Full Text] [PDF] |
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D. Burkhoff and A. S. Wechsler Surgical ventricular remodeling: A balancing act on systolic and diastolic properties. J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 459 - 463. [Full Text] [PDF] |
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X.-J. Du, X.-M. Gao, H. Kiriazis, X.-L. Moore, Z. Ming, Y. Su, A. M. Finch, R. A. Hannan, A. M. Dart, and R. M. Graham Transgenic {alpha}1A-adrenergic activation limits post-infarct ventricular remodeling and dysfunction and improves survival Cardiovasc Res, September 1, 2006; 71(4): 735 - 743. [Abstract] [Full Text] [PDF] |
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B. Silke Beta-blockade in CHF: pathophysiological considerations Eur. Heart J. Suppl., June 1, 2006; 8(suppl_C): C13 - C18. [Abstract] [Full Text] [PDF] |
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M. F. Berry, A. J. Engler, Y. J. Woo, T. J. Pirolli, L. T. Bish, V. Jayasankar, K. J. Morine, T. J. Gardner, D. E. Discher, and H. L. Sweeney Mesenchymal stem cell injection after myocardial infarction improves myocardial compliance Am J Physiol Heart Circ Physiol, June 1, 2006; 290(6): H2196 - H2203. [Abstract] [Full Text] [PDF] |
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R. M. Lang, M. Bierig, R. B. Devereux, F. A. Flachskampf, E. Foster, P. A. Pellikka, M. H. Picard, M. J. Roman, J. Seward, J. Shanewise, et al. Recommendations for chamber quantification Eur J Echocardiogr, March 1, 2006; 7(2): 79 - 108. [Abstract] [Full Text] [PDF] |
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D. Vanhoutte, M. Schellings, Y. Pinto, and S. Heymans Relevance of matrix metalloproteinases and their inhibitors after myocardial infarction: A temporal and spatial window Cardiovasc Res, February 15, 2006; 69(3): 604 - 613. [Abstract] [Full Text] [PDF] |
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G. A. Ribeiro, C. E. da Costa, M. M. Lopes, A. N. Albuquerque, F. Antoniali, G. A. A. Reinert, and K. G. Franchini Left ventricular reconstruction benefits patients with ischemic cardiomyopathy and non-viable myocardium Eur. J. Cardiothorac. Surg., February 1, 2006; 29(2): 196 - 201. [Abstract] [Full Text] [PDF] |
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S. D. Solomon, N. Anavekar, H. Skali, J. J.V. McMurray, K. Swedberg, S. Yusuf, C. B. Granger, E. L. Michelson, D. Wang, S. Pocock, et al. Influence of Ejection Fraction on Cardiovascular Outcomes in a Broad Spectrum of Heart Failure Patients Circulation, December 13, 2005; 112(24): 3738 - 3744. [Abstract] [Full Text] [PDF] |
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S. H. Hohnloser Ventricular Arrhythmias: Antiadrenergic Therapy for the Patient with Coronary Artery Disease Journal of Cardiovascular Pharmacology and Therapeutics, October 1, 2005; 10(4_suppl): S23 - S31. [Abstract] [PDF] |
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A. S. Blom, R. Mukherjee, J. J. Pilla, A. S. Lowry, W. M. Yarbrough, J. T. Mingoia, J. W. Hendrick, R. E. Stroud, J. E. McLean, J. Affuso, et al. Cardiac Support Device Modifies Left Ventricular Geometry and Myocardial Structure After Myocardial Infarction Circulation, August 30, 2005; 112(9): 1274 - 1283. [Abstract] [Full Text] [PDF] |
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M. H. Drazner The Transition From Hypertrophy to Failure: How Certain Are We? Circulation, August 16, 2005; 112(7): 936 - 938. [Full Text] [PDF] |
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R. A. Levine and E. Schwammenthal Ischemic Mitral Regurgitation on the Threshold of a Solution: From Paradoxes to Unifying Concepts Circulation, August 2, 2005; 112(5): 745 - 758. [Full Text] [PDF] |
