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排序方式: 共有112条查询结果,搜索用时 15 毫秒
11.
CHRISTOPH HEHRLEIN M.D. MARC KOLLUM M.D. AMINA ARAB M.D. HUSE KAMENCIC M.D. † JÜRGEN METZ M.D. † 《Journal of interventional cardiology》1999,12(4):299-304
Background: Restenosis after stent implantation is a common problem faced today by interventional cardiologists. It is primarily caused by excessive neointimal growth. Early clinical studies showed substantial reductions of neointimal volumes within bodies of32P radioactive coronary stents. Radiotherapy induces programmed cell death (apoptosis) in tumors but there is still debate whether irradiation causes apoptosis in arteries. Methods: We compared the time course of neointimal apoptosis after implanting 7-mm long 32P radioactive slotted tubular stents in rabbit iliac arteries. The stents were homogeneously ion-implanted with 32P at activity levels of 0.5 and 6 μCi. These stents produce continuous beta-particle emission at very low dose rates. Neointima formation was compared with nonradioactive stents by histomorphometry after 1, 4, and 12 weeks. Apoptosis was detected using the terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) assay method and transmission electron microscopy. Results: At an early follow-up of 1 week after stent implantation, no changes in neointimal apoptosis were found. The 32P stents at activities of 6 μCi, but not of 0.5 μCi, reduced neointimal crosssectional areas and cell numbers compared with control stents after 4 and 12 weeks. Apoptosis in the neointima increased after 4 weeks and was substantially elevated 12 weeks after implantation of 6 μCi 32P stents compared with 0.5 μCi and control stents (16% vs 6% and 3%, P < 0.01 for 6 vs 0.5 μCi and control stents, respectively). Conclusions: In this study, a dose dependent decrease in neointimal thickening and cell density within 32P beta-particle emitting stents was associated with an increased frequency of apoptosis. This increase in apoptosis occurred late in the time course of vascular healing after the implantation of 32P beta-particle emitting stents. Apoptosis seems to be involved in the mechanisms by which stent-based vascular irradiation reduces neointimal hyperplasia. 相似文献
12.
Expression of Opioid Receptor Subtypes and Their Ligands in Fibrillating Human Atria 总被引:2,自引:0,他引:2
UWE LENDECKEL CORNELIA MÜLLER CHRISTOPH RÖCKEN¶ BRITTA LAUBE§ MICHAEL TÄGER# CHRISTOF HUTH† HELMUT U. KLEIN‡ ANDREAS GOETTE‡ 《Pacing and clinical electrophysiology : PACE》2005,28(S1):S275-S279
The δ- and κ-receptor subtypes are both abundantly expressed in the human heart and participate in age- and stress-related alterations of cardiac function. Opioid receptor agonists mediate cardioprotection in response to ischemic preconditioning via increased intracellular Ca2 + levels, opening mitochondrial KATP channels, and PKC activation. We studied the expression of opioid receptor subtypes κ and δ, and of their ligand precursors, proopiomelanocortin (POMC) and preproenkephalin A (PENKA), in human atrial tissue of patients in sinus rhythm (SR), or persistent atrial fibrillation (AF). The mitochondrial size was also compared between the two groups. The atrial mRNA expression of opioid peptide precursors and receptors was assessed by competitive and real-time RT-PCR in 16 patients in AF and 16 patients in SR. Mitochondria were analyzed in the atrial tissue by electron microscopy in four patients in AF and four patients in SR. Both PENKA (SR: 100 ± 33% vs AF: 33 ± 21%; P < 0.05) and κ-receptor mRNA amounts (AF: 78 ± 20% vs SR: 100 ± 11%; P < 0.05) were both decreased in AF in comparison to SR. In addition, POMC mRNA levels were decreased in AF (SR: 100 ± 54% vs AF: 37 ± 26%; P < 0.05), whereas the expression of the corresponding δ-opioid receptor was unchanged (AF: 102 ± 34% vs 100 ± 44%). Mitochondrial size was increased during persistent AF. Persistent AF is associated with the down-regulation of the opioid receptor/ligand expression. This suggests a loss of protective capacity in the fibrillating atrial tissue, resulting in an ultrastructural remodeling of atrial myocytes. 相似文献
13.
