44 results on '"Hamm C"'
Search Results
2. Risikostratifizierung bei akutem Koronarsyndrom
- Author
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Hamm, C. W., Arntz, H.-R., editor, and Schuster, H.-P., editor
- Published
- 2000
- Full Text
- View/download PDF
3. Recanalization of Chronic Total Occlusions: Results and Complications
- Author
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Hamm, C. W., Bleifeld, W., Fleck, Eckart, editor, and Frantz, Eckart, editor
- Published
- 1991
- Full Text
- View/download PDF
4. Identification of patients with silent myocardial ischemia by metabolic, scintigraphic and angiographic findings
- Author
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Hamm, C. W., Kupper, W., Hinrichs, A., Bleifeld, W., v. Arnim, Th., editor, and Maseri, A., editor
- Published
- 1987
- Full Text
- View/download PDF
5. Prostaglandinmetaboliten bei Patienten mit instabiler Angina pectoris
- Author
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Kupper, W., Hamm, C. W., Bleifeld, W., v. Arnim, Th., editor, and Maseri, A., editor
- Published
- 1989
- Full Text
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6. Prostaglandin metabolites in unstable angina pectoris patients
- Author
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Kupper, W., Hamm, C. W., Bleifeld, W., v. Arnim, Th., editor, and Maseri, A., editor
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- 1989
- Full Text
- View/download PDF
7. Coronardurchblutung, myocardiale Laktatextraktion und Rhythmusstörungen bei Patienten mit Hauptstammstenose der linken Kranzarterie
- Author
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Kupper, W., primary, Hamm, C., additional, Hanrath, P., additional, Bleifeld, W., additional, and Mathey, D., additional
- Published
- 1978
- Full Text
- View/download PDF
8. Durchblutungs- und Stoffwechselverhalten druckhypertrophierter Herzen in Ruhe, unter Belastung und nach medikamentöser Koronargefäßdilatation
- Author
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Kupper, W., primary, Bleifeld, W., additional, Hanrath, P., additional, Hamm, C., additional, and Mathey, D., additional
- Published
- 1977
- Full Text
- View/download PDF
9. Left Main Coronary Artery Stenosis: Evaluation by Coronary Sinus Blood Flow, Lactate Metabolism and Holter Monitoring
- Author
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Hamm, C. W., primary, Kupper, W., additional, and Bleifeld, W., additional
- Published
- 1984
- Full Text
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10. Quantitative Assessment of Collateral Flow in Patients with Ischemic Heart Disease
- Author
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Kupper, W., primary, Hamm, C. W., additional, and Bleifeld, W. H., additional
- Published
- 1984
- Full Text
- View/download PDF
11. Coronardurchblutung, myocardiale Laktatextraktion und Rhythmusstörungen bei Patienten mit Hauptstammstenose der linken Kranzarterie
- Author
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Kupper, W., Hamm, C., Hanrath, P., Bleifeld, W., Mathey, D., Schaper, Wolfgang, editor, and Gottwik, Martin G., editor
- Published
- 1978
- Full Text
- View/download PDF
12. Cardiac angiosarcoma: case report and review of the literature.
- Author
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Brandt RR, Arnold R, Bohle RM, Dill T, and Hamm CW
- Subjects
- Female, Heart Neoplasms surgery, Humans, Middle Aged, Treatment Outcome, Ultrasonography, Heart Atria diagnostic imaging, Heart Atria surgery, Heart Neoplasms diagnostic imaging, Heart Ventricles diagnostic imaging, Heart Ventricles surgery
- Abstract
Angiosarcoma of the heart, the most common primary malignant cardiac tumor in adults is known to carry a dismal prognosis. The diagnosis is often delayed because of the nonspecific clinical presentation. Symptoms are determined by the size and location of the tumor. Echocardiography has become the primary diagnostic technique because of its high degree of accuracy, noninvasiveness, and cost effectiveness. Complete surgical resection is required for improved survival. Conventional postoperative chemotherapy does not appear to modify the clinical course. We report a case of cardiac angiosarcoma with a large mural mass infiltrating the right atrial and ventricular walls and critically review the pertinent literature.
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- 2005
- Full Text
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13. Treatment of in-stent restenosis with sirolimus-eluting-stents -- a six month clinical and angiographic follow-up.
- Author
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Rau M, Maikowski C, Weber M, Keil E, Elsässer A, Möllmann H, and Hamm C
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- Coronary Restenosis diagnostic imaging, Drug Implants administration & dosage, Equipment Design, Equipment Failure Analysis, Female, Follow-Up Studies, Graft Occlusion, Vascular diagnostic imaging, Humans, Immunosuppressive Agents administration & dosage, Male, Middle Aged, Radiography, Treatment Outcome, Blood Vessel Prosthesis adverse effects, Coronary Restenosis drug therapy, Coronary Restenosis etiology, Graft Occlusion, Vascular drug therapy, Graft Occlusion, Vascular etiology, Sirolimus administration & dosage, Stents adverse effects
- Abstract
Treatment of in-stent restenosis (ISR) remains a therapeutic challenge since many pharmacological and mechanical approaches have shown disappointing results except for brachytherapy. Drug-eluting stents (DES) have been reported to effectively reduce ISR in de novo lesions. We studied 55 consecutive patients with ISR in native coronary arteries and 7 with ISR in saphenous vein grafts (SVG) with elective indication for percutaneous coronary intervention (PCI), who underwent successful implantation with DES. No in-hospital postprocedural major adverse cardiac events were observed. All but one patient (n=61) underwent an angiographic follow-up at 183+/-30 days. Grade of stenosis was assessed by quantitative coronary angiography (QCA) at index procedure and at control angiography. Restenosis (>50%) occurred in 5 patients (8.2%). Target vessel revascularization was performed in an additional 4 patients. Minimal intimal hyperplasia was observed in all segments covered by DES (late loss 0.08+/-0.37 mm, loss index 0.11+/-0.47). One patient suffered from subacute stent thrombosis due to discontinuation of clopidogrel medication. At six month follow-up two patients had died. Death was not related to a restenosis in the treated segment. Conclusion Our experiences with DES treatment of ISR lesions show good angiographic and clinical results at index procedure and at the 6 month follow-up with low sub acute thrombosis rate as compared with existing treatment modalities. Restenosis rate seems to be at least as low as reported for brachytherapy.
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- 2005
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14. Transcatheter closure of a ruptured ventricular septum after myocardial infarction using a venous approach.
- Author
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Elsässer A, Möllmann H, Nef H, Dill T, Brandt R, Skwara W, Hennig T, Rau M, and Hamm C
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- Aged, Heart Failure etiology, Heart Failure surgery, Humans, Male, Myocardial Infarction complications, Rupture diagnosis, Rupture etiology, Rupture surgery, Cardiac Catheterization methods, Cardiovascular Surgical Procedures methods, Heart Septum injuries, Heart Septum surgery, Heart Ventricles injuries, Heart Ventricles surgery, Myocardial Infarction surgery
- Abstract
A 65-year old patient was admitted after having sustained a ventricular septum rupture 18 days after an anterior myocardial infarction. He developed acute heart failure. Given the extremely high perioperative risk in surgical approaches in this setting, we decided for a transcatheter closure of the defect with an exclusively venous approach. After a complete recovery, the patient underwent open heart surgery with aorto coronary bypass, aneurysmectomy, and removal of the closure device. This case demonstrates that transcatheter closure of a post infarction ventricular septum rupture is a technically feasible and suitable method.
