Long-term clinical outcome of sirolimus-eluting stent implantation in metabolic syndrome and diabetes.

Background: Patients with metabolic syndrome (MetS) are at increased risk of cardiovascular events. The long-term effectiveness of sirolimus-eluting stents (SES) in patients with MetS and in diabetic patients is not well defined.

Methods: 563 consecutive patients with 629 de novo coronary lesions (< 50 mm lesion length, reference diameter < 3.

Results of interventional treatment of stress positive coronary artery disease.

The aim of this study was to define the impact of percutaneous coronary intervention (PCI) including stenting in patients with stress-positive stable coronary artery disease on long-term prognosis and symptoms. A group of 1,018 patients were identified from the angiographic and single-photon emission computed tomographic (SPECT) databases (technetium-99m sestamibi or tetrofosmin at rest and during stress) January 1, 2000, to December 31, 2003, to have significant coronary artery disease (>50% diameter stenosis on quantitative coronary angiography) and positive SPECT findings. Two hundred sixty-six patients were medically treated.

Analysis of LV lead position in cardiac resynchronization therapy using different imaging modalities.

Objectives: This study sought to evaluate whether left ventricular (LV) lead position in cardiac resynchronization therapy (CRT) can be determined by myocardial deformation imaging during LV pacing and to compare imaging techniques for analysis of LV lead position.

Background: LV lead position has a significant impact on effectiveness of CRT, but clinically applicable methods to determine LV lead position are less defined.

Methods: In 56 patients (53 +/- 5 years, 34 men) undergoing CRT, fluoroscopy and 2 myocardial deformation imaging-based approaches were applied to determine the LV lead position.

Electrical stimulation of sympathetic neurons induces autocrine/paracrine effects of NGF mediated by TrkA.

Neuronal remodeling with increased sympathetic innervation density has been implicated in the pathogenesis of atrial fibrillation (AF). Recently, increased transcardiac nerve growth factor (NGF) levels were observed in a canine model of AF. Whether atrial myocytes or cardiac sympathetic neurons are the source of neurotrophins, and whether NGF is the main neurotrophic factor contributing to sympathetic nerve sprouting (SNS) in AF still remains unclear.

Follow-up results after interventional treatment of infarct-related saphenous vein graft occlusion.

Background: Acute occlusion of saphenous vein grafts resulting in acute coronary syndromes may be treated with interventional revascularization. Few data are available on intermediate and long-term results after revascularization of acute saphenous vein graft occlusion.

Methods: Fifty patients (67+/-10 years, 47 male) with troponin-positive acute coronary syndrome because of acute total or subtotal occlusion [thrombolysis in myocardial infarction (TIMI) flow 0=39, TIMI 1=8, TIMI 2=3] of one saphenous vein graft (12.

Stress/rest myocardial perfusion scintigraphy in patients without significant coronary artery disease.

Aim: To define the prognostic impact of stress myocardial perfusion scintigraphy (MPS) in patients with angiographic exclusion of significant coronary artery disease.

Methods: Angiographic and MPS databases were matched to define patients without significant coronary artery disease by quantitative angiography (diameter stenosis <50%) who underwent stress MPS and coronary angiography within a time period of 3 months. A total of 118 patients were identified and followed for a mean of 6.

Outpatient induction -- how safe.

There is a world-wide interest in outpatient care. Induction of labor is commonly offered to women with prolonged pregnancy, and evidence from randomized controlled studies suggest that inpatient and outpatient induction achieve comparative maternal and fetal outcomes. However, safety data are very limited.

Advanced speckle tracking echocardiography allowing a three-myocardial layer-specific analysis of deformation parameters.

Aims: Different layers of myocardium may contribute differently to myocardial deformation. Speckle tracking based on high resolution two-dimensional (2D) echocardiography has been used to define myocardial deformation parameters of whole left ventricular (LV) segments. This study evaluated with a Novell analysis modality allowing layer-specific analysis of deformation if there are differences in myocardial deformation between different layers of myocardium.

MR imaging of thrombi using EP-2104R, a fibrin-specific contrast agent: initial results in patients.

