Cardiology Clinics 1999: Vol 17 Index

9 Pages·1999·2 MB·English

CUMULATIVE INDEX 1999
Volume 17
February CARDIOVASCULAR DISEASE IN THE ELDERLY, pages 1-245
May UNSTABLE ANGINA, pages 247-441
August STRESS ECHOCARDIOGRAPHY, pages 443-608
November DISEASES OF THE AORTA, pages 609-854
Note: Page numbers of article titles are in boldface type.
Abciximab, 349, 350 natural history, pathogenesis, and etiology of, 615-
Aging. See also Elderly. 635
and cardiovascular disease, 51-65 natural history of, 615-619, 706-708
abdominal aneurysm in, 58, 59 normal aging effects and, 622
ankle-brachial blood pressure and, 56-58 pathogenesis of, 619-622, 701
brain pathology in, subclinical, 59, 60 risk factors for, 701
carotid artery disease in, 57-59 size of, 616, 618, 619
coronary and aortic calcification in, 60-62 smoking and, 617
echocardiographic changes in, 60 surgical treatment of, 709, 710
endothelial function in, 62-64 survival rates in, 618
prevalence of subclinical disease in, 54-56 syphilis and, 617
subclinical measurements in, 51-65 thoracic, 226, 227
vascular stiffness in, 62 timing of surgical intervention for, 706-708
cardiovascular consequences of, 35-49 versus Marfan syndrome, 688, 689
and exercise response in humans, 42-47 atherosclerotic, imaging findings in, 674-676
challenges of studying, 35, 36 definition of, 739
in animal models, 36, 37 mycotic, imaging findings in, 676
in humans, 36-39 thoracic aortic, alternative estimation strategy in eval-
response to catecholamines and, 39 uation of data on, 799, 800
cardiovascular pharmacology of, 17-34 complication rates of, 829, 830
in the United States, 1-3 conventional versus instrumental variables estima-
Amiodarone, pharmacology of, in the elderly, 29, 30 tion approach to interpretation of data on, 800,
Amyloidosis, in the elderly, 167-169 801
familial, 169 developing surgical intervention criteria for, 827-
primary, 168, 169 839
Ancrod, 338 growth rates of, 828-839
Aneurysm(s), abdominal, in the elderly, 58, 59 interpreting data on, 797-805
aortic, 615-625, 630, 631, 697, 698 long-term survival following, 833, 834
adventitial lamellar degeneration and, 622 measurement error in evaluation of, 798
arteriosclerosis and, 617, 618 prophylactic repair of in Marfan syndrome, 837
ascending, 623 risk factor analysis and, 799, 800
changes in aortic wall and, 619-622 selection bias in interpretation of data on, 801-803
chronic dissection and, 617 thoracoabdominal aortic, operative technique for,
chronic obstructive pulmonary disease and, 616, 754-761
617 preoperative evaluation of, 753, 754
clinical features of, 703, 704 preventing ischemic complications after surgical
descending, 624 treatment of, 762, 763
diagnostic approaches to, 703, 704 results of surgical treatment of, 762
epidemiology of, 700 surgical treatment of, 753-761
etiology of, 623-625 with acute distal aortic dissection, surgical treat-
family history in, 624, 625 ment of, 761, 762
hypertension and, 616, 617 with concomitant proximal aortic disease, staged
imaging of, 674-676, 705 surgical repair of, 761
in Marfan syndrome, 623, 624, 708 treatment of, early history of, 609
in multiple sites, 618 in early modern period, 609, 610
848 CUMULATIVE INDEX 1999
Aneurysm(s) (Continued) effect of heart rate on, 728
in the modern era, 610, 611 effect of smoking on, 727, 728
Angina, unstable. See Unstable angina. Aortic dysfunction, reversibility of, by intra-aortic
Angiography, coronary, early use of in unstable angina, balloon counterpulsation, 731
373-386 future directions in, 734, 735
for unstable angina, 425 in hyperlipidemia, 729, 730
Angioplasty, coronary, percutaneous transluminal, in hypertension, 728, 729
391-396, 425-429 in postmenopausal women, 730, 731
in unstable angina, 253, 254 surgical remedies for, 733
Angiotensin-converting enzyme, for heart failure, in the Aortic energy loss, 726
elderly, 126, 127 Aortic pressure-diameter relation, 722, 724, 725
Angiotensin-converting enzyme inhibitors, Aortic regurgitation, in the elderly, 151, 152
pharmacology of, in the elderly, 30 stress echocardiography in, 566-568
Anticoagulants. See also specific types, e.g., Thrombin Aortic root replacement, 742-748
inhibitors. grafts in, composite, 742, 743
for unstable angina, 327-343 homograft, 743-745
comparison of, 339, 340 porcine xenograft, 745
duration of therapy with, 340 pulmonary valve autotransplant, 745-747