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S. D. Solomon, H. Skali, N. S. Anavekar, M. Bourgoun, S. Barvik, J. K. Ghali, J. W. Warnica, M. Khrakovskaya, J. M. O. Arnold, Y. Schwartz, et al. Changes in Ventricular Size and Function in Patients Treated With Valsartan, Captopril, or Both After Myocardial Infarction Circulation, June 28, 2005; 111(25): 3411 - 3419. [Abstract] [Full Text] [PDF] |
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K. O. Akosah, A. M. Schaper, L. M. Haus, M. A. Mathiason, S. I. Barnhart, and V. L. McHugh Improving Outcomes in Heart Failure in the Community: Long-term Survival Benefit of a Disease-Management Program Chest, June 1, 2005; 127(6): 2042 - 2048. [Abstract] [Full Text] [PDF] |
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J G F Cleland, A Torabi, and N K Khan Epidemiology and management of heart failure and left ventricular systolic dysfunction in the aftermath of a myocardial infarction Heart, May 1, 2005; 91(suppl_2): ii7 - ii13. [Abstract] [Full Text] [PDF] |
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P. A. Grayburn, C. P. Appleton, A. N. DeMaria, B. Greenberg, B. Lowes, J. Oh, J. F. Plehn, P. Rahko, M. St. John Sutton, E. J. Eichhorn, et al. Echocardiographic predictors of morbidity and mortality in patients with advanced heart failure: The Beta-blocker Evaluation of Survival Trial (BEST) J. Am. Coll. Cardiol., April 5, 2005; 45(7): 1064 - 1071. [Abstract] [Full Text] [PDF] |
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R. Hoffmann, S. von Bardeleben, F. ten Cate, A. C. Borges, J. Kasprzak, C. Firschke, S. Lafitte, N. Al-Saadi, S. Kuntz-Hehner, M. Engelhardt, et al. Assessment of systolic left ventricular function: a multi-centre comparison of cineventriculography, cardiac magnetic resonance imaging, unenhanced and contrast-enhanced echocardiography Eur. Heart J., March 2, 2005; 26(6): 607 - 616. [Abstract] [Full Text] [PDF] |
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F. Bursi, M. Enriquez-Sarano, V. T. Nkomo, S. J. Jacobsen, S. A. Weston, R. A. Meverden, and V. L. Roger Heart Failure and Death After Myocardial Infarction in the Community: The Emerging Role of Mitral Regurgitation Circulation, January 25, 2005; 111(3): 295 - 301. [Abstract] [Full Text] [PDF] |
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A. Schuh, S. Breuer, R. Al Dashti, N. Sulemanjee, P. Hanrath, C. Weber, B. F. Uretsky, and E. R. Schwarz Administration of Vascular Endothelial Growth Factor Adjunctive to Fetal Cardiomyocyte Transplantation and Improvement of Cardiac Function in the Rat Model Journal of Cardiovascular Pharmacology and Therapeutics, January 1, 2005; 10(1): 55 - 66. [Abstract] [PDF] |
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M. F. Berry, T. J. Pirolli, V. Jayasankar, K. J. Morine, M. A. Moise, O. Fisher, T. J. Gardner, P. H. Patterson, and Y. J. Woo Targeted overexpression of leukemia inhibitory factor to preserve myocardium in a rat model of postinfarction heart failure J. Thorac. Cardiovasc. Surg., December 1, 2004; 128(6): 866 - 875. [Abstract] [Full Text] [PDF] |
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S. D. Solomon, D. Wang, P. Finn, H. Skali, L. Zornoff, J. J.V. McMurray, K. Swedberg, S. Yusuf, C. B. Granger, E. L. Michelson, et al. Effect of Candesartan on Cause-Specific Mortality in Heart Failure Patients: The Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity (CHARM) Program Circulation, October 12, 2004; 110(15): 2180 - 2183. [Abstract] [Full Text] [PDF] |