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- 2005
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15. Left atrial myxoma diagnosed and characterized by cardiac magnetic resonance imaging.
- Author
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Deetjen A, Möllmann S, Dill T, and Hamm CW
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- Aged, Diagnosis, Differential, Dyspnea etiology, Heart Atria pathology, Heart Atria surgery, Heart Diseases complications, Heart Diseases diagnosis, Heart Neoplasms complications, Heart Neoplasms surgery, Humans, Magnetic Resonance Imaging, Male, Myxoma complications, Myxoma surgery, Thrombosis complications, Thrombosis diagnosis, Treatment Outcome, Dyspnea diagnosis, Heart Neoplasms pathology, Myxoma pathology
- Abstract
A 71 year old man was referred for MRI investigation of the heart. He had a history of progressive dyspnea. Due to his echocardiographical findings and the known history of permanent atrial fibrillation, his cardiologist suspected atrial thrombi. MRI investigation of the heart showed a left atrial mass pedunculated at the atrial septum which showed signal enhancement after intravenous administration of gadolinium-DTPA. Left atrial myxoma was suspected. The patient underwent surgery with resection of the tumor and patch-occlusion of the atrial septum. Histology confirmed a polypoid cardial myxoma.
- Published
- 2005
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16. Clopidogrel in acute coronary syndrome: when, how much, how long?
- Author
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Elsässer A, Nef H, Möllmann H, and Hamm CW
- Subjects
- Acute Disease, Aspirin administration & dosage, Clopidogrel, Dose-Response Relationship, Drug, Drug Administration Schedule, Germany, Humans, Practice Patterns, Physicians', Syndrome, Ticlopidine administration & dosage, Treatment Outcome, Angina, Unstable drug therapy, Clinical Trials as Topic, Coronary Disease drug therapy, Myocardial Infarction drug therapy, Platelet Aggregation Inhibitors administration & dosage, Practice Guidelines as Topic, Ticlopidine analogs & derivatives
- Abstract
An important part of the therapy management of acute coronary syndrome (ACS) consists of antiplatelet drugs. Whereas the administration of acetylsalicylic acid (ASA) is well established, the guidelines recommend the additive use of clopidogrel in patients with ACS without persisting ST-elevation. Clopidogrel should be added to ASA as soon as possible in patients with a non-invasive treatment strategy and continued for more than 1 month (class 1A) and up to 9 months (class 1B). In patients for whom a percutaneous coronary intervention (PCI) is planned, an additional loading-dose of 300 mg clopidogrel should be given on top of ASA (100 mg). These recommendations are based on data recently published in the CURE and CREDO trials, which however should be critically discussed: In these trials, an absolute risk reduction of only 2% could be documented by additive use of clopidogrel. The combined endpoint of cardiovascular death, myocardial infarction and stroke is significantly reduced, but there was no improvement taken the individual endpoints alone. In additional, the data for duration of clopidogrel therapy were determined by taken the mean follow-up of these studies. The efficacy of the dual antiplatelet therapy should be discussed in the context of an increased frequency of major bleedings (in total 1%) and should be considered against a reasonable cost effective background. An adequate therapy with clopidogrel in patients presenting ACS should be confirmed by further trials. Until more detailed data are available, the guideline recommendations should be implemented based on of patient's individual risk.
- Published
- 2005
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17. Influence of the angiotensin converting enzyme inhibitor ramipril on high-sensitivity C-reactive protein (hs-CRP) in patients with documented atherosclerosis.
- Author
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Mitrovic V, Klein HH, Krekel N, Kreuzer J, Fichtlscherer S, Schirmer A, Paar WD, and Hamm CW
- Subjects
- Adult, Aged, Angiotensin-Converting Enzyme Inhibitors adverse effects, Blood Pressure drug effects, Cholesterol, LDL blood, Coronary Disease blood, Coronary Disease drug therapy, Drug Therapy, Combination, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Hypolipidemic Agents therapeutic use, Male, Middle Aged, Premedication, Prospective Studies, Ramipril adverse effects, Treatment Outcome, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Arteriosclerosis drug therapy, Coronary Artery Disease drug therapy, Ramipril therapeutic use
- Abstract
Unlabelled: Some medications have been shown to produce reductions in hs-CRP levels after initiating therapy. Whereas the role of the renin-angiotensin system in the inflammatory process has been documented in more detail during the last few years, the impact of an ACE-inhibitor therapy on this process has not been fully understood so far. The aim of this study was to investigate the effect of a therapy with the angiotensin-converting enzyme (ACE) inhibitor ramipril on hs-CRP plasma concentrations in patients with atherosclerosis., Methods and Results: A total of 24 patients were enrolled in this prospective, uncontrolled, open-label multicenter study. Inclusion criteria were documented atherosclerosis, baseline high-sensitivity C-reactive protein between 3 and 12 mg/l, LDL-Cholesterol < or =150 mg/dl and no previous treatment with ACE inhibitors or angiotensin receptor blockers. Ten patients, pretreated with statins, and 10 patients not previously treated with statins were eligible for statistical analysis. Baseline high-sensitivity C-reactive protein was significantly decreased from 3.99+/-1.61 mg/l (mean+/-SD) to 2.72+/-1.19 mg/l (-32%) after 3 months treatment with 10 mg ramipril daily (p=0.0002). The decrease was more pronounced in patients who had not been treated with statins previously (-1.50 mg/l+/-1.44 mg/l) compared to those who were pretreated (-0.90 mg/l+/-0.93 mg/l)., Conclusions: The ACE inhibitor ramipril administered in a daily dose of 10 mg to patients with atherosclerosis reduces the high-sensitivity C-reactive protein concentration. This effect may contribute to cardiovascular risk reduction mediated by ramipril aside from the blood pressure lowering effect.
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- 2005
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18. Sirolimus-eluting stent treatment for isolated proximal left anterior descending artery stenoses. Results from the prospective multi-center German Cypher Registry.
