bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the Severity of Migraine: Development of the MIGSEV Scale
Authors: El Hasnaoui Abdelkader , Vray Muriel , Richard Alain , Nachit‐Ouinekh Fatima , Boureau François , For The MIGSEV Group  
Published: June 2003

Objectives.—To identify items that serve to assess the severity of migraine with a high level of clinical and psychometric relevance and to combine these into a unitary severity scale.Background.—Severity of migraine is an important determinant of patient quality of life and of health care resource utilization. Despite this, no validated method exists for measuring migraine severity.Methods.—After selection from the medical literature items of potential relevance to the severity of migraine, consensus meetings led to a choice of items which subsequently were refined further on the basis of patient interviews. The psychometric properties of those items then were assessed in a survey involving 287 migraineurs. The methods used to test reliability and validity included test‐retest, calculation of Cronbach α coefficient, analysis of factorial structure using principal components analysis, a comparison of the agreement between doctors' and patients' assessments, and correlation with a validated quality‐of‐life questionnaire. The most pertinent items revealed by the factorial analysis were combined in a unitary scale.Results.—Seven items reflecting severity were identified by expert consensus. These were intensity of pain, tolerability, disability in daily activities, presence of nausea or vomiting, resistance to treatment, duration of attacks, and frequency of attacks. Principal components analysis identified 3 dimensions accounting for 65% of the overall variance related to intensity of attacks, resistance to treatment, and frequency of attacks. The internal consistency and the reproducibility of the items appeared quite satisfactory, and variations in these items were correlated with quality‐of‐life scores. The 4 items related to intensity of attacks were combined into a single scale with 3 response modalities.Conclusions.—The 3 dimensions identified by this investigation appeared medically relevant and to have good psychometric properties. The items on the intensity dimension can be used to generate a simple scale for assessing migraine attack severity.
Factors Associated With Burden of Primary Headache in a Specialty Clinic
Authors: Cassidy Eugene M. , Tomkins Esther , Hardiman Orla , O'Keane Veronica 
Published: June 2003

Objective.—To examine factors associated with social, occupational, and psychological burden of common primary headache (migraine and tension‐type headache).Background.—The personal and social burden of primary headache is high. Health, occupational, social, and psychological factors contributing to burden in people with disabling headache have not been fully unravelled.Methods.—One hundred eighty consecutive patients with either migraine or tension‐type headache attending a specialty headache outpatient clinic for the first time were evaluated over a 9‐month period. Headache subtype was operationally defined according to International Headache Society criteria. Headache frequency, duration, and severity were recorded. Occupational and social disability were quantified using the Migraine Disability Assessment questionnaire. Psychological burden was quantified using the 28‐item General Health Questionnaire, the Beck Depression Inventory, and the State‐Trait Anxiety Inventory. Premorbid vulnerability to life stress was quantified using the neuroticism subscale of the Eysenck Personality Inventory.Results.—Patients with frequent (chronic) headache scored higher on the Migraine Disability Assessment questionnaire and had higher Beck Depression Inventory and General Health Questionnaire depression scores than those with less frequent (episodic) headache. Frequency of headache, but not pain severity, duration, or diagnosis, predicted both Migraine Disability Assessment total disability and General Health Questionnaire/Beck Depression Inventory depression. Neuroticism was predictive of depression but not disability. Patients with chronic migraine had the highest depression and disability scores.Conclusion.—The number of days per month with headache is a key determinant of headache‐related burden in those attending specialty clinics. Frequent (chronic) headache is associated with significantly higher psychopathology scores and general social impairment, but the direction of this relationship is not clear. Those with migraine and chronicity are the most impaired.
Differences in Anger Expression Between Individuals With and Without Headache After Controlling for Depression and Anxiety
Authors: Nicholson Robert A. , Gramling Sandra E. , Ong Jason C. , Buenevar Luis 
Published: June 2003