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G. Heusch Postconditioning: Old wine in a new bottle? J. Am. Coll. Cardiol., September 1, 2004; 44(5): 1111 - 1112. [Full Text] [PDF] |
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B. Pieske Reverse remodeling in heart failure - fact or fiction? Eur. Heart J. Suppl., August 1, 2004; 6(suppl_D): D66 - D78. [Abstract] [Full Text] [PDF] |
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M. Cirillo, A. Amaducci, F. Brunelli, M. Dalla Tomba, P. Parrella, G. Tasca, G. Troise, and E. Quaini Determinants of postinfarction remodeling affect outcome and left ventricular geometry after surgical treatment of ischemic cardiomyopathy J. Thorac. Cardiovasc. Surg., June 1, 2004; 127(6): 1648 - 1656. [Abstract] [Full Text] [PDF] |
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H. F.J Mannaerts, J. A van der Heide, O. Kamp, M. G Stoel, J. Twisk, and C. A Visser Early identification of left ventricular remodelling after myocardial infarction, assessed by transthoracic 3D echocardiography Eur. Heart J., April 2, 2004; 25(8): 680 - 687. [Abstract] [Full Text] [PDF] |
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K. Shan, G. Constantine, M. Sivananthan, and S. D. Flamm Role of Cardiac Magnetic Resonance Imaging in the Assessment of Myocardial Viability Circulation, March 23, 2004; 109(11): 1328 - 1334. [Full Text] [PDF] |
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T. S. Guy IV, S. L. Moainie, J. H. Gorman III, B. M. Jackson, T. Plappert, Y. Enomoto, M. G. St. John-Sutton, L. H. Edmunds Jr, and R. C. Gorman Prevention of ischemic mitral regurgitation does not influence the outcome of remodeling after posterolateral myocardial infarction J. Am. Coll. Cardiol., February 4, 2004; 43(3): 377 - 383. [Abstract] [Full Text] [PDF] |
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R. A. Ahokas, K. J. Warrington, I. C. Gerling, Y. Sun, L. A. Wodi, P. A. Herring, L. Lu, S. K. Bhattacharya, A. E. Postlethwaite, and K. T. Weber Aldosteronism and Peripheral Blood Mononuclear Cell Activation: A Neuroendocrine-Immune Interface Circ. Res., November 14, 2003; 93 (10): e124 - e135. [Abstract] [Full Text] [PDF] |
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L. Tavazzi Heart rate as a therapeutic target in heart failure? Eur. Heart J. Suppl., September 1, 2003; 5(suppl_G): G15 - G18. [Abstract] [PDF] |
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E. M. Wilson, S. L. Moainie, J. M. Baskin, A. S. Lowry, A. M. Deschamps, R. Mukherjee, T. S. Guy, M. G. St John-Sutton, J. H. Gorman III, L. H. Edmunds Jr, et al. Region- and Type-Specific Induction of Matrix Metalloproteinases in Post-Myocardial Infarction Remodeling Circulation, June 10, 2003; 107(22): 2857 - 2863. [Abstract] [Full Text] [PDF] |
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M. St John Sutton, D. Lee, J. L. Rouleau, S. Goldman, T. Plappert, E. Braunwald, and M. A. Pfeffer Left Ventricular Remodeling and Ventricular Arrhythmias After Myocardial Infarction Circulation, May 27, 2003; 107(20): 2577 - 2582. [Abstract] [Full Text] [PDF] |
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M. G. St John Sutton, T. Plappert, W. T. Abraham, A. L. Smith, D. B. DeLurgio, A. R. Leon, E. Loh, D. Z. Kocovic, W. G. Fisher, M. Ellestad, et al. Effect of Cardiac Resynchronization Therapy on Left Ventricular Size and Function in Chronic Heart Failure Circulation, April 22, 2003; 107(15): 1985 - 1990. [Abstract] [Full Text] [PDF] |
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A. T. Askari, M.-L. Brennan, X. Zhou, J. Drinko, A. Morehead, J. D. Thomas, E. J. Topol, S. L. Hazen, and M. S. Penn Myeloperoxidase and Plasminogen Activator Inhibitor 1 Play a Central Role in Ventricular Remodeling after Myocardial Infarction J. Exp. Med., March 3, 2003; 197(5): 615 - 624. [Abstract] [Full Text] [PDF] |
