Search Results - (Author, Cooperation:R. Erbel)

Showing 1 - 20 results of 42, query time: 0.42s Refine Results
  1. 1
    D. Shungin ; T. W. Winkler ; D. C. Croteau-Chonka ; T. Ferreira ; A. E. Locke ; R. Magi ; R. J. Strawbridge ; T. H. Pers ; K. Fischer ; A. E. Justice ; T. Workalemahu ; J. M. Wu ; M. L. Buchkovich ; N. L. Heard-Costa ; T. S. Roman ; A. W. Drong ; C. Song ; S. Gustafsson ; F. R. Day ; T. Esko ; T. Fall ; Z. Kutalik ; J. Luan ; J. C. Randall ; A. Scherag ; S. Vedantam ; A. R. Wood ; J. Chen ; R. Fehrmann ; J. Karjalainen ; B. Kahali ; C. T. Liu ; E. M. Schmidt ; D. Absher ; N. Amin ; D. Anderson ; M. Beekman ; J. L. Bragg-Gresham ; S. Buyske ; A. Demirkan ; G. B. Ehret ; M. F. Feitosa ; A. Goel ; A. U. Jackson ; T. Johnson ; M. E. Kleber ; K. Kristiansson ; M. Mangino ; I. Mateo Leach ; C. Medina-Gomez ; C. D. Palmer ; D. Pasko ; S. Pechlivanis ; M. J. Peters ; I. Prokopenko ; A. Stancakova ; Y. Ju Sung ; T. Tanaka ; A. Teumer ; J. V. Van Vliet-Ostaptchouk ; L. Yengo ; W. Zhang ; E. Albrecht ; J. Arnlov ; G. M. Arscott ; S. Bandinelli ; A. Barrett ; C. Bellis ; A. J. Bennett ; C. Berne ; M. Bluher ; S. Bohringer ; F. Bonnet ; Y. Bottcher ; M. Bruinenberg ; D. B. Carba ; I. H. Caspersen ; R. Clarke ; E. W. Daw ; J. Deelen ; E. Deelman ; G. Delgado ; A. S. Doney ; N. Eklund ; M. R. Erdos ; K. Estrada ; E. Eury ; N. Friedrich ; M. E. Garcia ; V. Giedraitis ; B. Gigante ; A. S. Go ; A. Golay ; H. Grallert ; T. B. Grammer ; J. Grassler ; J. Grewal ; C. J. Groves ; T. Haller ; G. Hallmans ; C. A. Hartman ; M. Hassinen ; C. Hayward ; K. Heikkila ; K. H. Herzig ; Q. Helmer ; H. L. Hillege ; O. Holmen ; S. C. Hunt ; A. Isaacs ; T. Ittermann ; A. L. James ; I. Johansson ; T. Juliusdottir ; I. P. Kalafati ; L. Kinnunen ; W. Koenig ; I. K. Kooner ; W. Kratzer ; C. Lamina ; K. Leander ; N. R. Lee ; P. Lichtner ; L. Lind ; J. Lindstrom ; S. Lobbens ; M. Lorentzon ; F. Mach ; P. K. Magnusson ; A. Mahajan ; W. L. McArdle ; C. Menni ; S. Merger ; E. Mihailov ; L. Milani ; R. Mills ; A. Moayyeri ; K. L. Monda ; S. P. Mooijaart ; T. W. Muhleisen ; A. Mulas ; G. Muller ; M. Muller-Nurasyid ; R. Nagaraja ; M. A. Nalls ; N. Narisu ; N. Glorioso ; I. M. Nolte ; M. Olden ; N. W. Rayner ; F. Renstrom ; J. S. Ried ; N. R. Robertson ; L. M. Rose ; S. Sanna ; H. Scharnagl ; S. Scholtens ; B. Sennblad ; T. Seufferlein ; C. M. Sitlani ; A. Vernon Smith ; K. Stirrups ; H. M. Stringham ; J. Sundstrom ; M. A. Swertz ; A. J. Swift ; A. C. Syvanen ; B. O. Tayo ; B. Thorand ; G. Thorleifsson ; A. Tomaschitz ; C. Troffa ; F. V. van Oort ; N. Verweij ; J. M. Vonk ; L. L. Waite ; R. Wennauer ; T. Wilsgaard ; M. K. Wojczynski ; A. Wong ; Q. Zhang ; J. Hua Zhao ; E. P. Brennan ; M. Choi ; P. Eriksson ; L. Folkersen ; A. Franco-Cereceda ; A. G. Gharavi ; A. K. Hedman ; M. F. Hivert ; J. Huang ; S. Kanoni ; F. Karpe ; S. Keildson ; K. Kiryluk ; L. Liang ; R. P. Lifton ; B. Ma ; A. J. McKnight ; R. McPherson ; A. Metspalu ; J. L. Min ; M. F. Moffatt ; G. W. Montgomery ; J. M. Murabito ; G. Nicholson ; D. R. Nyholt ; C. Olsson ; J. R. Perry ; E. Reinmaa ; R. M. Salem ; N. Sandholm ; E. E. Schadt ; R. A. Scott ; L. Stolk ; E. E. Vallejo ; H. J. Westra ; K. T. Zondervan ; P. Amouyel ; D. Arveiler ; S. J. Bakker ; J. Beilby ; R. N. Bergman ; J. Blangero ; M. J. Brown ; M. Burnier ; H. Campbell ; A. Chakravarti ; P. S. Chines ; S. Claudi-Boehm ; F. S. Collins ; D. C. Crawford ; J. Danesh ; U. de Faire ; E. J. de Geus ; M. Dorr ; R. Erbel ; J. G. Eriksson ; M. Farrall ; E. Ferrannini ; J. Ferrieres ; N. G. Forouhi ; T. Forrester ; O. H. Franco ; R. T. Gansevoort ; C. Gieger ; V. Gudnason ; C. A. Haiman ; T. B. Harris ; A. T. Hattersley ; M. Heliovaara ; A. A. Hicks ; A. D. Hingorani ; W. Hoffmann ; A. Hofman ; G. Homuth ; S. E. Humphries ; E. Hypponen ; T. Illig ; M. R. Jarvelin ; B. Johansen ; P. Jousilahti ; A. M. Jula ; J. Kaprio ; F. Kee ; S. M. Keinanen-Kiukaanniemi ; J. S. Kooner ; C. Kooperberg ; P. Kovacs ; A. T. Kraja ; M. Kumari ; K. Kuulasmaa ; J. Kuusisto ; T. A. Lakka ; C. Langenberg ; L. Le Marchand ; T. Lehtimaki ; V. Lyssenko ; S. Mannisto ; A. Marette ; T. C. Matise ; C. A. McKenzie ; B. McKnight ; A. W. Musk ; S. Mohlenkamp ; A. D. Morris ; M. Nelis ; C. Ohlsson ; A. J. Oldehinkel ; K. K. Ong ; L. J. Palmer ; B. W. Penninx ; A. Peters ; P. P. Pramstaller ; O. T. Raitakari ; T. Rankinen ; D. C. Rao ; T. K. Rice ; P. M. Ridker ; M. D. Ritchie ; I. Rudan ; V. Salomaa ; N. J. Samani ; J. Saramies ; M. A. Sarzynski ; P. E. Schwarz ; A. R. Shuldiner ; J. A. Staessen ; V. Steinthorsdottir ; R. P. Stolk ; K. Strauch ; A. Tonjes ; A. Tremblay ; E. Tremoli ; M. C. Vohl ; U. Volker ; P. Vollenweider ; J. F. Wilson ; J. C. Witteman ; L. S. Adair ; M. Bochud ; B. O. Boehm ; S. R. Bornstein ; C. Bouchard ; S. Cauchi ; M. J. Caulfield ; J. C. Chambers ; D. I. Chasman ; R. S. Cooper ; G. Dedoussis ; L. Ferrucci ; P. Froguel ; H. J. Grabe ; A. Hamsten ; J. Hui ; K. Hveem ; K. H. Jockel ; M. Kivimaki ; D. Kuh ; M. Laakso ; Y. Liu ; W. Marz ; P. B. Munroe ; I. Njolstad ; B. A. Oostra ; C. N. Palmer ; N. L. Pedersen ; M. Perola ; L. Perusse ; U. Peters ; C. Power ; T. Quertermous ; R. Rauramaa ; F. Rivadeneira ; T. E. Saaristo ; D. Saleheen ; J. Sinisalo ; P. E. Slagboom ; H. Snieder ; T. D. Spector ; U. Thorsteinsdottir ; M. Stumvoll ; J. Tuomilehto ; A. G. Uitterlinden ; M. Uusitupa ; P. van der Harst ; G. Veronesi ; M. Walker ; N. J. Wareham ; H. Watkins ; H. E. Wichmann ; G. R. Abecasis ; T. L. Assimes ; S. I. Berndt ; M. Boehnke ; I. B. Borecki ; P. Deloukas ; L. Franke ; T. M. Frayling ; L. C. Groop ; D. J. Hunter ; R. C. Kaplan ; J. R. O'Connell ; L. Qi ; D. Schlessinger ; D. P. Strachan ; K. Stefansson ; C. M. van Duijn ; C. J. Willer ; P. M. Visscher ; J. Yang ; J. N. Hirschhorn ; M. C. Zillikens ; M. I. McCarthy ; E. K. Speliotes ; K. E. North ; C. S. Fox ; I. Barroso ; P. W. Franks ; E. Ingelsson ; I. M. Heid ; R. J. Loos ; L. A. Cupples ; A. P. Morris ; C. M. Lindgren ; K. L. Mohlke
    Nature Publishing Group (NPG)
    Published 2015
    Staff View
    Publication Date:
    2015-02-13
    Publisher:
    Nature Publishing Group (NPG)
    Print ISSN:
    0028-0836
    Electronic ISSN:
    1476-4687
    Topics:
    Biology
    Chemistry and Pharmacology
    Medicine
    Natural Sciences in General
    Physics
    Keywords:
    Adipocytes/metabolism ; Adipogenesis/genetics ; Adipose Tissue/*metabolism ; Age Factors ; *Body Fat Distribution ; Body Mass Index ; Continental Population Groups/genetics ; Epigenesis, Genetic ; Europe/ethnology ; Female ; Genome, Human/genetics ; *Genome-Wide Association Study ; Humans ; Insulin/*metabolism ; Insulin Resistance/genetics ; Male ; Models, Biological ; Neovascularization, Physiologic/genetics ; Obesity/genetics ; Polymorphism, Single Nucleotide/genetics ; Quantitative Trait Loci/*genetics ; Sex Characteristics ; Transcription, Genetic/genetics ; Waist-Hip Ratio
    Published by:
    http://www.nature.com/

