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Die Transmurale ERP-Dispersion von Epi-,Mid-und Endomyokard im gesunden und hypertrophierten Hundemyokard

Journal of Huazhong University of Science and Technology(Medical Sciences) 2001年第2期21卷 89-92页

作者：吕家高陆再英 Abteilung für kardiologie Tongji Klinik Tongji Medizinisches Institut Huazhong Universität für Wissenschaft und Technik Wuhan Abteilung für kardiologie Innere Medizin III Universität Heidelberg Deutschland

Viele Studien haben das Vorliegen von M Zellen im Midmyokard des Hundes in vitro beobachtet und weiterhin gefunden, da das Vorliegen von M Zellen zur Differenz der Repolarisation und zur Dispersion der Refraktarzeit zwischen Midmyokard und Epi und Endomyokard fuhren *** Dispersion hat enge Beziehungen mit der Entstehung der Arrhythmie. Aber die Beobachtungen in vitro waren nicht konkordant mit den Ergebnissen in vivo. Mittels direkten Messungen der ERP in drei Myokardschichten wurde erstmals im gesunden Hundemyokard und im hypertrophierten Hundemyokard in vivo untersucht. Die Untersuchung hat gezeigt, da die ERP von Endomyokard, Epimyokard und Midmyokard im gesunden Hundeherzen homogen sind. Die relevante transmurale Refraktargradient, die die Induktion einer kreisenden Erregung begunstigt, besteht unter physiologischen Bedingungen nicht. Im Gegensatz dazu konnte eine deutliche Verlangerung der ERP in allen Myokardschichten von hypertrophierten Hundeherzen nachgewiesen werden.. Weiterhin wurde gezeigt, da eine transmurale ERP Dispersion zwischen verschiedenen Myokardschichten im hypertrophierten Hundemyokard besteht. Es ist zu postulieren, da diese transmurale ERP Dispersion als Substrat fur die Arrhythmie angesehen werden kann,weil diese Dispersion die lokalen kreisende Erregung zwischen Epikard und Midkard, oder zwischen Midkard und Endokard begunstigen kann. Nach den Ergebnissen lat sich postulieren, da eine transmurale ERP Dispersion durch eine plotzliche Zykluslangeveranderung, namlich durch eine Kurz Lang und eine Lang Kurz Sequenz verstarkt werden kann.

关键词： normale Myokard hypertrophierte Myokard transmurale ERP Dispersion

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Frequency of apoptosisin cardiac myocytes of patients with myocarditisand dilated cardiomyopathy

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Chinese Medical Journal 1999年第9期112卷 96-96页

作者： JiangtaoYu JunYe BernwardLauer VolkerAdams StephanGielen UweKuhl AxelRahmel GerhardSchuler RainerHambrecht Universitat Leipzig-Herzzentrum GmbH Klinik fur lnnere Medizin/Kardiologie Germany Abteilung fur kardiologie Klinikum Benjamin Franklin der Freien Universitat Berlin Germany

Background Programmed cell death has previously been observed in animal models of viral myocarditis and in patients with end stage dilated cardio myopathy (DCM). The purpose of the present study was to investigate if apoptosis is also detectable in endomyocardial biopsies of patients with clinical and immuno histological signs of myocarditis. Methods Right ventricular myocardial biopsies were obtained from 53 patients with clinically suspected myocarditis (left ventricular ejection fraction 30±14%). Cardiac tissues from 4 patients with end stage heart failure were obtained during heart transplantation. Diagnosis of myocarditis and DCM was based on clinical presentation and on histological and immunohistological findings. The presence of apoptosis was investigated in paraffin embedded tissue sections by in situ end labeling of nuclear DNA strand breaks. Results By histological and immunohistological analysis 19 patients (36%) were diagnosed as myocarditis and 34 patients (64%) as DCM. Apoptosis was detected in 9 out of 19 patients with myocarditis, in 12 out of 34 patients with DCM (47% versus 35%, p=NS), and in all patients with end stage heart failure. Conclusions A high frequency of apoptosis was detectable in endomyocardial biopsies of patients with immunohistologically documented myocarditis. The rate of apoptosis in patients with myocarditis, however, was not different to patients with DCM. These findings suggest that apoptosis may be one common pathway in the pathogenesis of cardiac contractile dysfunction in patients with myocarditis and DCM.

