Incomplete stent apposition after implantation of paclitaxel-eluting stents or bare metal stents: insights from the randomized TAXUS II trial.

Background: The clinical impact of late incomplete stent apposition (ISA) for drug-eluting stents is unknown. We sought to prospectively investigate the incidence and extent of ISA after the procedure and at 6-month follow-up of paclitaxel-eluting stents in comparison with bare metal stents (BMS) and survey the clinical significance of ISA over a period of 12 months.

Methods And Results: TAXUS II was a randomized, double-blind study with 536 patients in 2 consecutive cohorts comparing slow-release (SR; 131 patients) and moderate-release (MR; 135 patients) paclitaxel-eluting stents with BMS (270 patients).

Impaired mechanisms of leukocyte adhesion in vitro by the calcium channel antagonist mibefradil.

Purpose: Enhanced adhesion to the vascular endothelium and excessive trafficking to extravascular locations can lead to serious tissue injury and destruction. Therefore, interfering with molecular mechanisms of leukocyte adhesion to the vascular endothelium is an important goal to block diseases like chronic inflammations and atherosclerosis.

Methods: We studied the influence of the calcium antagonists mibefradil (T-type channel blocker), amlodipine and verapamil (both L-type channel blockers) on mechanisms related to leukocyte adhesion using isolated peripheral human blood leukocytes.

Immediate and late effects of coronary angiography on soluble endothelial cell markers and P-selectin in patients with and without coronary artery disease.

Endothelial cell injury and platelet activation are considered primary events in the pathogenesis of coronary artery disease (CAD) and are marked by plasma concentrations of von Willebrand factor (vWF) and soluble thrombomodulin, and by soluble P-selectin, respectively. Because both endothelial cells and platelets interact with contrast media, we aimed to detect immediate and 24-h changes in these markers following coronary angiography in patients with and without CAD. Sixteen patients with angiographically proven CAD and 14 patients without significant coronary stenosis were investigated.

Heart rate variability and ischaemia in patients with coronary heart disease and stable angina pectoris; influence of drug therapy and prognostic value. TIBBS Investigators Group. Total Ischemic Burden Bisoprolol Study.

Aims: Determination of the influence of therapy with bisoprolol and nifedipine on the heart rate variability of patients from the Total Ischemic Burden Bisoprolol Study and examination of the prognostic value.

Methods And Results: Four hundred and twenty-two patients with stable angina were included. The heart rate variability was determined over a period of 24 h.

Quality Determining Parameters of Balloon Angioplasty Catheters.

The investigations carried out on balloon angioplasty catheters using a parameter test unit allow an objective comparison and a qualitative assessment of catheter brands with respect to their stenosis passability. The design of the test unit allows the measure of other parameters important for clinical practice, such as pushability and trackability. Altogether 8 over-the-wire and 10 monorail-catheters from 7 different manufacturers were investigated by our study.

[Imprints of coronary plaque particles in the PTCA balloon surface during the dilatation processing].

Unlabelled: Seventy-six PTCA-balloons after coronary angioplasty were studied for superficial changes using scanning electron microscopy (SEM) after fixing in glutardialdehyde. Coronary plaque particles were identified on the balloon surface in 52 cases (68%). Twelve new and unused balloons were subjected to the same chemical treatment and SEM showed no imprints.

[The incidence of silent myocardial ischemia].

Retrospectively evaluated was the patient population of the years 1982 to 1988 which underwent ergometric investigations concerning the appearance of silent myocardial ischaemias. In 256 reactions of exercise ischaemia of patients with definitive coronary disease in 47 cases angina pectoris appeared (18.4%).

[Ventricle-vessels relationship in aspects of hypertension].

The diagnostics of the ventricle-vessel relations in arterial hypertension is significant in particular for advanced stages. Under the aspect to regard the cardiac contraction in form of a model as temporarily varying elastance of the volume invasively (P-measurement, V-measurement, preload alteration via balloon in the inferior vena cava) relations of the ventricular pressure volume (ESPVR, EDPVR) and system-arterial ones in form of the effective arterial elastance can be established. Additionally calculated functional curves give separated information concerning the influence of preload, afterload and contractility on the stroke work.