naturally occurring, 339 Ross procedure for, 745-747
novel, 338, 339 valve-sparing, 741, 747, 748
overview of, 327, 328 Aortic rupture, 740
Antihypertensive drugs, in the elderly, economic Aortic stenosis, stress echocardiography in, 563-566
considerations in selection of, 88 Aortic stiffness constant, 723, 725
indications and contraindications of, 85-87 Aortic strain, 722
morbidity and mortality trial experience in, 85, 86 Aortic surgery, use of biological glue in, 779-796
predicted efficacy of, 87, 88 future of, 792, 793
quality-of-life issues in selection of, 88, 89 results of, 790, 791
selection of, 85-89 Aortic valve disease, in the elderly, 137-146
Antiplatelet therapy, for treatment of acute coronary asymptomatic, 142
syndromes, 345-357 diagnosis of, 141, 142
for unstable angina, 416 etiology and pathology of, 138, 139
recommendations for, 353, 354 physical examination for, 140, 141
role of in maintenance of patency following acute cor- prevalence of, 137, 138
onary syndrome, 346, 347 prosthetic valves in, 146
Antistasin, 339 symptomatic, 143, 144
Antithrombin III, 339 symptoms of, 139, 140
Antyllus, 609 treatment of, 144-146
Aorta, ascending, atherosclerotic disease in, severe, 748, Aortic valve repair, use of biological glue in, 787-788
749 Aortic valve replacement, stress echocardiography in
complex problems of, 748, 749 assessment of, 568, 569
endocarditis and, 748 Aortic wall, hemodynamic forces on, 702
replacement of, 741, 742 intrinsic properties of, 701, 702
surgical techniques for, 739-750 Arachnodactyly, contractural, congenital, versus Marfan
terms and definitions of, 739-741 syndrome, 689
use of biological glue in replacement of, 785-788 Argatroban, 337
atherosclerotic disease of, 711, 712 Aspirin, as antiplatelet agent, 347, 348
elastic properties of, indexes of, 722-726 for heart failure in the elderly, 128, 129
methodological considerations in measurement of, for unstable angina, 360, 416, 417
726 prevention of, 252
wave reflections and aortoventricular coupling as Atherectomy, coronary, for unstable angina, 430, 431
measures of, 726, 727 Atherogenesis, and plaque progression, 263, 264
function of, measurement of, 721-724 Atherosclerosis, 51-54
medical treatment of, part I, 697-715 aortic, 711-713
part II, 717-737 plaque rupture and, in unstable angina, 263-270
pathology of, 718-721 Atherosclerotic lesions. See also Plaque, atherosclerotic.
spontaneous echocardiographic contrast in, 720, 721 classification of, 283-285
structural failure of, mechanisms of, 720 origin of, 283
thoracic. See Thoracic aorta. phases of, 283-285
thoracoabdominal, indications for surgery of, 752, 753 Atrial pacing, transesophageal, 531, 532
surgical techniques for, 751-765 Autotransplant, of pulmonary valve, for aortic root
Aortic arch, replacement of, use of biological glue in, replacement, 745-747
788, 789
surgical repair of, results of, 775, 776
techniques in, 770-775
surgical techniques for, 767-778 Baby boomers, aging of, 1-3
Aortic disease, definition, incidence, and classification Bahnson, Henry, 611
of, 697-701 Beals syndrome, 688
genetic basis of, 683-695 Beta blockers, aortic function and, 731, 732
Aortic distensibility, 722 for heart failure in the elderly, 128
effect of age on, 726, 727 for unstable angina, 362, 363, 418
CUMULATIVE INDEX 1999 849
Beta-adrenergic antagonists, pharmacology of, in the volume rendering in, 660-662
elderly, 30 Consumer Bill of Rights for Health Care, 70, 71
Cooper, Astley, 610
Coronary artery bypass graft, in the elderly, 219-221
combined procedures in, 223
Calcium channel antagonists, 128 repeated procedure in, 221, 222
for unstable angina, 363, 364, 418, 419 in unstable angina, 253, 254
pharmacology of, in the elderly, 30, 31 Coronary artery disease, in the elderly, inoperable, 224
Cardiac function, effect of aging process on, and Coronary artery dissection, peripartum, associated with
vascular changes in animal models and humans, non-Q wave myocardial infarction, 404-406
39-42 Coronary heart disease, in the elderly, cardiac
disease factors in, 38, 39, 42, 46 rehabilitation and, 116
in animal models, 36 clinical aspects of, 94-96
in humans, 36-39 stable and unstable syndromes of, 93~122. See also
lifestyle factors in, 38, 41, 42, 46, 47 Coronary syndromes, acute and Ischemic
response to catecholamines in animal models and, syndromes, stable.
