Zeitschrift fur Kardiologie最新文献

{"title":"[Pulmonary hypertension].","authors":"G. Schuler","doi":"10.1093/med/9780190884512.003.0025","DOIUrl":"https://doi.org/10.1093/med/9780190884512.003.0025","url":null,"abstract":"Depending on their size pulmonary emboli are responsible for an abrupt rise in pulmonary artery pressure. Not only mechanical obstruction, but also liberation of vasoactive substances from platelets trapped within the emboli represent the underlying mechanism. Intrapulmonary shunts, caused by vaso- and bronchoconstriction, may result in arterial hypoxemia. Although this clinical finding is encountered in most cases, normal arterial blood gases do not rule out significant pulmonary embolism. Even a small rise in pulmonary artery pressure causes significant reduction of right ventricular stroke volume and a decrease in left ventricular filling pressure. Impaired left ventricular filling is aggravated by biventricular interdependence. Elevated pulmonary artery pressures during rest and exercise are normalized by effective fibrinolytic therapy.","PeriodicalId":23757,"journal":{"name":"Zeitschrift fur Kardiologie","volume":"5 1","pages":"21-3"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79460144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[History of atrial fibrillation].","authors":"T. Fazekas, G. Liszkai, H. Bielik, B. Lüderitz","doi":"10.1556/IMAS.3.2011.3.14","DOIUrl":"https://doi.org/10.1556/IMAS.3.2011.3.14","url":null,"abstract":"The authors review the history of atrial fibrillation, the most frequent clinically observed cardiac arrhythmia. A French \"clinicopathologist\", Jean Baptist de Sénac (1693-1770), was the first who assumed a correlation between \"rebellious palpitation\" and a stenosis of the mitral valve. From an analysis of simultaneously recorded arterial and venous pressure curves, the Scottish Sir James Mackenzie (1853-1925) demonstrated that a presystolic a wave cannot be seen on the jugular phlebogram during \"pulsus irregularis perpetuus\". The first human ECG depicting atrial fibrillation was published by Willem Einthoven (1860-1927) in 1906. The proof of a direct connection between absolute arrhythmia and auricular fibrillation was established by two Viennese physicians, Rothberger and Winterberg. The major discoveries relating to the pathomechanism and the clinical features of atrial fibrillation in the 20(th) century stemmed from the scientific activities of Karel Frederik Wenckebach, Sir Thomas Lewis, Gordon Moe, and Maurits Allessie.","PeriodicalId":23757,"journal":{"name":"Zeitschrift fur Kardiologie","volume":"55 1","pages":"122-7"},"PeriodicalIF":0.0,"publicationDate":"2011-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82741478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful treatment of oleander intoxication (cardiac glycosides) with digoxin-specific Fab antibody fragments in a 7-year-old child: case report and review of literature.","authors":"C Camphausen,&nbsp;N A Haas,&nbsp;A C Mattke","doi":"10.1007/s00392-005-0293-3","DOIUrl":"https://doi.org/10.1007/s00392-005-0293-3","url":null,"abstract":"<p><strong>Unlabelled: </strong>A 7-year-old girl presented six hours after ingestion of a yellow oleander seed (Thevetia peruviana) with severe emesis, change in colour vision and complete heart block. Initial treatment with phenytoin and isoprenalin infusion led to intermittent supraventricular and ventricular tachycardia. The patient was then treated with two intravenous doses of 190 mg of digoxin-specific Fab antibody fragments (Digibind). Subsequently the patient's rhythm reverted to sinus rhythm and the symptoms resolved within 2 hours.</p><p><strong>Conclusion: </strong>administration of digoxin-specific Fab antibody fragments in an otherwise healthy child after oleander intoxication is safe and without adverse reactions.</p>","PeriodicalId":23757,"journal":{"name":"Zeitschrift fur Kardiologie","volume":"94 12","pages":"817-23"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00392-005-0293-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25774930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy-associated spontaneous coronary artery dissection: impact of medical treatment. Case report and systematic review.","authors":"M Maeder,&nbsp;P Ammann,&nbsp;G Drack,&nbsp;H Rickli","doi":"10.1007/s00392-005-0302-6","DOIUrl":"https://doi.org/10.1007/s00392-005-0302-6","url":null,"abstract":"<p><p>We report on a 22- year-old woman with postpartum dissection of the left anterior descending artery and the intermediate branch. The patient was treated with acetylsalicylic acid (ASA), clopidogrel, and betablocker only. Coronary angiography performed 20 months later revealed complete resolution of the dissection sites. The patient's cardiovascular risk factors included mild smoking and high total cholesterol and low-density-lipoprotein-cholesterol levels, which showed a marked fall after pregnancy without pharmacological cholesterol-modifying therapy raising the question whether pregnancy-related hypercholesterolemia contributed to the pathogenesis of pregnancy-associated spontaneous coronary artery dissection (P-SCAD). In a systematic review of the literature, 16 women [median age 34 (31-36.5) years] with P-SCAD and angiographic follow-up were identified. The majority (69%) of P-SCAD cases occurred postpartum [median time after delivery: 13 (7-21) days]. In 10/16 (63%) patients medical treatment including betablocker and antiplatelet therapy was given leading to complete resolution of the dissection in 5 of them (31% of all patients) at follow-up, whereas in the other 5 patients the dissections were persisting or even progressive. Of the medically treated patients, 80% were free of symptoms suggestive for ischemia at follow-up. In 5/16 patients percutaneous coronary intervention (PCI) was performed as first-line therapy. Three patients underwent coronary artery bypass grafting, which was performed primarily in one patient, and secondarily in two patients with persisting dissections and ongoing ischemic symptoms after previous medical treatment or PCI without stenting, respectively. In conclusion, medical treatment including ASA, clopidogrel and betablocker therapy results in an excellent clinical and angiographic result in approximately one third of patients with P-SCAD.