- Author
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Khattab AA, Hamm CW, Senges J, Toelg R, Geist V, Bonzel T, Kelm M, Levenson B, Nienaber CA, Sabin G, Schneider S, Tebbe U, and Richardt G
- Subjects
- Activities of Daily Living classification, Administration, Topical, Aged, Cause of Death, Coronary Stenosis diagnostic imaging, Coronary Stenosis mortality, Female, Follow-Up Studies, Germany, Humans, Intracranial Embolism mortality, Male, Middle Aged, Myocardial Infarction mortality, Outcome Assessment, Health Care statistics & numerical data, Prospective Studies, Radiography, Registries statistics & numerical data, Survival Analysis, Treatment Outcome, Coated Materials, Biocompatible, Coronary Stenosis therapy, Sirolimus administration & dosage, Stents
- Abstract
Background: Stenting of isolated proximal LAD stenoses is still a controversial issue since it is associated with higher target vessel revascularization (TVR) rate than both bypass surgery using the internal mammary artery, and stenting of other coronary artery territories. The sirolimus- eluting stent (SES) has been reported to significantly reduce restenosis rates in de novo coronary lesions. Therefore, we compared patients from the German Cypher Registry treated with SES for isolated proximal LAD lesions with those stented for isolated lesions in the proximal LCX or RCA., Methods: A total of 349 patients treated with SES were analyzed. 249 patients were treated for proximal LAD stenosis, and 100 for proximal LCX/RCA stenoses. The combined clinical endpoint was MACCE (death of any cause, non-fatal MI and non-fatal stroke) and TVR at 6 months., Results: In-hospital events (death, MI and TVR) did not differ significantly between both groups (3.2% for the LAD group vs 2.0% for the LCX/RCA-group, p=0.73). The combined end point of death of any cause, non-fatal MI and non-fatal stroke at six months was 2.6% in the LAD group, and 2.2% in the LCX/RCA group (p=1.0). TVR occurred in 4.8% of the LAD group and in 6.5% of the LCX/RCA group at six months (p=0.58). The percentage of patients free from angina at daily activities was 80.6% in the LAD group, and 77.4% in the LCX/ RCA group (p=0.52)., Conclusion: SES once implanted into isolated proximal LAD stenoses appears as effective as reported in other vessel territories. Accordingly, stenting of the proximal LAD using SES might prove a suitable alternative to surgery.
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- 2005
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19. [Quantification of valvular lesions in patients with left ventricular dysfunction].
- Author
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Brandt RR, Oppacher M, Elsässer A, and Hamm CW
- Subjects
- Aortic Valve diagnostic imaging, Aortic Valve physiopathology, Aortic Valve Stenosis physiopathology, Blood Flow Velocity physiology, Blood Pressure physiology, Echocardiography, Stress, Heart Failure diagnostic imaging, Heart Failure physiopathology, Humans, Mitral Valve diagnostic imaging, Mitral Valve physiopathology, Mitral Valve Insufficiency physiopathology, Prognosis, Sensitivity and Specificity, Ventricular Dysfunction, Left physiopathology, Aortic Valve Stenosis diagnostic imaging, Echocardiography, Transesophageal, Hemodynamics physiology, Mitral Valve Insufficiency diagnostic imaging, Ultrasonography, Doppler, Ventricular Dysfunction, Left diagnostic imaging
- Abstract
Echocardiography is the preferred method for assessment of aortic and mitral valvular lesions. The pressure gradient in aortic stenosis may be misleading in patients with poor left ventricular function. Aortic valve area planimetry by transesophageal echocardiography results in a flow independent anatomic measurement. Low-dose dobutamine stress echocardiography provides important prognostic information. Quantitative Doppler echocardiography allows accurate assessment of mitral regurgitation severity. However, the definition of what is severe mitral regurgitation is different in patients with left ventricular dysfunction.
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- 2005
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20. [Ambulatory electrocardioversion of atrial fibrillation by means of biphasic versus monophasic shock delivery. A prospective randomized study].
- Author
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Neumann T, Erdogan A, Reiner C, Siemon G, Kurzidim K, Berkowitsch A, Kuniss M, Sperzel J, Hamm CW, and Pitschner HF
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- Female, Germany epidemiology, Humans, Male, Middle Aged, Prospective Studies, Treatment Outcome, Ambulatory Care methods, Ambulatory Care statistics & numerical data, Atrial Fibrillation epidemiology, Atrial Fibrillation therapy, Electric Countershock methods, Electric Countershock statistics & numerical data
- Abstract
Transthoracic electrical cardioversion using a monophasic waveform is the most common method converting persistent atrial fibrillation into sinus rhythm. Recently, cardioversion with a new biphasic waveform has shown promising results for treatment of atrial fibrillation. We undertook a randomized prospective trial comparing the efficacy and safety of the two waveforms for ambulatory cardioversion of atrial fibrillation. A total of 118 consecutive patients (mean age 62 years [SD 11]) presenting with persistent atrial fibrillation (mean duration 8 months [SD 11]) for ambulatory electrical cardioversion were randomized to receive either monophasic (n = 57) or biphasic shocks (n = 61). We used a standardized step-up protocol with increasing shock energies (100-360 joules) in either group. In all patients an anterior-posterior shock electrode position was used. If sinus rhythm was not achieved with the third (360 joules) shock, cardioversion was repeated with the opposite waveform. The two groups did not differ in demographic or disease-related data. The success rate was 100% for the biphasic and 73.7% for the monophasic waveform (p < 0.001). Biphasic patients required fewer shocks (1.5 versus 2.9) and a lower mean cumulative energy (203 versus 570 joules) (p < 0.001). Twelve out of 15 unsuccessfully treated monophasic patients were converted with biphasic shocks. The success rate for all 118 patients was 97.5%. No major acute complications were observed. For ambulatory transthoracic cardioversion of persistent atrial fibrillation biphasic shocks are of greater efficacy and require less energy than monophasic shocks. The procedure can be performed ambulatory and is safe regardless of shock waveform used.
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- 2004
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21. [Guidelines: Acute coronary syndrome (ACS). II: Acute coronary syndrome with ST-elevation].
- Author
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Hamm CW
- Subjects
- Acute Disease, Angioplasty, Balloon, Coronary methods, Fibrinolytic Agents administration & dosage, Germany, Humans, Patient Care Management methods, Patient Care Management standards, Practice Guidelines as Topic, Risk Assessment methods, Risk Assessment standards, Syndrome, Coronary Disease diagnosis, Coronary Disease therapy, Electrocardiography methods, Electrocardiography standards, Fibrinolytic Agents therapeutic use, Myocardial Infarction diagnosis, Myocardial Infarction therapy, Practice Patterns, Physicians' standards
- Published
- 2004
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22. "Real life" use of sirolimus-eluting coronary stents in Germany. Results from the prospective multi-centre German Cypher Registry.