Objective.—To evaluate whether anger and anger expression are different between persons with and without headache after controlling for depression and anxiety.Background.—Persons with headache may experience more problems with anger and its expression when compared with persons without headache. It is important to establish whether differences exist for persons with and without headache on trait anger and anger expression independent of depression and anxiety. To date, however, this issue has received little attention in the empirical literature. The current study measured trait anger, anger‐in, hostility, anxiety, and depression among persons with and without headache, and evaluated whether trait anger and anger‐in differentiated groups independent of depression and anxiety.Methods.—Participants were 422 adults recruited from a larger study within a university setting. Of those, 171 suffered from headache (mean age, 21 years; 81% were female; 69% were white; mean years with pain, 7.53). Another 251 sex‐matched individuals (mean age, 21 years; 81% female; 62% white) met criteria for the headache‐free group. Participants provided information regarding their headache characteristics and were administered affective trait measures (Trait version of the State‐Trait Anxiety Inventory, Brief Symptom Inventory‐Depression), trait anger measures (Trait Anger Scale, Cook‐Medley Hostility Scale), and a measure of the extent to which individuals hold their anger in.Results.—Multivariate analysis of variance revealed significant differences between the 2 groups (Wilks λ  =  .86, P  <  .001, η2  =  .14). Step‐down analysis revealed that even after controlling for all other variables, those in the headache group had higher levels of anger‐in (P  <  .001, η2  =  .08; mean, 18.98 versus 15.68). Trait anger and hostility did not differ between groups after controlling for depression and anxiety. Logistic regression revealed that anger‐in contributed most to predicting headache status (P  <  .001; partial r  =  .23).Conclusions.—The current findings indicate that persons with headache hold their anger in more than those without headache even after controlling for levels of trait anger, depression, and anxiety. However, after controlling for depression and anxiety, individuals no longer differed on trait anger. Also, anger‐in was the strongest predictor of headache. The current findings suggest that holding anger in is more common among headache sufferers. Given recent findings regarding the negative effect of holding anger in among persons with pain conditions, this may be an important factor to evaluate when considering psychological/emotional factors affecting headache.
Phased‐Array Intracardiac Echocardiography for Defining Cavotricuspid Isthmus Anatomy During Radiofrequency Ablation of Typical Atrial Flutter
Authors: Morton Joseph B. , Sanders Prashanthan , Davidson Neil C. , Sparks Paul B. , Vohra Jitendra K. , Kalman Jonathan M. 
Published: June 2003

Introduction: Cavotricuspid isthmus (CTI) topography includes ridges, pouches, recesses, and trabeculations. These features may limit the success of radiofrequency ablation (RFA) of typical atrial flutter (AFL). The aim of this study was to assess the utility of phased‐array intracardiac echocardiography (ICE) for imaging the CTI and monitoring RFA of AFL.
Methods and Results: Fifteen patients (mean age

64 ± 9

years) underwent ICE assessment (imaging frequency 7.5–10 MHz) before and after RFA of AFL. The ICE catheter was positioned at the inferior vena cava‐right atrial junction and the following parameters were measured: (1) CTI length from the tricuspid valve to the eustachian ridge; (2) extent of CTI pouching; and (3) thickness pre/post RFA of the anterior, mid, and posterior CTI. CTI length was

35 ± 6 mm

at end‐ventricular systole but shorter

(30 ± 6 mm)

and more pouched at end‐ventricular diastole

(P = 0.02)
. A pouch or recess was seen in 11 of 15 patients (mean depth6 ± 2 mm). The septal CTI was more pouched than the lateral CTI, but the latter had more prominent trabeculations. Trabeculations were seen in 10 of 15 patients, and at these locations the CTI was4.6 ± 1 mmthick. Anterior, mid, and posterior CTI thickness pre‐RFA was4.1 ± 0.8, 3.3 ± 0.5, and2.7 ± 0.9 mm, respectively (P < 0.001by analysis of variance). ICE guided RFA away from unfavorable CTI features (recesses/thick trabeculations). RFA applications created discrete CTI lesions that coalesced, forming diffuse CTI swelling. Post‐RFA thickness was as follows: anterior4.8 ± 0.8 mm (P = NSvs pre); mid3.8 ± 0.8 mm (P = 0.05 vs pre); and posterior3.8 ± 0.8 mm (P = 0.02 vs pre).
Conclusion: Phased‐array ICE permits novel real‐time CTI imaging with excellent endocardial resolution and may facilitate RFA of AFL. (J Cardiovasc Electrophysiol, Vol. 14, pp. 591‐597, June 2003)
Endocardial Mapping of Right Ventricular Outflow Tract Tachycardia Using Noncontact Activation Mapping
Authors: Ribbing Michael , Wasmer Kristina , Mönnig Gerold , Kirchhof Paulus , Loh Peter , Breithardt Günter , Haverkamp Wilhelm , Eckardt Lars 
Published: June 2003

Introduction: Activation mapping and pace mapping identify successful ablation sites for catheter ablation of right ventricular outflow tract (RVOT) tachycardia. These methods are limited in patients with nonsustained tachycardia or isolated ventricular ectopic beats. We investigated the feasibility of using noncontact mapping to guide the ablation of RVOT arrhythmias.
Methods and Results: Nine patients with RVOT tachycardia and three patients with ectopic beats were studied using noncontact mapping. A multielectrode array catheter was introduced into the RVOT and tachycardia was analyzed using a virtual geometry. The earliest endocardial activation estimated by virtual electrograms was displayed on an isopotential color map and measured