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R. Mukherjee, T. A. Brinsa, K. B. Dowdy, A. A. Scott, J. M. Baskin, A. M. Deschamps, A. S. Lowry, G. P. Escobar, D. G. Lucas, W. M. Yarbrough, et al. Myocardial Infarct Expansion and Matrix Metalloproteinase Inhibition Circulation, February 4, 2003; 107(4): 618 - 625. [Abstract] [Full Text] [PDF] |
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B. M. Jackson, J. H. Gorman III, I. S. Salgo, S. L. Moainie, T. Plappert, M. St. John-Sutton, L. H. Edmunds Jr., and R. C. Gorman Border zone geometry increases wall stress after myocardial infarction: contrast echocardiographic assessment Am J Physiol Heart Circ Physiol, February 1, 2003; 284(2): H475 - H479. [Abstract] [Full Text] [PDF] |
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K.-H. Mak, K.-S. Chia, J.D. Kark, T. Chua, C. Tan, B.-H. Foong, Y.-L. Lim, and S.-K. Chew Ethnic differences in acute myocardial infarction in Singapore Eur. Heart J., January 2, 2003; 24(2): 151 - 160. [Abstract] [Full Text] [PDF] |
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E. Lonn, H.C. Gerstein, M. Smieja, J.F.E. Mann, and S. Yusuf Mechanisms of cardiovascular risk reduction with ramipril: insights from HOPE and HOPE substudies Eur. Heart J. Suppl., January 1, 2003; 5(suppl_A): A43 - A48. [Abstract] [PDF] |
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J. R. R. Heyen, E. R. Blasi, K. Nikula, R. Rocha, H. A. Daust, G. Frierdich, J. F. Van Vleet, P. De Ciechi, E. G. McMahon, and A. E. Rudolph Structural, functional, and molecular characterization of the SHHF model of heart failure Am J Physiol Heart Circ Physiol, November 1, 2002; 283(5): H1775 - H1784. [Abstract] [Full Text] [PDF] |
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B. M. Jackson, J. H. Gorman III, S. L. Moainie, T. S. Guy, N. Narula, J. Narula, M. G. St. John-Sutton, L. H. Edmunds Jr, and R. C. Gorman Extension of borderzone myocardium in postinfarction dilated cardiomyopathy J. Am. Coll. Cardiol., September 18, 2002; 40(6): 1160 - 1167. [Abstract] [Full Text] [PDF] |
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S. L. Moainie, J. H. Gorman III, T. S. Guy, F. W. Bowen III, B. M. Jackson, T. Plappert, N. Narula, M. G. St. John-Sutton, J. Narula, L. H. Edmunds Jr, et al. An ovine model of postinfarction dilated cardiomyopathy Ann. Thorac. Surg., September 1, 2002; 74(3): 753 - 760. [Abstract] [Full Text] [PDF] |
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S. L. Moainie, T. S. Guy, J. H. Gorman III, T. Plappert, B. M. Jackson, M. G. St. John-Sutton, L. H. Edmunds Jr, and R. C. Gorman Infarct restraint attenuates remodeling and reduces chronic ischemic mitral regurgitation after postero-lateral infarction Ann. Thorac. Surg., August 1, 2002; 74(2): 444 - 449. [Abstract] [Full Text] [PDF] |
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I. S. Anand, V. G. Florea, and L. Fisher Surrogate end points in heart failure J. Am. Coll. Cardiol., May 1, 2002; 39(9): 1414 - 1421. [Abstract] [Full Text] [PDF] |
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L. A. M. Zornoff, H. Skali, M. A. Pfeffer, M. St. John Sutton, J. L. Rouleau, G. A. Lamas, T. Plappert, J. R. Rouleau, L. A. Moye, S. J. Lewis, et al. Right ventricular dysfunction and risk of heart failure and mortality after myocardial infarction J. Am. Coll. Cardiol., May 1, 2002; 39(9): 1450 - 1455. [Abstract] [Full Text] [PDF] |
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M. St. John Sutton and C.H. Scott A prediction rule for left ventricular dilatation post-MI? Eur. Heart J., April 1, 2002; 23(7): 509 - 511. [Full Text] [PDF] |
