396 results on '"Hess OM"'
Search Results
2. LV hypertrophy and diastolic heart failure
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BETOCCHI, SANDRO, HESS OM, Betocchi, Sandro, and Hess, Om
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- 2000
3. Long term follow up of patients with endomyocardial fibrosis: effects of surgery
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Rolf Jenni, Hess Om, M. I. Turina, U Schneider, and J Turina
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Heart Ventricles ,Endomyocardial fibrosis ,Ventricular Dysfunction, Left ,Mitral valve ,Internal medicine ,medicine ,Humans ,Heart Valve Prosthesis Implantation ,Atrioventricular valve ,Tricuspid valve ,business.industry ,Mitral valve replacement ,Stroke Volume ,Stroke volume ,Middle Aged ,Endomyocardial Fibrosis ,Surgery ,Survival Rate ,medicine.anatomical_structure ,Treatment Outcome ,Ventricle ,Echocardiography ,Papers ,Cardiology ,End-diastolic volume ,Mitral Valve ,Female ,Tricuspid Valve ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Aims—To determine the long term outcome of patients with endomyocardial fibrosis and to compare echocardiographic and haemodynamic data before and after ventricular endocardial resection. Patients—Seventeen patients (11 women and six men; mean age 35.5 years) diagnosed with endomyocardial fibrosis at the University Hospital in Zurich, Switzerland from 1971 to 1995. Twelve patients (70%) had partial obliteration of both ventricles and in five patients (30%) the fibrotic lesions were limited to the left ventricle. Methods—Fourteen of the 17 patients had surgical resection: fibrosis was resected from both ventricles in five patients and from the left ventricle only in nine patients. Ten patients had mitral valve replacement and two had tricuspid valve replacement. Left ventricle endocardial resection was done without reconstruction or replacement of the atrioventricular valve in three patients. Preoperative and postoperatve echocardiographic data were available for 11 patients and haemodynamic data for six patients. Patients were followed up for 0.4-19 years (mean 8.6). Results—Preoperatively four patients were NYHA functional class IV and 10 were class III; postoperatively one patient was class III, seven class II, and six class I. Preoperatively, echocardiography showed obliteration of the left ventricular apex and inflow tract in all patients, which decreased or disappeared after surgery. Left ventricular end diastolic pressure decreased from 25 mm Hg before surgery to 14 mm Hg after successful resection of the fibrosis. Left ventricular end diastolic volume (normal 93 (17) ml/m2) increased from 65 ml/m2 to 97 ml/m2 (p
- Published
- 1998
4. Left ventricular chamber dilatation in hypertrophic cardiomyopathy: related variables and prognosis in patients with medical and surgical therapy
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G. Vassalli, Hess Om, Christian Seiler, M. I. Turina, and Rolf Jenni
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Adult ,Male ,medicine.medical_specialty ,Cardiac Catheterization ,Heart disease ,Adolescent ,medicine.medical_treatment ,Diastole ,Left ventricular hypertrophy ,Disease-Free Survival ,Risk Factors ,Internal medicine ,medicine ,Humans ,Child ,Survival rate ,Cardiac catheterization ,Aged ,Retrospective Studies ,Ultrasonography ,business.industry ,Incidence (epidemiology) ,Incidence ,Hypertrophic cardiomyopathy ,Retrospective cohort study ,Cardiomyopathy, Hypertrophic ,Middle Aged ,medicine.disease ,Survival Rate ,Child, Preschool ,Cardiology ,Female ,Hypertrophy, Left Ventricular ,Cardiology and Cardiovascular Medicine ,business ,Research Article ,Follow-Up Studies - Abstract
BACKGROUND--To determine the incidence and prognosis of left ventricular dilatation and systolic dysfunction in 139 patients with hypertrophic cardiomyopathy during long term follow up. METHODS--Left ventricular chamber dilatation and systolic dysfunction (both together referred to as left ventricular chamber dilatation) were determined echocardiographically. Chamber dilatation was defined as an increase in the left ventricular end diastolic diameter of > 2% per year combined with a decrease in midventricular systolic fractional shortening of > 2% per year of follow up [10.3 (SD 6) years]. The predictive value for left ventricular chamber dilatation of clinical, invasive, and echocardiographic variables and its prognosis were assessed. RESULTS--In 119 of 139 individuals (86%), left ventricular chamber size and systolic function remained stable (group 1), and in 20/139 patients (14%) left ventricular chamber dilatation occurred during follow up (group 2). At baseline examination, symptoms such as dyspnoea and syncope occurred less often in group 1 than in group 2; New York Heart Association classification was lower in group 1 than in group 2 (P = 0.001). Left ventricular mass index relative to sex specific normal values was increased by 18% in group 1 and by 41% in group 2 (P = 0.04). Cumulative survival rates were slightly although not significantly higher in group 1 than in group 2. Event-free survival was significantly higher in group 1 than in group 2 (P < 0.05). CONCLUSIONS--(1) The development of left ventricular chamber dilatation and systolic dysfunction in hypertrophic cardiomyopathy occurs in approximately 1.5% of the patients per year. (2) Factors associated with left ventricular dilatation are dyspnoea, syncope, a higher functional classification, and a higher degree of left ventricular hypertrophy. (3) Patients with chamber dilatation have a worse prognosis than those without, particularly regarding quality of life.
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- 1995
5. Heartfunction in chronic pressure overload caused by aortic stenosis: the role ofcollagen tissue]
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Villari, B, Hess, Om, Piscione, Federico, Vassalli, G, Weber, Kt, and Chiariello, M.
- Published
- 1994
6. Normalisation of IMA-flow after coronary bypass surgery
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Walpoth, B, primary, Schmid, M, additional, Schwab, A, additional, Bosshard, A, additional, Cikirikcioglu, M, additional, Eckstein, FS, additional, Carrel, TP, additional, and Hess, OM, additional
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- 2007
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7. Titanium coating improves neo-endothelialisation of ePTFE grafts
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Cikirikcioglu, M, primary, Sedelnikov, N, additional, Osorio Da Cruz, S, additional, Khabiri, E, additional, Donmez Antal, A, additional, Tille, JC, additional, Karaca, S, additional, Hess, OM, additional, Kalangos, A, additional, and Walpoth, B, additional
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- 2006
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8. Herzinsuffizienz: Definition, Ursachen und Formen
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Hess, OM, primary
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- 2003
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9. Insuffisance cardiaque: définition, étiologies et classifications
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Hess, OM, primary
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- 2003
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10. Formes familiales de cardiomyopathie non ischémique
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Hullin, R, primary, Mohacsi, PJ, additional, and Hess, OM, additional
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- 2003
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11. Familiäre Formen der nicht ischämischen Kardiomyopathie
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Hullin, R, primary, Mohacsi, PJ, additional, and Hess, OM, additional
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- 2003
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12. Intracardiac Ace-inhibition Improves Diastolic Function By Different Mechanisms in Patients With Aortic-stenosis and Dilated Cardiomyopathy
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UCL, Friedrich, SP., Lorell, BH., Hayashida, W., Rousseau, MF., Keighley, CS., Douglas, PS., Benedict, C., Hess, OM., Krayenbuehl, HP., Grossman, W., Pouleur, H., UCL, Friedrich, SP., Lorell, BH., Hayashida, W., Rousseau, MF., Keighley, CS., Douglas, PS., Benedict, C., Hess, OM., Krayenbuehl, HP., Grossman, W., and Pouleur, H.
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- 1993
13. Intracardiac Ace Inhibition Improves Diastolic Distensibility in Patients With Left-ventricular Hypertrophy Due To Aortic-stenosis
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UCL, Friedrich, SP., Lorell, BH., Douglas, PS., Gordon, S., Grossman, W., Benedict, C., Hess, OM., Krayenbuehl, HP., Eberli, F., Rousseau, MF., Pouleur, H., UCL, Friedrich, SP., Lorell, BH., Douglas, PS., Gordon, S., Grossman, W., Benedict, C., Hess, OM., Krayenbuehl, HP., Eberli, F., Rousseau, MF., and Pouleur, H.