39 Coronary syndromes, acute, in the elderly, 104-113
response to catecholamines in humans and, 42-47
Cardiomyopathies, in the elderly, 159-172
hypertensive hypertrophic, 163-166
hypertrophic, 159-166 DeBakey, Michael, 611
hypertrophic obstructive, 160-163 Deep hypothermic circulatory arrest, in surgery of the
restrictive, 166-170 aortic arch, 767-769
Cardiovascular disease, aging and. See Aging, and clinical data in, 768, 769
cardiovascular disease. experimental data in, 768
in the elderly, and heterogeneity of aging process, 5, 6 Depression, in unstable angina, 251, 252
challenge of health care delivery in, 1-15 Digoxin, for heart failure, in the elderly, 127, 128
coronary revascularization procedures and, 7-9 pharmacology of, in the elderly, 31
cost implications of, 6, 7 Dipyridamole, historical background of, 481, 482
cost-effectiveness issues and, 10, 11 in transesophageal stress echocardiography, for evalu-
defining old age and, 5 ation of coronary artery disease, 505
defining therapeutic goals in, 6 Dipyridamole stress echocardiography, 481-499, 529,
epidemiology of, 2, 4,5 530
future approaches to cost containment and, 11-13 diagnostic accuracy of, 485, 486
lack of research data on, 5 electrocardiogram during, 486
management of, 5, 6 future of, 494, 495
Medicare and, 9, 10 hyperemic stress and, 482
Cardiovascular surgery, in the elderly, 213-231 in assessment of myocardial viability, 491, 492
complications of, 217, 218 in women, 575
preoperative evaluation and, 213-216 prognostic effectiveness -“ 576
procedures in, 216-228 increased oxygen demand in, 484, 485
Cardioverter defibrillator, implantable, in the elderly, ischemic stress and, 482
cost-effectiveness of therapy with, 193, 194 justification for use of, 494
Carotid artery disease, in the elderly, 57-59 pathophysiologic basis of, 482-484
Carrel, Alexis, 610 perfusion scintigraphy versus two-dimensional echo-
Cerebral perfusion, in deep hypothermic circulatory cardiography in, 489
arrest, antegrade, 769, 770 prognostic value of, 489-491
retrograde, 769 tolerability and safety of, 492-494
Chest pain, evaluation of, 307-326 versus dobutamine stress echocardiography, 487-489
clinical symptoms and signs of, 308, 309 versus exercise echocardiography, 489
echocardiography in, 320-322 Dissection, aortic, 625-630, 631, 632, 698-700
electrocardiac, 309-311 atherosclerosis and, 641
exercise treadmill testing in, 318, 319 choosing an imaging modality for, 668, 669
radionuclide perfusion imaging in, 319, 320 classic, 637-641
triage of, using predictive models, 311-313 clinical features of, 704
Chest pain observation units, in evaluation of chest definition of, 739
pain patients, 322 diagnostic approaches to, 704
Circulatory arrest, deep hypothermic. See Deep epidemiology of, 700, 701
hypothermic circulatory arrest. etiology of, 630
Clopidogrel, 348, 349 imaging of, 668-672, 705, 706
for unstable angina, 417, 418 imaging pitfalls in, 671
Coagulation abnormalities, in the acute coronary in Marfan syndrome, 629, 630
syndromes, 283-294 intimal tear in, 703
Computed tomography, for imaging of thoracic aortic intraoperative use of biological glue in, 784, 785
disease, 659-663 long-term management of, 711
indications for, 662, 663 medical therapy for, 709
overview of, 659, 660 natural history, pathogenesis, and etiology of,
spiral, 660 615-635
technique of, 660 natural history of, 626-629
three-dimensional, 660-662 pathogenesis of, 629, 630, 701
850 CUMULATIVE INDEX 1999
Dissection (Continued) in aortic dissection, 820-822
pathologic variants of, 637-657 acute, 822-824
risk factors for, 701 in malperfusion syndromes, 820-822
surgical treatment of, 710, 711 second generation endografts and, 818-820
type A, 626-629 Eptifibatide, 350, 351
type B, 628, 629 Exercise, echocardiography, imaging modalities in, 450