DEBRA E. WEESE-MAYER JEAN M. SILVESTRI ANNA S. KENNY MICHEL N. ILBAWI SUSAN A. HAUPTMAN JACK W. LIPTON PASI P. TALONEN HONESTO GARRIDO GARCIA JOHN W. WATT GERHARD EXNER GERHARD A. BAER JOHN A. ELEFTERIADES WILLIAM T. PERUZZI CHARLES G. ALEX RICHARD HARLID WOLTER VINCKEN G. MICHAEL DAVIS MARC DECRAMER CHRISTOPH KUENZLE ARNE SÆTERHAUG JOHANNES G. SCHÖBER 《Pacing and clinical electrophysiology : PACE》1996,19(9):1311-1319
We sought to determine the international experience with the quadripolar diaphragm pacer system and to test two hypotheses: the incidence of pacer complications would be (1) increased among pediatric as compared to adult patients; and (2) highest among active pediatric patients with idiopathic congenital central hypoventilation syndrome (CCHS). Data were collected via a questionnaire coupled with the Atrotech Registry data for a total of 64 patients (35 children and 29 adults) from 14 countries. Thoracic implantation of electrodes and bilateral pacer use each occurred in 94% of all subjects. Tetraplegic (vs pediatric CCHS) patients were more typically paced 24 hours/day (P = 0.001). Pacing duration averaged 2.0 ± 1.0 years among children and 2.2 ± 1.1 years among adults. Infections occurred among 2.9% of surgical procedures, all in pediatric CCHS patients (vs pediatric tetraplegic patients, P = 0.01). The incidence of mechanical trauma was 3.8%, without significant differences among patient groups. The incidence of presumed electrode and receiver failure were 3.1% and 5.9%, respectively, with internal component failure greater among pediatric CCHS than pediatric tetraplegic patients (P < 0.01). Intermittent or absent function of 0–4 electrode combinations occurred among 19% of all patients, with increased frequency among pediatric CCHS than pediatric tetraplegic patients (P < 0.03). Complication- free successful pacing occurred in 60% of pediatric and 52% of adult patients. In all, 94 % of the pediatric and 86% of the adult patients paced successfully after the necessary intervention. Although pacer complications were not increased among pediatric as compared to adult patients, the incidence of complications was highest among the active pediatric patients with CCHS. Longitudinal study of these patients will provide invaluable information for modification and improvement of the quadripolar system. 相似文献
14.
Impact of the Right Ventricular Lead Position on Clinical End Points in CRT Recipients—A Subanalysis of the Multicenter Randomized SPICE Trial 下载免费PDF全文
STEFAN ASBACH M.D. CARSTEN LENNERZ M.D. VERENA SEMMLER M.D. CHRISTIAN GREBMER M.D. ULRICH SOLZBACH M.D. AXEL KLOPPE M.D. NORBERT KLEIN M.D. ISTVAN SZENDEY M.D. GEORGE ANDRIKOPOULOS M.D. STYLIANOS TZEIS M.D. CHRISTOPH BODE M.D. CHRISTOF KOLB M.D. †; ON BEHALF OF THE SPICE STUDY INVESTIGATORS 《Pacing and clinical electrophysiology : PACE》2016,39(3):261-267
15.
SEAN C. BEINART M.D. M.S.C.R. F.A.C.C. F.H.R.S. ANDREA NATALE M.D. F.A.C.C. F.H.R.S. F.E.S.C. ATUL VERMA M.D. F.R.C.P. ALPESH AMIN M.D. M.B.A. M.A.C.P. S.F.H.M. SCOTT KASNER M.D. M.S.C.E. F.A.H.A. F.A.A.N. HANS‐CHRISTOPH DIENER M.D. Ph.D. ERIKA POULIOT M.S. NORELI FRANCO Ph.D. SUNEET MITTAL M.D. F.A.C.C. 《Pacing and clinical electrophysiology : PACE》2016,39(8):837-842
16.