- Published
- 1992
14. Correspondence
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Weiss Bm and Hess Om
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medicine.medical_specialty ,Text mining ,Vascular disease ,business.industry ,Internal medicine ,cardiovascular system ,medicine ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business - Published
- 1999
15. Oversizing and restenosis with self-expanding stents in iliofemoral arteries.
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Saguner AM, Traupe T, Räber L, Hess N, Banz Y, Saguner AR, Diehm N, Hess OM, Saguner, Ardan M, Traupe, Tobias, Räber, Lorenz, Hess, Nina, Banz, Yara, Saguner, Arhan R, Diehm, Nicolas, and Hess, Otto M
- Abstract
Purpose: Uncoated self-expanding nitinol stents (NS) are commonly oversized in peripheral arteries. In current practice, 1-mm oversizing is recommended. Yet, oversizing of NS may be associated with increased restenosis. To provide further evidence, NS were implanted in porcine iliofemoral arteries with a stent-to-artery-ratio between 1.0 and 2.3. Besides conventional uncoated NS, a novel self-expanding NS with an antiproliferative titanium-nitride-oxide (TiNOX) coating was tested for safety and efficacy.Methods: Ten uncoated NS and six TiNOX-coated NS (5-6 mm) were implanted randomly in the iliofemoral artery of six mini-pigs. After implantation, quantitative angiography (QA) was performed for calculation of artery and minimal luminal diameter. Follow-up was performed by QA and histomorphometry after 5 months.Results: Stent migration, stent fracture, or thrombus formation were not observed. All stents were patent at follow-up. Based on the location of the stent (iliac/femoral) and the stent-to-artery-ratio, stent segments were divided into "normal-sized" (stent-to-artery-ratio < 1.4, n = 12) and "oversized" (stent-to-artery-ratio ≥ 1.4, n = 9). All stent segments expanded to their near nominal diameter during follow-up. Normal-sized stent segments increased their diameter by 6% and oversized segments by 29%. A significant correlation between oversizing and restenosis by both angiography and histomorphometry was observed. Restenosis rates were similar for uncoated NS and TiNOX-coated NS.Conclusions: TiNOX-coated NS are as safe and effective as uncoated NS in the porcine iliofemoral artery. All stents further expand to near their nominal diameter during follow-up. Oversizing is linearly and positively correlated with neointimal proliferation and restenosis, which may not be reduced by TiNOX-coating. [ABSTRACT FROM AUTHOR]- Published
- 2012
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16. Persistent diastolic dysfunction late after valve replacement in severe aortic regurgitation.
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Villari B, Sossalla S, Ciampi Q, Petruzziello B, Turina J, Schneider J, Turina M, and Hess OM
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- 2009
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17. Randomized comparison of a titanium-nitride-oxide-coated stent with a stainless steel stent for coronary revascularization: the TiNOX trial.
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Windecker S, Simon R, Lins M, Klauss V, Eberli FR, Roffi M, Pedrazzini G, Moccetti T, Wenaweser P, Togni M, Tüller D, Zbinden R, Seiler C, Mehilli J, Kastrati A, Meier B, Hess OM, Windecker, Stephan, Simon, Rüdiger, and Lins, Markus
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- 2005
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18. Deleterious effect of coronary brachytherapy on vasomotor response to exercise.
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Togni M, Windecker S, Wenaweser P, Tueller D, Kaisaier A, Maier W, Meier B, Hess OM, Togni, Mario, Windecker, Stephan, Wenaweser, Peter, Tueller, David, Kaisaier, Abudukadier, Maier, Willibald, Meier, Bernhard, and Hess, Otto M
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- 2004
19. Effect of homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin B6 on clinical outcome after percutaneous coronary intervention: the Swiss Heart study: a randomized controlled trial.
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Schnyder G, Roffi M, Flammer Y, Pin R, Hess OM, Schnyder, Guido, Roffi, Marco, Flammer, Yvonne, Pin, Riccardo, and Hess, Otto Martin
- Abstract
Context: Plasma homocysteine level has been recognized as an important cardiovascular risk factor that predicts adverse cardiac events in patients with established coronary atherosclerosis and influences restenosis rate after percutaneous coronary intervention.Objective: To evaluate the effect of homocysteine-lowering therapy on clinical outcome after percutaneous coronary intervention.Design, Setting, and Participants: Randomized, double-blind placebo-controlled trial involving 553 patients referred to the University Hospital in Bern, Switzerland, from May 1998 to April 1999 and enrolled after successful angioplasty of at least 1 significant coronary stenosis (> or = 50%).Intervention: Participants were randomly assigned to receive a combination of folic acid (1 mg/d), vitamin B12 (cyanocobalamin, 400 micro g/d), and vitamin B6 (pyridoxine hydrochloride, 10 mg/d) (n = 272) or placebo (n = 281) for 6 months.Main Outcome Measure: Composite end point of major adverse events defined as death, nonfatal myocardial infarction, and need for repeat revascularization, evaluated at 6 months and 1 year.Results: After a mean (SD) follow-up of 11 (3) months, the composite end point was significantly lower at 1 year in patients treated with homocysteine-lowering therapy (15.4% vs 22.8%; relative risk [RR], 0.68; 95% confidence interval [CI], 0.48-0.96; P =.03), primarily due to a reduced rate of target lesion revascularization (9.9% vs 16.0%; RR, 0.62; 95% CI, 0.40-0.97; P =.03). A nonsignificant trend was seen toward fewer deaths (1.5% vs 2.8%; RR, 0.54; 95% CI, 0.16-1.70; P =.27) and nonfatal myocardial infarctions (2.6% vs 4.3%; RR, 0.60; 95% CI, 0.24-1.51; P =.27) with homocysteine-lowering therapy. These findings remained unchanged after adjustment for potential confounders.Conclusion: Homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin B6 significantly decreases the incidence of major adverse events after percutaneous coronary intervention. [ABSTRACT FROM AUTHOR]- Published
- 2002
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20. High level of cholesterol increases coronary vasomotor tone during exercise.
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Kaufmann P, Matter C, Mandinov L, Frielingsdorf J, Seiler C, Hess OM, Kaufmann, P, Matter, C, Mandinov, L, Frielingsdorf, J, Seiler, C, and Hess, O M
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- 2000
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21. Massive rezidivierende Lungenembolien beim Hund ohne pulmonale Hypertonie
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W. H. Weihe, J. Schneider, Hess Om, H. P. Krayenbühl, and I. Seidl
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Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,General Medicine ,medicine.disease ,business ,Microsphere ,Pulmonary embolism - Abstract
Mit dem Ziel, eine pulmonale Hypertonie zu erzeugen, wurden 10 Hunden Kopolymer-Kugelchen (Durchmesser 35–300 µm) i.v. injiziert. Obwohl uber Monate hinweg bis zu 15g Granulate embolisiert wurden, stieg bei keinem Tier der Druck im kleinen Kreislauf dauerhaft an. Die histologische Untersuchung der Lunge ergab, das die Kugelchen nach kurzer Zeit vorwiegend extravasal liegen. Eine nektrotisierende Entzundung zerstort die Arterienwand und erlaubt den Kugelchen, das Gefas zu verlassen. Das entzundliche Granulationsgewebe verhindert eine wesentliche Blutung. Die Entzundung klingt nach einigen Monaten ab und hinterlast ein freies und intaktes Gefas.
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- 1980
22. Aneurysma der Arteria pulmonalis bei Fallotscher Tetralogie
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Hess Om and Goebel N
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medicine.medical_specialty ,Aneurysm ,business.industry ,medicine.artery ,Internal medicine ,Pulmonary artery ,Cardiology ,medicine ,Radiology, Nuclear Medicine and imaging ,Congenital malformations ,Tetralogy ,business ,medicine.disease - Published
- 1982
23. Akute bakterielle Endokarditis mit Streptokokken der Lancefield-Gruppe C
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Turina M, Hess Om, Kugelmeier J, Baumann Pc, Rüegg P, and Biedermann Hp
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medicine.medical_specialty ,Septic shock ,business.industry ,General Medicine ,Regurgitation (circulation) ,Dehiscence ,medicine.disease ,law.invention ,Stenosis ,law ,Artificial heart ,Internal medicine ,Circulatory system ,cardiovascular system ,medicine ,Cardiology ,Myocardial infarction ,Aortic rupture ,business - Abstract
An Angell-Shiley heterograft valve was implanted in a 32-year-old woman with severe aortic regurgitation and stenosis. Post-operatively acute bacterial endocarditis occurred, due to group C streptococci. Because of severe acute aortic insufficiency with partial dehiscence of the heterograft valve and increasing left heart failure re-operation was necessary. After successful replacement of the valve an aortocoronary bypass was connected to the left circumflex artery because of displacement of the left coronary ostium. In addition, an aortoplasty was performed for spontaneous aortic rupture. Because of severe left heart failure with myocardial infarction in the course of the operation circulatory support with a paracorporeal artificial heart was necessary for 60 hours postoperatively. Despite transitory improvement the patient died from septic shock 30 days after the re-operation.
