[Catheter-Based Septal Ablation for Hypertrophic Obstructive Cardiomyopathy: Long-Term Follow-Up 1996-2016].

Since the first publication in 1995 percutaneous septal ablation (acronyms in alphabetical order: ASA, ESA, NSMR, PTSMA, TASH, among others) has made its way from a small case series into the international guidelines for patients with HOCM and symptoms not responding to medical treatment. We now report on the long-term course (20 years) in the first 6 cases who were successfully treated in our institution in early 1996, published in this Journal shortly thereafter.

[From cardiovascular prevention to anti-aging medicine: influence on telomere and cell aging].

The most important cardiovascular risk factors (hypercholesterolemia , hypertension, diabetes, chronic stress, physical inactivity, smoking, adipositas) were evaluated in the second half of the last century using placebo controlled trials. The mechanismen of action was not fully understood or remained unclear. In some studies not only the risk of atherosclerosis was reduced but life expectancy was improved.

Beneficial effects of atorvastatin on myocardial regions with initially low vasodilatory capacity at various stages of coronary artery disease.

Purpose: The aim of this study was to analyse non-invasively the regional effect of therapy with an HMG-CoA reductase inhibitor on myocardial blood flow in patients with coronary artery disease (CAD) with special reference to segments with initially substantially impaired vasodilation.

Methods: The study included 26 patients with untreated hypercholesterolaemia. Coronary angiography revealed CAD in nine patients with stenosis >50% and wall irregularities or minimal stenosis <30% in 17 patients.

Echo-guided percutaneous septal ablation for symptomatic hypertrophic obstructive cardiomyopathy: 7 years of experience.

Aims: To analyze the impact of intra-procedural echocardiographic imaging on the interventional strategy in ethanol-induced septal ablation (PTSMA) for symptomatic hypertrophic obstructive cardiomyopathy (HOCM), based on a single-center experience of 7 years.

Methods And Results: PTSMA was intended for refractory symptoms in 337 patients (pts.) with HOCM (mean age: 54 +/- 15 years), with 312 procedures completed by injection of 2.

[Predicting the risk of atrioventricular conduction lesions after percutaneous septal ablation for obstructive hypertrophic cardiomyopathy].

Background And Introduction: Damage to the AV conduction system is a frequent complication of percutaneous septal ablation (PTSMA) that needs early and reliable identification of those patients (pts.) at risk for complete heart block (CHB) and subsequent pacemaker implantation.

Methods And Results: In the first 39 pts.

Health policy and outlook.

Health policy has great influence on the daily work of every cardiologist. The influence of progress of practical cardiology on health policy in our country on the one hand and the influence of health policy on cardiology on the other hand are discussed, In the 1970s cardiac rehabilitation in special rehabilitation clinics was developed as a consequence of the usual therapy at that time with longer periods of bedrest and late invasive diagnostic procedures. Patients got a right on rehabilitation by law.

[123I]-phenylpentadecanoic acid uptake in patients with dilated cardiomyopathy.

Background: The rate constant for global fatty acid influx (k(1)) was studied in 12 male patients with dilated cardiomyopathy (DCM).

Method: 10 normal subjects served as controls. 201-Thallium (201TI) and [123I]-phenyl-pentadecanoic acid (IPPA) were administered during bicycle exercise under fasting conditions.

[Scleredema adultorum in secondary hyperparathyroidism].

Scleredema adultorum, or Buschke's scleredema, belongs to the group of mucinoses. It is characterised by thickened and indurated skin. Histopathology shows thickened dermis with an infiltration of mucin between swollen collagen bundles.

[One-year follow-up after echocardiographically-guided percutaneous septal ablation in hypertrophic obstructive cardiomyopathy].

Background: Percutaneous transluminal septal myocardial ablation by alcohol-induced septal branch occlusion was introduced as a new treatment option in symptomatic patients with hypertrophic obstructive cardiomyopathy. Echocardiographic monitoring of the procedure resulted in improvement of acute results. In this study we analyzed the follow-up after echocardiographic guided septal ablation.

[Post-traumatic pyoderma gangrenosum: combination therapy with intravenous immunoglobulins and systemic corticosteroids].

Pyoderma gangraenosum is a rare, chronic type of skin ulceration of unknown aetiology. It occasionally appears following trauma. There are no set standards for the treatment of pyoderma gangraenosum.

Cardiac catheterization in Germany. Diffusion and utilization from 1984 to 1996.

Objective: To describe the diffusion of cardiac catheterization technologies and time trends of their use according to setting and geographic region in Germany during a 13-year period. It is hypothesized that the cardiac catheterization technology has matured from an experimental state to a broadly accepted technology.

Methods: Data come from the annual survey of the German Society for Cardiovascular Research.

Effects of lovastatin on progression of non-dilated and dilated coronary segments and on restenosis in patients after PTCA. The cholesterol lowering atherosclerosis PTCA trial (CLAPT).

Objectives: The Cholesterol Lowering Atherosclerosis PTCA Trial (CLAPT) is a prospective, randomized trial with blinded angiographic end-points to assess the effect of 2-year's treatment with lovastatin initiated 4 weeks prior to PTCA, compared to usual care on non-dilated coronary segments and on dilated coronary lesions in male patients with total cholesterol between 200 and 300 mg. dl(-1)who underwent elective PTCA.