    Latest Papers from Table of Contents or Articles in Press
  2. 2
    A. E. Locke ; B. Kahali ; S. I. Berndt ; A. E. Justice ; T. H. Pers ; F. R. Day ; C. Powell ; S. Vedantam ; M. L. Buchkovich ; J. Yang ; D. C. Croteau-Chonka ; T. Esko ; T. Fall ; T. Ferreira ; S. Gustafsson ; Z. Kutalik ; J. Luan ; R. Magi ; J. C. Randall ; T. W. Winkler ; A. R. Wood ; T. Workalemahu ; J. D. Faul ; J. A. Smith ; J. Hua Zhao ; W. Zhao ; J. Chen ; R. Fehrmann ; A. K. Hedman ; J. Karjalainen ; E. M. Schmidt ; D. Absher ; N. Amin ; D. Anderson ; M. Beekman ; J. L. Bolton ; J. L. Bragg-Gresham ; S. Buyske ; A. Demirkan ; G. Deng ; G. B. Ehret ; B. Feenstra ; M. F. Feitosa ; K. Fischer ; A. Goel ; J. Gong ; A. U. Jackson ; S. Kanoni ; M. E. Kleber ; K. Kristiansson ; U. Lim ; V. Lotay ; M. Mangino ; I. Mateo Leach ; C. Medina-Gomez ; S. E. Medland ; M. A. Nalls ; C. D. Palmer ; D. Pasko ; S. Pechlivanis ; M. J. Peters ; I. Prokopenko ; D. Shungin ; A. Stancakova ; R. J. Strawbridge ; Y. Ju Sung ; T. Tanaka ; A. Teumer ; S. Trompet ; S. W. van der Laan ; J. van Setten ; J. V. Van Vliet-Ostaptchouk ; Z. Wang ; L. Yengo ; W. Zhang ; A. Isaacs ; E. Albrecht ; J. Arnlov ; G. M. Arscott ; A. P. Attwood ; S. Bandinelli ; A. Barrett ; I. N. Bas ; C. Bellis ; A. J. Bennett ; C. Berne ; R. Blagieva ; M. Bluher ; S. Bohringer ; L. L. Bonnycastle ; Y. Bottcher ; H. A. Boyd ; M. Bruinenberg ; I. H. Caspersen ; Y. D. Ida Chen ; R. Clarke ; E. W. Daw ; A. J. de Craen ; G. Delgado ; M. Dimitriou ; A. S. Doney ; N. Eklund ; K. Estrada ; E. Eury ; L. Folkersen ; R. M. Fraser ; M. E. Garcia ; F. Geller ; V. Giedraitis ; B. Gigante ; A. S. Go ; A. Golay ; A. H. Goodall ; S. D. Gordon ; M. Gorski ; H. J. Grabe ; H. Grallert ; T. B. Grammer ; J. Grassler ; H. Gronberg ; C. J. Groves ; G. Gusto ; J. Haessler ; P. Hall ; T. Haller ; G. Hallmans ; C. A. Hartman ; M. Hassinen ; C. Hayward ; N. L. Heard-Costa ; Q. Helmer ; C. Hengstenberg ; O. Holmen ; J. J. Hottenga ; A. L. James ; J. M. Jeff ; A. Johansson ; J. Jolley ; T. Juliusdottir ; L. Kinnunen ; W. Koenig ; M. Koskenvuo ; W. Kratzer ; J. Laitinen ; C. Lamina ; K. Leander ; N. R. Lee ; P. Lichtner ; L. Lind ; J. Lindstrom ; K. Sin Lo ; S. Lobbens ; R. Lorbeer ; Y. Lu ; F. Mach ; P. K. Magnusson ; A. Mahajan ; W. L. McArdle ; S. McLachlan ; C. Menni ; S. Merger ; E. Mihailov ; L. Milani ; A. Moayyeri ; K. L. Monda ; M. A. Morken ; A. Mulas ; G. Muller ; M. Muller-Nurasyid ; A. W. Musk ; R. Nagaraja ; M. M. Nothen ; I. M. Nolte ; S. Pilz ; N. W. Rayner ; F. Renstrom ; R. Rettig ; J. S. Ried ; S. Ripke ; N. R. Robertson ; L. M. Rose ; S. Sanna ; H. Scharnagl ; S. Scholtens ; F. R. Schumacher ; W. R. Scott ; T. Seufferlein ; J. Shi ; A. Vernon Smith ; J. Smolonska ; A. V. Stanton ; V. Steinthorsdottir ; K. Stirrups ; H. M. Stringham ; J. Sundstrom ; M. A. Swertz ; A. J. Swift ; A. C. Syvanen ; S. T. Tan ; B. O. Tayo ; B. Thorand ; G. Thorleifsson ; J. P. Tyrer ; H. W. Uh ; L. Vandenput ; F. C. Verhulst ; S. H. Vermeulen ; N. Verweij ; J. M. Vonk ; L. L. Waite ; H. R. Warren ; D. Waterworth ; M. N. Weedon ; L. R. Wilkens ; C. Willenborg ; T. Wilsgaard ; M. K. Wojczynski ; A. Wong ; A. F. Wright ; Q. Zhang ; E. P. Brennan ; M. Choi ; Z. Dastani ; A. W. Drong ; P. Eriksson ; A. Franco-Cereceda ; J. R. Gadin ; A. G. Gharavi ; M. E. Goddard ; R. E. Handsaker ; J. Huang ; F. Karpe ; S. Kathiresan ; S. Keildson ; K. Kiryluk ; M. Kubo ; J. Y. Lee ; L. Liang ; R. P. Lifton ; B. Ma ; S. A. McCarroll ; A. J. McKnight ; J. L. Min ; M. F. Moffatt ; G. W. Montgomery ; J. M. Murabito ; G. Nicholson ; D. R. Nyholt ; Y. Okada ; J. R. Perry ; R. Dorajoo ; E. Reinmaa ; R. M. Salem ; N. Sandholm ; R. A. Scott ; L. Stolk ; A. Takahashi ; F. M. Van't Hooft ; A. A. Vinkhuyzen ; H. J. Westra ; W. Zheng ; K. T. Zondervan ; A. C. Heath ; D. Arveiler ; S. J. Bakker ; J. Beilby ; R. N. Bergman ; J. Blangero ; P. Bovet ; H. Campbell ; M. J. Caulfield ; G. Cesana ; A. Chakravarti ; D. I. Chasman ; P. S. Chines ; F. S. Collins ; D. C. Crawford ; L. A. Cupples ; D. Cusi ; J. Danesh ; U. de Faire ; H. M. den Ruijter ; A. F. Dominiczak ; R. Erbel ; J. Erdmann ; J. G. Eriksson ; M. Farrall ; S. B. Felix ; E. Ferrannini ; J. Ferrieres ; I. Ford ; N. G. Forouhi ; T. Forrester ; O. H. Franco ; R. T. Gansevoort ; P. V. Gejman ; C. Gieger ; O. Gottesman ; V. Gudnason ; U. Gyllensten ; A. S. Hall ; T. B. Harris ; A. T. Hattersley ; A. A. Hicks ; L. A. Hindorff ; A. D. Hingorani ; A. Hofman ; G. Homuth ; G. K. Hovingh ; S. E. Humphries ; S. C. Hunt ; E. Hypponen ; T. Illig ; K. B. Jacobs ; M. R. Jarvelin ; K. H. Jockel ; B. Johansen ; P. Jousilahti ; J. W. Jukema ; A. M. Jula ; J. Kaprio ; J. J. Kastelein ; S. M. Keinanen-Kiukaanniemi ; L. A. Kiemeney ; P. Knekt ; J. S. Kooner ; C. Kooperberg ; P. Kovacs ; A. T. Kraja ; M. Kumari ; J. Kuusisto ; T. A. Lakka ; C. Langenberg ; L. Le Marchand ; T. Lehtimaki ; V. Lyssenko ; S. Mannisto ; A. Marette ; T. C. Matise ; C. A. McKenzie ; B. McKnight ; F. L. Moll ; A. D. Morris ; A. P. Morris ; J. C. Murray ; M. Nelis ; C. Ohlsson ; A. J. Oldehinkel ; K. K. Ong ; P. A. Madden ; G. Pasterkamp ; J. F. Peden ; A. Peters ; D. S. Postma ; P. P. Pramstaller ; J. F. Price ; L. Qi ; O. T. Raitakari ; T. Rankinen ; D. C. Rao ; T. K. Rice ; P. M. Ridker ; J. D. Rioux ; M. D. Ritchie ; I. Rudan ; V. Salomaa ; N. J. Samani ; J. Saramies ; M. A. Sarzynski ; H. Schunkert ; P. E. Schwarz ; P. Sever ; A. R. Shuldiner ; J. Sinisalo ; R. P. Stolk ; K. Strauch ; A. Tonjes ; D. A. Tregouet ; A. Tremblay ; E. Tremoli ; J. Virtamo ; M. C. Vohl ; U. Volker ; G. Waeber ; G. Willemsen ; J. C. Witteman ; M. C. Zillikens ; L. S. Adair ; P. Amouyel ; F. W. Asselbergs ; T. L. Assimes ; M. Bochud ; B. O. Boehm ; E. Boerwinkle ; S. R. Bornstein ; E. P. Bottinger ; C. Bouchard ; S. Cauchi ; J. C. Chambers ; S. J. Chanock ; R. S. Cooper ; P. I. de Bakker ; G. Dedoussis ; L. Ferrucci ; P. W. Franks ; P. Froguel ; L. C. Groop ; C. A. Haiman ; A. Hamsten ; J. Hui ; D. J. Hunter ; K. Hveem ; R. C. Kaplan ; M. Kivimaki ; D. Kuh ; M. Laakso ; Y. Liu ; N. G. Martin ; W. Marz ; M. Melbye ; A. Metspalu ; S. Moebus ; P. B. Munroe ; I. Njolstad ; B. A. Oostra ; C. N. Palmer ; N. L. Pedersen ; M. Perola ; L. Perusse ; U. Peters ; C. Power ; T. Quertermous ; R. Rauramaa ; F. Rivadeneira ; T. E. Saaristo ; D. Saleheen ; N. Sattar ; E. E. Schadt ; D. Schlessinger ; P. E. Slagboom ; H. Snieder ; T. D. Spector ; U. Thorsteinsdottir ; M. Stumvoll ; J. Tuomilehto ; A. G. Uitterlinden ; M. Uusitupa ; P. van der Harst ; M. Walker ; H. Wallaschofski ; N. J. Wareham ; H. Watkins ; D. R. Weir ; H. E. Wichmann ; J. F. Wilson ; P. Zanen ; I. B. Borecki ; P. Deloukas ; C. S. Fox ; I. M. Heid ; J. R. O'Connell ; D. P. Strachan ; K. Stefansson ; C. M. van Duijn ; G. R. Abecasis ; L. Franke ; T. M. Frayling ; M. I. McCarthy ; P. M. Visscher ; A. Scherag ; C. J. Willer ; M. Boehnke ; K. L. Mohlke ; C. M. Lindgren ; J. S. Beckmann ; I. Barroso ; K. E. North ; E. Ingelsson ; J. N. Hirschhorn ; R. J. Loos ; E. K. Speliotes
    Nature Publishing Group (NPG)
    Published 2015
    Staff View
    Publication Date:
    2015-02-13
    Publisher:
    Nature Publishing Group (NPG)
    Print ISSN:
    0028-0836
    Electronic ISSN:
    1476-4687
    Topics:
    Biology
    Chemistry and Pharmacology
    Medicine
    Natural Sciences in General
    Physics
    Keywords:
    Adipogenesis/genetics ; Adiposity/genetics ; Age Factors ; *Body Mass Index ; Continental Population Groups/genetics ; Energy Metabolism/genetics ; Europe/ethnology ; Female ; Genetic Predisposition to Disease/genetics ; *Genome-Wide Association Study ; Glutamic Acid/metabolism ; Humans ; Insulin/metabolism/secretion ; Male ; Obesity/*genetics/*metabolism ; Polymorphism, Single Nucleotide/genetics ; Quantitative Trait Loci/genetics ; Synapses/metabolism
    Published by:
    http://www.nature.com/