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- 1979
24. Zur Diagnostik der Kardiomyopathien
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Krayenbühl Hp, Turina J, and Hess Om
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General Medicine - Published
- 1977
25. Diastolic properties of the normal left ventricle during supine exercise
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Hess Om, Hans P. Krayenbuehl, Manfred Ritter, and H Nonogi
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Adult ,Male ,medicine.medical_specialty ,Heart Ventricles ,Physical Exertion ,Blood Pressure ,Supination ,Diastole ,Internal medicine ,Medicine ,Humans ,Ventricular Function ,End-systolic volume ,business.industry ,Heart ,Stroke volume ,Middle Aged ,Myocardial Contraction ,Pulse pressure ,Delta-v (physics) ,Preload ,Blood pressure ,Cardiology ,Ventricular pressure ,Exercise Test ,End-diastolic volume ,Cineangiography ,Female ,Cardiology and Cardiovascular Medicine ,business ,Research Article - Abstract
Diastolic function in response to dynamic exercise was studied by biplane left ventriculography and by measuring left ventricular pressure with a high fidelity micromanometer tipped catheter at rest and during supine bicycle exercise in nine normal subjects. During exercise there was a fall in end systolic volume, in the time constant of left ventricular isovolumic pressure decay, and in the lowest diastolic pressure. Stroke volume, peak filling rate, mean passive filling rate, and the volume at the lowest diastolic pressure increased. There was an increase in the number of time constants that had elapsed before the lowest diastolic pressure was reached and the slope of the pressure-volume curves during passive filling (delta P/delta V) increased without changes in end diastolic pressure and volume. These results show that during exercise elastic recoil is enhanced and left ventricular relaxation is faster and more complete. Both phenomena reduce the lowest diastolic filling pressure. The observed increase in chamber stiffness from rest to exercise is probably related to increased resistance of the left ventricular wall caused by higher passive filling rates. The enhanced early diastolic pressure decay during exercise allows stroke volume to increase despite an increase in diastolic viscoelastic resistance and chamber stiffness.
- Published
- 1988
26. Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice: data from a large two-institutional cohort study.
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Daemen J, Wenaweser P, Tsuchida K, Abrecht L, Vaina S, Morger C, Kukreja N, Jüni P, Sianos G, Hellige G, van Domburg RT, Hess OM, Boersma E, Meier B, Windecker S, and Serruys PW
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- 2007
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27. Sirolimus-eluting and paclitaxel-eluting stents for coronary revascularization.
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Windecker S, Remondino A, Eberli FR, Jüni P, Räber L, Wenaweser P, Togni M, Billinger M, Tüller D, Seiler C, Roffi M, Corti R, Sütsch G, Maier W, Lüscher T, Hess OM, Egger M, and Meier B
- Published
- 2005
28. Effect of homocysteine-lowering therapy on restenosis after percutaneous coronary intervention for narrowings in small coronary arteries.
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Schnyder G, Roffi M, Flammer Y, Pin R, Eberli FR, Meier B, Turi ZG, Hess OM, Schnyder, Guido, Roffi, Marco, Flammer, Yvonne, Pin, Riccardo, Eberli, Franz R, Meier, Bernhard, Turi, Zoltan G, and Hess, Otto M
- Published
- 2003
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29. Plasma homocysteine levels and late outcome after coronary angioplasty.
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Schnyder G, Flammer Y, Roffi M, Pin R, Hess OM, Faxon D, Schnyder, Guido, Flammer, Yvonne, Roffi, Marco, Pin, Riccardo, and Hess, Otto Martin
- Abstract
Objectives: The aim of this study was to evaluate a possible relationship between homocysteine levels on admission and late outcome after successful percutaneous coronary intervention (PCI).Background: Increasing evidence suggests that mild to moderate elevation of total plasma homocysteine is a graded and potentially modifiable risk factor for cardiovascular disease and death that appears to be largely independent of other traditional risk factors.Methods: A total of 549 patients were included after successful PCI of at least one coronary stenosis (> or =50%). End points were cardiac death, nonfatal myocardial infarction (MI), target lesion revascularization (TLR), and a composite of major adverse cardiac events (MACE). The relationship between homocysteine levels and study endpoints was assessed.Results: After a median (+/- SD) follow-up of 58 +/- 20 weeks, 6 patients died of cardiac death, 14 were diagnosed with a new MI, and 71 underwent repeat TLR. A graded relationship between homocysteine levels (quartiles) and freedom from MACE was found (p = 0.01). Homocysteine levels (+/- SD) were associated with cardiac death (14.9 +/- 1.7 micromol/l vs. 9.6 +/- 4.3 micromol/l, p < 0.005), TLR (10.7 +/- 4.4 micromol/l vs. 9.5 +/- 4.3 micromol/l, p < 0.05), and overall MACE (11.0 +/- 4.4 micromol/l vs. 9.4 +/- 4.3 micromol/l, p < 0.005). These findings remained unchanged after adjustment for potential confounders.Conclusions: Plasma homocysteine is an independent predictor of mortality, nonfatal MI, TLR, and overall adverse late outcome after successful coronary angioplasty. [ABSTRACT FROM AUTHOR]- Published
- 2002
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30. Decreased rate of coronary restenosis after lowering of plasma homocysteine levels.
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Schnyder G, Roffi M, Pin R, Flammer Y, Lange H, Eberli FR, Meier B, Turi ZG, and Hess OM
- Published
- 2001
31. Assessment of right ventricular motion with magnetic resonance tissue tagging and slice following
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Nagel, E, Stuber, M, Fischer, SE, Boesiger, P, Simon, R, and Hess, OM
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- 1995
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32. Regional left ventricular mechanics in hypertrophic cardiomyopathy
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Om. Hess, H Nonogi, Maria Angela Losi, H P Krayenbuehl, Sandro Betocchi, Betocchi, Sandro, Hess, Om, Losi, MARIA ANGELA, Nonogi, H, and Krayenbuehl, Hp
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Adult ,Male ,Cardiac Catheterization ,medicine.medical_specialty ,Asynergy ,Heart disease ,Diastole ,Hemodynamics ,Ventricular Function, Left ,Ventricular Outflow Obstruction ,Muscle hypertrophy ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Angiocardiography ,medicine.diagnostic_test ,business.industry ,Hypertrophic cardiomyopathy ,Cardiomyopathy, Hypertrophic ,Middle Aged ,medicine.disease ,Radiography ,medicine.anatomical_structure ,Ventricle ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
BACKGROUND Nonuniformity is a determinant of diastolic function. In patients with hypertrophic cardiomyopathy, hypertrophy, abnormal calcium handling, and regional ischemia can also play a role. This study was designed to assess regional mechanics, asynchrony, and asynergy in patients with hypertrophic cardiomyopathy. METHODS AND RESULTS Nine control subjects and 22 patients with hypertrophic cardiomyopathy were studied by biplane left ventriculography and high-fidelity pressure tracings for the assessment of diastolic function by computing the time constant of isovolumic relaxation, peak filling rate, and the constant of passive chamber stiffness. Regional mechanics were evaluated by dividing the left ventricle into six sectors in the right and left anterior oblique projections. Systolic and diastolic asynchrony were assessed from the coefficient of variation of the regional time intervals from end diastole to end systole and to peak filling rate, respectively. Asynergy was evaluated from the coefficient of variation of the regional area reduction. Regional passive elastic properties were estimated by computing the regional constant of chamber stiffness. In patients with hypertrophic cardiomyopathy, isovolumic relaxation was prolonged (time constant of isovolumic relaxation 101 +/- 41 versus 51 +/- 16 milliseconds in control subjects; P < .001) and the constant of chamber stiffness was increased (0.056 +/- 0.038 versus 0.025 +/- 0.010 mL-1; P < .001). Both systolic and diastolic asynchrony as well as asynergy were found. Regional mechanics showed hyperkinesia in the free wall, whereas the septum exhibited normal wall motion and increased constant of chamber stiffness. CONCLUSIONS Diastolic function is impaired in hypertrophic cardiomyopathy, and such an impairment is the consequence of nonuniformity and hypertrophy. The regions where the myopathic process is more pronounced show normal wall motion but increased stiffness. The inhomogeneity of regional wall motion with regional hyperkinesia and normokinesia of neighboring regions results in left ventricular asynergy.