Ventricular Oversensing: 总被引:8,自引:1,他引:7
SLAWOMIR WERETKA JOCHEN MICHAELSEN RUEDIGER BECKER CHRISTOPH A. KARLE FREDERIK VOSS THOMAS HILBEL BRIGITTE R. OSSWALD† MALTE L. BAHNER‡ JULIA C. SENGES WOLFGANG KUEBLER WOLFGANG SCHOELS 《Pacing and clinical electrophysiology : PACE》2003,26(1P1):65-70
WERETKA, S., et al. : Ventricular Oversensing: A Study of 101 Patients Implanted with Dual Chamber Defibrillators and Two Different Lead Systems . Modern dual chamber ICD systems are able to overcome various sensing problems. However, improvement of their performance is still required. The aim of this study was to assess the sensing function in 101 consecutive patients (84 men, 17 women; mean age 63 ± 12 years; mean follow-up 24 ± 4 months) implanted with dual chamber defibrillators and integrated (IB) or dedicated bipolar (DB) lead systems. Follow-up data were analyzed for the presence of ventricular oversensing. Oversensing occurred in 25 (25%) patients, significantly more frequent in patients implanted with IB compared to DB lead systems (21/52 vs 4/49, P = 0.0002). Patients with cardiomyopathies (CMs) were more prone to sensing malfunctions than patients with no CM (12/30 vs 13/71, P = 0.04). T wave oversensing (n = 14), respirophasic ventricular oversensing (n = 4), and P wave oversensing (n = 6) were the most common pitfalls of ventricular sensing. P wave oversensing was unique to the IB lead system. CT scans performed in these patients disclosed the position of the RV coil to be proximal to the tricuspid area. Four patients received inappropriate ICD shocks due to oversensing. In all but two patients who received lead revision, oversensing was resolved by noninvasive means. In conclusion: (1) ventricular oversensing is a common problem occurring in up to 25% of patients with dual chamber ICDs; (2) P wave oversensing is a ventricular sensing problem affecting function of 11% of dual chamber devices with IB lead systems; (3) IB leads are significantly more susceptible to T wave and P wave oversensing than DB leads; and (4) patients with cardiomyopathies are more prone to oversensing than patients with other heart diseases. (PACE 2003; 26[Pt. I]:65–70) 相似文献
17.
JENS JUNG ARMIN HEISEL CEM ÖZBEK WOLFGANG BAY HANS P. STOLL SEMI SEN CHRISTOPH ALEXANDER HERMANN SGHIEFFER 《Pacing and clinical electrophysiology : PACE》1994,17(11):2183-2186
The presence of ventricular late potentials (LPs) early after acute myocardial infarction (AMI) was recently reported to correlate with left ventricular dilatation subsequent to AMI. We assessed prospectively the relationship between LP (time domain) in the late phase of AMI and left ventricular end-diastolic volume (EDV) measured by equilibrium radionuclide angiocardiography 4 weeks and 12 months after AMI. In 80 consecutive patients 4 weeks and 12 months after thrombolytic therapy for AMI, LP and EDV were deter mined (EDV1, EDV2). There was no significant correlation between QRS duration (r = 0.18), RMS40 (r = 0.08), or LAS40 (r = 0.1) and EDV1 or EDV2 in patients with or without LP at baseline. In both groups (patients with [n = 15] and without LP [n = 65]), EDVl and EDV2 were comparable (128 ± 32 mL vs 126 ± 35 mL; 114 ± 40 mL vs 117 ± 36 mL; P = NS). In addition, there was no significant difference between EDVl and EDV2 in patients who developed new LP (n = 6) or lost LP (n = 9) 12 months after AMI. In contrast to LP in the very early phase after AMI, there seems to be no significant correlation between the high resolution ECG in the late phase after thrombolytic therapy for AMI and left ventricular EDV. 相似文献
18.
RAINER GRADAUS MICHAEL BLOCK ANJA DORSZEWSKI CHRISTOPH SCHRIEVER DIETER HAMMEL HANS H. SCHELD MARTIN BORGGREFE GÜNTER BREITHARDT DIRK BÖCKER 《Pacing and clinical electrophysiology : PACE》2001,24(4):416-423
GRADAUS, R., et al. : Implantation of a Dual Chamber Pacing and Sensing Single Pass Defibrillation Lead. Dual-chamber ICDs are increasingly used to avoid inappropriate shocks due to supraventricular tachycardias. Additionally, many ICD patients will probably benefit from dual chamber pacing. The purpose of this pilot study was to evaluate the intraoperative performance and short-term follow-up of an innovative single pass right ventricular defibrillation lead capable of bipolar sensing and pacing in the right atrium and ventricle. Implantation of this single pass right ventricular defibrillation lead was successful in all 13 patients ( age 63 ± 8 years ; LVEF 0.44 ± 0.16 ; New York Heart Association [NYHA] 2.4 ± 0.4 , previous open heart surgery in all patients). The operation time was 79 ± 29 minutes, the fluoroscopy time 4.7 ± 3.1 minutes. No perioperative complications occurred. The intraoperative atrial sensing was 1.7 ± 0.5 mV , the atrial pacing threshold product was 0.20 ± 0.14 V/ms ( range 0.03–0.50 V/ms ). The defibrillation threshold was 8.8 ± 2.7 J . At prehospital discharge and at 1-month and 3-month follow-up, atrial sensing was 1.9 ± 0.9, 2.1 ± 0.5, and 2.7 ± 0.6 mV , respectively, ( P = NS, P < 0.05, P < 0.05 to implant, respectively), the mean atrial threshold product 0.79, 1.65, and 1.29 V/ms , respectively. In two patients, an intermittent exit block occurred in different body postures. All spontaneous and induced ventricular arrhythmias were detected and terminated appropriately. Thus, in a highly selected patient group, atrial and ventricular sensing and pacing with a single lead is possible under consideration of an atrial pacing dysfunction in 17% of patients. 相似文献
19.