    Latest Papers from Table of Contents or Articles in Press
  3. 3
    MÖHLENKAMP, S. ; BARTEL, T. ; SACK, S. ; RÜTTERMANN, V. ; SIMON, H. ; GE, J. ; HAUDE, M. ; SCHMALTZ, A.A. ; ERBEL, R.

    Oxford, UK : Blackwell Publishing Ltd
    Published 1997
    Staff View
    ISSN:
    1540-8183
    Source:
    Blackwell Publishing Journal Backfiles 1879-2005
    Topics:
    Medicine
    Notes:
    The occlusion of patent ductus arteriosus (PDA) by Gianturco coils has been performed in a growing number of patients since its introduction at the beginning of this decade. The procedure is considered to be effective and safe. Yet embolization of the coil into the pulmonary artery system and residual shunting are typical complications. In some cases a coil loop may protrude into the aortic or pulmonary artery lumen and thus may result in flow disturbances. We report a case of thrombus formation on an intraaortic coil loop after retrograde embolization of a PDA in an adult.
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1111/j.1540-8183.1997.tb00068.x

    Articles: DFG German National Licenses
  4. 4
    ERBEL, R. ; GÖRGE, G. ; GERBER, T. ; GE, J. ; THELEN, M. ; RUMPELT, H.J. ; MEYER, J.

    Oxford, UK : Blackwell Publishing Ltd
    Published 1992
    Staff View
    ISSN:
    1540-8183
    Source:
    Blackwell Publishing Journal Backfiles 1879-2005
    Topics:
    Medicine
    Notes:
    Balloon angioplasty of the coarctation of the aorta can result in intimal or medial or even adventitial dissections as demonstrated by in vitro studies and animal experiments. As a typical sign of stretching of the aortic wall, patients complain of pain during the angioplasty procedure. In the literature, aortic wall rupture and ventricular fibrillation during the procedure are reported. Additional sudden deaths can occur within 40 hours after the procedure. Mortality ranges from 0.1% to 2.5%. By transesophageal echocardiography, monitoring of balloon angioplasty, control of the positioning of the balloon, and control of the results and detection of complications are possible. Intimal as well as medial dissections can be detected with observed healing for intimal but also medial dissections. In order to avoid the patient's discomfort, intraaortic ultrasound will be used in the future, when major methodological improvements are done. Computed tomography demonstrates medial dissections but is not able to visualize intimal dissections. Using computed tomography and magnetic resonance after angioplasty of the coarctation of the aorta, irregularities are described in up to 17% of the patients. For angiography, a low detection rate of medial dissections has to be expected, when not biplane angiographies of the whole thoracic aorta are performend. Medial dissections can be seen, but intimal dissections are missed. In conclusion, a review of the literature demonstrates a high incidence of intimal and medial dissections after angioplasty of the coarctation of the aorta with spontaneous healing in most patients. As is the way with coronary angioplasty, aortic wall ruptures are rare, but stand-by surgery is necessary.
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1111/j.1540-8183.1992.tb00414.x

    Articles: DFG German National Licenses
  5. 5
    Schappert, T. ; Sadony, V. ; Schoen, F. ; Birgelen, C. V. ; Zerkowski, H.-R. ; Erbel, R.

    Oxford, UK : Blackwell Publishing Ltd
    Published 1994
    Staff View
    ISSN:
    1540-8191
    Source:
    Blackwell Publishing Journal Backfiles 1879-2005
    Topics:
    Medicine
    Notes:
    The classical triad of sudden devastating chest pain, electrocardiographic absence of acute myocardial Infarction, and Identification of an upstream flap in the ascending aorta by transesophageal echocardlography (TEE) Indicates aortic type A dissection requiring emergent surgery. Among 34 patients presenting with clinical signs and symptoms of an aortic dissection, three did not show the mandatory flap in the upstream aorta. The only echocardlographic finding was aortic wall thickening Indicating an intramural hematoma. Two of these patients showed early aortic ectasia and one showed a pericardial effusion. Despite the missing flap echocardiographlcally, surgery was performed in all three patients. The surgical approach was the same as that for patients with a type A dissection. Two patients are doing well after the procedure, and one patient died after reoperation. The postoperatlve histologic work-up confirmed that there was no intimal tear or dissection of the intimal layer. We conclude that the echocardiographic finding of an Intramural hematoma combined with typical clinical signs of chest pain, with myocardial infarction ruled out, requires emergent surgical intervention. (J Card Surg 1994;9:508–515)
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1111/j.1540-8191.1994.tb00884.x

    Articles: DFG German National Licenses
  6. 6
    Hillen, U. ; Haude, M. ; Erbel, R. ; Goos, M.

    Oxford, UK : Munksgaard International Publishers
    Published 2002
    Staff View
    ISSN:
    1600-0536
    Source:
    Blackwell Publishing Journal Backfiles 1879-2005
    Topics:
    Medicine
    Notes:
    In-stent restenosis is a complication which impairs the success of coronary stenting. Recently, it was supposed that a delayed hypersensitivity reaction to nickel and molybdenum might be one of the triggering factors in in-stent restenosis. We have analyzed the data collected in our centre with respect to this hypothesis. Altogether, 34 patients were investigated (24 male, 10 female). Patch tests were performed with the standard series of the German Contact Dermatitis Research Group and a metal series containing the metal components of 316 L stainless steel. A positive patch test reaction to nickel was observed in 4 (11.8%) patients. None of the patients showed sensitization to the other metals. Retrospective analysis was performed in 20 patients: 2 of these patients had a positive patch test reaction to nickel, one of whom had an in-stent restenosis, and the other not. Restenoses were predominantly observed in patients with negative patch test reactions to nickel (6/18 patients). Out of the patients who were investigated prospectively only one showed sensitization to nickel. Restenosis was observed in 2 patients: neither patient had nickel allergy. Although it still cannot be excluded that metal allergy may play a role in the restenosis process in coronary stenting, there is at present little evidence for it.
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1034/j.1600-0536.2002.470607.x

    Articles: DFG German National Licenses
  7. 7
    Darius, H. ; Erbel, R. ; Schmucker, B. ; Meyer, J.

    Amsterdam : Elsevier
    Staff View
    ISSN:
    0022-2828
    Source:
    Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics:
    Medicine
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1016/S0022-2828(87)80053-6

    Articles: DFG German National Licenses
  8. 8
    Staff View
    ISSN:
    1573-0743
    Keywords:
    transesophageal echocardiography ; valve surgery
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Notes:
    Summary In 17 patients (10 patients with mitral insufficiency, 5 patients with tricuspid regurgitation, 2 patients with mitral stenosis) the result of valve reconstruction was evaluated by intraoperative two-dimensional transesophageal contrast-echocardiography (TEE). Therefore, 1–2 cc of an agitated contrast-medium (GelifundolR) were injected into the left or right ventricle. The result of reconstruction was assessed by the extent of regurgitant microbubbles into the left or right atrium. A successful valve repair could be demonstrated in 15 patients without or with only minimal regurgitation of contrast-fluid. In one patient residual severe mitral insufficiency after valve reconstruction could only be detected when valve function was examined by contrast-TEE in the beating heart. An intraoperative decision for valve replacement was made. In another patient, mild to moderate residual mitral incompetence was shown; no further surgical intervention was done. By TEE the function of reconstructed valves can be examined under physiological conditions in the beating heart. Surgeons can obtain additional intra-operatively information and certainty about the result of reconstruction and an early decision for valve replacement can be made if necessary.
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1007/BF01553933