- Published
- 1993
33. Use of the World Health Organization primary eye care protocol to investigate the ocular health status of school children in Rwanda.
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Mathenge WC, Bello NR, Hess OM, Dangou JM, Nkurikiye J, and Levin AV
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- Humans, Child, Cross-Sectional Studies, Rwanda, Visual Acuity, Prevalence, Refractive Errors diagnosis, Conjunctivitis, Allergic, Vision Screening methods
- Abstract
Purpose: To assess the ocular health status of primary and secondary schoolchildren in Rwanda and to explore the use of the World Health Organization (WHO) primary eye care screening protocol., Methods: This was a cross-sectional population-based study across 19 schools in Rwanda. Initial screening was carried out using the WHO screening protocol, whereby visual acuity was measured using a tumbling E Snellen chart (6/60 and 6/12). Abnormal ocular features were identified using a flashlight and history against a checklist. All children with abnormal screening were referred to an on-site ophthalmic clinic for full examination. Those who could not be treated on-site were referred to an ophthalmologist at a hospital for specialist care., Results: A total of 24,892 children underwent ocular health screening. Of those, 1,865 (7.5%) failed the primary screening; 658 (2.6%) were false positives (35.3% of those who failed screening), and 1,207 (4.8%) true positives. The most frequently observed ocular diagnoses were allergic conjunctivitis (3.11%) and strabismus (0.26%). Refractive error was very rare (0.18%)., Conclusions: The WHO primary eye care curriculum provides existing health personnel with an approach to school-based vision screening that uses a standardized checklist and low-cost resources. In our study cohort, results indicated a low frequency of refractive error; the overwhelming majority of ocular problems could be identified on visual inspection., (Copyright © 2023. Published by Elsevier Inc.)
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- 2023
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34. Subjective and objective measures of the patient experience before, during, and after intravitreal anti-vascular endothelial growth factor injections.
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Mekala S, Dhoble P, Vishwaraj CR, Khodifad AM, Hess OM, and Lavanya GS
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- Aged, Bevacizumab, Humans, Intravitreal Injections, Middle Aged, Patient Outcome Assessment, Ranibizumab, Angiogenesis Inhibitors adverse effects, Vascular Endothelial Growth Factor A
- Abstract
Purpose: To assess patient experience of intravitreal injections using vital-signs, visual-experience, pain-rating and emotional response during intravitreal anti-VEGF injections., Methods: A prospective observational study of patient experience of intravitreal anti-VEGF injections done following metrics were collected pre-injection, during injection, and post-injection: pain assessment using visual analog score, fear-response rating, visual-experience questionnaire, and vital-signs., Results: A total of one-hundred-and-seventy-four patients undergoing intravitreal anti-VEGF injections for retinal pathologies were included in the study. Mean age was 58.8 ± 10.4 years in <5 injection group (n = 133) and 59.02 ± 9.0 years in ≥5 injection group (n = 41) (P = 0.90).During injection, 90.2% of patients in <5 injection group reported moderate or severe pain compared to 78% of patients in ≥5 injection group. In pre and post-injection phases, mild-to-moderate pain was reported in both groups (P = <0.001). Ninety-two (52.9%) patients reported having a mild frightening experience. There was no statistical significance in patients assessment of fear with respect to age, sex, or number of injections. The Systolic Blood Pressure (SBP) during and following injection ((SBP 171.7 ± 21.1,150.8 ± 16.2) procedures was significantly higher in cases with <5 injections when comparing to cases with >5 injections (SBP 159.7 ± 26.4, 143.2 ± 17.0) (P = 0.003), (P = 0.011). DBP, heart rate, pulse rate measurements were similar among patients in all phases of the study., Conclusion: We report a large sample size with comprehensive assessments of the patient experience. Higher pain ratings in the <5 injection group, the increase in the SBP in the pre-and during injection phases, and the overall rating of mild-to-moderate fear during the procedure., Competing Interests: None
- Published
- 2021
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35. Preoperative and perioperative music to reduce anxiety during first-time phacoemulsification cataract surgery in the high-volume setting: randomized controlled trial.
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Muddana SK, Hess OM, Sundar S, and Venkatesh R
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- Aged, Anxiety prevention & control, Humans, India, Middle Aged, Prospective Studies, Cataract, Music, Phacoemulsification
- Abstract
Purpose: To determine whether preoperative and perioperative music exposure reduced patient self-rated anxiety and physiologic indicators of stress during first-time phacoemulsification cataract surgery in the high-volume setting., Setting: Aravind Eye Care System, Pondicherry, India., Design: Prospective single-masked randomized controlled trial., Methods: Patients were provided music before and during first-time phacoemulsification in 1 group and patients underwent surgery without music in another group. Measurements of blood pressure (BP), heart rate, respiration rate, and a Likert scale anxiety rating were collected at preoperative, perioperative, and postoperative timepoints., Results: One hundred sixty-five patients (aged 53-65 years) were provided music using a portable MP3 player before and during first-time phacoemulsification, and 165 patients underwent surgery without music. Systolic and diastolic BPs were statistically significantly lower in the music intervention group at the postoperative timepoint, with similar physiologic measures between groups during the perioperative timepoints. In the preoperative period, before music exposure, 62 patients (38%) in the music group reported being very or extremely anxious. After 10 minutes of music exposure, only 7 patients (4%) reported this anxiety level. In the perioperative period, 80 patients (48%) in the intervention group reported feeling not at all or a little anxious, compared with 50 patients (30%) of the control group. In the postoperative period, 139 (84%) music group patients felt not at all or a little anxious postoperatively compared with 92 patients (56%) in the control group., Conclusions: Marked reductions in self-reported anxiety preoperatively, intraoperatively, and postoperatively when exposed to music and a statistically significant decrease in postoperative BP showed that music can be an inexpensive and effective solution to improve the patient experience of cataract surgery in the high-volume setting., (Copyright © 2021 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)
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- 2021
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36. Knowledge, attitude and practise toward COVID-19 among patients presenting to five tertiary eye care hospitals in South India - A multicentre questionnaire-based survey.
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Christy JS, Kaur K, Gurnani B, Hess OM, Narendran K, Venugopal A, Anuja J, Manohar D, Raman R, and Venkatesh R
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- Adolescent, Adult, Attitude to Health, COVID-19, Coronavirus Infections transmission, Cross-Sectional Studies, Disease Transmission, Infectious prevention & control, Female, Health Surveys, Humans, India epidemiology, Male, Middle Aged, Pandemics, Pneumonia, Viral transmission, SARS-CoV-2, Surveys and Questionnaires, Young Adult, Betacoronavirus, Coronavirus Infections epidemiology, Health Knowledge, Attitudes, Practice, Pneumonia, Viral epidemiology, Tertiary Care Centers statistics & numerical data
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Purpose: The aim of this study was to assess the knowledge, attitude, and practice (KAP) pattern towards COVID-19, among patients presenting to eye care hospitals during the last phase of lockdown period., Methods: A multicenter cross-sectional survey was conducted from May 15 to June 15, 2020 in five tertiary eye care hospitals in South India to assess the KAP towards COVID-19. Each of the hospitals belonged to one of the three different zones assigned in India based on number of infections. Red zones represent hotspots and orange/green zones represent regions with medium and lower caseloads, respectively. A validated questionnaire was administered through telephone and responses were recorded on a Google form., Results: Out of the total (n = 6119) participants, 3081 were from hospitals in green zone, 2110 from the orange zone, and 928 from red zone. Majority of participants were above 50 years of age (42%) and 15.54% were illiterate. The mean (percentage) scores of knowledge, attitude, and practice were 21.26 (82%), 9.37 (92%), and 10.32 (86%), respectively. KAP among patients more than 50 years of age and in illiterate individuals was significantly less (P < 0.01) when compared with all other groups. Participants from red zone had a significantly better attitude (P < 0.01) compared to other centers., Conclusion: Although the overall KAP regarding COVID-19 disease was robust (above 80% in all categories) in our participants, the high risk elderly population (>50 years) and illiterate individuals had a significantly lower KAP. These are populations in which education should be emphasized and appropriately delivered as a way to reduce COVID-19 risk., Competing Interests: None
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- 2020
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37. Effect of pressure-controlled intermittent coronary sinus occlusion (PICSO) on myocardial ischaemia and reperfusion in a closed-chest porcine model.