- Author
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Zahn R, Hamm CW, Zeymer U, Schneider S, Nienaber CA, Richardt G, Kelm M, Levenson B, Bonzel T, Tebbe U, Schöbel WA, Sabin G, and Senges J
- Subjects
- Comorbidity, Coronary Restenosis drug therapy, Drug Delivery Systems statistics & numerical data, Female, Germany epidemiology, Humans, Male, Middle Aged, Blood Vessel Prosthesis statistics & numerical data, Coronary Disease epidemiology, Coronary Disease surgery, Coronary Restenosis epidemiology, Coronary Restenosis prevention & control, Registries, Sirolimus administration & dosage, Stents statistics & numerical data
- Abstract
Background: Drugeluting stents (DES) are currently judged to be a "break-through" technology for the prevention of restenosis after percutaneous coronary interventions (PCI). However, experience is limited to randomised controlled clinical trials (RCT) in selected lesions and the currently available DES are more expensive compared to conventional "bare" stents. Therefore, actual clinical practice may be very different to RCT., Methods: We analysed the data of the German Cypher trade mark Registry, a nationwide registry which was initiated in parallel to the launch of the first DES, the Cypher trade mark sirolimus-eluting coronary stent, in April 2002., Results: From April 2002 until March 2003, 1638 procedures at 88 hospitals were included in the German Cypher trade mark Registry. The mean inclusion rate per centre and month remained low (<3 procedures/month and participating hospital) during the whole inclusion period. Most patients presented with stable angina pectoris (45.8%); however, 6.4% of patients were treated for a non-ST elevation myocardial infarction, 10.3% of patients for ST elevation myocardial infarction and 1.7% in cardiogenic shock. In patients without ST elevation myocardial infarction, a de novo stenosis was treated in 68.4% of cases, a restenosis in 4.1%, and an in-stent restenosis in 25.5% of cases. Chronic total occlusions were treated in 6.1% of patients. Predilatation was performed in 68.3% of patients and 1.05 +/- 0.35 Cypher trade mark stents were implanted per patient with a median (quartiles) stent length of 18 (13-21) mm. PCI-related death occurred in 0.1% of patients and a Q-wave myocardial infarction in 1.1%. Urgent re-PCI before hospital discharge was performed in 1.3% and urgent bypass surgery in 0.1% of cases., Conclusions: The use of the sirolimus-eluting coronary stents in this "real life" registry was found to be safe concerning acute complications. In about one half of the registry patients, the DES was implanted in lesions that were excluded from RCTs.
- Published
- 2004
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23. [Cardiopulmonary exercise capacity increases after interventional ASD-closure].
- Author
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Weber M, Neumann T, Rau M, Brandt R, Dill T, Maikowski C, Mitrovic V, and Hamm C
- Subjects
- Adolescent, Adult, Aged, Anaerobic Threshold physiology, Cardiac Catheterization, Echocardiography, Female, Follow-Up Studies, Heart Septal Defects, Atrial physiopathology, Humans, Male, Middle Aged, Oxygen blood, Physical Exertion physiology, Postoperative Complications physiopathology, Prosthesis Implantation, Spirometry, Exercise Test, Heart Septal Defects, Atrial surgery, Physical Endurance physiology, Postoperative Complications diagnosis
- Abstract
Background: In patients with atrial septal defects of the secundum-type (ASD), exercise tolerance is reduced. Generally, ASD closure is recommended in symptomatic patients and in patients with a relevant left-to-right shunt (Qp/Qs > 1.5). Only few data are available concerning objective parameters of cardiopulmonary exercise capacity. The aim of this study was to evaluate exercise capacity as achieved by ergospirometry in adult patients with an ASD at baseline and in the long-term following transcatheter closure., Methods and Results: Thirty consecutive patients (8 male; mean age 43.4 years; defect size 23.5 mm; pulmonary-to-systemic flow ratio (Qp/Qs) 1.94) performed exercise testing on a supine bicycle ergometer. At baseline, oxygen consumption at maximal exercise (VO(2) peak) was 14.3 ml/min kg, oxygen consumption at the anaerobic threshold (VO(2)-AT) was 11.2 ml/min/kg and maximal achieved workload was 86 Watt. At one and six months after ASD-closure, there was no relevant increase of the VO(2) peak, the VO(2)-AT or the maximal workload. After 12 months, there was a significant increase of the VO(2) peak (15.1 ml/min/kg, p = 0.049), the VO(2)-AT (13 ml/min/kg, p < 0.001) and the maximal workload (99 Watt, p < 0.01). An increase of the oxygen consumption at the anaerobic threshold (Delta VO(2) AT) could be seen in 24 out of 30 patients and was independent of shunt volume (Q(p)/Q(s) < or = 2, 1.95 ml/ min/kg; Q(p)/Q(s) > 2, 2.13 ml/min/ kg; ns), defect size (defect < or = 24 mm, 2.0 ml/min/kg; defect > 24 mm, 1.5 ml/min/kg; ns), age (age < or = 44 years, 1.97 ml/min/kg; age >44 years, 1.66 ml/min/kg; ns), gender (female 1.56 ml/min/ kg; male 1.91 ml/min/kg; ns) and of the existence of a residual shunt. Highly symptomatic patients had a tendency to have greater benefit from ASD-closure as compared to mildly symptomatic patients (NYHA 0/I 1.85 ml/min/kg; NYHA II 1.5 ml/min/ kg; NYHA III 2.7 ml/min/kg; ns). There was no correlation between shunt volume, shunt size, pulmonal arterial pressure and increase of the oxygen consumption at the anaerobic threshold (Delta VO(2) AT)., Conclusion: There is no relevant improvement in exercise capacity early (1-6 months) after interventional ASD-closure, but late after ASD-closure (12 months) exercise capacity improves significantly. This improvement can be found in almost all patients independent of gender, age, symptoms, shunt volume and defect size.
- Published
- 2004
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24. [Guidelines: acute coronary syndrome (ACS). 1: ACS without persistent ST segment elevations].
- Author
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Hamm CW
- Subjects
- Acute Disease, Angina, Unstable therapy, Biomarkers blood, Coronary Disease therapy, Creatine Kinase blood, Creatine Kinase, MB Form, Diagnostic Imaging, Evidence-Based Medicine, Germany, Humans, Isoenzymes blood, Myocardial Infarction therapy, Predictive Value of Tests, Risk Assessment, Syndrome, Treatment Outcome, Troponin blood, Angina, Unstable diagnosis, Coronary Disease diagnosis, Death, Sudden, Cardiac, Electrocardiography, Myocardial Infarction diagnosis
- Published
- 2004
- Full Text
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25. [Cooled tip ablation of left ventricular outflow tract tachycardia through the aortic sinus of valsalva].
- Author
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Kurzidim K, Neumann T, Vukajlovic D, Güttler N, Sperzel J, Bahavar H, Hamm CW, and Pitschner HF
- Subjects
- Adult, Coronary Angiography, Echocardiography, Electrocardiography, Electrophysiologic Techniques, Cardiac, Female, Follow-Up Studies, Humans, Male, Middle Aged, Sinus of Valsalva, Tachycardia, Ventricular diagnosis, Tachycardia, Ventricular physiopathology, Time Factors, Ventricular Premature Complexes diagnosis, Ventricular Premature Complexes physiopathology, Catheter Ablation methods, Tachycardia, Ventricular surgery
- Abstract
Background: Monomorphic tachycardia with an epicardial site of the arrhythmic focus in the left ventricular outflow tract (LVOT) usually cannot be ablated by an endocardial approach. We describe the use of cooled tip catheter ablation through the aortic sinus of valsalva to treat LVOT tachycardia., Methods: In seven patients (four males, one with valvular cardiomyopathy, six patients without heart disease) with sustained and non-sustained ventricular tachycardia (VT) an epicardial focus of LVOT tachycardia could be identified by pace-mapping and earliest local activation within the aortic sinus of valsalva. Coronary angiography served to define the position of the coronary arteries with respect to the ablation catheter. High frequency current was delivered using a closed-loop cooled tip catheter system (Chilli Cool(R), Boston Scientific). ECG, Holter-ECG, echocardiography and transesophageal echocardiography were performed after the procedure and 3 months later., Results: Foci were located in the left (two patients), in the right (three) and in the a coronary aortic sinus (two). Successful ablation could be achieved in six patients. No procedure-related complications could be observed during a mean follow-up of 4.2 months., Conclusion: Monomorphic VT with epicardial origin in the LVOT can be successfully treated by cooled tip ablation through the aortic sinus of valsalva. The use of a cooled tip ablation system may be favourable in several ways: 1) it allows the creation of deep lesions necessary to reach remote foci; 2) due to lower temperatures at the catheter/tissue interface surface tissue damage may be reduced; 3) lower catheter temperature may additionally reduce the risk of local clot formation which is crucial for all left-sided procedures and especially for ablation in the sinus of valsalva.