关键词： Frequency of apoptosisin cardiac myocytes of patients with myocarditisand dilated cardiomyopathy

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Surgical-interventional hybrid orchestra consisting of Potts shunt, transcatheter tricuspid valve repair by Edwards-valve in a 26-year-old patient with pulmonary hypertension and right ventricular failure

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World Journal of Cardiovascular Diseases 2013年第6期3卷 1-4页

作者： Sabine Recla Blanka Steinbrenner Jennifer Schreier Stephan Fichtlscherer Dorle Schmidt Christian Apitz Matthias Muller Juergen Bauer Hakan Akintuerk Dietmar Schranz Hessiches Kinderherzzentrum Universitatskliniken GiessenFrankfurtGermany Medizinische Klinik III Kardiologie UniversitatsklinikumFrankfurtGermany

Reported here is a 26-year-old patient with corrected congenital interrupted aortic arch admitted with massive hemoptysis and severe suprasystemic pul-monary hypertension provided him for heart-lung transplantation. Initial closure of a small aorto-pulmonary collateral remained ineffective. Persistent life-threatening hemoptysis led to the decision for a modified Potts shunt with the aim of decompressing the right ventricle and avoiding pulmonary-hypertensive crisis. The hemoptysis did not recur. However, the patient’s oxygen transport condition deteriorated and necessitated an orchestra of interventional-surgical approaches from re-coarctation stenting, Potts shunt flow reducing to surgical and transcatheter tricuspid valve repair with transient ECMO before the patient could be discharged home.

关键词： Pulmonary Hypertension Potts Shunt Edwards Tricuspid Valve Hybrid-Procedure

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Artificial sweetener sucralose: a possible modulator of autoimmune diseases

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Signal Transduction and Targeted Therapy 2023年第11期8卷 5123-5125页

作者： Nicolle Kränkel Ursula Rauch-Kroehnert Deutsches Herzzentrum der Charité Klinik für KardiologieAngiologie und IntensivmedizinCampus Benjamin-Franklin(CBF)12203BerlinGermany DZHK(German Centre for Cardiovascular Research) Partner site BerlinBerlinGermany Friede Springer—Centre of Cardiovascular Prevention@Charité Charité—University Medicine BerlinBerlinGermany

In their research article in Nature in March 2023,Fabio Zani and colleagues reported that high concentrations of the zero-calorie artificial sweetener sucralose affected the proliferation and differentiation of T cells toward interferon-γ-producing subsets,with no effect observed for B cells and myeloid cells.1 The publication has raised high hopes in the lay press on a widely available cure for patients suffering from autoimmune diseases.

关键词： autoimmune interferon diseases

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Catheter ablation of atrial fibrillation facilitated by preprocedural three-dimensional transesophageal echocardiography: Long-term outcome

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World Journal of Cardiology 2017年第6期9卷 539-546页

作者： Klaus Kettering Felix Gramley Stephan von Bardeleben Department of Cardiology University of Frankfurt HPK Heidelberger Praxisklinik für Innere Medizin Kardiologie und Pneumologie Department of Cardiology University of Mainz