    Articles: DFG German National Licenses
  9. 9
    Staff View
    ISSN:
    1573-0743
    Keywords:
    myocardial perfusion ; coronary flow reserve ; densitometry ; digital subtraction angiocardiography
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Notes:
    Summary From densitometric evaluation of digital subtraction cineangiocardiograms the parameter ‘Mean Rise Time’ (MRT), defined as the time from the onset of local myocardial contrast medium opacification to the point of maximal opacification can be derived; this parameter revealed a close correlation with the results on myocardial perfusion obtained by Thallium-201 scintigraphy. A prolonged ‘Mean Rise Time’ was indicative of an impairment of myocardial perfusion. We have developed a heart-phase gated real-time digitization procedure and computer-supported method for the densitometric estimation of the MRT to obtain information about the effect of coronary balloon dilatation on myocardial perfusion before and after stimulation of coronary flow reserve by Moxaverin. In 22 patients with single vessel coronary artery disease Moxaverin caused a significant prolongation of the post-stenotic MRT (2.3±1.2s (mean ± s.d.) vs. 2.9±1.1s, p〈0.05), while after successful dilatation of the obstructive lesion a significant shortening of the MRT was found after stimulation of the coronary flow reserve (2.5±1.2s vs. 1.9±0.9s, p〈0.05). A highly significant decrease in MRT after Moxaverin was measured post-dilatation in comparison to the initial pre-dilatation results (2.9±1.1s vs. 1.9±0.9s, p〈0.005); this shows that the effect of successful balloon dilatation on the post-stenotic myocardial perfusion can be described very well by this parameter. These results demonstrate that information about post-stenotic myocardial perfusion during interventional heart catheterization can be obtained from digital densitometry.
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1007/BF01814885

    Articles: DFG German National Licenses
  10. 10
    Schnell, N. ; Brennecke, R. ; Erbel, R. ; Meyer, J.
    Springer
    Published 1988
    Staff View
    ISSN:
    1573-0743
    Keywords:
    coronary angiography ; low and high definition video systems ; digital imaging
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Notes:
    Summary We evaluated the requirements on spatial resolution of digital imaging equipment in the cardiac catheterization laboratory. Fifty cinefilms of the heart as the biological object and one film of a lead — ladder — pattern as an objective test were used. The patient films were examined for the visibility of the left ventricular angiogram, coronary arterial tree, coronary artery lesions, branching of septal arteries and the number of septal arteries. All films were viewed three times: with a 625 line TV-system, with a 1249 line TV-system and with a cineprojector. It was found that two application areas with different demands on the spatial and temporal resolution can be distinguished: 1) low spatial resolution and high temporal resolution, e.g. left ventriculography; and 2) high spatial resolution and low temporal resolution, e.g. coronary arteriography. For the diagnostic assessment of the state of the coronary system, the spatial resolution provided by the 1249 line TV-system was sufficient. Exceeding this resolution by using cinefilm quality provided no additional diagnostic information. A frame rate lower than 50 frames per second for coronary arteriography seems possible.
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1007/BF01814883

    Articles: DFG German National Licenses
  11. 11
    Staff View
    ISSN:
    1432-0584
    Keywords:
    Intracoronary stenting ; Aggressive anticoagulation ; Subacute occlusion ; Bleeding complication ; Prothrombin fragment 1+2
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Notes:
    Summary Patients with intracoronary stent implantation are treated with aggressive anticoagulant and antiplatelet therapy consisting of high-dose heparin, phenprocoumon, acetylsalicylic acid, dipyridamole, and the infusion of dextran to prevent a subacute thrombotic occlusion of the stented segment. In an effort to optimize this treatment by reducing both imminent bleeding complications and subacute thrombotic occlusion, the concentrations of prothrombin fragment 1+2 (F1+2) were determined after intracoronary Palmaz-Schatz stent implantation in 19 consecutive patients. The F1+2 concentrations after stent implantation and before the initiation of oral anticoagulant therapy (OAT) were 0.35 nm/l and 0.25–0.53 nm/l (median and 25th–75th percentile), versus 0.74 nm/l and 0.52–0.78 nm/l, in healthy subjects and 0.61 nm/l and 0.30–1.02 nm/l in 15 patients with ongoing proximal DVT. Nine days after initiation of OAT, F1+2 concentrations in both patient groups had not yet reached levels observed in patients with OAT in the stable state (0.16 nm/l, 0.12–0.26 nm/l;n=76;P〈0.0001 compared with healthy subjects; INR 2.0–4.5). Despite an INR greater than 2.0, accompanying heparinization was terminated on day 9. In two stented patients a minor bleeding complication arose after the removal of the arterial catheter. Subacute thrombotic occlusions were not observed. Since F1+2 concentrations did not exceed the upper limit of normal range (1.11 nm/l) in any of the 19 patients, the therapeutic regimen was not changed. Monitoring F1+2 may thus be helpful in introducing a more individual treatment if aggressive anticoagulation has to be performed.
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1007/BF01698135

    Articles: DFG German National Licenses
  12. 12
    Belz, G. G. ; Erbel, R. ; Schumann, K. ; Gilfrich, H. J.
    Springer
    Published 1978
    Staff View
    ISSN:
    1432-1041
    Keywords:
    Digitoxin ; β-acetyldigoxin ; plasma levels ; cardiac performance ; dose-effect relationship ; 86-Rb-erythrocyte assay ; systolic time intervals
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Chemistry and Pharmacology
    Medicine
    Notes:
    Summary An inter-individual, randomized, double-blind study of digitoxin (Dt) and β-acetyl digoxin (D) was performed in 120 healthy male volunteers. Groups of 10 persons each received orally D 0, 0.1, 0.2, 0.3, 0.4, 0.5 or 0.6 mg and Dt 0.04, 0.08, 0.12, or 0.16 mg daily for 7 days; Loading doses were given for the first three days. Plasma levels were measured with an86Rb-erythrocyte assay 24 h after the last dose. ECG, carotid artery pulse and phonocardiogram were recorded prior to (b) and 24 h after (a) the last dose. QTc, amplitude of T-waves in V2 to V6, electromechanical systole (QS2c) and left ventricular ejection time (LVETc) were measured. The differences between a and b (Δ-values) reflect glycoside-induced changes in heart function. The plasma glycoside concentrations depended on dose and ranged from 0 to 2.4 ng/ml for D and from 0 to 42 ng/ml for Dt. QTc, QS2c, and LVETc were significantly shortened by the glycosides and typical parallel, sigmoid, log dose-response curves were obtained for the Δ-values. Dt was 3.8-times as potent as D in diminishing these parameters. The maximal effect of the two glycosides was almost identical at the highest doses: Δ-QTc=−45 ms, Δ-QS2c=−25 ms, Δ-LVETc=−12.5 ms. The latter two parameters showed a plateau of maximum efficacy. Both glycosides caused significant flattening of T-waves, Dt being 7.2-times as potent as D. Significant relationships between plasma concentration and cardiac effects were observed (p〈0.001)−Δ-QTc (D: r=0.7; Dt: r=0.77), Δ-QS2c (D: r=0.7; Dt: r=0.75), and Δ-LVETc (D: r=0.46; Dt: r=0.43); D correlated less well than Dt with the flattening of T (r=0.46; r=0.76, respectively). The most important conclusions were that: Dt was about 4-times as potent as D in influencing cardiac performance; the effects of D and Dt on systolic time intervals reached a plateau at “therapeutic” doses; Dt induced more pronounced flattening of the T-wave than D; and plasma glycoside levels within the “therapeutic” range corresponded to observed effects on the heart.
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1007/BF00609753

    Articles: DFG German National Licenses
  13. 13
    Hammann, Klaus P. ; Henkel, B. ; Erbel, R. ; Krämers, G.
    Springer
    Published 1985
    Staff View
    ISSN:
    1433-8491
    Keywords:
    Varicella-zoster ; Hemichorea ; Endocarditis
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Notes:
    Summary A 20-year-old woman developed transient right-sided hemichoreatic movements after household exposure to varicella-zoster. Some days before the appearance of involuntary movements a vesicular rash had occurred. About 6 months later an elevated IgG serum titer against varicella virus was found and two-dimensional echocardiography showed signs of an endocarditis. During the following 2 months the IgG value returned to within the normal range and the choreatic movements disappeared almost totally. The possibility is discussed that endocarditis had been caused and maintained by serum antibodies to varicella-zoster virus which cross-reacted with valvular tissue. Embolization to the region of the left striatum and/or post-infectious encephalitis in this region are assumed to be the most plausible causes of the transient hemichorea.
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1007/BF00386059