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R. C. Gorman and J. H. Gorman III Cellular myoplasty: What are we really trying to achieve? J. Thorac. Cardiovasc. Surg., March 1, 2002; 123(3): 582 - 583. [Full Text] [PDF] |
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R. C. Gorman and J. H. Gorman III Cellular myoplasty: what are we really trying to achieve? Ann. Thorac. Surg., January 1, 2002; 73(1): 342 - 343. [Full Text] [PDF] |
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K. T. Weber Aldosterone in Congestive Heart Failure N. Engl. J. Med., December 6, 2001; 345(23): 1689 - 1697. [Full Text] [PDF] |
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F. W. Bowen, S. C. Jones, N. Narula, M. G. St. John Sutton, T. Plappert, L. H. Edmunds Jr, and I. M.C. Dixon Restraining acute infarct expansion decreases collagenase activity in borderzone myocardium Ann. Thorac. Surg., December 1, 2001; 72(6): 1950 - 1956. [Abstract] [Full Text] [PDF] |
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J. G F Cleland, J. John, J. Dhawan, and A. Clark What is the optimal medical management of ischaemic heart failure? Br. Med. Bull., October 1, 2001; 59(1): 135 - 158. [Abstract] [Full Text] [PDF] |
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H. L. Thomson, A.-J. Basmadjian, A. J. Rainbird, M. Razavi, J.-F. Avierinos, P. A. Pellikka, K. R. Bailey, J. F. Breen, and M. Enriquez-Sarano Contrast echocardiography improves the accuracy and reproducibility of left ventricular remodeling measurements: A prospective, randomly assigned, blinded study J. Am. Coll. Cardiol., September 1, 2001; 38(3): 867 - 875. [Abstract] [Full Text] [PDF] |
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J.G.F. Cleland, K. Thygesen, B.F. Uretsky, P. Armstrong, J.D. Horowitz, B. Massie, M. Packer, P.A. Poole-Wilson, L. Ryden, and on behalf of the ATLAS investigators Cardiovascular critical event pathways for the progression of heart failure; a report from the ATLAS study Eur. Heart J., September 1, 2001; 22(17): 1601 - 1612. [Abstract] [PDF] |
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A.U Khand, I Gemmell, A.C Rankin, and J.G.F Cleland Clinical events leading to the progression of heart failure: insights from a national database of hospital discharges Eur. Heart J., January 2, 2001; 22(2): 153 - 164. [Abstract] [PDF] |
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K. T Weber and Yao Sun Recruitable ACE and tissue repair in the infarcted heart Journal of Renin-Angiotensin-Aldosterone System, December 1, 2000; 1(4): 295 - 303. [PDF] |
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H. Takano, X.-L. Tang, E. Kodani, and R. Bolli Late preconditioning enhances recovery of myocardial function after infarction in conscious rabbits Am J Physiol Heart Circ Physiol, November 1, 2000; 279(5): H2372 - H2381. [Abstract] [Full Text] [PDF] |
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I. Morishima, T. Sone, K. Okumura, H. Tsuboi, J. Kondo, H. Mukawa, H. Matsui, Y. Toki, T. Ito, and T. Hayakawa Angiographic no-reflow phenomenon as a predictor of adverse long-term outcome in patients treated with percutaneous transluminal coronary angioplasty for first acute myocardial infarction J. Am. Coll. Cardiol., October 1, 2000; 36(4): 1202 - 1209. [Abstract] [Full Text] [PDF] |
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S. E WIEGERS and M. S. J. SUTTON When should ACE inhibitors or warfarin be discontinued after myocardial infarction? Heart, October 1, 2000; 84(4): 361 - 362. [Full Text] |