SLAWOMIR WERETKA RUEDIGER BECKER THOMAS HILBEL CHRISTOPH KARLE BRIGITTE R. OSSWALD WOLFGANG KUEBLER WOLFGANG SCHOELS 《Pacing and clinical electrophysiology : PACE》2001,24(8):1240-1246
WERETKA, S., et al. : Far-Field R Wave Oversensing in a Dual Chamber Arrhythmia Management Device: Predisposing Factors and Practical Implications. Initial experience with the Medtronic Jewel 7250, the ICD designed to detect and treat ventricular and supraventricular tachyarrhythmias, is very promising. Its effectiveness, however, depends on sensing performance, which has not yet been systematically examined. The aim of the study was to determine the incidence of, predisposing factors for, and practical implications of far-field R wave oversensing (FFRWOS) in this dual chamber ICD. During a total follow-up of 797 months in 48 patients who had the Jewel 7250, follow-up strip charts, 12-channel Holter recordings and, in particular cases, Holter recordings with intracardiac markers were analyzed for the presence of FFRWOS. FFRWOS was documented in ten (21.3%) patients. Compared to other lead locations, the right atrial appendage lead position was most frequently associated with FFRWOS ( 7/27 vs 3/21, P < 0.05 ). Patients with FFRWOS had significantly more treated and nontreated atrial episodes, many of which were judged to have been detected inappropriately. In one case, inappropriate atrial antitachycardia pacing due to R wave oversensing triggered sustained ventricular tachycardia, terminated eventually with a high energy shock. In dual chamber ICDs, FFRWOS may represent a frequent phenomenon possibly leading to serious consequences. For atrial leads, a lateral atrial wall position seems to be preferable. In most cases, FFRWOS can be eliminated by optimization of atrial sensing parameters. Given the possibility of ventricular proarrhythmia with atrial pacing therapy, the capability of ventricular backup defibrillation in respective devices is at least reassuring. 相似文献
20.
CHRISTOPH HAMELMANN BIRGIT FOERSTER GERD D. BURCHARD ROLF D. HORSTMANN 《Parasite immunology》1992,14(1):23-35
The effect of nonimmune human serum on Entamoeba histolytica trophozoites was studied: (a) using whole serum in the presence of Ca and Mg ions allowing complement activation via both the alternative and classical pathways or in the presence of MgEGTA permitting alternative pathway activation only; (b) using different E. histolytica isolates; (c) varying serum and trophozoite concentrations and the time of incubation; and (d) using three different methods to quantify lysis, i.e., microscopic inspection, flow cytometry and 111In release. All three methods yielded similar results, with flow cytometry being most sensitive in identifying membrane damage and 111In release being most valid in determining cell death. Microscopic analysis was reliable only when a chamber was used to calculate the number of complement treated cells in relation to the initial cell count. E. histolytica isolates were classified into three groups according to their susceptibility to lysis by complement: (i) pathogenic isolates after long term cultivation in vitro were susceptible; (ii) pathogenic isolates after recent in vivo passage were less susceptible; and (iii) nonpathogenic isolates were nearly unaffected by exposure to the alternative pathway alone. The extent of lysis of the various isolates correlated with the degree of complement consumption in the serum samples, suggesting that unlysed isolates did not activate complement under the conditions employed. In general, lysis of susceptible trophozoites increased with the serum concentration and with the time of incubation. However, when the trophozoite concentration was 10(6)/ml or higher, lysis no longer reflected complement susceptibility because of exhaustion of the complement supply. 相似文献