AIM To evaluate the long-term outcome of catheter ablation of atrial fibrillation(AF) facilitated by preprocedural threedimensional(3-D) transesophageal *** In 50 patients, 3D transesophageal echocardiography(3D TEE) was performed immediately prior to an ablation procedure(paroxysmal AF: 30 patients, persistent AF: 20 patients). The images were available throughout the ablation procedure. Two different ablation strategies were used. In most of the patients with paroxysmal AF, the cryoablation technique was used(Arctic Front Balloon, Cryo Cath Technologies/Medtronic; group A2). In the other patients, a circumferential pulmonary vein ablation was performed using the CARTO system [Biosense Webster; group A1(paroxysmal AF), group B(persistent AF)]. Success rates and complication rates were analysed at 4-year *** A 3D TEE could be performed successfully in all patients prior to the ablation procedure and all four pulmonaryvein ostia could be evaluated in 84% of patients. The image quality was excellent in the majority of patients and several variations of the pulmonary vein anatomy could be visualized precisely(e.g., common pulmonary vein ostia, accessory pulmonary veins, varying diameter of the left atrial appendage and its distance to the left superior pulmonary vein). All ablation procedures could be performed as planned and almost all pulmonary veins could be isolated successfully. At 48-mo followup, 68.0% of all patients were free from an arrhythmia recurrence(group A1: 72.7%, group A2: 73.7%, group B: 60.0%). There were no major ***3 D TEE provides an excellent overview over the left atrial anatomy prior to AF ablation procedures and these procedures are associated with a favourable long-term outcome.

关键词： Pulmonary veins Catheter ablation Atrial fibrillation Transesophageal echocardiography Three-dimensional echocardiography

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冠心病电子束X线体层影像术——冠状动脉钙化的流行与分布以及650例患者冠状动脉危险因子的相关性

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Oncology and Translational Medicine 1997年第1期14卷 47-48页

作者： A.Schmermund,S.Lange,C.Sehnert,K.Altmaier,D.Baumgart,G.Grge,R.Erbel,R.Seibel,D.Grnemeyer,陈继华 Abterlung fr kardiologie Universittsklinikum Hufelandstr.55 D-45122 Essen Germany Abterlung fr kardiologie Universittsklinikum Hufelandstr.55 D-45122 Essen Germany Abterlung fr kardiologie Universittsklinikum Hufelandstr.55 D-45122 Essen Germany Abterlung fr kardiologie Universittsklinikum Hufelandstr.55 D-45122 Essen Germany Abterlung fr kardiologie Universittsklinikum Hufelandstr.55 D-45122 Essen Germany Abterlung fr kardiologie Universittsklinikum Hufelandstr.55 D-45122 Essen Germany Abterlung fr kardiologie Universittsklinikum Hufelandstr.55 D-45122 Essen Germany Abterlung fr kardiologie Universittsklinikum Hufelandstr.55 D-45122 Essen Germany Abterlung fr kardiologie Universittsklinikum Hufelandstr.55 D-45122 Essen Germany 同济医科大学

冠状动脉钙化可采用电子束X线体层影像术(EBT)验证,这是一项非侵入性的灵敏度很高的检查手段。文献报道,将病理、血管造影术。

关键词：冠状动脉体层冠心病冠状动脉病体层照片影像术危险因子患者相关性

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Readmission after acute decompensation:challenges in heart failure care

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中华心力衰竭和心肌病杂志（中英文） 2018年第2期2卷 114-118页

作者： Michael Bohm Christian Werner Yvonne Bewarder Jan Wintrich Ingrid Kindermann Universitiitsklinikurri des Saarlandes Klinik fur Innere Medizin IIIUniversitat des Saarlandes KardiologieAngiologie und lnlemistische Intensivmedizin Kirrberger Str.I 66421 Homburg/SaarGermany

Introduction Despite intensive multidrug therapy,patients with heart failure are often readmitted resulting in an annual rehospitalization rate for heart failure in the United States of 1 million patients per year[1].Despite evidence-based treatments,often initiated in the hospital,these individuals face a high post discharge mortality and rehospitalization rate,such as 15% and 30%,respectively,within 60-90 days[2-4].Mechanistically,in the vulnerable phase an excess of neuroendocrine activation is likely to contribute to the high event *** example is the escape phenomenon of the renin-angiotensin-aldosterone system (RAAS) providing the basis for a combined inhibitor therapy in this condition[5-7] in stable ***,in the post-discharge vulnerable phase,combined RAAS inhibition with the renin inhibitor aliskiren failed to show benefits[s-9].The treatment of these patients is limited due to the fact that they quite often have low blood pressure and high heart rate preventing physicians to treat patients with adequate dosis of neuroendocrine antagonists[10].