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N.G Bellenger, M.I Burgess, S.G Ray, A Lahiri, A.J.S Coats, J.G.F Cleland, and D.J Pennell Comparison of left ventricular ejection fraction and volumes in heart failure by echocardiography, radionuclide ventriculography and cardiovascular magnetic resonance. Are they interchangeable? Eur. Heart J., August 2, 2000; 21(16): 1387 - 1396. [Abstract] [PDF] |
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M. V. Cohen, X.-M. Yang, T. Neumann, G. Heusch, and J. M. Downey Favorable Remodeling Enhances Recovery of Regional Myocardial Function in the Weeks After Infarction in Ischemically Preconditioned Hearts Circulation, August 1, 2000; 102(5): 579 - 583. [Abstract] [Full Text] [PDF] |
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H. Li, H. Simon, T. M.A. Bocan, and J.T. Peterson MMP/TIMP expression in spontaneously hypertensive heart failure rats: the effect of ACE- and MMP-inhibition Cardiovasc Res, May 1, 2000; 46(2): 298 - 306. [Abstract] [Full Text] [PDF] |
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U. P. Jorde, P. V. Ennezat, J. Lisker, V. Suryadevara, J. Infeld, S. Cukon, A. Hammer, E. H. Sonnenblick, and T. H. Le Jemtel Maximally Recommended Doses of Angiotensin-Converting Enzyme (ACE) Inhibitors Do Not Completely Prevent ACE-Mediated Formation of Angiotensin II in Chronic Heart Failure Circulation, February 29, 2000; 101(8): 844 - 846. [Abstract] [Full Text] [PDF] |
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E Roig, F Perez-Villa, M Morales, W Jimenez, J Orus, M Heras, and G Sanz Clinical implications of increased plasma angiotensin II despite ACE inhibitor therapy in patients with congestive heart failure Eur. Heart J., January 1, 2000; 21(1): 53 - 57. [Abstract] [PDF] |
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S. D. Kim Measurement of the Renin-Angiotensin System in Heart Failure Biol Res Nurs, January 1, 2000; 1(3): 210 - 226. [Abstract] [PDF] |
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L. Gullestad, P.a. Aukrust, T. Ueland, T. Espevik, G. Yee, R. Vagelos, S. S. Froland, and M. Fowler Effect of high- versus low-dose angiotensin converting enzyme inhibition on cytokine levels in chronic heart failure J. Am. Coll. Cardiol., December 1, 1999; 34(7): 2061 - 2067. [Abstract] [Full Text] [PDF] |
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C.H. Davies and Y. Bashir Beta-blockers for heart failure-time to think the unthinkable? QJM, November 1, 1999; 92(11): 673 - 678. [Full Text] [PDF] |
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G. Hamroff, S. D. Katz, D. Mancini, I. Blaufarb, R. Bijou, R. Patel, G. Jondeau, M.-T. Olivari, S. Thomas, and T. H. Le Jemtel Addition of Angiotensin II Receptor Blockade to Maximal Angiotensin-Converting Enzyme Inhibition Improves Exercise Capacity in Patients With Severe Congestive Heart Failure Circulation, March 2, 1999; 99(8): 990 - 992. [Abstract] [Full Text] [PDF] |
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S. T. Kelley, R. Malekan, J. H. Gorman III, B. M. Jackson, R. C. Gorman, Y. Suzuki, T. Plappert, D. K. Bogen, M. G. St. J. Sutton, and L. H. Edmunds Jr Restraining Infarct Expansion Preserves Left Ventricular Geometry and Function After Acute Anteroapical Infarction Circulation, January 12, 1999; 99(1): 135 - 142. [Abstract] [Full Text] [PDF] |
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D. Kalra, N. Sivasubramanian, and D. L. Mann Angiotensin II Induces Tumor Necrosis Factor Biosynthesis in the Adult Mammalian Heart Through a Protein Kinase C-Dependent Pathway Circulation, May 7, 2002; 105(18): 2198 - 2205. [Abstract] [Full Text] [PDF] |
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