33 ± 13 msec

before onset of QRS. Virtual unipolar electrograms at this site demonstrated QS morphology. Guided by a locator signal, ablation was performed with a mean of

6.9 ± 2.2

radiofrequency deliveries. Acute success was achieved in all patients. During follow‐up, one patient had a recurrence of RVOT tachycardia. Compared with patients

(n = 21)

who underwent catheter ablation using a conventional approach, a higher success rate was achieved by noncontact mapping. Procedure time was significantly longer in the noncontact mapping group. Fluoroscopy time was not significantly different in the two groups.
Conclusion: Noncontact mapping can be used as a reliable tool to identify the site of earliest endocardial activation and to guide the ablation procedure in patients with RVOT tachycardia and in patients with ectopic beats originating from the RVOT. (J Cardiovasc Electrophysiol, Vol. 14, pp. 602‐608, June 2003)
Role of Autonomic Tone in the Initiation and Termination of Paroxysmal Atrial Fibrillation in Patients Without Structural Heart Disease
Authors: Tomita Takeshi , Takei Manabu , Saikawa Yuko , Hanaoka Takeshi , Uchikawa Shin‐Ichiroh , Tsutsui Hiroshi , Aruga Masakazu , Miyashita Toyohisa , Yazaki Yoshikazu , Imamura Hiroshi , Kinoshita Osamu , Owa Mafumi , Kubo Keishi 
Published: June 2003

Introduction: Previous studies have suggested that paroxysmal atrial fibrillation (PAF) of vagal origin often occurs at night and PAF of sympathetic origin occurs during the daytime; however, autonomic tone after spontaneous termination of PAF has not been determined. The aim of this study was to evaluate by heart rate variability (HRV) analysis the relationship between the time of PAF onset and autonomic tone before and after PAF.
Methods and Results: Twenty‐three patients (

65 ± 2

years) who underwent 24‐hour ambulatory monitoring, had one or more episodes of PAF (>30 min), and had maintained normal sinus rhythm for >60 min before/after PAF were enrolled in this study. Mean duration of PAF was

6.2 ± 1.2

hours. HRV parameters were analyzed in a 10‐minutes section at 60 minutes, 20 minutes, and immediately before the onset of PAF and after its termination. PAF began at night in 14 patients (group N) and during the daytime in 9 patients (group D). In group N, the high‐frequency (HF) component and low‐frequency (LF) component showed a significant decrease after PAF; PAF was preceded by a gradual increase in HF and LF. Changes in the LF/HF ratio, however, did not occur before or after PAF. Conversely, group D showed a significant increase in the LF/HF ratio before PAF and a decrease in LF and the LF/HF ratio after PAF, but no changes in HF. These changes in HRV parameters were not influenced by the duration or termination time of PAF.
Conclusion: This study suggests that the autonomic nervous system plays an important role in both the initiation and termination of PAF. Furthermore, the time of PAF onset influences the autonomic tone at the initiation and termination of PAF. (J Cardiovasc Electrophysiol, Vol. 14, pp. 559‐564, June 2003)
Block of HERG‐Carried K+ Currents by the New Repolarization Delaying Agent H 345/52
Authors: Amos Gregory J. , Jacobson Ingemar , Duker Göran , Carlsson Leif 
Published: June 2003

Introduction: The aim of this study was to analyze the block of HERG‐carried membrane currents caused by H 345/52, a new antiarrhythmic compound with low proarrhythmic activity, in transfected mouse fibroblasts.
Methods and Results: Using the whole‐cell configuration of the voltage patch clamp technique, it was demonstrated that H 345/52 concentration‐dependently blocked HERG‐carried currents with an IC50 of 230 nM. H 345/52 preferentially bound to the open channel with unusually rapid kinetics and was trapped by channel closure. Voltage‐independent behavior of H 345/52 was observed during both square‐pulse and action potential clamp protocols. In contrast, the Class III agents dofetilide (10 nM) and almokalant (250 nM) demonstrated significant membrane potential‐dependent effects during square‐pulse clamp protocols. When using action potential clamp protocols, voltage dependence was seen with dofetilide but not with almokalant. Mathematical simulations of human ventricular action potentials predicted that the different voltage‐dependent behaviors would not produce marked variations in action potential duration prolongation patterns.
Conclusion: We propose that block of IKr is the principal mechanism by which H 345/52 delays repolarization in human myocardium. The voltage independence of HERG/IKr block is unlikely to underlie the low proarrhythmic potential, and ancillary effects on other membrane currents must be considered. (J Cardiovasc Electrophysiol, Vol. 14, pp. 651‐658, June 2003)
Usefulness of a New Radiofrequency Thermal Balloon Catheter for Pulmonary Vein Isolation:
Authors: Satake Shutaro , Tanaka Kazushi , Saito Shigeru , Tanaka Shinji , Sohara HiroshI , Hiroe Yoshitaka , Miyashita Yusuke , Takahashi Saeko , Murakami Masato , Watanabe Yoshio 
Published: June 2003