[Effects of diltiazem in acute and long-term administration].

In 16 patients with unstable angina pectoris haemodynamic and clinical effects of diltiazem were investigated. In a second group patients (n = 11) with unstable or therapy-refractory course the long-term effect was tested. The acute intervention with injected and infused diltiazem via an improved oxygen balance due to decreased minute work and reduced product of cardiac frequency and pressure stabilized the clinical picture from the haemodynamic aspect.

[A measuring procedure for experimental determination of tensile strength of catheters and flexible probes].

In order to obtain a more objective description of the properties usually subsumed under such terms as the "handling" of catheters, it is necessary to measure the significant parameter bending stiffness. A contact-free method of recording the oscillations of rod-shaped elements is presented. The stiffness EI can be calculated from the measured characteristic frequency.

[Definition and classification of heart failure].

The definition of the syndrome of heart failure is dependent upon clinical, pathophysiological and biochemical criteria. The interrelationship of the contributing factors in a given hemodynamic situation must be clarified by simple examination. "Heart failure" implies a condition with insufficient peripheral perfusion, despite a normal blood volume, a sufficient or increased filling pressure, and intact intrinsic and extrinsic compensatory mechanisms.

[Treatment indications of hypertensive blood pressure dysregulation (a 7-year follow-up)].

The results of the present course investigations by means of bicycle ergometry over seven years on patients with vitality-limiting load hypertension in normotensive and initial situation of the borderline blood pressure, respectively, render necessary from the point of view of the authors an increase of the former indications to treatment. Situative measurement of blood pressure only at rest are hereby not sufficient and demand a bicycle-ergometric objectivation of the possible hypertensive dysregulation of blood pressure in patients with anamnestically restricted range of physical efficacy. In patients with exclusively under load increased vitality-limiting blood pressure values the ergometry represents the diagnostic method of choice.

Relationship between design and control of artificial heart for protection of the right/left balance.

Right/left matching in the total artificial heart (TAH) is essential to prevent fatal volume displacement into the pulmonary circuit. Measurements were made with three different sized Rostock pneumatic artificial ventricles incorporated in the Donovan mock circulatory system together with the heart driver AKT 86. First for each ventricle we determined the dependence of the maximum effective stroke volume on the systolic driving pressure and the afterload.

[Current status of the use of the artificial heart and ventricular assist systems].

The state of the technical development of the mechanical assist systems and the artificial heart, respectively, guarantees a sufficient support of the circulatory system up to the improvement of the own heart function or to the possible heart transplantation. There is the necessity for the temporarily limited support of the heart, but also for the long-term one. Independent of the underlying etiology in acute conditions of cardiac failure in many cases the external supporting system may be sufficiently helpful.

[The status of prazosin in therapy of chronic heart failure].

Cardiac dysfunction and neurohumoral dysregulation show that the administration of vasodilators is reasonable in a cardiac insufficiency which is therapy-refractory against glycosides and saluretics. The alpha 1-blocker prazosin is a potent substance. On the basis of haemodynamic investigations of 55 patients the acute effects are demonstrated.

[Kineto- and displacement cardiography in heart valve diseases and possible diagnostic values].

With the help of the method of the kinetocardiography (KKG) inaugurated by Eddleman and the displacement cardiography (DKG) using a high fidelity changer, apart from a control group of 12 test persons with healthy heart 8 different groups of cardiac abnormalities consisting of altogether 88 patients were examined. Displacement cardiography and kinetocardiography did not significantly differ in the course of the curves. The courses of the curves for the cardiac abnormalities proved reproducible.

[Therapeutic possibilities in terminal heart failure].

The severe and terminal cardiac insufficiency with myogenic failure and severe neurohumoral dysregulation means a problem situation in the chronically progressive or acute form of the course. The medicamentous treatment in form of the basis therapy with glycosides and saluretics may be improved by vasodilators or/and adrenergic agonists. In most cases we succeed in stabilizing the cardiovascular situation once to several times.