This study was an initial phase II trial in humans of molecular magnetic resonance (MR) imaging for improved visualization of thrombi in vessel territories potentially responsible for stroke using a new fibrin-specific contrast agent (EP-2104R). Eleven patients with thrombus in the left ventricle (n = 2), left or right atrium (n = 4), thoracic aorta (n = 4) or carotid artery (n = 1) as verified by an index examination (ultrasound, computed tomograpy, or conventional MR) were enrolled. All MR imaging was performed on 1.

Relation of optimal lead positioning as defined by three-dimensional echocardiography to long-term benefit of cardiac resynchronization.

We sought to define the impact of echocardiographically defined left ventricular (LV) lead position on the efficacy of cardiac resynchronization therapy (CRT) in a serial study using 3-dimensional echocardiography. Fifty-eight consecutive patients (53+/-9 years of age; 37 men) with heart failure were included in the study. Echocardiograms were obtained before CRT, within 7 days after implantation, and at 12+/-2 months of follow-up using a 3-dimensional digital ultrasound scanner (iE33, Philips, Andover, Massachusetts).

Impact of the metabolic syndrome on angiographic and clinical events after coronary intervention using bare-metal or sirolimus-eluting stents.

Patients with metabolic syndrome (MS) are at increased risk for cardiovascular events. Although the number of patients with MS requiring coronary revascularization is increasing rapidly, the impact of MS on clinical events and restenosis in patients who undergo stent placement is not well defined. Seven hundred thirty-four consecutive patients with 734 de novo coronary lesions (<50 mm lesion length, reference vessel diameter <3.

Impact of left ventricular lead position in cardiac resynchronization therapy on left ventricular remodelling. A circumferential strain analysis based on 2D echocardiography.

Aims: To assess if myocardial deformation imaging allows definition of an optimal left ventricular (LV) lead position with improved effectiveness of cardiac resynchronization therapy (CRT) on LV reverse remodelling.

Methods: Circumferential strain imaging based on tracking of acoustic markers within 2D echo images (GE Ultrasound) was performed in 47 heart failure patients (59 +/- 9 years, 28 men) at baseline, one day postoperatively, 3 and 10 months after initiation of CRT. Myocardial deformation imaging was used to determine(1) the segment with latest peak negative systolic circumferential strain prior to CRT, and(2) the segment with maximal temporal difference of peak strain before-to-on CRT as the segment with greatest benefit of CRT and assumed LV lead position.

Impact of left ventricular lead position on the efficacy of cardiac resynchronisation therapy: a two-dimensional strain echocardiography study.

Background: Definition of the optimal left ventricular (LV) lead position in cardiac resynchronisation therapy (CRT) is desirable.

Objective: To define the optimal LV lead position in CRT and assess the effectiveness of CRT depending on the LV lead position using new myocardial deformation imaging.

Methods: Myocardial deformation imaging based on tracking of acoustic tissue pixels in two-dimensional echocardiographic images (EchoPAC, GE ultrasound) was performed in 47 patients with heart failure at baseline and during CRT.

Report on the 2005 European paediatric orthopaedic society traveling fellowship.

The here given report should abridge our experiences and scientific exchanges during a 2-week lasting fellowship in North America sponsored by European Paediatric Orthopaedic Society and Pediatric Orthopaedic Society of North America. We would like to thank all people involved in this extraordinary experience for their efforts, especially the European Paediatric Orthopaedic Society, giving us the honor and privilege of exchanging knowledge overseas.

Analysis of myocardial perfusion or myocardial function for detection of regional myocardial abnormalities. An echocardiographic multicenter comparison study using myocardial contrast echocardiography and 2D echocardiography.

Background: Echocardiography based myocardial perfusion imaging and regional wall motion analysis are used for evaluation of coronary artery disease and regional myocardial abnormalities.

Aim: This study sought to compare myocardial contrast echocardiography (MCE) and 2D echocardiography with regard to interobserver variability and detection of regional myocardial abnormalities.

Methods: In 70 patients evenly distributed between three ejection fraction groups based on biplane cineventriculography ( > 55%, 35-55%, < 35%), unenhanced and contrast enhanced 2D echocardiography and myocardial contrast echocardiography (MCE; SonoVue; Bracco) were performed.