Introduction: A rapidly firing or triggered ectopic focus located within a pulmonary vein (PV) or close to the PV ostium could induce atrial fibrillation (AF). The aim of this study was to evaluate the efficacy and safety of a radiofrequency thermal balloon catheter for isolation of the PV from the left atrium (LA).
Methods and Results: Twenty patients with drug‐resistant paroxysmal AF were treated by isolating the superior PVs using an RF thermal balloon catheter. Using a transseptal approach, the balloon, which had an inflated diameter 5 to 10 mm larger than that of the PV ostium, was wedged at the LA‐PV junction. It was heated by a very‐high‐frequency current (13.56 MHZ) applied to the coil electrode inside the balloon for 2 to 3 minutes, and the procedure was repeated up to four times. The balloon center temperature was maintained at 60° to 75°C by regulating generator output. Successful PV isolation was achieved in 19 of the 20 left superior PVs and in all 20 of the right superior PVs and was associated with a decrease in amplitude of the ostial potentials. Total procedure time was

1.8 ± 0.5

hours, which included

22 ± 7

minutes of fluoroscopy time. After a follow‐up period of

8.1 ± 0.8

months, 17 patients were free from AF, with 10 not taking any antiarrhythmic drugs and 7 taking the same antiarrhythmic agent as before ablation. Electron beam computed tomography revealed no complications, such as PV stenosis at ablation sites.
Conclusion: The PV and its ostial region can be safely and quickly isolated from the LA by circumferential ablation around the PV ostia using a radiofrequency thermal balloon catheter for treatment of AF. (J Cardiovasc Electrophysiol, Vol. 14, pp. 609‐615, June 2003)
Improved Survival of Cardiac Transplantation Candidates with Implantable Cardioverter Defibrillator Therapy:
Authors: Ermis Cengiz , Zadeii Gino , Zhu Alan X. , Fabian William , Collins Joanne , Lurie Keith G. , Sakaguchi Scott , Benditt David G 
Published: June 2003

Introduction:Survival in patients awaiting cardiac transplantation is poor due to the severity of left ventricular dysfunction and the susceptibility to ventricular arrhythmia. The potential role of implantable cardioverter defibrillators (ICDs) in this group of patients has been the subject of increasing interest. The aims of this study were to ascertain whether ICDs improve the survival rate of patients on the waiting list for cardiac transplantation and whether any improvement is independent of concomitant beta‐blocker or amiodarone therapy.Methods and Results:Data comprised findings from 310 consecutive patients at a single center who were evaluated and deemed suitable for cardiac transplantation and placed on the waiting list. Kaplan‐Meier actuarial approach was used for survival analysis. Survival analysis censored patients at time of transplantation or death. Of the 310 patients, 111 (35.8%) underwent successful cardiac transplantation and 164 (52.9%) died while waiting; 35 patients remain on the waiting list. Fifty‐nine (19%) patients had ICD placement for ventricular arrhythmias prior to or after being listed. Twenty‐nine (49.1%) ICD patients survived until cardiac transplantation, 13 (22%) patients died, and 17 (28.8%) remain on the waiting list. Among non‐ICD patients, 82 (32.7%) received transplants, 151 (60.2%) died, and 18 (7.2%) remain on the waiting list. Survival rates at 6 months and 1, 2, 3, and 4 years were better for all ICD patients compared to non‐ICD patients (log‐rankx2, P = 0.0001). By multivariate analysis, ICD therapy and beta‐blocker treatment were the strongest predictors of survival. Further, ICD treatment was associated with improved survival independent of concomitant treatment with beta‐blocker or amiodarone. Among ICD and non‐ICD patients treated with a beta‐blocker or amiodarone, survivals at the 1 and 4 years were 93% vs 69% and 57% vs 32%, respectively (log‐rankx2, P = 0.003).Conclusion:ICD therapy is associated with improved survival in high‐risk cardiac transplant candidates, and ICD benefit appears to be independent of concomitant treatment.(J Cardiovasc Electrophysiol, Vol. 14, pp. 578‐583, June 2003)
Clinical Outcome of Very Late Recurrence of Atrial Fibrillation after Catheter Ablation of Paroxysmal Atrial Fibrillation
Authors: Hsieh Ming‐Hsiung , Tai Ching‐Tai , TSAI Chin‐Feng , Lin Wei‐Shiang , Lin Yung‐Kuo , Tsao Hsuan‐Ming , Huang Jin‐Long , Ueng Kwo‐Chang , Yu Wen‐Chung , Chan Paul , Ding Yu‐An , Chang Mau‐Song , Chen Shih‐Ann 
Published: June 2003