- Published
- 2002
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26. [Effect of the imidazoline receptor agonist moxonidine on hemodynamics, coronary circulation, metabolic ischemia markers and the neurohumoral system in patients with essential hypertension. Effects of moxonidine on coronary circulation].
- Author
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Mitrovic V, Hamel M, Miric M, Thormann J, and Hamm C
- Subjects
- Aged, Angina Pectoris blood, Antihypertensive Agents adverse effects, Blood Flow Velocity drug effects, Electrocardiography drug effects, Exercise Test drug effects, Female, Humans, Hypertension blood, Hypertrophy, Left Ventricular blood, Imidazoles adverse effects, Imidazoline Receptors, Lactic Acid blood, Male, Middle Aged, Oxygen blood, Angina Pectoris drug therapy, Antihypertensive Agents therapeutic use, Coronary Circulation drug effects, Energy Metabolism drug effects, Hemodynamics drug effects, Hypertension drug therapy, Hypertrophy, Left Ventricular drug therapy, Imidazoles therapeutic use, Neurotransmitter Agents blood, Receptors, Drug agonists
- Abstract
Moxonidine is a new centrally active imidazoline-receptor agonist being effectively applied in the treatment of arterial hypertension due to its sympathicolytic potency. This is the first investigation regarding the effects of moxonidine on coronary and systemic hemodynamics, metabolic markers of ischemia and neurohumoral parameters in patients with essential hypertension (WHO I-II). We studied moxonidine (single dose of 0.4 mg p.o.) in 22 patients with left ventricular (LV) hypertrophy, ST segment depressions during exercise, pectanginal complaints and negative coronarograms. Assessments included arterial blood pressure, cardiac output, pulmonary artery pressure mean (PAPm), pulmonary capillary wedge pressure (PCWP) and coronary sinus flow (CSF) by intravascular Doppler technique. The moxonidine-induced parameter changes 2 hours later were as follows: a decrease in systolic/diastolic pressure by 28/10 mmHg, and in heart rate by 5 bpm, associated with a decline of PAPm by 17% and of PCWP by 26%. LV work was reduced by 26%, MVO2 by 18% and CSF by 16%. Average peak velocity in CS fell by 18% and coronary flow reserve (with adenosine) increased by 12%. CS-O2 saturation rose by 4%, accompanied by an increase in lactate extraction by 17%, a decrease in norepinephrine spillover by 30% and in arterial endotheline by 20%. In conclusion, moxonidine produces clinically relevant sympathicolysis with beneficial effects on hemodynamics, coronary circulation and neurohumoral parameters.
- Published
- 2001
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27. [17th report of performance statistics of heart catheterization laboratories in Germany. Results of a combined survey by the Committee of Clinical Cardiology and the Interventional Cardiology (for ESC) and Angiology Working Groups of the German Society of Cardiology-Cardiovascular Research for the year 2000].
- Author
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Mannebach H, Hamm C, and Horstkotte D
- Subjects
- Adult, Germany epidemiology, Heart Diseases epidemiology, Humans, Utilization Review statistics & numerical data, Cardiac Catheterization statistics & numerical data
- Published
- 2001
- Full Text
- View/download PDF
28. [Guidelines for equipping and managing heart catheter rooms (1st revision). Issued by the governing body of the German Society of Cardiology-Heart and Cardiovascular Research. Revised by order of the Committee of Clinical Cardiology].
- Author
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Hamm CW, Bösenberg H, Brennecke R, Daschner F, Dziekan G, Erbel R, Ewen K, Geffers C, Hausdorf G, Kelm M, Rüden H, Sauer G, and Strauer B
- Subjects
- Germany, Humans, Cardiac Catheterization, Hospital Units organization & administration, Quality Assurance, Health Care
- Published
- 2001
- Full Text
- View/download PDF
29. [New thrombocyte aggregation inhibitor in therapy of unstable angina].
- Author
-
Hamm C
- Subjects
- Abciximab, Antibodies, Monoclonal adverse effects, Eptifibatide, Humans, Immunoglobulin Fab Fragments adverse effects, Myocardial Infarction prevention & control, Peptides adverse effects, Platelet Aggregation Inhibitors adverse effects, Randomized Controlled Trials as Topic, Tirofiban, Tyrosine adverse effects, Angina, Unstable drug therapy, Antibodies, Monoclonal therapeutic use, Immunoglobulin Fab Fragments therapeutic use, Peptides therapeutic use, Platelet Aggregation Inhibitors therapeutic use, Tyrosine analogs & derivatives, Tyrosine therapeutic use
- Abstract
Unstable angina is a critical phase of coronary heart disease with a risk for myocardial infarction or death of up to 20% within 30 days. Glycoprotein IIb/IIIa antagonists are a new class of potent antiplatelet drugs. In several large randomized trials, it has been well established that the antibody abciximab, and the low molecular synthetic compounds tirofiban and eptifibatide, reduce the cardiac event rate by 10 to 70% in patients with and without percutaneous interventions. This effect was found to be predominately present in patients with elevated troponins. Accordingly, glycoprotein IIb/IIIa antagonists represent a major achievement for the treatment regimen of patients with unstable angina.
- Published
- 2000
- Full Text
- View/download PDF
30. [Double ventricular excitation in dual atrioventricular node conduction physiology: catheter ablation of the slow conduction pathway of the dual atrioventricular node].
- Author
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Neumann T, Schulte B, Pitschner HF, Neuss H, Hamm C, and Neuzner J
- Subjects
- Atrioventricular Node physiopathology, Diagnosis, Differential, Electrocardiography, Ambulatory, Female, Humans, Middle Aged, Tachycardia, Paroxysmal physiopathology, Atrioventricular Node surgery, Catheter Ablation, Electrocardiography, Tachycardia, Paroxysmal surgery
- Abstract
A variety of electrocardiographic manifestations of dual AV nodal physiology have been reported. The specific subtype dual ventricular response is considered as a very rare phenomenon. We present the case of a 53 year old lady who suffered from paroxysmal regular tachycardias for more than seven years. In the last 6 months the symptomatology of the cardiac arrhythmia changed to more persistent und irregular rhythm disturbances. Treatment with class Ia antiarrhythmic drugs and beta-blocking agents failed. The latter even seemed to worsen her very disturbing palpitations. After examination of the ECG recordings, the diagnosis of dual AV nodal physiology with double ventricular response was made--the lady was referred to our institution for electrophysiological testing and radiofrequency catheter ablation of the slow pathway. An invasive electrophysiological study reconfirmed the diagnosis of a dual AV nodal conduction pattern with irregular double ventricular response. The radiofrequency catheter ablation of the the slow pathway achieved a complete cessation of the double ventricular response. This satisfactory outcome was confirmed by analysis of a postinterventional 24 hour holter recording and an exercise stress test. During a follow-up period of three months, the patient remained free of symptoms and there was no recurrence of dual AV nodal conduction physiology in the surface ECG.