versus penetrating atherosclerotic ulcer and in prevention of unstable angina, 252
intramural hematoma, 645-653 Exercise echocardiography, 447-460, 525-528
Diuretics, for heart failure, in the elderly, 128 accuracy of, 452-455
pharmacology of, in the elderly, 31, 32 advantages and disadvantages of, 451, 452
Dobutamine, in transesophageal stress analysis methods in, 450, 451
echocardiography, for evaluation of coronary artery electrocardiogram in, 601, 602
disease, 505, 506 in women, 574, 575
pharmacology of, 462 prognostic effectiveness of, 576
Dobutamine stress echocardiography, 461-479 isometric stress in, 450
and atropine infusion in, 467 methodology of, 448
clinical uses of, 469-472 performance methodology of, 448-456
contraindications to, 469 postinfarct prognosis and, 456
detection of myocardial hibernation with, 542, 543 post-treadmill imaging in, 448, 449
diagnostic accuracy of, 470, 471 problems and future developments of, 456
electrocardiographic, echocardiographic, and vital prognostic implications of, 454, 456
sign monitoring in, 467, 468 role of techniques of, 452
historical development of, 461, 462 supine bicycle ergometry in, 449
hypotension and left ventricular outflow tract obstruc- upright bicycle ergometry in, 449, 450
tion in, 464 versus radionuclide techniques, 454
in assessment of myocardial viability, 471 Exercise electrocardiogram, as stress test modality, 601,
in diagnostic evaluation of chest pain, 469-471 602
in diagnostic evaluation of known coronary artery dis- Exercise testing, advantages and disadvantages of, 600
ease, 471, 472 Exercise treadmill testing, in chest pain evaluation, 318,
in post-myocardial infarction assessment, 471 319
in valvular heart disease, 474
in women, 575
prognostic effectiveness of, 576
infusion endpoints in, 466 Factor Xa inhibitors, 338, 339
labcratory setup and personnel for, 466 Fibrillation, atrial, in the elderly, 173-188
Ohio State University protocol of, 466-468 approach to the patient in, 177-179
pathophysiology of, 462-464 atrial pathophysiology associated with, 173-175
prediction of reversible dysfunction with, following cause of, 175
acute myocardial infarction, 540 chronic, management of, 179-182
protocols of, 464-468 congestive heart failure and, 175, 176
risk stratification in, 472-474 emboli and, 176, 177
for chest pain patients, 472 implantable atrial defibrillators, 184, 188
for known coronary artery disease, 472 intermittent, management of, 182, 183
preoperative, for noncardiac surgery, 472-474 long-term anticoagulation therapy for, 180-182
safety and complications of, 468, 469 pacemakers for, 184
versus myocardial perfusion techniques, 543-547 prevalence of, 173
versus nuclear perfusion imaging, 474, 475 prognosis in, 175-177
versus perfusion imaging, 540 radiofrequency ablation in, 184
reversion of, 183, 184
surgical maze in, 184
Fibrillinopathies, 683
Echocardiography, advantages and disadvantages of, Fibrin glue, 783, 784
599 clinical use of, 784, 785
stress. See Stress echocardiography. in cardiac and aortic surgery, 783, 784
Ectopia lentis, familial, versus Marfan syndrome, 690
Ehlers-Danlos syndrome, aortic dissection in, 629, 630,
638-640
Elderly. See also Aging. Galen, 609
cardiovascular disease in. See Cardiovascular disease, in Gelatin-resorcinol-formalin (GRF) glue, 780-782
the elderly. Be clinical use of, 784, 785
challenge of health care delivery to, 1-15 in surgery for acute aortic dissection, 782, 783
hypertension in. See Hypertension, in the elderly. Glue, biological, fibrin, 783, 784
Electrocardiogram, advantages and disadvantages of, gelatin-resorcinol-formalin, 780-782
599 use of in aortic surgery, 779-796
Endocarditis, in ascending aorta, 748 GP IIB-IIIA antagonists, 349-353
infective, in the elderly, 152, 153 oral, 352, 353
Endovascular solutions for thoracic aortic disease, Graft(s). See also Coronary artery bypass grafts.