</p>","PeriodicalId":23757,"journal":{"name":"Zeitschrift fur Kardiologie","volume":"94 12","pages":"829-35"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00392-005-0302-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25774932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac angiosarcoma: case report and review of the literature.","authors":"R R Brandt,&nbsp;R Arnold,&nbsp;R M Bohle,&nbsp;T Dill,&nbsp;C W Hamm","doi":"10.1007/s00392-005-0296-0","DOIUrl":"https://doi.org/10.1007/s00392-005-0296-0","url":null,"abstract":"<p><p>Angiosarcoma of the heart, the most common primary malignant cardiac tumor in adults is known to carry a dismal prognosis. The diagnosis is often delayed because of the nonspecific clinical presentation. Symptoms are determined by the size and location of the tumor. Echocardiography has become the primary diagnostic technique because of its high degree of accuracy, noninvasiveness, and cost effectiveness. Complete surgical resection is required for improved survival. Conventional postoperative chemotherapy does not appear to modify the clinical course. We report a case of cardiac angiosarcoma with a large mural mass infiltrating the right atrial and ventricular walls and critically review the pertinent literature.</p>","PeriodicalId":23757,"journal":{"name":"Zeitschrift fur Kardiologie","volume":"94 12","pages":"824-8"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00392-005-0296-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25774931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Position paper to the taking of quality controls for resting, exercise, and long-term-ECG].","authors":"G Sauer,&nbsp;D Andresen,&nbsp;R Cierpka,&nbsp;B Lemke,&nbsp;F Mibach,&nbsp;Ch Perings,&nbsp;R Vaerst","doi":"10.1007/s00392-005-0320-4","DOIUrl":"https://doi.org/10.1007/s00392-005-0320-4","url":null,"abstract":"","PeriodicalId":23757,"journal":{"name":"Zeitschrift fur Kardiologie","volume":"94 12","pages":"844-57"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00392-005-0320-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25774934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary fistula of right coronary artery to vena cava superior and ectasia of pulmonary artery.","authors":"A Koch,&nbsp;C Sebening,&nbsp;R DeSimone,&nbsp;L Jahn,&nbsp;F-U Sack,&nbsp;S Hagl","doi":"10.1007/s00392-005-0291-5","DOIUrl":"https://doi.org/10.1007/s00392-005-0291-5","url":null,"abstract":"<p><p>We report on a patient with coronary heart disease, a coronary fistula of right coronary artery to vena cava superior and pulmonary hypertension. Combined with coronary artery revascularization, the coronary fistula was closed successfully.</p>","PeriodicalId":23757,"journal":{"name":"Zeitschrift fur Kardiologie","volume":"94 12","pages":"813-6"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00392-005-0291-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25774929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slow pathway ablation in children with documented reentrant supraventricular tachycardia not inducible during invasive electrophysiologic study.","authors":"M Emmel,&nbsp;K Brockmeier,&nbsp;N Sreeram","doi":"10.1007/s00392-005-0305-3","DOIUrl":"https://doi.org/10.1007/s00392-005-0305-3","url":null,"abstract":"<p><strong>Unlabelled: </strong>Radiofrequency catheter ablation (RFA) has become the procedure of choice for permanent therapy of atrioventricular nodal reentrant tachycardia (AVNRT). This report presents our experience with atrio-ventricular node (AVN) modification in patients with documented narrow complex reentrant SVT, but no evidence for an accessory pathway, and no inducible tachyarrhythmia during invasive electrophysiology (EP) study.</p><p><strong>Methods: </strong>The study population consists of nine children, age range 6-13 years (median 9) with previously documented SVT who had no tachyarrhythmia inducible during EP study (at baseline and following isoprenaline infusion). Eight of the 9 EP studies were performed under general anesthesia, and one under conscious sedation. An accessory pathway was excluded in all patients by appropriate atrial and ventricular extrastimulus pacing techniques. Eight of the nine patients had dual AV nodal physiology, and one had single AV nodal echo beats. The slow AV nodal pathway was empirically ablated, by applying RF lesions in the right inferoseptal AV groove, achieving catheter tip temperature of 50 degrees C. The appearance of an accelerated junctional rhythm during RF application was deemed to denote a successful application site. AV conduction during RF application was confirmed by incremental atrial pacing. The catheter position, and its relation to the compact AV node was constantly monitored using the LocaLisa navigation system. The end-point was absence of dual AVN physiology, and/or AV nodal echo beats.