Introduction: High recurrence rate is still a major problem associated with ablation of paroxysmal atrial fibrillation (AF). Most of the recurrences occur within 6 months after ablation. The characteristics of very late recurrent AF (>12 months after ablation) have not been reported.
Methods and Results: Two hundred seven patients with drug‐refractory AF underwent successful focal ablation or isolation of AF foci. After the first ablation procedure, Holter monitoring and event recorders were used to evaluate symptomatic recurrent AF. A second ablation procedure was recommended if the antiarrhythmic drugs could not control recurrent AF. During long‐term follow‐up (mean

30 ± 11

months, up to 51 months), 70 patients had recurrent AF, including 13 patients (6%) with very late (>12 months) recurrent AF (group 1) and 57 patients (28%) with late (within 12 months after ablation) recurrent AF(group 2). Group 1 patients had a significantly lower incidence of multiple (≥2) AF foci

(23% vs 63%, P = 0.02)

than group 2 patients. In addition, the incidence of antiarrhythmic drugs use

(38% vs 84%, P = 0.001)

to maintain sinus rhythm after the first episode of recurrent AF was significantly lower in group 1 than group 2 patients, and the incidence of a second intervention procedure

(8% vs 35%, P = 0.051)

tended to be lower in group 1 than group 2 patients.
Conclusion: The incidence of very late recurrent AF after ablation of paroxysmal AF is very low, and the clinical outcome of patients with very late recurrent AF is benign.
(J Cardiovasc Electrophysiol, Vol. 14, pp. 598‐601, June 2003)
An Alternatively Spliced Variant of CXCR3 Mediates the Inhibition of Endothelial Cell Growth Induced by IP-10, Mig, and I-TAC, and Acts as Functional Receptor for Platelet Factor 4
Authors: Lasagni Laura , Francalanci Michela , Annunziato Francesco , Lazzeri Elena , Giannini Stefano , Cosmi Lorenzo , Sagrinati Costanza , Mazzinghi Benedetta , Orlando Claudio , Maggi Enrico , Marra Fabio , Romagnani Sergio , Serio Mario , Romagnani Paola 
Published: June 2003

The chemokines CXCL9/Mig, CXCL10/IP-10, and CXCL11/I-TAC regulate lymphocyte chemotaxis, mediate vascular pericyte proliferation, and act as angiostatic agents, thus inhibiting tumor growth. These multiple activities are apparently mediated by a unique G protein–coupled receptor, termed CXCR3. The chemokine CXCL4/PF4 shares several activities with CXCL9, CXCL10, and CXCL11, including a powerful angiostatic effect, but its specific receptor is still unknown. Here, we describe a distinct, previously unrecognized receptor named CXCR3-B, derived from an alternative splicing of the CXCR3 gene that mediates the angiostatic activity of CXCR3 ligands and also acts as functional receptor for CXCL4.
Human microvascular endothelial cell line-1 (HMEC-1), transfected with either the known CXCR3 (renamed CXCR3-A) or CXCR3-B, bound CXCL9, CXCL10, and CXCL11, whereas CXCL4 showed high affinity only for CXCR3-B. Overexpression of CXCR3-A induced an increase of survival, whereas overexpression of CXCR3-B dramatically reduced DNA synthesis and up-regulated apoptotic HMEC-1 death through activation of distinct signal transduction pathways. Remarkably, primary cultures of human microvascular endothelial cells, whose growth is inhibited by CXCL9, CXCL10, CXCL11, and CXCL4, expressed CXCR3-B, but not CXCR3-A. Finally, monoclonal antibodies raised to selectively recognize CXCR3-B reacted with endothelial cells from neoplastic tissues, providing evidence that CXCR3-B is also expressed in vivo and may account for the angiostatic effects of CXC chemokines.