815-825 composite, in aortic root replacement, 742-744
in aneurysms of the descending thoracic aorta, 815- Gross, Robert, 611
818 Guthrie, Charles, 610
CUMULATIVE INDEX 1999 851
Heart failure, in the elderly, 123-135 management of, 100-104
activity prescription in, 131, 132 noninvasive testing in, 97-99
clinical features of, 124-126 physical examination for, 97
diagnostic evaluation of, 125, 126
diastolic, 129, 130
epidemiology of, 123
ethical and end-of-life decisions in, 132 Lamifiban, 351, 352
etiology and precipitating factors of, 124, 125 Lipid-lowering therapy, in prevention of unstable
management of, 126-132 angina, 252
nonpharmacologic treatment of, 130, 131
pathophysiology of, 123, 124
prevention of, 132
symptoms and signs of, 125 Magnetic resonance imaging, in thoracic aortic disease,
systolic, 126-129 contrast-enhanced, 665, 666
systolic versus diastolic, 126 indications for, 666
with normal systolic function, 124 overview of, 663
Hematoma(s), intramural, 644 time-of-flight, 663, 665
definition of, 740 traditional, 663
imaging findings in, 672-674 Managed care, for older patients with cardiac disease,
versus classic aortic dissection and penetrating 71-75
atherosclerotic ulcer, 645-653 cardiovascular disease management in, 72, 73
Heparin, for unstable angina, 360, 361, 420 creative approaches to, 73, 74
low-molecular-weight, 331-334 promises and perils of, 67-77
advantages of over unfractionated heparin, 331, 332 for the elderly, 69-71
clinical trials supporting, 332-334 history of, in younger and older populations, 67-69
for unstable angina, 420-423 Marfan, Antoine, 683
history of, 331 Marfan syndrome, 683-695
limitations of, 334 aortic aneurysm in, 623, 624
structure and mechanism of action of, 331 aortic dissection in, 629, 630, 638-640, 687
unfractionated, 328-331 aortic regurgitation in, 687
clinical trials supporting, 329, 330 aortic root enlargement in, 687
complications of therapy with, 330 cardiovascular manifestations of, 685, 687
history of, 328 diagnosis of, 684-688
limitations of, 330, 331 differential diagnosis of, 689-690
structure and mechanism of action of, 328, 329 elastin-associated microfibrils in, 684
versus low-molecular-weight heparin, 331, 332 FBN1 gene in, 684
versus hirudin, 335 FBN1 gene mutation analysis in, 690
Heparinoids, 334 fibrillin biochemical studies in, 691
Hirudin, 335, 336 fibrillin immunofluorescence studies in, 691
low-molecular-weight, 423, 424 genetic linkage analysis in, 690
versus heparin, 335 laboratory diagnosis of, 690
Hirulog, 336, 337 management of, 691-694
Homocystinuria, versus Marfan syndrome, 689 cardiovascular problems and, 692-694
Homografts, in aortic root replacement, 743-745 in pregnant patients, 694, 695
Hunter, John, 609 ocular problems and, 694
Hyperlipidemia, aortic dysfunction in, reversibility of, skeletal problems and, 694
729, 730 MASS phenotype and, 689, 690
Hypertension, aortic dysfunction in, reversibility of, 728, medical therapy in, 708, 709
729 mitral valve prolapse in, 688
in the elderly, 79-91 raolecular basis of, 683, 684
blood pressure goals of therapy for, 84, 85 natural history of, 691
blood pressure levels for initiation of drug therapy neonatal, 688, 689
for, 83, 84 ocular manifestations of, 685
classification and prevalence of, 80 skeletal manifestations of, 685
epidemiology of, 79, 80 thoracic aneurysms in, 708
left ventricular hypertrophy and, 236-238 Marfan-like connective tissue disorder, 690
lifestyle changes in treatment of, 80, 81 Matas, Rudolph, 610
morbidity and mortality trials in, 81-83 Medicare Health Maintenance Organizations (HMOs),
pulse pressure and risk in, 79, 80 68, 69
risk of systolic and diastolic blood pressure, 79 Medicare Risk Program, 68
selecting drugs for. See Antihypertensive drugs, in the Medicine Versus Angiography in Thrombolytic
elderly. Exclusion Trial, 381
Mitral valve annular calcification, in the elderly, 146,
147
Mitral valve prolapse (MVP) syndrome, familial, versus
Ischemic syndromes, stable, in the elderly, catheter- Marfan syndrome, 690
based interventions for, 101-104 Mitral valve regurgitation, in the elderly, 147-150
coronary arteriography in, 99, 100 stress echocardiography in, 561-563
coronary artery bypass grafting for, 101-104 Mitral valve replacement, evaluation of, stress
drug therapy for, 100, 101 echocardiography in, 563
852 CUMULATIVE INDEX 1999
Mitral valve stenosis, in the elderly, 150, 151 angiotensin-converting enzyme inhibitors and, 30
stress echocardiography in, 556-561 bioavailability and, 18, 19
Mortality compression, 1 biotransformation and elimination and, 20
Myocardial hibernation, 541, 542 calcium channel antagonists and, 30, 31
Myocardial infarction, acute, in the elderly, 105-113 digoxin and, 31
clinical presentation of, 106 discontinuation of cardiovascular medication and,
electrocardiographic findings and enzyme studies 28, 29
in, 106, 107 distribution and, 19, 20
management of, 108-113 diuretics and, 31, 32
prognosis of, 107, 108 drug clearance and, 20
risk stratification and management after, 113-116 drug-disease interactions and, 27-29
drug-drug interactions and, 25-27
Myocardial injury, biochemical markers of, 313-318
drug-nutrient interactions and, 26-28
in diagnosis and prognostication of acute coronary
elimination half-life and, 22
syndromes, 316, 317
hepatic clearance and, 20, 21, 23
in diagnosis of acute myocardial infarction, 314-316
nitrates and, 32
point-of-care testing for, 317, 318
nonhepatic, nonrenal drug clearance and
Myocardial ischemia detectors, 599, 600 biotransformation and, 22, 23
Myocardial stunning, 539, 540 pharmacodynamics and, 22, 24
Myocardial viability, after acute myocardial infarction,
renal clearance and, 21, 23
clinical relevance of, 540, 541 Plaque, atherosclerotic. See also Atherosclerotic lesions.