Methods And Results: Two hundred and twenty six patients were randomized 4 weeks prior to PTCA to special care (diet plus lovastatin n=112) or usual care (diet; n=114).

Intraprocedural myocardial contrast echocardiography as a routine procedure in percutaneous transluminal septal myocardial ablation: detection of threatening myocardial necrosis distant from the septal target area.

Percutaneous transluminal septal myocardial ablation (PTSMA) has been introduced as an alternative to surgery for symptomatic hypertrophic obstructive cardiomyopathy (HOCM). Visualization of the ablation area prior to induction of the chemical necrosis is possible by intraprocedural myocardial contrast echocardiography (MCE). We report on two patients in whom MCE showed opacification of the medial papillary muscle or the left ventricular posterolateral free wall.

Percutaneous transluminal septal ablation in hypertrophic obstructive cardiomyopathy.

Background: Percutaneous transluminal septal myocardial ablation (PTSMA) by alcohol-induced occlusion of septal branches with resulting reduction of LV outflow-tract gradient (LVOTG) is a new treatment option in symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM).

Methods: In 1996 and 1997 we treated 114 symptomatic patients (56 female; age 53.3 +/- 15.

Improvement in coronary flow reserve determined by positron emission tomography after 6 months of cholesterol-lowering therapy in patients with early stages of coronary atherosclerosis.

Background: Early stages of coronary atherosclerosis are characterized by a mainly functional impairment of coronary vasodilator capacity under the impact of such risk factors as hypercholesterolemia. The goal of this study was to determine whether 6-month cholesterol-lowering therapy improves coronary flow reserve in patients with angina, reduced flow reserve despite minimally diseased coronary vessels or even normal angiogram, and mild to moderately elevated LDL levels on average.

Methods And Results: We noninvasively investigated 23 consecutive patients (18 men, 5 women; mean age, 56+/-7.

Validation of the Omron F3 blood pressure measuring device for use in the finger through simultaneous invasive comparative measurements according to the German Institute for Validation (DIN) 58130 protocol.

Objectives And Design: Simultaneous invasive comparative measurements in order to validate the blood pressure measuring device Omron F3 for use in the finger, in accordance with the German Institute for Validation (DIN) 58130 protocol.

Methods: A total of five consecutive simultaneous blood pressure comparative measurements were carried out in each of 15 patients (n = 75). Blood pressure was measured in the left index finger using the blood pressure measuring device Omron F3, and at the same time invasively using a pigtail catheter situated in the aortic arch.

Outflow acceleration assessed by continuous-wave doppler echocardiography in left ventricular hypertrophy: an analysis of 103 consecutive cases.

The effect of provocation on left ventricular (LV) outflow was studied by continuous-wave Doppler echocardiography in 103 nonselected, consecutively enrolled patients with LV hypertrophy (LVH), either due to pressure overload (97 patients) or hypertrophic cardiomyopathy (HCM, 6 patients). In 34 patients with LVH, outflow acceleration (gradients ranging from 18 to 122 mm Hg) was induced or accentuated by the Valsalva maneuver after 1.6 mg nitroglycerine sublingually independent of LVH etiology.

Percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: results with respect to intraprocedural myocardial contrast echocardiography.

Background: Percutaneous transluminal septal myocardial ablation (PTSMA) has been introduced as an alternative procedure for reducing the left ventricular outflow tract gradient (LVOTG) in hypertrophic obstructive cardiomyopathy. We report on the acute and mid-term results in 91 symptomatic patients with respect to intraprocedural myocardial contrast echocardiography (MCE).

Methods And Results: PTSMA was intended for 46 women and 45 men (54.

[Improved coronary vasodilator capacity by drug lipid lowering therapy in patients in the early stage of coronary atherosclerosis with reduced coronary reserves and moderate LDL hypercholesteremia].

Background: An abnormal coronary flow reserve represents an early marker of impaired blood flow regulation in the natural history of coronary atherosclerosis under the impact of risk factors such as hypercholesterolemia. Our clinical investigation was aimed at assessing noninvasively the integrative coronary flow response to dipyridamole stress in 18 consecutive patients with microvascular angina, only moderately elevated LDL-cholesterol levels (168 +/- 33 mg/dl), and reduced vasodilator capacity despite normal (n = 9) or slightly abnormal (n = 9) coronary arteriograms (minimal disease with luminal irregularities and/or diameter reduction < or = 30%) before and after 6-month lipid-lowering therapy (simvastatin).

Methods: Regional and averaged myocardial blood flow were measured at rest and after dipyridamole induced vasodilation (0.

[Changes in life style as a causal therapeutic approach in coronary heart disease].

Life style measures (weight reduction and control, reduction of total fat calories to < 30% of total calories, modification of fat intake to increased monounsaturated vegetable fat, increased intake of dietary fibers, increased physical activity, controlled stress relaxation) are the basis of longterm therapy of coronary heart disease. For transformation to daily life both patient and doctor need motivation, information, patience, and realistic aims. For realization the 10 rules of medical information should be followed.