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Khattab AA, Stieger S, Kamat PJ, Vandenberghe S, Bongoni A, Stone GW, Seiler C, Meier B, Hess OM, and Rieben R
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- Animals, Cardiac Catheters, Disease Models, Animal, Equipment Design, Immunoglobulin G metabolism, Immunoglobulin M metabolism, Ischemic Preconditioning, Myocardial instrumentation, Microcirculation, Myocardial Infarction immunology, Myocardial Infarction pathology, Myocardial Infarction physiopathology, Myocardial Reperfusion Injury immunology, Myocardial Reperfusion Injury pathology, Myocardial Reperfusion Injury physiopathology, Myocardium immunology, Myocardium pathology, Necrosis, Swine, Time Factors, Ventricular Pressure, Arterial Pressure, Cardiac Catheterization instrumentation, Coronary Circulation, Coronary Sinus physiopathology, Ischemic Preconditioning, Myocardial methods, Myocardial Infarction prevention & control, Myocardial Reperfusion Injury prevention & control
- Abstract
Aims: To investigate a pressure-controlled intermittent coronary sinus occlusion (PICSO) system in an ischaemia/reperfusion model., Methods and Results: We randomly assigned 18 pigs subjected to 60 minutes ischaemia by left anterior descending (LAD) coronary artery balloon occlusion to PICSO (n=12, groups A and B) or to controls (n=6, group C). PICSO started 10 minutes before (group A), or 10 minutes after (group B) reperfusion and was maintained for 180 minutes. A continuous drop of distal LAD pressure was observed in group C. At 180 minutes of reperfusion, LAD diastolic pressure was significantly lower in group C compared to groups A and B (p=0.02). LAD mean pressure was significantly less than the systemic arterial mean pressure in group C (p=0.02), and the diastolic flow slope was flat, compared to groups A and B (p=0.03). IgG and IgM antibody deposition was significantly higher in ischaemic compared to non-ischaemic tissue in group C (p<0.05). Significantly more haemorrhagic lesions were seen in the ischaemic myocardium of group C, compared to groups A and B (p=0.002). The necrotic area differed non-significantly among groups., Conclusions: PICSO was safe and effective in improving coronary perfusion pressure and reducing antibody deposition consistent with reduced microvascular obstruction and ischaemia/reperfusion injury.
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- 2013
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38. Cardiac shock wave therapy for chronic refractory angina pectoris. A prospective placebo-controlled randomized trial.
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Schmid JP, Capoferri M, Wahl A, Eshtehardi P, and Hess OM
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- Aged, Angina Pectoris psychology, Chronic Disease, Exercise Test, Female, Humans, Male, Middle Aged, Prospective Studies, Quality of Life, Angina Pectoris therapy, High-Energy Shock Waves therapeutic use
- Abstract
Background: Cardiac shock wave therapy (CSWT) delivered to the myocardium increases capillary density and regional myocardial blood flow in animal experiments. In addition, nonenzymatic nitric oxide production and the upregulation of vascular growth factor's mRNA by CSWT have been described. The aim of the study was therefore to test its potential to relieve symptoms in patients with chronic stable angina pectoris., Methods: Twenty-one patients (mean age 68.2 ± 8.3 years, 19 males) with chronic refractory angina pectoris and evidence of inducible myocardial ischemia during MIBI-SPECT imaging, were randomized into a treatment (n = 11) and a placebo arm (n = 10). The region of exercise-induced ischemia was treated with echocardiographic guidance during nine sessions over a period of 3 months. One session of CSWT consisted of 200 shots/spot (9--12 spots/session) with an energy intensity of 0.09 mJ/mm(2) . In the control group acoustic simulation was performed without energy application. Medication was kept unchanged during the whole treatment period., Results: In the treatment group, symptoms improved in 9/11 patients, and the ischemic threshold, determined by cardiopulmonary exercise stress testing, increased from 80 ± 28 to 95 ± 28 W (P= 0.036). In the placebo arm, only 2/10 patients reported an improvement and the ischemic threshold remained unchanged (98 ± 23 to 107 ± 23 W; P= 0.141). The items "physical functioning" (P= 0.043), "general health perception" (P= 0.046), and "vitality" (P= 0.035) of the SF-36 questionnaire significantly improved in the treatment arm, whereas in the placebo arm, no significant change was noted. Neither arrhythmias, troponin rise nor complications were observed during treatment., Conclusions: This placebo controlled trial shows a significant improvement in symptoms, quality of life parameters and ischemic threshold during exercise in patients with chronic refractory angina pectoris treated with CSWT. Thus, CSWT represents a new option for the treatment of patients with refractory AP., (© 2012 Blackwell Publishing Ltd.)
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- 2013
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39. Additive effect of homocysteine- and cholesterol-lowering therapy on endothelium-dependent vasodilation in patients with cardiovascular disease.
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Wustmann K, Klaey M, Burow A, Shaw SG, Hess OM, and Allemann Y
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- Aged, Anticholesteremic Agents adverse effects, Brachial Artery physiology, Double-Blind Method, Endothelium drug effects, Endpoint Determination, Female, Fluorobenzenes therapeutic use, Homocysteine blood, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors adverse effects, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Lipids blood, Male, Middle Aged, Patient Compliance, Pyrimidines therapeutic use, Rosuvastatin Calcium, Sulfonamides therapeutic use, Vasodilation drug effects, Vitamin B Complex adverse effects, Vitamin B Complex blood, Vitamin B Complex therapeutic use, Vitamins blood, Vitamins therapeutic use, Anticholesteremic Agents therapeutic use, Cardiovascular Diseases physiopathology, Endothelium physiology, Homocysteine antagonists & inhibitors, Vasodilation physiology
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Aim: Endothelial dysfunction is a marker for development and progression of atherosclerosis. Statin therapy improves endothelial function in cardiovascular patients by reducing LDL-cholesterol and by pleiotropic effects. B-group vitamin supplementation restores endothelial function mainly by reducing homocysteine-induced oxidative stress. Thus, we evaluated the effect of rosuvastatin, B-group vitamins and their combination on endothelial function in high-risk cardiovascular patients., Methods: Thirty-six patients with cardiovascular disease were randomly, double-blinded assigned to either rosuvastatin 10 mg (group R, n = 18) or vitamin supplementation consisting of folic acid 1 mg, vitamin B12 0.4 mg, and B6 10 mg (group V, n = 18) for 6 weeks. After 6 weeks all patients received rosuvastatin and vitamin supplementation in combination for additional 6 weeks. Endothelial function was assessed by flow-mediated vasodilation (FMD) at baseline and after 6- and 12-week treatment., Results: At baseline, FMD, plasma lipids, vitamins, and homocysteine were comparable between both groups. After 6 weeks, FMD improved in both groups (from 4.4 ± 1.6 to 6.9 ± 1.4% group R, P= 0.0004 and from 4.9 ± 1.8 to 6.4 ± 1.8% group V, P= 0.0002). This improvement in FMD was mainly associated with a decrease of plasma lipids in group R and a decrease of homocysteine in group V. After 12 weeks, the combined therapy with rosuvastatin and vitamins further improved FMD to the normal range in 26/33 patients compared to 5/36 at baseline (P < 0.0001)., Conclusions: In conclusion, both treatments, rosuvastatin and B-group vitamin supplementation, improved endothelial function in high-risk cardiovascular patients. The combination of both therapies had an additive effect on endothelial function suggesting different mechanisms of action., (© 2011 Blackwell Publishing Ltd.)
