Determinants of mortality after cardiac surgery: results of the registry of the Arbeitsgemeinschaft Leitender Kardiologischer Krankenhausärzte (ALKK) on 10 525 patients.

Background: Mortality from cardiac surgery is an essential indicator of quality and forms the basis of treatment strategy decisions in eligible patients. No contemporary complete data on unselected adult cardiac surgery patients are available in Germany.

Methods And Results: A registry was started in June 1997 of all patients referred to surgery from 85 cardiology centres in Germany.

[Thrombolysis therapy and coronary angiography in acute myocardial infarct in the Augsburg region: results of the Augsburger Heart infarct register 1985-1987].

In the years 1985-87, the Augsburg Coronary Event Register registered 1333 hospitalized patients who had survived an acute myocardial infarction (AMI) for at least 24 h. In 953 patients, data on time intervals in the prehospital phase were documented in addition to the medical records data in a standardized nurse interview. The time from onset of AMI until the patient called for medical attention constituted most of the prehospital time delay.

[Surgical aortic valve replacement for acute Streptococcus viridans endocarditis with simultaneous moderate hemophilia A].

This is a report of a 25-year-old patient with known aortic valve stenosis since early youth and hemophilia A, showing recurrent joint bleeding. Acute Streptococcus endocarditis induced aortic valve insufficiency resulting in cardiac failure. Aortic valve replacement was performed after substitution of factor VIII, during which intra- and postoperative bleeding was prolonged by pericardial adhesions.

Prognostic implications of transient--predominantly silent--ischaemia in patients with unstable angina pectoris.

The occurrence of unstable angina pectoris, despite medical treatment, is generally regarded as an ominous prognostic sign and an indication for invasive diagnosis and revascularization. We investigated 38 consecutive patients with severe unstable angina with a mean of 2.5 days of continuous two-channel, frequency modulated Holter monitoring for ST segment analysis.

[Primary dissection of the left coronary artery with rupture of the ventricle in a 27-year-old patient].

This report of a 27-year-old patient describes an extensive infarction of the anterior wall due to primary dissection of the left coronary artery in the absence of the circumflex artery followed by rupture of the left ventricle. In earlier reports an aortocoronary bypass operation was usually performed in similar situations. Although the final outcome was lethal, this case report shows recanalization by methods of "interventional cardiology" to be a potentially successful alternative which may be of value when bypass operation is not available or contraindicated, as in developing cardiogenic shock.

[Intracoronary nifedipine--separation of drug specific and vehicle-induced effects].

In 22 patients we studied the effects of 0.2 mg nifedipine given intracoronary during the course of routine PTCA. In 9 patients the effect of the nifedipine-free solvent was additionally tested.

Physical activity decreases the number of beta-adrenergic receptors on human lymphocytes.

On intact human lymphocytes a specific binding site (BS) for 125I-Cyanopindolol (125I-CYP), a derivative of the beta-blocking drug pindolol, was characterized. Inhibition of binding for catecholamines in the following order of potency: l-isoprenaline greater than l-adrenaline greater than l-noradrenaline proves the BS as a beta 2-receptor subtype. In 77 healthy persons (36 females, 41 males) the number of BS amounted to 2,639 +/- 125 BS/cell without any significant correlation to age (17-86 years) or sex.

Cardiac glycoside receptors in cultured heart cells--II. Characterization of a high affinity and a low affinity binding site in heart muscle cells from neonatal rats.

The binding of [3H]ouabain has been studied in (Na+ + K+)-ATPase enriched cardiac cell membranes, as well as in cardiac muscle and non-muscle cells in culture--all obtained from hearts of neonatal rats. The binding has been correlated with ouabain-induced inhibition of (Na+ + K+)-ATPase (cardiac cell membranes) and the inhibition of active (86Rb+ + K+)-influx (cardiac muscle and non-muscle cells in culture). Furthermore, the effect of ouabain on the amplitude of cell-wall motion and contraction velocity has been studied in electrically driven cardiac muscle cells.

Influence of digitalis and diuretics on ouabain binding sites on human erythrocytes.

It has been reported that during chronic treatment with digitalis, the number of digitalis binding sites is increased in human erythrocytes [22]. From this finding a tachyphylaxis for cardiac glycosides has been postulated. We reinvestigated this problem in several groups of patients.

Cardiac glycoside binding sites in cultured heart muscle cells.

Binding of (3H)-ouabain to cultured cardiac muscle and non muscle cells from chicken embryos and neonatal rats has been characterized and correlated with ouabain-induced inhibition of the sodium pump, as well as with the positive inotropic action of the drug. Cardiac muscle and non muscle cells from 10-12 day-old chicken embryos are characterized by a single class of ouabain binding sites (muscle cells: dissociation constant KD = 1.5 X 10(-7) M; binding capacity B = 2.

Cardiac glycoside receptors in cultured heart cells--I. Characterization of one single class of high affinity receptors in heart muscle cells from chick embryos.

Binding of (3H)-ouabain and ouabain-induced inhibition of the sodium pump and of the (Na+ + K+)-ATPase have been characterized in cultured cardiac muscle and non muscle cells, as well as in cardiac cell membranes--all obtained from chick embryos. In both cell types, ouabain binds to a single type of binding sites in a temperature-dependent manner. The association rate but not the dissociation rate, is lowered by K+; specific binding is lost after heat-denaturation of the cells.

Effect of vanadium in the +5, +4 and +3 oxidation states on cardiac force of contraction, adenylate cyclase and (Na+ + K+)-ATPase activity.

The influence of vanadium in the nominally +5 (NH4VO3; referred to as V5+), +4 (C10H14O5V and VOSO4; V4+) and +3 oxidation states (VCl3; V3+) on cardiac force of contraction, adenylate cyclase and (Na+ + K+)-ATPase activity was investigated in order to determine which form of vanadium mediates the cardiac effects. V5+, V4+ and V3+ (300 microM each) increased the force of contraction of isolated electrically driven cat papillary muscles by about 100%. In the presence of the reducing agent ascorbic acid (5 mM) none of the three compounds led to any distinct increase in force of contraction.