Implantation of paclitaxel-eluting stents in saphenous vein grafts: clinical and angiographic follow-up results from a multicentre study.

Objective: To define the clinical and angiographic follow-up results after implantation of paclitaxel-eluting stents (PESs) in stenotic saphenous vein grafts (SVGs).

Design: Prospective multicentre study. Comparison with a control group.

Three-year follow-up after intracoronary beta-radiation therapy for in-stent restenosis.

Background: Most studies that proved intracoronary radiation therapy (IRT) to be highly effective to reduce recurrent restenosis after treatment of in-stent restenosis (ISR) have looked at time periods up to 12 months. Whether the beneficial effect from radiation is sustained during long-term follow-up remains a concern. This study sought to evaluate the effectiveness of IRT using a beta-emitter during a 3-year follow-up period.

Strain rate analysis allows detection of differences in diastolic function between viable and nonviable myocardial segments.

Analysis of diastolic function for assessment of myocardial viability has not been evaluated. Strain rate (SR) analysis allows quantitative segmental analysis of myocardial function and has been used during dobutamine stimulation for assessment of systolic functional reserve. In 37 patients with ischemic left ventricular dysfunction diastolic function was evaluated at rest and during low-dose dobutamine stimulation (10 mug/kg/min) using SR imaging and related to F18-fluorodeoxyglucose positron emission tomography.

Superiority of sirolimus eluting stent compared with intracoronary beta radiation for treatment of in-stent restenosis: a matched comparison.

Objective: To compare acute and follow up clinical and angiographic results after treatment of in-stent restenosis (ISR) by sirolimus eluting stents (SES) with results obtained after intracoronary radiation therapy (IRT).

Design: Matched pair analysis.

Methods: 62 consecutive ISR lesions (< 30 mm lesion length, reference diameter < 3.

Sirolimus- and paclitaxel-eluting stents in comparison with balloon angioplasty for treatment of in-stent restenosis.

This study evaluated the acute and follow-up effectiveness of sirolimus-eluting stents (SESs) and nonpolymer-based paclitaxel-eluting stents (PESs) in comparison will balloon angioplasty for treatment of complex in-stent restenosis (ISR) lesions. Drug-eluting stents have been demonstrated to be highly effective for treatment of de novo lesions. The use of drug-eluting stents for treatment of complex ISR is less well defined.

Assessment of systolic left ventricular function: a multi-centre comparison of cineventriculography, cardiac magnetic resonance imaging, unenhanced and contrast-enhanced echocardiography.

Aims: To assess the agreement of left ventricular ejection fraction (LVEF) determinations from unenhanced echocardiography, contrast-enhanced echocardiography, magnetic resonance imaging (MRI), and cineventriculography as well as the inter-observer agreement for each method.

Methods And Results: In 120 patients, with evenly distributed EF-groups (> 55, 35-55, < 35%), cineventriculography, unenhanced echocardiography with second harmonic imaging, and contrast echocardiography at low mechanical index with iv administration of SonoVue were performed. In addition, cardiac MRI at 1.

Intravascular ultrasonic comparative analysis of degree of intimal hyperplasia produced by four different stents in the coronary arteries.

Intravascular ultrasound studies were performed at angiographic follow-up on 121 native coronary lesions treated with 1 bare metal stent (n = 50), high-dose dexamethasone-eluting stents (n = 18), non-polymer-based paclitaxel-eluting stents (n = 18), or sirolimus-eluting stents (n = 35). Paclitaxel- and sirolimus-eluting stents reduced mean intimal hyperplasia thickness compared with bare metal stents by 49% and 90% (p = 0.048 and p <0.

New approaches to the visualization, quantification and explanation of acid-induced water loss from Ca-alginate hydrogel beads.

The water loss of Ca-alginate hydrogels at pHs below 4.0 was visualized with 1HNMR-imaging by covering a single alginate bead with cyclohexane-d12 in a specially equipped NMR-tube and adding propionic acid at defined concentrations. The exact amount of water expelled from the beads was calculated from their weight loss and correlated with the acid concentrations and pHs within the hydrogel matrix.