Induction of subaortic septal ischaemia to reduce obstruction in hypertrophic obstructive cardiomyopathy: Studies to develop a new catheter-based concept of treatment

AIM: To develop a new catheter-based method of treatment in patientswith hypertrophic obstructive cardiomyopathy. METHOD: Does abolition of the blood supply to the subaortic part ofthe septum lead to regional myocardial ischaemia and a decreasein the left ventricular outflow tract gradient? To find thisout, in 10 consecutive patients the first larger septal branchof the left anterior descending coronary artery was temporarilyoccluded with conventional percutaneous transluminal coronaryangioplasty. The intracoronary electrocardiogram was registeredfor objective verification of the intended ischaemia. The intraventricularpressure was measured at rest and at the post extrasystolicbeat under programmed electrostimulation of the right ventricle. RESULTS: During occlusion, regional ischaemia was observed in all patients.Simultaneously, there was a significant reduction of the intraventriculargradient from 56·2 mmHg to 32·2 mmHg (P<0·05)followed by an increase from 32·2 mmHg to 61·1mmHg (P<0·01) after release of occlusion of the septalbranch. During ischaemia there was no increase in left ventricularend-diastolic pressure. CONCLUSION: We conclude that the results form the basis for a new catheterinterventional therapy in hypertrophic obstructive cardiomyopathy.     

The diagnostic value of M-mode-, two-dimensional echocardiography, and computed tomography in comparison to the results of cardiac catheterization in the diagnosis of tumors of the heart (author's transl)

12 patients with cardiac tumors (7 myxomas of the left, 2 of the right atrium, 2 ventricular, 2 intramural tumors and 1 epicardial cyst) were examined by M-Mode-(ME) and two-dimensional (2DE) echocardiography, computertomography (CT) and heart catheterization (HK) with angiography (A). The results were compared with intraoperative findings. There were no false negative results with 2DE and CT, but in 1 case the size of an intramural tumor was underestimated by 2DE. With ME all atrial myxomas were diagnosed, but 2 ventricular and 2 intramural tumors as well as the epicardial cyst were overlooked. Also with HK and A, the 2 intramural tumors and the epicardial cyst were not recognized well. The results indicate that the diagnosis of cardiac tumors can be made with great accuracy by noninvasive methods. The sensitivity of the single methods depends on the location of the tumors.     

Buchbesprechungen

Ohne Zusammenfassung     

Buchbesprechungen

Ohne Zusammenfassung     

Buchbesprechungen

Ohne Zusammenfassung     

Is there a link between adult neurogenesis and learning?

During the past several years, evidence has accumulated suggesting a relationship between newly born cells in the hippocampus and various types of learning and memory. However, most of the evidence is correlational and some of it does not agree. This review discusses both sides of this issue, considering the effects of learning on the production of new neurons in the dentate gyrus and the question of whether newly born cells participate in learning and memory.