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- 2012
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40. A prospective randomised comparison of titanium-nitride-oxide-coated bioactive stents with everolimus-eluting stents in acute coronary syndrome: the BASE-ACS trial.
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Karjalainen PP, Niemelä M, Airaksinen JK, Rivero-Crespo F, Romppanen H, Sia J, Lalmand J, de Bruyne B, Debelder A, Carlier M, Nammas W, Ylitalo A, and Hess OM
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- Adult, Aged, Everolimus, Female, Humans, Male, Middle Aged, Platelet Aggregation Inhibitors therapeutic use, Prospective Studies, Sirolimus administration & dosage, Acute Coronary Syndrome therapy, Angioplasty, Balloon, Coronary adverse effects, Drug-Eluting Stents adverse effects, Sirolimus analogs & derivatives, Stents adverse effects, Titanium administration & dosage
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Aims: Titanium-nitride-oxide-coated bioactive stents (BAS) have demonstrated a favourable outcome when compared with paclitaxel-eluting stents in patients with acute myocardial infarction (MI). In a prospective randomised non-inferiority study design, we compared the safety and efficacy of BAS versus everolimus-eluting stents (EES) in patients with acute coronary syndrome (ACS)., Methods and Results: We randomised 827 patients with ACS (1:1) to either BAS (417) or EES (410). The primary endpoint was a composite of cardiac death, non-fatal MI or ischaemia-driven target lesion revascularisation (TLR) at 12-month follow-up. Analyses were performed by intention to treat. At 12-month follow-up, the primary composite endpoint occurred in 9.6% of patients in the BAS group and 9.0% of those in the EES group (HR [hazard ratio] 1.04, 95% CI [confidence interval] 0.81-1.32, p=0.81, p for non-inferiority =0.001). Non-fatal MI was significantly less frequent in the BAS as compared with the EES group (2.2% vs. 5.9%, p=0.007). However, the individual rates of cardiac death and ischaemia-driven TLR were similar between the two groups (1.9% vs. 1.0%, p=0.39, and 6.5% vs. 4.9%, p=0.37, respectively)., Conclusions: In patients presenting with ACS, BAS achieved a clinical outcome that was non-inferior to EES at 12-month follow-up.
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- 2012
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41. Evaluation of multimeric tyrosine-O-sulfate as a cytoprotectant in an in vivo model of acute myocardial infarction in pigs.
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Banz Y, Hess OM, Meier P, Korchagina EY, Gordeeva EA, Robson SC, Gajanayake T, Csizmadia E, Mettler D, Haeberli A, Bovin NV, and Rieben R
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- Animals, Complement Pathway, Classical drug effects, Cytoprotection drug effects, Dose-Response Relationship, Drug, Granulocytes pathology, Hemodynamics drug effects, Myocardial Infarction immunology, Myocardial Reperfusion, Myocardial Reperfusion Injury immunology, Myocardial Reperfusion Injury pathology, Neutrophils pathology, Sus scrofa, Thromboplastin metabolism, Tyrosine pharmacology, Ventricular Fibrillation chemically induced, Anticoagulants pharmacology, Complement Inactivating Agents pharmacology, Myocardial Infarction complications, Myocardial Reperfusion Injury prevention & control, Tyrosine analogs & derivatives
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Objectives: Intracoronary administration of glycosaminoglycan analogs, including the complement inhibitor dextran sulfate, attenuates myocardial ischemia/reperfusion injury (I/R injury). However, dextran sulfate has a distinct anticoagulatory effect, possibly limiting its use in specific situations in vivo. We therefore developed multimeric tyrosine sulfate (sTyr-PAA), a novel, minimally anticoagulatory, fully synthetic non-carbohydrate-containing polyacrylamide conjugate, for in vivo testing in an acute closed-chest porcine model of acute myocardial infarction., Methods: Following balloon occlusion of the left anterior descending artery just after the first diagonal branch (60-minute ischemia), sTyr-PAA (approx. 10 mg/kg bodyweight, fraction with strongest complement-inhibitory and minimal anticoagulatory properties, n = 11) or phosphate-buffered saline (controls, n = 9) was administered intracoronarily into ischemic myocardium prior to 120 min of reperfusion., Results: sTyr-PAA significantly reduced infarct size (from 61.0 ± 12.0% of the ischemic area at risk to 39.4 ± 17.0%), plasma creatine kinase, local complement deposition and tissue factor upregulation, without affecting systemic coagulation. Protection was associated with significantly reduced myocardial neutrophil extravasation and translated into a significant improvement of ejection fraction and left ventricular enddiastolic pressure., Conclusions: sTyr-PAA protected significantly against myocardial I/R injury without substantially affecting systemic coagulation. Local intravascular sTyr-PAA administration may prove advantageous in situations where bleeding complications are likely or are to be avoided at all costs., (Copyright © 2012 S. Karger AG, Basel.)
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- 2012
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42. Clinical long-term outcome after implantation of titanium nitride-oxide coated stents compared with paclitaxel- or sirolimus-eluting stents: propensity-score matched analysis.
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Limacher A, Räber L, Laube E, Lauterburg A, Lötscher S, Hess N, Moschovitis A, Baldinger SH, Wenaweser P, Meier B, Hess OM, and Jüni P
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- Aged, Contraindications, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Longitudinal Studies, Male, Middle Aged, Platelet Aggregation Inhibitors, Proportional Hazards Models, Prospective Studies, Registries, Thrombosis prevention & control, Treatment Outcome, Angioplasty, Balloon, Coronary methods, Coronary Artery Disease therapy, Drug-Eluting Stents, Paclitaxel, Propensity Score, Sirolimus, Stents, Titanium
- Abstract
Aims: We performed a propensity score matched analysis to explore whether TiNOX stents are superior to paclitaxel- (PES) and sirolimus-eluting stents (SES) in routine clinical practice., Methods and Results: A total of 1,607 patients undergoing implantation of SES, PES or TiNOX stents were prospectively entered into a stent registry and followed up for three years. Using propensity score matching, we compared clinical outcome among 319 pairs of patients treated with TiNOX stents or SES and 337 pairs of patients treated with TiNOX stents or PES. The primary outcome MACE, a composite of death, myocardial infarction, and target vessel revascularisation occurred in 20% of patients with TiNOX stents, 19% of patients with SES and 23% of patients with PES at 3-years. The hazard ratio was 1.00 comparing TiNOX stents with SES (95% CI 0.69-1.45, p=1.00), and 0.95 comparing TiNOX stents with PES (95% CI 0.66-1.36, p=0.78)., Conclusion: We did not find evidence to suggest superiority of TiNOX stents over SES or PES. In view of similar clinical outcomes, but with the reduced duration of dual antiplatelet therapy used with the TiNOX stent, we suggest that TiNOX stents may be an alternative to drug-eluting stents in patients unsuitable for long-term dual antiplatelet therapy.
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- 2012
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43. Assessment of right ventricular systolic function: comparison between cardiac magnetic resonance derived ejection fraction and pulsed-wave tissue Doppler imaging of the tricuspid annulus.
