| 1. |
- Andersson, Bert, 1952, et al.
(författare)
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Recovery from left ventricular asynergy in ischemic cardiomyopathy following long-term beta blockade treatment.
- 1994
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Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 85:1, s. 14-22
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Tidskriftsartikel (refereegranskat)abstract
- It has been suggested that long-term beta blockade treatment in congestive heart failure might be less effective in patients with ischemic cardiomyopathy as compared with patients having idiopathic dilated cardiomyopathy. This study was performed to evaluate the effect of long-term adrenergic beta blockade treatment on regional myocardial function in patients with ischemic cardiomyopathy. The regional wall motion (RWM) was evaluated in 12 patients with ischemic cardiomyopathy before and after long-term open treatment with metoprolol. On average, the patients were treated over 11 months (range 6-36 months). The regional left ventricular function was assessed using two-dimensional echocardiographic recordings by two independent blinded observers. The RWM score was evaluated in 16 segments of the left ventricle on a scale from 0 (hypercontractility) to 5 (dyskinesia). Following treatment, there was an improvement in general ventricular function (ejection fraction 0.24-0.31; p = 0.01) as well as in RWM (86 improved segments, 48 deteriorated, 49 unchanged; p < 0.002). Ventricular segments with poor contractility (RWM score > or = 3.5) tended to improve (53 improved segments, 16 deteriorated, 13 unchanged; p < 0.0001), whereas less severely impaired segments (RWM score < 3.5) did not improve (33 improved segments, 32 deteriorated, 36 unchanged; NS). It is suggested that poorly contracting myocardial segments might improve following beta blockade treatment, while an effect on less impaired segments might be lacking. An improvement in overall myocardial function would then be harder to detect.
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| 2. |
- Herlitz, Johan, 1949, et al.
(författare)
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Delay time between onset of myocardial infarction and start of thrombolysis in relation to prognosis.
- 1993
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Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 82:5, s. 347-53
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Tidskriftsartikel (refereegranskat)abstract
- In 292 patients with suspected acute myocardial infarction given thrombolytic agents, we describe the delay time between the onset of pain and the start of thrombolysis and relate the observations to the prognosis. In 3%, treatment was started 1 h or less and in 22% 2 h or less after onset of symptoms. The median delay time between onset of symptoms and arrival in hospital was 1 h 38 min, and the median delay time between the arrival in hospital and start of thrombolysis was 1 h 25 min. A very strong association between delay time to thrombolysis and mortality during 2 weeks and 1 year of follow-up was observed.
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| 3. |
- Herlitz, Johan, et al.
(författare)
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Effects of a media campaign to reduce delay times for acute myocardial infarction on the burden of chest pain patients in the emergency department
- 1991
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Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 79:2, s. 127-134
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Tidskriftsartikel (refereegranskat)abstract
- We evaluated the effect of a media campaign aimed at reducing delay times in suspected acute myocardial infarction (AMI) on the volume of chest pain patients seen in the emergency department. During the 1st week of the campaign, the mean number of chest pain patients increased from 10.5 per day prior to the start to 25.4. However, the number declined rapidly in subsequent months. The greatest increase was observed in patients with chest pain in whom AMI was not suspected on examination. During the campaign, 4,805 patients with chest pain appeared in the emergency department as compared with 4,407 patients during the same time period prior to its start, an increase of 9%. The number of patients with confirmed AMI increased from 595 to 629 (6%).
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| 4. |
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| 5. |
- Herlitz, Johan, et al.
(författare)
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Occurence of chest pain more than 24 hours after hospital admission in acute myocardial infarction and its relation to prognosis
- 1992
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Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 81:1, s. 46-53
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Tidskriftsartikel (refereegranskat)abstract
- In 857 consecutive patients with acute myocardial infarction (AMI), the occurrence of chest pain more than 24 h after hospital admission is described and related to death or reinfarction during one year of follow-up. Prolonged chest pain was observed in 333 patients (39%). In this group 15% died and 7% developed reinfarction during the first month as compared with 10% (p < 0.05) and 2% (p < 0.01) respectively in patients without prolonged pain. However, during one year of follow-up mortality did not differ significantly between patients with (27%) and without (24%) prolonged pain. The 1-year reinfarction rate was similar in the two groups (18% and 14%, respectively; NS). We conclude that AMI patients with prolonged chest pain have a particularly high mortality during the first month. However, during a longer follow-up the prognosis is similar in patients with and without prolonged chest pain.
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| 6. |
- Herlitz, Johan, et al.