    Articles: DFG German National Licenses
  14. 14
    Staff View
    ISSN:
    1573-0743
    Keywords:
    aortic dissection ; transoesophageal echocardiography
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Notes:
    Summary The diagnostic value of transoesophageal echocardiography was evaluated in 24 patients with aortic dissection and compared to transthoracic two-dimensional echocardiography, computer tomography, aortography, surgery and autopsy. Using transoesophageal echocardiography we found in 5 patients a type I dissection, in 5 patients a type II and in 14 patients a type III dissection. Transthoracic two-dimensional echocardiography was positive in 3/5 type I, 2/5 in type II and 2/14 in type III dissections. Computer tomography was unable to demonstrate an intimal flap in 1/2 patients with type I, 2/3 type II and 1/11 type III dissections. Aortography was negative in 1/4 type I, 3/5 type II and 3/12 patients with type III dissection. Additional information concerning thrombus formation, localisation of the entry tear, differentiation between true and false lumen, flow dynamics within the true and false lumen as well as accompaning aortic regurgitation may be obtained by transoesophageal echocardography.
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1007/BF01553934

    Articles: DFG German National Licenses
  15. 15
    Staff View
    ISSN:
    1573-0743
    Keywords:
    densitometry ; myocardial perfusion ; coronary angioplasty ; digital subtraction angiocardiography
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Notes:
    Summary X-ray densitometric evaluation of digital subtraction angiocardiograms allows an assessment of myocardial perfusion by means of the parameter ‘MEAN RISE TIME’ (MRT), defined as the time from the onset of local myocardial contrast medium opacification to the point of maximum opacification. Best results are obtained when the response of that parameter is compared before and after stimulation of coronary flow by papaverine. A prolongation of this parameter, especially after papaverine, was indicative of an impairment of myocardial perfusion, when compared to the results obtained by TL-201 scintigraphy. In 50 patients with single vessel coronary artery disease the results of MRT pre and post papaverine before and after coronary angioplasty, as well as after 6 months were evaluated for 204 post-stenotic regions-of-interest. Before angioplasty papaverine induced a significant prolongation of post-stenotic MRT (2.3s ± 0.9s vs. 3.1s ± 0.8s; p〈0.01), while after successful angioplasty post-stenotic MRT was measured significantly shorter after stimulation of coronary flow (2.6s ± 1.0s vs. 1.9s ± 0.9s; p〈0.01). This indicated an improvement in myocardial perfusion. Nevertheless, 16/50 patients still presented pathological results of post-stenotic MRT after papaverine, although angioplasty was regarded successful. These patients presented a markedly higher rate of restenosis (14/16 patients after 6 months), a higher rate of dissections at the dilatation site and a higher rate of dilated vessels, supplying myocardial areas after a Q-wave myocardial infarction. Thus, these results demonstrate the additional information about the short-and long-term outcome of an angioplasty procedure by densitometric myocardial perfusion analysis.
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1007/BF01833987

    Articles: DFG German National Licenses
  16. 16
    Staff View
    ISSN:
    1573-0743
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1007/BF01795123

    Articles: DFG German National Licenses
  17. 17
    Staff View
    ISSN:
    1435-1285
    Keywords:
    Key words Tissue Doppler echocardiography – diastolic function – pseudonormalization – left ventricular filling pressures – arterial hypertension ; Schlüsselwörter Gewebedopplerechokardiographie – diastolische Funktion – Pseudonormalisierung – linksventrikuläre Füllungsdrücke – arterielle Hypertonie
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Description / Table of Contents:
    Zusammenfassung Hintergrund: Zur Analyse der linksventrikulären Relaxation werden die früh- und spätdiastolischen Geschwindigkeitsmaxima über der Mitralis (E, A) mit dem gepulsten Doppler abgeleitet sowie die Dauer der Dezelerations- und isovolumetrischen Relaxationszeit bestimmt. Alle genannten Parameter ändern sich jedoch in Abhängigkeit von Alter, Herzfrequenz und Lastbedingungen. Die Erfassung der diastolischen Exkursion des Mitralrings mittels Gewebedopplerechokardiographie (TDE) soll eine lastunabhängige Beurteilung der linksventrikulären, diastolischen Funktion ermöglichen. Ziel der Studie: Ziel der vorliegenden Studie war die Erfassung der diagnostischen Wertigkeit der Mitralringexkusion in der Beurteilung der diastolischen, linksventrikulären Funktion. Patienten und Methoden: Drei Gruppen von Patienten mit einer systolischen Ejektionsfraktion 〉 45 % wurden untersucht: 10 Kontrollprobanden (60 ± 10 J., KON-Gruppe), 15 asymptomatische Patienten mit koronarer Herzerkrankung (60 ± 11 J., KHK-Gruppe) und 15 Patienten mit langjähriger, arterieller Hypertonie und Symptomen der Herzinsuffizienz (58 ± 9 J., HYP-Gruppe). Das Mitraleinstromprofil (E, A, E/A) wurde mittels gepulstem Doppler gemessen und die Dezelerations- (DT) sowie isovolumetrische Relaxationszeit (IVRT) bestimmt. Systolische, früh- und spätdiastolische Geschwindigkeiten des medialen Mitralanulus (ST, ET, AT, ET/AT) wurden mittels gepulstem TDE abgeleitet. Bei allen Patienten wurde im Rahmen einer Linksherzkatheteruntersuchung der linksventrikuläre, enddiastolische Füllungsdruck (LVED) bestimmt. Ergebnisse: In der HYP-Gruppe waren ET (6,9 ± 4,8 cm/s) und ET/AT (0,71 ± 0,28) im Vergleich zur KON-Gruppe (11,7 ± 4,7 cm/s bzw. 1,11 ± 0,36, p 〈 0,05) und zur KHK-Gruppe (8,9 ± 5,4 cm/s bzw. 0,85 ± 0,26, p = ns) vermindert. Die drei Gruppen unterschieden sich nicht hinsichtlich der mitralen E/A-Ratio, der Dezelerations- und isovolumetrischen Relaxationszeit. LVED war in der HYP-Gruppe (16 ± 8 mm Hg) höher als in der KON-Gruppe (8 ± 3, p 〈 0,05) und der KHK-Gruppe (12 ± 6 mm Hg, p = ns). Keine Korrelation wurde zwischen ET und LVED gefunden (r = 0,26). Wenn die Kombination aus mitraler E/A-Ratio 〉 1 und einem LVEDP ≥ 15 mm Hg als Pseudonormalisierung klassifiziert wurde, identifizierten eine frühdiastolische Mitralringexkursion (ET) 〈 7 cm/s und eine ET/AT-Ratio 〈 1 eine Pseudonormalisierung mit einer Sensitivität von 77 % und einer Spezifität von 88%. Schlußfolgerung: Das mit TDE gemessene frühdiastolische Geschwindigkeitsmaximum des medialen Mitralanulus (ET) ist ein lastunabhängiger Index der linksventrikulären Relaxation. TDE identifiziert die diastolische Funktionsstörung bei Patienten mit pseudonormalem Mitraleinstromprofil und erhöhten Füllungsdrücken.
    Notes:
    Summary Background: Mitral inflow velocity, deceleration time, and isovolumic relaxation time recorded by Doppler echocardiography have been widely used to evaluate left ventricular diastolic function but are affected by age, heart rate, loading conditions, and other factors. The diastolic mitral anulus velocity assessed by tissue Doppler echocardiography (TDE) was suggested to provide additional information about LV relaxation less affected by filling pressures. Aim of this study: This study was designed to assess the clinical utility of mitral anulus velocity in the evaluation of left ventricular diastolic function. Patients and methods: Three groups of patients with a systolic ejection fraction 〉 45 % were separated: 10 normal volunteers (60 ± 10 y, CON group), 15 asymptomatic patients with known coronary artery disease (60 ± 11 y, CAD group) and 15 patients with longterm arterial hypertension and heart failure symptoms (58 ± 9 y, HYP group). The mitral inflow profile (E, A, E/A) was measured by pulsed Doppler, and the deceleration time (DT) and the isovolumic relaxation period (IVRT) were calculated. Systolic, early, and late diastolic velocities of the septal mitral anulus (ST, ET, AT, ET/AT) were assessed by pulsed TDE. All study subjects had invasive measurements of left ventricular end diastolic filling pressures during left heart catheterization. Results: In the AH group, ET (6.9 ± 4.8 cm/s) and ET/AT (0.71 ± 0.28) were reduced compared to the CON group (11.7 ± 4.7 cm/s and 1.11 ± 0.36, p 〈 0.05, respectively) and the CAD group (8.9 ± 5.4 cm/s and 0.85 ± 0.26, respectively, p = ns). The groups did not differ with respect to the mitral E/A ratio, the deceleration time and the isovolumic relaxation time. LVED in the HYP group (16 ± 8 mm Hg) was elevated compared to the CON group (8 ± 3, p 〈 0.05) and the CAD group (12 ± 6 mm Hg, p = ns). No correlation was found between ET and LVED (r = 0.26). When the combination of mitral E/A ratio 〉 1 with LVED ≥ 15 mm Hg was classified as pseudonormalization, the pseudonormalization could be identified by a peak early diastolic mitral anulus velocity (ET) 〈 7 cm/s and an ET/AT ratio 〈 1 with a sensitivity of 77 % and a specificity of 88%. Conclusions: The early diastolic mitral anulus velocity assessed by TDE (ET) is a preload-independent index of LV relaxation. TDE permits the detection of diastolic dysfunction in patients with a pseudonormal mitral inflow and elevated filling pressures.
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1007/s003920050297