- Published
- 2000
- Full Text
- View/download PDF
31. [Interventional therapy of aortic isthmus stenosis with concomitant thoracic aortic aneurysm with a stent graft].
- Author
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John A, Gunn J, Bowes RJ, Gaines PA, and Hamm CW
- Subjects
- Adult, Aortic Aneurysm, Thoracic complications, Aortic Aneurysm, Thoracic diagnosis, Aortic Coarctation complications, Aortic Coarctation diagnosis, Aortography, Catheterization, Follow-Up Studies, Humans, Male, Aortic Aneurysm, Thoracic surgery, Aortic Coarctation surgery, Blood Vessel Prosthesis Implantation, Stents
- Abstract
A 23 year old male presented with hypertension and a systolic murmur. ECG and echo revealed signs of left ventricular hypertrophy. Aortography showed aortic coarctation (delta p max. 40 mmHg) in combination with an aneurysm originating from the coarcted segment distal from the origin of the left subclavian artery. Coarctation and aneurysm were treated using direct placement of a stent graft and subsequent balloon dilatation. On final aortography, the outline of the stented segment was smooth with good stent apposition and the aneurysm entry was closed. The residual gradient was 10 mmHg (max). Six months later, the patient has no symptoms and a blood pressure of 120/80 mmHg on both arms.
- Published
- 2000
- Full Text
- View/download PDF
32. [Intravenous coronary angiography with synchrotron radiation].
- Author
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Dill T, Job H, Dix WR, Ventura R, Kupper W, Hamm CW, and Meinertz T
- Subjects
- Aged, Coronary Artery Bypass, Coronary Disease surgery, Equipment Design, Female, Humans, Male, Middle Aged, Observer Variation, Postoperative Complications diagnostic imaging, Predictive Value of Tests, Coronary Angiography instrumentation, Coronary Disease diagnostic imaging, Synchrotrons
- Abstract
Introduction: Coronary artery disease still remains the primary cause of death in the western industrialized world. Although the clinical value of selective coronary angiography (SCA) is beyond dispute, the associated risk of an invasive approach, the inherent costs and the necessary hospitalization have lead to the development and investigation of novel non-invasive techniques for coronary imaging. Intravenous coronary angiography (ICA) has been shown to permit non-invasive imaging of the coronary arteries., Methods: In 66 pts (80% male, age 62 (+/- 8.5 yrs) after interventional therapy/CABG operation, ICA and a SCA were carried out within a time interval of < 6 weeks. After determination of the individual circulation time, contrast media (370 mg iodine/ml, 15 ml/s, 21 ml) was injected via a sheath in the cubital vein while the patient was sitting in an upright position in a specially designed scanning chair. In two different projections 6-8 images/patient were obtained for further image processing and evaluation. 182 target vessels had to be evaluated (LAD 55, Cfx 21, RCA 54, Grafts 52). In 50 target vessels one or more stents were implanted., Results: 182 target vessels were evaluated according to the following criteria: no stenosis, < 70%, > = 70%, occlusion. Evaluation of the ICA and SCA images was performed by two independent investigators. Due to poor image quality, 17 vessels were not evaluated. The ICA findings were compared to that of SCA. For the LAD a sensitivity of 84% (specificity 93%), for the RCA a sensitivity of 85% (specificity 97%), for the Cfx a sensitivity of 67% (specificity 90%), and for grafts a sensitivity of 85% (specificity 97%) was calculated., Conclusion: ICA proved to be a feasible and safe technique for follow-up after coronary intervention/CABG operation on an outpatient basis. Evaluation of stents and severe calcification is possible. A good image quality provided, LAD RCA and grafts can be evaluated with an acceptable sensitivity and specificity. Due to superimpositioning the low sensitivity for the Cfx has to be compensated by further image processing.
- Published
- 2000
- Full Text
- View/download PDF
33. [Role of Chlamydia pneumoniae in the pathogenesis of coronary disease].
- Author
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Kähler J, Köster R, Bräser JH, Schäfer P, Terres W, Hamm CW, and Meinertz T
- Subjects
- Adolescent, Adult, Animals, Anti-Bacterial Agents therapeutic use, Antibodies, Bacterial analysis, Arteriosclerosis etiology, Child, Child, Preschool, Chlamydia Infections diagnosis, Chlamydia Infections drug therapy, Coronary Artery Disease etiology, Enzyme-Linked Immunosorbent Assay, Female, Fluorescent Antibody Technique, Humans, Immunoglobulin G analysis, Male, Rabbits, Randomized Controlled Trials as Topic, Risk Factors, Chlamydia Infections complications, Chlamydophila pneumoniae immunology, Chlamydophila pneumoniae physiology, Coronary Disease etiology
- Abstract
Several studies have demonstrated an association Chlamydia pneumoniae with coronary artery disease, suggesting that infection with C. pneumoniae increases the risk for coronary artery disease by factor 2 or more. Since atherosclerosis is considered to be a chronic inflammatory process, these data would fit into the response-to-injury hypothesis of atherosclerosis rather than representing a completely novel concept. Several pathomechanisms as increased cytokine synthesis, proliferative and proaggregatory effects could transmit the effects of chronic C. pneumoniae infection. Animal models and first clinical trials using antibiotic therapy seem to support an etiological role of C. pneumoniae in coronary artery disease. In this paper the current knowledge of the role of C. pneumoniae in coronary artery disease is reviewed and possible pathomechanisms are discussed.
- Published
- 1999
- Full Text
- View/download PDF
34. [Reports by the German Society of Cardiology-Heart and Cardiovascular Research. Report by the "Interventional Cardiology" Study Group 1998/99].
- Author
-
Bonzel T and Hamm C
- Subjects
- Germany, Humans, Cardiac Catheterization, Cardiology, Radiology, Interventional
- Published
- 1999
- Full Text
- View/download PDF
35. [Acute results of ablation of coronary in-stent restenoses with eccentric excimer laser catheters].