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Wahl A, Praz F, Schwerzmann M, Bonel H, Koestner SC, Hullin R, Schmid JP, Stuber T, Delacrétaz E, Hess OM, Meier B, and Seiler C
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- Adult, Cardiomyopathy, Dilated diagnostic imaging, Cardiomyopathy, Dilated pathology, Cardiomyopathy, Dilated physiopathology, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease pathology, Coronary Artery Disease physiopathology, Echocardiography, Doppler, Pulsed methods, Echocardiography, Doppler, Pulsed standards, Female, Heart Defects, Congenital diagnostic imaging, Heart Defects, Congenital pathology, Heart Defects, Congenital physiopathology, Humans, Hypertension, Pulmonary diagnostic imaging, Hypertension, Pulmonary pathology, Hypertension, Pulmonary physiopathology, Magnetic Resonance Imaging methods, Magnetic Resonance Imaging standards, Male, Middle Aged, Predictive Value of Tests, Reproducibility of Results, Sensitivity and Specificity, Tricuspid Valve diagnostic imaging, Tricuspid Valve pathology, Heart Diseases diagnostic imaging, Heart Diseases pathology, Heart Diseases physiopathology, Stroke Volume physiology, Systole physiology, Tricuspid Valve physiology, Ventricular Function, Right physiology
- Abstract
Background: Systolic right ventricular (RV) function is an important predictor in the course of various congenital and acquired heart diseases. Its practical determination by echocardiography remains challenging. We compared routine assessment of lateral tricuspid annular systolic motion velocity (TV(lat), cm/s) using pulsed-wave tissue Doppler imaging from the apical 4-chamber view with cardiac magnetic resonance (CMR) as reference method., Methods and Results: 254 individuals (43 ± 18 years) underwent both CMR (contiguous short axis slices; retrogated cine steady state free precession technique; manual contour tracing) and echocardiography within 2 ± 2 months. Seventy-five had coronary artery disease, 87 congenital heart disease, 17 dilated cardiomyopathy, 15 pulmonary artery hypertension, and 47 normal findings. RV ejection fraction (EF) by CMR was 51 ± 12% (range 17-78%). There was a linear correlation between RVEF and TV(lat) (r=0.60; p<0.0001). A TV(lat) cut-off of 12 cm/s identified patients with normal EF (≥50%) with 81% sensitivity and 68% specificity, and a threshold of TV(lat) <9 cm/s identified patients with severely reduced RVEF (<30%) with 82% sensitivity and 86% specificity., Conclusions: Systolic long-axis velocity measurements of the lateral tricuspid annulus allow a reliable assessment of RVEF in clinical routine. A threshold of TV(lat)<9 cm/s identifies patients with severely reduced RVEF (<30%) with high sensitivity and specificity., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)
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- 2011
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44. Impact of arterial injury on neointimal hyperplasia after implantation of drug-eluting stents in coronary arteries: an intravascular ultrasound study.
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Eshtehardi P, Cook S, Wandel S, Räber L, Wenaweser P, Togni M, Vogel R, Garachemani A, Eberli FR, Lüscher TF, Jüni P, Hess OM, Meier B, and Windecker S
- Subjects
- Aged, Animals, Coronary Angiography, Coronary Vessels diagnostic imaging, Female, Humans, Hyperplasia, Male, Middle Aged, Paclitaxel administration & dosage, Sirolimus administration & dosage, Tunica Intima diagnostic imaging, Angioplasty, Balloon, Coronary adverse effects, Coronary Vessels pathology, Drug-Eluting Stents adverse effects, Tunica Intima pathology, Ultrasonography, Interventional methods
- Abstract
Aims: We investigated the impact of arterial injury on neointimal hyperplasia following implantation of drug-eluting stents (DES)., Methods and Results: A total of 196 patients with 223 segments (sirolimus-eluting stents [SES]: 104, paclitaxel-eluting stents [PES]: 119) underwent intravascular ultrasound eight months after DES implantation. Arterial injury was defined as the balloon-to-artery ratio (BAR). Segments were categorised into two groups: high BAR defined as BAR>1.1 (120 segments), and low BAR defined as BAR < or =1.1 (103 segments). Baseline clinical characteristics were similar for both groups. Although reference vessel diameter was smaller, stent diameter, maximal balloon pressure and balloon diameter were higher in the high BAR compared with the low BAR group. Lumen (7.10±1.91 vs. 6.25±1.69, p=0.001), stent (7.31±1.95 vs. 6.41±1.80, p=0.001), and external elastic membrane (17.1±4.9 vs. 14.8±4.0, p<0.0001) areas (mm2) were higher, but neointimal hyperplasia (0.21±0.36 vs. 0.16±0.48, p=0.42) area (mm2) was similar in the high BAR compared with the low BAR group. Arterial injury as assessed by BAR was not associated with the amount of neointimal hyperplasia (R2=0.003, p=0.40)., Conclusions: Arterial injury does not correlate with the amount of neointimal hyperplasia following DES implantation. Conventionally aggressive DES implantation techniques do not adversely affect long-term outcome with respect to restenosis.
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- 2010
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45. A randomised determination of the Effect of Fluvastatin and Atorvastatin on top of dual antiplatelet treatment on platelet aggregation after implantation of coronary drug-eluting stents. The EFA-Trial.
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Wenaweser P, Eshtehardi P, Abrecht L, Zwahlen M, Schmidlin K, Windecker S, Meier B, Haeberli A, and Hess OM
- Subjects
- Aged, Angioplasty, Balloon, Coronary adverse effects, Aspirin therapeutic use, Atorvastatin, Chi-Square Distribution, Clopidogrel, Coronary Artery Disease blood, Coronary Artery Disease drug therapy, Drug Interactions, Drug Therapy, Combination, Female, Fluvastatin, Humans, Male, Middle Aged, Platelet Function Tests, Prospective Studies, Prosthesis Design, Switzerland, Ticlopidine analogs & derivatives, Ticlopidine therapeutic use, Time Factors, Treatment Outcome, Angioplasty, Balloon, Coronary instrumentation, Coronary Artery Disease therapy, Drug-Eluting Stents, Fatty Acids, Monounsaturated therapeutic use, Heptanoic Acids therapeutic use, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Indoles therapeutic use, Platelet Aggregation drug effects, Platelet Aggregation Inhibitors therapeutic use, Pyrroles therapeutic use
- Abstract
Drug-drug interaction between statins metabolised by cytochrome P450 3A4 and clopidogrel have been claimed to attenuate the inhibitory effect of clopidogrel. However, published data regarding this drug-drug interaction are controversial. We aimed to determine the effect of fluvastatin and atorvastatin on the inhibitory effect of dual antiplatelet therapy with acetylsalicylic acid (ASA) and clopidogrel. One hundred one patients with symptomatic stable coronary artery disease undergoing percutaneous coronary intervention and drug-eluting stent implantation were enrolled in this prospective randomised study. After an interval of two weeks under dual antiplatelet therapy with ASA and clopidogrel, without any lipid-lowering drug, 87 patients were randomised to receive a treatment with either fluvastatin 80 mg daily or atorvastatin 40 mg daily in addition to the dual antiplatelet therapy for one month. Platelet aggregation was assessed using light transmission aggregometry and whole blood impedance platelet aggregometry prior to randomisation and after one month of receiving assigned statin and dual antiplatelet treatment. Platelet function assessment after one month of statin and dual antiplatelet therapy did not show a significant change in platelet aggregation from 1st to 2nd assessment for either statin group. There was also no difference between atorvastatin and fluvastatin treatment arms. In conclusion, neither atorvastatin 40 mg daily nor fluvastatin 80 mg daily administered in combination with standard dual antiplatelet therapy following coronary drug-eluting stent implantation significantly interfere with the antiaggregatory effect of ASA and clopidogrel.
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- 2010
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46. Plasma homocysteine and cardiovascular risk in heart failure with and without cardiorenal syndrome.
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Maurer M, Burri S, de Marchi S, Hullin R, Martinelli M, Mohacsi P, and Hess OM
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- Adult, Aged, Biomarkers blood, Cardiovascular Diseases blood, Cardiovascular Diseases complications, Disease-Free Survival, Female, Follow-Up Studies, Humans, Male, Middle Aged, Risk Factors, Syndrome, Heart Failure blood, Heart Failure complications, Homocysteine blood, Kidney Diseases blood, Kidney Diseases complications
- Abstract
Introduction: Plasma homocysteine (Hcy) has been associated with an increased cardiovascular (CV) risk in patients with chronic heart failure (CHF). Thus, we investigated whether Hcy has a prognostic impact on CV events in CHF-patients with and without cardiorenal syndrome (CRS)., Methods: 161 patients with CHF were included in the present analysis. 94 patients had systolic (SD) (EF <40%) and 67 diastolic (DD) dysfunction (EF>or=40%). 60 had cardiorenal syndrome (CRS+ creatinine clearance<60 ml/min). Mean ejection fraction was 38+/-16% (n=153) and mean VO2 max 19+/-7 ml/min (n=87)., Results: Homocysteine is significantly increased in patients with CHF (20+/-7 micromol/l). The increase correlates not only with the severity of the disease (NYHA, EF, VO2max), but also with various metabolic (BNP, uric acid) and nephrologic parameters (creatinine, creatinine clearance). During follow-up (23+/-37 months), patients with the highest homocysteine (>or=20 micromol/l) passed away more often (p<0.035) or decompensated more frequently (p<0.004) than those with a low Hcy. In patients with CRS the rate of decompensation was significantly higher than in those without CRS (p<0.0007)., Conclusions: Homocysteine is an important marker for an increased CV risk in patients with CHF. A homocysteine of >/=20 micromol/l is associated with a high risk to decompensate or to die (odds ratio 2.57). The presence of CRS is also associated with an increased CV risk (odds ratio 3.7) and predicts an adverse clinical outcome., (Copyright (c) 2008. Published by Elsevier Ireland Ltd.)
