European heart journal
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European heart journal · Jul 1997
Randomized Controlled Trial Comparative Study Clinical TrialStreptokinase vs alteplase in massive pulmonary embolism. A randomized trial assessing right heart haemodynamics and pulmonary vascular obstruction.
The aim of the study was to test the efficacy of recombinant tissue plasminogen activator and streptokinase in massive pulmonary embolism, the primary endpoints being haemodynamic improvement and thrombus lysis, and the secondary endpoints efficacy and safety. ⋯ These results proved that, when the full dose of streptokinase has been given over 12 h, its efficacy is as good as that of 2 h of recombinant tissue plasminogen. A further trial aimed at comparing recombinant tissue plasminogen activator and streptokinase infused over a 2 h period is needed to determine whether a similar efficacy can be obtained.
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European heart journal · Jul 1997
The apical long-axis rather than the two-chamber view should be used in combination with the four-chamber view for accurate assessment of left ventricular volumes and function.
Most biplane methods for the echocardiographic calculation of left ventricular volumes assume orthogonality between paired views from the apical window. Our aim was to study the accuracy of biplane left ventricular volume calculations when either the apical two-chamber or long-axis views are combined with the four-chamber view. The left ventricular volumes calculated from three-dimensional echocardiographic data sets were used as a reference. Twenty-seven patients underwent precordial three-dimensional echocardiography using rotational acquisition of planes at 2-degree intervals, with ECG and respiratory gating. End-diastolic and end-systolic left ventricular volumes and ejection fraction on three-dimensional echocardiography were calculated by (1) Simpson's methods (3DS) at 3 mm short-axis slice thickness (reference method) and by (2) biplane ellipse from paired views using either apical four- and two-chamber views (BE-A) or apical four- and long-axis views (BE-B). Observer variabilities were studied by the standard error of the estimate % (SEE) in 19 patients for all methods. ⋯ Both apical two-chamber and apical long-axis views are not orthogonal to the apical four-chamber view. Observer variabilities of BE-B were smaller than that for BE-A. BE-A and BE-B have excellent correlation and non-significant differences with 3DS for left ventricular volume and ejection fraction calculations. There were closer limits of agreement between BE-B with 3DS for left ventricular volume and ejection fraction calculations than that between BE-A and 3DS. Therefore, we recommend the use of the apical long-axis rather than the two-chamber view in combination with the four-chamber view for accurate biplane left ventricular volume and ejection fraction calculations.
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European heart journal · Jul 1997
Out-of-hospital cardiac arrests of non-cardiac origin. Epidemiology and outcome.
The aim of the study was to determine the epidemiology of out-of-hospital cardiac arrests of non-cardiac origin and survival following resuscitation, using the Utstein method of data collection. ⋯ These results indicate that sudden out-of-hospital cardiac arrest more often has a non-cardiac cause than previously believed. Although survival is not as likely as from cardiac arrest of cardiac origin, since non-cardiac-cause survivors comprise one fifth of all out-of-hospital cardiac arrest survivors, resuscitation efforts are worthwhile.