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| 1 | It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis显示文摘Background There is concern that blood pressure(BP)lowering in acute stroke may compromise cerebral perfusion and worsen outcome in the presence of carotid stenosis.We assessed the effect of glyceryl trinitrate(GTN)in patients with carotid stenosis using data from the Efficacy of Nitric Oxide in Stroke(ENOS)Trial.Methods ENOS randomised 4011 patients with acute stroke and raised systolic BP(140-220 mm Hg)to transdermal GTN or no GTN within 48 hours of onset.Those on prestroke antihypertensives were also randomised to stop or continue their medication for 7 days.The primary outcome was the modified Rankin Scale(mRS)at day 90.Ipsilateral carotid stenosis was split:<30%;30-<50%;50-<70%;≥70%.Data are ORs with 95%CIs adjusted for baseline prognostic factors.results 2023(60.5%)ischaemic stroke participants had carotid imaging.As compared with<30%,≥70%ipsilateral stenosis was associated with an unfavourable shift in mRS(worse outcome)at 90 days(OR 1.88,95%CI 1.44 to 2.44,p<0.001).Those with≥70%stenosis who received GTN versus no GTN had a favourable shift in mRS(OR 0.56,95%CI 0.34 to 0.93,p=0.024).In those with 50-<70%stenosis,continuing versus stopping prestroke antihypertensives was associated with worse disability,mood,quality of life and cognition at 90 days.Clinical outcomes did not differ across bilateral stenosis groups.Conclusions Following ischaemic stroke,severe ipsilateral carotid stenosis is associated with worse functional outcome at 90 days.GTN appears safe in ipsilateral or bilateral carotid stenosis,and might improve outcome in severe ipsilateral carotid stenosis. | Jason P Appleton Lisa J Woodhouse Andrew Belcher Daniel Bereczki Eivind Berge Valeria Caso Hui Meng Chang Hanne K Christensen Ronan Collins John Gommans Ann C Laska George Ntaios Serefnur Ozturk Gillian M Sare Szabolcs Szatmari Yongjun Wang Joanna M Wardlaw Nikola Sprigg Philip M Bath for the ENOS investigators | 2019 | Stroke & Vascular Neurology2019，4，1： | 6 |
| 2 | Relation of Transmitral Flow Velocity Patterns to Left Ventrieular Diastolic Function: New Insights from a Combined Hemodynamic and Doppler Eehocardiographie Study显示文摘 | Appleton C P Hatle L K Popp R L | 1988 | J Am Coil Cardiol1988，12，2： | 1 |
| 3 | Demonstration of Restrictive Ventricular Physiology by Doppler Eehocardiography显示文摘 | Appleton C P Hatle L K Popp R L | 1988 | J Am Coll Cardiol1988，11，4： | 1 |
| 4 | Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures:a comparative simultaneous Doppler-catheterization study显示文摘 | OMMEN S R NISHIMURA R A APPLETON C P | 2000 | Circulation2000，102，15： | 1 |
| 5 | Guidelines forcounselling in infertility:outline version显示文摘 | Boivin J Appleton T C Baetens P | | 0，，06： | 1 |
| 6 | Recommen-dations for the evaluation of left ventricular diastolic functionby echocardiography 显示文摘 | Nagueh S F Appleton C P Gillebert T C | 2009 | Am Soc Echocardiogr2009，22，2： | 1 |
| 7 | Recommenda- tions for the evaluation of left ventricular diastolic funetion by e- chocardiography显示文摘 | Nagueh S F Appleton C P Gilleben T C | 2009 | Eur J Echocardiogr2009，10，2： | 1 |
| 8 | Recommendations for the evaluation of left ventricular diastolicfunction by echocardiography 显示文摘 | NAGUEH S F APPLETON C P GILLEBEHT T C | 2009 | J Am Soc Echocardiogr2009，22，2： | 1 |
| 9 | Relation of transmitral flow velocity patterns to left ventrieular diastolic function, New insights from a combined hemodynamie and Doppler echocardiographic study显示文摘 | APPLETON C P HATLE L K POPP R L | 1988 | J Am Coll Cardiol1988，12，2： | 1 |
| 10 | Recommendations for the evaluation of left ventricular diastolic function by echocardiography显示文摘 | NAGUEH S F APPLETON C P GILLEBERT T C | 2009 | J Am Soc Echocardiogr2009，22，： | 1 |
| 11 | Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonvalvular atrial fibrillation in 840 elderly men and women显示文摘 | Teresa S.M Tsang Bernard J Gersh Christopher P Appleton A.Jamil Tajik Marion E Barnes Kent R Bailey Jae K Oh Cynthia Leibson Samantha C Montgomery James B Seward | 2002 | Journal of the American College of Cardiology2002，，： | 1 |
| 12 | Left atrial size: physiologic determinants and clinical appli- cations显示文摘 | ABHAYARATNA W P SEWARD J B APPLETON C P | 2006 | Journal of the American College of Cardiology2006，47，12： | 1 |
| 13 | The role of left atrial function in diatolic heart failure显示文摘 | APPLETON C P KOVA S J | 2009 | Circ Cardiovac Imaging2009，2，1： | 1 |
| 14 | Rec-ommendations for the evaluation of left ventricular dias-tolic function by echocardiography 显示文摘 | Nagueh S F Appleton C P Gillebert T C' | 2009 | Eur J Echocar-diogr2009，10，2： | 1 |
| 15 | Recommendations for the evaluation of left ventricular diastolic function by echocardiography显示文摘 | Nagueh S F Appleton C P Gillebert T C | 2009 | Am Soc Echocardiogr2009，22，2： | 1 |
| 16 | Clinical utility of Doppler eehocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: a comparative simultaneous Doppler-catheterization study 显示文摘 | Ommen S R Nishimura R A Appleton C P | 2000 | Circulation2000，102，15： | 1 |
| 17 | Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonval- vularatrial fibrillation in 840 elderly men and women 显示文摘 | Tsang T S Gersh B J Appleton C P | 2002 | Am Coil Cardiol2002，40，2： | 1 |
| 18 | Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures:A comparative simultaneous Doppler-catheterization study显示文摘 | OMMEN S R NISHIMURA R A APPLETON C P | 2000 | Circulation2000，102，15： | 1 |
| 19 | The role of left atrial function indiastolic heart failure显示文摘 | APPLETON C P KOVACS S J | 2009 | Circ Cardiovasc Imaging2009，2，1： | 1 |
| 20 | Left atrial size:physiologic determinants and clinical applications显示文摘 | ABHAYARATNA W P SEWARD J B APPLETON C P | 2006 | J Am Coll Cardiol2006，47，： | 1 |
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