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Pathologic Q Waves and Prolonged QTc Time in Preoperative ECG Are Predictive for Perioperative Cardiovascular Events

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World Journal of Cardiovascular Diseases 2014年第10期4卷 498-509页

作者： thomas wolters Michael Weber thomas Neumann Hans-Georg Strauß Andreas Luchner Manfred Seeberger Christian Mueller Christoph Liebetrau Svetlana Apostolovic Radmilo Jankovic Dragic Bankovic Marina Jovic Vesselin Mitrovic Holger Nef Helge Mollmann Karl Werdan Christian W. Hamm Axel Schlitt Department of Medicine III University Clinic Halle (Saale) Halle Germany Department of Medicine Clinic Grabs Grabs Switzerland Department of Cardiology Kerckhoff Heart and Thorax Center Bad Nauheim Germany Department of Medicine II Clinic Gro&szlig -Umstadt Gro&szlig -Umstadt Germany Department of Medicine II University of Regensburg Regensburg Germany Department of Cardiology University of Basel Basel Switzerland University Cardiology Clinic Ni&scaron Serbia Department of Mathematical Sciences University of Kragujevac Kragujevac Serbia Department of Medicine I University Clinic of Gie&szlig en and Marburg Gie&szlig en Germany Department of Medicine I Paracelsus-Harz-Clinic Bad Suderode Quedlinburg Germany

Aims: The value of ECG in the perioperative risk stratification under modern treatment options is uncertain. The main objective of the present analysis was to determine the usefulness of a pre-operative ECG derivation for evaluating the risk of perioperative morbidity and mortality. Methods: We performed a secondary analysis of the prospective, international, multicenter, observational “No-Risk” Study (N-terminal B-type natriuretic peptide [NT-proBNP] for the assessment of the perioperative cardiac risk after major noncardiac surgery) to determine the prognostic value of 12-lead ECG. Inclusion criteria were age >55 years and at least one of the following cardiovascular risk factors: arterial hypertension, diabetes mellitus, dyslipidemia, active smoking, and family history positive for coronary heart disease. The combined primary endpoint included total mortality, acute myocardial infarction (NSTEMI and STEMI), cardiopulmonary resuscitation, heart failure, and asystole or ventricular fibrillation during hospitalization. ECGs from 616 patients enrolled from 2006 to 2009 prior to noncardiac surgery in the No-Risk Study were analyzed. Results: The mean age was 67.6 (±8.1) years;300 (48.7%) patients were male. Fourteen (2.3%) patients suffered from the combined primary endpoint while in the hospital. In Kaplan-Meier analyses, a pathologic Q wave and QTc > 500 ms were significantly related to the incidence of the primary endpoint (p p = 0.042, respectively), whereas other ECG parameters such as LBBB, RBBB, PQ interval, QRS interval, and others were not related to worse in-hospital outcome. Conclusion: The 12-lead ECG is still an important diagnostic tool for perioperative risk assessment of cardiovascular events in noncardiac surgery in patients at risk.

关键词： ECG Perioperative Risk Cardiovascular Risk

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Teriflunomide provides protective properties after oxygen-glucose-deprivation in hippocampal and cerebellar slice cultures

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Neural Regeneration Research 2021年第11期16卷 2243-2249页

作者： Anna wolters Judith Reuther Philipp Gude thomas Weber Carsten Theiss Heike Vogelsang Veronika Matschke Institute of Anatomy Department of CytologyMedical FacultyRuhr University BochumBochumGermany Department of Anaesthesiology and Intensive Care Medicine Ruhr University BochumSt.Josef HospitalBochumGermany

One of the major challenges in emergency medicine is out-of-hospital cardiac arrest(OHCA).Every year,about 53–62/100000 people worldwide suffer an out-of-hospital cardiac arrest with serious consequences,whereas persistent brain injury is a major cause of morbidity and mortality of those surviving a cardiac ***,only few and insufficient strategies are known to limit neurological damage of ischemia and reperfusion *** aim of the present study was to investigate whether teriflunomide,an approved drug for treatment of relapsing-remitting-multiple-sclerosis,exerts a protective effect on brain cells in an in vitro model of ***,organotypic slice cultures from rat hippocampus and cerebellum were exposed to oxygen-glucose-deprivation and subsequently treated with *** administration of teriflunomide in the reperfusion time on both hippocampal and cerebellar slice cultures significantly decreased the amount of detectable propidium iodide signal compared with an untreated culture,indicating that more cells survive after ***,hippocampal slice cultures showed a higher vulnerability to ischemic conditions and a more sensitive response to teriflunomide compared with cerebellar slice *** study suggests that teriflunomide,applied as a post-treatment after an oxygenglucose-deprivation,has a protective effect on hippocampal and cerebellar cells in organotypic slice cultures of *** procedures were conducted under established standards of the German federal state of North Rhine Westphalia,in accordance with the European Communities Council Directive 2010/63/EU on the protection of animals used for scientific purposes.

关键词： brain damage cardiac arrest cell death hypoxic chamber ischemia organotypic slice cultures post-treatment resuscitation

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