关键词： Readmission Introduction challenges

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急性心肌梗塞的介入治疗

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Oncology and Translational Medicine 1998年第2期 14-16页

作者： M.P.Heintzen,C.J.Michel,S.Schlter,M.Leschke,B.Schwartzkopff,E.G.Vester,M.Kelm,T.M.Schiele,B.E.Strauer,张金枝 kardiologie Pneumologie Angiologie Heinrich-Heine-Universitt Moorenstr.5 D-40225 Düsseldorf Germany Medizinische Klinik und Poliklinik B kardiologie Pneumologie Medizinische Klinik und Poliklinik B Angiologie Heinrich-Heine-Universitt Moorenstr.5 D-40225 Düsseldorf Germany Medizinische Klinik und Poliklinik B kardiologie Pneumologie Angiologie Heinrich-Heine-Universitt kardiologie Moorenstr.5 D-40225 Düsseldorf Germany Medizinische Klinik und Poliklinik B kardiologie Pneumologie Angiologie Heinrich-Heine-Universitt Moorenstr.5 D-40225 Düsseldorf Pneumologie Germany Medizinische Klinik und Poliklinik B kardiologie Pneumologie Angiologie Heinrich-Heine-Universitt Moorenstr.5 D-40225 Düsseldorf Germany Medizinische Klinik und Poliklinik B Angiologie kardiologie Pneumologie Angiologie Heinrich-Heine-Universitt Moorenstr.5 D-40225 Düsseldorf Germany Medizinische Klinik und Poliklinik B kardiologie Pneumologie Heinrich-Heine-Universitt Angiologie Heinrich-Heine-Universitt Moorenstr.5 D-40225 Düsseldorf Germany Medizinische Klinik und Poliklinik B kardiologie Pneumologie Angiologie Heinrich-Heine-Universitt Moorenstr.5 Moorenstr.5 D-40225 Düsseldorf Germany 同济医科大学附属协和医院 D-40225 Düsseldorf Germany Medizinische Klinik und Poliklinik B

近10年来,急性心肌梗塞(AMI)的治疗发生了显著变化。60年代其死亡率为4O％,监护病房及其网络建立后,其死亡率降至15％～20％,80年代溶栓治疗使其死亡率降至6％～11％。目前认为直接PTCA是AMI病人血管再灌注最有效的治疗方法。

关键词：溶栓治疗病人介入治疗 PTCA 急性心肌梗塞 AMI 血管再闭塞血管再通再灌注

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Noninvasive Surrogates for Left Ventricular Filling Pressure in Patients with Valvular Heart Disease

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International Journal of Clinical Medicine 2015年第3期6卷 193-203页

作者： Debora Brala Thomas G. Allison Wilhelm Haverkamp Ingolf Schimke Olaf Schulz Department of Cardiology Universitatsmedizin Berlin Berlin Germany Department of Cardiology Sana Klinikum Lichtenberg Berlin Germany Deparment of Cardiovascular Diseases Mayo Clinic and Medical School Rochester MN USA Kardio-West Praxis für Interventionelle und Konventionelle Kardiologie Spandau Berlin Germany

