Heart : official journal of the British Cardiac Society
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To determine the after-effects on sympathetic nerve activity and calf and systemic haemodynamics of symptom-limited exercise in young patients with dilated cardiomyopathy. ⋯ In young patients with dilated cardiomyopathy the haemodynamic after-effects of submaximal symptom-limited exercise resemble responses to pharmacological afterload reduction but are not accompanied by reflex sympathetic activation. Sustained calf and systemic vasodilation after exercise were not attenuated, as compared with healthy controls. These cardiac, peripheral, and sympathoneural after-effects provide further support for exercise training as a non-pharmacological adjunct to the management of chronic stable heart failure.
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To test whether very early resumption of ambulation after femoral cardiac catheterisation is feasible and safe in patients with stable symptoms. ⋯ Supervised resumption of ambulation 3 h after uncomplicated cardiac studies with 5F femoral arterial catheters is safe and feasible in most ambulant patients undergoing elective cardiac catheterisation.
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The purpose of this study was to examine clinical and echocardiographic predictors of outcome in a cohort of patients with Marfan's syndrome. ⋯ A low risk subgroup of patients with Marfan's syndrome can be identified as those with an aortic ratio < 1.3 and an annual change in aortic ratio of < 5%. These findings are helpful in optimising echocardiographic monitoring and risk stratification of patients with Marfan's syndrome.
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To analyse profiles of coronary artery flow velocity at rest in patients with aortic stenosis and to determine whether changes of the coronary artery flow velocities are related to symptoms in patients with aortic stenosis. ⋯ Increased pressure gradient across the aortic valve and enhanced systolic wall stress result in characteristic changes of the profile of coronary flow velocities in patients with aortic stenosis. Decreased or reversed systolic flow velocities are compensated by enhanced diastolic flow velocities, particularly in patients with angina and syncope. This characteristic pattern of the profile of coronary artery flow velocities in patients with angina or syncope may be useful for differentiating those patients from asymptomatic patients.
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Randomized Controlled Trial Clinical Trial
Early continuous ST segment monitoring in unstable angina: prognostic value additional to the clinical characteristics and the admission electrocardiogram.
In unstable angina, clinical characteristics, resting electrocardiography, and early continuous ST segment monitoring have been individually reported to identify subgroups at increased risk of adverse outcome. It is not known, however, whether continuous ST monitoring provides additional prognostic information in such a setting. ⋯ Patients with unstable angina and a normal admission ECG have a good prognosis, while ST segment depression predicts an adverse outcome. Transient myocardial ischaemia detected by continuous ST segment monitoring in such patients receiving optimal medical treatment provides prognostic information additional to that gleaned from the clinical characteristics or the admission ECG.