    Articles: DFG German National Licenses
  18. 18
    Görge, G. ; Ge, J. ; von Birgelen, C. ; Erbel, R.
    Springer
    Published 1998
    Staff View
    ISSN:
    1435-1285
    Keywords:
    Schlüsselwörter Intravasaler Ultraschall (IVUS) – PTCA – koronare Herzkrankheit – Angiographie ; Key words Intravascular ultrasound – PTCA – coronary heart disease – angiography – restenosis – coronary stents
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Description / Table of Contents:
    Summary Intravascular ultrasound (IVUS) has evolved to a research tool to an intrinsic part of modern invasive cardiology. The main reason is the capability to obtain “in-vivo” micro anatomy by means of miniaturized echo-transducers with an outer diameter of 2.9–3.5 French. For the first time it is possible to base decisions not only on lumenograms but also on vessel wall assessment. The capabilities of IVUS can be divided in its diagnostic and intervention associated potentials. The diagnostic strength of IVUS is the ability to monitor compensatory coronary artery enlargement as a response to arteriosclerosis, to assess intermediate lesions, to reveal occult left main stem disease, and angiographically “silent” arteriosclerosis. In conjunction with the estimation of intracoronary flow reserve, patients with the diagnosis of coronary “syndrome X” can be better classified into those with or without early signs of arteriosclerosis. Additionally, IVUS is at present the only method allowing the classification of coronary artery lesions according to the AHA/ACC Stary classification. The intervention associated potentials of IVUS are the ability to allow optimal device selection, i.e. rotablators in calcified lesions or atherectomy devices in large plaque burden. The effects of PTCA on vessel wall morphology can be studied in great detail and the effect on luminal gain can be assessed almost on-line. The correlation between IVUS and angiography for estimation of luminal dimensions is inferior, because angiography is not able to describe complex luminal geometries. Several groups showed that the residual plaque area even after angiographically successful PTCA lies still in the range of 60%. A significant reduction of this number may influence long-term outcome after PTCA. Minimal luminal areas and residual plaque area after PTCA seem to be an indicator of restenosis, while the presence or absence of dissections seem to be less predictive. Additionally, the main mechanism of restenosis after PTCA is vessel shrinkage, not intimal hyperplasia. Intravascular monitoring of stent expansion led to high-pressure stent deployment with significant increase in post-procedural luminal diameters and finally the ability to withhold anticoagulation in patients with optimal stent deployment and to lower subacute stent thrombosis rates. First results for IVUS guided PTCA show a superior gain in post procedural free lumen without an increased complication rate. In the future, integrated devices, like balloons on IVUS catheters, steerable catheters, integrated flow and pressure transducers, tissue characterisation, and 0.018 inch IVUS guidewires will further enhance the usefulness of IVUS.
    Notes:
    Zusammenfassung Innerhalb weniger Jahre hat sich der intravasale Ultraschall (IVUS) einen festen Platz in der invasiven kardiologischen Diagnostik erobert. Durch die intrakoronare Positionierung von miniaturisierten Echosonden mit einem Durchmesser von 2,9–3,5 French wurde es möglich, tomographische, mikroanatomische Gefäßwandschnitte “in vivo” anzufertigen. Die derzeitigen Indikationen des IVUS können unterteilt werden in diagnostische und Interventionen-assoziierte Fragestellungen. Die diagnostischen Stärken des IVUS liegen in der Möglichkeit, die kompensatorische Vergrößerung von Koronarsegmenten als Antwort auf eine zunehmende Arteriosklerose in vivo darzustellen, angiographisch unklare Veränderungen am Hauptstamm in ihrer Bedeutung für den Patienten zu verifizieren und das Ausmaß arteriosklerotischer Veränderung bei angiographisch “normalen” Kranzarterien darzustellen. Dadurch ist zusammen mit Bestimmung der Flußreserve eine neue Einteilung von Patienten mit einem sog. koronaren “Syndrom X” notwendig geworden. Der IVUS ist derzeit die einzige Methode, die einen Vergleich der Stenosemorphologie mit der sog. Stary-Klassifikation in vivo zuläßt. Periinterventionell ist der IVUS theoretisch hilfreich bei der Auswahl des geeigneten Instrumentariums, z.B. dem Rotablator bei stark kalzifizierten Läsionen. Der IVUS kann in vivo die Effekte der PTCA auf die Plaque- und Gefäßwandmorphologie darstellen und die residuale Flächenstenose nach PTCA exakt bestimmen. Die Korrelation der Lumendurchmesser nach PTCA zwischen der Angiographie und dem IVUS ist schlecht, da die Angiographie komplexe, lumenseitig gelegene Morphologien nicht genau erfassen kann. Darüber hinaus konnten verschiedene Arbeitsgruppen zeigen, daß selbst nach angiographisch erfolgreicher PTCA die Stenose im Mittel bei 60% lag. Der mittels IVUS bestimmte residuale minimale Gefäßdurchmesser nach PTCA und die residuale Plaquefläche sind von mehreren Arbeitsgruppen als prognostisch wichtige Indikatoren für die Entwicklung einer Restenose nach PTCA identifiziert worden. Der IVUS hat darüber hinaus die Stentimplantation durch die sog. Hochdruckimplantation optimiert. Dadurch kann eine wesentliche Vergrößerung des postinterventionellen minimalen Lumendiameters erreicht und die Rate der subakuten Stentthrombosen gesenkt werden. Erste Untersuchungen zeigen darüber hinaus den Wert der IVUS-optimierten PTCA, die in der Regel die Verwendung größerer Ballons ohne erhöhte Komplikationsrate erlaubt und zu einem größeren minimalen Lumen nach PTCA führt. Die Zukunft des intravasalen Ultraschalls liegt in kombinierten interventionellen Instrumenten wie z.B. PTCA-Ballons auf IVUS-Kathetern. Wesentlich ist eine noch bessere Integration des IVUS in den Untersuchungsablauf und der Nachweis der Kosteneffektivität.
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1007/s003920050216