</p><p><strong>Results: </strong>Successful slow pathway ablation was achieved in all patients. One patient appeared to have two separate slow pathways with different locations and two AH-jumps, which were both successfully ablated. None of the patients had evidence of temporary or permanent AV block at follow-up (median duration 9 months, range 4 to 36 months); none has had recurrence of symptoms or documented tachyarrhythmia.</p><p><strong>Conclusions: </strong>In children with structurally normal hearts, a previously documented SVT, absence of an accessory pathway and noninducibility of SVT during EP study, empirical slow pathway ablation appears to be justified.</p>","PeriodicalId":23757,"journal":{"name":"Zeitschrift fur Kardiologie","volume":"94 12","pages":"808-12"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00392-005-0305-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25773774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience with INR self-management: patient selection and complication rates.","authors":"H Voeller,&nbsp;C Dovifat,&nbsp;K Wegscheider","doi":"10.1007/s00392-005-0304-4","DOIUrl":"https://doi.org/10.1007/s00392-005-0304-4","url":null,"abstract":"<p><strong>Background: </strong>INR self-management can reduce the risk of complications for patients with indication of long-term oral anticoagulation therapy. However, little is known about early indicators of complication risk.</p><p><strong>Methods: </strong>In a prospective study on 330 consecutive patients all participants were informed about oral anticoagulation by a structured teaching program. The two groups were divided as to whether they received usual medical care provided by a family physician (n=220) or self-management (n=110) on a portable coagulation monitor (CoaguChek System). After a mean follow up of 13.3+/-4.4 months, the participants of the study were interviewed by a structured questionnaire to obtain information about hemorrhagic and thromboembolic complications as well as survival.</p><p><strong>Results: </strong>In comparison to patients under usual care, patients with INR selfmanagement were significantly younger (58 vs 64 years) and had fewer comorbidities (diabetes and hypertension) as well as a higher ejection fraction (53.6 vs 51.1%). Indication for anticoagulation, age and heart rhythm explained 58% of the differences between the management groups. There was no significant difference in the overall complication rates between the two groups (usual care vs selfmanagement): major bleeding 0.5 vs 0.9%, cerebral embolism (TIA or stroke) 1.9 vs 0.9%, hospital admission 2.3 vs 1.8%. A high BMI (OR=1.5; 95% CI 1.06-1.25; p=0.001) or a high therapeutic INR range (OR=2.42; 95% CI 1.16-5.1; p=0.019) is associated with a higher complication rate.</p><p><strong>Conclusions: </strong>Complication rates for patients with long-term oral anticoagulant therapy did not differ significantly between usual care and self-management. Rather, the patient's body weight and the requirement of high anticoagulation intensity drive the complication risk under both management systems.</p>","PeriodicalId":23757,"journal":{"name":"Zeitschrift fur Kardiologie","volume":"94 12","pages":"801-7"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00392-005-0304-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25773773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stent-supported angioplasty versus endarterectomy for carotid artery stenosis: evidence from current randomized trials.","authors":"R Zahn,&nbsp;M Hochadel,&nbsp;A Grau,&nbsp;J Senges","doi":"10.1007/s00392-005-0311-5","DOIUrl":"https://doi.org/10.1007/s00392-005-0311-5","url":null,"abstract":"<p><strong>Background: </strong>Carotid artery stenting (CAS) for carotid artery stenoses is evolving as an alternative to carotid endarterectomy (CEA). However, the value of CAS is still a matter of debate. Therefore, we performed a metaanalysis of the randomized controlled clinical trials (RCT) on this issue.</p><p><strong>Methods: </strong>RCTs were identified through searching MEDLINE, textbooks and by personal communication.</p><p><strong>Results: </strong>Six finished RCTs on this issue could be identified, including 1263 patients, 628 randomized to CAS and 635 to CEA. The 30-day death or stroke rate was 8.0% (50/628) in patients treated with CAS compared to 6.1% (39/635) in CEA patients (OR=1.36, 95% CI: 0.88-2.11; p=0.17; p for heterogeneity=0.009). The rate of cranial nerve palsy was 7.1% in the CEA compared to 0% in the CAS group (p<0.0001). The rate of myocardial infarctions was reduced from 3.1 to 1% (OR=0.32, 95% CI: 0.12- 0.81; p=0.02; p for heterogeneity=0.49). The death or stroke rate during follow-up was 12.1% in patients treated with CAS compared to 12.2% in CEA patients (OR=0.99, 95% CI: 0.70-1.42; p=0.98; p for heterogeneity=0.02).</p><p><strong>Conclusion: </strong>The available RCT data on CAS vs. CEA suggest that both methods seem to be equally effective concerning short- and medium-term results, while CAS is associated with lower minor complications than CEA. However, because of the significant heterogeneity between the study outcomes, the results of the large RCTs underway should be awaited before it can be advised to use CAS in a broader perspective.</p>","PeriodicalId":23757,"journal":{"name":"Zeitschrift fur Kardiologie","volume":"94 12","pages":"836-43"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00392-005-0311-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25774933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}