assessment of with stress echocardiography, 539-553 assessment of, by angiography, 296-298
clinical implications of, in left ventricular dysfunction, by angioscopy, 298-300
550, 551 by intracoronary ultrasound, 300-303
contractile function versus perfusion in assessment of, classification of, 283-285
547, 548 clinical sequelae of rupture of, 289, 290
in chronic coronary artery disease and left ventricular disruption of, 268
dysfunction, clinical importance of, 548-550 and thrombosis, 271-281
myocardial contrast echocardiography for assessment infection as trigger of, 275, 276
of, 545-547 mechanical, hemodynamic, and emotional triggers
radionuclide techniques for assessment of, 543-545 of, 276
potential triggers of, 275-278
role of inflammation, metalloproteinases, and
apoptosis in, 272-275
Nitrates, aortic function and, 732, 733 thrombosis following, 275
for unstable angina, 361, 362, 419, 420 fibrous cap of, thickness and composition of, 272
pharmacology of, in the elderly, 32 fissured or ruptured, composition of, 272-275
Noncardiac surgery in the elderly, assessment of heterogeneity of, 264-266
cardiovascular risks in, 197-211 histopathologic analysis of, 295, 296
age-related changes and implications for surgery in, inflammation and cap strength of, 268
200-202 lipid-rich core of, 266, 267
lipoprotein transport in formation of, 285, 286
intraoperative management of, 206-208
patient factors in, 197, 198 progression of, atherogenesis and, 263, 264
role of infectious agents in instability of, 286
postoperative management of, 208
role of inflammatory cells in instability of, 286
preoperative assessment and management of,
rupture of, 286, 297
202-206
adjunctive therapies for, 292
procedure factors in, 198
antithrombotic and antiplatelet therapies for, 291
protocol factors in, 199 glycoprotein IIb/IIla receptor antagonists for, 291,
provider factors in, 198, 199 292
surgical outcomes and aging in, 199, 200 histopathology of, 263-270
Noonan syndrome, aortic dissection in, 638-640 treatment of, 291, 292
Nuclear perfusion imaging, advantages and stabilization of, 277, 278
disadvantages of, 599 thrombosis following rupture of, 288, 289
unstable, characterization of by angiography, angios-
copy, and intravascular ultrasound, 295-305
vasospasm following rupture of, 289
Ochsner, Alton, 611 vulnerability of, 266
Osler, William, 610 Plaque rupture, prevention of, 733, 734
Preventive cardiology, diabetes and insulin resistance,
239
in the elderly, homocysteine and, 239
lipids and, 236
Pain, aortic, 718-720
Paré, Ambrose, 609 oxidation and, 239
Penetrating atherosclerotic ulcers, 641-644 smoking and, 238, 239
Prostheses, aortic, 740, 741
Phavrermsaucso kicnlaestsiicc s,a oratigce -rdeilsastecetdi ocn,h an6g4e5s- 65a6n d, 17-22 Protein C, 339
Pseudoaneurysms, 676
Pharmacology, cardiovascular, of aging, 17-34
definition of, 741
absorption and, 18
B-adrenergic antagonists and, 30
adverse drug reactions and, 24-29
amiodarone and, 29, 30 Radionuclide myocardial perfusion imaging, 532, 533
CUMULATIVE INDEX 1999 853
Recombinant tick anticoagulant peptide, 338, 339 factors affecting test performance of, 577, 578
Rehabilitation, cardiac, in the elderly, 233-242 implications of a positive result for, 578, 579
Ochsner studies of, 234, 235 limitations of, 602, 603
Ross procedure, for aortic root replacement, 745-747 myocardial imaging in, 602
myocardial ischemia detectors in, 599, 600
pharmacologic, 461-479
transesophageal. See Transesophageal echocardiography
Scoliosis, in Marfan syndrome, management of, 693
with stress.