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- 2010
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47. Randomised comparison of titanium-nitride-oxide coated stents with bare metal stents: five year follow-up of the TiNOX trial.
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Moschovitis A, Simon R, Seidenstücker A, Klauss V, Baylacher M, Lüscher TF, Moccetti T, Windecker S, Meier B, and Hess OM
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- Aged, Angioplasty, Balloon, Coronary adverse effects, Angioplasty, Balloon, Coronary mortality, Coronary Angiography, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease mortality, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Myocardial Infarction etiology, Myocardial Infarction prevention & control, Prosthesis Design, Thrombosis etiology, Thrombosis prevention & control, Time Factors, Treatment Outcome, Angioplasty, Balloon, Coronary instrumentation, Coated Materials, Biocompatible, Coronary Artery Disease therapy, Stainless Steel, Stents, Titanium
- Abstract
Aims: Revascularisation with Titanium-Nitride-Oxide (TiNOX) coated stents is safe and effective in patients with de novo native coronary artery lesions. In the TiNOX trial there was a reduction in restenosis and major adverse cardiac events as compared with stainless steel stents of otherwise identical design. The purpose of the present study was to evaluate the long-term outcome of these patients over five years., Methods and Results: In 2003, 92 patients with de novo lesions were randomly assigned to treatment with TiNOX coated stents (n=45) or stainless steel stents (n=47; control). Baseline characteristics were similar in both groups. Follow-up at six months and five years was obtained in 87 patients. Five patients were lost to follow-up due to emigration or change in home address. At six months and five years, significantly less major adverse cardiac events (MACE) occurred in the TiNOX group (7% vs. 27%, [p=0.02] respectively and 16% vs. 39%, [p=0.03]), largely driven by a reduced need for target-lesion revascularisation. No stent thrombosis occurred in the TiNOX group vs. one in the control group. Patients in the TiNOX-group had lower all-cause mortality and less myocardial infarction, but the difference was not statistically significant., Conclusions: Five-year follow-up after implantation of titanium-nitride-oxide coated stents is favourable with a low rate of MACE and no stent thrombosis compared to bare metal stents of identical design. The need for revascularisation at five years was 9% in the TiNOX and 25% in the control group with little progression of native coronary disease.
- Published
- 2010
48. Dual low response to acetylsalicylic acid and clopidogrel is associated with myonecrosis and stent thrombosis after coronary stent implantation.
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Eshtehardi P, Windecker S, Cook S, Billinger M, Togni M, Garachemani A, Meier B, Hess OM, and Wenaweser P
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- Acute Coronary Syndrome therapy, Aged, Clopidogrel, Coronary Thrombosis prevention & control, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Multivariate Analysis, Myocardium pathology, Stents, Ticlopidine therapeutic use, Angioplasty, Balloon, Coronary adverse effects, Aspirin therapeutic use, Coronary Artery Disease therapy, Coronary Thrombosis etiology, Platelet Aggregation Inhibitors therapeutic use, Ticlopidine analogs & derivatives
- Abstract
Background: Impaired response to antiplatelet therapy with acetylsalicylic acid (ASA) and clopidogrel (CLO) has been associated with an increased risk of stent thrombosis and ischemic events after coronary stent implantation. We sought to investigate whether patients with a low response (LR) to ASA or CLO are at increased risk for periprocedural and short-term ischemic events after coronary stent implantation., Methods: A total of 219 patients pretreated with ASA and CLO underwent percutaneous coronary intervention (PCI) with stent implantation. Whole blood impedance platelet aggregometry was performed with the Multiplate analyzer (Dynabyte, Munich, Germany) to test the response to ASA (ASPI test) and CLO (ADP test) within 12 to 18 hours after PCI. Patients were classified as ASA-LR, CLO-LR, dual LR, and controls. Study end points included myocardial infarction, stent thrombosis, and death assessed during the periprocedural period and at 30 days., Results: Acetylsalicylic acid-LR was present in 34 (16%), CLO-LR in 33 (15%), and dual LR in 19 (9%) patients. Percutaneous coronary intervention-related myocardial infarction was encountered in 19 (9%) patients, with the highest incidence in dual-LR group (26.3%, P = .039). Composite ischemic events at 30 days were significantly more frequent in the dual-LR group than in other groups (36.8% vs 8.8% ASA-LR vs 6.1% CLO-LR vs 6.8% controls, P < .001). In multivariable analysis, dual LR (odds ratio 7.35, 95% CI 2.21-24.42, P < .001) and multivessel PCI (odds ratio 4.56, 95% CI 1.33-15.62, P = .016) were independently associated with ischemic events at 30 days., Conclusion: Dual LR to ASA and CLO is associated with an increased risk for short-term ischemic events after coronary stent implantation., (2010 Mosby, Inc. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
49. Resting heart rate and cardiovascular events: time for a new crusade?
- Author
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Cook S and Hess OM
- Subjects
- Acute Coronary Syndrome mortality, Acute Coronary Syndrome physiopathology, Cardiovascular Diseases physiopathology, Humans, Plaque, Atherosclerotic mortality, Plaque, Atherosclerotic physiopathology, Cardiovascular Diseases mortality, Heart Rate physiology
- Published
- 2010
- Full Text
- View/download PDF
50. Transient apical ballooning syndrome--clinical characteristics, ballooning pattern, and long-term follow-up in a Swiss population.
- Author
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Eshtehardi P, Koestner SC, Adorjan P, Windecker S, Meier B, Hess OM, Wahl A, and Cook S
- Subjects
- Aged, Cohort Studies, Coronary Angiography methods, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Stress, Psychological diagnostic imaging, Stress, Psychological epidemiology, Stress, Psychological therapy, Switzerland epidemiology, Takotsubo Cardiomyopathy epidemiology, Time Factors, Takotsubo Cardiomyopathy diagnostic imaging, Takotsubo Cardiomyopathy therapy
- Abstract
Background: Transient apical ballooning syndrome (TABS) or Takotsubo cardiomyopathy mimics acute ST-elevation myocardial infarction, but is considered to have a good prognosis with only moderate elevation of myocardial enzymes and full recovery of left ventricular function. Although it is increasingly reported, its exact incidence, clinical presentation, and prognosis in non-Asian populations remain largely unknown., Objective: To describe the clinical characteristics and long-term follow-up of patients who presented with TABS at our institution over a 3 year-period., Methods: Patients were retrospectively retrieved from our local database. Patient charts were carefully reviewed and the diagnosis of TABS was based on the Mayo Clinic diagnostic criteria. Moreover, psychosocial stress or gastrointestinal disease was recorded., Results: During the study period, 13,715 coronary angiographies were performed at our institution, including 2459 patients presenting with an acute coronary syndrome (ACS). Forty-one TABS were diagnosed, which represents an incidence of 1.7% of ACS-patients and 0.3% of all coronary angiographies performed, respectively. Mean age was 65 years, with 85% women. Clinical presentations included chest pain, dyspnoea, and cardiogenic shock. A preceding psychological or physical condition perceived as "stress" was reported in 61%. At a mean follow-up of 675+/-288 days, none of the patients died of cardiac causes, but two patients had a recurrence of symptoms., Conclusions: This is the largest cohort of TABS patients reported out of Europe so far. The good overall prognosis and low likelihood of recurrence were confirmed.
- Published
- 2009
- Full Text
- View/download PDF
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