    Articles: DFG German National Licenses
  19. 19
    Staff View
    ISSN:
    1435-1285
    Keywords:
    Key words Echocardiography – quality management – data set – standards ; Schlüsselwörter Echokardiographie – Qualitätssicherung – Datensatz – Standardisierung
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Description / Table of Contents:
    Zusammenfassung In der Echokardiographie fehlen bislang einheitliche Standards zur Befunddokumentation. Diese Standards sind jedoch notwendig, um die Vergleichbarkeit von Befunden zu ermöglichen und eine optimale elektronische Befundkommunikation zu gewährleisten, sodass den Ansprüchen an die Qualitätssicherung in der Echokardiographie genüge getan wird. Daher wurde im Arbeitskreis „Standardisierung und LV-Funktion” der Deutschen Gesellschaft für Kardiologie eine Konsensusempfehlung zur Befunddokumentation entwickelt. Diese wird in der vorliegenden Arbeit vorgestellt und anhand praktischer Beispiele erläutert. Weiterhin wird der Prototyp eines Computerprogramms, als Beispiel der anwenderorientierten Umsetzung des Datensatzes, vorgestellt. Der vollständige Datensatz für die transthorakale und transösophageale Echokardiographie sowie der Programmprototyp sind unter der folgenden Internetadresse verfügbar: ¶http://echo.ma.uni-heidelberg.de.
    Notes:
    Summary Presently, there are no well-defined standards for documentation of echocardiographic studies. Nevertheless, standards are essential to provide comparability of data and to realize electronic communication, both essential for quality management in echocardiography. Therefore, the working group „Standards and LV function” of the German Society of Cardiology developed a consensus for documentation of echocardiographic studies. In the present paper this consensus is presented and illustrated by typical clinical examples. Additionally, a prototype of a user-oriented software based on this data set is presented. The complete data set for transesophageal and transthoracic echocardiography and the software prototype can be downloaded at http://echo.ma.uni-heidelberg.de.
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1007/s003920050465

    Articles: DFG German National Licenses
  20. 20
    Staff View
    ISSN:
    1435-1285
    Keywords:
    Schlüsselwörter Koronare Herzkrankheit – intravaskulärer Ultraschall – Elektronenstrahltomographie ; Key words Coronary artery disease – intracoronary ultrasound – electron beam CT
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Description / Table of Contents:
    Summary Techniques in the field of coronary artery imaging can be divided into two groups: invasive and non-invasive methods. Apart from the conventional coronary artery angiography, invasive methods include intracoronary ultrasound, intracoronary angioscopy, and optical coherence tomography. Non-invasive methods include magnetic resonance tomography, synchrotron-coronary angiography, and electron beam computed tomography. In the late 1980s, intracoronary ultrasound has come into clinical practice. It offers a real-time, cross-sectional image of the coronary artery in high resolution. Coronary arteries enlarge in the presence of atherosclerotic plaque formation in order to compensate for luminal narrowing caused by plaque formation (remodeling). With coronary angiography, the plaque formation cannot be detected until a lumen reduction of about 40–45%. With intravascular ultrasound, the early stages of atherosclerosis can clearly be demonstrated. In combination with the intracoronary Doppler technique, syndrome X can be differentiated. Another important role of intracoronary ultrasound in the diagnosis of coronary artery disease is to guide coronary interventions and to assess the result of coronary interventions especially to evaluate the result of stent implantation. Due to the clinical use of intracoronary ultrasound and the guidance of high pressure stent implantation, the incidence of acute stent thrombosis has decreased to about 1%. Coronary angioscopy portrays the surface of the vessel lumen. It is helpful to identify the mural thrombus especially to differentiate fresh and chronic thrombus formation. Magnetic resonance tomography is able to image the coronary arterial contour of the proximal segment. With today's gating technique, it is possible to portray the whole coronary tree and avoid disturbances resulting from the heart beat and respiration. Electron beam computed tomography is a very promising technique in screening for coronary artery disease. It is a very sensitive method to identify coronary calcification and, thus, to detect atherosclerotic plaque. Studies have shown that the presence of calcification almost invariably indicates the presence of coronary artery disease and that the absence of calcification can nearly rule out significant coronary artery disease. Moreover, a close correlation exists between the amount of calcification and the severity of coronary artery disease. Additionally, in combination with contrast injection, coronary artery perfusion can be evaluated. This is important to assess the conductance of coronary stent and bypass graft.
    Notes:
    Zusammenfassung Die bildgebenden Verfahren zur Darstellung der Koronararterien können in zwei Gruppen unterteilt werden: invasive und nicht invasive Methoden. Neben der konventionellen Koronarangiographie gehören zur Gruppe der invasiven Techniken auch der intrakoronare Ultraschall, die intrakoronare Angioskopie und die Optische Kohärenztomographie. Die nicht invasiven Methoden umfassen die Magnetresonanztomographie, die Synchrotron-Koronarangiographie und die Elektronenstrahltomographie. Der intrakoronare Ultraschall wurde Ende der 80er Jahre in die klinische Praxis eingeführt. Dieser ermöglicht eine hochauflösende Querschnittsdarstellung der Koronararterien in Echtzeit. In den ersten Stadien der arteriosklerotischen Plaquebildung kommt es zu einer Erweiterung der Koronararterien (Remodeling), um der plaquebedingten Lumeneinengung entgegen zu wirken. Daher kann mittels Koronarangiographie eine Plaquebildung erst ab einer Lumenreduktion um 40–45% nachgewiesen werden. Da mit dem intrakoronaren Ultraschall auch die Gefäßwand dargestellt werden kann, ist die Erfassung früher Arteriosklerosestadien möglich. In Kombination mit der intrakoronaren Dopplertechnik kann zudem das Syndrom X abgegrenzt werden. Ein weiteres wichtiges Einsatzgebiet des intrakoronaren Ultraschalls ist die Beurteilung von Interventionsergebnissen, insbesondere nach Stent-Implantation. Durch den intrakoronaren Ultraschall in Kombination mit Hochdruck-Stent-Implantationen und adjuvanter Medikation konnte die Rate der akuten Stent-Thrombose auf 1% reduziert werden. Mit der intrakoronaren Angioskopie wird die Oberfläche der Gefäßwand dargestellt. Sie ist hilfreich für die Identifizierung wandständiger Thromben und geeignet zur Differenzierung zwischen frischer und chronischer Thrombusbildung. Die Magnetresonanztomographie ermöglicht die Konturerkennung der proximalen Koronarsegmente. Mit modernen Gating-Techniken können Bildunschärfen durch Verringerung der Herzschlag- und Atmungsartefakte reduziert werden. Die Elektronenstrahltomographie ist ein vielversprechendes Verfahren zum Screening der koronaren Herzkrankheit. Es ist eine sehr sensitive Methode zur Darstellung von koronaren Kalzifikationen und damit arteriosklerotischer Plaquebildung. Das Fehlen koronarer Kalzifikationen schließt eine stenosierende koronare Herzkrankheit mit einer sehr hohen Wahrscheinlichkeit aus. Ferner besteht eine enge Korrelation koronarer Kalzifikationen mit dem Schweregrad der koronaren Herzkrankheit. Durch zusätzliche Kontrastmittelinjektion kann auch die myokardiale Perfusion beurteilt werden. Dies kann für die Beurteilung nach koronaren Stent-Implantationen und nach Bypass-Operationen von Bedeutung sein.
    Type of Medium:
    Electronic Resource
    URL:
    http://dx.doi.org/10.1007/s003920050540

    Articles: DFG German National Licenses