Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Mar 1999
Tolerability and efficacy of carvedilol in patients with New York Heart Association class IV heart failure.
The purpose of this study was to assess the tolerability and efficacy of carvedilol in patients with New York Heart Association (NYHA) functional class IV symptoms. ⋯ Patients with chronic NYHA class IV heart failure are more likely to develop adverse events during initiation and dose titration when compared with less symptomatic patients but are more likely to show symptomatic improvement in the long term. We conclude that carvedilol is a useful adjunctive therapy for patients with NYHA class IV heart failure; however, they require close observation during initiation and titration of the drug.
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J. Am. Coll. Cardiol. · Mar 1999
Comparative StudyImproved accuracy and precision of thermodilution cardiac output measurement using a dual thermistor catheter system.
To assess whether thermodilution cardiac output determination based on measurement of injectate temperature in vivo leads to more accurate and precise estimates and to study the influence of chilled injectate on test performance. ⋯ This new dual thermistor approach results in a significant improvement in both precision and accuracy of thermodilution cardiac output measurement.
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J. Am. Coll. Cardiol. · Feb 1999
Randomized Controlled Trial Comparative Study Clinical TrialA prospective randomized trial of prevention measures in patients at high risk for contrast nephropathy: results of the P.R.I.N.C.E. Study. Prevention of Radiocontrast Induced Nephropathy Clinical Evaluation.
This study was done to test the hypothesis that a forced diuresis with maintenance of intravascular volume after contrast exposure would reduce the rate of contrast-induced renal injury. ⋯ Forced diuresis with intravenous crystalloid, furosemide, and mannitol if hemodynamics permit, beginning at the start of angiography provides a modest benefit against contrast-induced nephropathy provided a high urine flow rate can be achieved.
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J. Am. Coll. Cardiol. · Feb 1999
Comparative StudyFavorable effects of flecainide in transvenous internal cardioversion of atrial fibrillation.
The aim of the study was to evaluate the effects of intravenous (IV) flecainide on defibrillation energy requirements in patients treated with low-energy internal atrial cardioversion. ⋯ Intravenous flecainide reduces atrial defibrillation threshold in patients treated with low-energy internal atrial cardioversion. This reduction in threshold results in lower shock-induced discomfort. Additionally, flecainide may increase the procedure success rate in patients with chronic persistent atrial fibrillation.
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J. Am. Coll. Cardiol. · Feb 1999
Comparative StudyAbility of troponins to predict adverse outcomes in patients with renal insufficiency and suspected acute coronary syndromes: a case-matched study.
The purpose of this study was to investigate the utility of cardiac troponin T and troponin I for predicting outcomes in patients presenting with suspected acute coronary syndromes and renal insufficiency relative to that observed in similar patients without renal disease. ⋯ The ability of cardiac troponin T and troponin I to predict risk for subsequent adverse outcomes in patients presenting with suspected acute coronary syndromes is reduced in the presence of renal insufficiency.