(författare)
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Prognosis in diabetics with chest pain or other symptoms suggestive of acute myocardial infarction
- 1992
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Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 80:3-4, s. 237-245
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Tidskriftsartikel (refereegranskat)abstract
- We evaluated the prognosis of 599 diabetics who came to the emergency department with chest pain or other symptoms suggestive of acute myocardial infarction (AMI). They made up 8% of the patients with such symptoms (n = 7,157). Diabetics had a 1-year mortality rate of 25% as compared with 10% for nondiabetics (p less than 0.001). The difference remained significant regardless of whether there was a strong or a vague initial suspicion of AMI. On admission, independent risk factors for death were age, acute congestive heart failure and initial degree of suspicion of AMI. We conclude that among diabetics who appear in the emergency department with chest pain or other symptoms suggestive of AMI, 25% are dead within 1 year. The prognosis is directly related to the initial suspicion of AMI.
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| 7. |
- Herlitz, Johan, et al.
(författare)
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Ten-year mortality among patients with suspected acute myocardial infarction in relation to early diagnosis
- 1994
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Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 84:2, s. 114-120
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies have compared the outcome between patients with and without a confirmed acute myocardial infarction (AMI) mainly during the first few years after its onset. Our aim was to compare the prognosis between patients with and without a confirmed AMI during 10 years of follow-up. Patients participating in an early intervention trial with metoprolol in suspected AMI between 1976 and 1981 took part in this evaluation. The total 10-year mortality rate including hospital mortality was 51% for patients with confirmed AMI as compared with 32% for patients with a possible AMI and 23% for patients in whom AMI was definitely ruled out (p < 0.001). The 10-year mortality after discharge from hospital was in AMI 46%, possible AMI 32% and in definitely ruled out AMI 23% (p < 0.001). When simultaneously considering age, sex, previous history of cardiovascular disease and smoking, the development of AMI appeared as an independent predictor of death (p < 0.001). Thus, among patients hospitalized due to suspected AMI, 10-year mortality after discharge from hospital was directly related to the diagnosis during the first 3 days in hospital.
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| 8. |
- Karlson, BW, et al.
(författare)
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Characteristics and prognosis of patients with acute myocardial infarction in relation to whether they were treated in the coronary care unit or in other ward
- 1992
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Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 81:2-3, s. 134-144
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Tidskriftsartikel (refereegranskat)abstract
- The characteristics and the prognosis in 921 consecutive patients with acute myocardial infarction (AMI) admitted to one single hospital are described and related to whether they were treated in the coronary care unit or not. Patients treated in the coronary care unit (n = 779) had a 1-year mortality rate of 26% as compared with 41% for patients treated in general wards (n = 115; p < 0.001) and 74% for patients treated in the intensive care unit (n = 27; p < 0.001). Patients treated outside the coronary care unit had a different risk factor pattern including a higher age and a higher prevalence of a previous cardiovascular disease. Independent clinical risk indicators for death among patients in the coronary care unit were in order of significance, high age (p < 0.001), arrhythmia on admission (p < 0.01), acute congestive heart failure on admission (p < 0.01) and a history of diabetes mellitus (p < 0.05). In patients treated in general wards, the only risk indicator for death was a history of congestive heart failure.
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| 9. |
- Karlson, BW, et al.
(författare)
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Clinical factors associated with pain in acute myocardial infarction
- 1993
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Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 83:1-2, s. 107-117
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Tidskriftsartikel (refereegranskat)abstract
- In an unselected population of 921 consecutive patients with acute myocardial infarction admitted to one single hospital, regardless of age and whether they were admitted to the coronary care unit or not, we describe the course of pain during hospitalization. Patients with a history of angina pectoris, patients with a particularly long delay time, and patients not transported by ambulance had the longest duration of pain.
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| 10. |
- Karlson, BW, et al.
(författare)
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Patients with suspected acute myocardial infarction and acute heart failure : Does it matter whether an infarction was developed or not?
- 1994
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Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 84:2, s. 126-134
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Tidskriftsartikel (refereegranskat)abstract
- Symptoms of acute severe congestive heart failure always raise the suspicion of acute myocardial infarction (AMI). Our aim was to describe the characteristics and the prognosis among patients with acute severe congestive heart failure in relation to whether or not it was caused by AMI. Consecutive patients admitted to one single hospital during 21 months due to suspected AMI, who either had initial symptoms of acute severe congestive heart failure or developed such symptoms during the subsequent days, were prospectively followed for 1 year in terms of mortality and morbidity. Of 531 patients who fulfilled previously defined criteria for severe congestive heart failure, 40% developed AMI during the first 3 days in hospital. At baseline, these patients differed from the others, having a less frequent history of known congestive heart failure. Mortality during 1 year of follow-up was 47% among patients who developed AMI versus 38% among those who did not (p < 0.05). In addition to age and a history of diabetes, development of AMI was independently associated with death.
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