- Author
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Köster R, Hamm CW, Terres W, Koschyk DH, Reimers J, Kähler J, and Meinertz T
- Subjects
- Adult, Aged, Coronary Angiography, Coronary Artery Disease diagnostic imaging, Equipment Design, Equipment Failure Analysis, Female, Humans, Male, Middle Aged, Recurrence, Reoperation, Treatment Outcome, Angioplasty, Balloon, Coronary instrumentation, Angioplasty, Balloon, Laser-Assisted instrumentation, Coronary Artery Disease surgery, Stents
- Abstract
Unlabelled: Laser catheters which run eccentrically on a guide wire were developed for maximization of luminal gain by excimer laser angioplasty (ELCA). We investigated the safety and efficacy of ELCA with these new catheters plus PTCA in patients with restenoses or occlusions in coronary stents. ELCA was performed in 57 patients (60 +/- 9 years) with stenoses in 75 stents (35 AVE Micro stents, 26 Palmaz-Schatz stents, 7 NIR stents, 7 other stents). In 44 patients eccentric 1.7 mm catheters and in 13 patients 2.0 mm catheters were used. The success of the intervention was analyzed by intravascular ultrasound (IVUS) in a subgroup of 7 patients treated with five 1.7 mm and two 2.0 mm catheters. The laser catheters could be advanced through the in-stent restenoses in 56 patients. A passage inhibition occurred in one patient with an inadequately expanded stent < 2.0 mm in diameter. ELCA reduced the diameter stenoses from 77 +/- 10% before intervention to 44 +/- 8% after treatment with the 1.7 mm catheter (n = 43) or to 34 +/- 9% after passages with the 2.0 mm catheter (P < 0.001). PTCA further reduced the diameter stenosis to 11 +/- 12% (P < 0.001). The IVUS analysis revealed a smooth ablation profile in all patients. In 4 patients creatine kinase elevations > or = 2 times normal value occurred. There was no evidence of a Q-wave infarction. No dissections were observed within the stents. Outside of the stents there were dissections in 5 vessels, which required the implantation of additional stents., Conclusions: ELCA with eccentric laser catheters for treatment of in-stent restenosis is safe and effective. The incidence of complications is acceptable.
- Published
- 1998
- Full Text
- View/download PDF
36. [Comparative studies of PTCA versus bypass operation: rationale for patient-oriented therapy].
- Author
-
Hamm CW
- Subjects
- Coronary Disease mortality, Humans, Randomized Controlled Trials as Topic, Survival Rate, Treatment Outcome, Angioplasty, Balloon, Coronary, Coronary Artery Bypass, Coronary Disease therapy
- Abstract
Treatment of symptomatic multivessel coronary disease with balloon angioplasty (PTCA) or bypass surgery as based on the results of 5 large, randomized trials is equivalent with respect to clinical outcome and risk. After PTCA, however, the rate of reinterventions is considerably higher. During long-term follow-up in the BARI trial, mortality was lower in diabetic patients undergoing surgery. Individual therapeutic decision making by the treating physician proved to be an important factor for the patients' prognosis. The role of new devices (stents) is currently under investigation in new large randomized trials.
- Published
- 1998
- Full Text
- View/download PDF
37. [Endothelins in cardiovascular diseases].
- Author
-
Kähler J, Köster R, Paul M, Hamm CW, and Meinertz T
- Subjects
- Animals, Humans, Receptors, Endothelin physiology, Cardiovascular Diseases physiopathology, Endothelins physiology, Hemodynamics physiology
- Abstract
Endothelins are peptides with powerful vasoconstrictor and mitogenic properties. It has become evident that endothelins are involved in many regulatory mechanisms of the circulation in which they have a modulating role both in short and in long term. However, in many cases it remains unclear whether the alteration of the endothelin metabolism is a primary pathology or a secondary phenomenon. The synthesis of endothelin receptor antagonists and animal models with altered endothelin metabolism have opened a new era of endothelin research that will allow insight into the mechanisms of endothelin-action and eventually might lead to new therapeutic concepts. This review discusses the evidence both in favor and against pathogenic effects of endothelins in cardiovascular disease.
- Published
- 1997
- Full Text
- View/download PDF
38. [Initial clinical and angiographic results with the AVE Micro-Stent].
- Author
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Köster R, Terres W, Hamm C, Kähler J, and Meinertz T
- Subjects
- Adult, Aged, Aged, 80 and over, Coronary Artery Bypass, Coronary Disease diagnostic imaging, Equipment Design, Female, Follow-Up Studies, Graft Occlusion, Vascular diagnostic imaging, Graft Occlusion, Vascular therapy, Humans, Male, Middle Aged, Treatment Outcome, Angioplasty, Balloon, Coronary instrumentation, Coronary Angiography, Coronary Disease therapy, Stents
- Abstract
Unlabelled: The AVE Micro Stent is a flexible stent with a small surface. Aim of this study was to investigate safety and efficacy of this stent. 105 AVE Micro Stents were deployed in 78 lesions in 64 patients. The implantation was performed electively (19%), after unsatisfactory PTCA (59%), and as "bailout" (23%) into left main (1), LAD (23), LCX (15), RCA (19) or CABG (6). Minimal lumen diameter and percent diameter stenosis were measured by quantitative coronary angiography before and after interventions and, in 21 patients, after 3 months. Stent-implantation was successful in 62 of 64 patients. The passage of the AVE Micro Stents through deployed stents (46) was successful in all of 28 cases. There were no deaths or myocardial infarctions. In two patients, subacute thromboses with subsequent increase of CK occurred, which were successfully treated. The minimal lumen diameter was 0.77 +/- 0.62 mm before intervention, 2.98 +/- 0.48 mm after implantation (p < 0.001), and 2.03 +/- 1.21 after 3 months (p < 0.001). The percent diameter stenosis was 75 +/- 20% before intervention, 39 +/- 20% after PTCA and 0 +/- 12% after implantation (p < 0.001). After 3 months, six of 21 patients (29%) with follow-up angiography had a restenosis, defined as > 50% diameter stenosis compared with the reference vessel., Conclusions: 1) The AVE Micro Stent is a flexible stent, which can be safely and efficiently deployed even through implanted stents. 2) The AVE Micro Stent appears to be particularly suitable for "bailout" therapy of dissections. 3) The rate of subacute thrombosis was low with this stent.
- Published
- 1996
39. [Peripheral embolism of hemostasis collagen (VasoSeal)].
- Author
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Stiel GM, Beythien C, Kalkowski H, Hamper K, Rohwer HD, Nienaber CA, and Hamm CW
- Subjects
- Aged, Collagen administration & dosage, Coronary Disease diagnostic imaging, Humans, Male, Angioplasty, Balloon, Coronary instrumentation, Atherectomy, Coronary instrumentation, Collagen adverse effects, Coronary Angiography instrumentation, Coronary Disease therapy, Embolism diagnostic imaging, Hemostasis, Surgical instrumentation, Ischemia diagnostic imaging, Leg blood supply
- Abstract
VasoSeal is a purified bovine, absorbable collagen plug currently successfully used to close the femoral arterial puncture site after cardiac catheterization under full anticoagulation. Up to now there has been no experience with potential complications. We observed acute ischemia in the right lower leg of 2/100 patients 36 resp. 24 h after successful closure of the puncture site with VasoSeal. Angiography confirmed acute occlusion of the distal A. poplitea dextra. A 25-mm resp. 50-mm long cylindrical foreign body embolus was removed with a Fogarty-catheter by retrograde indirect embolectomy. Histopathology confirmed a fresh collagen clot with appositional thrombosis.