Selection bias in interpretation of data, 801-803 types of stressors in, 597-599
correcting for, 802, 803 Stress myocardial imaging, 602
definition of, 801, 802
Stress myocardial perfusion imaging, 603, 604
Sinus of Valsalva, aneurysm and fistula of, 748
Stress reduction, in prevention of unstable angina, 251,
Smoking cessation, in prevention of unstable angina,
252
251 Stroke, aortic imaging in, 679, 680
Spinal cord, protection of during thoracic aortic surgery,
Stunning, myocardial, 539, 540
807-813
Surgery, cardiovascular, in the elderly. See Cardiovascular
adjuncts to aneurysm repair and, 810-812
delayed postoperative paraplegia and, 812 surgery, in the elderly.
effects of clamping the descending thoracic aorta noncardiac, in the elderly. See Noncardiac surgery in
and, 808, 809 the elderly.
ischemia and, 808
minimizing cord ischemia during aortic clamping
as, 809, 810
Tachycardia, ventricular, in the elderly, ablative therapy
relevant arterial anatomy in, 807, 808
for, 191
Stenting, intracoronary, for unstable angina, 429, 430
electrophysiologic testing in, 190, 191
Stickler syndrome, versus Marfan syndrome, 690
implantable cardioverter defibrillator for, 192, 193
Stress echocardiography, 602
arbutamine, 475, 476 pharmacologic therapy for, 191, 192
choice of stress test in, 600, 601 prophylactic treatment of, 193
choosing the appropriate modality in, 597-606 treatment of, 189-193, 191-193
cost effectiveness of, 583-595 triggers of, 189, 190
analysis of, 583, 584 Thienopyridines, 348, 349
Thoracic aorta, surgery of, history of, 609-613
future directions in, 592, 593
issues in evaluation of, 584-592 modern era of, 610, 611
cost issues in, 585, 586 ongoing challenges of, 611, 612
dipyridamole. See Dipyridamole stress echocardiography. Thoracic aortic disease, imaging of, 659-682
computed tomography in, 659-663
dobutamine. See Dobutamine stress echocardiography.
effectiveness issues in, 586-592 magnetic resonance imaging in, 663-666
in diagnosis of coronary artery disease, 587, 588 transesophageal echocardiography in, 666-668
in patients after myocardial infarction, 589, 590 summary of articles on and conclusions about, 841-
in patients after revascularization, 590, 591 845
in preoperative cardiovascular evaluation for non- transthoracic echocardiography in imaging of, 668
cardiac surgery, 591, 592 Thrombin inhibitors, direct, 335-337
in women, 588, 589 indirect, 328-334
evolution of, 443-446 Thrombocytopenia, heparin-induced, 330
for risk assessment of patients after myocardial in- Thrombolysis, rheolytic, 411
farction, 521-538 Thrombolysis in Myocardial Infarction IIb Trial, 378, 379
application of, 525-532 Thrombolytic therapy, for unstable angina, 424
applications of, 525-532 Thrombosis, acute, 288, 289
approaches to, 522-525 following plaque rupture, 288
clinical aspects of, 523 prevention of, 290
exercise testing and, 524, 525 risk factors for, 289
integrated approaches to, 534, 535 substrate dependency of, 288
new developments in, 532 tissue factor dependency of, 289
pathogenesis in, 522 and plaque disruption, 271-281
rationale of, 522, 523 coronary, clinical manifestations of, 276, 277
resting left ventricular function and, 523, 524 in the acute coronary syndromes, 283-294
versus radionuclide myocardial perfusion imaging, Thromboxane inhibitors, 347-349
532, 533 Ticlopidine, 348, 349
in aortic regurgitation, 566-568 for unstable angina, 417
in aortic stenosis, 563-566 Tirofiban, 352
in assessment of aortic valve replacement, 568, 569 Transection, aortic, imaging of, 676, 677
in mitral valve regurgitation, 561-563 Transesophageal echocardiography, in imaging of
in mitral valve replacement, 563 thoracic aortic disease, overview of, 666-668
in mitral valve stenosis, 556-561 patient selection and contraindications in, 667
in valvular heart disease, 555-572 preparation for, 667, 668
in women, 573-582 procedural pitfalls of, 668
and test performance for chest pain diagnosis, 574, technique of, 667, 668
575 Transesophageal echocardiography with stress,
cost effectiveness and diagnostic strategies of, 579, dobutamine in, results of, 506-509
