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6. Kardiomyopathien

Author

Schultheiß, H.P., Kühl, U., Steinbeck, Gerhard, editor, Paumgartner, Gustav, editor, Brandt, T., editor, Göke, B., editor, Greten, N., editor, Hiddemann, W., editor, Lode, H., editor, Mann, K., editor, Riess, H., editor, Risler, T., editor, Schattenkirchner, M., editor, Seeger, W., editor, and Wehling, M., editor

Published
2005
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7. Kardiovaskuläre Infektionen

Author

Holzheimer, R.G., D., Horstkotte, U., Kühl, J., Niebel, Piper, C., Wiemer, M., Kühl, U., Wienner, M., Adam, D., editor, Doerr, H. W., editor, Link, H., editor, and Lode, H., editor

Published
2004
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13. QRS fragmentation as a possible electrocardiographic diagnostic marker in patients with acute myocarditis: preliminary histopathological validation

Author

Ferrero, P, Piazza, I, Kühl, U, Grosu, A, Tschöpe, C, Senni, M, Ferrero P, Piazza I, Kühl U, Grosu A, Tschöpe C, Senni M, Ferrero, P, Piazza, I, Kühl, U, Grosu, A, Tschöpe, C, Senni, M, Ferrero P, Piazza I, Kühl U, Grosu A, Tschöpe C, and Senni M

Abstract

Aims: We aim to assess the reproducibility of QRS fragmentation (fQRS) on a multi-centre dataset of patients with acute myocarditis (AM), including a histopathological validation in a subgroup with biopsy-proven disease. Electrocardiogram (ECG) in patients with myocarditis is usually considered aspecific. ST changes and conduction anomalies have been commonly reported so far. We have previously described fQRS in patients with AM. Methods and results: Patients admitted between 2008 and 2019 in two centres with a diagnosis of AM were included. Standard ECG, echocardiography, and cardiac magnetic resonance (CMR) findings were recorded at baseline and at follow-up (FU). Eighty patients were analysed, 66 men (82%), with median age of 34 (26–43) years. Twenty-two patients had biopsy-proven AM. At presentation, 61 patients (76%) displayed fQRS. Median ejection fraction (EF) was 55% (43–60). Seventy-two patients (90%) underwent CMR and displayed late gadolinium enhancement (LGE). ECG leads showed that fQRS correlated with distribution of LGE. In patients with positive biopsy, fQRS was present in 18 (81%). Median FU was 419 days (224–956). Complete FU was available for 64 patients (80%), and 33 patients (52%) displayed persistence of fQRS. Median EF was 60% (57–64). Eleven patients underwent a repeated biopsy at FU, eight of whom had persistent inflammation and fQRS. Fifteen patients (23%) had ventricular tachycardia, 14 of whom still showed fQRS. Conclusions: In this cohort fQRS was confirmed as an additional useful ECG sign. Persistence of fQRS was associated with ongoing inflammation and with a poorer outcome in terms of ventricular function and occurrence of arrhythmias.

Published
2020

41. Myokardbiopsie bei Kardiomyopathie: Wann und warum?

Author

Kühl U and Heinz-Peter Schultheiss

Subjects
medicine.medical_specialty, Myocarditis, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Cardiomyopathy, General Medicine, medicine.disease, Endomyocardial biopsy, Internal medicine, Heart failure, Biopsy, Cardiology, Medicine, Differential diagnosis, business, Endocardium, Cardiac catheterization
Published
2009
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42. Wiederholte Ingestion potentiell letaler Thalliummengen in suizidaler Absicht

Author

Dieter Horstkotte, Hort W, B. E. Strauer, Rolf Michael Klein, Kühl U, Iffland R, B. Kutkuhn, and R. Niehues

Subjects
medicine.medical_specialty, Abdominal pain, business.industry, medicine.medical_treatment, Urinary system, chemistry.chemical_element, Poison control, General Medicine, Urine, Surgery, chemistry, Anesthesia, Vomiting, Thallium, Medicine, Ingestion, medicine.symptom, business, Dialysis
Abstract

30 minutes after drinking half a cup of rat poison a 16-year-old girl was admitted to hospital. In addition to various enteric detoxification measures forced dialysis was instituted and, after the urinary thallium level had become known (9 mg/l), haemodialysis was begun and ferric ferrocyanide (Prussian blue) administered (0.5 mg daily for six days). She had no symptoms at any time. After 10 days she was discharged. Five days after discharge she was again admitted, with colic-like abdominal pain, vomiting, paraesthesias of the hands and feet, and in a state of agitation. She had once again ingested rat poison, about one cup. Physical examination revealed little of consequence, except diffuse alopecia. Urinary thallium concentration was 37 mg/l. In the electrocardiogram the P-R interval was shortened to 0.11 s and T waves inverted in leads III and V1. Electronmicroscopy of cardiac and skeletal biopsies revealed lipid droplets, increased sarcoplasm and widening of some of the tubules. Treatment consisted of haemodialysis, forced diuresis (1 l urine/h), administration of ferric ferrocyanide, orthograde intestinal infusions and potassium substitution (serum level: 5 mmol/l). After 28 days the patient was discharged into psychiatric care.

Published
2008
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43. Lesen macht stark. Grundschule [3./4. Klasse]. Lehrerheft

Author

Becker-Mrotzek, Michael, Bredthauer, St., Bulut, N., Dreier, S., Günther, H., Hippmann, K., Holm, A., Jambor-Fahlen, Simone, Jost, Jörg, Krüppel, L., Kühl, U., Prien, A., Röhrbein, W., Scholz, V., Schneider-Strenge, G., Weiß, J., Becker-Mrotzek, Michael, Bredthauer, St., Bulut, N., Dreier, S., Günther, H., Hippmann, K., Holm, A., Jambor-Fahlen, Simone, Jost, Jörg, Krüppel, L., Kühl, U., Prien, A., Röhrbein, W., Scholz, V., Schneider-Strenge, G., and Weiß, J.

Published
2017

44. Lesen macht stark. Grundschule [3./4. Klasse]. Schülerheft

Author

Becker-Mrotzek, Michael, Bredthauer, St., Bulut, N., Dreier, S., Günther, H., Hippmann, K., Holm, A., Jambor-Fahlen, Simone, Jost, Jörg, Krüppel, L., Kühl, U., Prien, A., Röhrbein, W., Scholz, V., Schneider-Strenge, G., Weiß, J., Becker-Mrotzek, Michael, Bredthauer, St., Bulut, N., Dreier, S., Günther, H., Hippmann, K., Holm, A., Jambor-Fahlen, Simone, Jost, Jörg, Krüppel, L., Kühl, U., Prien, A., Röhrbein, W., Scholz, V., Schneider-Strenge, G., and Weiß, J.

Published
2017

46. [Classification of the cardiomyopathies]

Author

Elliott P, Andersson B, Arbustini E, Bilinska Z, Franco Cecchi, Charron P, Dubourg O, Kühl U, Maisch B, Wj, Mckenna, Monserrat L, Pankuwelt S, Rapezzi C, Seferovic P, Tavazzi L, Keren A, Elliott P, Andersson B, Arbustini E, Bilinska Z, Cecchi F, Charron P, Dubourg O, Kühl U, Maisch B, McKenna WJ, Monserrat L, Pankuwelt S, Rapezzi C, Seferovic P, Tavazzi L, and Keren A

Subjects
Humans, Cardiomyopathies
Published
2008

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