- Published
- 1992
40. [Cardiovascular risk factors and restenosis after PTCA].
- Author
-
Terres W, Hamm CW, Ruchelka A, Weilepp A, and Kupper W
- Subjects
- Aged, Aspirin administration & dosage, Combined Modality Therapy, Coronary Disease diagnostic imaging, Coronary Disease etiology, Diabetes Complications, Diabetes Mellitus diagnostic imaging, Female, Follow-Up Studies, Humans, Hypercholesterolemia complications, Hypercholesterolemia diagnostic imaging, Hypertension complications, Hypertension diagnostic imaging, Male, Middle Aged, Myocardial Infarction diagnostic imaging, Myocardial Infarction etiology, Prospective Studies, Risk Factors, Smoking adverse effects, Angioplasty, Balloon, Coronary, Coronary Angiography, Coronary Disease therapy, Myocardial Infarction therapy
- Abstract
We prospectively investigated the influence of the cardiovascular risk factors hypercholesterolemia, smoking, diabetes mellitus, and arterial hypertension on the occurrence and extent of restenosis after successful coronary dilatation (PTCA). Of the 103 patients included in the study, control coronary angiography was obtained in 75 (73%) after 173 +/- 117 days. The restenosis rate (82 stenoses), defined as greater than or equal to 50% loss of initial gain in percent diameter stenosis, was 37%. Older age, male gender, and a history of diabetes mellitus were associated with a significantly increased mean extent of restenosis (p less than 0.05). In patients with hypertension, the initial success of dilatation was less than in controls without hypertension (p less than 0.05), and restenosis tended to be enhanced (p = 0.06). The risk of restenosis was unaffected by smoking and the presence of hypercholesterolemia. In spite of the mostly insignificant influence of single cardiovascular risk factors, the extent of restenosis clearly increased with the number of risk factors.
- Published
- 1992
41. [Improvement of chronic regionally impaired myocardial function immediately after coronary angioplasty].
- Author
-
Schuchert A, Hamm CW, Reimers J, Middendorf N, and Bleifeld W
- Subjects
- Aged, Cardiac Output physiology, Electrocardiography, Exercise Test, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Infarction physiopathology, Myocardial Infarction therapy, Prospective Studies, Ventricular Function, Left physiology, Angina Pectoris physiopathology, Angina Pectoris therapy, Angioplasty, Balloon, Coronary, Coronary Disease physiopathology, Coronary Disease therapy, Myocardial Contraction physiology
- Abstract
Unlabelled: The effect of PTCA on chronically impaired, regional wall motion was studied in 40 patients with stable angina and stenoses in the left anterior descending artery. Left-ventricular angiograms were obtained before, 15 min after PTCA and, additionally, in eight patients 15 +/- 5 weeks after PTCA. Left-ventricular ejection fraction and regional myocardial function were assessed by the centerline method. Patients with no (n = 18) or non-Q-wave (n = 12) infarction were compared to patients with Q-wave infarction (n = 10). After PTCA, ejection fraction increased from 54 +/- 8% to 59 +/- 8% (p less than 0.05) and regional function improved significantly (maximal standard deviation before PTCA: 2.8 +/- 0.8; after PTCA: 1.9 +/- 0.9- segments below the first standard deviation before PTCA: 31 +/- 16; after PTCA: 19 +/- 17). The improvements were found in patients with no or non-Q-wave infarction. The benefit on regional function was unchanged at follow-up., Conclusions: PTCA reduced chronic regional myocardial dysfunction in 78% of the patients with stable angina within 15 min. Reversible myocardial dysfunction is most likely related to hibernating myocardium.
- Published
- 1991
42. [Circulatory and metabolic action of pressure-induced cardiac hypertrophy in rest, during exercise and following medicinal dilatation of the coronary vessels].
- Author
-
Kupper W, Bleifeld W, Hanrath P, Hamm C, and Mathey D
- Subjects
- Aortic Valve Stenosis complications, Cardiomegaly etiology, Humans, Physical Exertion, Rest, Thermodilution, Aortic Valve Stenosis physiopathology, Cardiomegaly physiopathology, Coronary Circulation drug effects, Dipyridamole pharmacology, Lactates blood, Oxygen blood
- Published
- 1977
43. [Avulsion of a calcified leaflet as a complication of aortic valvuloplasty].
- Author
-
Hamm CW, Langes K, Vogel M, Schröder S, and Bleifeld W
- Subjects
- Aged, Aortic Valve Insufficiency surgery, Aortic Valve Stenosis surgery, Bioprosthesis, Calcinosis surgery, Female, Heart Valve Prosthesis, Humans, Aortic Valve injuries, Aortic Valve Insufficiency etiology, Aortic Valve Stenosis therapy, Calcinosis therapy, Catheterization adverse effects
- Abstract
Valvuloplasty was recently introduced as a palliative treatment of calcific aortic stenosis in elderly patients. Embolisation of valvular material has not been described as complication yet. We describe the detachment of a large calcific fragment resulting in acute, severe aortic incompetence in a 76-year-old patient. During immediate operative valve replacement the calcific embolus was recovered from the abdominal aorta.
- Published
- 1988
44. [Left ventricular diastolic function in PTCA: a Doppler echocardiographic study].
- Author
-
Lange HW, Schlüter M, Hamm C, Schofer J, Kupper W, Mathey DG, and Bleifeld W
- Subjects
- Adult, Aged, Cardiac Output, Diastole, Female, Humans, Male, Middle Aged, Systole, Angioplasty, Balloon, Coronary Disease therapy, Echocardiography, Myocardial Contraction
- Abstract
The measurement of left ventricular inflow by Doppler echocardiography provides a continuous, non-invasive assessment of parameters of diastolic function. We studied changes in left ventricular diastolic function during percutaneous transluminal coronary angioplasty (PTCA) of the left anterior descending coronary artery (LAD). In ten patients, the diastolic flow velocity profile across the mitral valve was measured by Doppler echocardiography, before and 60 s after inflation and 60 s after deflation of the balloon. The peak velocity of early diastolic filling (VE) significantly decreased during angioplasty, from 68 +/- 12 to 56 +/- 10 cm/s (p less than 0.001), while the peak velocity of late diastolic filling caused by atrial contraction (VA) showed no change. This resulted in a significant decline in the diastolic velocity ratio (VE/VA) from 1.11 +/- 0.47 to 0.92 +/- 0.35 (p less than 0.01). The total area under the diastolic flow velocity profile representing the total filling volume fell from 14.3 +/- 4.1 to 10.9 +/- 3.6 cm (p less than 0.001). The early diastolic filling fraction decreased from 68 +/- 5% to 64 +/- 7%, in favor of the filling fraction due to atrial contraction, which increased from 32 +/- 5%, to 36 +/- 7% (p less than 0.01). 60 s after deflation of the balloon, the parameters of diastolic filling returned to baseline values. We conclude from our results that diastolic dysfunction caused by angioplasty of the LAD results in a decrease in early diastolic left ventricular filling, which is completely reversible after 60 s.
- Published
- 1987
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