580 for evaluation of coronary artery disease, 501-520
854 CUMULATIVE INDEX 1999
Transesophageal echocardiography with stress (Continued) interesting cases of from the University of Texas Medi-
atrial pacing in, 503-505 cal Branch, 401-414
dipyridamole in, 505 intervention strategies for, 253-256
dobutamine in, 505, 506 direct costs of, 253, 254
evaluation of mechanism of chest pain and, 512- new technology costs of, 255, 256
514 nonmedical costs of, 254, 255
in patients with left ventricular dysfunction, 514— intracoronary stent technology in, 255
518 intracoronary thrombus and, 406-409
in women, 509-511 case study of, 406
ischemic threshold in, 511, 512 invasive management of, practical issues of, 383
stressors used in, 503-506 invasive versus conservative management of, results
technique of, 502, 503 from randomized trials of, 378-381
Transthoracic echocardiography, in imaging of thoracic measuring outcome in, 248-251
aortic disease, 668 by clinical events, 250, 251
Trauma, aortic, imaging findings in, 676-679 by economic analysis, 250
Treadmill testing, exercise, in chest pain evaluation, 318, by quality of life, 250
319 nitrates for, 361, 362
Troponins, cardiac, in diagnosis and prognostication of outpatient management of, 365, 366
acute coronary syndromes, 316, 317 pathophysiology of, 359, 360
Tuffier, Theodore, 610 peripartum, 404, 405
Turner syndrome, aortic dissection in, 638-640 prevention strategies for, 251-253
prognosis of, with medical therapy, 387, 388
rationale for consistent interventional treatment path-
way in, 375-377
Ulcer(s), atherosclerotic, penetrating. See Penetrating risk stratification in, 256, 257, 364, 365
atherosclerotic ulcers. routine coronary arteriography and revascularization
United States, population of, changing demographics of, in, 391-396
1-3 “traditional” medical therapy for, 359-371
Unstable angina, aggressive versus conservative therapy treatment of, quality-of-life measurements in, 254, 255
for, 387-399 unusual causes of, case study of, 404, 405
angioplasty procedures in, 253, 254
anticoagulant treatment for, 327-343
aspirin for, 360
beta blockers for, 362, 363 Valsalva, sinus of. See Sinus of Valsalva.
calcium antagonists for, 363, 364 Valve(s), prosthetic, in the elderly, 153, 154
coronary arteriography in, 388 Valve surgery, in the elderly, 224-227
coronary artery bypass graft in, 253, 254, 391, 392 aortic, 225
early use of coronary angiography and intervention complications of, 226
in, 373-386 mitral, 224
timing of, 381-383 Valvular disease, in the elderly, 137-158. See also
United States practice patterns of, 374, 375 specific types, e.g., Aortic valve disease, calcific.
worldwide practice patterns of, 373, 374 right-sided, in the elderly, 152
health care burden of, 247-261 stress echocardiography in, 555-572
heparin for, 360, 361 Vascular catastrophe, mechanics of, 720
high-risk subsets in, 401-404 Vasodilators, aortic function and, 732, 733
antianginal therapy for, 418-420 Vein graft disease, degenerative, 411
antiplatelet therapy for, 416 Ventricular arrhythmia(s), in the elderly, 189-195
antithrombotic therapy for, 420-424 Vesalius, Andreas, 609
aspirin therapy for, 416, 417 Veterans Administration Non-Q Wave Infarction
case study of, 401, 402 Strategies in Hospital trial, 379-381
Clopidogrel for, 417, 418
coronary angiography in, 425
coronary atherectomy in, 430, 431
interventional therapy for, 425-429 Warfarin, 337, 338
intracoronary stenting in, 429, 430 history of, 337, 338
management of, 415-434 in prevention of unstable angina, 253
medical therapy for, 416-418 mechanism of action of, 338
thrombolytic therapy for, 424 Women, stress echocardiography in, 573-582
Ticlopidine for, 417
identification of high-risk patients with, without coro-
nary angiography, 389, 390
in patient with prior coronary artery bypass grafting, Xenografts, porcine, in aortic root replacement, 745
409-412
case study of, 409, 410
in the elderly, 104, 105
inpatient medical management of, 366-369 Yale Center for Thoracic Aortic Disease, 827, 828