Background: Invasive measurement of left ventricular filling pressure is the gold standard for determining diastolic dysfunction and predicting subsequent outcomes. For repetitive assessment of diastolic function during long-term management, noninvasive surrogates are used. Their reliability and reproducibility should be validated separately for different cardiovascular diseases and conditions. The aim of this study was to identify noninvasive surrogates of invasively derived left ventricular filling pressure and to relate these surrogates to outcomes (death or valve replacement) in patients with stable, asymptomatic valvular heart disease and preserved ejection fraction. Materials and Methods: In a first cohort, we investigated 54 patients who had spiroergometry, echocardiography, and left heart catheterization within a range of 100 days. In a second cohort (n = 64), noninvasive measures were related to outcomes after follow-up of 694 ± 576 days. Transmitral doppler E/tissue doppler E’ (E/E’), E/flow propagation velocity (E/Vp), isovolumetric relaxation time/time to E’-time to E (IVRT/TE’-TE), ventilatory efficiency (VE/VCO2slope), O2 consumption at anaerobic threshold and at peak exercise (VO2AT, VO2peak) as well as NT-pro brain natriuretic peptide (NTpro-BNP) were assessed in relation to left ventricular filling pressure and outcome. Results: NT-proBNP, VO2AT, VE/VCO2slope as well as echocardiographic surrogates E/E’ and E/flow propagation velocity were indicators of elevated end diastolic filling pressure. In multivariable analysis, VO2AT was the only independent predictor. NT-proBNP was the only surrogate of left ventricular filling pressure which predicted outcome. Conclusion: In patients with asymptomatic valvular heart disease and preserved systolic function, spiroergometric parameters and NT-proBNP performed best to assess filling pressure. Only NT-proBNP showed prognostic value in this cohort.

关键词： Filling Pressure NT-proBNP E/E’ VO2 VE/VCO2slope Valvular Heart Disease

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西罗莫司洗脱支架置入和β射线照射治疗支架内再狭窄病变:比较容积血管内超声所评估的急性获得和晚期丢失的潜在机制

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世界核心医学期刊文摘（心脏病学分册） 2006年第1期2卷 30-31页

作者： Schiele T. M. Knig A. Rieber J. 王亭忠 Dr.kardiologie Klinikum der Universitt München-Innenstadt Ziemssenstrasse 1 80336 Munich Germany

Background: The aim of the study was to compare the angioplasty mechanisms of drug(sirolimus)-eluting stent(DES) implantation and vascular brachytherapy(VBT) for the treatment of in-stent restenosis(ISR) as assessed by intravascular ultrasound(IVUS). Methods: We performed IVUS in 53 patients(28 DES, 25 VBT) before and after angioplasty of ISR and at 6-month follow-up. Cross-sectional areas of the external elastic membrane, the stent, and the lumen were measured. Plaque +media, peristent plaque, and intimal hyperplasia areas were calculated, respectively. Results: Clinical and IVUS baseline characteristics did not differ between groups at baseline. After the index procedure, the lumen at the stent site was smaller in the DES group(DES 6.7±2.0 mm2 vs VBT 7.5±2.2 mm2, P=.042). Because of less intimal hyperplasia(DES 0.2±0.5 mm2 vs VBT 0.7±0.7 mm2, P=.043), the lumen dimensions revealed no difference between groups at follow-up(DES 6.5±2.3 mm2 vs VBT 6.8±2.2 mm2, P=.374). At the reference site, the index procedure led to a similar increase of plaque +media(DES 0.9±0.9 mm2 vs VBT 0.6±1.2 mm2, P=.150). At follow-up, the plaque +media was significantly smaller in the DES group(DES 8.0±6.6 mm2 vs VBT 9.9±7.8 mm2, P=.013). Conclusions: Drug-eluting stent for the treatment of ISR more effectively inhibits neointima formation when compared with VBT. Yet insufficient stent expansion might be a reason for device failure and should be avoided. At the reference site, lumen loss by an increased plaque burden, as has been well recognized following VBT, is not present with DES.

关键词：支架内再狭窄病变 β射线照射治疗血管内超声支架置入西罗莫司洗脱血管成形术潜在晚期急性

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